Journal of the Epidemiology Foundation of India
type: channel
description: Journal of the Epidemiology Foundation of India is an official publication of the Epidemiology Foundation of India (EFI). The journal is published in English on quarterly basis and follows double blinded peer review process. Moreover, Journal allows free access (Open Access) to its contents and authors may archive published articles.
publisher: MRI Publication Pvt Ltd on the behalf of Epidemiology Foundation of India
language: en
publication name: Journal of the Epidemiology Foundation of India
issn: 3048-8559
items: Assessment of Mental Health of School-Going Adolescents in Rural Areas of Ghaziabad
items: Nutritional Adequacy Beyond Macronutrients: Dietary Diversity and its Determinants Among PLHIV In Northern India
items: Ensuring Dignity at Birth: Bridging Gaps in Respectful Maternity Care in India and Beyond
items: Latent Tuberculosis Infection Diagnostics: Comparative Performance of TST, IGRAs, and Cy-Tb
items: IMAGE GUIDED MANAGEMENT OF OBSTRUCTIVE JAUNDICE
items: Developing a New Assistive Technology: Parameters, Standards and Compliance Frameworks
items: Development of a composite malaria burden index using principal component analysis for comparative assessment of tribal and non-tribal districts in Chhattisgarh
items: Factors Affecting Health-Seeking Behaviour among High-Risk Pregnant Women in Rural Haryana: A Mixed-Methods Study
items: Violence as a Public Health Issue: A Narrative Review
items: Prescription Audit in outpatient department of a district level government hospital in northern Kashmir: an observational study
items: Assistive Technology (AT) Landscape in India: The Story so far and Road Ahead
items: ACUTE RHEUMATIC FEVER
items: https://efi.org.in/journal/index.php/JEFI/article/view/530
items: The prevalence of sleep disorders in adults: a descriptive population-based study in Western Uttar Pradesh
items: Exploring the impact of Yoga on Postpartum Depression: Implications for Maternal Mental Health- A Narrative Review
items: Impact of Educational Program on Nursing Officers’ Knowledge of Emerging & Re-emerging Diseases in Punjab, India
items: Comparative accuracy of chatbots for queries related to methods of tobacco cessation: A systematic review
items: Rapid Multi – State Assessment Of Birth Waiting Homes Under NHM: Functioning, Utilization, Cost-Effectiveness And Policy Implications
items: Need based training of Community Health Volunteers for Cervical Cancer in Delhi – A before and after study
items: Comparative Evaluation of Residual Diagnostic Measures for Outlier Detection in Linear Regression: An Empirical Study Using Heart Rate Data
items: Prevalence of Low Bone Mineral Density and Assessment of Screening Tools in a Rural Area of Delhi
items: Assessment of stress, anxiety, and depression among medical students at a medical college in North India
items: Comparative Study of Nutritional Status among Populations of Umarwada (Urban Area) and Olpad (Rural Area): A Community-Based Cross-Sectional Study in Surat.
items: Feasibility of a Multi-Stakeholder Engagement Model for Community-Based Management of Malnutrition
items: Relationship of Vitamin D status with obesity amongst children residing in Himachal Pradesh, India
items: Early postnatal care and full immunization: district-level evidence from National Family Health Survey (NFHS-5), India
items: Sociodemographic, clinical and dietary determinants of Gestational diabetes mellitus: A Case-control Study.
items: Effect of School Eye Health Education Program on Eye Health Knowledge and Practice Among School Students in Rural Aligarh: An Interventional Study
items: Prevalence of Workplace Violence Against Doctors in a Tertiary Care Hospital of Delhi
items: https://efi.org.in/journal/index.php/JEFI/article/view/525

Assessment of Mental Health of School-Going Adolescents in Rural Areas of Ghaziabad
type: item
description: Background: India has one of the largest adolescent populations globally. Mental health problems during adolescence can significantly affect growth, academic performance, and future well-being. Despite its importance, adolescent mental health remains underexplored, particularly in rural areas. Aims & Objectives: To assess the mental health status of school-going adolescents studying in classes 6 to 10 in rural schools of Ghaziabad and to determine its association with selected sociodemographic factors. Methodology: A community-based cross-sectional study was conducted among 357 adolescents aged 12–17 years studying in rural schools of Ghaziabad. Data were collected using a predesigned semi-structured questionnaire covering sociodemographic details and mental health assessment. Responses were recorded on a Likert scale and total scores were categorized as Poor (<13), Satisfactory (13–26), and Good (>26). Institutional permission was obtained, and consent was taken from school authorities. Data were analysed using Statistical Package for the Social Sciences version 26. Results: More than half of the adolescents (54.3%) had poor mental health status, while 43.2% had satisfactory and 2.5% had good mental health. Younger adolescents (12–13 years) showed poorer mental health compared to older groups. Significant associations were observed between mental health status and age, family income, and living with parents. Common psychological concerns included feeling low, difficulty concentrating, sleep disturbances, and thoughts of self-harm. Findings were consistent with studies conducted in Bangladesh and rural Tamil Nadu showing high levels of adolescent psychological distress. Conclusion: A considerable proportion of rural adolescents demonstrated poor mental health. Strengthening school-based counselling services, enhancing parental engagement, and implementing community awareness programmes are essential to improve adolescent mental well-being in rural Ghaziabad.
subject: EFICON 2025 Abstracts
  topic: section
creator: Mehak Pal Kaur
creator: Deepika Agrawal
creator: Syed Hasan Nawaz Zaidi
creator: Neha Jetli
rights: Copyright (c) 2025 Mehak Pal Kaur, Deepika Agrawal, Syed Hasan Nawaz Zaidi, Neha Jetli (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 64
ending page: 64
doi: 10.56450/JEFI.2025.v3i2Suppl.064

Nutritional Adequacy Beyond Macronutrients: Dietary Diversity and its Determinants Among PLHIV In Northern India
type: item
description: Introduction: Dietary diversity is a critical component of nutritional adequacy and overall health. In people living with HIV (PLHIV), suboptimal dietary diversity can worsen nutritional deficiencies and compromise immune recovery. Limited evidence exists regarding dietary diversity patterns and influencing factors among PLHIV in North India. Objectives: To assess the level of dietary diversity and determine its socio-demographic and clinical correlates among PLHIV attending a tertiary care hospital. Methods: A cross-sectional study was conducted among 400 adults enrolled at an ART Centre in Western Uttar Pradesh. Data on socio-demographic and HIV-related characteristics were collected using a structured proforma. Dietary diversity was assessed by 24-hour recall using the FAO 10-food group method. Dietary Diversity Score (DDS) ranged from 0–10 and was categorized as low (0–3), medium (4–6), and high (7–10). Descriptive statistics were applied; association analysis with selected variables is ongoing. Results: The mean age of participants was 41.1 ± 10.8 years, and 52.5% were male. Most were rural residents (74.8%) and unemployed (46%). The mean DDS was 4.06 ± 1.40, with over half (52.3%) having low dietary diversity, 39.2% moderate, and only 8.5% high diversity. The distribution was right-skewed, reflecting limited consumption of diverse food groups. Conclusion: Dietary diversity was found to be suboptimal among PLHIV, suggesting inadequate diet quality and potential nutritional vulnerability. Further statistical analysis to identify socio-demographic and clinical factors associated with dietary diversity is underway and will be presented at the conference. Keywords: Nutrition, PLHIV, Dietary diversity
subject: EFICON 2025 Abstracts
  topic: section
creator: Syed Sohaib Hashmi
creator: Mohammad Athar Ansari
creator: Ali Jafar Abedi
creator: Salman Khalil
rights: Copyright (c) 2025 Syed Sohaib Hashmi, Mohammad Athar Ansari, Ali Jafar Abedi, Salman Khalil (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 63
ending page: 63
doi: 10.56450/JEFI.2025.v3i2Suppl.063

