A Cross-Sectional Study on Leisure Time Management and Physical Activity Index among Female Adolescent Medical Students in Delhi

Adolescence is the most promising and also most vulnerable span of life. Being the most energetic and enthusiastic, they spend their time in academic activities, sports, household chores and in various other activities. Free time to do something apart from scheduled academic work, business or household activities is conceptualized as leisure time [1].Leisure time management is important as they cannot compromise with their scheduled academic activities. Leisure time activities differ across countries, age groups, sex and ethnic groups as per different studies but done mostly in Western countries [2–5]. Furthermore, those adolescents who are in professional courses might have less leisure time. Moreover, females might be more vulnerable because they are prone to less outdoor activities and outdoor sports in comparison to males. Thus it is very important to address these issues, particularly leisure time activity and time management, because it serves as a basis for evidence generation in decision-making and policy formulation. An attempt was made to carry out a cross-sectional study in the adolescent female students pursuing a professional course in a medical college of New Delhi

Factors affecting enrolment of PLHIV into ART services in India

At the end of 2007, India had an estimated 2.31 million people living with HIV, and an HIV prevalence of 0.34 percent. Despite the low HIV prevalence, these statistics place India among countries with a large number of people living with HIV (PLHIV). To address the care and support needs of PLHIV, the Ministry of Health and Family Welfare, Government of India, initiated a national program in 2004 to provide free antiretroviral therapy (ART) for PLHIV. By March 2009, there were 211 functioning Antiretroviral Treatment Centers and 254 Community Care Centers across the country, and to date 217,781 individuals are receiving ART. A major challenge for the health system has been to increase utilization of ART services and enrollment into the program. The Population Council, with support from the National AIDS Control Organization, undertook a multisite study in four high-HIV-preva¬lence and three low-HIV-prevalence-states. This document describes the context and factors that influence the uptake of ART services in those states

