Journal of the Epidemiology Foundation of India
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.
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The Association between passenger overloading, spinal posture changes, and work-related musculoskeletal disorders among three-wheeler drivers in Chandigarh
Background: Three-wheelers are a vital mode of transport in Chandigarh, with approximately 7,440 drivers facing occupational health risks including prolonged sitting and poor ergonomics. A significant, under-observed factor is passenger overloading, which alters vehicle balance and compels drivers to adopt strained or unnatural postures. Over time, these postural deviations may increase the risk of work-related musculoskeletal disorders (WMSDs), particularly in the back and neck. Aims & Objectives: This study aims to investigate the association between habitual postural changes induced by passenger overloading of driving seat only and the prevalence of WMSDs among three-wheeler drivers in Chandigarh. To determine the prevalence and location of WMSDs among the study population using the Nordic Musculoskeletal Questionnaire. To assess and categorize the drivers' work habits and specific spinal posture changes associated with varying passenger loads using a standardized observation checklist and interview. To identify the socio-demographic, work duration, and overloading factors correlated with the incidence of WMSDs. Methodology: A cross-sectional study is being conducted among approximately 200 auto-rickshaw drivers in Chandigarh using convenience sampling. WMSD prevalence is assessed via the internationally validated Nordic Musculoskeletal Questionnaire (NMQ), while the primary exposure—passenger overloading (defined as habitually carrying >3 passengers)—is assessed via self-report. Results & Conclusion: Data collection and analysis are currently underway as part of an ongoing dissertation. Findings are expected to inform targeted ergonomic interventions and relevant public health policies for this occupational group to mitigate the specific postural deviations, such as hunched back or twisted spine, hypothesized to correlate with higher incidences of low back and neck pain.
Copyright (c) 2025 Shivani Shivani, Manoj Kumar, Paravreet Kaur (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
An Analysis of the Nexus Between Government Health Expenditure and Key Health Indicators in India: A Longitudinal Study from 2013-14 to 2021-22
Background: India has a complex health finance system comprising public and private financing. Despite the presence of a public healthcare system, the private sector is the major contributor to the healthcare services in India. Analyzing the relationship between government health expenditure and public health outcome is crucial, witnessing a shift in public health spending in recent years. This study helps understand how health expenditure trends align with major health indicators. Aim: This paper analyzes the correlation between Government of India’s health expenditure - measured across GDP (Gross Domestic Product), THE (Total Health Expenditure) - and the critical health indicators - neonatal, infant, child and maternal mortality rates and life expectancy at birth, over the study period 2013-14 to 2021-22. Methods: A longitudinal trend analysis was conducted for the period 2013-2021 using secondary published data. Health expenditure data were sourced from National Health Accounts (NHA) - India, and key health indicators were obtained from United Nations Inter-Agency Group for Child Mortality Estimation (UN-IGME) and the World Bank. Results: The Pearson correlational model demonstrated a significant inverse relationship between public health financing and mortality. GHE as a percentage of THE shows near-perfect negative correlation with NMR (r = -0.95), IMR (r = -0.96) and U5MR (r = -0.95%). Contrariwise, OOPE as a percentage of THE showed a strong near-positive relationship against NMR (r = 0.96), IMR (r = 0.97) and U5MR (r = 0.97). Moreover, sustained rise in per capita GHE is associated with reduced MMR. Conclusion: The study is evident of a positive association between increased public health expenditure and improved public health indicators in India. The findings demonstrate a transition from private and OOPE spending towards increased public health investment, which strongly correlates with positive public health indicators. Keywords: Government Health Expenditure (GHE); Out-of-Pocket-Expenditure (OOPE); Child Mortality; Maternal Mortality
Copyright (c) 2025 AMOS ALLAN SUBBA, Abuk, Naveditta, Gopal, SS Tiwari, Varsha (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Factors Affecting Health-Seeking Behaviour among High-Risk Pregnant Women in Rural Haryana: A Mixed-Methods Study
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 infrastructure is largely in place, functional gaps and multi-level barriers significantly impede HRP management in rural Haryana. Targeted frontline worker training, referral system reform, community engagement addressing cultural barriers, and policy-level resource investment are essential. These findings have direct implications for strengthening PMSMA implementation and achieving equitable maternal health outcomes in rural India especially for High-risk pregnancy.
Copyright (c) 2025 Srishti Singh, Varun Arora, Anik Chakraborty, Narender Bhukkal, Amandeep Kaur, Trushna Parida (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Development of a composite malaria burden index using principal component analysis for comparative assessment of tribal and non-tribal districts in Chhattisgarh
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. The findings highlight a disproportionately higher burden in tribal districts of Chhattisgarh, emphasizing the need for intensified malaria control interventions in these high-risk areas.