Ensuring Dignity at Birth: Bridging Gaps in Respectful Maternity Care in India and Beyond
type: item
description: Introduction: Respectful maternity care (RMC) is a human-rights-based approach ensuring dignity, privacy, confidentiality, informed consent, effective communication, non-discrimination, emotional support, pain relief, choice of birthing position, and companionship during labour. These components are essential for improving maternal satisfaction, reducing mistreatment, and encouraging facility-based childbirth. Four studies were analyzed: tertiary care hospitals in Bhopal (n≈150) and Odisha (n=246), a community-based study in Northern India (n=485), and a global scoping review (10 studies). Results Gandhi Medical College, Bhopal, Madhya Pradesh – Tertiary Care (Shwetha et al., 2023): Patient satisfaction scores in labour rooms and OT ranged 4.55–4.59/5, indicating generally positive experiences. All India Institute of Medical Sciences, Bhubaneswar Odisha–Tertiary care (Yadav et al., 2023 n=246): 35% reported good RMC; dignified care (82%) and non-discrimination (79%) were strong; consent (48%) and confidentiality (52%) were weak. Barriers: staff shortage, workload. All India Institute of Medical Sciences, New Delhi, northern India rural villages – Community-based (Kaur et al., 2023, n=485): 88.7% experienced RMC; communication and autonomy scored 62.9%. Gaps: poor communication, no choice of birthing position, inadequate pain relief, absence of companion. Global Review – Multi-country (Mira-Catalá et al., 2024, 10 studies, Africa, Mexico, USA): Interventions like provider training, maternity open days, checklists, and continuous user feedback improved RMC. Reductions were noted in physical abuse (4%→2%), non-consented care (83%→65%), and verbal abuse (18%→11%), while women’s reports of respectful care increased from 12% to 64%. Conclusion: Although RMC practices are improving in India, significant gaps remain, particularly in consent, communication, autonomy, and emotional support. Prioritizing continuous provider training, patient-centered policies, monitoring mecha…
subject: EFICON 2025 Abstracts
  topic: section
creator: Rozaline Lenka
creator: Srikanth Srinivasan
creator: Yogesh Jain
creator: Gautam Mohanan
creator: Priyanka Sidholi
creator: Sanjana Jaiswal
creator: Smilee Choudhary
rights: Copyright (c) 2025 Rozaline Lenka, Srikanth Srinivasan, Yogesh Jain, Dr. Gautam Mohanan, Priyanka Sidholi, Sanjana Jaiswal, Smilee Choudhary (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 60
ending page: 60
doi: 10.56450/JEFI.2025.v3i2Suppl.060

Latent Tuberculosis Infection Diagnostics: Comparative Performance of TST, IGRAs, and Cy-Tb
type: item
description: Background: Traditional methods such as Tuberculin Skin Test (TST) demonstrates reduced specificity due to BCG vaccination and environmental mycobacteria cross-reactivity. Interferon-Gamma Release Assays (IGRAs) improve specificity but require complex laboratory infrastructure. The Cy-Tb skin test has emerged as an affordable, and field-friendly diagnostic alternative. Objective: This review synthesizes current evidence comparing LTBI diagnostics, focusing on procedures, diagnostic accuracy, safety, and programmatic relevance of Cy-Tb relative to TST and IGRA, with emphasis on high TB burden settings. Methods: Comprehensive searches were conducted in Medline and Scopus databases using terms such as “latent tuberculosis infection,” “Cy-Tb skin test,” “tuberculin skin test,” “interferon-gamma release assay,” and “diagnostic accuracy.” 35 studies published between 2015-2025 were included. Results: Sensitivity for Cy-Tb ranged from 70% to 80%, and specificity ranged from 98% to 99% (Ruhwald M et al., South Africa and Muniyandi M et al., India). TST sensitivity ranged from 60% to 77%, while specificity from 55% to 65% in BCG vaccinated populations. (Chandrasekaran P et al., India). For IGRAs, sensitivity ranged from 75% to 85%, and specificity from 95% to 98%. (Chandrasekaran P et al., India and Pai M et al., Canada) The concordance between Cy-Tb and IGRA exceeds 90%, demonstrating strong diagnostic agreement (Aggerbeck H et al., 2018). Cy-Tb is associated mainly with mild, transient local injection site. TST can cause local skin reactions and rare systemic hypersensitivity, while IGRAs carry minimal risk (Hamada et al., China). Conclusion: Cy-Tb offer improved specificity and comparable sensitivity to IGRAs with simplicity and cost-effectiveness suitable for large-scale implementation in high-burden settings. Scalable and accessible LTBI diagnostics with favourable safety profiles, like Cy-Tb, are critical to accelerating TB elimination efforts globally. Keywords: laten…
subject: EFICON 2025 Abstracts
  topic: section
creator: Smilee Choudhary
creator: Suman Saurabh
creator: Manoj Kumar Gupta
creator: Rozaline Lenka
creator: Priyanka Sidholi
creator: Sanjana Jaiswal
rights: Copyright (c) 2025 Smilee Choudhary, Suman Saurabh, Manoj Kumar Gupta, Rozaline Lenka, Priyanka Sidholi, Sanjana Jaiswal (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 72
ending page: 72
doi: 10.56450/JEFI.2025.v3i2Suppl.072

IMAGE GUIDED MANAGEMENT OF OBSTRUCTIVE JAUNDICE
type: item
subject: Standard Treatment Workflow (STW)
  topic: section
creator: Sanjiv Sharma
creator: Amar Mukund
creator: Pushpinder Singh Khera
creator: Rengarajan Rajagopal
creator: Pankaj Banode
creator: N Shyam Kumar
creator: Sanjeev Kumar
creator: Manish Shaw
creator: Pradeep Hatimota
creator: Niraj Pandey
rights: Copyright (c) 2024 Sanjiv Sharma, Amar Mukund, Pushpinder Singh Khera, Rengarajan Rajagopal, Pankaj Banode, N Shyam Kumar, Sanjeev Kumar, Manish Shaw, Pradeep Hatimota, Niraj Pandey (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-04-28
publication date: 2025-04-28
starting page: S271
ending page: S272
doi: 10.56450/JEFI.2024.v2i2Suppl.009

Developing a New Assistive Technology: Parameters, Standards and Compliance Frameworks
type: item
description: Background: Assistive Technology (AT) development in India lacks a unified compliance and regulatory framework. Objective: To provide a framework that guides innovators in developing ATs aligned with regulatory, ethical, and quality standards. Methods: A comprehensive synthesis of national (ICMR, CDSCO, BIS, MoHFW, MeitY, MoSJE) and international (ISO, IEC, FDA, WHO, CE) standards was undertaken to frame a multi-tier compliance pathway. Results: A structured compliance process integrating user-centric design, safety testing, ethical, clinical validation, and digital interoperability was developed. Conclusion: The proposed framework enables developers to design, test, and commercialize ATs safely, ensuring compliance, accessibility, and sustainability across India’s regulatory ecosystem.
subject: Short Article
  topic: section
subject: Assistive Technology
  topic: keywords
subject: Compliance Framework
  topic: keywords
subject: Standards
  topic: keywords
subject: Accessibility
  topic: keywords
creator: Hitesh K Sharma
creator: Ashoo Grover
creator: Ravinder Singh
rights: Copyright (c) 2025 Hitesh K Sharma, Ashoo Grover, Ravinder Singh (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-12-31
publication date: 2025-12-31
starting page: 66
ending page: 70
doi: 10.56450//JEFI.2025.v3i1Suppl.009

Development of a composite malaria burden index using principal component analysis for comparative assessment of tribal and non-tribal districts in Chhattisgarh
type: item
description: Background: Malaria remains a significant public health problem globally and in India. Despite accounting for only 2.29% of India’s population, Chhattisgarh contributes a disproportionately high share of malaria cases and deaths in the country. Traditional surveillance indicators often provide fragmented information on disease burden. A composite index integrating multiple indicators may provide a more comprehensive assessment of malaria burden and help identify high-risk areas for targeted interventions. Objectives: To develop a composite Malaria Burden Index (MBI) using Principal Component Analysis (PCA) and to compare the malaria burden between tribal and non-tribal districts of Chhattisgarh. Methods: A secondary data analysis was conducted using district-level malaria surveillance data for 2024 obtained from the National Vector-Borne Disease Control Programme (NVBDCP) database. Five key malaria indicators were included: Annual Parasite Incidence (API), Annual Blood Examination Rate (ABER), Slide Positivity Rate (SPR), Annual Falciparum Incidence (AFI), and Slide Falciparum Rate (SFR). Districts were categorized as tribal or non-tribal according to the Ministry of Tribal Affairs classification. PCA was performed using IBM SPSS Statistics (version 25) to construct the composite MBI based on the correlation matrix. The first principal component (PC1) was retained as the MBI. Results: The first principal component (PC1) had an eigenvalue of 4.739 and explained 94.78% of the total variance and was retained as the Composite Malaria Burden Index. Based on these scores, districts were categorized into low, moderate, and high malaria burden groups. High MBI scores are concentrated in the southern tribal districts, particularly Bijapur, Narayanpur, and Dakshin Bastar. Most non-tribal districts fall into the low or moderate burden categories. Conclusion: The Composite Malaria Burden Index provides an integrated measure for assessing malaria burden at the district level. Th…
subject: EFICON 2025 Abstracts
  topic: section
creator: Sanooja Sherin Chakkalakkunnan
creator: Arvind Shukla
creator: Gouri Kumari Padhy
rights: Copyright (c) 2025 Sanooja Sherin Chakkalakkunnan (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 75
ending page: 75
doi: 10.56450/JEFI.2025.v3i2Suppl.075

