Key factors influencing public health students and curricula in India: Recommendations from a mixed methods analysis.

BACKGROUND: Building on a distinguished history of community medicine training, public health programs have been expanding in India in recent years. The COVID-19 pandemic has brought additional attention to the importance of public health programs and the need for a strong workforce. This paper aims to assess the current capacity for public health education and training in India and provide recommendations for improved approaches to meet current and future public health needs. METHODS: We conducted a desk review of public health training programs via extensive internet searches, literature reviews, and expert faculty consultations. Among those programs, we purposively selected faculty members to participate in in-depth interviews. We developed summary statistics based on the desk review. For qualitative analysis, we utilized a combination of deductive and inductive coding to identify key themes and systematically reviewed the strengths and weaknesses of each theme. RESULTS: The desk review captured 59 institutions offering public health training across India. The majority of training programs were graduate level degrees including Master of Public Health and Master of Science degrees. Key factors impacting these programs included collaborations, mentorship, curriculum standardization, tuition and funding, and student demand for public health education and careers. Collaborations and mentorship were highly valued but varied in quality across institutions. Curricula lacked standardization but also contained substantial flexibility and innovation as a result. Public sector programs were perceived to be affordable though fees and stipends varied across institutions. Further development of career opportunities in public health is needed. CONCLUSION: Public health education and training in India have a strong foothold. There are numerous opportunities for continued expansion and strengthening of this field, to support a robust multi-disciplinary public health workforce that will contribute towards achieving the sustainable development goals.

Assessing the Knowledge, Attitude and Practices of Students Regarding the COVID-19 Pandemic

Introduction:The coronavirus disease (COVID-19) pandemic has impacted everyone, including students. Accurate information about the disease, its spread, preventive measures and government-issued advisories is critical for containing an outbreak. We evaluated the knowledge, attitudes and practices, and the key behavioural determinants of clinical outcomes, among university students.Materials and methods:We conducted a cross-sectional study among IIHMR University students (31 March to 10 April 2020), soon after the nationwide lockdown in India. Through purposive sampling, we enrolled 529 students, who completed a semi-structured questionnaire (44% completion rate). Knowledge level of the participants was assessed using a scoring system, and chi-squared test andt-test were performed to detect significant (p< 0.05) differences among various groups.Results:More than 70 per cent of students had good knowledge of COVID-19 symptoms, mode of transmission and preventive measures, and 66 per cent knew about treatment approaches. Social media (83%) and TV (77%) were their primary sources of information. Most students showed a willingness to follow social distancing and lockdown guidelines;however, only 27 per cent perceived the risk of infection. Nearly all students reported compliance with government health advisories.Conclusions:We evaluated COVID-19 awareness and impacts of various information sources on effective outbreak containment. Improved community engagement activities and effective communication are needed during widespread disease outbreaks.

COVID-19 Pandemic in Rajasthan: Mathematical Modelling and Social Distancing

Background: Mathematical modelling of epidemics and pandemics serves as an input to policymakers and health planners for preparedness and planning for the containment of infectious diseases and their progression in the population. The susceptible-exposed-infectious/asymptomatic-recovered social distancing (SEIAR-SD) model, an extended application of the original Kermack-McKendrick and Fred Brauer models, was developed to predict the incidence of the COVID-19 pandemic and its progression and duration in the state of Rajasthan, India. Objective: The study aimed at developing a mathematical model, the SEIAR-SD model, of the COVID-19 pandemic in the state of Rajasthan, for predicting the number of cases, progression of the pandemic and its duration. Materials and methods: The SEIAR-SD model was applied for different values of population proportion, symptomatic and asymptomatic cases and social distancing parameters to evaluate the effect of variations in the number of infected persons, size of the pandemic and its duration, with value of other variable constant. Actual reported cases were plotted and juxtaposed on the prediction models for comparison. Results: Social distancing was the crucial determinant of the magnitude of COVID-19 cases, the progression of the pandemic and its duration. In the absence of any proven treatment or vaccine, effective social distancing would reduce the number of infections and shorten the peak and duration of the pandemic. Loosening social distancing will increase the number of cases and lead to a heightened peak and prolonged duration of the pandemic. Conclusions: In the absence of an effective treatment or a vaccine against COVID-19, social distancing (lockdown) and public health interventions-case detection with testing and isolation, contact tracing and quarantining-will be crucial for the prevention of the spread of the pandemic and for saving lives.

Personal Protective Equipment: Challenges and Strategies to Combat COVID-19 in India: A Narrative Review

The current outbreak of the coronavirus disease (COVID-19) has become a pandemic. All COVID-19-affected countries in the world are implementing containment interventions and trying their best to fight against the disease to halt the further spread of the infection and to reduce mortality. The public health workforce and healthcare staff in clinical settings are playing a crucial role in the early detection of cases, contact tracing and treatment of patients. The availability of personal protective equipment (PPE) and their consistent, proper use by healthcare providers and public health professionals is a crucial factor in combating any infectious disease in a crisis. The requirement of PPE has exponentially increased, as more and more countries are experiencing the COVID-19 pandemic. The rapid spread of the pandemic has created a temporary shortage of PPE in many countries, including India. The lack of PPE has affected the morale of healthcare workers (HCWs) and other frontline warriors in fighting the coronavirus disease, as more than 22,000 health workers in 56 countries have suffered from COVID-19. Some of them have succumbed to it across all countries, including India (WHO). We have reviewed the available literature to understand the challenges in ensuring adequate availability and consistent use of PPE and the strategies for the rational use of PPE in India. Our study reveals that India has responded swiftly to enhance the accessibility of PPE and put in place strategies for the judicious use of PPE to reduce the incidence of the COVID-19 infection to a bare minimum in healthcare settings. In the present article, we report the current status of COVID-19 among HCWs. We have reviewed the challenges and the surge strategies adopted by India to produce or procure good-quality PPE and supply it to all service delivery points in adequate quantities.