The Lancet Global Health Commission on Global Eye Health: vision beyond 2020

Eye health and vision have widespread and profound implications for many aspects of life, health, sustainable development, and the economy. Yet nowadays, many people, families, and populations continue to suffer the consequences of poor access to high-quality, affordable eye care, leading to vision impairment and blindness. In 2020, an estimated 596 million people had distance vision impairment worldwide, of whom 43 million were blind. Another 510 million people had uncorrected near vision impairment, simply because of not having reading spectacles. A large proportion of those affected (90%), live in low-income and middle-income countries (LMICs). However, encouragingly, more than 90% of people with vision impairment have a preventable or treatable cause with existing highly cost-effective interventions. Eye conditions affect all stages of life, with young children and older people being particularly affected. Crucially, women, rural populations, and ethnic minority groups are more likely to have vision impairment, and this pervasive inequality needs to be addressed. By 2050, population ageing, growth, and urbanisation might lead to an estimated 895 million people with distance vision impairment, of whom 61 million will be blind. Action to prioritise eye health is needed now. This Commission defines eye health as maximised vision, ocular health, and functional ability, thereby contributing to overall health and wellbeing, social inclusion, and quality of life. Eye health is essential to achieve many of the Sustainable Development Goals (SDGs). Poor eye health and impaired vision have a negative effect on quality of life and restrict equitable access to and achievement in education and the workplace. Vision loss has substantial financial implications for affected individuals, families, and communities. Although high-quality data for global economic estimates are scarce, particularly for LMICs, conservative assessments based on the latest prevalence figures for 2020 suggest that annual global productivity loss from vision impairment is approximately US$410·7 billion purchasing power parity. Vision impairment reduces mobility, affects mental wellbeing, exacerbates risk of dementia, increases likelihood of falls and road traffic crashes, increases the need for social care, and ultimately leads to higher mortality rates. By contrast, vision facilitates many daily life activities, enables better educational outcomes, and increases work productivity, reducing inequality. An increasing amount of evidence shows the potential for vision to advance the SDGs, by contributing towards poverty reduction, zero hunger, good health and wellbeing, quality education, gender equality, and decent work. Eye health is a global public priority, transforming lives in both poor and wealthy communities. Therefore, eye health needs to be reframed as a development as well as a health issue and given greater prominence within the global development and health agendas. Vision loss has many causes that require promotional, preventive, treatment, and rehabilitative interventions. Cataract, uncorrected refractive error, glaucoma, age-related macular degeneration, and diabetic retinopathy are responsible for most global vision impairment. Research has identified treatments to reduce or eliminate blindness from all these conditions; the priority is to deliver treatments where they are most needed. Proven eye care interventions, such as cataract surgery and spectacle provision, are among the most cost-effective in all of health care. Greater financial investment is needed so that millions of people living with unnecessary vision impairment and blindness can benefit from these interventions. Lessons from the past three decades give hope that this challenge can be met. Between 1990 and 2020, the age-standardised global prevalence of blindness fell by 28·5%. Since the 1990s, prevalence of major infectious causes of blindness—onchocerciasis and trachoma—have declined substantially. Hope remains that by 2030, the transmission of onchocerciasis will be interrupted, and trachoma will be eliminated as a public health problem in every country worldwide. However, the ageing population has led to a higher crude prevalence of age-related causes of blindness, and thus an increased total number of people with blindness in some regions. Despite this progress, business as usual will not keep pace with the demographic trends of an ageing global population or address the inequities that persist in each country. New threats to eye health are emerging, including the worldwide increase in diabetic retinopathy, high myopia, retinopathy of prematurity, and chronic eye diseases of ageing such as glaucoma and age-related macular degeneration. With the projected increase in such conditions and their associated vision loss over the coming decades, urgent action is needed to develop innovative treatments and deliver services at a greater scale than previously achieved. Good eye health at the community and national level has been marginalised as a luxury available to only wealthy or urban areas. Eye health needs to be urgently brought into the mainstream of national health and development policy, planning, financing, and action. The challenge is to develop and deliver comprehensive eye health services (promotion, prevention, treatment, rehabilitation) that address the full range of eye conditions within the context of universal health coverage. Accessing services should not bring the risk of falling into poverty and services should be of high quality, as envisaged by the WHO framework for health-care quality: effective, safe, people-centred, timely, equitable, integrated, and efficient. To this framework we add the need for services to be environmentally sustainable. Universal health coverage is not universal without eye care. Multiple obstacles need to be overcome to achieve universal coverage for eye health. Important issues include complex barriers to availability and access to quality services, cost, major shortages and maldistribution of well-trained personnel, and lack of suitable, well maintained equipment and consumables. These issues are particularly widespread in LMICs, but also occur in underserved communities in high-income countries. Strong partnerships need to be formed with natural allies working in areas affected by eye health, such as non-communicable diseases, neglected tropical diseases, healthy ageing, children's services, education, disability, and rehabilitation. The eye health sector has traditionally focused on treatment and rehabilitation, and underused health promotion and prevention strategies to lessen the impact of eye disease and reduce inequality. Solving these problems will depend on solutions established from high quality evidence that can guide more effective implementation at scale. Evidence-based approaches will need to address existing deficiencies in the supply and demand. Strategic investments in discovery research, harnessing new findings from diverse fields, and implementation research to guide effective scale up are needed globally. Encouragingly, developments in telemedicine, mobile health, artificial intelligence, and distance learning could potentially enable eye care professionals to deliver higher quality care that is more plentiful, equitable, and cost-effective. This Commission did a Grand Challenges in Global Eye Health prioritisation exercise to highlight key areas for concerted research and action. This exercise has identified a broad set of challenges spanning the fields of epidemiology, health systems, diagnostics, therapeutics, and implementation. The most compelling of these issues, picked from among 3400 suggestions proposed by 336 people from 118 countries, can help to frame the future research agenda for global eye health. In this Commission, we harness lessons learned from over two decades, present the growing evidence for the life-transforming impact of eye care, and provide a thorough understanding of rapid developments in the field. This report was created through a broad consultation involving experts within and outside the eye care sector to help inform governments and other stakeholders about the path forward for eye health beyond 2020, to further the SDGs (including universal health coverage), and work towards a world without avoidable vision loss. The next few years are a crucial time for the global eye health community and its partners in health care, government, and other sectors to consider the successes and challenges encountered in the past two decades, and at the same time to chart a way forward for the upcoming decades. Moving forward requires building on the strong foundation laid by WHO and partners in VISION 2020 with renewed impetus to ultimately deliver high quality universal eye health care for all

Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study

18% of the world's population lives in India, and many states of India have populations similar to those of large countries. Action to effectively improve population health in India requires availability of reliable and comprehensive state-level estimates of disease burden and risk factors over time. Such comprehensive estimates have not been available so far for all major diseases and risk factors. Thus, we aimed to estimate the disease burden and risk factors in every state of India as part of the Global Burden of Disease (GBD) Study 2016

Utilization of Janani Suraksha Yojana in Balijan and Doimukh Blocks of Papumpare District, Arunachal Pradesh, India

Background: Janani Suraksha Yojana (JSY) is a conditional cash incentive scheme focused on institutional delivery to reduce maternal and infant mortality.Objectives: To examine the factors influencing utilization of the JSY and role of key informants of the study like District Reproductive and Child Health Officer (DRCHO), Medical Officer (MO), Auxiliary Nurse Midwifery (ANM), Lady Health Visitor (LHV) and Accredited Social Health Activist (ASHA) at Community Health Centers (CHC) and Sub Centers (SC).Method: An observational study in two randomly selected blocks namely, Balijan and Doimukh of Papumpare District, Arunachal Pradesh, was carried out with some in-depth interviews. A total of 71 respondents were interviewed after obtaining informed consent.Result: All the respondents registered their pregnancy at CHC Balijan and Doimukh Blocks respectively. Awareness on JSY by the beneficiaries through ASHAs accounted for 37.53%, while motivation to avail JSY by beneficiaries was 34.3%; 85% prospective beneficiaries desired to avail JSY and 27.45% of non-beneficiaries cited transportation problem as a reason for not availing JSY. Key informants agreed that lack of transportation from the village to hospital and preference of private hospitals were main reasons for non-utilization of the scheme. Delay in disbursement of money by hospital and several rounds of trip for this purpose resulted in increased out-of-pocket expenditure as cited by the respondents. Low cash incentive, lack of dedicated fund for fuel of ambulances stationed in hospitals (CHCs and SCs) and low honorarium to ASHAs were reasoned as challenges by the key informants.Discussion: Issues related to health infrastructure and ASHAs have to be addressed for further progress

Reducing Air Pollution - Towards making Indore a Smart, Clean, and Healthy City

Introduction: The Government of India initiated the Smart City Mission in 2015 with the aim of comprehensive urban development for 100 cities. Swachh Bharat Mission was also launched nationwide in 2014 with the goal of advancing universal sanitation coverage. Indore was selected as a Smart City; it was also declared the cleanest city in India in 2017 and in 2018 under Swachh Bharat. Indore is also participating in the United States Agency for International Development (USAID) - funded Building Healthy Cities Project, with the objective of improving the health of the city environment. As part of that objective, a closer examination of air pollution levels was conducted.Methodology: Annual average concentrations for sulphur dioxide, nitrogen oxides, and particulate matter (PM2.5 and PM10) from three air pollution measuring stations located in Indore’s Polo Ground (industrial), Kothari Market (commercial), and Kanodia Road, Vijay Nagar (residential) were analysed for trends during the last five years (2013-2017). For 2017, month-wise data were analysed for seasonal variations.Results: The annual average concentration of sulphur dioxide and nitrogen oxides did not change during the preceding five years. A declining trend was observed at all sites in concentration of PM10 from a range of 118-187 μg/m3 in 2013 to 77-81 μg/m3 in 2017. The PM2.5 concentration was measured only since 2016; 2017 levels were less when compared to the preceding year. Lower values were observed during the rainy season (July to September) for all pollutants. It was observed that, during the period, declining trend for PM10, various interventions were initiated in Indore, including night mechanical sweeping of city roads, free left loop roads to reduce traffic congestion, and an efficient systematic collection and disposal of solid waste.Conclusion: Declining trends of air pollution in particulate matter in Indore is evident, possibly due to various measures taken by the Municipal Corporation and Indore Smart City Mission. Further analysis is needed to understand how these trends can be sustained and how they may impact the respiratory health of Indore citizens