Factors Affecting Health-Seeking Behaviour among High-Risk Pregnant Women in Rural Haryana: A Mixed-Methods Study
type: item
description: Background: High-risk pregnancy (HRP) constitutes 20–30% of all pregnancies in India and contributes to 75% of perinatal morbidity and mortality. Despite national programmes such as the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), only 14% of pregnancies are currently classified as high-risk on national platforms. Sub-centres represent the most peripheral public health unit, yet their readiness to manage HRP remains understudied, particularly in rural Haryana. Objectives: To assess infrastructure and service readiness of rural sub-centres for maternal healthcare and to explore healthcare provider perspectives on barriers in the management of high-risk pregnancies. Methods: A community-based, cross-sectional, convergent parallel mixed-methods study was conducted across 10 randomly selected sub-centres under CHC Dighal and CHC Dubaldhan, Jhajjar district, Haryana. Quantitative data were collected using a validated sub-centre checklist. Qualitative data were obtained through in-depth interviews (IDIs) with 12 healthcare workers (4 LMOs, 4 ANMs, 4 ASHAs) and analysed using inductive thematic analysis. Ethical clearance was obtained from the IEC, Pt. B. D. Sharma PGIMS, Rohtak. Results: Most sub-centres had adequate basic infrastructure — 90% had electricity, water supply (80%), and essential diagnostic equipment. However, 30% lacked examination tables and blood glucose measurement was absent in 30% of facilities. All sub-centres referred identified HRP cases (100%). Five barrier themes emerged from IDIs: challenges in client engagement, inadequate infrastructure and care provision, barriers to timely ANC registration, limited community acceptance and support, and gaps in access to comprehensive maternal healthcare. Key barriers included communication difficulties, transportation deficits, healthcare worker knowledge deficiencies across all cadres, cultural misconceptions about pregnancy and inadequate family involvement. Conclusion: While basic sub-centre infrastr…
subject: EFICON 2025 Abstracts
  topic: section
creator: Srishti Singh
creator: Varun Arora
creator: Anik Chakraborty
creator: Narender Bhukkal
creator: Amandeep Kaur
creator: Trushna Parida
rights: Copyright (c) 2025 Srishti Singh, Varun Arora, Anik Chakraborty, Narender Bhukkal, Amandeep Kaur, Trushna Parida (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 71
ending page: 71
doi: 10.56450/JEFI.2025.v3i2Suppl.071

Violence as a Public Health Issue: A Narrative Review
type: item
description: Background: Despite significant economic growth, India confronts an endemic crisis of violence. This paper argues for a paradigm shift, reframing violence from a purely criminal-legal issue to a multifaceted public health epidemic that requires a prevention-oriented approach. Methods: The analysis adopts a public health lens, employing the Four-Step Scientific Methodology and the Social-Ecological Model as foundational frameworks. It synthesizes and examines national data from key surveillance systems, including the National Family Health Survey (NFHS) and the National Crime Records Bureau (NCRB), to define the problem and identify its structural determinants. Results: The epidemiological findings reveal a crisis of staggering proportions. Nearly one-third of married women (29.3%) experience spousal violence (NFHS-5), and the nation's suicide rate reached an unprecedented high of 12.4 per 100,000 population in 2022 (NCRB). Deep-rooted determinants, including patriarchy, caste hierarchies, and socioeconomic deprivation, were identified as primary drivers. The appraisal of systemic responses revealed significant implementation gaps in progressive laws like the PWDVA (2005) and an underutilization of the healthcare system as a frontline for intervention. Conclusion: Violence in India is a preventable public health epidemic. A comprehensive, multi-pronged strategy is essential, operating across primary, secondary, and tertiary prevention levels. This includes sustained public awareness campaigns, strengthening the healthcare response, and providing integrated, long-term support for survivors to foster a safer and more just society. Keywords: Violence, Public Health, India, Structural Determinants, Prevention
subject: EFICON 2025 Abstracts
  topic: section
creator: Sanjana Jaiswal
creator: Simlee Choudhary
creator: Priyanka Sidholi
creator: Rozaline Lenka
rights: Copyright (c) 2025 Sanjana Jaiswal, Simlee Choudhary, Priyanka Sidholi, Rozaline Lenka (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 73
ending page: 73
doi: 10.56450/JEFI.2025.v3i2Suppl.073

Prescription Audit in outpatient department of a district level government hospital in northern Kashmir: an observational study
type: item
description: Background: An ‘audit’ is defined as ‘the review and the evaluation of the health care procedures and documentation for the purpose of comparing the quality of care which is provided, with the accepted standards’. Studying the prescription audit is that part of the audit which seeks to monitor, evaluate and if necessary, suggest modifications in the prescribing practices of medical practitioners. Aims and objectives: In this study, we aimed to study the prescription pattern and assess the quality of prescription, with the standard prescription norms in Out Patient department of various specialities of a Government District Hospital. Methodology: This observational study was conducted on the patients receiving medication during treatment in the outpatient departments of various specialities of the District Hospital, over a period of one month and the calculated sample size was 95 (according to the guidelines of prescription audit by MoHFW). An additional sample of 5 was included in the study, making the total sample size 100. Results: A total of 20 parameters were assessed using a checklist. It was found that out of 100 study participants, brief history was mentioned in 51% prescriptions; dosage, duration and frequency was mentioned in 72% prescriptions, sign and stamp of the treating doctor was present on 37% prescriptions; medications were written in capital letters in 70% prescriptions, but were written in generic form in only 17% prescriptions. 78% of the medication orders were clear and readable; route of administration was not mentioned in 65% prescriptions. Vitamins, tonics or enzymes were prescribed in only 10% prescriptions, while antibiotics were prescribed in 44% prescriptions. Conclusion: This study provides insights into prescription patterns and quality. By addressing the identified limitations and incorporating recommendations, healthcare providers can enhance the quality of prescriptions, leading to improved patient care and treatment outcomes in the …
subject: EFICON 2025 Abstracts
  topic: section
creator: Numan Farooq Kawa
creator: Rohul Jabeen Shah
creator: Anjum Fazili
creator: Hanna Zahoor Hamdani
rights: Copyright (c) 2025 Numan Farooq Kawa, Rohul Jabeen Shah, Anjum Fazili, Hanna Zahoor Hamdani (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 69
ending page: 69
doi: 10.56450/JEFI.2025.v3i2Suppl.069