Copyright (c) 2025 Sanooja Sherin Chakkalakkunnan (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Exploring the impact of Yoga on Postpartum Depression: Implications for Maternal Mental Health- A Narrative Review
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 adjunct to conventional care for postpartum depression, promoting maternal well-being. Further large-scale, standardized trials are needed to establish efficacy and integration into maternal health services. Keywords: postpartum depression, yoga, maternal mental health, non-pharmacological therapy, Mind-body intervention
Copyright (c) 2025 Priyanka Sidholi, Naveen KH, Manoj Kumar Gupta, Srikanth Srinivasan, Naresh Nebhinani (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Latent Tuberculosis Infection Diagnostics: Comparative Performance of TST, IGRAs, and Cy-Tb
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: latent tuberculosis infection, Cy-Tb test, tuberculin skin test, interferon-gamma release assay, TB preventive therapy, cost-effectiveness, high-burden settings.
Copyright (c) 2025 Smilee Choudhary, Suman Saurabh, Manoj Kumar Gupta, Rozaline Lenka, Priyanka Sidholi, Sanjana Jaiswal (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Violence as a Public Health Issue: A Narrative Review
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
Copyright (c) 2025 Sanjana Jaiswal, Simlee Choudhary, Priyanka Sidholi, Rozaline Lenka (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Impact of Educational Program on Nursing Officers’ Knowledge of Emerging & Re-emerging Diseases in Punjab, India
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.
Copyright (c) 2025 Kamlesh K Sharma, Simarjeet Kaur, Atul Sharma (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Prescription Audit in outpatient department of a district level government hospital in northern Kashmir: an observational study
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 outpatient setting.
Copyright (c) 2025 Numan Farooq Kawa, Rohul Jabeen Shah, Anjum Fazili, Hanna Zahoor Hamdani (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Comparative accuracy of chatbots for queries related to methods of tobacco cessation: A systematic review
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 and contextual understanding, inconsistencies persist, particularly in region-specific or non-English responses. Further standardization of benchmarking methods and continuous model training on verified cessation guidelines are recommended to enhance clinical applicability and public health integration.
Copyright (c) 2025 Sonal Bhatia, Harsh Priya, Nitesh Tiwari, Bharathi M. Purohit, Partha Haldar (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Rapid Multi – State Assessment Of Birth Waiting Homes Under NHM: Functioning, Utilization, Cost-Effectiveness And Policy Implications
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 in dedicated staffing, monitoring systems, and structured referral linkages constrained effectiveness. Conclusion: The effectiveness of BWHs depends less on infrastructure alone and more on preventive utilisation, dedicated HR, clear governance frameworks, and integration with antenatal and referral systems. Strengthened operational norms and earmarked recurrent funding are critical for scaling up BWHs in high-need geographies.
Copyright (c) 2025 Kalpana Pawalia, Bhavna Nahata, Kannan P, K Madan Gopal (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
A Cross-sectional study on Family Quality of Life and Depression, Anxiety and Stress among Post Graduate Medical Residents in Tertiary care Hospital of Delhi
Background: Medical residency is a demanding phase with long hours, emotional exhaustion, and constant high-stakes decision-making. These pressures affect residents’ psychological wellbeing, leading to depression, anxiety, and stress. Supportive families with healthy communication and closeness help residents adapt to work stressors, whereas dysfunctional dynamics increase vulnerability to distress. Clarifying these links can inform targeted wellbeing strategies in residency programs. Understanding residents’ family context is essential for designing comprehensive institutional mental health support interventions and policies within training systems. Aim: To assess the correlation between Family Quality of Life and Depression, Anxiety, and Stress among Postgraduate Medical Residents in a tertiary care hospital of Delhi. Primary objective: To determine the correlation between family quality of life and depression, anxiety, and stress among postgraduate medical residents working in a tertiary care hospital in Delhi. Secondary objective: To determine the correlation between coping mechanisms and depression, anxiety, and stress among postgraduate medical residents working in a tertiary care hospital in Delhi. Methodology: A cross-sectional study was conducted among 246 postgraduate residents at VMMC and Safdarjung Hospital, Delhi, selected through two-stage sampling. Data were collected using validated instruments: a sociodemographic questionnaire, Family APGAR scale, DASS-21, and Brief COPE inventory. Spearman’s rank correlation was applied to assess relationships among variables. Results: Participants’ median age was 27 years; 79.7% were from clinical departments. Family APGAR scores correlated negatively with depression (ρ = -0.347, p<0.001), anxiety (ρ = -0.309, p<0.001), and stress (ρ = -0.326, p<0.001). Avoidant coping correlated negatively with family quality of life (ρ = -0.258, p<0.001), while emotion-focused coping showed a weaker negative association (ρ = -0.134, p=0.036); problem-focused coping was not significant (p=0.24). Conclusion: Better family functioning is linked to lower distress in residents. Strengthening family support and coping skills significantly improve mental health during residency.
