Indian Journal of Community Health
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Promotion and strategies of menstrual cup use among healthcare providers: A primer towards a sustainable solution for menstrual health and hygiene management in India
Menstrual cups are considered a sustainable solution for menstrual health and hygiene management, as they are cost-effective, environment-friendly, reusable and offer health benefits over traditional menstrual hygiene products such as pads and tampons. However, in lower middle income countries (LMICs), menstrual cup use is limited. Recently, India's current menstrual hygiene program has included menstrual cups as an option for menstrual health and hygiene management. However, the menstrual cup has not been promoted widely in the Indian context. Even if the use of menstrual cups among female healthcare providers in India is minimal, the manuscript identified the crucial challenges in menstrual health and hygiene management, the role of menstrual cups as a solution and the essential strategies to increase menstrual cup use. Programmatic success requires endorsement from healthcare providers as they are trusted sources of information related to healthcare. Good experiences and leading examples from healthcare providers about using menstrual cups is a welcoming step in the path of the dream of a "pad-free country" for India
Reimagining Healthcare Equity: Advocating for Inclusion of Septorhinoplasty under Ayushman Bharat PMJAY
Septo-rhinoplasty, commonly known as nose reshaping surgery, has long been associated with cosmetic enhancements in urban centers. However, it's crucial to recognize the transformative impact Septo-rhinoplasty can have in rural India, extending beyond aesthetics to address significant health and social aspects. In rural areas, where access to specialized medical care is limited, individuals often bear the physical and psychological burdens of nasal deformities without recourse. Congenital anomalies, trauma, and functional impairments due to a misshapen nose can adversely affect a person's quality of life. Septo-rhinoplasty emerges as a beacon of hope, offering not just cosmetic improvements but substantial functional benefits
Validation of new invasive digital hemoglobinometer for hemoglobin estimation as point-of-care device among pregnant women in a facility setting India
Background: Anemia poses a significant health challenge for pregnant women (PW), and accurate and timely diagnosis is essential for effective management. Objective: The objective was to assess the diagnostic validity of the new digital hemoglobinometer for hemoglobin against laboratory-based hematology autoanalyzer among PW. Methodology: The study was conducted at a secondary-level healthcare facility among 204 pregnant women to be sampled conveniently, their sociodemographic and iron intake data collected, and hemoglobin levels assessed using a digital hemoglobinometer (Device A) and a hematology analyzer. Specificity, sensitivity, PPV, NPV, diagnostic accuracy, and method agreement were evaluated via Bland-Altman analysis and Lin's concordance correlation coefficient. Results: The proportion of anemia using the Device A was 64.7% while the hematology analyzer reported a proportion of 52.9%. Device A showed a sensitivity of 97.22%, specificity of 80.30%, and diagnostic accuracy of 86.3%, with substantial agreement indicated by Cohen's kappa coefficient (kappa = 0.72) and the weighted kappa coefficient for different grades of anemia was 0.67. Bland-Altman analysis revealed a mean difference (bias) of -0.28 (± 0.5) between the two methods, with limits of agreement at -1.24 and 0.68. Lin's concordance correlation coefficient of absolute agreement was 0.91. Conclusion: The DH showed high sensitivity and diagnostic accuracy for anemia detection in PW, with substantial agreement with the hematology analyzer. It offers a convenient and rapid alternative for POC hemoglobin estimation in resource-constrained settings
Correlation between perceived social support and quality of sleep and its effect on the academic performance of undergraduate medical students: A cross-sectional study
Background: Social support can be explained as the availability or existence of people who make us feel loved, cared for and valued, people on whom we can rely. Apart from physical health, social networking and interaction uplift mental health, well-being, and academic performance of individuals. Sleep has been associated with achievements in academic indicators of a person, as its deficit causes a lack of attention and concentration. Methods: A survey was designed to conduct cross-sectional study among the undergraduate medical students. The validated 12 item multidimensional scale of perceived social support and 19 self -rated questions of Pittsburgh sleep quality index was used for assessing the social support and sleep quality among the students and how it affected their academic performance. Data was collected in google forms and coded & cleaned and then exported for statistical analysis, to SPSS version 20. Results: Of the total 385 undergraduate medical students, majority were female respondent and from 2nd Professional. Most of the students scored between 60-69% in their university exam. Majority of the student has poor sleep quality. The academic performance has statistically significant association with perceived social support while age of the student was significantly associated with poor quality of sleep. A negative correlation was noted between perceived social support and sleep quality. Conclusion: This study has highlighted the negative impact of a lack of perceived social support on the sleep quality of medical students. Results also showed evidence of an overall poor quality of sleep in the medical students
Educational Introspections of Medical Students Post Disability Competencies Training: A Qualitative Study
Background: Despite the substantial presence of persons with disabilities (PWD) in the population, they face many barriers in healthcare. Competency-Based Medical Education (CBME) is increasingly used to address these gaps. Aims and Objective: This study assesses the impact of disability competencies training on medical students' attitudes towards PWD. It aims to explore new perspectives, identify attitudinal shifts, evaluate training effectiveness, and promote solution-oriented learning. Materials and Methods: Five Focus Group Discussions (FGD) with 8 participants each, a series of themes related to the understanding of disability and empathy were explored. The participants, who had undergone training in disability competencies. The FGDs were facilitated by trained moderators and analysed employing thematic analysis and generating tree maps. Results: Key themes evolved from the students' new perspectives towards PWD, which included Inclusion and Responsibility, Empathy and Understanding, Managing patients with disabilities, Equity and rights, and Acceptance. Themes also emerged regarding the impact of training, revealing an Attitudinal Shift, Engagement and Interaction, Personal Impact, and Solution-Oriented Learning. Conclusion: Disability competency training significantly transforms medical students' attitudes, fostering a more inclusive, empathetic approach in healthcare. This shift is crucial for integrating disability competencies into medical education, especially in developing countrie
