Role of family physicians in providing primary healthcare during COVID-19 pandemic.

According to the World Health Organization, over 41 million cases of COVID-19 and 1 million deaths have been reported globally. More than 7 million cases of coronavirus have been reported in India alone. The growing number of cases of coronavirus worldwide poses numerous challenges to the country's current healthcare delivery system, especially in developing nations such as India. In such a situation, the task of maintaining continuity in the provision of comprehensive primary healthcare services in the community becomes a big challenge. This article discusses how family physicians can help to augment the healthcare system at the time of pandemic by providing easily accessible, holistic healthcare and by use of telemedicine. It also talks about the need to mainstream family medicine into the undergraduate and postgraduate medical curriculum and establish a robust network of family physicians trained in outbreak response and disease preparedness. For this study we looked for all papers with the terms 'Family physician', 'COVID-19', 'pandemic', and 'Primary health care'. Databases searched include PubMed, Google Scholar and DOAJ, using key words - family physician, family medicine, primary healthcare, COVID-19, and pandemic in different combinations.

Determinants of adherence to antihypertensive treatment among patients attending a primary care clinic with limited medical armamentarium in Delhi, India: A qualitative study.

OBJECTIVE: To determine perspectives on reasons for non-adherence to antihypertensive therapy and its socioeconomic determinants among patients attending a primary care center in a low-income area in Delhi, India. METHODS: We conducted in-depth interviews with a total of 30 patients having hypertension at a primary care facility located in a low-income urban area in Delhi. RESULTS: All the participants were aware that hypertension was a serious illness, and medication intake was necessary throughout life to prevent uncontrolled hypertension. All participants in varying quantities practiced salt restriction, but the consumption of fresh fruit and vegetables was low primarily due to economic reasons. The participants were unable to differentiate the concept of exercise from physical activity. Medication adherence was suboptimal, and significant reasons for non-adherence were forgetfulness, carelessness and running out of drug stocks. Blood pressure control was also suboptimal in a majority of the participants, but combination therapy was restricted due to limited medical armamentarium at the clinic. Laboratory investigations for monitoring target end-organ damage were either delayed or not conducted in most participants. DISCUSSION: Hypertensive patients undergoing treatment at primary care facilities often report suboptimal medical adherence and treatment outcomes, with socioeconomic causes being a major driver of non-adherence.

Effect of Intimate Partner Violence on Maternal and Birth Outcomes of Pregnancy among Antenatal Clinic Attendees in Delhi: A Prospective Observational Study.

CONTEXT: Violence against women is a major public health problem and a violation of their human rights. Intimate partner violence (IPV) during pregnancy has been linked to various adverse maternal health outcomes and birth outcomes. AIMS: The aim of this study is to assess the magnitude of maternal complications and adverse birth outcomes in relation to IPV. SETTINGS AND DESIGN: Prospective observational study was conducted from April 2015 to May 2018 in the antenatal clinic of a Tertiary Care Hospital in Delhi. SUBJECTS AND METHODS: Sample of 1500 pregnant women (≤20 weeks gestation) were recruited and followed up at regular intervals, up to the birth outcome. STATISTICAL ANALYSIS USED: Data were analyzed using the Statistical Package for the Social Sciences version 25. Value of P < 0.05 was considered statistically significant. RESULTS: Prevalence of IPV at baseline was 29.7%. Significantly higher proportion of IPV victims (47.2%) had poor weight gain during the pregnancy. Subjects reporting violence at any of the study contacts had a higher incidence of preterm delivery (12.7%), and a significantly higher incidence of low birth weight in the newborns (32.1% vs 22.3%) (P < 0.05). CONCLUSIONS: The findings reveal that IPV during pregnancy is common and significantly associated with adverse maternal and birth outcomes. The findings stress need for research and development of a screening tool to identify violence early in pregnancy and thus prevent its consequences.

Magnitude of domestic violence and its socio-demographic correlates among pregnant women in Delhi.

CONTEXT: Domestic violence is violation of basic human rights, and poses a threat to the physical, mental, and social health aspects of women and her children. The causation of domestic violence is precipitated by many risk factors. AIMS: Aim was to estimate the magnitude of domestic violence overall, and its sub-types, among pregnant women. The study also aimed to find the associated socio-demographic determinants of domestic violence among the subjects. SETTINGS AND DESIGN: The study was designed as a cross-sectional study to estimate the prevalence of domestic violence and to find socio-demographic correlates in its causation. A total of 1500 apparently healthy pregnant women, with gestation up to 20 weeks were interviewed. METHODS AND MATERIALS: A pre-tested semi-structured interview schedule was used to collect data on socio-demographic variables and details of domestic violence, after explaining the purpose of study to the subjects and obtaining informed consent. STATISTICAL ANALYSIS USED: Data was entered in Ms-Excel and IBM SPSS Version 25 was used for statistical analysis. RESULTS: The findings revealed overall prevalence of domestic violence to be 29.7%, with emotional and verbal type of violence being most common type. Caste, religion, literacy status of study subjects, and occupational status of spouses of study subjects were reported as significant correlates affecting the causation of domestic violence among the subjects. CONCLUSIONS: The findings highlight the burden and thus, stress for the need for effective involvement of all sectors in the elimination of domestic violence against women as a public health issue and develop zero-tolerance towards it.