Copyright (c) 2025 Shalini Smanla, Aditi Yadav, Shirish Karni, Seema Verma (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Assessment of Emotional and Behavioral Problems Among Adolescent Girls in a Government School, Delhi
Background: Adolescence is a critical developmental period characterized by significant emotional and behavioral changes. In India, adolescents constitute about one-fifth of the population, yet mental health problems in this group remain under-documented. This study aimed to assess the prevalence and pattern of emotional and behavioral problems among adolescent girls in a government senior secondary school in Delhi using a validated screening tool. Methodology: A cross-sectional study was conducted over four months among 433 adolescent girls from classes 9 to 12 at Government Girls Senior Secondary School No.1, Najafgarh. Participants were selected via stratified random selection based on course groups and probability proportional to size. Data were collected using a socio-demographic profile and the self-administered Strengths and Difficulties Questionnaire (SDQ), which assesses five subscales: Emotional, Conduct, Hyperactivity, Peer, and Prosocial behavior. Results: The mean age of participants was 15.5 ± 1.24 years. Analysis of socio-demographic data revealed that 31% of participants were from Class 12, 30% from Class 11, 20% from Class 9, and 19% from Class 10. A vast majority (93%) identified as Hindu, 68% lived in nuclear families, and 54% had two or fewer siblings. Findings indicated a substantial mental health burden, as nearly 60% of students demonstrated borderline or abnormal total SDQ scores. Specifically, abnormal behaviors were most prevalent in hyperactivity (34%) and peer difficulties (24.9%), while 16.4% showed abnormal emotional difficulties. Significant associations were found between hyperactivity and nuclear family structures (p=0.04), while conduct problems were significantly more frequent in younger students £ 15 years (p=0.001). Emotional difficulties were also significantly associated with the presence of siblings (p=0.04). Conclusion: A significant mental health burden exists among adolescent girls, with 60% showing emotional or behavioral difficulties. Factors such as age, family type, and sibling presence significantly influence these outcomes. Strengthening school-based mental health programs through the effective implementation of "Manodarpan" is essential for early detection, counseling, and enhancing emotional resilience.
Copyright (c) 2025 Ghurumourthy Dhandapani, Anubha Gupta, Geeta Yadav, Shveta Lukhmana, Sahadev Santra (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Healthcare System Barriers in the Management of High-Risk Pregnancy: A Mixed Methods Study from District Jhajjar, Haryana, India
Background: High-risk pregnancies (HRPs) contribute substantially to maternal morbidity and mortality in India. Effective management is critical for early identification, monitoring, and timely referral. However, systemic constraints may limit optimal service delivery. This study assessed healthcare system barriers in the management of HRPs in a rural district of Haryana using a mixed methods approach. Methods: A convergent mixed methods study was conducted in District Jhajjar, Haryana. Quantitative assessment of 10 subcentres was undertaken using a structured facility checklist to evaluate infrastructure, availability of essential equipment, and provision of antenatal services. Concurrently, in-depth interviews were conducted with 12 frontline healthcare providers (4 Lady Medical Officers, 4 Auxiliary Nurse Midwives, and 4 Accredited Social Health Activists) to explore perceived barriers in HRP identification, referral, and service delivery. Quantitative data were analyzed descriptively. Qualitative data were transcribed verbatim and analyzed using inductive thematic analysis. Findings were integrated during interpretation. Results: While most subcentres had basic utilities, 40% reported inadequate space, 30% lacked examination tables, and 30% did not conduct blood glucose testing during antenatal visits. Equipment gaps and service limitations were noted in several facilities. Thematic analysis revealed challenges in client engagement and referral compliance, infrastructural and logistical constraints, barriers to timely antenatal care, limited community support, and gaps in referral coordination. Providers emphasized that infrastructural limitations and transport delays hindered effective management of HRPs. Conclusion: Healthcare system constraints continue to impede optimal management of high-risk pregnancies in rural Haryana. Strengthening facility readiness, ensuring essential diagnostic services, and improving referral coordination are necessary to enhance maternal health outcomes.
Copyright (c) 2025 Srishti Singh, Varun Kumar Arora, Anik Chakraborty, Narender Kumar, Amandeep Kaur, Trushna Parida (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Nutritional Adequacy Beyond Macronutrients: Dietary Diversity and its Determinants Among PLHIV In Northern India
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
Copyright (c) 2025 Syed Sohaib Hashmi, Mohammad Athar Ansari, Ali Jafar Abedi, Salman Khalil (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Assessment of Mental Health of School-Going Adolescents in Rural Areas of Ghaziabad
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.
