Background: Opioid abuse affects not only user's health but also productivity, security, and health-care costs. Better understanding about the risk factors of opioid use is in need in Myanmar as the country has heavy burdens of opioid abuse. Objectives: The present study aimed to identify the determinants of opioid use among adult males in Kachin State, Myanmar. Methods: This case–control study was conducted in Myitkyina city of Kachin State in August 2019. The ratio of case and control was 1:3, of which there were 109 opioid users and 327 controls who never used illicit drugs. Inclusion criteria for the participants were males of 18 years' old or above. Cases were recruited with the help of a nongovernmental organization, whereas controls were randomly selected from household registration of local government. Data were collected using face-to-face structured questionnaire interview. Multivariable logistic regressions were used to identify the determinants. Results: The factors associated with opioids use among males in Kachin state had peers who used opioids (adjusted odds ratio [AOR] = 21.67, 95% confident interval [CI]: 10.41–45.09), smoking cigarette or cheroot (AOR = 7.5, 95% CI: 4.03–13.94), aged 25 years or older (AOR = 3.46, 95% CI: 1.73–6.95), and were non-Kachin ethnic (AOR = 2.52, 95% CI: 1.36–4.64). Conclusion: The study indicated that peers had the strongest influence on opioid use, followed by smoking habits as well as age and ethnicity. Effective prevention programs are essential for vulnerable groups.

Background: Soil-transmitted helminth (STH) infections have adverse physical and mental effect, especially in preschool (3–6 years) and school-age children (6–14 years). They are associated with socio-behavioral factors of poverty and poor personal and community hygiene. Objectives: To determine the prevalence, intensity, and the type of helminths infection harbored by the school age children (6–14 years) and to examine the relationship between STH infection and their potential risk factors and associated variables. Methods: This cross-sectional study was conducted from January to December 2016 among 250 school age children residing in an urban resettlement colony of East Delhi. Data were collected using a semistructured interview schedule. Stool sample was tested using the Kato Katz technique. Data were analyzed in SPSS software version 16, and multivariable regression analysis was done to calculate the odds of various risk factors. Results: The prevalence of STH was found to be 54.8%, and majority (85.3%) of Ascaris and all Trichuris infections were of light intensity. Multivariable logistic regression analysis confirmed that children having poor handwashing behavior in school, irregular handwashing before eating, having pica, and lack of de-worming had higher odds of having STH infection. Conclusion: The prevalence of STH in the study area is substantially high, and the findings suggest that besides mass de-worming strategy, behavior change, and improvement in hygiene are required to control STH.

Background: Outpatient department (OPD) table surfaces frequently touched by patients and health-care workers in hospitals harbor potential pathogens and may act as source of infectious agents. Objectives: This study aimed to determine the pattern of bacterial contamination of surfaces of OPD tables in relation to existing cleaning/disinfection practices. Methods: The descriptive study was conducted during July 2018–September 2018. A total of 128 swabs were collected from 32 OPD table surfaces immediately after cleaning or disinfection and then at 30 min, 2 h, and 4 h interval after cleaning or disinfection. Type and concentration of cleaner or disinfectant, number of cleaning strokes on table, and time of last washing of cleaning cloth with detergent were also noted from each location. Isolation, identification, and antibiotic susceptibility testing of the isolates were performed by standard microbiological techniques. Results: A total of 337 bacterial isolates were recovered from 126 samples. Multidrug resistant Staphylococci, Acinetobacter, Pseudomonas, Klebsiella, and Escherichia coli were isolated. The mean bacterial colony count increased with time (P < 0.0001). Hand rub use, cleaning of OPD table surfaces with disinfectant, and more number of strokes with cleaning cloth resulted in decrease in colony count of bacteria isolated. Conclusion: High bacterial contamination of frequently touched OPD table surfaces with variety of potential pathogens like Staphylococcus, Acinetobacter, Pseudomonas, Klebsiella, and E. coli was detected. Hand hygiene among health-care workers and regular and frequent cleaning and disinfection of OPD table surfaces are highly recommended to prevent cross-transmission.

