Background:Neonatal deaths remain a significant global health concern, with low birth weight (LBW) being a major contributing factor. Tele-counseling emerges as a scalable strategy to complement existing efforts to reduce neonatal morbidity. Material and Methods:This was a community-based quasi-experimental study conducted with 80 LBW neonates, non-randomly assigned to intervention (tele-counseling) and control groups. The intervention group received structured tele-counseling for eight weeks, covering neonatal care aspects, including breastfeeding, hygiene, vaccination, thermal care, and danger sign recognition. The control group received routine postnatal care without tele-counseling. Statistical Analysis Used:Data were collected through a semistructured questionnaire and analyzed using Chi-square tests and Kaplan-Meier survival curves. Results:Exclusive breastfeeding rates significantly improved in the intervention group (22.5% to 90%). Hand hygiene practices also showed a significant improvement (37.5%-85%). Morbidity incidence was lower in the intervention group (22.5%) compared to the controls (45.0%), with statistical significance (P = 0.033). Conclusions:Tele-counseling is an effective tool for improving neonatal care practices and reducing morbidity among LBW infants. Integrating tele-counseling into national health initiatives such as Home-Based Newborn Care (HBNC) and Ayushman Bharat Digital Mission (ABDM) can enhance neonatal survival outcomes, particularly in underserved regions.
Background:Sleep is essential for physical, emotional, and cognitive well-being. This study aimed to estimate the prevalence and determinants of poor sleep quality among undergraduate students in a city in Haryana. Materials and Methods:This cross-sectional study was conducted among 600 randomly selected undergraduate students in medical, paramedical, and other graduate colleges. Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). A Google form questionnaire containing demographic details of students, PSQI, and International Physical Activity Questionnaire-Short Form (IPAQ-SF) was shared with students. Pearson's Chi-Square test and logistic regression were used for analysis. Results:Of the 541 respondents, 65.4% had poor sleep quality (PSQI >5). On multivariable binary logistic regression analysis, the odds of poor sleep quality were approximately two times in students from urban family backgrounds and who lacked moderate to vigorous physical activity, as compared to their reference group, respectively. The odds ratio of poor sleep quality was 2.7 times among those who were dissatisfied with their academic performance than those who were satisfied. The odds of poor sleep quality increased by 23% for every one-hour increase in duration of non-academic screen use. Conclusion:Approximately two-thirds of undergraduate college students in Karnal city, Haryana, had poor sleep quality. Urban family background, physical inactivity, dissatisfaction with academic performance, and increased screen use for non-academic purposes were significant predictors of poor sleep quality. Interventions promoting physical activity, healthy screen-use practices, and student well-being may help improve sleep quality among undergraduate students.
Background:Empathy is widely recognized as a core component of patient-centered care and an important professional competency for medical graduates. In India, the attitude, ethics, and communication (AETCOM) module was introduced within the competency-based MBBS curriculum to foster empathy, communication skills, and professionalism. However, limited qualitative evidence exists regarding students' experiences of empathy-focused teaching within this curriculum. This study explored medical students' perceptions and experiences of empathy-focused AETCOM sessions and their views regarding the teachability of empathy. Methods:An exploratory qualitative descriptive survey was conducted among second-year MBBS students at a tertiary-care medical institute in June 2025. An anonymous online survey containing a single open-ended question-"What are your perceptions and experiences regarding the AETCOM classes focused on empathy?"-was administered following informed consent. Seventy-five students submitted written responses. Responses were reviewed independently by two researchers and organized into descriptive categories representing common patterns in participants' experiences and perceptions. Results:Four broad categories were identified. Students generally perceived role-plays, simulations, patient narratives, and faculty experiences as valuable learning approaches. Participants described increased awareness of active listening, patient-centered communication, and patients' emotional concerns. Suggested improvements included greater use of interactive and practice-oriented teaching methods, shorter sessions, and incorporation of emotional resilience and self-care training. A small minority of students expressed reservations regarding the impact of empathy teaching and viewed empathy primarily as an innate personal attribute. Conclusion:Students generally viewed empathy-focused AETCOM sessions positively, particularly when delivered through interactive and experiential approaches. The findings suggest that learner feedback may help inform the ongoing refinement of empathy-focused teaching within undergraduate medical education.
