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Background: Differentiated tuberculosis care (DTC) approach is the need of the hour to mitigate those risks and provide better treatment outcomes to reduce both mortality and morbidity. Before implementing such an approach, there should be adequate literature on healthcare facility assessment along with qualitative exploration on readiness and acceptability among various stakeholders that are currently needed to fill the gaps in National Tuberculosis Elimination Program. Objectives: Our study objectives were to assess the availability of equipment, treatment, and investigations for managing patients under the DTC approach, to explore the readiness, acceptability, and feasibility of the DTC approach among healthcare providers involved in TB care provision, and to determine the knowledge regarding DTC approach among healthcare providers delivering TB care for COVID-positive pulmonary TB patients. Materials and Methods: All Peripheral Health Institutes (PHIs) in two randomly chosen blocks within the Tiruchirappalli district's health units were selected for the healthcare facilities assessment. By the universal sampling method, all the stakeholders were included. The study population was assessed for their knowledge regarding DTC. Checklist-based assessment of the feasibility of healthcare services followed by a questionnaire-based knowledge assessment was done. An in-depth interview-based exploration of readiness and acceptability of the DTC approach was conducted. This study was conducted among various stakeholders involved in TB care in selected PHIs of Tiruchirappalli from July 2022 to October 2022. Results: The majority of healthcare workers (HCWs) are unaware of bidirectional screening (89.0%) and lack training in providing TB care to COVID-co-infected patients (87.8%), although the majority were aware of risk stratification for TB patients (90.2%) and are linking TB with other co-morbidities (82.9%). About 62.2% of HCWs claimed they are not using information communication technology-based services to receive lab findings from public scans and laboratory centers, and more than one-third were unaware of these facilities. Based on the qualitative assessment, most of them were willing to undergo periodic training to improvise their approach and treatment. Also, most of the HCWs felt manpower can be increased for the specific care of the patients. Conclusion: The research suggests that with sufficient training and upskilling of the HCWs, DTC is almost feasible and that HCWs will accept it if specific strategies are used. More studies like these in assessing the feasibility and acceptability of this DTC approach and exploring the challenges and solutions will help the policymakers in finding the lacunae before implementing this DTC model in various states across India.
RESUMO
BACKGROUND: Healthcare expenditures exacerbate poverty, with about 39 million people falling into poverty every year because of such expenditures. Tobacco and alcohol consumption in addition to harmful health impact have economic consequences at household level. AIM: To evaluate healthcare, alcohol, and tobacco expenditures among households in rural Puducherry and their impact on household expenditure patterns. MATERIALS AND METHODS: A community-based cross-sectional analytical study was conducted in selected villages within 5 km of a medical college hospital in Puducherry from September 2016 to June 2017. Sociodemographic details and various household expenditures were obtained from 817 households with 3459 individuals. Data were analyzed using STATA (v14). RESULTS: Higher mean percentage of health expenditure was found among households with low socioeconomic status [17.7 (95% confidence interval (CI): 14-21.3)] and no health insurance schemes [13.4 (95% CI: 11.1-15.7)]. Households with low socioeconomic status [13.1 (95% CI: 7.5-18.7)] had higher tobacco-alcohol expenditure. Increased health expenditure among households was positively correlated with loan (rs = 0.48). Increased alcohol-tobacco expenditure among households was negatively correlated with food (rs= -0.52) and education (rs= -0.70) expenditure. CONCLUSION: Healthcare and alcohol-tobacco expenditure individually contributed to one-tenth of the household budget. Spending on healthcare, alcohol, and tobacco created significant negative influence on investment in human capital development.
RESUMO
INTRODUCTION: Cancer is a major public health problem worldwide. There is an urgent need for a reinvigorated and tailored approach to promote cancer prevention and treatment-related health education, especially among the youth. OBJECTIVE: (1) To assess the knowledge and awareness of the students of adolescent age group about cancer. (2) To compare two methods of health education on improving awareness about cancer among these students. METHODOLOGY: We conducted an interventional study among students (both male and female) of adolescent age group (10-19 years) who attend Government school (Lakkur and Kugur) in Sarjapur PHC between May and September 2014. A standard pretested validated questionnaire-adopted from Cancer Awareness Measure-translated into Kannada was used. After pretest, health education was given by two modes: in Lakkur - child to child, and Kugur - routine (lecture). Following 2 days of health education, an immediate posttest was conducted. After 2 weeks, the second posttest was conducted. RESULTS: In Kugur School, 96 students and Lakkur School, 104 students participated. The mean age group of students in both the schools was 14 years. The preexisting knowledge scores between both the schools were not statistically significant. There was a significant increase in knowledge of the posttest scores in all three domains of cancer questionnaire in both the schools. Child to child program in Lakkur School was found to be more effective in increasing the knowledge scores. CONCLUSION: To increase the awareness of cancer among schools using child to child method for health education. School curriculum should include sessions on cancer education and reinforced to students periodically. To sustain this measure, school teachers could be trained in nuances of cancer prevention and treatment.
RESUMO
BACKGROUND: Work capacity is the ability to perform real physical work, and work ability is a result of interaction of worker to his or her work that is how good a worker is at present, in near future, and how able is he or she to do his or her work with respect to work demands and health and mental resources. OBJECTIVE: To assess the work capacity and work ability and to study the factors associated with work capacity and work ability of workers at a tea plantation in South India. MATERIALS AND METHODS: A cross-sectional study was conducted at a tea plantation in Annamalai, South India, from March to May 2015. Data were collected using a structured interview schedule comprising of three parts as follows: sociodemographic data, work ability questionnaire, and work capacity assessment. RESULTS: Of the 199 subjects participated in the study, majority [90 (45.3%)] were in the age group of 46-55 years, and 128 (64.3%) were females. Of the 199 workers, 12.6% had poor aerobic capacity (by Harvard Step test), 88.4% had an endurance of more than 1 h, 70.9% had better work productivity and energetic efficiency, and the voluntary activity workers spent most time on household chores. Of the 199 workers assessed, only 9.6% had good work ability. There is negative correlation between work ability and body mass index (BMI). CONCLUSION: Our study found 12.6% workers with poor aerobic capacity and 9.6% of workers with good work ability. Periodic health examinations and other screening procedures should be made as routine in workplace to improve work ability and capacity.
