Prevalence and correlates of childhood obesity in suburban area of Odisha: A cross sectional study

Introduction: In India obesity and overweight is increasing among urban adolescents. Both under and over nutrition is grappling the country at faster rate. Present study was an attempt to explore obesity and overweight prevalence among school going children in suburban areas of Cuttack city, Odisha, India and their correlates. Methodology: A cross-sectional study was done among school children in suburban area of Cuttack city, Odisha. A predesigned and pretested questionnaire was used to interview the study participants to elicit information about their age, number of siblings, birth order of the child, working status of parents, television screen viewing time, mode of transport to school and dietary habit of the students. A total of 550 children studying in class five to ten participated in our study. Result: Out of 550 children screened, nearly (14) 2.5% students were thin or severely thin, whereas (67)12.1% students were overweight or obese. Univariate analysis revealed that girls were almost five times at higher risk of being overweight/obesity compared to boys (OR: 4.78 95%CI: 1.35-16.93). Children who used motorized vehicles for going to school had an unadjusted Odds ratio of 10.08 [95%CI: 2.08-48.77] of being overweight or obese compared to those who walked to school. Having more than one child at home (OR= 0.15, 95%CI: 0.039-0.6) and doing physical activity for more than 30min per day (0.105, 95%CI: 0.015-0.72) were found to be protective against overweight and obesity. Conclusion: Bearing in mind the burden of overweight and obesity among school children there is a need for periodic screening, awareness at school and parent counselling

A conceptual framework on health professionals' engagement towards pharmacovigilance: a qualitative exploration

Background: With the growing reliance on drug therapy in the recent era, the safety of medications is one of the vital parameters for the success of any medicine. Considering this, pharmacovigilance (PV) was developed to provide adequate identification, reporting, evaluation, and understanding of adverse drug reactions (ADR). The objective of this study was to understand the opinion of health care providers on PV, the current reporting mechanisms, identifying the causes for underreporting, and the existing process in clinical practice.Methods: A qualitative study using pretested interview guide was conducted among 20 different cadres of healthcare personnel (doctors, pharmacists, and staff nurses) from various hospitals such as government, private, corporate, and medical college of Odisha state. The data were analysed using a thematic analysis. The meaning units have been identified from the transcript and coded with MAXQDA software (MAXQDA Analytics Pro 2020, VERBI GmbH Berlin).Results: Participants showed a lack of awareness regarding the concept of PV. A cluster of challenges such as lack of ADR monitoring, non-conducive work atmosphere and lack of cooperation between staff, lack of knowledge among the health professionals, and fear of legal liability as major pitfalls causing poor ADR reporting. To enhance the pharmacovigilance practice, participants suggested context-specific strategies such as IEC activities, innovative ideas to improve ADR monitoring, regular monitoring.Conclusions: Capacity building through training, regular monitoring and supervision to strengthen the pharmacovigilance practices is the current need in India

Global Health Teaching in India: A Curricular Landscape

Today, health has transcended national boundaries and become more multifaceted. Global health has evolved as a new paradigm and is recently being identified as a thrust area now in India. Despite an existing need for a standardized global health curriculum, there is little information available on its education and curriculum in medical and health education space. In the Indian context, we are yet to have a fuller picture of the current status, including, content, structure, selection, teaching methods of global health, and how students are evaluated in India. The objective of this study was to map courses relating to studies on global health in India and analyze its mode of delivery. A detailed Internet search was carried out to identify global health courses and analyzed for: (i) whether global health is a part of the teaching curriculum, (ii) mode of teaching, (iii) broad contents, (iv) instructional formats, (v) assessment, and (vi) selection process. It was found that delivery of global health education in India was fragmented with limited focus at the undergraduate and postgraduate levels. Global health teaching was largely based on certificate courses or online courses, with hardly any institutions imparting a distinct global health education program. There is also no definite specification as to which institutes can impart teaching on global health education and what the specific eligibility requirements are. Our analysis suggests that efforts should be directed toward integrating global health education into broader public health curriculum. At the same time, the need for generation of global health leaders, creation of a common forum for addressing merits and demerits of global health issues, as well as creation of more opportunities for placements are recognized

Hand hygiene behavior among urban slum children and their care takers in Odisha, India

