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The World Health Organization (WHO) Package of essential noncommunicable disease interventions (known as WHO PEN) was designed for the prevention, early detection, treatment and care of diabetes, cancer, chronic respiratory [...]

Infection with varicella zoster virus (VZV; also known as chickenpox virus), a human herpesvirus, occurs worldwide, and most persons living in temperate regions become immune by contracting varicella illness or [...]

Background India accounts for one-quarter of the world's TB cases. Despite efforts to engage the private sector in India's National TB Elimination Program, informal healthcare providers (IPs), who serve as the first contact for a significant TB patients, remain grossly underutilised. However, considering the substantial evidence establishing IPs' role in patients' care pathway, it is essential to expand the evidence base regarding their knowledge in TB care. Methods We conducted a cross-sectional study in the Birbhum district of West Bengal, India. The data were collected using the TB vignette among 331 IPs (165 trained and 166 untrained). The correct case management was defined following India's Technical and Operational Guidelines for TB Control. Results Overall, IPs demonstrated a suboptimal level of knowledge in TB care. IPs exhibited the lowest knowledge in asking essential history questions (all four: 5.4% and at least two: 21.7%) compared with ordering sputum test (76.1%), making a correct diagnosis (83.3%) and appropriate referrals (100%). Nonetheless, a statistically significant difference in knowledge (in most domains of TB care) was observed between trained and untrained IPs. Conclusions This study identifies gaps in IPs' knowledge in TB care. However, the observed significant difference between the trained and untrained groups indicates a positive impact of training in improving IPs' knowledge in TB care. [ABSTRACT FROM AUTHOR]

Multiple studies suggest that diabetes mellitus (DM) is a potential risk factor for tuberculosis (TB) development and treatment, especially in low- and middle-income countries. The study aimed to test concomitancy between DM and TB among adults in India. Data were from the 2015-16 National Family Health Survey (NFHS-4). The study sample comprised 107,575 men aged 15-54 and 677,292 women aged 15-49 for which data on DM status were available in the survey. The association between state-level prevalence of TB and DM was examined and robust Poisson regression analysis applied to examine the effect of DM on TB. A high prevalence of TB was observed among individuals with diabetes in India in 2015-16. A total of 866 per 100,000 men and 405 per 100,000 women who self-reported having diabetes also had TB; among those who self-reported not having diabetes the ratios were 407 per 100,000 men and 241 per 100,000 women. The risk of having TB among those who self-reported having DM was higher for both men (2.03, 95% CI: 1.26, 3.28) and women (1.79, 95% CI: 1.48, 2.49) than for those who did not self-report having DM. Adults who were diagnosed with diabetes (including pre-diabetes) also had a higher rate of TB (477 per 100,000 men and 331 per 100,000 women) than those who were not diagnosed (410 per 100,000 men and 239 per 100,000 women). Adults from poor families, with lower BMIs, lower levels of literacy and who were not working had a higher risk of TB-DM co-morbidity. The state-level pattern of co-morbidity, the under-reporting of DM (undiagnosed) and TB stigmatization are discussed. The study confirms that diabetes is an important co-morbid feature with TB in India, and reinforces the need to raise awareness on screening for the co-existence of DM and TB with integrated health programmes for the two conditions. [ABSTRACT FROM AUTHOR]

Objective In India, a Health Management Information System (HMIS) is used to capture and aggregate data from health facilities across the country to inform decision making by healthcare managers and policymakers. In a country with the unparalleled sociocultural diversity of India, the dynamics of sociotechnical systems produce unique challenges. The study attempts to understand the sociotechnical factors that influence HMIS at the district level. Methods The study is conducted among the healthcare workers who were involved in managing the district HMIS for over a year. We employed quota sampling and conducted face-to-face interviews with eight healthcare workers. The interviews were transcribed and coded using an analytical framework derived from the Performance of Routine Information System Management (PRISM) framework for HMIS evaluation. Results We identified 61 codes sorted into 11 categories and grouped into 3 deductive themes (derived from the PRISM framework, ie, technical processes, challenges and data quality) and 2 inductive themes (ie, the role of private enterprise and human resource management). Conclusion The study reveals areas to improve and lays emphasis on change management. Future evaluations should involve a complete evaluation of the district HMIS using the four PRISM tools and will inform a collaboratively developed plan to address HMIS issues for health system strengthening. [ABSTRACT FROM AUTHOR]

Introduction:The proportion of people aged over 60 years is increasing globally and expected to double by 2050 [1]. The World Health Organization and health systems globally have identified mobile health (mHealth) as an important strategy to address the health needs of this growing population group. Healthcare innovations focused on ageing, including mHealth interventions, provide an opportunity to enhance service delivery. A systematic review [2] was undertaken to answer the following questions: 1. How is mHealth being used to promote healthy ageing and support the delivery of age-friendly health and long-term care services? 2. What are the effective models for implementing mHealth interventions? 3. What are the lessons learnt from implementation of mHealth initiatives? 4. Is there enough evidence to support the impact of mHealth interventions? Methods:The review was conducted in late 2017, following the PRISMA[3] guidelines for systematic reviews. MEDLINE, EMBASE, Global Health, PsycINFO, Scopus, ScienceDirect, CINAHL and the Cochrane Library were searched.A combination of the terms 'mHealth OR mobile health' AND 'healthy ageing' AND 'aged care' was used along with the five domains of the RE-AIM framework [4]. The inclusion criteria were: (i) literature published from 2007 to 2017 on mHealth interventions, and (ii) mHealth interventions conducted on people aged 45 years and older. Results:Of 2883 records identified, 133 studies were included in the qualitative synthesis. Most mHealth interventions were an adjunct to existing age-friendly health services, particularly for older adults with chronic health conditions. There were no examples of scaled-up implementations or systematic evaluations of successful feasibility and usability studies that implemented mHealth. The rapid pace of technological change as well as development, adoption and demise of mHealth apps presents crucial challenges for consumers, health care providers and policy makers. Overall, there is a lack of conclusive evidence regarding cost-effectiveness of mHealth to improve healthy ageing and support age-friendly health services. Implications for policy, practice and research: Future mHealth research needs robust experimental designs and a person-centred, biopsychosocial approach that looks at multi-level determinants of health care. Collaborative partnerships for the design, development, testing, implementation and evaluation of mHealth apps are essential. Robust governance frameworks for mHealth strategies are also required, as there is a risk the mHealth initiatives will further fragment care due to development and use of too many disparate apps and platforms without shared data frameworks or governance. [ABSTRACT FROM AUTHOR]

This paper draws on the vision, mission and experience with the WHO Collaborating Centre on eHealth (WHOCC-eHealth) and Yunus Social Business Health Hub (YSBHH) based at UNSW Australia, and the Asia electronic Health Information Network (AeHIN). Global eHealth aims to provide equitable access to ICT and health care, particularly to the poor, vulnerable and disadvantaged. Social business aims to solve social and economic problem. Its best known product is microcredit financial services for the poor which are small loans that enable them to "produce something, sell something, earn something to develop self-reliance and a life of dignity". Citizen engagement and community participation is integral to both constructs within the context of global partnerships for Integrated People-Centred Health Services (IPCHS) and Sustainable Development Goals (SDGs). The eHealth dimension is consumer heath informatics, social media, mHealth and the Internet of Things. The convergence is multidimensional, mutually beneficial and requires good governance and leadership.