ABSTRACT
Background: Essential health services including immunization were significantly impacted due to COVID-19 with devastating outcomes in low- and middle-income countries (LMIC). The disruption in immunization services due to global pandemic and measures undertaken at regional levels to overcome need to be studied as pandemic preparedness strategy. Objective: To document the contextual narratives related to immunization services during the Covid-19 disease outbreakby interviewing qualified paediatricians in the field practice area of private tertiary care teaching medical college Methodology: In-depth phone-based interviews were conducted with paediatricians in diverse settings during November 2020 to March 2021. Reflexive thematic analysis was performed, major themes identi-fied, and case studies documented. Results: Paediatricians shared rich experiences related to immunization services impacted due to COVID-19 especially during the earlier months due to imposition of lockdowns leading to discontinua-tion, disruption of services, decrease in volume of immunizations, modest transition to telehealth ser-vice delivery, facility-level changes brought in to ensure immunization services and capacity building measures for upskilling. Conclusions: Contextual narratives revealed in this study provide rich narrative about the disruption of immunization services due to COVID-19. These findings need to be understood and leveraged to be fu-ture ready and prevent further disruptions by identifying and scaling up key solutions piloted in this study.
ABSTRACT
Background:Tobacco harm reduction when advocated by care providers as continuum of care towards the goal of tobacco cessation might result in long-term abstinence than it is currently seen. This study aimed to qualitatively explore the healthcare professionals approach and self-reported practices related to tobacco harm reduction and smoking cessation. Methods: A purposive sample (N=36) of multi-specialty healthcare professionals providing tobacco related cessation services at six private medical teaching institutes were engaged in semi-structured qualitative interviews between July 2020 and October 2020 in Chennai. Results: The results indicated that majority of the healthcare professional抯 lack conceptual understanding about tobacco harm reduction. Harm reduction was practised and nicotine replacement therapy was prescribed by psychiatrists in this study. Majority of the healthcare professionals were found to have misconceptions that promoting harm reducing practices instead of cessation might result in continued addiction to nicotine products among the clientele. Conclusions: The findings reveal that tobacco harm reduction remains an under-utilized clinical practise in Indian setting due to knowledge and awareness gaps among multi-specialty healthcare professionals. Improved sensitization through continuous medical education updates is needed to inform effective clinician-affirmative tobacco harm reduction practices.