Assistive Technology (AT) Landscape in India: The Story so far and Road Ahead
type: item
description: The importance of Assistive technology (AT) is gaining serious attention worldwide due to recent technological advancements, an aging population, and the rising prevalence of non-communicable diseases (NCDs) and functional impairments. Global reports on AT reveal that one in every three globally requires at least one AT and this need is further exacerbated by age, region and socioeconomic status, making individuals belonging to LMICs the most vulnerable. The preliminary findings of the ICMR-initiated rATA survey, currently underway across India, reveal a significant gap between AT needs and AT access, with females, older age groups, and individuals from rural and tribal areas being the most vulnerable. Although there have been significant innovations in the field of AT with the advent of Artificial Intelligence (AI) and machine learning (ML), affordability, accessibility and limited customisations as per user needs hinder the wider adoption of AT, especially in India, with a vast population, diverse cultural and geographical landscapes and limited awareness about AT services and products. Indian government initiatives such as the RPwD Act, ADIP and RVY schemes, intended at provisioning AT services for eligible individuals which includes persons with disabilities (PwDs) and individuals above 60 years, have substantially failed to deliver as promised mainly due to inadequate financial allocations, poor distribution and supply chain networks, weak regulatory enforcements and limited awareness of schemes among the targeted beneficiaries. In this regard, this article attempts to provide a comprehensive overview of the current situation of AT in India, focusing on government initiatives and schemes, current demand and scope for AT, barriers in AT adoption and finally recommendations and best practices for a successful AT adoption in India.
subject: Review Article
  topic: section
subject: Assistive Technology
  topic: keywords
subject: Functional Impairments
  topic: keywords
subject: Unmet Needs
  topic: keywords
subject: Accessibility
  topic: keywords
subject: User-centric Design
  topic: keywords
creator: Meely Panda
creator: Tarun Chandra Gaddam
rights: Copyright (c) 2025 Meely Panda, Tarun Chandra Gaddam (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-12-31
publication date: 2025-12-31
starting page: 37
ending page: 45
doi: 10.56450//JEFI.2025.v3i1Suppl.006

ACUTE RHEUMATIC FEVER
type: item
subject: Standard Treatment Workflow (STW)
  topic: section
creator: Krishna Kumar
creator: Saurabh Gupta
creator: Shreepal Jain
creator: Ritchie Sharon Solomon
creator: Navaneetha Sasikumar
creator: Debashree Ganguly
rights: Copyright (c) 2024 Krishna Kumar, Saurabh Gupta, Shreepal Jain, Ritchie Sharon Solomon, Navaneetha Sasikumar, Debashree Ganguly (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-04-28
publication date: 2025-04-28
starting page: S307
ending page: S309
doi: 10.56450/JEFI.2024.v2i2Suppl.027

https://efi.org.in/journal/index.php/JEFI/article/view/530
type: item
title: Prevalence of Adverse Events Following Immunization (AEFI) among Children (0–16 Years) Receiving Routine Vaccines under the National Immunization Schedule: A Cross-Sectional Study in a Tertiary Hospital, June September 2025
description: Introduction: India’s National Immunization Schedule (NIS) ensures universal access to vaccines against vaccine-preventable diseases 2. Although vaccines are safe, no vaccine is entirely without risk, and adverse reactions will occasionally occur following immunization 3. Adverse Events Following Immunization (AEFI) require robust monitoring to maintain public confidence and safety surveillance Objectives: To estimate the prevalence of AEFI among children (0–16 years) receiving routine vaccines under NIS and to identify sociodemographic and vaccine-related factors associated with AEFI occurrence in a tertiary care setting Methodology: A cross-sectional study was conducted from June to September 2025 at the Immunization Clinic of a tertiary hospital in West Bengal. A total of 286 children (0–16 years) and their caregivers were recruited. Data were collected using a pre-tested structured questionnaire capturing: Sociodemographic profile, Vaccine type, dose, and site, Occurrence and type of AEFI within 7 days post-vaccination. Descriptive statistics were used to estimate prevalence, and the Chi-square test assessed associations between independent variables and AEFI occurrence, with p < 0.05 considered significant Results: The overall prevalence of AEFI was 25.9% (n=74). The most common AEFI was fever (82.4%), followed by local swelling at the injection site (28.4%). Most AEFIs appeared within 24 hours of vaccination, with fever subsiding by day 3, while 5.4% of swelling cases persisted up to day 7. A majority of AEFIs (63.5%) occurred in the 1 to below 9 month age group, followed by 16–24 months (16.2) Conclusion: The study highlights that while most AEFIs are minor and self-limiting. Strengthening AEFI surveillance systems, and ensuring timely management and reporting are crucial to sustaining trust in India’s Universal Immunization Programme
subject: EFICON 2025 Abstracts
  topic: section
subject: Health Policies, Systems and Management
  topic: category
subject: Adverse Events Following Immunization, National Immunization Schedule, Universal Immunization Program, Vaccine Safety, Children, India
  topic: keywords
creator: Haritha H P
creator: Gitismita Naik
creator: Sunil Dash
rights: Copyright (c) 2025 Dr Haritha H P, Dr Gitismita Naik, Dr Sunil Dash (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 92
ending page: 92
doi: 10.56450/JEFI.2025.v3i2Suppl.092

The prevalence of sleep disorders in adults: a descriptive population-based study in Western Uttar Pradesh
type: item
description: Background Sleep-related disorders are increasingly recognized as important contributors to non-communicable diseases, particularly cardiovascular conditions. Disorders such as obstructive sleep apnea (OSA), insomnia, and poor sleep quality are linked with hypertension, diabetes, obesity, and physical inactivity. Despite their growing significance, community-based data from India, especially Western Uttar Pradesh, are limited. Early detection through simple screening tools like the STOP-BANG questionnaire can facilitate timely intervention and reduce disease burden. Aims & Objectives Aim: To assess the prevalence of sleep-related disorders and their association with cardiovascular risk factors. Objectives: (1) To estimate the prevalence of sleep-related disorders; (2) To determine the prevalence of cardiovascular risk factors; (3) To assess their association Methodology A community-based cross-sectional study was conducted among 1600 adults aged 30–70 years in four districts of Western Uttar Pradesh using multistage random sampling. Data were collected using validated tools including the Global Sleep Assessment Questionnaire, Pittsburgh Sleep Quality Index, STOP-BANG questionnaire, Epworth Sleepiness Scale, and Global Physical Activity Questionnaire. Anthropometric and clinical measurements were recorded. Results Sleep-related breathing disorders and insomnia were observed in 37% and 36% of participants, respectively. Poor sleep quality was reported by 23.9%, and 11% had daytime dysfunction. OSA prevalence (STOP-BANG ≥3) was 11.8%, significantly higher among males (p<0.001). Overweight/obesity (34.3%), hypertension (19.3%), and diabetes (12.3%) were common. Significant associations were found between sleep disorders and cardiovascular risk factors. Conclusion Sleep-related disorders are highly prevalent and strongly associated with cardiovascular risk factors. Health practitioners should be aware of this high prevalence, as early identification and treatment can imp…
subject: EFICON 2025 Abstracts
  topic: section
subject: sleep-related disorders, obstructive sleep apnea, cardiovascular risk factors,
  topic: keywords
creator: Rambha Pathak
creator: Rashmi Upadhyay
creator: Saurabh Srivastava
creator: Kiran Jakhar
creator: Abhishek Bharti
creator: Kriti Singh
rights: Copyright (c) 2025 Rambha Pathak, Dr.Rashmi Upadhyay, Dr. Saurabh Srivastava, Dr.Kiran Jakhar, Dr Abhishek Bharti, Dr Kriti Singh (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 87
ending page: 87
doi: 10.56450/JEFI.2025.v3i2Suppl.087

Exploring the impact of Yoga on Postpartum Depression: Implications for Maternal Mental Health- A Narrative Review
type: item
description: Background: Postpartum depression (PPD) is affecting 19% of women within the first year after childbirth globally. PPD significantly impacts a mother’s emotional well-being, underscoring the need for early identification and intervention. Pharmacological treatments, though effective, may be limited by breastfeeding safety concerns. Consequently, non-pharmacological approaches such as yoga have gained attention as accessible strategies to enhance maternal well-being. Objective: This narrative review synthesizes current evidence on the effectiveness of yoga-based interventions in alleviating postpartum depressive symptoms and improving maternal mental health. Methods: This comprehensive review analyzed data from twelve research papers and reviews published between 2012- 2025. Studies involving postpartum women (≤12 months after delivery) receiving yoga interventions were included. Data on study design, intervention characteristics, and mental-health outcomes were narratively synthesized. Results: Anxiety and depression were assessed with different scales, reported a statistical diminution of anxiety when applying the interventions: yoga during pregnancy (p < 0.001) and in postpartum (p < 0.05). Visual Reality enhanced mindfulness and yoga intervention’s therapeutic effects offers a powerful, scalable approach to treating postpartum depression and anxiety immediate changes in EPDS scores were strongly correlated with changes in GAD-7 scores (r = 0.68, P < 0.001), and moderately correlated with changes in salivary cortisol levels (r = 0.53, P < 0.01). Laughter Yoga (LY) significantly reduced postpartum depression symptoms (t (102) = -14.007; p = 0.000 < 0.05). Yoga was significantly associated with a reduction of depressive symptoms during the postpartum period (SMD, −0.73 [95% CI, −1.84 to −0.43], P < 0.001). However, most studies had small sample sizes and limited follow-up, restricting generalizability. Conclusion: Evidence indicates that yoga is a feasible, low-risk…
subject: EFICON 2025 Abstracts
  topic: section
creator: Priyanka Sidholi
creator: Naveen KH
creator: Manoj Kumar Gupta
creator: Srikanth Srinivasan
creator: Naresh Nebhinani
rights: Copyright (c) 2025 Priyanka Sidholi, Naveen KH, Manoj Kumar Gupta, Srikanth Srinivasan, Naresh Nebhinani (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 74
ending page: 74
doi: 10.56450/JEFI.2025.v3i2Suppl.074

