Cost of implementing the QualityRights programme in public hospitals in Gujarat providing mental healthcare

Background & objectives: Investment in mental health is quite meagre worldwide, including in India. The costs of new interventions must be clarified to ensure the appropriate utilization of available resources. The government of Gujarat implemented QualityRights intervention at six public mental health hospitals. This study was aimed to project the costs of scaling up of the Gujarat QualityRights intervention to understand the additional resources needed for a broader implementation. Methods: Economic costs of the QualityRights intervention were calculated using an ingredients-based approach from the health systems’ perspective. Major activities within the QualityRights intervention included assessment visits, meetings, training of trainers, provision of peer support and onsite training. Results: Total costs of implementing the QualityRights intervention varied from Indian Rupees (?) 0.59 million to ? 2.59 million [1United States Dollars (US $) = ? 74.132] across six intervention sites at 2020 prices with 69-79 per cent of the cost being time cost. Scaling up the intervention to the entire State of Gujarat would require about two per cent increase in financial investment, or about 7.5 per cent increase in total cost including time costs over and above the costs of usual care for people with mental health conditions in public health facilities across the State. Interpretation & conclusions: The findings of this study suggest that human resources were the major cost contributor of the programme. Given the shortage of trained human resources in the mental health sector, appropriate planning during the scale-up phase of the QualityRights intervention is required to ensure all staff members receive the required training, and the treatment is not compromised during this training phase. As only about two per cent increase in financial cost can improve the quality of mental healthcare significantly, the State government can plan for its scale-up across the State.

Referral Of Patients With Chest Symptoms From Adult Out-Patient Department To Designated Microscopy Centre In A Medical College Hospital Of Kolkata

Background: Referral for microscopy plays a crucial role in case identification for pulmonary tuberculosis. Objectives: The study was conducted to assess the proportion of referral to designated microscopy centre. Methods: A cross–sectional study among 100 chest symptomatic willing patients attending adult medical outdoor department was done. Interview and prescription auditing were data collection method to assess referral. Statistical analysis was done through Epi–Info program. Results: Mean age of the patients was 41.21 years. Co–morbidity (16%) & history of contact (6%) was evaluated. Only cough, both cough and chest pains were the predominant symptoms among 39 percent, 51 percent of patients respectively. Significant amount of patients (73.58%) had no idea for duration of chest pain. Associated symptoms were low grade fever (60%), weight loss (13%). Time–interval for care–seeking was found by < 4 weeks (41%), > 4 weeks (19%), at 8 weeks (21%) and at 1st day (19%). Chest symptomatics were referred to Designated Microscopy Centre (11%) in significantly lower than referred to chest department (92%). Conclusion: The chest symptomatics were not referred to DMC at the proposed level. A sizable number of patients (21%) attended hospital for health care services after a long interval (8 weeks). Implications: Sensitization of doctors on the program protocol is required to overcome the poor situation of referral to Designated Microscopy Centre.

Spectrum of visual impairment among urban female school students of Surat.

Aim: Eye morbidities with or without symptoms delineate a significant morbidity among adolescent schoolgirls in India. The study was undertaken to assess the extent of visual impairment and ocular morbidity to identify influencing factors and the impact on scholastic performance. Materials and Methods: A population-based cross-sectional study was undertaken among 3002 urban girl students of Surat in Gujarat, India. Overall prevalence of refractive error was found to be 15.22%; myopia affected 91.47%, hyperopia 4.60%, and astigmatism 0.04%. The prevalence of myopia and astigmatism was more in higher age groups, while hyperopia was more in lower age groups; even students with good vision reported ophthalmic symptoms. Of all spectacle users, in 29.73% cases the eyesight was not found to be with the best possible corrections. Refractive error was observed to be higher among the general caste (50.98%) and among Muslims (54.05%). Still, among those with problems of eyesight, 75.93% students had good academic performance. Associated ocular morbidity was noted in 20.35% participants along with the refractive error. Conclusion: This study highlighted the load of eye morbidities of adolescent Indian urban girls.

PCR-based detection of microcystin-producing cyanobacterial blooms from Central India.

Microcystin synthetase-gene-specific primers were used to identify hepatotoxic microcystin producing genotypes in six Microcystis spp.-dominant water blooms. Four blooms gave positive PCR reaction. They produced microcystin-RR and -LR amounting to 0.037 to 0.095% of the dry mass.