Determining the Role of Service Quality, Trust, and Commitment to Customer Loyalty for Telecom Service Users: A PLS‐SEM Approach

Purpose – The purpose of this paper is to determine the role of service quality (SQ), trust and commitment to customer loyalty (CL) for telecom service users. Further, the moderating role of gender, marital status and connection type within the model was tested. Design/methodology/approach – A measurement model was created based on valid 615 responses from Indian TSUs for SQ, trust, commitment and loyalty with the help of partial least squares structural equation modeling (PLS-SEM). Multi-group analysis (MGA) was conducted to understand the moderating effect of marital status, gender and connection type within the model. Findings – The results suggest that, out of five dimensions of SQ, only responsiveness, assurance and empathy have a significant positive relationship with both commitment and trust. Tangibility has a significant positive relationship with trust only. Both commitment and trust have a significant impact on loyalty. It was noticed that both commitment and trust act as mediators between three SQ dimensions (assurance, empathy and responsiveness) and CL. MGA revealed that empathy and responsiveness positively induce trust in telecom users who are single. Whereas, assurance increases commitment toward telecom service providers in married users. Assurance and empathy significantly contribute toward commitment and trust, respectively, in male users as compared to females. Empathy was found important for postpaid users for trust-building, whereas trust was found to be more important for prepaid users to stay loyal to the service provider. Originality/value – This article contributes toward understanding the role of SQ, trust and commitment to CL moderated by marital status, gender and connection type in an integrated model concerning telecom servic

Impact of health education on unmet needs of contraception in urban slums of Chandigarh, India

Background: Unmet need points to gap between some women reproductive intention and their contraceptive behavior. Unmet need for contraception is mainly attributed to lack of information, negative attitude, fear of adverse effects and social influences. The objective of this study was to investigate awareness and practice of contraceptive usage. And to estimate unmet need of contraception in the studied population and to identify the factors associated with it, and to evaluate impact of health education on unmet needs of contraception.Methods: A community-based longitudinal study was conducted in four randomly selected urban slum areas (colonies) of Chandigarh, India. A systematic two-stage random sample design was adopted.Results: Overall contraceptive awareness rates among women and men were increased from 84.1% to 96.3% and from 82.2% to 95.5% in post-interventional survey as compared to baseline survey. Contraceptive prevalence rates were found to be 57.3% and 65.5% respectively in pre interventional and post interventional surveys, against contraceptive awareness rates of 81.7% and 95.5% respectively, resulting in gaps between knowledge and practice to be unmet needs of contraception to the extents of 24.4% and 30.0% respectively in the two surveys.Conclusions: There is an urgent need of adopting some population specific integral strategies for changing social norms and attitudes of couples regarding reproductive issues, increase in contraceptives awareness as well as practice for reductions in unmet needs of contraception and unwanted/unplanned pregnancies

Prevalence of cough more than two weeks among OPD attendees, and smear microscopy outcome among them

Abstract Tuberculosis (TB) is a public health emergency, which challenges the health indicators of India. Delayed diagnosis of TB may result in more extensive disease, more complications, and lead to a higher mortality. It also leads to an increased period of infectivity in the community. Revised National Tuberculosis Control Programme (RNTCP) of the country has modified the definition of a pulmonary TB suspect so as to include an additional proportion of people with cough of 2 weeks duration, which will help in reducing the delay in starting treatment. This study was carried out with the objective of estimating the prevalence of cough more than 2 weeks among OPD attendees, and smear microscopy outcome among them and to assess the treatment seeking behavior of patients with cough ≥ 2 weeks. The present cross-sectional study was carried out at Out-Patient Department of GianSagar Medical College and Hospital, Banur, Distt. Patiala , Punjab. All adult chest symptomatics with cough of two weeks or more than two weeks duration attending in OPD were screened for pulmonary tuberculosis by examining the two sputum smears in designated microscopy center as per RNTCP guidelines. A total of 16030 adult patients attended outpatients department (OPD) in the months of May and June 2013. Out of these, 561(3.5%) patients reported cough. Among patients who reported cough, 70(12.5%) patients reported cough ≥ 2 weeks duration.Of those who coughed for two weeks or more, 10 (14.2%) had smear positive PTB .Of the patients who had cough ≥ 2 weeks duration, only 21.4% of patients reported to a health facility for treatment within 1 st week of symptoms and majority (50%) of them preferred going to private practitioners.It may be concluded that reservoir of tuberculosis infection can only be reduced by early detection and prompt and complete treatment of sputum positive cases

