{"title":"Economic burden of suicide deaths in India (2019): a retrospective, cross-sectional study","authors":"Anukrati Nigam , Madhurima Vuddemarry , Siddhesh Zadey","doi":"10.1016/j.lansea.2024.100477","DOIUrl":"10.1016/j.lansea.2024.100477","url":null,"abstract":"<div><h3>Background</h3><p>India has the highest number of suicide deaths in the world. Suicide prevention requires policy attention and resource allocation. Evidence of economic losses due to disease burden can influence such allocations. We assessed the economic burden and its distribution across states and demographic groups in India.</p></div><div><h3>Methods</h3><p>We used the human capital approach in this retrospective cross-sectional analysis to assess the economic burden of suicide in India for the year 2019 for 28 Indian states and 3 union territories (UTs). We calculated the monetary value for the years of life lost disaggregated by states, age groups, and sexes. For sensitivity, we present a library of estimates using different discount rates, life expectancy thresholds, and estimates specific to the populations that can participate in the workforce.</p></div><div><h3>Findings</h3><p>The national economic burden of suicide was US$ 16,749,079,455 (95% Uncertainty Interval: 11,913,034,910–22,404,233,468). The top three states, Karnataka, Tamil Nadu, and Maharashtra, contributed to 44.82% of the total burden in India. The age group 20–34 years had the largest suicide burden and contributed to 53.05% of the overall national economic burden (US$ 8,885,436,385 [6,493,912,818–11,694,138,884]). Twenty states and UTs had a greater economic burden for females than males.</p></div><div><h3>Interpretation</h3><p>The current analysis ascertains a high economic burden of suicide among the Indian youth and females, necessitating concerted multisectoral efforts and immediate investments.</p></div><div><h3>Funding</h3><p>None.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"29 ","pages":"Article 100477"},"PeriodicalIF":5.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001276/pdfft?md5=f3f420bf992727bc720efd9e7e068098&pid=1-s2.0-S2772368224001276-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172021","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":"The South Asian phenotype: greater clarity would help to improve cardiometabolic health","authors":"Andrew Peter Hills","doi":"10.1016/j.lansea.2024.100482","DOIUrl":"10.1016/j.lansea.2024.100482","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"29 ","pages":"Article 100482"},"PeriodicalIF":5.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277236822400132X/pdfft?md5=d095378538069e07072fa72d5bdafc32&pid=1-s2.0-S277236822400132X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142167766","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":"Incidence of Kawasaki disease among children in Chandigarh, India during 2015–2019: a trend analysis","authors":"Rakesh Kumar Pilania , Suprit Basu , Jyoti Dixit , Rajni Kumrah , Ankur Kumar Jindal , Abarna Thangaraj , Ruby Nimesh , Taranpreet Kaur , Pandiarajan Vignesh , Deepti Suri , Amit Rawat , Sanjeev H. Naganur , Manphool Singhal , Shankar Prinja , Surjit Singh","doi":"10.1016/j.lansea.2024.100474","DOIUrl":"10.1016/j.lansea.2024.100474","url":null,"abstract":"<div><h3>Background</h3><p>Only limited information exists regarding the epidemiology of Kawasaki disease (KD) in low-income and middle-income countries. The present study provides the incidence of KD during 2015–2019 in Chandigarh, north India. Our centre follows the largest KD cohort in India.</p></div><div><h3>Methods</h3><p>Children with KD at Chandigarh diagnosed during January 2015–December 2019 were enrolled in the study. Annual incidence rates were determined using decadal growth rates of the National Census 2011. We computed the incidence of KD in children aged <5, and <15 years. We also undertook linear trend analysis using our incidence data from 1994 to 2019.</p></div><div><h3>Findings</h3><p>During 2015–2019, 83 patients (66 males, 17 females) were diagnosed with KD in Chandigarh. Incidence rates during these 5 years were 5.64, 9.25, 9.11, 9.87, and 9.72/100,000 in children aged <5 years, and 2.65, 4.44, 3.86, 5.07, 4.74/100,000 in children aged <15 years. The median age at diagnosis was 48 months (range: 12 days to 15 years). Compared to previous data (2009–2014), there was a 53.1% increase in annual incidence of KD in children aged <5 years, and a 53.7% increase in children aged <15 years. Coronary artery abnormalities during acute phase were noted in 16.9%, and in 7.2% of patients at 6 weeks of follow-up. The trend analysis indicated a monthly rise of 0.002 cases per 100,000 children aged <5 years, and 0.0165 cases per 100,000 children aged <15 years.</p></div><div><h3>Interpretation</h3><p>The incidence of KD has continued to show an upward trend in Chandigarh over the period 2015–2019. This may indicate a true rise in the occurrence of KD or may reflect better disease ascertainment as a result of greater awareness about KD amongst healthcare professionals.</p></div><div><h3>Funding</h3><p>None.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"29 ","pages":"Article 100474"},"PeriodicalIF":5.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001240/pdfft?md5=c0c09c983cef3a5e1a297a58054e86e4&pid=1-s2.0-S2772368224001240-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163412","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}