Impact of Educational Program on Nursing Officers’ Knowledge of Emerging & Re-emerging Diseases in Punjab, India
type: item
description: Introduction: Emerging and re-emerging diseases, such as tuberculosis, dengue, malaria, and influenza, remain major global health challenges. Nursing officers are vital in detection and management, yet knowledge gaps persist. This study aimed to assess the effectiveness of an educational intervention to improve their knowledge in selected institutions of Punjab, India. Methodology: A one group pre and post-test research design was adopted to conduct study among 30 nursing officers working in selected institutions of Punjab selected through convenience sampling. Structured questionnaire was used to collect the data from participants. Descriptive and inferential statistics was done with SPSS version 24. Results: Mean knowledge scores improved significantly across most domains. Scores for emerging and re-emerging conditions increased from 11.4±2.88 to 16.5±1.99 (p<0.05). Knowledge about tuberculosis, vector-borne diseases, and rabies improved from 10.9±3.72 to 17.6±1.77 (p<0.05); HIV, hepatitis, and diarrhoeal diseases from 11.8±3.34 to 17.5±1.57 (p<0.05); cardiovascular diseases, diabetes, and stroke from 9.96±3.22 to 13.8±2.22 (p<0.05); prevention and management of NAFLD and COPD from 11.6±2.49 to 16.4±3.14 (p<0.05); and mental well-being from 13.3±2.52 to 17.6±2.61 respectively. Only cancer prevention and management showed a modest, statistically non-significant change 9.20±2.51 to 11.55±1.86 (p=0.76). Conclusion: Structured educational intervention significantly improved nursing officers’ knowledge across multiple domains of emerging and re-emerging communicable diseases. Integrating such targeted training into routine professional development programs can strengthen the capacity of healthcare systems to detect, prevent, and control communicable disease outbreaks which can contribute to improved public health outcomes in Punjab and beyond.
subject: EFICON 2025 Abstracts
  topic: section
creator: Kamlesh K Sharma
creator: Simarjeet Kaur
creator: Atul Sharma
rights: Copyright (c) 2025 Kamlesh K Sharma, Simarjeet Kaur, Atul Sharma (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 70
ending page: 70
doi: 10.56450/JEFI.2025.v3i2Suppl.070

Comparative accuracy of chatbots for queries related to methods of tobacco cessation: A systematic review
type: item
description: Background: Artificial intelligence (AI)-based conversational agents, including chatbots and machine learning (ML) platforms, are increasingly being used to disseminate health information and assist in tobacco cessation counselling. However, their comparative accuracy in providing evidence-based tobacco cessation advice remains unclear. Objective: This systematic review aimed to evaluate and compare the accuracy of responses provided by chatbots and ML platforms to queries related to methods of tobacco cessation. Methods: Following PRISMA guidelines, a comprehensive electronic search was performed in October 2025 across PubMed, EMBASE, Web of Science, and Scopus. The search strategy was structured using the PICO framework. Grey literature was identified through Google Scholar and OpenGrey, and reference lists of included studies were hand-searched. Eligible studies included descriptive, observational, cohort, cross-sectional, and case-control designs that compared the accuracy of chatbots or ML-based systems for tobacco cessation queries. Data were extracted and synthesized narratively, with quantitative measures of accuracy expressed as frequencies, proportions, or mean differences. Results: A total of 2,516 records were identified (PubMed=1,587; EMBASE=371; Web of Science=558). After removing duplicates and screening, preliminary inclusion suggests that most studies evaluated chatbots such as ChatGPT, Gemini, and Perplexity for smoking cessation counselling and pharmacotherapy recommendations. Early evidence indicates substantial variability in accuracy across platforms, with large language models (LLMs) giving similar accuracies compared to earlier or rule-based systems. Factors such as prompt phrasing, question domain, and language significantly influenced accuracy levels. Discussion: The findings highlight an evolving but uneven performance landscape among AI conversational agents for tobacco cessation. While newer generative AI models show improved reliability…
subject: EFICON 2025 Abstracts
  topic: section
creator: Sonal Bhatia
creator: Harsh Priya
creator: Nitesh Tiwari
creator: Bharathi M. Purohit
creator: Partha Haldar
rights: Copyright (c) 2025 Sonal Bhatia, Harsh Priya, Nitesh Tiwari, Bharathi M. Purohit, Partha Haldar (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 68
ending page: 68
doi: 10.56450/JEFI.2025.v3i2Suppl.068

Rapid Multi – State Assessment Of Birth Waiting Homes Under NHM: Functioning, Utilization, Cost-Effectiveness And Policy Implications
type: item
description: Background: Maternal mortality remains a significant public health concern in India, particularly in tribal and geographically remote regions where delays in accessing institutional delivery care persist. Birth Waiting Homes (BWHs), supported under the National Health Mission (NHM), aim to reduce the second delay by providing temporary residential accommodation near delivery facilities for pregnant women from hard-to-reach areas. Despite scale-up across several states, systematic evidence on their functioning, utilisation, and effectiveness remains limited. Aims & Objectives: This rapid multi-state assessment aimed to evaluate the functioning, operational models, utilisation patterns, cost structures, and policy relevance of BWHs across selected states. Specific objectives included assessing infrastructure, governance mechanisms, staffing arrangements, user experiences, and their potential contribution to improving maternal health outcomes. Methodology: A mixed-methods cross-sectional design was adopted across five states—Odisha, Madhya Pradesh, Gujarat, Tripura, and Telangana—covering 14 functional BWHs in 10 districts. Data collection included facility assessments, stakeholder and beneficiary interviews, programme document review, and costing analysis. Quantitative data were analysed descriptively, while qualitative data underwent thematic analysis. Results: Findings demonstrate considerable inter-state variation in performance and operational models. Odisha, operating largely through an NGO-supported model with defined standard operating procedures and dedicated staffing, achieved consistently high QSI scores (up to 88%) and higher utilisation with earlier pre-delivery admissions. In contrast, government-managed models in Madhya Pradesh and Gujarat often functioned as extensions of antenatal wards, with weaker governance, limited preventive admissions, and lower QSI scores (50–71%). Infrastructure availability was generally adequate across states; however, gaps i…
subject: EFICON 2025 Abstracts
  topic: section
creator: Kalpana Pawalia
creator: Bhavna Nahata
creator: Kannan P
creator: Madan Gopal
rights: Copyright (c) 2025 Kalpana Pawalia, Bhavna Nahata, Kannan P, K Madan Gopal (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 67
ending page: 67
doi: 10.56450/JEFI.2025.v3i2Suppl.067