Physical Distancing is Better than Social Distancing”: A Breakdown of the Shift in Society’s Psychology and Behaviour
This study focuses on social and physical distancing narratives during the outbreak of Covid-19 in India. Researchers have attempted to explore the trajectory of discursive practices that define social and physical distancing and its impact on human psychology. Further, the study looks at the communication strategies that have been mediated to create a mediatized reality focused on keeping a safe distance from one another to prevent the spread of the virus that caused self-isolation, compelled quarantine, and worry over health issues like psychological distress, Depression, and mental anxiety. Researchers have incorporated mediation, analyzing the narratives around societal and cultural practices that are integral to societal behavioral patterns. Implementing physical distancing in India happened because many communities understood social distancing along caste lines. Major highlights of the study are that despite the efforts made by the Government, media, and other institutions, discriminatory practices existed
Perceptions of Medical Students on Research Curriculum: A Cross-sectional Study
Introduction: Medical colleges promote research by incorporating it into the curriculum, which enables students to acknowledge it as a career prospect. The aim of the study was to assess the perceptions of medical students on research curriculum. Methods: This cross-sectional study was conducted among 544 medical students (interns and post-graduates) at AIIMS Rishikesh in 2020. Data was collected thorough online self-administered questionnaire. A comparison between groups was made using the Mann-Whitney test or chi-square test p < 0.05 was considered statistically significant. Results: Out of 544 participants, 218 (40.1%) responded with complete data. The total median score for the self-perceived ability of study participants regarding performing the research tasks differed significantly between interns and post-graduates [29.5 (24.0–34.2) vs 33 (25.2–39.7), p = 0.03]. They suggested that mandatory research projects, workshops, and training should be included in the curriculum. Conclusion: Feedback from medical students regarding the need for guided research projects, hands-on training, and inclusion of research methodology as a course in UG curriculum and provision of support in the form of incentives, academic credits, and motivation are well noted and guide the resource faculties to modify their teaching and student support programs
Assessing Household Catastrophic Healthcare Expenditure and its Associated Factors: A Study in a North-Eastern State of India
Background: Out-of-pocket expenses (OOPE) are the primary means of funding healthcare costs in developing nations, and when the cost is too high, it leads to catastrophic healthcare expenditures (CHE). Aim & Objective: This study aimed to assess the proportion of households that faced CHE and also examined the associated factors that determine CHE at the household level. Methods and Material: Between September 2020 and February 2021, a cross-sectional study covering a sample of 771 households was conducted in four districts of Assam. A multistage sampling design was employed to select the sample households. Statistical analysis used: Binary logistic regression analysis has been performed to ascertain the factors that could determine household CHE. Results: 23% households had experienced CHE, high dependence on the private healthcare system. Monthly household income, duration of illness, presence of children under five years of age and elderly members, education of household head, and health insurance were the significant factors influencing CHE. Conclusions: The study identified the growing use of private healthcare services as a major concern that contributes to the prevalence of CHE. To make all healthcare services accessible and affordable and to lower OOP on healthcare, it is also crucial to improve the infrastructure and quality of the public healthcare system in rural and remote locations
Airborne Infection Control measures among Government and Private Health Facilities in a hilly district of North India
Introduction: Guidelines for Airborne Infection Control in Health Care Settings were published in the 2010 to reduce Airborne Infections in health service providers and visitors to health facilities. Objectives: To evaluate healthcare facilities regarding implementation of Guidelines for Airborne Infection Control in Health Care Settings. Methods: An analytic, cross- sectional, health care facility-based study in the district Solan of Himachal Pradesh. A total 53 health care facilities from both public and private sectors were assessed and compared. Results: The implementation of these guidelines was unsatisfactory. Government health care facilities were better implementing the guidelines, compared to the private sector. Conclusion: The guidelines are over a decade old and implementation is not optimal. Efforts and emphasis are required to be put into implementation of these guidelines in health care facilities. An update of policy with stringent penalties are advocated for better compliance in the private sector
Impact Assessment of Iron and Folic Acid Supplementation with and Without Intensive Health Education in Pregnant Women of Rural Area of District Etawah: An Interventional Study
Background: Low birth weight , post-partum haemorrhage still births and maternal deaths are associated with anaemia in pregnancy. If prevalence of anemia will be reduced then there will be improvement in maternal and child health and its outcome. Aim & Objectives: To evaluate the changes in the hematological profile of the study subjects and to determine the impact of intensive health education intervention on anemia status of pregnant women. Methodology: A Community based interventional study was conducted among 200 Pregnant women of selected villages in rural area of Etawah district (100 women in each interventional and non-interventional group) using a self-developed, pre designed, pretested, structured and validated questionnaire. statistical package for social sciences (SPSS) software was used to analyse the data. Result: After health education intervention there is significant increase in the haematological profile of study participants of interventional group (p<0.05) as before intervention values of mean Hb was 10.58±1.79 gm/dl which became 11.72±1.48 gm/dl There were 34 (73.9%) participants in the interventional group that were originally anaemic before the study, but after the intervention, they became non-anaemic. Conclusion: Health education sessions helped the pregnant women to improve their knowledge regarding anemia in pregnancy, as well as improve their ability to select iron rich foods, increase compliance with iron supplementation, and raise their haemoglobin levels