Indian Journal of Community Medicine最新文献

{"title":"Public-Private Partnership Model in Delivering Quality Health Care and Medical Education - An Enduring Success Story for the Past Seven Decades.","authors":"Bhaskaran Unnikrishnan, Gurpur Guni Laxman Prabhu, Potti Laxminarayana Gangadhara Rao, Nithin Kumar","doi":"10.4103/ijcm.ijcm_430_24","DOIUrl":"10.4103/ijcm.ijcm_430_24","url":null,"abstract":"<p><p>Public-private partnerships (PPPs) are integral to the National Health Mission (NHM). Kasturba Medical College (KMC), Mangalore, was the first private institution in India to embrace the PPP model way back in 1953. The then Government of Madras permitted KMC Mangalore to partner with the 2 district hospitals - the Government Wenlock and the Lady Goschen Hospitals. For almost seven decades, KMC Mangalore has been using the clinical facilities at District Wenlock and Lady Goschen hospitals to provide quality health care and also train the Undergraduate and Postgraduate students of KMC. The Manipal experiment is a shining example of public-private collaboration to provide quality accessible health care to everyone, which is in line with the Sustainable Development Goal (SDG) 3 and its targets.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"786-790"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819814","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":"Intimate Partner Violence and Mental Health Problems in Married Women in Rural Central India: A Community-based Cross-sectional Study.","authors":"Harshal S Sathe, Chetna H Maliye, Poonam S Varma, Bishan S Garg, Kalyani Shahare, Roshan Rathod","doi":"10.4103/ijcm.ijcm_677_22","DOIUrl":"10.4103/ijcm.ijcm_677_22","url":null,"abstract":"<p><p>Intimate partner violence (IPV) is a significant social issue affecting women in rural India, with deleterious consequences for their physical and mental health. The \"mental health problems and psychosocial factors associated with IPV\" is an under-researched topic in Central India. The cross-sectional observational descriptive study was part of a project aimed at strengthening the health sector response to gender-based violence. Eighty consenting women from 19 villages in a district in Central India, who acknowledged experiencing IPV, participated in the study. A predesigned and pretested sociodemographic questionnaire, the WHO multicountry women's questionnaire, and self-report scales for depression, anxiety, stress, and post-traumatic stress disorder (PTSD) were used to interview the women. The mean age of the respondents was 31.13 ± 6.96 years. The majority of the women (95%) experienced severe physical violence. In addition, a majority of these women simultaneously faced emotional abuse, whereas more than one-third suffered from sexual abuse from their partners. Self-reporting measures showed that nearly two-thirds of the participants had PTSD and moderate-to-severe depression and anxiety. A substantial number of study participants believed that IPV is a private matter for a couple and justified violence if the wife was unfaithful, disobedient, or neglectful of children and household duties. The under-reporting of IPV, presence of misconceptions, and high prevalence of associated mental health problems among IPV-affected women highlight the need for interventions tailored to the needs of battered women.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"866-872"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819809","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":"Telemedicine-Enabled Otoscopes as Catalysts for Accessible and Preventive Ear Health Care: Systematic Review and Meta-analysis.","authors":"Girish Chandra Dash, Krushna Chandra Sahoo, Shubhankar Dubey, Rakesh Kumar Sahoo, Jyotsna Naik, Kavitha Rajsekar, Debdutta Bhattacharya, Sanghamitra Pati","doi":"10.4103/ijcm.ijcm_9_24","DOIUrl":"10.4103/ijcm.ijcm_9_24","url":null,"abstract":"<p><strong>Background: </strong>Maintaining optimal hearing health and preventing ear infections is crucial across all life stages, spanning from before birth and infancy to middle age and beyond. The primary aim of the research was to evaluate and compare the effectiveness of the telemedicine-enabled otoscope (TEO) in diagnosing ear diseases with that of the conventional otoscope.</p><p><strong>Materials and methods: </strong>The databases PubMed, Cochrane, and Embase were thoroughly searched to find original studies on TEO at the community as well as hospital levels along with meta-analysis for comparison with standard diagnostic methods using traditional otoscopes.</p><p><strong>Results: </strong>The telemedicine-equipped otoscope displays a sensitivity of 82% (confidence interval 0.78-0.95) and a specificity of 95% (confidence interval 0.93-0.96). When employed by physicians, the combined sensitivity and specificity become 84% (confidence interval 0.79-0.88) and 91% (confidence interval 0.87-0.94), respectively. Community Health Workers (CHWs) using telemedicine-enabled otoscopes exhibit a collective sensitivity of 80% (confidence interval 0.72-0.87) and a collective specificity of 97% (confidence interval 0.95-0.98). Snapping multiple photographs and removal of cerumen where necessary in increasing the quality of the photographs for diagnosis.