Need based training of Community Health Volunteers for Cervical Cancer in Delhi – A before and after study
type: item
description: Background: Cervical cancer, accounts for 6%–29% of all cancers among women, is the 2nd most common cause of cancer among females in India after cancer of breast. Nearly 20%–25% of the cervical cancer related death globally occurs in India. Key to reduce burden of cervical cancer is early detection with timely treatment. Under National Health Mission, community health platforms are functioning and its members play key role in generating awareness related to health, hygiene, nutrition, water, sanitation and social determinants in community. The present study identified gaps in awareness about cervical cancer among community health volunteers (CHV) and addressed through need- based training. Materials &Methods: A before and after study was conducted among 135 CHV from January-December,2023 in Delhi, using 100% sampling technique. They were interviewed using pre-tested structured questionnaire and training was provided addressing gaps identified in pretest. Data analysis was done by Microsoft excel, SPSS Result: The mean pretest score 8.47(SD=4.76) improved to 18.29(SD=2.92) post test score. The knowledge score of CHV showed statistically significant improvement (P<.0001). There was significant improvement in scores of all areas of cervical cancer except participation in health education programme , at the end of 6 months. Conclusion: The need-based assessment proved effective in identifying gaps in knowledge about various aspects of cervical cancer among CHV which is critical for uptake of any screening program in a developing country. Thus, need based capacity building of health workforce is essential to achieve the goal of universal health coverage.
subject: EFICON 2025 Abstracts
  topic: section
subject: Public Health Research
  topic: category
subject: Cervical Cancer, need based training, community health volunteers.
  topic: keywords
creator: Sudipta Basa
creator: Nandini Sharma
creator: Madhulekha Bhattacharya
rights: Copyright (c) 2025 Dr Sudipta Basa, Dr Nandini Sharma, Dr Madhulekha Bhattacharya (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 91
ending page: 91
doi: 10.56450/JEFI.2025.v3i2Suppl.091

Comparative Evaluation of Residual Diagnostic Measures for Outlier Detection in Linear Regression: An Empirical Study Using Heart Rate Data
type: item
description: Outliers in medical datasets can substantially distort regression models, leading to biased estimates and unreliable clinical inferences. This study evaluated residual-based diagnostic methods-including standardized residuals, Cook's Distance, DFFITS, DFBETAS, Covariance Ratio, and standardized scores-for detecting influential observations in a simple linear regression model. Using age as the predictor and heart rate as the outcome, data from 30 individuals were analyzed. The initial model (R² = 0.22) revealed one highly influential outlier (heart rate = 290 at age 42), consistently identified across multiple diagnostics. Removal of this case improved model adequacy, yielding a more stable regression (R² = 0.10) with no further significant outliers detected. Findings highlight that even a single outlier can markedly distort regression-based conclusions, underscoring the importance of employing complementary diagnostic tools to ensure valid statistical inference in medical research.
subject: EFICON 2025 Abstracts
  topic: section
subject: Outlier detection linear regression residual diagnostics
  topic: keywords
creator: Shashank Kirti
rights: Copyright (c) 2025 Dr Shashank Kirti (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 84
ending page: 84
doi: 10.56450/JEFI.2025.v3i2Suppl.084

Prevalence of Low Bone Mineral Density and Assessment of Screening Tools in a Rural Area of Delhi
type: item
description: Introduction Osteoporosis poses a disproportionate burden on postmenopausal women, yet access to DXA-based bone mineral density (BMD) measurement remains severely limited in rural India, with only 700–800 scanners serving over 140 million postmenopausal women. This study aimed to determine the prevalence of osteoporosis and osteopenia in a rural Delhi cohort, examine associations with lifestyle and menopausal symptom burden, and compare the diagnostic performance of five validated screening tools—OSTA, SCORE, ABONE, ORAI, and OSIRIS—against DXA-measured BMD. Methodology This community-based cross-sectional study enrolled 94 women aged 40 years and above at the Rural Health Training Centre, Najafgarh, under the SNSP Abhiyan. BMD was assessed via portable peripheral DEXA at the right calcaneus and classified per WHO T-score criteria. Participants completed a sociodemographic and lifestyle questionnaire and the validated 11-item Menopause Rating Scale (MRS). Diagnostic performance of five risk scores was evaluated using sensitivity, specificity, PPV, NPV, and ROC curve analysis. Results Mean age was 52.5 ± 8.8 years and mean age of menopause was 44.8 ± 9.9 years. BMD was abnormal in 93.7% of participants—51.1% osteopenic and 42.6% osteoporotic. Lower educational status was significantly associated with abnormal BMD (p = 0.028). Multivariate regression identified age (p = 0.038) and somatic menopausal symptom severity (p = 0.026) as independent predictors of reduced BMD. OSTA demonstrated the highest sensitivity (85.7%) and NPV (98.1%) with an AUC of 0.73. SCORE had the highest PPV (85%) but poor sensitivity (42.5%) and an AUC of 0.50. ABONE, ORAI, and OSIRIS showed moderate performance with AUCs of 0.53–0.57. Conclusion This study reveals a high burden of low BMD among rural women in Delhi. OSTA emerged as the most effective primary screening tool, supporting targeted DXA referrals in resource-constrained settings. Age and somatic menopausal symptom severity were signi…
subject: EFICON 2025 Abstracts
  topic: section
subject: Osteopenia
  topic: keywords
subject: Osteoporosis
  topic: keywords
subject: Bone Mineral Density
  topic: keywords
subject: Menopause
  topic: keywords
creator: Anubha Gupta
creator: Ghurumourthy D.
creator: Geeta Yadav
rights: Copyright (c) 2025 Anubha gupta, Ghurumourthy D., Geeta Yadav (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 83
ending page: 83
doi: 10.56450/JEFI.2025.v3i2Suppl.083

Assessment of stress, anxiety, and depression among medical students at a medical college in North India
type: item
description: Abstract: Introduction – Medical students are more vulnerable to stress, anxiety, and depression than students in other courses. Mental health issues can adversely affect academic performance, professional development, and the delivery of quality patient care. The aim of this study was to estimate the prevalence of stress, anxiety, and depression among medical students at a medical college in North India. Material and methods – A cross-sectional study conducted from August to October 2024 at JNMCH, AMU, among undergraduate medical students. The sample size calculated was 258. All medical students willing to participate were included, and students with diagnosed psychiatric illnesses receiving treatment were excluded. PSS SCALE, GAD-7, and PHQ-9 were used. The questionnaires were administered through the Google link on WhatsApp groups. Data analysed and appropriate tests used. Results – The mean age of participants was 20.81 ± 1.44 years. Males (64.6%) were more than females (35.4%). The majority live in a hostel (72.6%). Approximately 3/4th of the students (75.80%) had moderate to severe perceived stress. 15.0% had moderate to severe anxiety, and 11.0% had severe depression. Conclusion – Early identification and intervention are crucial to support student well-being and academic performance. Regular conduction of mental health screening programs for medical students to identify those at risk early, and provide accessible counseling and psychological support services within the college.
subject: EFICON 2025 Abstracts
  topic: section
subject: Stress, Anxiety, Depression, Medical students, North India.
  topic: keywords
creator: Absar Ahmad
creator: Subhash Kumar
creator: Mohd Yasir Zubair
creator: Sameena Ahmad
creator: Uzma Eram
creator: Saira Mehnaz
rights: Copyright (c) 2025 Absar Ahmad, Subhash Kumar, Dr. Mohd Yasir Zubair, Sameena Ahmad, Uzma Eram, Saira Mehnaz (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 81
ending page: 81
doi: 10.56450/JEFI.2025.v3i2Suppl.081

Comparative Study of Nutritional Status among Populations of Umarwada (Urban Area) and Olpad (Rural Area): A Community-Based Cross-Sectional Study in Surat.
type: item
description: Background: Nutrition is a fundamental determinant of health, growth, and productivity. Rapid urbanization has resulted in dietary transitions and lifestyle-related health issues, while rural populations continue to face challenges of undernutrition. Understanding the nutritional differences between urban and rural populations is essential to address the double burden of malnutrition in India. Objectives: To assess the nutritional status of individuals in Umarwada (urban) and Olpad (rural) areas. To compare the prevalence of undernutrition and overnutrition between the two populations. To identify socio-demographic factors associated with nutritional outcomes. Methods: A community-based cross-sectional study will be conducted among [sample size, e.g., 200] participants each from Umarwada (urban) and Olpad (rural) areas of Surat district. Nutritional status will be assessed using anthropometric indicators (BMI, MUAC), dietary recall, and clinical examination. Socio-demographic data will be collected through a pre-tested structured questionnaire. Statistical analysis will include chi-square test and logistic regression to identify predictors of nutritional status. Expected Results: It is anticipated that undernutrition (stunting, thinness, anemia) will be more prevalent in the Olpad (rural) population, while overnutrition (overweight, obesity, and lifestyle-related NCD risks) will be higher among Umarwada (urban) participants. Socio-economic status, dietary diversity, and physical activity are expected to show significant associations with nutritional outcomes. Conclusion: The study will highlight contrasting nutritional challenges in Umarwada (urban) and Olpad (rural) communities, emphasizing the need for context-specific interventions—strengthening undernutrition programs in rural areas and addressing lifestyle-related overnutrition in urban settings. The findings can provide evidence for policymakers to design integrated nutrition and public health strategies.
subject: EFICON 2025 Abstracts
  topic: section
subject: Nutrition, Umarwada, Olpad, Urban, Rural, Malnutrition, Community Medicine
  topic: keywords
creator: Manishkumar Bhoi
creator: Bipin Vasava
rights: Copyright (c) 2025 Dr.Manishkumar Bhoi, Dr. Bipin Vasava (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 78
ending page: 78
doi: 10.56450/JEFI.2025.v3i2Suppl.078

