Indian journal of public health最新文献

Background: Utilization of institutional maternal delivery is the cornerstone for the health of both mother and child which provides essential emergency care and reduces the risk of maternal and neonatal mortality. The aim of the current study is to analyze the perceptions of pregnant women regarding the place of maternal delivery in Lahaul and Spiti.

Materials and methods: A cross-section study was conducted among 410 pregnant women in remote district of Himachal Pradesh. Data collection was done by multistage random sampling through an interview method using a structured questionnaire. Descriptive statistics, principal component analysis, and logistic regression were applied to find out the outcomes.

Results: Out of 410 study participants, 230 women had perception for utilizing the institutional maternal delivery and 180 had perception to utilize home delivery. More than 80% of women who preferred institutional birth had high severity for medical complications and preterm birth threat. The women who attended more than 4 antenatal care (ANC) visits had 2.86 more chances to go for hospital birth (confidence interval [CI] = 0.41-4.23, P < 0.05). The odds of women who believed in high perceived threat in home delivery had 1.99 more chances to go for institutional maternal delivery.

Conclusion: The study highlights that public maternal health policies in the remote areas are to increase the proportion of utilization of institutional maternal deliveries. The policy imperative for remote villages requires to upgrade the weak health infrastructure and boost ANC and transportation facilities for better implementation of government maternity healthcare schemes.

Background: Understanding and addressing barriers to cataract surgery is important in increasing cataract surgical coverage. Barriers differ across time and place; therefore, periodic evaluation in the area of operation of an eye care provider is required.

Objectives: The objective is to enumerate the barriers to cataract surgery in central Chhattisgarh.

Materials and methods: A hospital-based cross-sectional study was carried out among community outreach patients with cataract in 2022. Patients were selected through systematic random sampling.

Results: Of the 2210 patients, 1026 completed the survey. Overall person-related barriers (65.3%) were more common than service-related barriers (34.7%). The different barriers were lack of escort (34.0%), cost of surgery (17.7%), lack of awareness of cataract (9.6%), fear of losing eyesight (6.8%), unfelt need (6.3%), waiting for outreach camp to happen in a close-by location (5.9%), waiting for the cataract to mature (4.6%), do not know where to go (3.9%), busy with work (3.7%), living far from the hospital (1.9%), need not felt - old age (1.7%), blindness is God's will (1.4%), other health reasons (1.1%), being female (0.8%), and village not connected to the main road/lack of transport (0.6%). Person-related barriers were more common (P < 0.05) in female patients, illiterate patients, and those from a lower socio-economic class. Fear of losing eyesight was the most common barrier in patients who had poor vision following cataract surgery in the other eye.

Conclusion: Person-related barriers were more common than service-related barriers for accessing eye care services. Important service-related barriers were the cost of surgery and lack of awareness about cataract.

Background: High blood pressure (BP) is increasing at an alarming rate in India and is the leading cause of cardiovascular disease. Increasing obesity is one of the risk factors for the increasing trend in hypertension among young adults.

Objectives: This study aimed to assess the comparative abilities of anthropometric indices of general and central obesity in predicting hypertension among apparently healthy young adults.

Materials and methods: A cross-sectional study was conducted among 493 healthy young adults aged 18 and 25 years. Height, weight, waist, and hip circumference were measured, and anthropometric indices were calculated. BP was measured using an automated BP monitor. Statistical methods such as independent t-test, linear regression, and receiver operating characteristic (ROC) analysis were employed.

Results: The prevalence of systolic and diastolic hypertension in males was 15.2% and 17.9%, whereas in females, it was 13% and 14.3%. All anthropometric indices positively correlated with systolic BP and diastolic BP, with the highest being waist circumference (WC). The area under ROC curves (AUC) of the anthropometric indices for predicting hypertension showed that WC had the largest AUCs for systolic and diastolic hypertension, respectively. In males and females, WC had the highest sensitivities of 85.4% and 90.3% for systolic and 84.3% and 88.6% for diastolic hypertension.

