Performance of health and wellness centre in providing primary care services in Chhattisgarh, India.

INTRODUCTION: Primary health care has regained its importance in global policy making. In 2018, the Government of India initiated the Ayushman Bharat - Comprehensive Primary Health Care (AB-CPHC) programme. It was based on upgrading the existing primary health facilities into Health and Wellness Centers (HWCs). The current study aimed to assess the readiness and performance of HWCs in providing comprehensive primary health care services in India's Chhattisgarh state. METHODS: We conducted a cross-sectional health facility assessment with a state-representative sample of 404 HWCs. A standardized health facility survey tool was used to collect information on essential inputs and service outputs of HWCs. The expected population healthcare needs were estimated using secondary sources. The performance of HWCs was assessed by comparing the volume of services provided against the expected population need for outpatient care. RESULTS: On an average, 358 outpatients including 128 non-communicable disease (NCD) patients were treated monthly at an HWC. HWCs were able to cover 31% of the total population's health need for outpatient care, 26% for hypertension, and 21% for diabetes care. In addition to services for reproductive and child health, HWCs provided services for common acute ailments (cold, cough, fever, aches and pains); infections of skin, eye, ear, and reproductive tract, and minor injuries. HWCs were also contributing significantly to national disease control programmes. Acute ailments followed by NCDs and communicable diseases had the largest share among services provided. The key gaps were in coverage of mental illnesses and chronic respiratory diseases. Most of the HWCs showed adequate readiness for the availability of required human resources, supplies, and infrastructure. CONCLUSION: HWCs were able to provide a comprehensive range of primary care services and able to cater to a sizable portion of the rural population's acute and chronic health care needs. The performance was made possible by the adequate availability of medicines, staff, training programmes and tele-consultation linkages. If HWCs in other states are able to reach a similar level of performance, the initiative will prove to be a game changer for equitable primary care in India.

Profile and predictors of babies admitted to SNCUs of two tribal districts of Chhattisgarh.

Background: The neonatal period is the crucial and vulnerable period of the human life cycle. Various research has been conducted worldwide that provide the baseline data on clinical profiles and predictors of outcomes of babies admitted to sick newborn care units (SNCUs). Nonetheless, studies on tribal areas and community outreach areas are rare. In the present study, predictors and profiles of patients admitted to SNCU, in the Dantewada and Bijapur districts of Chhattisgarh, India, were evaluated which shall help prioritize patient care and preventive approaches. Methods: This retrospective study was undertaken from January 2019 to December 2020 in the SNCUs of Dantewada and Bijapur. Neonatal and maternal characteristics, course during labor, treatment given to the neonates, and outcome data were obtained and analysed. Results: In total, 1,531 neonates were enrolled in the study. Mothers had a mean age of 25.6 years (standard deviation [SD] ±4.9) with birth spacing less than 2 years (60.3%) and antenatal care (ANC) visits less than 4 (50.4%). Neonates were low birth weight (43.75%) and were home-delivered (15.8%). One hundred forty-nine neonates died. In the multivariate regression model, extremely low birth weight babies, less than 1 kg (odds ratio [OR]: 11.59 confidence interval [CI] 4.625-31.58), gestational age less than 34 weeks (OR: 2.13 CI 1.291-3.532), central cyanosis (OR: 10.40 CI: 3.269-32.35), duration of IV fluid > 3 days (OR: 2.16 CI 0.793-0.880), duration of antibiotic >3 days (OR 0.63 CI 0.408-0.979) were found to be independent predictors of mortality among neonates. Conclusion: The prevalence of newborns aged less than 12 h is higher among the study population. Birth asphyxia, prematurity, neonatal jaundice, and sepsis were fundamental and leading causes of morbidity. Preterm birth and low birth weight babies had significantly high mortality. The government needs to focus on marginalized communities with target-based interventions and policies.

Mental Health Status of Health Care Professionals Working in Public and Private Sectors in Visakhapatnam: A Cross-Section Study.

Introduction: The material that is currently available on the psychological issues that doctors deal with is restricted to a few national surveys and certain particular hospital surveys. The motive of the current study was to define the mental health status of medical as well as surgical professionals working in the public and private sectors of Visakhapatnam, Andhra Pradesh, India. Methodology: A self-reported questionnaire survey was used in an observational cross-sectional study to appraise the mental health state of both private and public medical practitioners. The Kessler Psychological Distress Scale (K10) by William C. Menninger was applied. Results: The majority of study participants experienced psychological anguish, showing a substantial difference in the total level of psychological distress. When the Wellinger's Distress and the Kesslers Distress tools were compared, it was found that there was a substantial difference for all the variables taken into account in the current study, including gender, experience, marital status, children, and occupation, designation, and sector of work. Conclusion: Stress and burnout were more prevalent among medical specialists with lower yearly income, young ages, and fewer years of practice. Clinicians and policymakers must be proactive in creating programes that help healthcare professionals cope with stress and burnout.

An Assessment of the Profile and Predictors of Outcomes in COVID-19 Patients Hospitalized in a Tertiary Care Institute in Central India.

Background Coronavirus disease 2019 (COVID-19) is the largest pandemic that has affected people around the globe. Various researches have been conducted worldwide, but there is a scarcity of data from Central India on the relationship between several risk factors for infection and mortality. Our study assessed the predictors and patient profiles of those with COVID-19, which will aid in prioritizing patient treatment and preventive measures. Methods A retrospective study was done between March and December 2020. The study included 5,552 COVID-19 patients admitted to the All India Institute of Medical Sciences (AIIMS), Raipur. A validated questionnaire form provided by the WHO was used. Data for multiple clinical and nonclinical parameters were collected, and analysis was done using SPSS version 26 (IBM Corp., Armonk, NY, USA) and STATA version 12 (StataCorp LLC, College Station, TX, USA). Mortality and risk assessment of patients was done using multivariate logistic regression. Result In our study cohort of 5,552 COVID-19 patients, the median age was found to be 47 years (interquartile range (IQR): 31-60 years; range: 14-100 years), and 3,557 (64%) were male. Predominantly, patients presented with fever (41.30%), cough (40.20%), and dyspnea (29.29%). The major comorbidities were hypertension (29.70%), diabetes (25.40%), and chronic cardiac disease (5.79%). The common complications were liver dysfunction (26.83%), viral pneumonitis (23.66%), acute renal injury (15.25%), and acute respiratory distress syndrome (ARDS) (13.41%). In multivariate analysis, age (more than 40 years) (odds ratio (OR): 2.63; 95% confidence interval (CI): 1.531-4.512; p<0.001), diabetes (OR: 1.61; 95% CI: 1.088-2.399; p=0.017), obesity (OR: 6.88; 95% CI: 2.188-12.153; p=0.004), leukocytosis (OR: 1.74; 95% CI: 1.422-2.422; p<0.001), lymphocytopenia (OR: 2.54, 95% CI: 1.718-3.826; p<0.001), thrombocytopenia (OR: 1.15; 95% CI: 1.777-8.700; p=0.001), and ferritin concentration > 1,000 ng/mL (OR: 4.67; 95% CI: 1.991-10.975; p<0.001) were the independent predictors of mortality among COVID-19 patients. Conclusion The leading comorbidities in our study were hypertension, followed by diabetes. Patients who were 40 years or older, obese patients, and diabetic patients have a higher mortality risk. The poor prognostic predictors in COVID-19 patients were high ferritin levels (>1,000 ng/mL), leukocytosis, lymphocytopenia, and thrombocytopenia.