Indian journal of public health最新文献

Summary: Kota, Rajasthan, India, has emerged both as the "coaching capital" and a suicide cluster. The coaching industry is fueled by high-pressure entrance examinations and preference and parental pressure for science, technology, engineering, and mathematics courses, particularly for male children. This article draws upon the World Health Organization's definition of Commercial Determinants of Health to demonstrate that the commercial coaching model has resulted in serious adverse health outcomes, culminating in a suicide cluster. These suicide clusters need to be viewed through the lens of a commercial determinant of health, beyond an individual medical-psychiatric approach. This calls for both health systems and societal responses.

Summary: This qualitative study investigates how local Islamic belief systems shape the lived experiences of stigma, disclosure, and treatment seeking among people living with human immunodeficiency virus (PLHIV) in Kashmir. Drawing on in-depth interviews with 15 PLHIV and four Muslim religious scholars at a major antiretroviral therapy center, and analyzed using interpretative phenomenological analysis, the study reveals that religious values deeply inform individuals' emotional struggles and choices around care. The findings call for culturally grounded, faith-sensitive public health strategies that not only address medical needs but also engage with the moral and spiritual realities of those living with human immunodeficiency virus in conservative contexts.

Summary: The jigsaw technique involves splitting the topic into smaller bits and dividing the class into small groups to work on small problems, leading to a final collaborative learning outcome. 40 MBBS students participated in the jigsaw after a thorough briefing and meticulous planning by the mentors for the topic Nutrition. A pre- and postsession test depicted statistically significant improvement of 20.7% in the scores. The use of jigsaw as a teaching learning method was noted to increase the students' overall interest in the topic and lead to a better understanding among the learners. The faculty, too, found it very engaging.

Background: Pregnancy is a vital phase that significantly impacts both maternal health and birth outcomes. Quality of life (QoL) during pregnancy is a critical aspect of maternal health, influencing health outcomes of mothers and infants. It can be affected by multiple factors such as physical, emotional and psychological health, and social and financial aspects. All these factors must be considered while providing comprehensive care.

Objectives: The objectives of this study were to assess and compare the QoL scores of pregnant women in experimental and control groups after a 10-week follow-up period and investigate the correlation between posttest QoL scores and birth outcomes in pregnant women.

Materials and methods: A randomized controlled trial was carried out involving 184 pregnant women (92 experimental and 92 control) attending antenatal Outpatient Department, assessed for their QoL. Experimental group received multicomponent nursing interventions with routine care whereas control group received routine care.

Results and conclusion: Data were analyzed using the SPSS software version 26. Result revealed that experimental group's PCS and Mental Component Summary scores improved significantly after 10 weeks, from 62.75-77.40 to 80.85-90.56, respectively while the control group's scores declined. In addition, experimental group experienced better birth outcomes, with fewer preterm deliveries (1 vs. 11), lower cesarean sections (16 vs. 30), higher birth weights, and improved APGAR scores. QoL tends to decline as pregnancy progresses; however, the interventions helped to improve it resulting in better birth outcomes. The QoL can be enhanced by continuous monitoring, motivation, and extra support along with routine care which will reduce maternal as well as neonatal morbidity and mortality.

Introduction: Noncommunicable diseases (NCDs) are escalating in all gradients of population across globe. India launched a plan in 2017 for prevention and control of NCDs by addressing its social determinants and focusing multisectoral action (MSA). An assessment study of MSA in Uttar Pradesh informed that MSA is still at nascent stage of execution, and more focused efforts are needed to align all nonhealth sectors with health. This research provides inputs for implementing MSA after in-depth exploration of barriers in districts of Uttar Pradesh, India.

Objectives: To understand barriers in implementation of MSA for prevention and control of NCDs.

Materials and methods: A qualitative study was conducted with 29 key informants across various sectors from selected districts of Uttar Pradesh to identify barriers in MSA. Data were transcribed and translated before manual analysis. Codes and emerging themes were categorized into barriers. Content analysis of sector's websites was done to capture content related to MSA in public domain to get comprehensive understanding of barriers through data triangulation.

Results: There is no collaborative platform wherein different sectors could negotiate mandates and collaborate towards implementing MSA. Crucial barriers identified were lack of active participation from nonhealth sectors and frequent change of program nodal officers. The absence of monitoring mechanism for collaborative activities also emerged as an important barrier added by work culture and capacity of officers to implement MSA.

Conclusions: Establishment of functional platforms at districts for collaborative actions between sectors is essential along with extensive use of digital media to enhance coordination.