Feasibility of a Multi-Stakeholder Engagement Model for Community-Based Management of Malnutrition
type: item
description: Introduction: Childhood undernutrition remains a major public health challenge in India, with stunting at 35.5%, wasting at 19.3%, and underweight at 32.1% among children under five, disproportionately affecting rural areas. Gaps in early identification, treatment access, and caregiver knowledge limit the effectiveness of conventional programs. Community-based Management of Malnutrition (CMM) integrates local interventions with system convergence and caregiver empowerment to ensure sustained gains. This study aimed to develop a feasible village-level CMM delivery model focusing on stakeholder engagement, caregiver empowerment, and implementation fidelity. Methods: A multistakeholder team was formed through systematic mapping of village actors, including Sarpanch, Medical Officers, health workers, ASHAs, Anganwadi Workers (AWWs), and supervisors. Consultative discussions finalized camp plans, roles, and logistics. Caregivers of malnourished children were mobilized via ASHAs and AWWs. Process indicators - attendance, stakeholder participation, fidelity to planned activities, and operational feasibility, were documented. Growth outcomes were assessed after 3 months. Results: The SHINE Model: Stakeholder and Health-system Integration for Nutritional Empowerment model comprised five stations: anthropometry; anemia screening; demonstration of calorie-dense recipes using local foods and scheme awareness; health talks on balanced diet, weaning, and danger signs; and symptom-based treatment and referral. A total of 33 caregiver–child pairs (71.7% invited) attended. The 4-hour camp maintained fidelity to the planned activities, with consistent adherence to stakeholder roles and minimal additional costs, demonstrating operational feasibility. At 3 months, median (IQR) weight gain was 0.7 (0.3–1.0) kg and height gain was 1.0 (0–1.5) cm. Weight gain exceeded expected growth velocity in 61.3% (19/31) of children, while 16.1% (5/31) exceeded expected height gain as per WHO standar…
subject: EFICON 2025 Abstracts
  topic: section
subject: Nutritional Epidemiology
  topic: category
subject: Malnutrition
  topic: keywords
subject: Under-five children
  topic: keywords
subject: Community based management
  topic: keywords
subject: Multistakeholder engagement
  topic: keywords
creator: Surabhi Puri
creator: Harshal Ramesh Salve
rights: Copyright (c) 2025 Surabhi Puri, Harshal Ramesh Salve (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 94
ending page: 94
doi: 10.56450/JEFI.2025.v3i2Suppl.094

Relationship of Vitamin D status with obesity amongst children residing in Himachal Pradesh, India
type: item
description: Background Vitamin D deficiency and obesity have been recognized as significant health burden among children globally. Aims & Objectives We investigated the relationship between Vitamin D status and obesity in apparently healthy school children residing in Himachal Pradesh, India. Methodology A total of 800 school children (386 boys and 414 girls) aged 6-18y were enrolled from two high altitude regions (>1000 meters) of Himachal Pradesh, India. Fasting blood samples were collected for the estimation of serum 25-hydroxyvitamin D (25-OHD), using automated autoanalyzer (chemiluminescent immunoassay). The data was collected on age, gender, height, and weight using the standard equipments and procedure. The body mass index (BMI) was calculated for the determination of overweight and obesity. The association between serum 25-OHD and BMI was assessed using statistical methods carried out on STATA (version 14) software. Results A total of 573(71.6%) children were found with normal adiposity followed by underweight (214, 26.8%) and overweight (13, 1.6%). No significant difference was observed in the distribution of children in different categories of BMI and Vitamin D (p=0.580), neither in boys (p=0.449) nor in girls (p=0.330). Further, the correlation analysis also demonstrated a lack of correlation (r=0.04, p= 0.227) between serum 25-OHD and BMI. Conclusions Body adiposity was not associated with Vitamin D status of children in the present study. Key words Vitamin D, children, obesity
subject: EFICON 2025 Abstracts
  topic: section
subject: Nutritional Epidemiology
  topic: category
subject: Vitamin D, children, obesity
  topic: keywords
creator: Gajendra Singh
creator: Umesh Kapil
rights: Copyright (c) 2025 Dr. Gajendra Singh, Prof. Umesh Kapil (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 95
ending page: 95
doi: 10.56450/JEFI.2025.v3i2Suppl.095

Early postnatal care and full immunization: district-level evidence from National Family Health Survey (NFHS-5), India
type: item
description: Introduction Full immunization (12–23 months) remains uneven across Indian districts. Early postnatal care (PNC ≤2 days) may strengthen contact with the health system and improve vaccine completion. We examined whether districts with higher early PNC coverage also have higher full-immunization coverage. Methods Cross-sectional ecological analysis using NFHS-5 (2019–21) district factsheets (≈708 districts). Exposure: PNC within 2 days (%). Outcome: full immunization at 12–23 months (%). Using a simple DAG, we prespecified a minimal adjustment set: ANC ≥4, institutional births, women’s education (≥10 years) and literacy, improved drinking water, improved sanitation, clean fuel, adolescent motherhood, third-or-higher-order births, and sex ratio at birth. We also included state fixed effects. Primary analysis: OLS with state-clustered robust SEs. Effects are percentage points(pp) change in full immunization per +10-pp higher PNC. Robustness is checked using spline for non-linearity, influence trimming, leave-one-state-out. Results We will present adjusted associations of Change in full immunization per 10 percentage points (pp) in PNC with 95% CIs, diagnostics, and sensitivity results. Preliminary checks supported linearity, with estimates stable to influence trimming and leave-one-state-out. Conclusions A DAG-guided minimal adjustment with state fixed effects yields transparent, policy-relevant estimates from routine survey indicators. If a positive association is confirmed, strengthening early PNC, alongside ANC and institutional delivery, could help improve vaccine completion. This shows how to move beyond “adjust for everything” toward defensible models for MCH program analytics.
subject: EFICON 2025 Abstracts
  topic: section
subject: Health Policies, Systems and Management
  topic: category
creator: Karthik Balajee Laksham
creator: Rizwan Suliankatchi Abdulkader
rights: Copyright (c) 2025 Karthik Balajee Laksham, Rizwan Suliankatchi Abdulkader (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 93
ending page: 93
doi: 10.56450/JEFI.2025.v3i2Suppl.093