</p><p><strong>Conclusions: </strong>The TEO holds the promise of substantially enhancing the accessibility of audiology services, encompassing evaluation, public outreach, and fundamental care. Its implementation has the potential to fortify primary health care environments, contributing to the prevention of ear diseases and assisting in mitigating the shortage of skilled ear care professionals.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"796-804"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819382","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":"To Evaluate Structured Competency-Based Curriculum for Health Programs among Community Medicine Postgraduates: Mixed Method Approach.","authors":"Rashmi Kundapur, Anusha Rashmi, Kumar Guru Mishra, Gunvanti Rathod, Meely Panda, Vikas Bhatia, Shyamala Ravikoti","doi":"10.4103/ijcm.ijcm_66_22","DOIUrl":"10.4103/ijcm.ijcm_66_22","url":null,"abstract":"<p><strong>Background: </strong>The postgraduate curriculum needs to be given a definite shape so as to make health programs more intensive and integrative. In the present scenario, most of the information is unclear and infrequent. A structured public health competency-based education is an important aspect to consider for integrative health care. Evaluate the structured competency-based curriculum (SCBC) prepared on health program matters<i>.</i></p><p><strong>Methods: </strong>Mixed method model involving postgraduate students, faculties in community medicine departments of selected medical colleges and stakeholders from district administration. The SCBC was piloted and validated for use. The evaluation was then done based on pre- and posttest performance analysis, satisfaction survey, and questionnaires for reaction and learning components.</p><p><strong>Results: </strong>For a complete understanding of the program, students had to invest 52 hours of stipulated time. CBC assessment mean scores for a) problems in PHC and programmatic evaluation (78.9%) and b) identification of success and failure of programs (78.2%) were more than 75% mean score; whereas, assessment scores for topics on a) resource allocation and b) evaluation of program as write-up was 65% and 52%, respectively. As compared to the conventional method, the SCBC showed a critical evaluation score of 70% with a 0.001 significance level.</p><p><strong>Discussion and conclusion: </strong>Students' narratives were that they could understand as well as integrate them better on the field. There was enhanced satisfaction and encouragement. Structured curriculum will also help in making learning more student-centric and go a long way in boosting their creativity.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"812-817"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819393","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":"Determination of Direct and Indirect Costs Incurred by Tuberculosis Patients During Diagnosis and Treatment in Urban Areas of South Gujarat: A Mixed Method Approach.","authors":"Rutu Buch, Rahul Damor, J K Kosambiya","doi":"10.4103/ijcm.ijcm_711_22","DOIUrl":"10.4103/ijcm.ijcm_711_22","url":null,"abstract":"<p><p>Though many initiatives and monetary benefits are incorporated under RNTCP/NTEP, many patients might incur some out-of-pocket expenditure (OOP) related to diagnosis, treatment, and hospitalization. Such costs lead to further poverty and default. This study estimated OOP costs. A cross-sectional mixed method study was conducted in 2020. Data were collected from two selected UHCs (both public and private sectors) from all eight administrative zones. A total of 278 newly registered drug-sensitive tuberculosis patients at different stages of treatment were enrolled, and 18 IDIs were done after obtaining the consent. Among 278, 231 (83%) were seeking the treatment from the public sector and 47 (17%) from the private sector. The average direct, indirect, and total costs were Rs. 8812, Rs. 4825, and Rs. 13,637, respectively. Extra food and supplements are the major field of expenditure for those enrolled in the public sector. Higher costs were incurred by the private sector patients. Longer distances, a long waiting time, belief systems, and unavailability of facilities or drugs were the common reasons for not visiting the public sector. IDI results also supported the cost heads. The majority of the expenses occurred at the private settings before diagnosis. IDIs suggested to changes in the programmatic approach toward migrants, industrial workers, and women.