Background: Village health sanitation and nutrition day (VHSND) was conceived under the National Rural Health Mission to deliver maternal and child health and nutrition services at the village level in the anganwadi center. Multiple challenges, including a lack of convergence of frontline workers, were affecting service delivery at VHSND. As a public–private partnership Piramal Foundation proposed to revive the concept of VHSND. Objectives: The present study was aimed to demonstrate a model of VHSND to provide primary care related to maternal and child health and nutrition at the village level in 25 aspirational districts across seven states of India. Methods: The descriptive study was undertaken as a pilot phase. Of the purposively identified 506 VHSND sites, monitoring data on delivery of six basic primary care services at VHSND, collected as part of routine operations were compared for 229 sites for the month of September 2018 (baseline) and January 2019 (endline). Results: In model sites, there was the increased availability of drinking water and functional toilets; a significant improvement of availability of equipment for providing antenatal care services, immunization, and growth monitoring. However, the supply of drugs at these sites did not show a statistically significant change. There was also a significant improvement in the engagement of the Village Health Sanitation and Nutrition Committee (VHSNC) in the villages of the model VHSND sites. Conclusion: The model demonstrated the significant changes with effective supervision and participation of VHSNC members, demand generation activities complemented with improved supplies and widening range of services at the VHSND are required to be undertaken.

Background: Understanding the stress related to work among community health workers (CHWs) might be beneficial to plan intercessions to draw in and spur health-care professionals to toil in remote and disadvantaged region as well as to guarantee the quality of care. Objectives: This study was conducted to determine the prevalence, level, and sources of occupational stress among CHWs and coping strategies adopted by the CHWs. Methods: This cross-sectional study was conducted from January to April 2019 among 347 CHWs in 16 Primary Health Centres of Mangalore taluk, Karnataka. Occupational Stress Index and the Brief COPE scale were used to assess the stress level and coping strategy, respectively. Descriptive statistics and Chi-square test were used. The P = 0.05 was considered as significant. Results: The prevalence of occupational stress was found to be 40.5%. Stressors such as under participation, powerlessness, low status, and unprofitability were significantly associated with occupational stress. CHWs used various coping strategies such as self-distraction, active coping, denial, substance use, behavioral disengagement, venting, positive reframing, humor, and self-blame to manage their stress. Conclusion: Stress intercession programs could be conducted on a regular interval to make CHWs “stress-free”. Higher stress level might impede the performance of the workers, and hence addressing this is necessary. Similarly, positive coping strategies, such as active coping, should be promoted to manage stress.

Background: Ensuring universal access to sanitation in households is essential for public health. Objectives: The objective of the study was to assess the availability of sanitary latrine at the household level and its use at the individual level in a rural area and factors associated with availability and use of sanitary latrine. Methods: This cross-sectional study was conducted from December, 2016 to January 2017 (mention month and year) at the rural Health and Demographic Surveillance Site, Ballabgarh, in district Faridabad, Haryana, North India. A total of 16,896 households were studied. House-to-house visits were made by trained health workers who conducted interviews regarding availability and pattern of use of sanitary latrine in the household. The health worker also observed the type of sanitation facility, its functional status, availability of water, and hand-washing facility. Results: Individual household latrine (IHL) was present in 87.3% of the households. An improved sanitation facility was available in 84.8% of the households, while 15.2% of the households had unimproved or no sanitation facility. Hand-washing facility along with improved sanitation was present in 70.4% of the households. Nonavailability of latrine among socially disadvantaged communities (scheduled caste households) was significantly higher (19.4%) as compared to other castes (10.4%) (P < 0.001). A significantly higher proportion of households below poverty line (28.9%) lacked IHL as compared to those above the poverty line (11.0%) (P < 0.001). Nearly 11% of the individuals reported open defecation. Conclusion: The availability of sanitary latrines in the study area was high. Nonavailability of in-house sanitary latrine was higher among economically poor households and those belonging to socially disadvantaged communities.

Background: Combustion of kerosene and biomass fuel in the kitchen as cooking medium is one of the major sources of indoor air pollution. Such contaminated indoor air quality adversely affects the respiratory health of exposed individuals over a period of time. Homemaker women especially residing in slum areas are always vulnerable to indoor air-pollution-related health hazards. Objectives: The objective is to assess the relationship between various socio-demographic factors and usage patterns of cooking fuel; and to determine the effect of cooking medium namely biomass, kerosene on pulmonary function parameters. Methods: A cross-sectional observational study was carried out during April 2012 – April 2016 among 531 nontobacco addicted adult primary homemaker women residing in slums of Ahmedabad city of Gujarat. Basic information-related socio-demographic parameters were collected on a pretested questionnaire. Pulmonary function test (PFT) parameters were evaluated with standard techniques. The statistical analysis was carried out with SPSS software (version 17.0). Statistical tests of significance between groups and mean along with multivariate linear regression analysis were applied. Results: Predominant cooking medium for nearly 40% of slum households were kerosene and biomass. Mean value of forced expiratory volume in the 1^st s (FEV1) and FEV1/forced vital capacity (FVC) were significantly lower among Kerosene and biomass users compared to LPG users. Multivariate regression analysis with involvement of PFT parameters, cooking medium, and environmental tobacco smoke exposure (ETS) shows, deprivation of both FEV1 and FEV1/FVC were significantly related with the usage of kerosene and biomass; whereas no relation found with ETS. Conclusion: Reduction of pulmonary function parameters among the study participants were related with kerosene and biomass fuel usage in the kitchen.