Background: Evaluation and monitoring of public hospitals across Mizoram, India was conducted using hospital records and administrative data from 2016 to 2023.

Objectives: This study seeks to investigate the opportunity benefits of public health services in Mizoram by conducting a comprehensive economic analysis of their cost-effectiveness and cost-benefit while accounting for inflation.

Materials and methods: This study adapted and modified the inflation adjustment methodology employed in previous research to suit its specific requirements. In addition, relevant data were gathered from various official government documents and organizations to facilitate the analysis. Inflation-adjusted variables, cost-effectiveness, cost-benefit, and time series methods were employed for this study.

Results: The opportunity benefits estimated to be `33,462,912,272 in 2023, equivalent to 1,640,107,165 in purchasing power parity terms. A cost-effectiveness analysis revealed that public hospitals in the outpatient department had a cost-effectiveness ratio of 0.1323 (13.23%) or 1:8 compared to private hospitals during the study period. The inpatient department had a cost-effectiveness ratio of 0.3141 (31.4%) or 1:3. Furthermore, the cost-benefit ratio of total budgetary allocation to health care was 0.2835 (28.35%) or 1:4. The total opportunity benefits accounted for 17.9% of the Gross State Domestic Product of `190,368,300,000 in 2021-2022.

Conclusion: The expansion and development of public health systems are crucial for delivering essential healthcare services to the broader population, with a particular focus on vulnerable populations who are disproportionately affected by health disparities.

Background: Vitamin D3 deficiency is linked to various chronic and infectious ailments. While prior studies have explored its prevalence in Indian children, adolescents, and pregnant women, a comprehensive understanding is lacking.

Objective: The D3 PULSE survey aimed to capture doctor perspectives on Vitamin D3 deficiency in Indian outpatient department (OPD) patients.

Methods: This was a cross-sectional survey executed across India, in both urban and rural regions comprising 23 states and 4472 cities. The survey included 20,603 respondent doctors from diverse specialties. An online six-item questionnaire gathered the clinical opinions of respondents based on their routine practice, expertise, and preferences on the prevalence and treatment approaches of Vitamin D3 deficiency. Data were gathered and analyzed based on the responses to a six-item survey questionnaire.

Results: Survey results indicated Vitamin D3 deficiency in 51%-100% of OPD patients, prompting 58% of doctors to prescribe an 8-week course of 60K Vitamin D3 supplements primarily for deficiency and immune support. Sixty-seven percent of doctors clinically assess deficiency through symptoms such as fatigue and depression. Key considerations for doctors in choosing and prescribing Vitamin D3 supplements include desired serum level increase (67%) and patient compliance. Challenges include low patient awareness and therapy costs.

Conclusion: The D3 PULSE study highlights widespread Vitamin D3 deficiency (51%-100%) among Indian OPD patients. Management involves an 8-week course of 60K Vitamin D3 supplements, with considerations for serum level increase and patient compliance. Different formulations (tablets/capsules/sachets/injections) demonstrated similar efficacy. Lack of awareness and high therapy costs pose challenges to effective supplementation.

Background: Breast cancer is the most common cancer among Yemeni women. In this study, we aimed to determine the socioeconomic and lifestyle factors of breast cancer risk and survival among Yemeni women in Thamar.

Objectives: We assessed the association between socioeconomic status, lifestyle factors, and the risk of developing breast cancer; and compared disease-free survival (DFS) and overall survival between urban and rural breast cancer patients.

Materials and methods: We performed a retrospective, case-control study using data from the Thamar cancer registry and household survey. Cases were women with histologically confirmed breast cancer diagnosed from January 1, 2019 to December 31, 2023, and frequency-matched controls included women without breast cancer. Risk determinants were determined using multivariate logistic regression models and survival outcomes were analyzed using Cox regression.

Results: A total of 115 cases and 119 controls were included in the study. Significant breast cancer-associated factors were illiteracy (adjusted odds ratio [aOR] =5.46, P < 0.001), wood fuel for cooking (aOR =15.8, P < 0.001), low monthly income below 200 USD (aOR =12.1, P < 0.001), and postmenopausal status (aOR =2.54, P = 0.035). The comparison of DFS between urban and rural residents showed no statistically significant difference.

Conclusions: The study identified illiteracy, wood fuel for cooking, postmenopausal status, and low monthly income as key associated factor for breast cancer among the cases and controls examined. No significant difference in DFS was observed between urban and rural residents.