Challenges and opportunities in mixed method data collection on mental health issues of health care workers during COVID-19 pandemic in India

Background: The present paper describes the key challenges and opportunities of mixed method telephonic data collection for mental health research using field notes and the experiences of the investigators in a multicenter study in ten sites of India. The study was conducted in public and private hospitals to understand the mental health status, social stigma and coping strategies of different healthcare personnel during the COVID-19 pandemic in India.Methods: Qualitative and quantitative interviews were conducted telephonically. The experiences of data collection were noted as a field notes/diary by the data collectors and principal investigators.Results: The interviewers reported challenges such as network issues, lack of transfer of visual cues and sensitive content of data. Although the telephonic interviews present various challenges in mixed method data collection, it can be used as an alternative to face-to-face data collection using available technology.Conclusions: It is important that the investigators are well trained keeping these challenges in mind so that their capacity is built to deal with these challenges and good quality data is obtained

CHSI costing study-Challenges and solutions for cost data collection in private hospitals in India

INTRODUCTION: Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB PM-JAY) has enabled the Government of India to become a strategic purchaser of health care services from private providers. To generate base cost evidence for evidence-based policymaking the Costing of Health Services in India (CHSI) study was commissioned in 2018 for the price setting of health benefit packages. This paper reports the findings of a process evaluation of the cost data collection in the private hospitals. METHODS: The process evaluation of health system costing in private hospitals was an exploratory survey with mixed methods (quantitative and qualitative). We used three approaches-an online survey using a semi-structured questionnaire, in-depth interviews, and a review of monitoring data. The process of data collection was assessed in terms of time taken for different aspects, resources used, level and nature of difficulty encountered, challenges and solutions. RESULTS: The mean time taken for data collection in a private hospital was 9.31 (± 1.0) person months including time for obtaining permissions, actual data collection and entry, and addressing queries for data completeness and quality. The longest time was taken to collect data on human resources (30%), while it took the least time for collecting information on building and space (5%). On a scale of 1 (lowest) to 10 (highest) difficulty levels, the data on human resources was the most difficult to collect. This included data on salaries (8), time allocation (5.5) and leaves (5). DISCUSSION: Cost data from private hospitals is crucial for mixed health systems. Developing formal mechanisms of cost accounting data and data sharing as pre-requisites for empanelment under a national insurance scheme can significantly ease the process of cost data collection

Impact of online education on mental health of matriculating adolescents during COVID-19 pandemic in Western India

Background: School closures during COVID-19-Pandemic introduced online teaching- learning in low-&middle-income-countries (LMIC). We aimed to assess its impact on mental health (MH) of adolescents in India studying for matriculation. Material & Methods: A cross sectional study was carried out in Maharashtra, India in 2021. MH of matriculating adolescents was assessed by presence of symptoms of depression, anxiety, stress (DAS) using DASS-42 and emotional intelligence (EI) by Schutte’s self-report EI test (SET) with collection of socio-demographic information maintaining confidentiality. Higher are the DAS scores, greater is the severity of symptoms and higher the score better is EI. They were categorized as per convention by their inventors. Data were analyzed by SPSS-20 software. Impact of online teaching was assessed by comparing results of present study with pre- pandemic pilot and other studies. Results: Total 1103 adolescents participated, 42.9% were boys & 57.1% were girls. Mean age was 14.7 (+0.75) years, majority from middle socio-economic- status. Median DAS, EI scores showed no evidence of symptoms of DAS with EI in normal category. DAS scores were significantly lower and EI score was significantly higher than reported in pre-pandemic pilot and other studies.&nbsp

Emotional intelligence from gender perspective during mid to late adolescence in an Indian context

Background: Emotional Intelligence (EI) contributes to overall success in life. Our objectives are to explore EI among adolescents and its gender differences as per some parameters of social environments. Material and Methods: Present cross-sectional study was conducted in secondary schools in one of municipal corporations in western Maharashtra EI of adolescents studying in tenth standard in randomly selected secondary schools, was assessed by Schutte's Self-Reported Emotional Intelligence Test with collection of relevant sociodemographic information maintaining confidentiality. Data were analyzed by SPSS 20 software. Results: Total 1060 adolescents in 14-16 years of age participated in the study. Socio-economic status affected EI of adolescent girls more adversely than adolescent boys (P = 0.003, P = 0.036 respectively). Co-educational type of school favored lower EI than gender specific schools (P < 0.001). After gender wise stratification, EI did not differ significantly among boys (P = 0.154) with respect to type of schooling, but differed significantly (P = 0.001) among girls. Conclusion: Apart from continued efforts directed to for improvement in SES, mental health component of school health services needs to take a step forward for assessment and improvement of towards mental health parameters including EI of adolescents. EI training programs commenced in school activities based on gender, socio-economic status and other issues relevant to the situation shall prove beneficial in long run

A case series of cervico-vaginal cytology findings of female sex workers in an urban slum in Mumbai

INTRODUCTION Female sex workers (FSWs) belong to a marginalized social group, and lag in physical, psychological, social and economic spheres of their lives. It ultimately compromises their health. Belonging to a high-risk behaviour group, FSWs are at a higher risk of Sexually Transmitted Infections (STIs) and cervical cancers. Regular health check-ups can help them secure their physical health. Papanicolaou (Pap) smear test for cervico-vaginal cytology is an important component of health check-up, performed to detect infections and screen for cervical cancers

“CoviSainik program” – A novel public private partnership initiative in the control of COVID-19 in rural India