Background: Among children admitted with pneumonia, several modifiable predictors have been identified for deaths in children in hospitals. Despite the presence of a several national programs designed to address most of the risk factors directly or indirectly it is surprising that they continue to be common in children with pneumonia. Objectives: The objective is to determine the risk factors for pneumonia mortality in under-five children in a tertiary care hospital of Darjeeling district of West Bengal. Methods: An analytical study with case–control design was conducted between May 2016 and October 2017. Children aged 2–59 months admitted with the diagnosis of pneumonia were followed up after admission and who died were recruited as cases and two consecutive age- and sex-matched controls were recruited among children who were declared cured and discharged. A total of 95 cases and 190 controls were studied and the risk factors were compared in the pair matched groups by the conditional logistic regression. Results: Factors influencing childhood pneumonia mortality were severely underweight (adjusted odds ratio [AOR]: 3.66 [1.28,10.46]) unimmunized child (AOR 4.18 [1.53, 11.41]), lack of exclusive breast feeding (AOR: 3.12 [1.23, 7.91]), past history of diarrhea or acute respiratory infection in the last 3 months (AOR: 7.27 [3.68, 14.36]), hypoxemia on admission (AOR: 2.53 [1.14, 5.61]), sub-center as the first contact health facility (AOR: 6.49 [2.15, 19.67]), and antibiotic not received at first contact (AOR: 3.18 [1.36, 7.43]). Conclusions: Most of the risk factors for death in children between 6 and 59 months of age are directly or indirectly related to health service delivery and can be ameliorated through proper structural and administrative measures.

Background: Early detection of cervical cancer can significantly reduce the associated morbidities and mortality. However, uptake of screening for cervical cancer in India is not encouraging. Objectives: To assess the awareness about cervical cancer, willingness, and barriers for undergoing screening of cervical cancer among women in urban Pondicherry. Methods: This cross-sectional study was conducted among women of 30–65 years in urban Pondicherry during January – July 2019. A total of 219 women, selected using two-stage random sampling, were interviewed using a pretested semi-structured questionnaire. Multistep multivariable logistic regression was done to identify the independent correlates of willingness to undergo screening for cervical cancers. Results: About one-third women were aware of cervical cancer. Awareness was more among women who were young, had higher education, had family history of cancer, and currently working. Awareness of risk factors, signs and symptoms of cancer cervix was low. Although 60% of the women, who have been aware of cervical cancer, were aware of possibility of early detection, <15% were aware of the various methods. 32% of the women were willing to undergo screening for cervical cancer, and occupation, family history of cancer, and knowledge about risk factors were found to be independent correlates. Fear and “not having signs and symptoms” were the major reasons for unwillingness. Conclusion: Level of awareness and willingness for undergoing screening of cervical cancer was low in study area. Targeted interventions for awareness and health system efforts for addressing the reasons behind unwillingness are required.

Background: Thailand is exposed to multiple climate-related hazards. Those cause disaster, instability and destruction to human life and property. People affected by disasters need self-help capabilities. Therefore, local administration organizations (LAOs) and local community networks are critical. They act as social capital in communities who can contribute meaningfully to disaster management systems. Objective: The study aimed to assess procedures and activities of community networks focusing on disaster management and how social capitals are utilized. Methods: The qualitative study was conducted with 65 informants recruited through purposive sampling and snowball techniques from six outstanding LAOs. We analyzed data from in-depth interviews, observations, and focus group discussions with key informants. An inductive thematic analysis was performed to identify themes on procedures and activities related to social capital. Content analysis was used to analyze the data. Results: We identified three main outcomes. The social capital involved and collaborated with LAOs included civil groups, community organizations, community leaders, and other public and private organizations. Procedures and activities related to social capital working in disaster management in communities included predisaster phase, disaster phase, and postdisaster and recovery phase. The overall local community network was key to help disaster affected people in communities effectively. Conclusion: The findings suggest that social capital participation builds up a sustainable community self-management. The potential enhancement of the local community self-management is strongly based on relationships within the community structure. Community disaster self-management and is likely reducing risk factors and mitigate vulnerability.