Copyright (c) 2025 Mehak Pal Kaur, Deepika Agrawal, Syed Hasan Nawaz Zaidi, Neha Jetli (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Link Between Subclinical Eating Disorder And Mental Health Among Female Students Of Panjab University Chandigarh
Background: Subclinical eating disorders refer to disordered eating attitudes and behaviors that do not meet full diagnostic criteria but still cause significant psychological distress and functional impairment. Young women transitioning to university life are particularly vulnerable due to social comparison, lifestyle changes, altered eating habits, academic pressure, and increased independence. These factors may contribute to anxiety, stress, depression, and body image concerns. Early identification is important to prevent progression to clinical eating disorders. Aim: To determine the association between subclinical eating disorders and mental health among female students of Panjab University. OBJECTIVES: 1. To assess the prevalence of subclinical eating disorders. 2. To investigate the association between subclinical eating disorders and mental health status. 3. To examine the relationship between Body Mass Index (BMI) and subclinical eating disorders. METHODOLOGY: A cross-sectional study was conducted among 229 female students aged 18–35 years at Panjab University using purposive sampling. Data were collected using the Eating Attitudes Test (EAT-26) and Depression Anxiety Stress Scale (DASS-21). Statistical analysis was performed using SPSS version 31. Descriptive statistics and Chi-square tests were applied to determine associations. RESULTS: Among participants, 34.5% (n=79) scored ≥20 on EAT-26, indicating risk of subclinical eating disorders. Significant associations were observed between elevated EAT-26 scores and depression (p=0.006), anxiety (p=0.035), and stress (p=0.001). A statistically significant relationship was also found between BMI and eating disorder risk (p=0.007), with higher prevalence among overweight participants. CONCLUSION: Subclinical eating disorder risk is prevalent among female university students and is significantly associated with psychological distress and BMI. Early screening, mental health support, and body image interventions within university settings are recommended to prevent progression to clinical disorders.
Copyright (c) 2025 Harnoor Kaur, Garima, Paravreet Kaur, Manoj Kumar (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
The intersection of Artificial Intelligence (AI) and Maternal Health
Artificial Intelligence (AI) algorithms identify patterns and risk factors for potential complications by analyzing large datasets, thereby enabling early detection, monitoring and intervention. By supporting clinical decision-making and reducing diagnostic errors, AI can predict complications such as preeclampsia, gestational diabetes and preterm labour. AI-powered risk stratification tools categorize expectant mothers according to their risk levels and design personalized care plans tailored to individual needs. Wearables and remote monitoring technologies allow continuous tracking of maternal and fetal health parameters. Mobile health apps linked with AI-enabled wearables collect real-time data which is analyzed by AI-based platforms, enabling continuous care. This is helpful for pre- and post-natal monitoring, sending reminders for appointments or medication and issuing alerts for deviations from normal parameters. AI Chatbots provide virtual prenatal consultations and 24/7 AI-based support, improving access in remote, underserved areas and reducing dependency on in-person consultations for basic queries. AI algorithms help in identifying early signs of postpartum depression and can provide virtual cognitive behavioural therapy. Natural Language Processing tools can analyze speech and text for emotional distress during online consultations. Advanced image analysis by AI algorithms can detect abnormalities the human eye may overlook, reducing diagnostic errors. AI based genomic analysis can screen for foetal genetic conditions. Early detection of genetic disorders leads to better planning and maternal health outcomes. Real-time translation of healthcare information and consultations by AI-translation services, overcomes language barriers in multicultural or migrant communities. Developing AI-driven solutions and comprehensive maternal health monitoring systems will be crucial as the global community works towards achieving the Sustainable Development Goals related to maternal and child health. Integrating AI into global maternal health programs can significantly enhance their reach and impact, leading to improved maternal health outcomes. Governments and technology developers must collaborate to ensure accessible and effective AI solutions.