Biomedical waste management practices in a tertiary-care hospital in Punjab

Background: Biomedical waste (BMW) has recently emerged as an issue of major concern not only to hospitals and nursing homes, but also to the environmental and law enforcing agencies, media, and the general public. BMW forms approximately 1%–2% of the total municipal solid waste stream. Objectives: The aims of the study were the following: to get background information about the disposal of hospital waste; to determine the awareness regarding waste management practices; to document the waste management practices; and to suggest the possible remedial measures, if required. Subjects and Methods: A cross-sectional study was conducted in a medical college hospital in Patiala district. A survey of the personnel handling and monitoring the BMW was carried out using a scientifically prescribed questionnaire. Results: More than 90% of the nurses and laboratory technicians were well aware of the proper disposal of the sharps and infected waste, but only 50% of the sweepers could satisfactorily answer about the same. Among nurses, approximately 90% were aware that improper management of BMW causes environmental pollution and injuries, whereas 60% of nurses and laboratory technicians could enlist the diseases transmitted by improper handling of BMW. Approximately 40–60% of ward boys and sweepers were aware of the effects of poor handling of BMW on environment and the injuries caused by it, but none of them could tell the diseases transmitted by the improper recycling of hospital waste or by improper handling of BMW. Conclusion: The human element is found to be far more important than the technology. Almost any system of treatment and disposal of BMW that is operated by well-trained and well-motivated staff can provide greater protection to staff, patients, and the community than an expensive and sophisticated system that is managed by staff who do not understand the risk and the importance of their contribution

Impact of Health Education on Breastfeeding Behaviour of Mothers in UT Chandigarh

Introduction: Despite global efforts for improving nutritional status of children, desired outcomes could not be achieved. Infant and young child feeding practices (IYCF) may be influenced by some interventionAim: To evaluate the effects of interventions on optimal IYCF practices.Methodology: Community based longitudinal study was undertaken to find IYCF status among children in Rural, Urban and Slum population of UT Chandigarh. Mothers of infants willing to participate in the study and satisfying the inclusion criteria and also children below three years of age within selected clusters served as study units/respondents for qualitative as well as quantitative surveys at pre-interventional and post-interventional stages.Results: There were 279 mothers surveyed in the study group and 228 mothers in the control group based on intervention and no intervention respectively. About 46% mothers in the study group and 41.7 % mothers in the control group were of the opinion that prelacteal feed (PLF) should not be given. In both the groups, maximum of respondents were in favour of feeding colostrum. Also, 43.3% mothers in study group and 41.7% mothers in control groups opined that duration of breast feeding should be 6 months or more.Conclusions and Suggestions: Present study provides evidence of positive impact of interventions in terms of creating awareness and counselling of mothers and elderly women in the community on adoption of optimal IYCF by mothers. There is a need to plan area specific programs to create an enabling environment for comprehensive health education of mothers so as to protect, promote and sustain IYCF practices

A Study to Identify Gaps in Knowledge and Practices regarding Dengue in a Rural Population of Punjab