Background: Each year, between 50,000 and 100,000 women worldwide develop obstetric fistulae. Approximately 2 million girls across Asia and Africa are estimated to be affected by this condition. However, there is no reliable data on its prevalence in South-East Asia region (SEAR). Objectives: The objective of this study is to systematically review and synthesize the data on the prevalence and management of obstetric fistula in SEAR. Methods: We searched for the literature that described the prevalence and management practices of obstetric fistula in SEAR. We followed the PRISMA guidelines to select the articles for the review. The quality and relevance were assessed by two reviewers independently using the SIGN checklist. A total of five articles and reports were selected for the review. To review the management practices, we found 63 original studies that were included in the review. Results: We found five community-based studies estimating the prevalence of obstetric fistula in SEAR; 3 studies were from India, one from Bangladesh and one from Nepal. The pooled prevalence according to self-reports was 1.11 (3 studies including 671,133 participants, 95% confidence interval [CI] 1.09, 1.14) per 100 women. The pooled prevalence of obstetric fistula based on the clinical examination was 0.10 (3 studies involving 4547 participants, 95% CI 0.01, 0.20) per 100 women. The value was close to the pooled estimate based on the smaller studies. Conclusion: More studies are needed to estimate reliable community-based prevalence data and also need to develop evidence-based management guidelines.

Background: Monitoring of population salt intake is essential for compliance with the WHO target of a 30% relative reduction in mean population salt intake. Objective: This study was conducted to estimate the daily salt intake and find the associated variables among adult women in an urban resettlement colony of Delhi. Methods: In this community-based cross-sectional study, 426 women aged 20–59 years from an urban resettlement colony were randomly selected. Sociodemographic details, anthropometric measurements, blood pressure, and morning spot urine samples were obtained. INTERSALT equation was used to estimate the 24-h salt intake from spot urine sodium. Association of salt intake with related variables was studied using t-test/analysis of variance, and P < 0.05 was considered to be significant. Results: A total of 426 women participated in the study, and 381 participants' urine samples could be collected. The study participants' mean age (standard deviation [SD]) was 34.5 (9.4) years. The mean salt intake (SD, 95% confidence interval) of the participants calculated using the INTERSALT equation was 7.6 (1.7, 7.5–7.8) g/day. The salt intake was significantly associated with educational status, occupation, marital status, socioeconomic status, blood pressure, and waist circumference. Waist circumference was found to have a significant positive linear relationship with daily salt intake. Conclusion: The daily salt intake of this population was well above the recommendation and had a positive linear relationship with waist circumference. Reduction in daily salt intake is a must to control the epidemic of hypertension.

Retinopathy of prematurity (ROP), particularly severe ROP is a health concern. The study is aimed to ascertain the magnitude, profile, and outcome of ROP over 5 years at a level II neonatal unit in a district of West Bengal. From 2012 to 2016, a total of 691 newborns with birth weight (BW) <2000 g and/or gestational age < 35 weeks of a district level II neonatal care unit were screened for ROP. Retrospective analysis of these screened babies was performed using the principles of descriptive and inferential statistics. Overall, 38.5% of newborns had any stage ROP and13.2% severe ROP. Two-thirds of babies with severe ROP were <1250 g of BW. About 16.2% of the ROP cases suffered from aggressive posterior ROP (APROP). Oxygen and prematurity were found as significant risk factors. Substantially high occurrence of severe ROP and APROP warrants appropriate measures. Timely screening and intervention with referral to the neonatal ROP unit can improve the scenario.