Copyright (c) 2025 Niket Verma (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Effectiveness of community-based nutritional intervention on growth & nutritional indicators among malnourished children aged 13–60 months in rural Jhajjar, Haryana
Introduction: At the global level malnutrition among under-five children has been given immense priority. Child growth failure measured as stunting (height for age), wasting (weight for height) and underweight (weight for age). This study aimed to assess the effectiveness of community-based intervention on nutritional indicators and ICDS growth chart zones shift in 13-60 months malnourished children in rural area of district Jhajjar, Haryana. Methods: The study was a community-based cluster randomised experimental study. Out of 177 AWCs in the selected area, 80 children selected from 10 AWCs in the rural field practice area of Pt B D Sharma Postgraduate Institute of Medical Sciences, Rohtak and randomly allocated into 2 groups (5 in each): Intervention and Control group. First, the nutrition educational intervention module (a booklet) was designed for mothers of malnourished children. Second, the intervention was implemented on the intervention group and evaluated in terms of shift in zones as per colour coded ICDS growth charts, nutritional status, calorie and protein intake before and after intervention. Results: The proportion of children who were in yellow zone decreased from 82.5% to 27.5% (i.e. 55%) in intervention group and 85.0% to 57.5% (i.e. 27.5%) in the control group. The proportion of children who were in red zone decreased from 17.5% to 2.5% (i.e. 15%) in intervention group and 15.0% to 10.0% (i.e.05%) in the control group. This was statistically significant in absolute percentage change. Conclusion : Child health and nutrition programmes based on health education initiatives promote mother’s nutritional knowledge, child care practices and specific behavioral changes in caregivers which would improve the malnutrition status of children. 37.5% more overall improvement in malnourished children among intervention group occurred relatively as compared to control group. Keywords: community based intervention, malnourished children, mothers, nutritional educational intervention
Copyright (c) 2025 Varun Kumar Arora, Hement Kumar Sharma, Srishti Singh, Neha Grewal, Anjali Gupta, Trushna Parida (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Ensuring Dignity at Birth: Bridging Gaps in Respectful Maternity Care in India and Beyond
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 mechanisms, and empowerment of women during childbirth is essential to ensure universally dignified, equitable, and high-quality maternity care. Keywords: Pregnancy, Privacy, Respect, Physical abuse, Patient Centered Care
Copyright (c) 2025 Rozaline Lenka, Srikanth Srinivasan, Yogesh Jain, Dr. Gautam Mohanan, Priyanka Sidholi, Sanjana Jaiswal, Smilee Choudhary (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Designing an interventional training program for infection prevention and control among medical undergraduates
Introduction: Infection prevention and control (IPC) practices are the cornerstone for control of Healthcare Associated Infections (HAIs) which are a significant global burden. There exists a gap in the knowledge, attitude and practice (KAP) among healthcare providers of various categories as well as intra-category knowledge-practice gaps. Methods: A desk review was conducted with the aim of designing an interventional training program for the medical undergraduates in our tertiary teaching institution. Various databases were searched and relevant articles were shortlisted. Information related to IPC practices applicable to work ethic of doctors was extracted and compiled. Results: The studies varied with respect to the study population, mode of intervention, time of assessment post-intervention and research methods used. Studies among medical students were few. Consistent knowledge practice gaps of 20-40% and improvement with interactive methods was seen. Most studies (65%) assessed knowledge change post-intervention at 1 month, change in attitude is demonstrable post 3 months. Use of qualitative research methods was low in studies among Indian medical undergraduates. A mixed method interventional KAP study among medical undergraduates with educational interventions was designed as a mixed-method research which included Focus Group Discussions. The KAP questionnaire was validated and tested for internal consistency (Crohnbach alpha for knowledge 0.8, attitude 0.8 and practice 0.7). Conclusion: The structured training program will be based on insights from the study which will also guide appropriate suggestions for concerned administrative authorities. Keywords: Infection Prevention and Control, Medical Undergraduates, Training Program Development
Copyright (c) 2025 Arushi Arora, Adarshjot Kaur Toor, Sanjeev Mahajan, Loveena Oberoi (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
From Mine to Makeup: Occupational Hazards of Mica Mining and Ethical Implications for India’s Cosmetic Industry