Background:The Electronic Vaccine Intelligence Network (eVIN) was introduced in India to strengthen vaccine logistics through digitization and real-time stock and temperature monitoring. The present study assessed the cold chain infrastructure and vaccine logistics before and after eVIN implementation at cold chain points (CCPs) in Indore district. Material and Methods:A pre-post observational study was conducted at all functional CCPs of Indore district. Post-eVIN assessment (2020-2021) included 40 CCPs, while pre-eVIN data (2014-2015) from 36 CCPs were obtained from program records. A census approach was used. Data were collected using standardized supportive supervision checklists and secondary databases. Data were analyzed using descriptive statistics and expressed as frequencies and percentages. Results:Higher compliance was observed in various cold chain parameters in post-eVIN period. Most cold chain equipment were functional during assessment. Availability of functional power back-up increased from 22.2% to 72.5%. CCPs maintaining updated stock and distribution registers increased from 72.2% to 100%. The presence of functional thermometers increased from 83.3% to 90%. Real-time web-based documentation was implemented at all CCPs post-eVIN. Adequate infrastructure and compliance with vaccine storage norms were observed at most facilities. However, gaps persisted in stabilizer availability, ice-pack conditioning practices, and vaccine transport logistics, with no CCP having a dedicated vaccine van or trained driver. Conclusions:Better compliance in cold chain infrastructure, vaccine logistics, and documentation practices was observed after eVIN implementation. However, gaps in stabilizer availability, ice-pack conditioning, and vaccine transport logistics require targeted programmatic action to sustain improvements in routine immunization services.
Background:Hepatitis B remains a significant public health concern, particularly among occupational groups at risk of exposure. Food handlers are a crucial population to consider when assessing hepatitis B virus (HBV) seroprevalence in public health surveillance due to their frequent interaction with the community. Aims:To assess the HBV seroprevalence and associated factors among food handlers in Kozhikode. Materials and Methods:A community-based cross-sectional study was conducted using multistage sampling. Food handlers from various food establishments in three blocks of Kozhikode district were included. A total of 1,145 participants were recruited. Data were collected by interview using a pre-tested semi-structured questionnaire. Results are expressed as proportions and means with standard deviations. Results:Out of 1,145 participants, the majority were males, 77% of the participants were from Kerala. Injury was present in 2.2% of participants. HBV seroprevalence was 0.6% among food handlers. All positive participants were aged 31-45 years, 85.7% were male, and 43% were involved in cooking. However, all were asymptomatic and unaware of the infection. Conclusions:With a 0.6% HBV seroprevalence among food handlers, the public health implications are significant. A comprehensive health and safety package tailored for food handlers is essential to mitigate risks.
Introduction:Snake envenomation is a common life-threatening medical emergency, especially in rural areas where limited access to healthcare and a lack of awareness about proper first-aid procedures often lead victims to rely on traditional healers before seeking modern treatment. These practices, such as the use of tourniquets, pressure immobilization, and native concoctions, might result in adverse outcomes and cause delays in seeking medical assistance. Methodology:This Case series design was conducted to identify the prehospital practices among patients with snake envenomation who presented to the emergency department of a tertiary care hospital. The study included 100 adult participants with definite characteristics of snake envenomation. Consecutive sampling was used to select participants, and data collection focused on clinico-epidemiological profiles and prehospital practices, including traditional remedies and first aid measures. Continuous variables were presented as mean ± standard deviation or median, and associations were assessed using Chi-square or Fisher's exact test. Results:Participants had a mean age of 45.5 ± 15.6 years, with male predominance (71%) and the highest incidence in the 31-45 age group (33%). Most were from rural areas (94%). The median time from the bite to hospital admission was 90 minutes (IQR 4-180 minutes). 56% of participants used various methods before reaching the hospital. Washing the bite site with water and soap was the most common (19%), followed by topical native concoctions (17%) and pressure immobilization (17%). Conclusion:The study showed that various prehospital practices among patients were associated with threefold higher odds of delay in arriving at the hospital. The public should be educated to prevent unnecessary delays in transporting patients to the hospital because of these practices.