Youth involves a lot of mental health issues. A descriptive cross-sectional study was undertaken to determine the relationship between emotional intelligence, self-esteem, and assertiveness among 432 youth (18–23 years) from selected colleges of Udupi district, Karnataka using Schutte Self-Report Emotional Intelligence Test, Rosenberg self-esteem scale, and Youth Assertiveness Scale. The mean emotional intelligence among youth was 124.99 ± 18.71, whereas the mean self-esteem and assertiveness scores were 18.48 ± 3.33 and 60.706 ± 7.077, respectively. Linear relationships among the key variables were assessed using the Karl Pearson's correlation coefficient. Self-esteem and assertiveness showed a weak positive relationship (r = 0.282 and 0.288, P = 0.001 respectively) with emotional intelligence, whereas the relationship between self-esteem and assertiveness also revealed a positive relationship (r = 0.367, P = 0.001). The significant correlation between these variables indicates a need for regular assessment among the youth. Rising self-esteem and training in assertiveness help the individual to use his emotions wisely and improve emotional intelligence.

The burden of geriatric mental health in India is showing a silent epidemic trend, but the knowledge on spectrum of their mental well-being dwelling in slums is very trivial. This mixed-method study aimed to estimate the proportion of depression among elderly and to find out the gender-specific circumstances, leading to depression. A total of 209 subjects selected through multistage sampling from an urban slum in a city of Maharashtra were interviewed for estimating depression, and six focus group discussions (FGDs) were conducted to explore the circumstances. Overall, 42.1% of elderly people had depression with 2.8% severe depression. Major themes highlighted after FGDs were self-esteem, social role, dependence, negative experience, and disgrace among males, and among females, main themes were justifiable reason, managing mood, suppression, undesirable events, and stigma. Depression is a significant public health problem, and a diverse approach is required to understand the perception of elderlies which will highlight the core issues related to depression.

Patient living with chronic viral hepatitis in India faces the high cost of treatment and impoverishment. The present study is aimed to assess the cost of treatment and economic consequences among chronically infected viral hepatitis patients at a tertiary care hospital in Delhi. The descriptive cross-sectional study was undertaken during October 2016–January 2017. Three hundred and eighty-nine participants were interviewed through a schedule for variables and assessing both direct and indirect costs. Costs of hospital expenditure were extracted from records available with patients or databases of the hospital. The average outpatient expenditure and the inpatient costs were calculated. Direct nonmedical costs were also included. The analysis revealed the total cost of treatment ranged from Rs. 16,600/-to Rs. 1,709,000/-with a median of Rs. 193,500 per year. The cost of treatment increased with the severity of the disease. The cost of treatment led to impoverishment in 52.8% of families and imposed a substantial economic burden and consequences on the patients.

India is home to an estimated 57 million people (18% of the global estimate) affected by depression. We conducted a cross-sectional study to determine the prevalence of depression and associated factors among software professionals in Delhi National Capital Region, during 2017–2018 with a sample size of 310. Two-stage cluster sampling was used. A predesigned, pretested, semi-structured, English questionnaire was used. Patient Health Questionnaire 9, CAGE, CAGE Adapted to Include Drugs (CAGE-AID) questionnaire, Fagerstrom test for nicotine dependence questionnaire was used. Forty percent (124) of the participants were screened to have major depressive disorder. There was a statistically significant association between depression and marital status (P = 0.041), family type (P = 0.008), alcohol use (P < 0.001), substance use (P = 0.014), multiple roles in a project (P < 0.001), and shift of work (P < 0.008). Considering the high prevalence of depression, mental health screening program, sensitization, and promotion must be incorporated into the IT industry to prevent and detect depression early.

Substantial progress has been made to improve health in India in terms of availability, accessibility, cost-effectiveness, and quality. However, there are major health inequalities between and within the states. Strategic planning of health programs is required to address inequities in health. Need of the hour is to address this using a simplified strategic approach; who is left out, why are they left out, what causes are responsible for it and what are the determinants of inequality. The basic steps of strategic management, including strategic assessment, objectives, strategy formulation, and implementation, can be used to address the health equity. This article cites the examples of Serbia immunization programme, Government of India programme on Mission Indradhanush, and Thailand's universal health coverage to get better understanding to use strategic management to address health inequity. This approach is crucial in achieving sustainable development goals.

Health research plays an integral part in scientific and academic innovation in health care. India, a rapidly developing country, showed a tremendous increase in the number of health research projects and publications in recent years. Given the broad spectrum of health research areas and a vast number of funding agencies that fund specific areas, it is difficult to gain knowledge about them from a single source. Hence, we scanned the various funding opportunities which exist in India for healthcare research. Various agencies fund health-care research on their thrust areas of national importance. Choosing the funding agency depending on the area of interest and following the guidelines given by them ensures a successful proposal for funding. This article enlists various funding agencies and gives overall information about the nature of support and fund provided for health research in India.