Journal of Family Medicine and Primary Care最新文献

{"title":"Impact on maternal mental health on infants development: A narrative review.","authors":"Pravisha Devgade, Manoj Patil","doi":"10.4103/jfmpc.jfmpc_1052_23","DOIUrl":"10.4103/jfmpc.jfmpc_1052_23","url":null,"abstract":"<p><p>Mental health problems among expectant mothers and new mothers are important yet neglected health problems that significantly raise maternal and child morbidity and death in India. The mental health and well-being of parents have an impact on the growth and development of their children. Maternal depression during pregnancy and after delivery reduces the chance that a child survives since it signals that the baby will grow slowly and have a higher chance of developing diarrhea. More specifically, depression, one of the most common causes of disease-related limitation in women, not only impacts the women but also has an adverse effect on their children. This may impair a mother's capacity to care for her children, increasing the possibility that the kids will suffer from sickness, malnutrition, delayed development, and mental problems that could linger into adulthood. Reduced child growth has adverse effects on short-term and long-term effects on non-communicable illness risks, learning capacity, working ability, academic achievement, brain development, and non-communicable disease risks.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 5","pages":"1584-1588"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decadal trends of maternal mortality and utilization of maternal health care services in India: Evidence from nationally representative data.","authors":"Ravleen Kaur Bakshi, Neeta Kumar, Arti Srivastava, Sonam Kumari, Pradeep Aggarwal, Md Asif Khan, Khangembam Jitenkumar Singh","doi":"10.4103/jfmpc.jfmpc_916_24","DOIUrl":"10.4103/jfmpc.jfmpc_916_24","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The Sustainable Development Goals (SDGs) aim to reduce the global maternal mortality ratio (MMR) to less than 70 maternal deaths per 100,000 live births by 2030. In India, the MMR has significantly declined over the years and currently stands at 97 per 100,000 live births. Despite this achievement, accurately estimating maternal mortality remains a challenge, mainly because of incomplete records of maternal deaths and their causes. This study aims to review national trends in maternal mortality, using data from the Sample Registration System (SRS) and National Family Health Survey (NFHS). Additionally, it explores the relationship between improvements in the utilization of maternal healthcare services and their impact on reducing maternal mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;The study examines trends in maternal mortality using nationally available datasets such as the SRS, NFHS, National Sample Survey, and government administrative records. These publicly available sources provide insight into maternal healthcare utilization patterns over time. Key indicators analyzed include antenatal care (four or more visits), skilled birth attendance, and postnatal care utilization. Additionally, secondary sources like the World Health Report were reviewed for historical context.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;India has achieved a remarkable decline in MMR over the past three decades, dropping from 570 maternal deaths per 100,000 live births in 1990 to 103 in 2019-2020 and further to 97 in 2023. Historically, the MMR was much higher, with 1,287 maternal deaths per 100,000 live births recorded in 1957. The following decades witnessed a steady reduction: 1,355 in 1960, 892 in 1970, 437 in 1991, 327 in 2000, 212 in 2009, and 130 in 2015. A recent decline of 8.8% was observed between 2016 and 2018 (MMR: 113) and 2020 (MMR: 103). Concurrently, maternal healthcare utilization demonstrated significant improvement, with upward trends in antenatal care, institutional deliveries, and postnatal care across the country.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The consistent decline in India's MMR is because of improvements in socioeconomic conditions, healthcare infrastructure, and public health initiatives such as Janani Suraksha Yojana and Pradhan Mantri Surakshit Matritva Abhiyan. Enhanced transport networks, mobile communication, and rural infrastructure have improved access to maternal care, while grassroots workers such as Accredited Social Health Activists have strengthened antenatal and postnatal service delivery. However, direct obstetric causes like hemorrhage, infection, and sepsis still significantly contribute to maternal deaths. Achieving the SDG target of 70 maternal deaths per 100,000 live births by 2030 requires addressing regional disparities, strengthening health systems, and overcoming resource constraints. Closing gaps in maternal healthcare utilization and fostering collaboration among stakeholders i","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 5","pages":"1807-1817"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing health education to connect subject learning to real life: A pilot study for junior high school students.","authors":"Sae Nakaoka, Hiromi Kawasaki, Satoko Yamasaki, Sayo Mukaishima, Risako Sakai, Yuan Li, Zhengai Cui","doi":"10.4103/jfmpc.jfmpc_1540_24","DOIUrl":"10.4103/jfmpc.jfmpc_1540_24","url":null,"abstract":"<p><strong>Context: </strong>Family physicians find it difficult to choose correct words when explaining children's symptoms and treatments.