Human resource shortage in India's health sector: a scoping review of the current landscape.

BACKGROUND: For healthcare delivery to be optimally effective, health systems must possess adequate levels and we must ensure a fair distribution of human resources aimed at healthcare facilities. We conducted a scoping review to map the current state of human resources for health (HRH) in India and the reasons behind its shortage. METHODS: A systematic search was conducted in various electronic databases, from the earliest available date till February 2024. We applied a uniform analytical framework to all the primary research reports and adopted the "descriptive-analytical" method from the narrative paradigm. Inductive thematic analysis was conducted to arrange the retrieved data into categories based on related themes after creating a chart of HRH problems. RESULTS: A total of 9675 articles were retrieved for this review. 88 full texts were included for the final data analysis. The shortage was addressed in 30.6% studies (n = 27) whereas 69.3% of studies (n = 61) addressed reasons for the shortage. The thematic analysis of data regarding reasons for the shortage yielded five kinds of HRH-related problems such as inadequate HRH production, job dissatisfaction, brain drain, regulatory issues, and lack of training, monitoring, and evaluation that were causing a scarcity of HRH in India. CONCLUSION: There has been a persistent shortage and inequitable distribution of human resources in India with the rural expert cadres experiencing the most severe shortage. The health department needs to establish a productive recruitment system if long-term solutions are to be achieved. It is important to address the slow and sporadic nature of the recruitment system and the issue of job insecurity among medical officers, which in turn affects their other employment benefits, such as salary, pension, and recognition for the years of service.

Exercise Therapy and Electrotherapy as an Intervention for Primary Dysmenorrhea: A Systematic Review and Meta-Analysis.

Primary Dysmenorrhea (PD) is characterized by painful cramps before or during menstruation. It is generally treated with nonpharmacological methods. However, with the advancement of research and the passage of time, physiotherapy plays an increasingly important role in treating patients with PD. Electrotherapy and exercise therapy are conservative methods to treat PD. Alternative methods to minimize reliance on medicinal-based treatments are the need of the hour. This review aims to determine the efficacy of exercise-based therapies and electrotherapy modalities in treating PD. Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards have been used in the present systematic review and meta-analysis. Cochrane, PubMed, and Google Scholar were searched to facilitate the same. The articles from 2011 to 2021 were included in this review. The quality of the review was assessed using the Cochrane risk of bias tool. The visual analog scale was taken as a measure of pain intensity in the meta-analysis, and other outcomes have been included in the systematic review discussed. A total of 15 publications have been included, with a meta-analysis of 7. All included studies were of high quality (PEDro ≥ 5), and demonstrated the efficacy of exercise-based therapies and electrotherapy modalities in treating pain in females with PD. This review aims to check the impact of exercise and electrotherapy in females suffering from PD.

Effects of Yogic Interventions on Patients Diagnosed With Cardiac Diseases. A Systematic Review and Meta-Analysis.

Objective: Presently, evidence-based research studies on the efficacy of complimentary therapies like yoga for patients with different cardiac diseases are limited and conflicting. The objective of this study is to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) on yogic interventions compared with usual care or non-pharmacological treatment in patients diagnosed with cardiac diseases. Methods: We conducted an electronic search of literature published from 2006 to May 2021 through five databases. PRISMA statement was used to develop and report a systematic review and meta-analysis protocol. Sixteen RCTs were included in the systematic review and 11 RCTs were used for meta-analysis. Outcome measures were blood pressure, lipid profile, and psychosocial measures. The Cochrane collaboration tool was used to assess bias risk. Results: The results show that yogic interventions resulted in significant reduction in systolic (d = 046; 95% CI.08-0.84; I2 = 81.86%) and diastolic blood pressures (d = 0.56; 95% CI.13-0.99, I2 = 84.84%). A medium statistically significant increase in HDL (d =0.67; 95% CI 0 to 1.33; I2 79.7%) and a low but significant effect on LDL (d = 0.23; 95% CI -0.08-0.54; I2 32.61%), total cholesterol (d =0.28; 95% CI -0.14-0.7; I2 63.72%), and triglycerides (d = 0.43; 95% CI -0.1-0.97; I2 76.64%) were observed. Pooled effect sizes showed a medium to low statistically significant effect on psychosocial indicators viz., QoL, stress, anxiety, and depression. Conclusion: The meta-analysis found strong evidence of effectiveness of yogic interventions on lipid profile, blood pressure, and psychosocial outcomes in patients with diagnosed cardiac diseases.

Health and Fitness of Postmenopausal Women in Urban versus Rural Gurugram: A Cross-Sectional Study.