Background:Early detection of oral cancer is critical for reducing morbidity and mortality, yet uptake of screening among women remains low. Socio-economic disparities in screening can hinder equitable health outcomes. This study aimed to quantify inequalities in oral cancer screening among women and identify key contributors using decomposition analysis. Methods:We analyzed nationally representative survey data of women aged 30-49 years. Self-reported oral cancer screening was the outcome of interest. Socio-economic inequality was measured using the concentration index, and decomposition analysis was performed to assess the relative contribution of demographic, socio-economic, behavioral, and healthcare access factors. Results:Screening uptake was low and disproportionately concentrated among socio-economically advantaged women (Concentration Index: 0.006, 95% Confidence Interval: 0.005-0.007). Decomposition analysis revealed that education, household wealth, place of residence, and access to health information were the main contributors to observed inequalities, whereas age and marital status had smaller effects. Conclusion:Significant socio-economic inequalities exist in oral cancer screening among women. Policies should focus on equity-oriented strategies, including targeted outreach to disadvantaged groups, integration of screening into primary and women-centric healthcare services, and strengthened health education. Reducing these disparities is essential for improving early detection and ensuring equitable oral cancer prevention.
Background:Non-communicable diseases (NCDs) disproportionately impact low- and middle-income countries. In India, cardiovascular diseases (CVDs) lead in mortality and disability, driven by tobacco use, poor diet, and inactivity. Large-scale prevention remains limited. Aim:This study aims to identify CVD risk factors and estimate the 10-year risk of stroke or myocardial infarction (MI) among hypertensive patients attending the Medicine outpatient department (OPD) at All India Institute of Medical Sciences (AIIMS), Deoghar, India. Method:This cross-sectional study was conducted in the Medicine OPD of AIIMS Deoghar, Jharkhand, from February to June 2024, including 365 hypertensive patients aged ≥30 years selected through purposive sampling. Eligibility criteria and recruitment procedures were predefined. Data were collected using a pre-tested structured questionnaire covering sociodemographic, clinical, and behavioral factors. Blood pressure was measured using a calibrated mercury sphygmomanometer under standard conditions, and laboratory investigations (random blood sugar [RBS] and lipid profile) were performed as per hospital protocols. The primary outcome was the 10-year CVD risk estimated using QRISK 3, with relevant variables systematically recorded. The 10-year CVD risk was estimated using the QRISK3, a validated risk prediction tool originally developed in the United Kingdom. It calculates individual risk of developing CVD (including MI and stroke) based on multiple variables such as age, sex, smoking status, systolic blood pressure, total cholesterol/high-density lipoprotein (HDL) ratio, and comorbid conditions (e.g., diabetes, chronic kidney disease, atrial fibrillation, and rheumatoid arthritis). The algorithm provides an absolute 10-year risk percentage to guide cardiovascular risk stratification and preventive decision-making. Data were analyzed using SPSS version 22. Continuous variables were expressed as mean ± SD and categorical variables as proportions. Associations were assessed using Chi-square and Pearson's correlation. A P value < 0.05 was considered significant. Bias was minimized through standardized measurements and predefined criteria. Ethical approval was obtained from Institutional Ethics Committee (IEC) and Institutional Review Committee (IRC), AIIMS Deoghar, and written informed consent was taken from all participants. Results:The study included 57.8% male and 42.2% female participants. Smoking prevalence was high (88.8%), and 22.7% of participants had diabetes. Uncontrolled hypertension was present in 21.6%, with 20.8% receiving treatment. The mean 10-year QRISK3 score was 11.67 (SD = 11.16), with a relative risk mean of 1.53 (SD = 1.01). The mean QRISK3 Healthy Heart Age was 58.68 years (SD = 12.44), indicating a substantial deviation from optimal cardiovascular health. Correlation analysis revealed significant associations between age, systolic blood pressure, and RBS with CVD risk scores. Conclusion:Among hypertensive patients attending a tertiary-care center in Jharkhand, the mean 10-year QRISK3-estimated cardiovascular event risk was 11.67%, indicating a moderate-risk profile. Age, systolic blood pressure, glycemic status, and lipid abnormalities were the major contributors to risk. These findings highlight the need for routine cardiovascular risk assessment, optimal blood pressure control, smoking cessation, and improved diabetes management to reduce future stroke and MI risk.