Introduction: Mica, a naturally occurring mineral, is widely used in India’s cosmetic industry for lipsticks, eye-shadows, nail polish, and powders. Despite its commercial importance, mica mining in states such as Jharkhand and Bihar is largely informal and unregulated, exposing workers, including children, to serious occupational hazards. These include respiratory diseases, musculoskeletal injuries, and psychosocial stress, compounded by unsafe working conditions and environmental degradation. Evidence synthesis on the occupational, environmental, and social consequences of mica mining in India is limited. Methodology: A scoping review was conducted using PubMed, Scopus, Web of Science, ScienceDirect, Google Scholar, and grey literature, including NGO and investigative reports. Studies reporting occupational health outcomes, child labour, environmental exposure, or supply chain issues were included. Data were extracted on exposure, population, outcomes, and policy relevance, and findings were synthesized descriptively. Result: The review identified substantial evidence of occupational and environmental hazards, including chronic respiratory illness, musculoskeletal injuries, and widespread child labour. Environmental assessments highlighted soil and water contamination near mining sites. Reports confirm mica’s extensive use in the cosmetic industry and underline ethical concerns related to its sourcing. Existing policy initiatives, such as the Responsible Mica Initiative, show progress but enforcement remains limited. Conclusion: Mica mining in India poses significant occupational and environmental challenges. The cosmetic industry’s reliance on mica underscores an ethical imperative for responsible sourcing or safer alternatives. Strengthened regulations, elimination of child labour, and sustainable supply chain practices are critical to protect worker health and uphold industry ethics Keywords: Mica mining, Occupational health, Child labour, Environmental contamination, Cosmetic industry, India, Ethical sourcing, Public health
Copyright (c) 2025 Kunal Vats, Alan Lyander War, Ambreshwar Ghule, Yogesh Kumar Jain, Manoj Kumar Gupta (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Assessment of Opium Use Disorder and Opioid-Induced Bowel Dysfunction in a Rural Village of Western Rajasthan: A Cross-Sectional Study
Introduction: Opioid Use Disorder (OUD) affects 2.1% of India’s population. In western Rajasthan, opium use is culturally rooted and socially accepted. Opioid-Induced Bowel Dysfunction (OIBD) and Opioid Enteropathy (OE) are complications often overlooked in community settings, requiring population-level evidence. This study determines the prevalence of OUD in a rural village and assesses OIBD in those who had OUD, identifies individuals at high risk for OE, and characterizes the associated symptom profile in high-risk participants. Methodology: A community-based study was conducted in Khejarli, Jodhpur, using a 2-phase design. In Phase I, a universal sampling strategy was adopted, wherein eligible individuals were screened for OUD using the DSM-5 diagnostic criteria. In Phase II, OUD patients were assessed for OIBD using the Hindi-translated GSRS scale. High-risk OE was defined based on the presence of more than two Alarm symptoms with moderate to severe anaemia. Data were analysed using SPSS v23, applying descriptive and inferential statistics. Results: Out of 882 individuals screened, 136 (15.4%) were diagnosed with OUD (mean age: 49±14.2 years, 98.5% males). OIBD was in 113(83.1%), and 76(55.9%) of these individuals were identified as high-risk for OE, which was significantly associated with older age, lower educational status, longer duration, and greater severity of opioid use, higher morphine-equivalent consumption, financial debt due to opioid use, and presence of other substance use (p < 0.05). Conclusion: This study shows that a considerable burden of gastrointestinal complications exists among opioid users in rural communities. These findings recommend the need for early community-level screening and integrated public health interventions that address both opioid dependence and gastrointestinal health, particularly in resource-limited rural areas. Keywords: Opioid enteropathy, Opioid-induced bowel dysfunction, Opioid use disorder, Rural Population.
Copyright (c) 2025 Ateeq Ur Rehman Mullah, Ashish Agarwal, Pankaj Bhardwaj, Manoj Kumar Gupta, Chhagan Lal Birda, Prem Prakash Sharma, Manavi Vikram, Vaibhavi Minotra (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Gynaecological morbidities among women attending a cancer screening centre in rural Karnataka, India
Background: Reproductive illness is a common yet underreported issue among women in developing countries, including India, having a great impact on the health and quality of their lives. Studies have shown that despite this high prevalence, women in developing countries rarely approach health facilities. Methods: This was a cross-sectional study carried out among women attending a community cancer screening facility covering rural and semi-urban population of coastal Karnataka in Southern India. Participants’ demographic characteristics and reproductive history was assessed, and they were clinically screened for gynaecological morbidity. Study participants were subjected to per speculum examination and Pap smears followed by Visual Inspection with Acetic Acid (VIA) Results: Of the 599 women who consented to participate nearly 68% were in the age group of 30- 50 years. The Pap smear test diagnosed 36.9%of women with infection. Gynaecologic morbidity was found to be more (54.5%) among women less than 30 years of age and least (24.6%) in women more than 50 years of age. Predictably older women (>50 years of age) were observed to present with prolapse and this association was significant (p < 0.005). Around 51.3% of OCP users had infection on Pap smear versus 35.5% of non-users (p=0.048)., out of the 67 women positive for VIA, 3 women were found to have a positive Pap smear result, indicating presence of cervical cancer. Conclusion: The study underscores the urgent public health need to strengthen routine gynaecological screening, integrate reproductive health care into primary services, and promote community awareness. Early detection and timely management can prevent chronic complications and enhance women’s health and dignity across the life course.