Background: ”CoviSainik Program” was implemented in collaboration with the Ambuja Cement Foundation and Community Medicine Department in rural districts of eight states of India from May to December 2021 to create a cadre of volunteers. The aim of the present paper is to describe the program and evaluate it so that the findings can be the guiding tool for policymakers to replicate a similar program. Material and Method: A cross-sectional, mixed-method – concurrent study design was adopted to evaluate the program for its short-term outcomes such as gain in the basic knowledge of COVID-19 amongst master trainers and their feedback and program output viz – the proportion of volunteers trained and their profile by census sampling. Motivational factors, experiences of volunteers, and outcomes of COVID-19 work in their villages were explored by purposive with maximum diversity sampling with 62 online in-depth interviews and 8 online focus group discussions (FGDs). Results: There was a statistically significant difference in the pre-test (12.8 ± 5.6) and post-test (25.9 ± 9.3) scores of the Master Training Program evaluation test. Out of 6534 trained volunteers, 5901 worked as volunteers, and amongst those, 47.1%, 35.1%, and 17.8% worked for ≤3 months, 3 to 6 months, and ≥6 months, respectively, in their villages. The major themes generated for motivational factors to join the program were altruism, savior nature, generating awareness, and concern for others. The major outcomes generated by trained volunteers COVID-19 vaccination were in raising awareness on COVID-19 appropriate behavior and early identification of COVID-19 cases in their villages. Conclusion: The “CoviSainik Program” was successful in creating cadres of trained volunteers

Linking HIV & family planning services to improve dual methods of contraception among women infected with HIV in Mumbai, Maharashtra, India

Background & objectives: Preventing unintended pregnancies among people living with HIV (PLHIV) is one of the strategies of WHO for preventing parent-to-child transmission (PPTCT). Given the limitation of only condom use, the objective of this study was to improve use of dual contraceptive methods among HIV infected women. Methods: An experimental study among HIV positive women was conducted at two tertiary care level hospitals in Mumbai. Linking HIV with family planning services was the focus of intervention at one site and standard level of care was maintained at the control site. At each site, 150 HIV+ve women attending counselling and testing centres, who did not intend to get pregnant in the next one year and were eligible to use dual methods, were enrolled and followed up to one year. Results: At the end of one year, 60 per cent women in the intervention group reached Family Planning centres compared to eight per cent in the control group. There was three times more acceptance and continuation of use of dual methods along with increase in consistent use of condoms and less number of unplanned pregnancies in the intervention group than the control group. Interpretation & conclusions: The study findings demonstrate that linking HIV and family planning services may facilitate the uptake of dual methods of contraception without reducing consistent condom use among HIV infected women. The PPTCT programmes need to focus on the component of Prong 2 of PPTCT which aims to prevent unintended pregnancies among HIV positive women

The importance of husbands\u27 engagement in family planning discussion to promote contraception use for birth spacing in rural India

The objective of this study is to assess whether recent marital discussion on family planning is associated with contraceptive use among young couples residing in rural Maharashtra, India. The study methods used involved analysis of baseline data collected from 867 couples participating in the CHARM Family Planning evaluation trial. Participants were surveyed on demographics, contraceptive behaviour, and a six-item scale on marital discussions concerning family planning (including family size and contraceptive use) over the preceding six months. Multivariate logistic regression analysis assessed associations between marital family planning discussions and current modern contraceptive use for birth spacing, adjusting for demographics. The results revealed that 22.0 per cent of women reported current use of modern contraceptives for birth spacing. Nearly half (46.4 per cent) of women reported ‘high marital family planning discussion,’ based on a median split dichotomizing the scale as high or low. Women who reported ‘high discussion’ on family planning compared to those with ‘low discussion’ were seven times more likely to use modern contraceptives for birth spacing (45.4 per cent 9.8 per cent; adjusted odds ratio = 7.1, 95 per cent, confidence interval = 4.9 – 10.3). In conclusion, the findings support promotion of marital family planning counselling to improve contraceptive use among young rural married couples

Understanding men\u27s elevated alcohol use, gender equity ideologies, and intimate partner violence among married couples in rural India

Qualitative evidence suggests that husbands’ inequitable gender equity (GE) ideologies may influence associations between husbands’ alcohol use and intimate partner violence (IPV) against wives. However, little quantitative research exists on the subject. To address this gap in the literature, associations of husbands’ elevated alcohol use and GE ideologies with wives’ reports of IPV victimization among a sample of married couples in Maharashtra, India, were examined. Cross-sectional analyses were conducted using data from the baseline sample of the Counseling Husbands to Achieve Reproductive Health and Marital Equity (CHARM) study. Participants included couples aged 18 to 30 years (N = 1081). Regression models assessed the relationship between husbands’ elevated alcohol use and GE ideologies (using the Gender-Equitable Men [GEM] Scale) and wives’ history of physical and/or sexual IPV victimization ever in marriage. Husbands and wives were 18 to 30 years of age, and married on average of 3.9 years (SD ± 2.7). Few husbands (4.6%) reported elevated alcohol use. Husbands had mean GEM scores of 47.3 (SD ± 5.4, range: 35–67 out of possible range of 24–72; least equitable to most equitable). Approximately one fifth (22.3%) of wives reported a history of physical and/or sexual IPV. Wives were less likely to report IPV if husbands reported greater GE ideologies (adjusted odds ratio [AOR]: 0.97, 95% CI [0.95, 0.99]), and husband’s elevated alcohol use was associated with increased risk of IPV in the final adjusted model (AOR: 1.89, 95% CI [1.01, 3.40]). Findings from this study indicate the need for male participation in violence intervention and prevention services and, specifically, the need to integrate counseling on alcohol use and GE into such programming