Collaboration with medical colleges and public health institutions for implementation of national health programs: The way forward.

Health system strengthening is a much-needed priority to achieve the major public health goals of control, elimination, and eradication of various diseases. It depends on improving the country's ability to successfully perform essential functions while focusing on sustainability, equity, effectiveness, and efficiency. Medical colleges and public health institutions play an integral role in health system strengthening by educating and training the current and the future generations of health-care workforce with a vision to achieve the global standards in public health. This discussion focuses on the role of medical colleges and public health institutions in the success of various national health programs with a focus on challenges and improvement areas for the same.

Does the mode of delivery affect the health-related quality of life? A comparative analysis.

Background: Health-related quality of life (HRQoL) of postpartum mothers is a multidimensional concept and is relatively neglected in both researches and in practice as most postpartum researches have focused on the physical complications. In line with the global trends, India has witnessed a sharp rise in cesarean section (CS) deliveries and has become a global concern for the health of the mother as well as her quality of life. Objectives: This study was conducted to analyze and compare the HRQoL after normal vaginal delivery and CS in the postpartum women. Methods: It was a community-based cross-sectional study and a predesigned, pretested interview schedule was used in the form of a questionnaire including the Medical Outcomes Study Short Form 36 Health Survey for HRQoL. The study was conducted in a resettlement colony, Kalyanpuri located in Delhi, India with a total population of 25,754 with 4596 eligible couples in 4302 households from November 2018 to March 2020. The study participants comprised of a sample size of 330 post-partum women and the data were collected in the 6th week of post-partum period. Results: In our study, there were statistically significant (P < 0.05) differences with mode of delivery as one of the predictors of HRQoL of postpartum mothers. The study subjects with vaginal delivery had higher mean HRQoL score under all the domains. Conclusion: In CS, reduced physical activity, body pain not only affected the mental health domain score but also significantly impacted the emotional domain. Promoting the use of family planning services is also significant in improving maternal health and should be made a provision of quality of care and strengthening of quality improvement and sustainable quality assurance mechanisms are major problem-solving steps in improving access to healthcare.

A cross--sectional study of mental wellbeing with practice of yoga and meditation during COVID-19 pandemic.

BACKGROUND: COVID-19 pandemic has resulted in increased mental health issues. Yoga and meditation can help in alleviating mental stress and improving psychological wellbeing. METHODS: It was a community-based online cross-sectional study involving adult general population. Data collection was done by using a Google form link that was circulated via online platforms. The data were analyzed using Microsoft Excel and SPSS version 22. Qualitative data were expressed in proportions or percentages and quantitative data were expressed in mean and standard deviation. Chi-square test was used to check the association of various factors and mental wellbeing. RESULTS: A total of 649 (58.4%) subjects had normal mental wellbeing score, whereas 279 (25.1%) were found to be at risk of developing psychological distress and 184 (16.5%) were at risk of depression. A significantly larger proportion of subjects with normal mental wellbeing was found with the practice of both yoga and meditation (66.2%), followed by practice of only meditation (62.1%), only yoga (59.9%), and none of them (50.6%). A similar association of yoga and meditation practices was found with the change in eating, sleeping patterns, and family relations. The frequency of practice was positively associated with a higher level of mental wellbeing in the case of both yoga as well as meditation, with daily practice having the highest wellbeing scores. CONCLUSION: The practice of yoga and meditation, preferably both of them, is associated with higher level of mental wellbeing during the COVID-19 pandemic.

Seasonal variation of diarrheal diseases and drinking water quality in resettlement colony in Delhi, India: A community-based cross-sectional study.

Seasonal variation plays an important role in the occurrence of diarrheal diseases and distinct seasonal occurrence of diarrheal diseases, with bacterial diarrhea occurring more during the warm seasons and viral diarrhea occurring during the drier cool months, has been observed due to seasonal variation. Time-series cross-sectional study was conducted from January to December 2018 among 553 under-five children to assess seasonal variation of diarrheal diseases and its association with the drinking water quality in a resettlement colony of Delhi. The prevalence of diarrhea was 40.7% and was highest during the rainy season (67.6%). Majority of the water samples were found to be unsatisfactory for human consumption during the rainy and summer seasons. Significant and moderate relationship was found between the seasonal variation and occurrence of diarrhea (r = 0.728, P < 0.05) and most probable number count (r = 0.50, P < 0.05), respectively. Understanding the environmental factors that influences the occurrence of diarrheal diseases is warranted.

Air pollution and environmental risk factors for altered lung function among adult women of an urban slum area of Delhi: A prevalence study.

BACKGROUND: Household and ambient air pollution are jointly responsible for about 7 million premature deaths annually. Women living in slums, with unhealthy environment, both indoors and outdoors, particularly those living close to industrial and/or vehicular pollution zones due to multiple sources of air pollution, are at the higher risk of having impaired lung function tests. OBJECTIVE: The aim of this study was to estimate the prevalence of abnormal lung functions and to identify the environmental risk factors associated with them among adult women of 18-59 years. MATERIALS AND METHODS: A total of 550 women aged 18-59 years were approached in a representative urban slum. Five hundred consented to participate and 299 had prebronchodilator spirometry satisfying ATS standards. House visits to assess environmental conditions were conducted to determine their association with forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Chi-square test was used to test the association of risk factors with lung functions. ANOVA was used to test the association of mean values of FEV1 and FVC with age. RESULTS: Out of 299 participants with acceptable spirometric curves, 5% had reduced FEV1/FVC ratio than the normal and 26.8% and 17.4% had lower values than predicted for FVC and FEV1, respectively. Altered lung function was related to age, tobacco smoking, and history of respiratory disease. CONCLUSIONS: Both ambient and household air pollution have a deleterious pulmonary effect on long-term women residents of a representative urban slum in Delhi.