Objective. To study the knowledge and practice of hand washing among mothers and children of shikharchandi slum of Bhubaneswar, Odisha and to recommend possible measures to improve the current practices. Methodology. Present cross-sectional study was carried out in the Shikharchandi slum located in the Bhubaneswar city of Orissa state in India. 150 women and 80 children were interviewed. Chil- dren questionnaire were prepared to suit to their age and accord- ing to local context. Components of sanitation like food handling and hand washing were covered in this questionnaire. Results. Hand washing before preparing food is being practiced by 85% of women. Of all women interviewed, 77% wash hands before serving food. Only 15% children said soap was available in their school to wash hands. Out of total children interviewed, 76% told that their teachers tell about sanitation and hand washing in the class. Only 5% children told they were consulted by doctor/health worker during last 3 months. As many as 81% children told that they wash their hands before taking food and 19% children said they take their food without washing hands. Though most of the children told that they wash hands before tak- ing food, but only 17.5% told that they use soap for hand washing. Only 29% children told that their teachers check hand washing in school. When asked about critical timing of hand washing, 44% children told about at least two critical timings and 56% were unaware about the critical timings of hand washing. Conclusion. Inadequate knowledge on this among our study par- ticipant is a point of concern. Systematic integration of health and hygiene education in schools through curricular modifications could be an appropriate strategy

Factors influencing implementation of mass drug administration for lymphatic filariasis elimination: a mixed-method study in Odisha, India

Background: Lymphatic filariasis (LF) persists as a public health problem in India. Despite more than ten rounds of mass drug administration (MDA), LF continues to be endemic in the Dhenkanal district of Odisha. Hence, we assessed the coverage and compliance of the MDA program and explored the factors affecting it in the Dhenkanal district.Methods: An explanatory mixed-method study was conducted, wherein for the quantitative survey, 552 participants aged 2 years and above were recruited following a multistage cluster random sampling during February 2022. In-depth interviews were conducted among purposively selected key stakeholders and program implementers. Descriptive statistics were used to report coverage and compliance, along with a 95% confidence interval. Qualitative data were analyzed using a thematic approach.Results: We observed coverage of 99.28% and compliance of 85.87% for MDA drugs. Supervised drug administration proved to be a major pillar in increasing compliance. There was difficulty in administering drugs in urban areas due to gated societies, the absence of individuals during the day, and the perspective toward healthcare providers. Participants reported a lack of confidence in drug distributors and a fear of side effects as major causes for non-compliance.Conclusion: There is a need to strengthen MDA, especially in urban areas. An urban-specific strategy, along with surveillance, behavioral change communication, and the involvement of multi-disciplinary teams, is required

PRACTICING HEALTH PROMOTION IN PRIMARY CARE – A REFLECTIVE ENQUIRY

IntroductionHealth promotion is an integral part of routine clinical practice. The physicians’ role in improving the health status of the general population, through effective understanding and delivery of health promotion practice, is evident throughout the international literature. Data from India suggest that physicians have limited skills in delivering specific health promotion services. However, the data available on this is scarce. This study was planned to document the current health promotion knowledge, perception and practices of local primary care physicians in Odisha. MethodsAn exploratory study was planned between the months of January – February 2013 in Odisha among primary care physicians working in government set up. This exploratory study was conducted, using a two-step self-administered questionnaire, thirty physicians practicing under government health system were asked to map their ideal and current health promotion practice, and potential health promotion elements to be worked upon to enhance the practice. ResultsThe study recorded a significant difference between the mean of current and ideal health promotion practices. The study reported that physicians want to increase their practice on health education. ConclusionWe concluded that inclusion of health promotion practices in routine care is imperative for a strong healthcare system. It should be incorporated as a structured health promotion module in medical curriculum as well

Association of Oral Health with Multimorbidity among Older Adults:Findings from the Longitudinal Ageing Study in India, Wave-1, 2017–2019

India is witnessing an increase in the prevalence of multimorbidity. Oral health is related to overall health but is seldom included in the assessment of multimorbidity. Hence, this study aimed to estimate the prevalence of oral morbidity and explore its association with physical multimorbidity using data from Longitudinal Ageing Study in India (LASI). LASI is a nationwide survey amongst adults aged ≥ 45 years conducted in 2018. Descriptive analysis was performed on included participants (n = 59,764) to determine the prevalence of oral morbidity. Multivariable logistic regression assessed the association between oral morbidity and physical multimorbidity. Self-rated health was compared between multimorbid participants with and without oral morbidity. Oral morbidity was prevalent in 48.56% of participants and physical multimorbidity in 50.36%. Those with multimorbidity were at a higher risk of having any oral morbidity (AOR: 1.60 (1.48–1.73)) than those without multimorbidity. Participants who had only oral morbidity rated their health to be good more often than those who had physical multimorbidity and oral morbidity (40.84% vs. 32.98%). Oral morbidity is significantly associated with physical multimorbidity. Multimorbid participants perceived their health to be inferior to those with only oral morbidity. The findings suggest multidisciplinary health teams in primary care should include the management of oral morbidity and physical multimorbidity

