Male involvement as a significant contributor for enhancing maternal and child health-care services: A scoping review.

Men have conventionally been excluded from Maternal and Child Health (MCH) services, thereby reinforcing the erroneous notion that pregnancy and the processes leading to childbirth and child-rearing are the preserve of women. Participation of men in MCH is crucial for the reduction of infant and maternal mortality. This scoping review focuses on the contribution of male involvement to MCH care and explores the feasible strategies to improve it. Studies on male involvement in the crucial timelines of the MCH and strategies for implementing and improving male involvement in MCH care in India and other developing countries were obtained through a review of literature in PubMed databases using the medical subject headings (MeSH) terms and unpublished, grey literature during the year 1990-2020. Nearly 50 of the eligible articles were included and synthesized into a scoping review report. Findings revealed that the men's participation had a beneficial impact on all crucial timelines of MCH care. Yet, women perceived low male participation in most of the studies. Several different factors that influence have been identified, including education, socioeconomic status, traditional practices, negative stereotyping among males, and lack of male friendly health-care system. Utilization of community volunteers, male peer educators, workplace-based or mass media education, and men-friendly policy changes or health-care provider initiatives could be crucial in improving male involvement in MCH care. Despite worldwide acceptance as an essential contributor to enhancing MCH care, the scoping review revealed low male involvement levels in developing countries and identified strategies to address this lacuna.

Screening for respiratory morbidities and obstructive lung function among municipal waste handlers in Puducherry: A community-based cross-sectional study.

Background: Waste management is a societal problem because of its environmental impact and public health implications. Solid waste handlers have a high incidence of occupational health issues, with respiratory morbidities being the most common. Aim: To assess the prevalence of respiratory morbidities, obstructive lung pattern and its associated factors among municipal solid waste management workers in Puducherry. Materials and Methods: This community-based cross-sectional study was carried out in May and June 2018 among 264 solid waste management workers selected by simple random sampling. They underwent a semi-structured interview schedule capturing their sociodemographic characteristics, work profile, presence of respiratory symptoms, and morbidities followed by lung function tests using a portable spirometer. The data was entered using Epidata entry client and analyzed using SPSS (v16). Results: The mean age of the workers was 47.1 (±8.87) years. The majority were females (85.6%), working as waste collectors (86%) on day duty (73.5%). More than two in five workers had either respiratory morbidity (42.8%) or obstructive lung pattern (44%). Higher age, occupation as waste collector, night shift duty, not using face mask on duty, and not receiving training on waste handling were the factors significantly associated with the respiratory morbidities and obstructive lung function. Conclusion: The prevalence of respiratory morbidities and obstructive lung disease were high among municipal solid waste handlers. Measures are needed to improve the work environment of waste handlers by ensuring the availability of protective gears and adequate training on work handling based on ergonomic principles.

Safeguarding adolescent mental health in India (SAMA): study protocol for codesign and feasibility study of a school systems intervention targeting adolescent anxiety and depression in India.

INTRODUCTION: Symptoms of anxiety and depression in Indian adolescents are common. Schools can be opportune sites for delivery of mental health interventions. India, however, is without a evidence-based and integrated whole-school mental health approach. This article describes the study design for the safeguarding adolescent mental health in India (SAMA) project. The aim of SAMA is to codesign and feasibility test a suite of multicomponent interventions for mental health across the intersecting systems of adolescents, schools, families and their local communities in India. METHODS AND ANALYSIS: Our project will codesign and feasibility test four interventions to run in parallel in eight schools (three assigned to waitlist) in Bengaluru and Kolar in Karnataka, India. The primary aim is to reduce the prevalence of adolescent anxiety and depression. Codesign of interventions will build on existing evidence and resources. Interventions for adolescents at school will be universal, incorporating curriculum and social components. Interventions for parents and teachers will target mental health literacy, and also for teachers, training in positive behaviour practices. Intervention in the school community will target school climate to improve student mental health literacy and care. Intervention for the wider community will be via adolescent-led films and social media. We will generate intervention cost estimates, test outcome measures and identify pathways to increase policy action on the evidence. ETHICS AND DISSEMINATION: Ethical approval has been granted by the National Institute of Mental Health Neurosciences Research Ethics Committee (NIMHANS/26th IEC (Behv Sc Div/2020/2021)) and the University of Leeds School of Psychology Research Ethics Committee (PSYC-221). Certain data will be available on a data sharing site. Findings will be disseminated via peer-reviewed journals and conferences.

Expenditure on health care, tobacco, and alcohol: Evidence from household surveys in rural Puducherry.

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.

Stigma toward mental illness among higher secondary school teachers in Puducherry, South India.

BACKGROUND: A majority of mental illness start during adolescent period, and teachers can be a major resource in provision of mental health services to them. Stigma is a major barrier between persons with mental illness and opportunities to recover. MATERIALS AND METHODS: Cross-sectional analytical study was conducted to assess the stigma toward mental illness and associated factors among higher secondary school teachers in Puducherry from April 2017 to March 2018. Multistage sampling was used to select 566 teachers from 46 schools. A part of the vignette-based "Mental Health Literacy Scale" portraying depression was used to assess stigma toward mental illness. Sociodemographic and work characteristics were also obtained. Data were analyzed using SPSS v16. To identify factors associated with stigma, bivariate analysis was done using Chi-square test and multivariate analysis using logistic regression. RESULTS: Among the teachers, 72.9% and 65.7% showed overall agreement to personal and perceived stigma, respectively, toward case in vignette. Teachers in lower age group [adjusted odds ratio (AOR): 4.6 (95% confidence interval (CI): 2.54-8.33)], male gender [AOR: 2.79 (95% CI: 1.85-4.24)], working in urban [AOR: 2.8 (95% CI: 1.91-4.15)], private schools [AOR: 2.58 (95% CI: 1.77-3.77)], and less teaching experience [AOR: 3.72 (95% CI: 2.4-5.88)] had significantly higher personal stigma. Similarly, lower age group [AOR: 4.6 (95% CI: 2.54-8.33)], male gender [AOR: 2.79 (95% CI: 1.85-4.24)], working in urban [AOR: 2.8 (95% CI: 1.91-4.15)] schools, and less teaching experience [AOR: 3.72 (95% CI: 2.4-5.88)] had significantly higher perceived stigma. CONCLUSION: About 70% teachers showed overall agreement to stigma toward the depressive case vignette. The significant factors influencing stigma were identified. This can act as a baseline to implementmental health training program for teachers therefore bringing an attitudinal shift to being positive toward the psychologically disturbed.