An epidemiological study on home injuries among children of 0-14 years in South Delhi.

BACKGROUND: Injuries are an important public health problem worldwide, accounting for 5 million deaths, of which unintentional injuries account for 0.8 million deaths in children. Though there are many factors responsible for injury in the home, the environment plays an important role. OBJECTIVES: The objectives were to study the magnitude and pattern of home injuries in children aged 0-14 years and to assess the environmental risk associated with home injuries. METHODS: A community-based, cross-sectional study was conducted in 2015 in a ward of Mehrauli containing 20,800 households, and the total sample of children was selected from 400 households by systematic random sampling, with sampling interval being 52. Information was taken using a predesigned, semi-structured, pretested proforma from both the parents and children. The data collected were analyzed using SPSS version 12. RESULTS:: The prevalence of home injury was found to be 39.7% in the last 1 year, significantly higher in the age group of 1-3 years (54.3%) followed by 5-10 years (45.1%) (P = 0.000). The total number of injuries and the average number of injuries in girls were significantly higher than those of boys. The most common type of home injury was falls (59.5%) followed by injury with sharps and burn injury. The environmental risk was assessed using standard and working definitions and found unsafe electrical points (95.3%), unsafe stairs (100%), unsafe kitchen with access to sharps (29.3%), access to active fire (19.3%), and unsafe furniture and objects (22.8%). CONCLUSION: Though home injury did not occur in 60% of the children during the study period, the risk of injury in the future is high. Educating the parents and the children at schools and environmental modification are important strategies for prevention of home injury.

Post exposure management of animal bite cases attending a primary health center of Delhi.

Rabies is an ancient disease of mankind. Every year 4 million people are exposed worldwide after animal bite and around 60000 fell victim to the rabies of which more than 95% of cases are bitten by the dogs. Rabies is a disease associated with many myths. The present study was conducted to find out the clinical profile of the animal bite cases including the common practices, precautions adopted by them after animal bite and lastly the extent and completion of post exposure treatment. Total 147 cases of animal bites attended the OPD during the study. In present study, 123 (83.7%) cases were bitten by dogs, followed by monkey (8.2%) and cat (8.2%). Majority (54.4%) suffered class II bites followed by class I (31.3%) and class III bite (14.3%). Of the total 147 cases, 116 cases (78.9%) completed post exposure prophylaxis which was observed higher among male and in younger age group.

A study of malnutrition among children aged 6 months to 2 years from a resettlement colony of Delhi.

Nutritional status of 1661 children aged 6 months to 2 years who attended the Well Baby Clinic of UHC Gokulpuri, Delhi during the year 2000 was studied. 60.7% of them were malnourished. Undesirable practices of discarding the colostrum, not exclusively breast feeding the child till at least 4 months of age, delayed weaning, dilution of top milk, use of bottle and nipple for feeding the children are still widely prevalent.

Awareness and practices regarding malaria of catchment population of a primary health centre in Delhi.

Malaria is a major public health problem in India. IEC activities have been an important activity of National Anti Malaria Programme. The present study was undertaken with the objective to assess awareness and practices regarding malaria among patients attending malaria clinic. Literacy status was low among the respondents. About 57% of respondents were aware of the cause of malaria as parasite or mosquito and awareness increased with the literacy status (49.4% in illiterate to 85.4% in high school and above literate). More than half (51.0%) of the respondents attributed high fever with chills and rigor as the most important symptom of malaria, but some of the respondents also mentioned only high fever (18.9%) or high fever with diarrhea (21.2%) as main symptom of malaria. Majority of the respondents knew that mosquito bred in water (62.9%) and mosquito breeding could be prevented (56.6%), knowledge significantly better among literate than illiterates. The present study showed that the awareness and practices about the cause and prevention of malaria were just fair among the patients attending the Malaria Clinic of a Primary Health Centre of Delhi and were dependent upon the literacy status of the study population. Poor response towards practising preventive measures against mosquito bites as approx. one third were not practising any method could be due to poor awareness about malaria preventive measures.

Pulse polio programme: an overview of parent's perception.

India is contributing large number of total world's polio cases. The present study was carried out with the objective to assess the knowledge of the parents regarding pulse polio and their perception towards pulse polio and other immunization. The study revealed that children of all age groups participated in PPI though the coverage was low in 37-48 and 49-60 month age group. In all 30.5% children of respondents could not get OPV in the previous year and they came for the first time to the PPI centre. A significant finding of the study was the status of children regarding other immunization, as 59.5% of the respondents were not immunizing their children for other vaccines. In the present study, 73.2% of the respondents could tell correctly about pulse polio. Predominant source of information about pulse polio was found to be electronic media (55.8%) followed by health workers (20.9%). Only 8.4% respondents opined that distance of PPI centre was far away from their residence.

An epidemiological profile of gastro-enteritis deaths in Delhi state.

This paper describes epidemiological features of 75 gastro-enteritis deaths that occured in 22 major hospitals of Delhi during 1990-92. Three fourth's of deaths were in under five years of age group and more than half were infants. In 84 per cent, diarrhoea was of an acute watery type. Dehydration was the commonest immediate cause of death, while malnutrition was the commonest associated cause. No ORS/SSS/HAF was given to one fourth of the patients. Close relatives of two third's of deceased were either not aware at all about ORS/SSS or had incorrect information. In 87 per cent, food intake was either stopped or had been restricted. The study emphasizes the need for an intensive IEC campaign for prevention, and for better case management in the hospitals coupled with appropriate reorientation training of private practitioners.