Sociodemographic, clinical and dietary determinants of Gestational diabetes mellitus: A Case-control Study.
type: item
description: Title: Sociodemographic, clinical and dietary determinants of Gestational diabetes mellitus: A Case-control Study. Introduction: Gestational diabetes mellitus (GDM) is a common metabolic complication of pregnancy contributing to adverse maternal and neonatal outcomes. Its growing prevalence in India is linked to rising maternal age, overweight, and changing dietary habits. Identifying modifiable determinants, especially nutritional factors, is essential for prevention and early intervention. Methods: A case-control study was conducted among 100 pregnant women (50 newly diagnosed GDM cases and 50 controls) attending the antenatal clinic of Department of Obstetrics and Gynecology, JNMCH, AMU, Aligarh. Sociodemographic data was collected. Dietary intake and dietary diversity score (DDS) were assessed using 24-hour recall. Chi-square, independent t-test, and Fisher’s exact tests were applied using IBM SPSS version 20. Results: Socio-demographic factors were not found to be associated with GDM. Mean pre-pregnancy BMI was significantly higher among GDM cases than controls (26.07 ± 3.86 kg/m² vs 23.21 ± 3.35 kg/m²; p < 0.001). Poor dietary diversity (DDS<5) was higher in GDM cases than controls (40% vs 24%, p=0.06) though not statistically significant. Previous history of GDM was found in 12% cases vs 2% controls. Mean calorie, fat, carbohydrate and dietary fibers intakes were higher, and protein intake was lower among cases than controls although differences were not statistically significant. Conclusion: Higher pre-pregnancy BMI is a key modifiable risk factor for GDM. Promoting optimal weight attainment before planning pregnancy, taking fiber-rich diets, and improved dietary diversity among women of reproductive age women can reduce metabolic susceptibility and mitigate GDM risk.
subject: EFICON 2025 Abstracts
  topic: section
subject: Epidemiological Methods in Maternal Health
  topic: category
subject: Gestational Diabetes Mellitus, Determinants, Pre-pregnancy BMI
  topic: keywords
creator: Shafia Shafiq
rights: Copyright (c) 2025 Shafia Shafiq Shafia (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 90
ending page: 90
doi: 10.56450/JEFI.2025.v3i2Suppl.090

Effect of School Eye Health Education Program on Eye Health Knowledge and Practice Among School Students in Rural Aligarh: An Interventional Study
type: item
description: Background: Vision impairment in children remains a significant public health concern, with undiagnosed refractive errors adversely affecting academic performance and quality of life. Prolonged exposure to digital devices and near-distance activities has escalated the risk of myopia among school-age children. Rural populations are especially vulnerable due to limited awareness and restricted access to eye care services. Despite the recognized role of school-based health education in shaping early health behaviours, few Indian studies have evaluated structured interventions targeting ocular health literacy in rural settings. Objectives: To assess baseline knowledge, attitudes, and practices (KAP) regarding eye health among rural school students and to evaluate the effectiveness of a targeted health education intervention in improving these parameters. Methods: A single-arm quasi-experimental study was conducted in Jawan Block, Aligarh district, Uttar Pradesh. A total of 175 students from Classes VI–VIII across two randomly selected junior high schools participated. A validated KAP questionnaire (Cronbach's α = 0.83) was administered at baseline and at three-month follow-up. The intervention comprised eye health education using IEC charts and posters developed from the AIIMS Primary Eye Care booklet, supplemented by visual acuity testing and referrals. Results: Significant improvements were observed across all three domains. Knowledge of ocular symptoms rose from 65.3% to 88.2% (p<0.001), awareness of myopia from 25.3% to 66.0% (p<0.001), and awareness of eye donation from 24.0% to 83.3% (p<0.001). Attitudinally, spectacle-related stigma declined significantly (25.3% to 10.4%, p<0.001), while support for peers wearing glasses increased from 60.7% to 91.7% (p<0.001). In practice, regular outdoor activity improved (70.0% to 84.7%, p=0.002), use of unprescribed eye drops fell (34.0% to 20.8%, p=0.011), and eye clinic attendance rose from 40.0% to 56.9% (p=0.004). Conclus…
subject: EFICON 2025 Abstracts
  topic: section
subject: Public Health Research
  topic: category
subject: Eye health education
  topic: keywords
subject: School Children
  topic: keywords
subject: School-based intervention
  topic: keywords
subject: Refractive errors
  topic: keywords
subject: Ocular health literacy
  topic: keywords
creator: Mohd Yasir Zubair Yasir
creator: Absar Ahmad
creator: Shubham Upadhyay
creator: Saira Mehnaz
creator: Uzma Eram
rights: Copyright (c) 2025 Mohd Yasir Zubair Yasir, Absar Ahmad, Shubham Upadhyay, Saira Mehnaz, Uzma Eram (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 89
ending page: 89
doi: 10.56450/JEFI.2025.v3i2Suppl.089

Prevalence of Workplace Violence Against Doctors in a Tertiary Care Hospital of Delhi
type: item
description: Background: Workplace violence has emerged as a serious occupational hazard among healthcare professionals globally, affecting both developed and developing nations. In India, nearly three-fourths of doctors have faced some form of workplace violence, adversely impacting their safety, morale, and quality of patient care. This study aimed to assess the prevalence, associated factors, and consequences of workplace violence against doctors in a tertiary care hospital in Delhi. Aim: To study the prevalence of workplace violence against doctors in a tertiary care hospital of Delhi. Objectives: To determine the prevalence of Workplace violence against doctors at a tertiary care hospital of Delhi. Methods: A cross-sectional study was conducted among 420 doctors, including interns, junior residents, senior residents, and consultants from 14 departments of Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. Participants were selected using probability proportionate to size and simple random sampling. Data were collected using a pre-validated questionnaire on socio-demographic details, experiences of violence, and reporting practices. Analysis was done using SPSS version 21. Ethical clearance was obtained. Results: Workplace violence was reported by 63.6% (95% CI: 58.9%–68.2%) of doctors, primarily verbal abuse (63.6%; 95% CI: 59.0%–68.2%) and verbal threats (55.5%; 95% CI: 50.8%–60.1%). Incidents occurred mostly in clinical departments and during night shifts, with patients’ attendants (71%) as the main perpetrators. Only 33.3% had received formal communication-skill training, and half of the participants were aware of workplace violence laws. Although reporting procedures existed for 62.8%, only 34.0% were aware of the actual mechanism, and just 49.4% reported the incident. Violence led to emotional distress (74%), work-life imbalance (62%), and changes in patient management (58%). Conclusion: Workplace violence negatively affects doctors’ mental health and…
subject: EFICON 2025 Abstracts
  topic: section
subject: Workplace violence, Doctors, Verbal abuse
  topic: keywords
creator: Mohit Jain
creator: Anita Khokhar
rights: Copyright (c) 2025 MOHIT JAIN, ANITA KHOKHAR (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 86
ending page: 86
doi: 10.56450/JEFI.2025.v3i2Suppl.086

https://efi.org.in/journal/index.php/JEFI/article/view/525
type: item
title: To investigate the prevalence of leukorrhea among women attending Gauhati Medical College & Hospital and to accurately identify associated pathogenic microorganisms through conventional and molecular (16S rRNA sequencing) analyses.
description: Introduction: Leukorrhea, a non-bloody vaginal discharge, can be physiological or pathological. Pathological leukorrhea is commonly caused by microbial infections and presents symptoms like itching, burning, and pain. Early and accurate microbial identification is essential for effective treatment and management. Methods: A total of 50 vaginal swab samples were collected from women experiencing leukorrhea at a tertiary care hospital in Guwahati. The samples were subjected to morphological (colony characteristics), biochemical (Gram staining, catalase, citrate, indole), and molecular (16S rRNA gene sequencing) analyses. Fungal identification was done using LPCB staining and chromogenic media. Results: Biochemical and morphological methods identified common pathogens such as E. coli, Klebsiella spp., Staphylococcus spp., and Candida albicans. However, molecular analysis revealed the presence of Staphylococcus cohnii and Stutzerimonas stutzeri, highlighting discrepancies in traditional identification techniques. This underscores that species-level confirmation is only achievable through molecular sequencing methods, especially for atypical or non-culturable organisms. Discussion: The highest prevalence of leukorrhea was observed among women aged 30–35. Traditional methods were insufficient for definitive species-level identification, proving the critical need for sequencing technologies in microbial diagnostics. Conclusion: Accurate detection of pathogenic microbes causing leukorrhea requires integrating molecular sequencing techniques with classical methods. Sole reliance on morphological and biochemical tests can lead to misidentification and suboptimal treatment. This study emphasizes the need for molecular diagnostics to inform precise clinical interventions.
subject: EFICON 2025 Abstracts
  topic: section
subject: Epidemiological Methods in Maternal Health
  topic: category
subject: Leukorrhea, Pathogenic microbes, 16S rRNA sequencing, Molecular identification, Reproductive tract infections (RTIs)
  topic: keywords
creator: Syeda Tamanna
rights: Copyright (c) 2025 Syeda Tamanna (Author) https://creativecommons.org/licenses/by/4.0/
date: 2025-12-31
publication date: 2025-12-31
starting page: 88
ending page: 88
doi: 10.56450/JEFI.2025.v3i2Suppl.088