Development of a community orientation program (COP) as a community-based medical education method for undergraduate medical students: an experience from India.

BACKGROUND: Intra-regional cultural and linguistic differences are common in low- and middle-income countries. To sensitise undergraduate medical students to the social and contextual determinants of health to achieve the 'health for all' goal, these countries must focus on innovative teaching methods. The early introduction of a Community Orientation Program (COP) as a Community-based Medical Education (CBME) method could be a game changing strategy. In this paper the methods, evaluation, and implication of the COP in an Indian setting are described. METHODS: The curriculum of the COP was developed based on the analysis, design, development, implementation, and evaluation (ADDIE) model for educational intervention. In this learner-centric and supervised educational program, the key aim was to focus on developing students' communication skills, observation power and enhancing their motivation for learning through collaborative learning. To meet the objectives of the COP, a situated learning model under the constructivism theory was adopted. RESULTS: Between 2016 and 2019, 557 students were trained through the COP by visiting more than 1300 households in ten villages. To supplement the students' observations in the community, more than 150 small group discussions, a health education programme for the community and summary presentations were conducted. The students' feedback indicated the need to improve the clinical examinations demonstration quality and increase the number of instruments for clinical examinations. More than 80% of students felt that the program would assist them to improve their communication skills, their understanding of the various socio-demographic factors associated with the common diseases, and it will enable them to respect the local culture during their clinical practice. CONCLUSIONS: Early initiation of the COP as a CBME method in the undergraduate medical curriculum in an Indian setting has shown promising results. Further evidence is required to adopt such a program routinely for under-graduate medical teaching in the low- and middle- income settings.

A descriptive cross-sectional study on COVID-19 knowledge, attitude, and practices of South Indian population.

BACKGROUND: The 2019-novel coronavirus (2019-nCoV) started as an epidemic later transformed into a pandemic causing a threat to public health globally. Any community to fight the COVID-19 pandemic requires adequate knowledge, attitude of the people, and practice of the government-imposed laws and regulations. Based on these factors, we framed the objectives to find the sociodemographic profile of the study group and to assess their knowledge, attitude, and practice (KAP) toward COVID-19. These results will help the health planners and administrators in each state to find out the gap in health education efforts. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted on South Indian population to know KAP toward COVID-19. A convenient sampling technique was used to collect the data using Google forms, and analysis was done using the SPSS software version 21. The questionnaire includes sociodemographic information, KAP questions toward COVID-19, and perception toward national and community responses. RESULTS: A total of 1644 were participated; the average knowledge score was 17.5 (+1.9). Most of them (92.9%) respondent's perceived that early detection will have a better outcome from COVID-19, whereas the knowledge compared with practice, there is a significant difference Pearson correlation (0.404) P is < 0.001. CONCLUSIONS: Although a high level of knowledge on COVID-19 in the public gradually decreasing the practice of preventive measures, the government should continue the consistent efforts to change the behavioral communication and motivate the public social responsibility to adhere to the health protocols, masking, hand hygiene, social distancing, and vaccination to prevent expected COVID-19 subsequent episodes.

Utilization of Janani Shishu Suraksha Karyakram and estimation of out of pocket expenditure: A prospective follow-up study among mothers and newborns in Chittoor.

INTRODUCTION: Janani Sishu Suraksha Karyakram (JSSK) is a flagship program of India to reduce out of pocket expenditure (OOPE) of the families during childbirth and neonatal sicknesses. OBJECTIVES: To assess the utilization of JSSK while availing services for childbirth and newborn care in a secondary care hospital in Southern India; estimate the OOPE in services covered by JSSK and identify the associated factors with OOPE. METHODS: 228 mothers who delivered in the previous 2 days, were recruited from a secondary-level government hospital in Chittoor. Expenditure incurred under various components of JSSK was asked during the recruitment and subsequently through telephonic interviews. RESULTS: All components of JJSK, except transport, were fully utilized by the families. 138 mothers (60.5%, 95% CI: 54.0, 67.0), and all sick children (n = 138, 100%) who visited government hospital, incurred OOPE in the form of transport cost. The median expenditure of transport (from home to hospital and hospital to home) of the mothers was 250 INR (IQR: 100-513 INR). Transport expenditure was greater for the rural families (300 INR) than the urban families (100 INR) (p < 0.05). In multiple logistic regression, nuclear families were associated with high OOPE (AOR- 2.0, 95% CI: 1.1- 3.7). Though education of the mother showed high association (AOR- 2.7, 95% CI: 1.0- 7.8), it was not statistically significant (p = 0.05). CONCLUSION: The families utilize most of the components of JSSK, except transport. Family-centric counselling of the beneficiaries during antenatal check-ups and home visits by the healthcare workers can reduce transport-related OOPE.

Prevalence of mental illness and their association with sociodemographic factors in the rural geriatric population in Chittoor, Andhra Pradesh, India: A community-based study.

BACKGROUND: Mental health problems such as cognitive impairment, depression, anxiety, and sleep disorders arising out of senility, neurosis, and living conditions are common in the geriatric population. OBJECTIVE: The objective of this study was to estimate the prevalence of mental illness and to describe their sociodemographic factors in the rural geriatric population and see their association with other factors. METHODOLOGY: A community-based cross-sectional study was done on individuals aged more than 60 years. The study instruments were predesigned semi-structured questionnaire, Folstein's Mini-Mental Status Examination Scale for assessing dementia in cognitive functioning and Yesavages Geriatric Depression Scale to estimate the prevalence of depression and to assess the activities of the daily living by Barthel index and the anxiety were assessed based on the perception of the participants while conducting the interview. RESULTS: A total of 415 individuals participated, out of them 199 (47.9%) were males and 216 (52.1%) were females. Prevalence of mental illness was 217 (52.2%) with one or the other type of mental illness. The prevalence of cognitive impairment was 47.7% and depression according to Geriatric Depression Scale >5 was 27.7%. The remaining 62 (14.9%) had dementia and 30 (7.2%) had anxiety disorder as the mental illness. The socio-demographic factors such as age more than 70 years, female gender, illiterates, living in joint family, middle and lower socio-economic class, financially totally dependent and had poor and unfair relationship with the family members were strongly associated with the mental illness and it was statistically significant with P < 0.05. CONCLUSION: Measures should be taken to support the elders, establish community elderly societies, advisory offices, and services to help the elderly. The sequence of social interventions required for the management of the elderly psychological problems.