A study of organizational versus individual needs related to recruitment, deployment and promotion of doctors working in the government health system in Odisha state, India

Background An effective health workforce is essential for achieving health-related new Sustainable Development Goals. Odisha, one of the states in India with low health indicators, faces challenges in recruiting and retaining health staff in the public sector, especially doctors. Recruitment, deployment and career progression play an important role in attracting and retaining doctors. We examined the policies on recruitment, deployment and promotion for doctors in the state and how these policies were perceived to be implemented. Methods We undertook document review and four key informant interviews with senior state-level officials to delineate the policies for recruitment, deployment and promotion. We conducted 90 in-depth interviews, 86 with doctors from six districts and four at the state level to explore the perceptions of doctors about these policies. Results Despite the efforts by the Government of Odisha through regular recruitments, a quarter of the posts of doctors was vacant across all institutional levels in the state. The majority of doctors interviewed were unaware of existing government rules for placement, transfer and promotion. In addition, there were no explicit rules followed in placement and transfer. More than half (57%) of the doctors interviewed from well-accessible areas had never worked in the identified hard-to-reach areas in spite of having regulatory and incentive mechanisms. The average length of service before the first promotion was 26 (±3.5) years. The doctors expressed satisfaction with the recruitment process. They stated concerns over delayed first promotion, non-transparent deployment policies and ineffective incentive system. Almost all doctors suggested having time-bound and transparent policies. Conclusions Adequate and appropriate deployment of doctors is a challenge for the government as it has to align the individual aspirations of employees with organizational needs. Explicit rules for human resource management coupled with transparency in implementation can improve governance and build trust among doctors which would encourage them to work in the public sector

Prevalence, pattern and determinants of disabilities in India: Insights from NFHS-5 (2019–21)

There is a need to provide an overview of the disability burden in India as there are limited studies. The present study aimed to estimate the prevalence and assess the pattern and determinants of disability in India. We analyzed National Family Health Survey-5 data using the “svyset” command in STATA software. We assessed the correlates by multivariable regression and reported an adjusted prevalence ratio (aPR) with a 95% confidence interval (CI). QGIS 3.2.1 software was used for spatial analysis of distributions of different disabilities. The mean (SD) age of 28,43,917 respondents was 30.82 (20.62) years, with 75.83% (n = 21,56,633) and 44.44% (n = 12,63,086) of them being from a rural area and were not educated, respectively. The overall prevalence of disability was 4.52% [(95% CI: 4.48–4.55), n = 1,28,528]. Locomotor disabilities accounted for 44.70% of all disabilities (n = 51,659), followed by mental disabilities (20.28%, n = 23,436). Age 75 years and above (vs. 0–14 years) [aPR: 2.65 (2.50–2.81)], male (vs. female) [aPR: 1.02 (1.0–1.04)], no education (vs. higher education) [aPR 1.62 (1.56–1.68)], unmarried (vs married) [aPR: 1.76 (1.70–1.82)], seeking the care of non-governmental organization (NGO) (vs. other) [aPR: 1.32 (1.13–1.55)] were significant independent determinants. The highest overall prevalence of locomotor was in Lakshadweep/UTs (8.88%) and Delhi (57.03%), respectively. Out of every hundred individuals in India, four have a disability. More intervention strategies should be planned, considering factors like education, residence, health promotion and caste so that the services provided by the government can be available and accessible to everyone in need

A systematic review

Background: Multimorbidity is the co-occurrence of two or more diseases in the same individual. One method to identify this condition at an early stage is the use of specific markers for various combinations of morbidities. Nonetheless, evidence related to physiological markers in multimorbidity is limited. Objective: The aim was to perform a systematic review to identify physiological markers associated with multimorbidity. Design: Articles available on PubMed, Register of Controlled Trials, Academic Search Premier, CINAHL, Scopus, SocINDEX, Web of Science, LILACS, and SciELO, from their inception to May 2018, were systematically searched and reviewed. The project was registered in PROSPERO under the number CRD42017055522. Results: The systematic search identified 922 papers. After evaluation, 18 articles were included in the full review reporting at least one physiological marker in coexisting diseases or which are strongly associated with the presence of multimorbidity in the future. Only five of these studies examined multimorbidity in general, identifying five physiological markers associated with multimorbidity, namely, dehydroepiandrosterone sulfate (DHEAS), interleukin 6 (IL-6), C-reactive protein (CRP), lipoprotein (Lp), and cystatin C (Cyst-C). Conclusions: There is a paucity of studies related to physiological markers in multimorbidity. DHEAS, IL-6, CRP, Lp, and Cyst-C could be the initial focus for further investigation of physiological markers related to multimorbidity.info:eu-repo/semantics/publishedVersio