ABSTRACT
Background & objectives: Studying vaccine hesitancy is important for helping improve vaccine coverage against COVID-19. The objective of this study was to assess the prevalence and correlates of COVID-19 vaccine hesitancy in a rural community in India. Methods: A cross-sectional study of all adults aged over 18 yr was undertaken during July-August 2021, in a village outside Bengaluru city in southern India. Results: In our study, 68.7 per cent of the eligible 297 adult population accepted vaccination immediately, another 9.4 per cent hesitated but accepted vaccination without delay, a further 10.4 per cent delayed their vaccination and the remaining 11.5 per cent refused vaccination. The prevalence (95% confidence interval) of vaccine hesitancy was 21.9±4.8 per cent. Full vaccination was higher among males (76%) compared to females (58%, P<0.001). Those who hesitated and delayed vaccination (converts) were more likely to be from a nuclear family, whereas those who refused the vaccine were from a joint/three-generation family. Those who refused vaccination were adversely influenced by social media predominantly as also their religious/cultural beliefs and distrust on the pharmaceutical industry. Those who delayed but accepted vaccination were positively influenced by healthcare professionals and others who had accepted the vaccine recently. Geographic factors, cost of vaccine, and mode of administration were not the major concerns. Interpretation & conclusions: Vaccine uptake is a continuum. Our study helped identify the characteristics of those who delayed vaccination versus those who refused vaccination. This will help policymakers, programme managers and healthcare professionals to focus priority action on population subgroups for improving individual- and population-level protection.
ABSTRACT
Background. Studies investigating secular changes in tobacco use are rare in India. We estimated self-reported prevalence of tobacco use, across a 5-year interval, among medical students in Bengaluru, India. Methods. We did two cross-sectional studies during 2007 and 2013 among third year undergraduate medical students of four medical colleges in Bengaluru. A self-administered questionnaire was used to elicit information on tobacco smoking and chewing. Results. The participation rates were 82% (323/395) in 2007 and 78% (253/324) in 2013 (p=0.2). Among males, there was no statistically significant change in prevalence of current smoking (3.5% [6/172] in 2007 to 8.9% [12/ 135] in 2013 [p=0.053]); experimental use of tobacco had however increased from 24% (41/172) in 2007 to 42% (56/135) in 2013 (p=0.001). Similarly among females, experimental use was reported by 3.3% (5/151) in 2007 and 11.2% (13/116) in 2013 (p=0.01). Current smoking among female students was <1% in both the study years. Reported current chewing levels remained unchanged among males, 1.8% (2/171) and 3.7% (5/135) (p=0.2) and fell from 4% (6/146) in 2007 to 0% in 2013 among females (p=0.04). Conclusion. There was no increase in current smoking or chewing of tobacco but there was an increase in experimental smoking among male and female medical students in this southern Indian city. Schools and colleges must include tobacco control education in their curriculum. Natl Med J India 2016;29:274–6
ABSTRACT
About 700,000 Accredited Social Health Activists (ASHA) have been deployed as community health volunteers throughout India over the last few years. The objective of our study was to assess adherence to selection criteria in the recruitment of ASHA workers and to assess their performance against their job descriptions in Karnataka state, India. A cross-sectional survey, using a combination of quantitative and qualitative methods, was undertaken in 2012. Three districts, 12 taluks (subdistricts), and 300 villages were selected through a sequential sampling scheme. For the quantitative survey, 300 ASHAs and 1,800 mothers were interviewed using sets of structured questionnaire. For the qualitative study, programme officers were interviewed via in-depth interviews and focus group discussions. Mean±SD age of ASHAs was 30.3±5.0 years, and about 90% (261/294) were currently married, with eight years of schooling. ASHAs were predominantly (>80%) involved in certain tasks: home-visits, antenatal counselling, delivery escort services, breastfeeding advice, and immunization advice. Performance was moderate (40-60%) for: drug provision for tuberculosis, caring of children with diarrhoea or pneumonia, and organizing village meetings for health action. Performance was low (<25%) for advice on: contraceptive-use, obstetric danger sign assessment, and neonatal care. This was self-reported by ASHAs and corroborated by mothers. In conclusion, ASHA workers were largely recruited as per preset selection criteria with regard to age, education, family status, income, and residence. The ASHA workers were found to be functional in some areas with scope for improvement in others. The role of an ASHA worker was perceived to be more of a link-worker/facilitator rather than a community health worker or a social activist.