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"873-878"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819805","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":"Prevalence and Predictors of Depression Among Drug-Sensitive Tuberculosis Patients - A Cross-Sectional Study.","authors":"Deepak Sharma, Naveen K Goel, Ajeet Sidana, Kawaljeet S Sandha, Mamta Bishnoi","doi":"10.4103/ijcm.ijcm_167_23","DOIUrl":"10.4103/ijcm.ijcm_167_23","url":null,"abstract":"<p><strong>Background: </strong>According to World Health Organization, India is a high tuberculosis (TB) and depression burden state. The risk of depression is higher among TB patients. Therefore, it is vital to focus on the mental well-being of TB patients.</p><p><strong>Objective: </strong>The present study aimed to determine the prevalence and predictors of depression among drug-sensitive TB patients in Chandigarh city.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 305 TB patients. Trained investigators administered Patient Health Questionnaire 9 to screen for depression. Data analysis was done using Epi info software for windows.</p><p><strong>Results: </strong>The prevalence rate of depression among drug-sensitive TB patients was 7.2%. Current nonworking individuals were more likely to be depressed than their counterparts (OR = 3.7 (1.2-10.9)).</p><p><strong>Conclusion: </strong>Around one-tenth of the TB patients were suffering from depression. This necessitates physicians to regularly screen TB patients for depression and manage accordingly, which will help improve treatment adherence and outcome.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"879-882"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819813","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":"Verification of Sub-national Claim for 'TB-free' Status of Rajsamand District, Rajasthan, India-2020.","authors":"Kalika Gupta, Mitin Parmar, Kush Davda, Shivangi Davda, Pooja Soni, Ashok K Bhardwaj, Bhavesh Modi, Rajendra Awate","doi":"10.4103/ijcm.ijcm_35_23","DOIUrl":"10.4103/ijcm.ijcm_35_23","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) caused by Mycobacterium tuberculosis is an opportunistic infection that affects the lungs in humans. Caseload of TB has been deemed it endemic in various regions of the world and India is on top of that list. The Government of India has set out a goal to eliminate tuberculosis in India by the year 2025 with the help of the National Strategic Plan (NSP) 2017-25. The objective of the index study was to verify the claim of Rajsamand district in Rajasthan, that it witnessed a >20% reduction in TB incidence between 2015 and 2020.</p><p><strong>Methodology: </strong>This was a mixed-methods study. Quantitative component (cross-sectional study): Secondary data review (review of records from Nikshay notification systems and National tuberculosis elimination program (NTEP) reports, utilization of drugs in the public sector, and drug sales in the private sector). Primary data collection through survey. Qualitative component: nominal group technique and key informant interviews.</p><p><strong>Result: </strong>Percentage decline of a ≥ 20% incidence in 2020 compared to baseline 2015 was not seen. The number needed to test (increased by 18.26% in 2020 as compared to the baseline of 2015. TB Score of Rajsamand district for the year 2020 was 68.34 out of 100.</p><p><strong>Conclusion: </strong>Rajsamand district's claim of ≥20% reduction in TB incidence in the year 2020, was rejected.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"855-860"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819396","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":"Quality of Life of Breast Cancer Women under Treatment at a Tertiary Care Center of Western Maharashtra.","authors":"Tukaram J Gadekar, Sushil K Kaushik, Madhu Gadekar, Saurabh Bobdey, Dharmesh","doi":"10.4103/ijcm.ijcm_390_22","DOIUrl":"10.4103/ijcm.ijcm_390_22","url":null,"abstract":"<p><strong>Background: </strong>'Breast cancer' the most common cancer amongst females in India. Having good Quality of life (QoL) among the patients undergoing treatment is one of the vital and significant factors for ensuring holistic approach to treatment and well-being of cancer patients. The present study was conducted to assess the QoL and its determinants among breast cancer patients undergoing treatment at a tertiary care institute in western Maharashtra.</p><p><strong>Material and methodology: </strong>300 histopathologically confirmed breast cancer patients undergoing treatment at a tertiary care centre were divided into three groups to include 100 patients in each group. Group 1 (patients with duration of treatment 1 to 2 years) Group 2 (patients with duration of treatment 2 to 5 years) and Group 3 (more than 5 years). Validated tool Function Assessment of Cancer Therapy Breast specific (FACT-B) questionnaire was used to collect information on QoL and analysed using appropriate statistical tests.