RESUMO
Although the use of tobacco in the state of Punjab is below the national statistics of India, according to Global Adult Tobacco Survey (GATS) 2016 Report, its consumption has increased. Also, what sets it apart from rest of the nation is the cultural as well as the religious taboo associated with tobacco use. The case of Punjab is also peculiar because of the socio demographic profile of the region which has changed since Green Revolution. Having said that, use of tobacco is a social phenomenon and it becomes important to place tobacco use in a social and cultural context. The aim of the study is to explore the socio -cultural determinants of tobacco use within local and migrant groups in a district of Punjab. The tobacco users in the district were divided into groups of local and migrant labourers and focus group discussion was carried out with them. There were various social correlates of tobacco use in the district which saw variations within and across these groups. The socio demographic factors of age, gender, religion and place of residence were related to the use of tobacco and presented similarities and variations across the groups. The study concluded that tobacco prevention and control policies should include cultural interventions to change current traditional practices and social determinants which influence the use of tobacco.
RESUMO
This review article provides a historical context of tobacco use in Punjab, determined by the sociopolitical transitioning of this pre-colonial province to an autonomous Indian State. Although these events were marked by a complex historical process, the state's retention of its culture offers an interesting aspect of this development. For instance, these events have been marked from the conception of Sikhism to the changing borders of the territory of Punjab while positioning the use of tobacco within these boundaries. This social, economic and developmental history of Punjab has therefore been a subject of interest to the academic scholars and makers of tobacco-related policies.
Assuntos
Produtos do Tabaco , Uso de Tabaco , Humanos , Política Pública , ReligiãoRESUMO
BACKGROUND: The implementers of the tobacco control policy in the field have been neglected by the policymakers. They are the ones who have first-hand knowledge and their experiences in the field are not being used to bring about changes in the area of tobacco control. OBJECTIVE: The objective of this paper is to critically examine how Michael Lipsky's concept of street-level bureaucracy can be used to address tobacco control in the health department in district Jalandhar of Punjab. METHODS: Semi-structured interview schedules were used to interview Senior Medical Officers/Nodal Officers and Health Supervisors/Sanitary inspectors in four out of ten Community Health Centers and District hospital in Jalandhar. Data so collected were subjected to the process of inductive analysis and themes developed within the framework given by Lipsky. RESULTS: The street-level bureaucrats (SLBs) were not given adequate training, and various organizational resources for tobacco control are missing in the district. There are threats and challenges which are faced by them in the field, and they do not exercise decision-making power to handle these barriers for effective implementation of the tobacco control program. CONCLUSION: The government needs to be inclusive in the process of policymaking meaning that it can be more accommodative of the suggestions given by the SLBs and provide them with discretionary powers to exercise their role efficiently.
RESUMO
BACKGROUND: The Government of India is increasingly emphasizing the provisioning of dental services in public hospitals, but the rural and deprived sections are struggling to get basic dental procedures done in public hospitals. AIM: To study variations within and across public hospitals for provisioning of dental health settings in Jalandhar district of Punjab. SETTINGS AND DESIGN: The study area consisted of four Community Health Centers (CHCs) and District Hospital situated in Jalandhar, Punjab, India. MATERIALS AND METHODS: The dental infrastructure and dental procedures performed in the public hospital were checked with the help of a checklist as listed in the Indian Public Health Standards 2012 for CHCs and district hospital, and then, the variations within and across these public hospitals were compared. STATISTICAL ANALYSIS: Percentages were used to make comparisons within and across the public health institutions. RESULTS AND CONCLUSIONS: The results showed that out of total outpatient department (OPD) of the public hospitals, dental OPD formed 5%-10% in public hospitals and extraction was the most frequently performed procedure. There is no availability of prosthodontic and orthodontic procedures in the public hospitals. There were no dental auxiliaries in the CHCs, and there was lack of proper dental materials needed in the dental clinics.