Copyright (c) 2025 Zari Anjum, Suma Nair, Vibha Swaroop (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Behind the Glitter: Occupational, Environmental, and Public Health Impacts of India’s Mica Supply Chain
Introduction: Mica, a naturally reflective mineral, gives shimmer and glow to many cosmetic products such as lipsticks, eyeshadows, and highlighters. India remains one of the largest global producers of mica, particularly in Jharkhand and Bihar, where extraction is largely informal. This unregulated nature of mica mining exposes workers—including women and children—to unsafe occupational conditions, resulting in respiratory diseases, musculoskeletal disorders, and psychological stress. Beyond human health, the mining process contributes to environmental degradation and contamination of local ecosystems. Despite its economic significance, the broader public health and environmental implications of mica’s supply chain remain underexplored in India. Methodology: A scoping review was undertaken across PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar, supplemented with NGO and investigative reports. Studies and reports focusing on occupational hazards, environmental exposure, and community health outcomes related to mica mining and processing were included. Data were extracted on exposure type, affected populations, outcomes, and policy relevance, and were synthesized descriptively. Results: Evidence highlights serious occupational and environmental health challenges, including chronic respiratory illness, ergonomic strain, and child labour. Environmental assessments show heavy metal contamination of soil and water around mining regions. Broader community-level effects include malnutrition, poor sanitation, and limited healthcare access, contributing to an ongoing public health burden. Conclusion: India’s mica supply chain presents intertwined occupational, environmental, and ethical challenges. Addressing these requires stricter enforcement of safety standards, sustainable sourcing policies, and public health interventions to safeguard workers and mining-affected communities.
Copyright (c) 2025 Ambreshwar Ghule, Lyander Alan War, Kunal Vats, Yogesh Jain, Manoj Kumar Gupta (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Designing a BPACR Scoring System for a Tertiary Teaching Hospital.
Introduction: Birth Preparedness and Complication Readiness (BPACR) is a comprehensive strategy to promote timely utilization of skilled maternal, intranatal and neonatal care. Standardising the assessment of BPACR is of utmost importance to monitor effective implementation of related strategies and initiatives. Methods: A desk review was conducted with the aim of framing a locally relevant BPACR assessment tool. Various databases were searched and relevant articles were shortlisted and examined to study the items used in their respective BPACR scoring system. A contextually appropriate measurement tool for use in our tertiary teaching hospital was framed. Results: The reviewed studies demonstrated variation in BPACR assessment approaches. The number of items used ranged from 6 to 21 across various domains. Based on this review a scoring system was framed. Conclusion: A BPACR scoring system with 25 items, for use among post-partum women delivered at our tertiary teaching hospital was framed. Validity was ensured by group of experts from the departments of Community Medicine and Obstetrics and Gynaecology. Internal consistency was tested by Cronbach’s alpha (0.73). Each item will be given a score of 1 and grading done based on Bloom’s criteria as the items relate to knowledge, attitude and practice. As the institution is catering to mothers of different areas, our scoring system assesses individual preparedness. Keywords: Birth preparedness and complication readiness, BPACR Score, Tertiary teaching hospital.
Copyright (c) 2025 Kamini Raj, Sanjeev Mahajan, Adarshjot Kaur Toor, Suparna Grover (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
The Human Cost of Beauty: Occupational Risks and Public Health Burdens of Mica Mining in India
Introduction: Mica, a naturally shimmering mineral, forms the foundation of several cosmetic products, including eye shadows, highlighters, and nail polishes. In India, major mica deposits are found in Jharkhand and Bihar, where extraction remains largely informal and unregulated. Workers, including women and children, often mine under unsafe conditions with minimal protective equipment. Such practices expose them to a range of occupational hazards—respiratory illnesses, musculoskeletal disorders, injuries, and psychosocial stress—while also creating broader environmental and community health challenges. Despite the mineral’s economic value, research on the public health consequences of mica mining remains limited. Methodology: A scoping review was conducted using PubMed, Scopus, Web of Science, ScienceDirect, Google Scholar, and grey literature, including NGO and investigative reports. Studies focusing on occupational health outcomes, environmental exposure, or social determinants linked to mica mining were included. Data were extracted on exposure type, population, outcomes, and policy relevance, and synthesized descriptively. Results: Findings reveal significant evidence of occupational risks, particularly chronic respiratory disorders, ergonomic strain, and high rates of child labour. Environmental assessments report heavy metal contamination in soil and water near mining areas. Community-level effects include poor nutrition, limited healthcare access, and psychosocial strain among miners’ families. Conclusion: Mica mining poses a serious occupational and public health concern in India. Strengthening occupational safety standards, regulating informal mining, and promoting ethical, sustainable sourcing are critical to protect worker health and community well-being. Keywords: Mica mining, Occupational health, Public health, Child labour, Environmental contamination, India, Ethical sourcing.