Conclusion: Anthropometric indices of central adiposity were more significant predictors of hypertension.

Summary: The health-care workers (HCWs) were one of the vulnerable populations prioritized during the COVID-19 vaccination (COVISHIELD and COVAXIN) campaign. We aimed to estimate vaccine hesitancy and explore influencing factors among 238 HCWs in 21 Urban Primary Health Centres (UPHCs) across Hyderabad during June and July 2021. We used a semi-structured questionnaire and the SAGE determinants of vaccine hesitancy to determine factors underlying vaccine hesitancy and acceptance. A thematic framework was developed to unpack the factors that shaped the perceptions about the COVID-19 vaccine. We found a 17% hesitancy rate, primarily due to concerns about "vaccine-safety." HCWs were susceptible to misinformation, potentially shaping their views on COVID-19 vaccines. Despite regulatory approval, one in six HCWs in Hyderabad's UPHCs delayed or refused vaccinations, citing limited "vaccine-safety" information. This underscores the urgent need to address HCW vaccine hesitancy early, given its potential impact on general vaccine acceptance.

Summary: In the depth topic of child protection, the alarming prevalence of sexual violence remains a dark thread that permeates every layer of society. This report delves into the implementation of "KatakLarita," an innovative and inclusive educational initiative aimed at enhancing sexual safety education for deaf children. Results showed that using "KatakLarita" as learning media helped deaf students improve significantly in sexual safety knowledge.

Summary: This study was undertaken to assess the change in menstrual cycle interval, duration, amount of flow, and new onset of pain after the first and second dose of Covaxin vaccination among adolescent schoolgirls aged 15-18. Informed assent and parental consent were taken. Two hundred and thirty-three participants were approached and the response rate was 57.5%. One hundred and thirty-four respondents who participated had received at least one dose, and 116 among them had received both doses of Covaxin. About 17% of the girls had a body mass index above 25 kg/m2. We did not find any clinical or statistically significant difference in the interval or flow duration. About 19% reported new-onset mild pain during the menstrual cycle bleeding phase.

Background: Falls among adults with visual impairment (VI) are underreported or underrepresented compared to elderly falls.

Objectives: To report falls among the young, middle-aged, and elderly adults with VI.

Materials and methods: This cross-sectional study recruited subjects from a tertiary eye care center with VI aged ≥18 years based on clinical records. Occurrence and characteristics of falls in the past year were obtained over telephone. Falls and fear of falling were considered the primary and secondary outcomes, respectively.

Results: Of the 888 subjects, 18% (n = 160) reported having fallen at least once, and among them, 45.6% (n = 73) had multiple falls. Overall, fallers were more among the "young" (21.1%) than the "middle-aged" (16.0%) and the "elderly" (17.3%). Risk of falling was more among the blind (odds ratio (OR): 7.1; 95% confidence interval [CI]: 2.8-18.4, P < 0.001) than other categories of VI. Retinitis pigmentosa (RP) (OR: 4.4; 95% CI: 1.5-12.9, P = 0.007) and glaucoma (OR: 3.5; 95% CI: 1.3-9.8, P = 0.016) showed increased risk of falls. Overall "fear of falling" was reported by 11.3% (n = 100), out of which 30% (n = 48) were by fallers. Side vision difficulty was predominantly associated with falling, followed by staircase and night vision difficulties as perceived by subjects. Most of the falls happened outdoors and overall 38.8% had an injury after falls.

Conclusion: This study reported unique trend of increased occurrence of falls among the young with VI compared to older age groups. RP and glaucoma being peripheral vision loss causing diseases and increased severity of VI were more associated with falls and fear of falling.

Summary: This article aims to understand the implications of calamities and the resulting school closures on the mental health of adolescents. The impact of calamities, such as natural disasters or pandemics, on school closures and adolescents' mental health is complex. It is crucial to provide the necessary support, resources, and interventions to help adolescents navigate these challenging times and minimize the long-term impact on their mental well-being.