Background:The rapid increase in the use of electronic gadgets has markedly transformed the lifestyle patterns of young adults. These devices have become indispensable tools for communication, academic learning, and leisure activities. However, excessive use of electronic gadgets-particularly during evening hours and before bedtime-has been associated with disturbances in sleep patterns. Additionally, increased reliance on electronic devices (EDs) for leisure activities has contributed to reduced levels of physical activity among young adults, raising concerns about their overall health and well-being. Objective:This study aimed to assess the extent of ED usage and explore its relationship with sleep quality and physical activity levels among undergraduate nursing students in Manipal, Udupi, Karnataka. Methods:A cross-sectional descriptive study design was employed between January 2025 and June 2025 among undergraduate nursing students in Manipal, Udupi, Karnataka. A total of 380 students were randomly selected to participate in the study. Data were collected using self-administered questionnaires, including a demographic proforma, an electronic gadget usage questionnaire, the Sleep Quality Scale (SQS), and a physical activity level questionnaire. Results:Statistical analysis revealed that the mean age of the participants was 19.86 ± 1.4 years, and 62.9% of the students resided in hostels. Smartphones were the most commonly used devices (59.7%), followed by the use of multiple EDs (38.9%). A substantial proportion of participants (70%) reported using electronic gadgets for multiple purposes, including academics, social communication, and entertainment, and 40.3% reported spending 3-4 h per day on non-academic screen time. The majority of respondents (91.6%) demonstrated moderate levels of electronic gadget usage, while 66.6% reported poor sleep quality. With regard to physical activity, 55% of participants exhibited low activity levels. A statistically significant weak negative correlation was observed between electronic gadget usage and sleep quality (ρ = -0.213, P < 0.001), and the correlation between electronic gadget usage and physical activity was weakly negative but not statistically significant (ρ = -0.090, P = 0.080). In contrast, a significant positive correlation was found between physical activity and sleep quality (ρ = 0.195, P < 0.001). Ordinal logistic regression showed that extreme gadget usage is associated with poor sleep quality (odds ratio [OR]-5.16; P < 0.05), and the linear regression model examining the association between electronic gadget usage and physical activity was statistically significant (R² = 0.0483, P < 0.001). The results indicated that the usage of electronic gadgets was associated with poorer sleep quality and lower levels of physical activity among students. Conclusion:The findings of this study highlight the importance of adequate sleep and the need to limit ED use, particularly before bedtime, to promote better sleep quality. Encouraging increased physical activity and responsible ED usage is essential for maintaining optimal physical and mental well-being among nursing students and young adults.
Abstract Background: Over 86% of premature deaths from noncommunicable diseases (NCDs) occur in low- and middle-income countries. This study aimed to assess the impact of integrating components of the WHO’s Package of Essential Noncommunicable Disease (PEN) protocols on blood pressure control. Secondary objectives included evaluating changes in biological and behavioral NCD risk factors, 10-year cardiovascular disease (CVD) risk, and treatment adherence. Material and Methods: A quasi-experimental study was conducted in four health centers—two intervention (urban and rural) and two control sites. WHO-PEN protocols 1 and 2 were implemented in the intervention arm, where 302 patients received behavior-change interventions by trained nonphysician health workers using “Brief Advice.” The control arm (305 patients) received usual care. The intervention lasted six months, with follow-ups at two, four, and six months. Results: After six months, blood pressure control did not differ significantly between the intervention and control groups after adjustment for baseline blood pressure control, income, and family type (adjusted odds ratio [AOR] 0.71, P = 0.188). In the unadjusted analysis, 88.5% of patients in the intervention arm had controlled blood pressure, with a risk difference of − 7.03 (95% confidence interval [CI]: −12.8 to − 1.27), an odds ratio (OR) of 0.57 (95% CI: 0.36–0.91), and a statistically significant association ( P = 0.018). Significant improvements were observed in physical activity (≥150 minutes/week) with a risk difference of − 12.43 (95% CI: −22.25 to − 6.60), P < 0.001; vegetable consumption (−31.06, 95% CI: −34.65 to − 27.47), P < 0.001; and fruit intake (−41.46, 95% CI: −48.48 to − 34.44), P < 0.001. Conclusions: Behavior-change communication by nonphysician health workers, focusing on modifiable risk factors, improved healthy behaviors among NCD patients, while blood pressure control did not improve significantly after adjustment.
