WHO South-East Asia journal of public health最新文献

Abstract: Vaping was introduced as an alternative to traditional cigarettes to reduce health risks attributed to smoking. However, after the initial hype, soon adverse effects of vaping were reported, including e-cigarettes or vaping-associated lung injuries (EVALI). Despite the availability of evidence that vaping has health risks, its popularity has significantly increased among adolescents and youth. Acknowledging the negative consequences of vaping, there is a definite need to implement targeted public health interventions to reduce the incidence and impact of EVALI, especially among vulnerable population groups. A range of challenges has been identified that can act as barriers to reducing the impact of EVALI, and there is an indispensable need to overcome these for better outcomes. In conclusion, vaping-induced lung injuries can affect any user, and they are not a safer alternative to smoking as was thought earlier. Considering the extent of damage, these products can cause due to the presence of harmful components, it is the need of the hour to adopt multifaceted and proactive solutions to effectively address EVALI and prevent future cases.

Aims and objectives: This study aimed to evaluate palliative care capacity across eleven northern Indian hospitals whose physicians and nurses had undergone training as part of the Cancer Treatment Centers (CTC) program. An online rapid evaluation using The "Standards audit tool for Indian palliative care programs" developed by the Indian Association of Palliative Care (IAPC) was done to audit specific aspects of palliative care delivery including staff training, recordkeeping, availability of morphine, and continuing professional development programs. A descriptive analysis of the data was conducted. Additional information was obtained through surveys, site visits, document reviews, and interviews with program leaders. For each site, the researchers determined to what extent the program met the set IAPC of the Standards Audit Tool. The eleven centers satisfied most of the essential criteria and some of the desirable criteria. One center did not have an in-house access to oral morphine. Some of the lacunae were inadequate provision of home care, unavailability of care after business hours, place of multidisciplinary collaboration, and involvement of community and volunteers. There was evidence of teaching, training, team health, audit, and administrative support. These hospitals were delivering good quality palliative care as per IAPC standards in parts of northern India that are underserved. There is scope for improvement in the outreach to the community, and a more multidisciplinary approach is required.

Abstract: One in every four Sri Lankans will be an older person by the year 2041 with an increasing share of the very old elderly. The share of the population aged 65 years and above is projected to rise leading to an increase of the old age dependency ratio with female preponderance. With this demographic transition, and epidemiological profile dominated by noncommunicable disease, the health system warrants major changes to meet new demands. Policy dialogue on healthy aging was initiated with the aim of providing impactful support to build better and resilient primary healthcare-centered health system. The dialogue contributed to improve evidence-based decision-making, which entails creating the platforms supporting pathways between key stakeholders. Key issues to explore through policy dialogue were framed from the available evidence and desk reviews, that included examining policy-related literature and considered the ongoing primary healthcare reorientation in Sri Lanka. The methodology adopted for dialogue on healthy aging enriched by a comprehensive context review led to focused technical dialogues that aided the construction of a conceptual model to be considered within the current overall health structure being reoriented.

Context: The COVID-19 pandemic has had a severe impact on both the formal and informal sectors globally. Loss of income and employment among informal workers has increased their vulnerability, pushing them further into poverty which is likely to impact their health as well.

Aims: This paper assesses the impact of COVID-19 and its control measures on poverty dynamics within Nepal's urban informal economy, using a public health perspective.

Methods: Structured questionnaires were used to collect data from respondents. The analysis is based on 5 years of data (2015/16-2019/20) collected through face-to-face interviews with 423 informal economy workers from six metropolitan cities. The paper assesses trends in poverty transitions before and during the pandemic.

Results: The poverty rate among workers in the urban informal economy, which had been declining from 2015/16 to 2018/19, increased drastically during the COVID-19 pandemic. The data show that the number of workers who remained poor decreased steadily over the first 4 years but increased in the final year. Similarly, the number of workers who remained nonpoor grew over the first 4 years but declined in the last year. Transitions from nonpoor to poor also declined until 2018/19 but rose again in 2019/20 due to COVID-19.

Conclusions: The study highlights the importance of understanding poverty dynamics from a long-term perspective.The experiences in Nepal and globally highlight the need for both short-term and long-term interventions to reduce risks and support informal workers, enabling them to sustain their livelihoods and contribute to the well-being of low-income populations during public health crises.

Abstract: Multiple long-term conditions (MLTCs) defined as the co-occurrence of ≥2 chronic conditions are rising in low- and middle-income countries such as India. MLTCs can require continued medical support, investigations, and medications calling for health system strengthening. This highlights the need for assessing the burden of MLTC in the community. We estimated the prevalence of MLTCs and assessed their social determinants in Odisha, India. A cross-sectional study was conducted in two villages of Khordha district, Odisha, employing a systematic random sampling method. We recruited 530 adults aged ≥18 years between March and June 2023. Prevalence was presented as frequency and proportion, along with a 95% confidence interval (CI) as a measure of uncertainty. The relationship between MLTCs (≥2 conditions out of 28 assessed chronic conditions) and various sociodemographic traits - such as age, gender, education, and employment elicited using a validated Multimorbidity Assessment Questionnaire for Primary Care tool was examined through a multivariable logistic regression model. Results were expressed as adjusted odds ratios (AOR) with 95% CI. The overall prevalence of MLTCs was 29.21% (95% CI: 25.4-33.32). Individuals aged 60 years or older (AOR: 23.56 [95% CI: 7.55-73.53]), compared to those aged 18-30 years, and those residing in rural areas (AOR: 3.18 [95% CI: 1.70-5.92]), compared to their urban counterparts, were more likely to have MLTCs. Almost one-third of the adults had MLTCs that suggest an immediate need to develop, strengthen, and promote healthcare services for chronic conditions in the community that is accessible and cost-effective.

Background: Breast cancer accounts for 26.6% of cancers among Indian women. Lack of awareness and fear lead to late-stage presentations and high mortality. This study aims to describe a novel community participatory model for cancer control in a Grama Panchayat in northern Kerala.

Methods: The screening program in the Grama Panchayat was preceded by systematically planned, multifaceted, community-level cancer awareness activities, under the leadership of the Local Self Government Institution and technical support from a Comprehensive Cancer Care Center.

Results: The activities led to a screening participation rate of 96% among women above 30 years, in a breast cancer screening camp organised in the Grama Panchayat. Out of the 203 (6.2%) referred, 135 women (66.5%) underwent further investigations. The detection rate was 0.96 per 1000, all in the early stages.

Conclusion: Continuous community sensitization about cancer, alleviation of fear and misconceptions, accessible and approachable screening program settings, and an efficient patient navigation system, led by female Local Self Government Institution members, culminated in the successful 'Kannapuram Model', in terms of screening participation and treatment adherence.