Zubin Cyrus Shroff , Anas Ismail , Kaosar Afsana , Manuj Weerasinghe , Krishna D. Rao
{"title":"Engaging non-state providers towards PHC in South Asia: considerations for policymakers","authors":"Zubin Cyrus Shroff , Anas Ismail , Kaosar Afsana , Manuj Weerasinghe , Krishna D. Rao","doi":"10.1016/j.lansea.2024.100454","DOIUrl":"10.1016/j.lansea.2024.100454","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"28 ","pages":"Article 100454"},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001045/pdfft?md5=65c394e8406ccf0e1b90c1810a419bb0&pid=1-s2.0-S2772368224001045-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164315","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}
Prakriti Shrestha , Kaosar Afsana , Manuj C. Weerasinghe , Henry B. Perry , Harsha Joshi , Nisha Rana , Zahid Ali Memon , Nazrana Khaled , Sumit Malhotra , Surbhi Bhardwaj , Simrin Kafle , Yoko Inagaki , Austin Schimdt , Stephen Hodgins , Dinesh Neupane , Krishna D. Rao
{"title":"Strengthening primary health care through community health workers in South Asia","authors":"Prakriti Shrestha , Kaosar Afsana , Manuj C. Weerasinghe , Henry B. Perry , Harsha Joshi , Nisha Rana , Zahid Ali Memon , Nazrana Khaled , Sumit Malhotra , Surbhi Bhardwaj , Simrin Kafle , Yoko Inagaki , Austin Schimdt , Stephen Hodgins , Dinesh Neupane , Krishna D. Rao","doi":"10.1016/j.lansea.2024.100463","DOIUrl":"10.1016/j.lansea.2024.100463","url":null,"abstract":"<div><p>The growing health challenges in South Asia require further adaptations of community health worker (CHW) programs as a key element of primary health care (PHC). This paper provides a comparative analysis of CHW programs in five countries (Bangladesh, India, Nepal, Pakistan, and Sri Lanka), examines successes and challenges, and suggests reforms to better ensure highly performing CHW programs. To examine CHW programs in the region, we conducted a narrative review of the peer-reviewed and grey literatures, as well as eliciting opinions from experts. Common roles of CHWs include health education, community mobilization, and community-based services, particularly related to reproductive, maternal, neonatal, and child health. Some countries utilize CHWs for non-communicable diseases and other emerging health issues. To maximize the potential contribution of CHWs to achieving Universal Health Coverage, we recommend future research and policy focus on strengthening existing health systems to support the expansion of CHWs roles and better integrating of CHWs into national PHC systems. This is Paper 4 in the Series on Primary Health Care in South Asia, addressing areas that have the potential to revitalize health systems in South Asian countries.</p></div><div><h3>Funding</h3><p>The authors received financial support from the <span>Department of Health Systems Development, WHO South-East Asia Regional Office (WHO SEAR)</span>.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"28 ","pages":"Article 100463"},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001136/pdfft?md5=53aed950c64520a8f64853667fc32f47&pid=1-s2.0-S2772368224001136-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164232","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":"Primary health care in South Asia: a time for reform","authors":"Krishna D. Rao , Shankar Prinja , Sayed Masud , Kaosar Afsana , Susie Perera , Sudha Ramani , Manuj C. Weerasinghe","doi":"10.1016/j.lansea.2024.100467","DOIUrl":"10.1016/j.lansea.2024.100467","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"28 ","pages":"Article 100467"},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001173/pdfft?md5=949b4f239f8fdc062ea35665b3342123&pid=1-s2.0-S2772368224001173-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142161583","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}
Maya Sahu , Sailaxmi Gandhi , Ravikant Pinjarkar , Manjula M , Paulomi M. Sudhir , Rathi Balachandran
{"title":"Corrigendum to “Development and evaluation of a training of trainers intervention for nursing professionals during COVID-19 pandemic in India” [The Lancet Regional Health – Southeast Asia 25 (2024) 100413]","authors":"Maya Sahu , Sailaxmi Gandhi , Ravikant Pinjarkar , Manjula M , Paulomi M. Sudhir , Rathi Balachandran","doi":"10.1016/j.lansea.2024.100468","DOIUrl":"10.1016/j.lansea.2024.100468","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"28 ","pages":"Article 100468"},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001185/pdfft?md5=a1126a3ed63c6e37ffb638ab7687e12d&pid=1-s2.0-S2772368224001185-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164233","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}