Abstract Objective: To strengthen the WHO-Framework Convention on Tobacco Control (FCTC) MPOWER “warn” component, India implemented 85% pictorial health warnings (PHWs) on all tobacco packs in 2016, allowing a two-month grace period to clear old stock. We monitored compliance and the time taken to comply with the revised PHW rules effective December 1, 2020, during December 2020–May 2021. Methods: A cross-sectional survey assessed one prominent tobacco point-of-sale (PoS) in each of 21 cities across nine Indian states, with 24 follow-up visits. A “saturation approach” measured the weeks required for full adoption of new PHWs, with product and brand analyses conducted across all cities. Results: Tobacco companies took an average of 10 weeks to comply with PHW regulations for 399 products, exceeding the two-month legal limit. None of the surveyed cities attained both complete saturation and full regulatory compliance across all three tobacco product categories. Saturation in the first week of the observation was achieved by cigarette brands (“One and Only and Moments” ), smokeless tobacco brands (“ Eagle, and Gopal 100”) , and bidi brands (“ Desai bidi, Dinesh bidi, and Naresh bidi”) . Conclusions: Tobacco companies in India are non-compliant with the new PHW rules 2020, with diverse regional saturation trajectories. This clearly makes a case for the non-compliant industry behavior toward Indian regulations. There is a need to strengthen enforcement and reduce discrepancies across various city-states to ensure that the grace period is not violated by the tobacco companies.
Abstract Background: The National Tuberculosis Elimination Programme (NTEP) aims to eliminate catastrophic costs among people with tuberculosis (TB) and their households by 2025. This study assessed the economic burden of TB among people with TB in Uttar Pradesh, India, with particular focus on out-of-pocket (OOP) expenditure and catastrophic costs. Material and Methods: A cross-sectional survey was conducted among 209 people with TB from 10 districts of Uttar Pradesh using a structured questionnaire. Information related to household income, direct medical expenditure, indirect costs, and wage loss was collected. Expenditure data were summarized using median, interquartile range, mean, standard deviation, and proportions. Month-wise expenditure data were further analyzed using a Moving Average approach to estimate expenditure trends during the standard 6-month treatment period. Results: Approximately 19.5% of people with TB experienced catastrophic expenditure, with agricultural laborers (33%) and housewives (31%) disproportionately affected. The median catastrophic expenditure among affected households was Rs. 37,750/-. Indirect costs, particularly wage loss, contributed substantially to the overall financial burden. While nearly half of the participants reported no direct OOP expenditure, some households incurred very high treatment-related costs. The projected indirect expenditure per patient during the 6-month treatment period was approximately Rs. 5,000/-, of which wage loss accounted for nearly Rs. 4,000/-. Conclusions: Although direct treatment costs under NTEP were relatively low, indirect costs continued to impose substantial economic burden on affected households. Strengthening financial risk protection measures, wage compensation mechanisms, and patient-centered support strategies may help reduce catastrophic expenditure associated with TB care.
Background:Globally, more than one-fifth of smokers end up being hospitalized due to consequences. Hence, the study was designed to explore the behavioral pattern of smoking among patients admitted to a tertiary care hospital in North India. Methods:A qualitative study was conducted among 50 patients admitted to a tertiary care hospital in North India. The participants were categorized into groups using the Heaviness of Smoking Index (HSI). In-depth interviews using an interview guide were conducted with participants from these groups. Inductive thematic analysis was performed to identify themes and subthemes. The natural history of tobacco addiction was presented using concept maps. Results:All participants were male with a mean (SD) age of 51.0 (16.5) years, and the median (IQR) duration of smoking was 20.5 (5.9, 21.2) years. The majority (60%) of participants had moderate to severe addiction. Five major domains emerged drivers of smoking initiation (peer pressure, community norms, and individual curiosity), continuation of smoking (perceived benefits, normalization, concealment, and lack of familial regulation), consequences of smoking (progression to serious illnesses such as COPD, TB, and cancer, and social/familial conflict), thoughts of quitting (triggered by illness, medical advice, social disapproval, and family pressure), and failure to quit (nicotine dependence, withdrawal symptoms, and persistent peer influence). Conclusion:Smoking behavior among hospitalized male patients is shaped by complex interplay of their own willingness, peer and community influences, perceived benefits, and limited early awareness of harm. Medical illness and healthcare advice often initiate quitting intentions, but dependence and social pressures hinder cessation.