Copyright (c) 2025 Lyander Alan War, Ambreshwar Ghule, Kunal Vats Vats, Yogesh Jain, Manoj Kumar Gupta (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Double Burden: Maternal Non-Communicable Diseases and Perinatal Outcomes in India
Introduction: The increasing prevalence of NCDs such as diabetes, hypertension, and obesity among women of reproductive age can lead serious and lasting impacts on the health of both mother and child. The objective of this narrative review is to understand the association between maternal NCDs and adverse perinatal outcomes. Methodology: PubMed, Scopus, and Google Scholar databases were searched for studies using keywords like "maternal non-communicable diseases", "perinatal outcomes", "gestational diabetes", "hypertension in pregnancy", "maternal obesity". Articles exploring the link between pre-existing or gestationally-developed NCDs and specific perinatal outcomes were selected and reviewed. Results: Evidence shows a strong, consistent link between maternal NCDs and adverse perinatal outcomes. Hypertensive disorders complicated an estimated 7–10% of pregnancies and according to one prospective cohort study, severe pre-eclampsia was associated with a more than eightfold higher risk of perinatal death (Risk Ratio 8.60). Some Indian studies report gestational diabetes mellitus (GDM) prevalence as high as 14%; findings from a study showed GDM is a strong predictor for macrosomia and neonatal hypoglycaemia. Findings from a key Indian analysis showed that obese pregnant women had substantially higher odds of developing GDM (OR 4.85) and hypertensive disorders (OR 3.83). Conclusion: The increasing prevalence of NCDs among pregnant women in India poses a serious threat to achieving national and global maternal and child health goals. The findings of this review show an urgent need to transition from a purely infection-focused antenatal model to an integrated one that includes routine screening, early diagnosis, and effective management of NCDs. Keywords: Pregnancy, Gestational, Perinatal Death, Noncommunicable Diseases, Obesity.
Copyright (c) 2025 Shuchita Solanki, Muskan Thakur, Lyander Alan War, Hrudyashwari Kishor Khadse, Nikita Singh, Yogesh Jain, Manoj Kumar Gupta (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Risk perception and influencing factors for substance abuse in college going adolescents in Rohtak city: A qualitative study
Substance use among young people is no longer an unfamiliar concern- it has slowly made its way into college campuses. Adolescents often experiment with tobacco, alcohol, or drugs out of curiosity, peer influence, or emotional stress, without fully understanding the long-term harm.2023 UNODC reports shows overall drug use increase by 23% over the last decade. Risk perception is shaped not only by individual choices but also by family values, social pressure, and media exposure. This study explores how college going students in Rohtak perceive the risks of substance use and what factors influence them. This qualitative study was carried out in five colleges of Rohtak city. Data were collected through focused group discussions with students selected by purposive sampling and In-Depth interviews were conducted with students willing to discuss more about the subject using a pre-designed semi-structured interview schedule. Data were recorded, transcribed and analyzed using inductive thematic analysis. Six broad themes emerged from the study. Many students considered substances like cigarettes and alcohol as normal or social habits. Peer pressure and college environment played a major role. Family and cultural factors also contributed, especially where substance use was normalized at home. Media and social platforms often glamorized such behaviors, further shaping attitudes. Although students recognized the health risks, many believed they were personally immune. Students stressed upon the importance of counseling, awareness programs, and stricter campus monitoring to prevent substance use. Substance use among adolescents is not just an individual decision, it is a reflection of society, cultural values, emotional issues and accessibility. Students, although, understand the risks, they often underestimate the consequences. To tackle this a multipronged strategy needs to be applied like strengthening preventive education program and teacher-student interaction, policy implementation and institutional support, parental and family engagement initiatives, community involvement and awareness campaigns.
Copyright (c) 2025 Narender Kumar, Varun Kumar Arora, Srishti Singh, Neha Grewal, Trushna Parida, Dr Anjali Gupta (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Use of social media and its association with lifestyle related factors and quality of life among the employees of Aligarh Muslim University.
Introduction: Social media has become integral to daily life but is linked to lifestyle disturbances like poor sleep and inactivity. This study examined its use patterns and impact on lifestyle and quality of life among university employees. Methods: A cross-sectional study was conducted among 100 employees of Aligarh Muslim University from May 2025 to September 2025. The individual participant served as the study unit. Statistical analysis was done using SPSS version 20.0. Results: Among the participants, 78% were males and 22% females, with a mean age of 42.18 ± 8.45 years. Almost all (98%) used social media with YouTube (98%) being most used followed by WhatsApp (84%) and Facebook (74%). About 80% used it for more than 2 hours daily, primarily for entertainment (86%). Reported adverse effects included disturbed sleep (36%), reduced physical activity (30%), altered eating habits (16%) and poorer conversation quality (70.6%). Significant associations were found between type of social media use and its impact on sleep (p < 0.05) and physical inactivity (p < 0.05), while quality of life showed no significant association with type or duration of use. Conclusion: Social media use is nearly universal among university employees. However, prolonged and excessive use adversely affects sleep and physical activity, underscoring the need for balanced and mindful engagement to promote better lifestyle and quality of life.
Copyright (c) 2025 Chandramouli Mitra, Urfi (Author) https://creativecommons.org/licenses/by-nc-nd/4.0