Context: Throughout that process of menopause, a slew of health and fitness problems arise, all of which have a major effect on a woman's standard of living. Health-related physical fitness has been described as an individual's cardiac fitness (aerobic capacity), musculoskeletal fitness, and body composition. Aim: To investigate and compare the health and fitness of postmenopausal women in rural and urban Gurugram. Settings and Design: The postmenopausal women of Gurugram, both urban (n = 175) and rural (n = 175), who attended the outpatient department of SGT Hospital in the urban area and a house-to-house survey in the rural area, were the subjects of a cross-sectional survey that was carried out using interviews and a pretested semi-structured questionnaire. Levels of physical activity (PA) were assessed using the International PA Questionnaire (short form). The evaluation of body composition, which was the following step, included determining one's body mass index, waist circumference, and waist-hip ratio. Six-minute Walk Distance Test was used to assess cardiopulmonary fitness. Through chair squat tests, sit-and-reach tests, and grip tests, researchers were able to measure the lower limb strength, flexibility, and upper limb strength of participants. Results: The mean age of subjects was 53.61 ± 5.08 years. Most commonly reported health problems were hypertension (31.3%), hyperlipidemia (21.2%), and diabetes (13.4%). Odds of urban women developing hypertension, hyperlipidemia, and myocardial infarction (MI) were found to be 0.61, 0.42, and 0.96 times higher than rural women. There was a statistically significant difference for the squat test, grip test, body composition parameters, and aerobic capacity; however, no statistically significant difference was seen for sit-and-reach test (P > 0.05). Conclusions: The current research shows that postmenopausal women living in metropolitan areas may face higher health risks since they are more prone to develop hypertension, hyperlipidemia, and MI. Furthermore, all fitness metrics - aside from flexibility - were higher for rural women. The results of the current study highlight the urgent need for health promotion initiatives to enhance the health and fitness of urban postmenopausal women.

Impact of telehealth interventions on physiological and psychological outcomes in breast cancer survivors: A meta-analysis of randomised controlled trials.

Introduction: The use of telehealth interventions has been evaluated in different perspectives in women and also supported with various clinical trials, but its overall efficacy is still ascertained. The objective of the present review is to identify, appraise and analyze randomized controlled trials on breast cancer survivors who have participated in technology-based intervention programs incorporating a wide range of physical and psychological outcome measures. Material and methods: We conducted electronic search of the literature during last twenty years i.e., from 2001 till August 10, 2021 through four databases. Standardized mean difference with 95% confidence interval was used. Results: A total of 56 records were included in the qualitative and 28 in quantitative analysis. Pooled results show that telehealth interventions were associated with improved quality of life (SMD 0.48, 95% CI 0.03 to 0.92, p=0.04), reduced depression (SMD -1.27, 95% CI =-2.43 to -0.10 p=0.03), low distress and less perceived stress (SMD -0.40, 95% CI =-0.68 to -0.12, p=0.005). However, no significant differences were observed on weight change (SMD -0.27, 95% CI =-2.39 to 1.86, p=0.81) and anxiety scores (SMD -0.09, 95% CI =-0.20 to 0.02, p=0.10) between the two groups. Improvement in health care competence and fitness among participants was also reported. Conclusion: Study concludes that telehealth care is a quick, convenient and assuring approach to breast cancer care in women that can reduce treatment burden and subsequent disturbance to the lives of breast cancer survivors.

Translation and Cross-Cultural Adaptation of Spinal Cord Independence Measure version III in Hindi Language.

BACKGROUND: The Spinal Cord Independence Measure (SCIM III) specifically assesses individuals with spinal cord injuries. OBJECTIVES: The objective of this study was to translate the SCIM-III into Hindi language to make it available for use in large Indian Hindi speaking population in their native language. METHODS: The SCIM III was translated into the Hindi version with a forward-backward translation and made ready for application by a translation committee. The tool was then reviewed by a review committee to check the translation. Then, pilot testing was done, where patients' responses and comments were noted. A sample of 10 patients was recruited for the pilot testing. RESULTS: The scale was translated into Hindi by the liberal and literal methods. Translation and replacement of the words was done in discussion with professional translator in Hindi language and expert committee. After forward-backward translation and clinical review submitting the final version and then pilot study was done on 10 patients (7 males and 3 females) of spinal cord injury. The mean age is 27.1 years and mother tongue of all the patients was Hindi (100%). CONCLUSION: The Hindi version of the SCIM III is easy and understandable to the large Hindi speaking Indian population.