ABSTRACT
Background: India has launched Ayushman Bharat Digital Mission (ABDM), to provide an integrated digital health infrastructure. The success of digital health systems lies in their ability to achieve universal healthcare and incorporate all levels of disease prevention. The objective of this study was to develop an expert consensus on how Community Medicine (Preventive and Social Medicine) can be integrated into ABDM. Methods: A total of 17 and 15 participants, who were Community Medicine professionals with more than 10 years experience in the Public Health Sector and/or Medical Education in various parts of India, participated in round 1 and 2 of this Delphi study respectively. The study explored three domains: 1. Advantages and challenges of ABDM, and possible solutions; 2. Intersectoral convergence in Unified Health Interface (UHI) and 3. Way ahead in medical education and research. Results: Participants envisaged improved accessibility, affordability, and quality of care due to ABDM. However, awareness generation, reaching out to marginalized populations, human resource constraints, financial sustainability, and data security issues were anticipated challenges. The study identified plausible solutions addressing six broad challenges of ABDM and classified them based on the priority of implementation. Participants listed out nine key roles of Community Medicine professionals in digital health. The Study identified about 95 stakeholders who play direct and indirect roles in public health and can be connected to the general public through the Unified Health Interface of ABDM. Further, the study explored the future of medical education and research in the digital era. Conclusion: The Study contributes to broadening the scope of India's digital health mission, with elements of Community Medicine in its cornerstone.
ABSTRACT
Objective: In 2020, the world came to a standstill due to the havoc created by severe acute respiratory syndrome coronavirus-2. The onus of tackling the disease relies largely on healthcare workers. However, other members of society, such as police personnel and sanitary workers, also made a major contribution in disease prevention. Despite working relentlessly, they face stigma caused by misconceptions and false information that create a health gap. This study aimed to determine the level of stigma and discrimination against coronavirus disease-2019 (COVID-19) warriors, understand its effects, and assess the community perception of the causes of stigmatization. Methods: A cross-sectional study was conducted for 6 months. The sample size was time-bound, and a mixed method of sampling was employed. A total of 78 COVID-19 warriors and 68 participants from the community were enrolled. Stigma assessment was based on four domains: anticipated stigma, experienced stigma, internalized stigma, and disclosure concerns. Relevant tests of significance were applied, and the data are presented in percentages and ratios. Results: Of the participants, 46.1% were in the age group of 30-40 years, 47% were males, and 81% were doctors by profession and were engaged in a minimum of 6-12 h of duty for 2 weeks. Of the study population, 85.5% had anticipated stigma, whereas 72.2% had experienced stigma, 43.4% had internalized stigma, and 76.3% had disclosure concerns. Internalized stigma was found to be significantly associated with age (p<0.05) and personal attributes (p<0.05). Of the community participants, 47.1% had a doctor in their neighborhood, and contracting COVID-19 was the primary concern of 44.1% due to the presence of a COVID-19 warrior in their vicinity. Other concerns, such as having to take extra precautions and social distancing being compromised, were also reported. Conclusions: A significant level of stigma was experienced by COVID-19 warriors, causing a negative impact on their mental well-being.
ABSTRACT
Danger signs of pregnancy are warning signs that women encounter during pregnancy, child birth and post-partum period. It is important, to know these warning signs for women and health care providers to rule out serious complications and initiate treatment immediately. OBJECTIVES: 1. To assess the awareness of danger signs of pregnancy among pregnant women attending antenatal care in Nandagudi PHC. 2. To give health education to the pregnant women about the risk factors and danger signs. METHODOLOGY: A cross sectional study was conducted in PHC, Nandagudi , field practise area of MVJMC and RH. Study was carried out from September 2017 to November 2017. A total of 210 pregnant women who attended the ante natal clinic at PHC, Nandagudi were the study subjects. A pre designed pretested questionnaire was used. Data collected was thus entered in M S excel and was analysed using SPSS 21 version. RESULTS: 60% of the study population belonged to the age group 23-27. Majority (90%) of them knew the importance of iron and folic acid. 72% of the cases knew the importance of blood group in pregnancy. Majority (91%) preferred hospital delivery compared to home delivery (9%). All 210 women knew about only 3 danger signs, they are bleeding per vagina, loss of consciousness and convulsions. CONCLUSION: Every pregnant woman faces the risk of sudden, unpredictable complication that could end in death or injury to herself or to her infant. Hence, it is necessary to employ strategies to overcome such problems as they arise.
ABSTRACT
BACKGROUND: Active case finding (ACF) for tuberculosis (TB) is a promising tool to enhance early case detection among marginalized populations. As opposed to passive case finding, it involves systematically searching for TB in individuals who would not spontaneously present for care. The National TB Program (NTP) of India has initiated ACF for TB through the existing general health system since the end of 2017. However, prior to scale-up, there is need for exploring the implementation challenges and solutions to improve the efficiency of this program. OBJECTIVES: (1) To explore the enablers and challenges in the implementation of ACF for TB by NTP in the Bengaluru rural district of Karnataka, South India, and (2) to explore the perceived solutions to improve the efficiency of ACF activity. METHODS: A qualitative descriptive study was conducted in the Bengaluru rural district during July 2018. In-depth interviews using purposively selected health care providers involved in active case finding (n = 9) and presumptive TB patients (n = 9) and presumptive TB patients (. RESULTS: The challenges in conduct of ACF were as follows: inadequate training of health care workers, shortage of staff, indifferent attitude of community due to stigma, lack of awareness about TB, illiteracy, inability to convince patients for sputum test, and delay in getting CBNAAT results. The field staff recommended the installation of mobile CBNAAT machine, involvement of general health staff in activity, training of health workers on counseling of patients, and issue of identity cards for community health workers/volunteers so that people recognize them. CONCLUSION: The health system challenges in conduct of ACF need to be addressed by training the health staff involved in activity and also improving the access to TB diagnostics.
ABSTRACT
BACKGROUND: In India, the number of new breast cancer cases is about 115,000 per year and this is expected to rise to 250,000 new cases per year by 2015. It needs to be noted that breast cancer is leading in the age groups of 15-34 years which is a cause of concern as this denotes the need for educative and awareness programs targeting younger members of the society, to implement early practices of breast examination. This study was carried out with the intention of assessing the level of knowledge and awareness of carcinoma breast and breast self-examination (BSE) in female college students. MATERIALS AND METHODS: This cross-sectional study was carried out in a well-known basic sciences college. After the pretest questionnaire was given, an awareness talk was given about breast cancer and BSE. A posttest questionnaire was administered. The data of pre- and post-test were collected and analyzed using SPSS. RESULTS: Pretest and posttest were collected from 1030 students. The age of the study participants was ranged between 18 and 23 years. Most of them were aware of breast carcinoma, but half of them thought breast cancer affects the elderly. Regarding different aspects studied, 58% had a knowledge of at least one of the symptoms and 59% knew at least one of the risk factors for breast carcinoma. Only 185 (18%) women knew about BSE and 107 women practice it. CONCLUSIONS: This study concluded that the awareness of the breast cancer was good but the knowledge of signs and BSE was poor, which is utmost important for early detection and in reduction of mortality.