Background: Dengue fever is an emergent disease in India and is responsible for causing significant morbidity and mortality in most tropical and sub-tropical countries of the world.Objective: To assess the knowledge and practices regarding dengue adopted by the rural population attending the hospital.Study Design: A descriptive cross-sectional study concerning knowledge, attitudes and practices of dengue fever prevention among attendants of patients admitted in a tertiary care teaching hospital situated in rural Punjab.Study Population: 400 adult attendants of patients admitted in Gian Sagar Medical College and Hospital were interviewed using a pretested, pre-designed questionnaire regarding their knowledge, attitudes and practices about dengue fever.Results: 85.8% of the respondents knew that the vector for dengue is a mosquito. As regards common symptoms of dengue, fever was the most consistent response (90.8%) followed by headache (15.8%). It was observed that 94.1% respondents agreed that dengue is a serious illness. 90.0% respondents do nothing to eliminate standing water around the house to reduce mosquitoes. 47.5% respondents came to know about dengue fever through neighbors and 36.5% through TV/ radio.Conclusion: Dengue fever continues to be a public health problem in this area and there is a need for creating greater awareness among the people by information, education and communication (IEC) activities and social responsibility

Surveillance of communicable diseases in tertiary health care system in Chandigarh, UT

Background : Communicable disease surveillance is to have baseline data which will be helpful for planning and also for identifying epidemics under non-evident conditions. Objective : To delineate the pattern of occurrence of communicable diseases so as to enable early identification, followed by appropriate and timely response to outbreaks. Materials and Methods :Reports of listed communicable diseases from various departments and centers of Government Medical College, Chandigarh, involved in clinical care and laboratory diagnosis, were collected by the Department of Community Medicine on a weekly basis. Analysis of surveillance data was done for a period of 1 year - including reports from March 2005 to February 2006. Statistical Analysis : Percentage, normal test of proportions, time series analysis. Results : Out of 19,378 cases of various communicable diseases, 11,575, i.e., more than half, were dealt with by health centers. Thus maximum cases of acute respiratory infections (ARIs) [8,278 (71.87%)] and acute diarrheal diseases (ADDs) [3,148 (54.4%)] were dealt with by health centers. Of 19,378 cases, 11,518 (59.44%) were of ARIs, 5,786 (29.86%) of ADDs and 550 (2.84%) of pulmonary tuberculosis. There was no significant difference in the incidence of either disease between two sexes. Most, i.e., 4,413 (38.31%), cases of ARIs and 512 (86.49%) cases of pneumonia were reported in winter; ADDs - 2,607 (45.05%) in summer; and typhoid - 94 (41.04%) in the monsoon season. Conclusion : Maximum workload of common communicable diseases was borne by health centers. The most common morbidity was ARIs, followed by ADDs and pulmonary tuberculosis. No significant gender predilection was seen. Overall reporting of communicable diseases observed in three different seasons was found to show a gradual increase from winter to summer through monsoon. Some specific seasonal trends were demonstrated by various morbidities

Treatment outcomes of patients placed on treatment under directly observed therapy short-course (DOTS)

Background : Tuberculosis continues to be a pressing health problem in India. The Revised National Tuberculosis Programme (RNTCP), an application of Directly Observed Treatment Short-course (DOTS) in India, launched in 1997 needs contin-uous evaluation. Objective : To study the outcomes of treatment among the patients put on DOTS under RNTCP in Chandigarh, UT. Material & Methods : A Longitudi-nal study was conducted during 2004-2005 in 13 Microscopic centres (MC′s) spread over 2 Tuberculosis Units (TU′s) under District Tuberculosis Centre (DTC) in Union Territory (UT), Chandigarh. A sample of 265 respondents, selected by two-stage stratified random sampling technique, was recruited in the study cohort. Data analysis was done using SPSS-10 statistical software package. Results : For Category I and Category II patients, the Success rate was 98.6% and 90.4% respectively. The overall default rate was 1.1% and failure rate was 2.6%. For re-treatment cases, failure rate was higher i.e. 5.8%. The sputum conversion rate among the new smear positive cases was 93.8% at 3 months of treatment. For the re-treatment cases, spu-tum conversion rate at 3 months was 94.1%. Conclusion : The study concludes that RNTCP is running successfully in UT Chandigarh, having high success rate and low default rate. The reasons for high failure rate should be explored in depth