</p><p><strong>Aims: </strong>The aim of this study is to demonstrate the cross-curricular nature of health education using a case study on its implementation for junior high school students. Through this study, the potential of health education is examined to realize a method that enables students to apply what they learn in school to real-life situations. Family physicians can tailor instructions to junior high school students' learning stages.</p><p><strong>Materials and methods: </strong>This theme focused on blood pressure, which varied among junior high school students. A total of 105 junior high school students received health education and provided valid responses.</p><p><strong>Results: </strong>Mean scores in the cognitive domain were 9.3 before, 17.4 immediately after, and 11.6 one year after the education and given. Mean scores in the affective domain were 14.4, 16.3, and 15.0, respectively. Mean psychomotor domain scores were 11.7, 15.7, and 12.8, respectively. The scores increased significantly, indicating the effectiveness of education. Science and mathematics covered several units of health education. Health education intended to be relevant to the subject matter used learning content to explain bodily processes in an easy-to-understand way.</p><p><strong>Conclusions: </strong>The study concludes that health education has value in making explicit links between subject learning and real-life applications. It enables students to gain knowledge and effectively apply subject learning to everyday situations. As family physicians will understand junior high school students' learning and tailoring instructions, they can prompt children to take care of their health.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 5","pages":"1781-1787"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparation and validation of skim milk-based method for preservation of bacterial strain at resource-limited setup.","authors":"Sahjid Mukhida, Shazia Chavan, Vishal Pandya, Jaydev Pandya","doi":"10.4103/jfmpc.jfmpc_1626_24","DOIUrl":"10.4103/jfmpc.jfmpc_1626_24","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>To ensure quality control, microbiology laboratories should maintain a variety of bacterial and fungal strains. Once cultivated, these organisms can survive on the media as long as nutrients are available. Skim milk, a common freeze-drying protectant, can be used as a freezing solution for bacteria at low temperatures. The aim of this study was to prepare and validate a skim milk solution for bacterial strain storage.</p><p><strong>Methods: </strong>A 10% skim milk solution was prepared and stored into 2-3 ml aliquots in sterile plastic vials. Subcultured organisms were inoculated into vials and stored at -20°C in a deep freezer. We checked the quality of the bacterial strains at regular intervals: 7 days, 15 days, 1 month, 2 months, and 3 months. Each time, a subculture was performed from the same vial to check the characteristics of the bacterial strain. All characteristics were recorded in the study Performa until the study's completion.</p><p><strong>Results: </strong>A total of 15 strains, including Gram-positive cocci, Gram-negative bacilli, and yeast strains, were included in the study. At all subculture times, organisms grew properly and exhibited similar colony characteristics. No changes were observed in the subculture from the first to the last inoculation of the bacterial organisms. Biochemical tests were conducted every time a subculture was performed to check for variations in properties, which were found to be consistent over time.</p><p><strong>Conclusion: </strong>The skim milk solution offers an effective method for storing, maintaining, and reviving bacterial strains, for up to 3 months. This approach significantly reduces the labor-intensive work associated with regular subculture methods used for storing or reviving bacterial strains.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 5","pages":"1833-1842"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensorineural deafness in a child with Prader-Willi Syndrome-A rare case report.","authors":"Pratiksha Saikrishna, Saroj Kumar Tripathy, R G Medhagopal, Sarthak Das, Bhartendu Bharti, Archana Malik","doi":"10.4103/jfmpc.jfmpc_1867_24","DOIUrl":"10.4103/jfmpc.jfmpc_1867_24","url":null,"abstract":"<p><p>Prader-Willi syndrome (PWS) is a genetic condition, predominantly of sporadic origin, associated with chromosomal abnormalities involving the long arm of chromosome 15, specifically the q11-13 region. Of note, the STRC gene, located on chromosome 15q15.3, is implicated in congenital sensorineural hearing loss, primarily affecting the inner hair cells of the cochlea, and typically results in mild to moderate hearing impairment. In our case, the patient presented with unilateral profound hearing loss, predominantly involving the neural component-a unique finding not previously documented in the literature. Whether hearing impairments are an intrinsic feature of PWS or merely a coincidental association remains unclear. While routine monitoring in PWS typically focuses on growth, vision, sleep, developmental milestones, and endocrine function, auditory screening in asymptomatic children is often overlooked. This case underscores the need for further investigation into hearing issues in individuals with PWS.