</p><p><strong>Results: </strong>Mean age of patients was 53.2 + 10.08 years, 136 (45.33%) were from age group 51 to 65 years. Majority of the patients 106 (35.33%) were educated till secondary schooling and 172 (57.33 %) were belonging to the middle-upper class. Lump in breast was most common presenting symptom in 235 (78.33%) cases followed by nipple retraction. 275 (91.67 %) cases had infiltrating ductal Carcinoma and 144 (48%) patents were in Stage II cancer. Over all mean FACT-B score for QoL was 104.02 + 18.65 out of 141. Mean FACT-B score for Group 1, Group 2 and Group 3 was 88.18 +17.20, 105.89 + 11.78 and 118.28 + 12.45 respectively with (p< 0.05), suggests significant improvement in QoL with increase in time elapsed since treatment.</p><p><strong>Conclusion: </strong>Socio-demographic factors, type of surgery and duration of treatment had significant effect on QoL among breast cancer patients. Apropos physicians, paramedic staff and domestic care givers need to be sensitised on importance of QoL for collective and deliberate efforts to achieve holistic care. QoL can be made integral part of breast cancer treatment and management policy or programme.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"818-825"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818835","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":"Effectiveness of Osteoarthritis Management Program (OAMP) on the Level of Knowledge and Practice Regarding Self-Management Among Elderly with Osteoarthritis.","authors":"Pratima Sapkota, Venkatesan Balu, Sonia Kamei, Yumnam Sushma Devi","doi":"10.4103/ijcm.ijcm_39_23","DOIUrl":"10.4103/ijcm.ijcm_39_23","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effectiveness of osteoarthritis management program (OAMP) on the level of knowledge and practice regarding self-management among elderly with OA.</p><p><strong>Materials and methods: </strong>A quasi-experimental study was conducted among 60 elderly with osteoarthritis (OA) from March 1, 2021, to March 29, 2021. A community-based survey was conducted to identify the elderly with OA, and 60 persons were selected by using simple random technique. Knowledge was assessed through structured questionnaire, and non-observational checklist was used for Practice. OAMP was conducted to impart knowledge and practice skills.</p><p><strong>Results: </strong>The study findings showed that the majority of the participants had inadequate knowledge and poor practice before the intervention, whereas, after the implementation of OAMP, the maximum number of participants had adequate knowledge and good practices. The knowledge mean score increased from 52% to 86.7% and practices from 43.8% to 88.5%. There was a significant hike in the difference between the mean pre-test and post-test scores at <i>P</i> < 0.001 level.</p><p><strong>Conclusion: </strong>The present study proves that the use of OAMP is effective in increasing the level of knowledge and also in improving the practices among participants which help in self-management of OA and result in improvement in the level of physical function.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"861-865"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819806","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":"Five Years of National Health Policy in India: Critical Analysis of the Public Health Expenditure from 2017 to 2022 and Way Forward.","authors":"Sanjana Agrawal, Gopal Chauhan, Abhiruchi Galhotra, Sonu Goel","doi":"10.4103/ijcm.ijcm_823_22","DOIUrl":"10.4103/ijcm.ijcm_823_22","url":null,"abstract":"<p><p>This retrospective study assesses the impact of India's National Health Policy (NHP) 2017 on public health expenditure and its implications for achieving Universal Health Coverage (UHC) and Sustainable Development Goal 3 (SDG-3). Using secondary data analysis from government sources, we observed health budget trends relative to GDP from 2017 to 2022. The study found a marginal increase in public health expenditure from 0.9% to 1.6% of GDP, which is below the NHP's target of 2.5%. The results underscore the challenge of high out-of-pocket expenses, which remain a barrier to UHC. The COVID-19 pandemic has further highlighted the inadequacies of the current funding levels. We conclude that a substantial increase in health budget allocations is crucial for India to make significant strides toward UHC and meet SDG-3 targets. The study also calls for strategic enhancements in healthcare infrastructure and services to address the persistent gaps in healthcare delivery and financing. The findings advocate for a more aggressive approach to public health investment to ensure that quality healthcare services are accessible, affordable, and equitable for all citizens, thereby advancing India's progress toward comprehensive health coverage.</p>","PeriodicalId":45040,"journal":{"name":"Indian Journal of Community Medicine","volume":"49 6","pages":"883-885"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819808","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}