Background:Anemia is a global public health concern with adverse effects on health and socioeconomic development. Among the elderly, it is often underdiagnosed and undertreated despite being a marker of physiological decline and morbidity. With India undergoing demographic transition, the burden among the elderly is expected to increase. This study aimed to estimate the prevalence and associated factors of anemia among the urban Indian elderly population. Methods:A population-based cross-sectional study was conducted from January 2019 to June 2020 among 250 elderly individuals (≥60 years) in the urban field practice area of a medical college. Data on sociopersonal characteristics, dietary and personal habits, and comorbidities were collected using a pretested semistructured proforma. Hemoglobin was estimated using the HemoCue Hb 301 system, and anemia was classified as per WHO criteria. Data were analyzed using Chi-square test, t-test, and multivariable logistic regression. Results:The prevalence of anemia was 38.4%. Multivariable logistic regression analysis showed that increasing age, female sex, dependence in activities of daily living, and consumption of two or fewer meals per day were independently associated with anemia. Pallor was significantly associated with lower mean hemoglobin levels (P < 0.001). Conclusion:More than one-third of the urban Indian elderly population had anemia. Increasing age, female sex, dependence in activities of daily living, and consumption of two or fewer meals per day were independently associated with anemia. These findings highlight the need for routine screening, nutritional assessment, and functional evaluation among the elderly population and support greater inclusion of elderly in national demographic and health surveys and future anemia prevention and control initiatives.
India's Universal Immunization Programme (UIP) has substantially reduced the burden of vaccine-preventable diseases and remains one of the largest public health initiatives globally. However, despite sustained programmatic efforts, nearly one in four children remains incompletely immunized, and a considerable proportion of families continue to access vaccination services through the private healthcare sector. These services operate largely outside the governance framework of the UIP, resulting in fragmented practices, inconsistent reporting, variable quality standards, and missed opportunities for strengthening the national immunization ecosystem. This article argues that the private sector should be recognized not as a parallel system but as a strategic partner in achieving universal immunization goals. We propose a comprehensive integration framework that aligns private vaccination services with the UIP through six interconnected pillars: standardization of care, pricing and financing, capacity-building, vaccine storage and quality assurance, reporting and adverse event surveillance, and monitoring and evaluation. By embedding private providers within existing public health governance mechanisms and digital platforms, the framework promotes uniform standards of safety, accountability, affordability, and service delivery while preserving patient choice. Integrating private sector vaccination services through a coordinated, policy-driven approach offers a pragmatic pathway to improve coverage, strengthen surveillance, and build a more resilient and equitable immunization system in India.
Anemia prevalence in Indian pregnant women remains at 52.2% (The National Family Health Survey-5), necessitating rigorous comparison of standard versus newer iron formulations to optimize treatment in India. To evaluate the comparative effectiveness of oral and parenteral iron preparations in Indian pregnant women, focusing on hemoglobin and serum ferritin improvement. We searched PubMed, Embase, Cochrane Library, and Google Scholar for Randomized Controlled Trials (RCTs) published up to 2024. Only RCTs from India were included. Data from 17 trials (N = 2,228) were synthesized using network meta-analysis to estimate mean differences (MDs) in hemoglobin and serum ferritin levels. Within oral formulations, newer salts significantly outperformed the standard of care; specifically, ferrous asparto glycinate demonstrated the highest hemoglobin improvement (MD: 1.21 g/dL; 95% confidence interval [CI] 0.04-2.38) (hypothesis-generating; small sample), followed by ferrous bisglycinate and iron polymaltose complex, compared to ferrous sulfate. Among parenteral formulations, iron sucrose emerged as the superior agent (MD: 0.76 g/dL; 95% CI 0.52-1.00) for hemoglobin recovery. While the comparison between modes confirmed the known superiority of parenteral over oral iron (MD: 0.88 g/dL at 4 weeks), the network ranking highlights that newer oral molecules offer significantly better efficacy than the current standard, ferrous sulfate. Iron sucrose shows the highest efficacy for rapid hemoglobin correction. Among oral options, ferrous asparto glycinate, ferrous bisglycinate, and iron polymaltose complex provide better hemoglobin improvement than ferrous sulfate. These findings support a review of iron-molecule choices within the Anemia Mukt Bharat strategy. PROSPERO Registration Number: CRD42024570537.