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 5","pages":"2078-2080"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on external consistency of health management information system data at district level across India.","authors":"Nandhakumar Nachimuthu, R Uma Maheswari, Damodaran Vasudevan","doi":"10.4103/jfmpc.jfmpc_1967_24","DOIUrl":"10.4103/jfmpc.jfmpc_1967_24","url":null,"abstract":"<p><strong>Background: </strong>The WHO has provided toolkit for data quality review of Health Management Information System (HMIS) data, with external consistency of coverage rate being one dimension.</p><p><strong>Objective: </strong>To assess the level of external consistency of HMIS data compared with National Family Health Survey-5 (NFHS-5) data at district level across India.</p><p><strong>Methods: </strong>We used secondary data on health service delivery indicators across districts at meso-level collected from HMIS and NFHS-5 website. We collected data on 7 indicators: Mothers registered within trimester I, mothers with at least 4 antenatal visits, mothers last birth protected against tetanus, institutional births, births delivered by Caesarean section, sex ratio at birth, and pregnant women aged 15-49 years who are anaemic. We evaluated the agreement between HMIS and NFHS data for the above indicators using Pearson's correlation co-efficient, intraclass correlation coefficient, and Bland-Altman plot.</p><p><strong>Results: </strong>Data were available from both HMIS and NFHS-5 for 695 districts for the above indicators, except for pregnant women with anaemia, for whom data were available for 564 districts. Pearson corelation co-efficient showed a strong correlation between the two datasets for institutional births and delivery by caesarean section, while weak to moderate correlations were observed for the other indicators. Intraclass correlation coefficient showed discordance between the two datasets, and poor agreement was observed between the data for sex ratio at birth and mothers with at least 4 antenatal visits in Bland-Altman plot.</p><p><strong>Conclusion: </strong>Poor agreement was observed between HMIS and NFHS data for certain indicators, and steps can be taken to improve the quality of HMIS data for these indicators.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 5","pages":"1985-1991"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-based newborn care program braving the brunt of COVID-19 pandemic: A mixed-method study.","authors":"Poonam Joshi, Aloke Biswas, Bina Halder, Paramita Sengupta, Surya Kant Tiwari","doi":"10.4103/jfmpc.jfmpc_1406_24","DOIUrl":"10.4103/jfmpc.jfmpc_1406_24","url":null,"abstract":"<p><strong>Context: </strong>Maternal and newborn care are crucial in India's public healthcare system, yet high maternal and neonatal mortality rates persist. The home-based newborn care (HBNC) program was introduced to enhance maternal and child healthcare.</p><p><strong>Objectives: </strong>This study compares HBNC services before and during the COVID-19 pandemic until December 2021, focusing on changes in service utilization and challenges faced by accredited social health activist (ASHA) workers.</p><p><strong>Methods: </strong>A mixed-method approach was used in Chakdaha, Nadia district, West Bengal. Quantitative data from 2019 to 2021 were extracted from health records to analyze HBNC indicators, including deliveries, maternal education, breastfeeding rates, and home visits. Qualitative insights were gathered from ASHA workers to explore pandemic-related challenges. Data were analyzed using descriptive statistics and thematic analysis.</p><p><strong>Results: </strong>Over 2019-2021, 556, 621, and 606 deliveries were recorded, respectively. The study highlighted both the positive outcomes and challenges faced by ASHA workers during the pandemic. More than 95% of the infants were breastfed within 24 hours. Health education reached more mothers than deliveries, and ASHA home visits met standards. However, reductions in visits occurred in certain remote geographic areas due to transportation and supply shortages. ASHA workers faced operational challenges, including cultural barriers, increased workload, resource shortages, and logistical constraints affecting service delivery during the COVID-19 pandemic.</p><p><strong>Conclusion: </strong>Despite global disruptions, HBNC services showed resilience in maintaining essential care for neonates and mothers. ASHA workers played a critical role amidst challenges, highlighting the need for ongoing support and resources to sustain HBNC effectiveness amid evolving healthcare landscapes.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 5","pages":"1669-1674"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormonal influences on thermotactile threshold, pain perception threshold and tolerance: A digital thermoaesthesiometer study.","authors":"Punam Verma, Priti Bhanderi, Hitesh A Jani, Bhoopendra Patel, Rupali Parlewar","doi":"10.4103/jfmpc.jfmpc_1847_24","DOIUrl":"10.4103/jfmpc.jfmpc_1847_24","url":null,"abstract":"<p><strong>Objective: </strong>This study was undertaken to compare thermotactile and pain perception thresholds and tolerance in males and females with the help of a digital thermoaesthesiometer. In addition, the influence of the cyclical variation of hormones in the menstrual cycle on these sensory responses was investigated.</p><p><strong>Method: </strong>Two hundred thirty-six healthy subjects (118 males and 118 females) of 18-30 years of age participated in the study. Using the method of limits, hot thresholds and cold thresholds with pain perception and pain tolerance were measured on the index and little fingers of the right and left hand using a digital thermoaesthesiometer.