Susie Perera , Sudha Ramani , Taufique Joarder , Rajendra S. Shukla , Shehla Zaidi , Nalinda Wellappuli , Syed Masud Ahmed , Dinesh Neupane , Shankar Prinja , Archana Amatya , Krishna D. Rao
{"title":"Reorienting health systems towards Primary Health Care in South Asia","authors":"Susie Perera , Sudha Ramani , Taufique Joarder , Rajendra S. Shukla , Shehla Zaidi , Nalinda Wellappuli , Syed Masud Ahmed , Dinesh Neupane , Shankar Prinja , Archana Amatya , Krishna D. Rao","doi":"10.1016/j.lansea.2024.100466","DOIUrl":"10.1016/j.lansea.2024.100466","url":null,"abstract":"<div><p>This series, “Primary health care in South Asia”, is an effort to provide region-specific, evidence-based insights for reorienting health systems towards PHC. Led by regional thinkers, this series draws lessons from five countries in South Asia: Bangladesh, India, Nepal, Pakistan, and Sri Lanka. This is the last paper in the series that outlines points for future action. We call for action in three areas. First, the changing context in the region, with respect to epidemiological shifts, urbanisation, and privatisation, presents an important opportunity to appraise existing policies on PHC and reformulate them to meet the evolving needs of communities. Second, reorienting health systems towards PHC requires concrete efforts on three pillars-integrated services, multi-sectoral collaboration, and community empowerment. This paper collates nine action points that cut across these three pillars. These action points encompass contextualising policies on PHC, scaling up innovations, allocating adequate financial resources, strengthening the governance function of health ministries, establishing meaningful public-private engagements, using digital health tools, reorganising service delivery, enabling effective change–management processes, and encouraging practice-oriented research. Finally, we call for more research-policy-practice networks on PHC in South Asia that can generate evidence, bolster advocacy, and provide spaces for cross-learning.</p></div><div><h3>Funding</h3><p>WHO SEARO funded this paper. This source did not play any role in the design, analysis or preparation of the manuscript.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"28 ","pages":"Article 100466"},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001161/pdfft?md5=ab8f906e474ed2429e674daf26e86a51&pid=1-s2.0-S2772368224001161-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164234","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}
Anuradha V. Khadilkar , Chirantap Oza , Neha Kajale , Aman B. Pulungan , Suttipong Wacharasindhu , Annang Giri Moelyo , Gassani Amalia , Karn Wejaphikul , Madarina Julia , Prapai Dejkhamron , Vaman Khadilkar
{"title":"Local anthropometric parameters for assessing double burden of malnutrition in South Asian and Southeast Asian countries: a review and retrospective analysis","authors":"Anuradha V. Khadilkar , Chirantap Oza , Neha Kajale , Aman B. Pulungan , Suttipong Wacharasindhu , Annang Giri Moelyo , Gassani Amalia , Karn Wejaphikul , Madarina Julia , Prapai Dejkhamron , Vaman Khadilkar","doi":"10.1016/j.lansea.2024.100473","DOIUrl":"10.1016/j.lansea.2024.100473","url":null,"abstract":"<div><p>The double burden of malnutrition (DBM) is a significant public health issue in South and Southeast Asia (SA and SEA). This study aimed to assess the impact of using local and regional ethnicity-specific anthropometric references versus international references on the prevalence of DBM in these regions.</p><p>A narrative review of DBM prevalence using local versus international standards was conducted. Additionally, deidentified datasets from India and Indonesia were analyzed to evaluate the effectiveness of different growth standards in identifying DBM. Anthropometric Z-scores were compared, and sensitivity, specificity, and positive predictive value (PPV) were calculated.</p><p>WHO standards had the lowest specificity for identifying short stature in India and Indonesia. BMI-for-age charts using WHO Growth Reference (2007) had lower sensitivity and higher specificity for metabolic risk. Local references showed lower stunting and higher overweight or obesity prevalence. International standards overestimated stunting and underestimated obesity, leading to misclassification and missed cases of metabolic risk.</p></div><div><h3>Funding</h3><p>None.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"28 ","pages":"Article 100473"},"PeriodicalIF":5.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001239/pdfft?md5=d641cd010533aebc37ee677552786438&pid=1-s2.0-S2772368224001239-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142088747","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}