Background:Efficient inventory management is essential for ensuring uninterrupted drug availability and optimal utilization of limited healthcare resources. ABC-VED analysis is a widely used inventory control technique that classifies drugs according to annual expenditure and criticality. The present study was conducted to identify drugs requiring priority managerial control at a Rural Primary Health Centre (PHC) in Thane District, Maharashtra. Methods:A retrospective descriptive study was conducted at a Rural PHC in Thane District, Maharashtra, using pharmacy records from the calendar year 2023. Data on all drugs utilized at the PHC, including quantity consumed and unit cost, were collected. ABC analysis categorized drugs according to annual drug expenditure, while VED analysis classified drugs based on their criticality as Vital, Essential, or Desirable. An ABC-VED matrix was subsequently prepared to identify managerial priority categories. Results:A total of 40 drugs with an annual drug expenditure of ₹193,784.4 were analyzed. ABC analysis showed that Category A (5 drugs): 69.5% of annual expenditure, Category B (7 drugs): -19.2%, and Category C (28 drugs): -11.3%. expenditure. VED analysis identified 15 Vital, 13 Essential, and 12 Desirable drugs. ABC-VED matrix analysis categorized 19 drugs into Category I, 12 drugs into Category II, and 9 drugs into Category III, indicating the need for stringent managerial control. Conclusion:ABC-VED analysis is an effective tool in drug inventory control at PHC pharmacies. It results in proper and optimal usage of resources, maintains adequate availability of essential drugs, ensures economic viability, and supports effective health care delivery.
Healthcare waste management in rural and remote India should not be treated as merely a technical disposal problem but as a governance, behavioral, and community health challenge. Although India has a regulatory framework for biomedical waste management, implementation remains uneven in rural primary healthcare settings because of weak segregation practices, limited access to common biomedical waste treatment facilities, inadequate staff training, poor monitoring, and low community awareness. This viewpoint argues that rural healthcare waste management requires a decentralized and community-engaged model that links regulatory compliance with local participation and resource-sensitive sustainability. The paper proposes an adapted "Four Joints of Power" framework involving government agencies, healthcare institutions, communities, and non-governmental or private-sector partners. However, its application to India must be context-specific, aligned with the Biomedical Waste Management Rules, 2016, State Pollution Control Boards, district health authorities, and primary healthcare institutions. The Circular Economy approach can strengthen this framework by promoting waste minimization, safe segregation, recycling of non-hazardous waste, and appropriate decentralized treatment technologies, while recognizing rural barriers such as limited skilled manpower, weak supply chains, inadequate infrastructure, and regulatory constraints. Social workers can play a strategic role as facilitators of community awareness, behavior change, stakeholder coordination, and monitoring. The paper recommends an integrated rural healthcare waste management approach that combines policy enforcement, capacity-building, community participation, gender-sensitive occupational safety, and locally feasible sustainable waste practices.
Background:Musculoskeletal pain (MSP) is increasingly common among healthcare students, primarily due to poor ergonomic behavior, static postures, and limited physical activity during academic and clinical tasks. Adequate ergonomic knowledge and appropriate postural behaviors may help reduce the risk of musculoskeletal pain during training and future professional practice. Materials and Methods:A cross-sectional survey was conducted among 421 undergraduate students from five healthcare disciplines (Dental, Medical, Nursing, Pharmacy, and Physiotherapy) at a private university, in Bengaluru, India. The validated adult version of the Aristegui questionnaire was administered online. Responses to knowledge and behavior were scored and categorized into Good, Fair, and Poor levels. Descriptive statistics and Chi-square tests were used for analysis. Results:While 56.1% of students demonstrated good ergonomic knowledge, only 5.5% exhibited good ergonomic behavior. A significant association was observed between discipline and ergonomic knowledge (P = 0.033), whereas ergonomic behavior did not differ across disciplines (P = 0.520). MSP was reported by 68.2% of participants. Conclusion:These findings highlight a disconnect between knowledge and practice, reinforcing the need to integrate structured ergonomic education and hands-on training into healthcare curricula.