</p><p><strong>Result: </strong>Findings revealed statistically significant variations in these responses based on gender and the side of the body. Females are more sensitive to thermal sensation by having a lower thermotactile threshold. They have significantly higher sensitivity and pain tolerance during the luteal phase of the menstrual cycle.</p><p><strong>Conclusion: </strong>These results contribute to a deeper understanding of individual differences in sensory perception and have implications for clinical applications.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 5","pages":"1896-1903"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kerala's public healthcare services: Bihar's blueprint for post-COVID-19 resilience.","authors":"Rajani Mol, Bawa Singh, Vijay Kumar Chattu","doi":"10.4103/jfmpc.jfmpc_1800_24","DOIUrl":"10.4103/jfmpc.jfmpc_1800_24","url":null,"abstract":"<p><strong>Background and aim: </strong>The COVID-19 pandemic has exposed the vulnerability of the healthcare system in the Indian states. The pandemic has revealed the appalling lack of preparedness of the Indian states, as well as their inadequate public health systems, structural weaknesses, and gaps in the implementation of welfare programs. States like Kerala have well-managed healthcare services during COVID-19, and Kerala has a decentralized health model that provides affordable, accessible, and responsive healthcare to its population. On the other hand, Bihar has been struggling to provide basic health facilities to the state population and exposed the lackluster performance of the health sector. The paper primarily focuses on analyzing Bihar's health issues and suggesting ways the state might improve its health while implementing Kerala's healthcare model.</p><p><strong>Methods: </strong>A detailed search and analysis of health status and health care in these two states was done using major databases, such as Web of Science, Medicine/PubMed, Scopus, OVID, and Google Scholar search engines.</p><p><strong>Results: </strong>Bihar has been facing structural and functional deficiencies in the public health system, making it inadequate for handling the future healthcare needs of the people. However, Bihar can ensure no one is left behind by the law, which will help to maintain equality among the people.</p><p><strong>Conclusion: </strong>Therefore, Kerala's healthcare service and public policies, such as the public health Act, are role models for Bihar. The paper concludes that Kerala's public healthcare system offers strong health sector infrastructure and policy frameworks, effectively demonstrated by its impressive health indicators.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 5","pages":"1973-1979"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mix methodology study to compile the factors contributing towards poor uptake of antiretroviral therapy among high-risk groups: Female sex workers, people with intravenous drug use on opiod substitution therapy.","authors":"Debjani Sengupta, Archi Chandra, Upasana Poddar, Rahul Biswas, Pramit Ghosh, Arkaprovo Pal, Sandipta Chakraborty, Debjani Guchait","doi":"10.4103/jfmpc.jfmpc_1533_24","DOIUrl":"10.4103/jfmpc.jfmpc_1533_24","url":null,"abstract":"<p><strong>Background: </strong>Biobehavioral surveys confirm that HIV prevalence is high or 'concentrated' among 'key populations' (KPs) who have unprotected sexual contacts with multiple partners or who engage in injecting drug use. These populations include female sex workers (FSW), men who have sex with men (MSM), hijra/transgender (TG), and people who inject drugs (PWID). Antiretroviral therapy is offered under the program of National AIDS Control to Seropositive population at the designated center. Other than the stigma of being HIV positive, there is an additional factor present among these groups of people hindering their uptake of antiretroviral therapy.</p><p><strong>Aims: </strong>To identify and quantify the factors causing poor uptake of ART (antiretroviral therapy) among high risk group of subjects receiving antiretroviral therapy, namely, female sex workers (FEW) and intravenous drug users (IDU). A concurrent parallel design of mixed methodology was conducted with integration of the two arms at analysis.</p><p><strong>Material and method: </strong>The quantitative arm involves a retrospective cohort analysis of group on ART having \"exposure\" defined as <i>high risk behavior for</i> a period of 1 year. High-risk behavior constituted of exposure involved in commercial sex work and those exposed to intravenous drug usage. The comparator arm was sex-matched cohort who were sero-positive and on ART but did not have an \"exposure\" to defined high-risk behavior practice for a period of 1 year. The qualitative arm constituted of development of a grounded theory based on thematic analysis from coded transcripts.</p><p><strong>Result: </strong>Time taken to travel and expenditure incurred therein added with long waiting time compounded with loss of daily wage (reiterated in both arms) emerged to be the most prominent factor.</p><p><strong>Conclusion: </strong>Monetary incentive for travel, single window service rapid service and process to access drugs from any center (via a central registration system if possible) may be useful.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"14 5","pages":"1657-1661"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}