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   2013| January-March  | Volume 57 | Issue 1  
    Online since May 4, 2013

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An assessment of hepatitis B vaccine introduction in India: Lessons for roll out and scale up of new vaccines in immunization programs
Chandrakant Lahariya, BP Subramanya, Stephen Sosler
January-March 2013, 57(1):8-14
Background: Hepatitis B vaccine was introduced in the Universal Immunization Program (UIP) of 10 states of India in the year 2007-08. This assessment was planned and conducted to ascertain the reasons for low reported coverage of Hepatitis B (Hep B) vaccine in comparison of similarly timed diphtheria, pertussis, and tetanus (DPT) vaccine; to identify operational and programmatic challenges in new vaccine introductions, and to derive lessons for further scale up of Hep B vaccination (or for introduction of any new vaccine) in UIP of India. Materials and Methods: Purposive sampling with both quantitative and qualitative data collection. Two districts each were purposively selected from 5 of the 10 states, which introduced Hep B vaccine, in the year 2007-08. A protocol was devised and data was collected through desk review, in-depth interviews and on-site observation at state, districts and facility levels. The assessment was completed in December 2009. Results: Coverage with three doses of Hep B vaccine was lower than similarly timed three doses of DPT vaccine. Poor stock management ("stock outs or nil stocks" at various levels), incomplete recording and reporting, perceived high cost & related fear of wastage of vaccine in 10 dose vial, and incomplete knowledge amongst health functionaries about vaccination schedule were the main reasons cited for reported lower coverage. Hep B vaccine birth dose was introduced in only 3 of 5 states evaluated. The additional reasons for low Hep B birth dose coverage were lack of knowledge amongst Health Workers about birth dose administration, no mechanism for recording birth dose, and insufficient trainings, official communications, and coordination at various levels. Conclusions: This assessment documents challenges faced in the introduction of hepatitis B vaccine in UIP in India and summarizes the lessons learnt. It is concluded that for successful introduction and scale up of any new vaccine in national or state immunization program; clear and timely central level instructions and oversight and improved stock management is required. At state and district levels; quality trainings, effective supervision and monitoring, improving data recording and reporting are key factor for success. The additional focus on Hep B birth dose administration may help in improving coverage. The lessons from this assessment can possibly be utilized for future introduction and scale up of any new vaccine (or other similar interventions) in India or in any other developing country setting.
  17,651 1,331 13
Courses in reproductive and child health in India: An overview
Sutapa Bandyopadhyay Neogi, Ranjana Singh, Sumit Malhotra, Sanjay P Zodpey, Monika Chauhan
January-March 2013, 57(1):15-19
Defining the human resource needs for providing quality maternal, newborn, and child health services across such a large and diverse population country like India is truly challenging. The effective response to significant challenges and increased requirements of evidence-based effectiveness of the public health projects on maternal and child health is putting pressure on existing program managers to acquire new advanced academic training and information. The data regarding the existing courses on reproductive and child health and related fields in the country were obtained by a predefined search made on the Internet through the Google search engine in December 2011. The collected data were the name and location of the institution offering the respective course, theme, course duration, course structure, eligibility criteria, and mode of learning. In India, around 15 institutes are offering certificate/postgraduate diploma courses on maternal and child health either as a regular program or through distance education program. The admission procedure for each institute is independent of others. The courses vary in terms of duration, eligibility criteria, and fee structure. Conceptualizing an educational initiative in response to national demands for increased workforce capacity to eliminate key medical and nonmedical educational barriers and financial and nonfinancial barriers to advanced academic preparation would enhance the quality of services available in the region.
  7,398 452 -
Factors associated with low birth weight among newborns in an urban slum community in Bhopal
AK Choudhary, Asha Choudhary, SC Tiwari, R Dwivedi
January-March 2013, 57(1):20-23
A community based cohort study on birth weight of newborns was conducted among pregnant women of an urban slum in Bhupal, India. The study was carried out to assess the magnitude of low birth weight (LBW) and factors contributing it in an urban slum community. Socio-demographic and maternal characteristics were examined applying statistical techniques to find out the variables associated with the LBW. An additional schedule was used to collect information from mothers about their socio-demographic background, dietary intake and the rest during the pregnancy. Weight of newborns of mothers registered in the study and delivering at the district hospital was recorded. Mean birth weight of newborns of 290 registered mothers was 2.57 ± 0.36 g. One hundred and five newborns (36.2%) had a birth weight lesser than 2500 g. Among different variables studied, statistically significant association was found in case of occupation, daily calorie intake and duration of day-time rest taken by pregnant women.
  6,029 1,204 3
Prevalence of diabetes mellitus, impaired fasting glucose, impaired glucose tolerance, and its correlates among police personnel in Bankura district of west Bengal
Pranav Kumar, Debabrata Mallik, Dipta Kanti Mukhopadhyay, Apurba Sinhababu, Banamali Sinha Mahapatra, Phalguni Chakrabarti
January-March 2013, 57(1):24-28
A cross-sectional study was conducted among police personnel (N = 1817) in Bankura District, West Bengal, India to estimate the prevalence of diabetes mellitus (DM), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and its correlates during July-November, 2011. Participants were enquired about their age, gender, physical activity, and predominant occupational activity. Diagnosis of DM, IFG, and IGT was based on a history, fasting, and 2-h post-load blood glucose estimation as per World Health Organization (WHO) criteria. Body mass index, waist circumference (WC), and blood pressure (BP) were estimated. Out of 1817 subjects, DM was found in 15%, 1.1% had IFG and 5.7% had IGT. Age >50 years, family history of diabetes, hypertension, and abdominal obesity were found to be significantly associated with DM and IGT, whereas IFG was significantly associated with the family history of diabetes and hypertension. High prevalence of diabetes and pre-diabetic condition warrants early effective intervention to keep the police force healthy and agile.
  5,653 878 8
A study on socio-demographic characteristics of alcoholics attending the de-addiction center at Burdwan medical college and hospital in West Bengal
Aditya Prasad Sarkar, Subrata Sen, Sudhakar Mondal, Om Prakash Singh, Amitava Chakraborty, Bikash Swaika
January-March 2013, 57(1):33-35
Prevalence of alcohol use in India is reported to be 21.4% and there is increasing alcohol intake among the young people. The present study was undertaken to study the socio-demographic characteristics of patients having alcohol-related disorders attending the de-addiction center at Burdwan Medical College in West Bengal and to find out some factors responsible for that. A clinic-based descriptive cross-sectional study was conducted among 187 patients with the help of pre-tested pre-designed schedule after obtaining informed consent. Data analysis was carried out with the help of Epi info software version 6. Majority of the patients were male, in productive age group and married. Age of initiation and amount of alcohol intake were significantly associated with positive family history of alcoholism. Children having family history of alcoholism should be counseled to prevent development of alcoholism.
  5,333 693 2
Assessment of village water and sanitation committee in a district of Tamil Nadu, India
SR Ganesh, S Ganesh Kumar, Sonali Sarkar, Sitanshu Sekhar Kar, Gautam Roy, KC Premarajan
January-March 2013, 57(1):43-46
A descriptive study was conducted among 75 members of five Village Water and Sanitation Committees (VWSCs) and 15 local residents in Tamil Nadu, India to assess committee's formation and decision making process. There were 64% females and rest were males, all aged between 20 years and 45 years. A total of 50.7% of them passed 12 th standard and 29.3% belonged to self-help groups. Although, all of them were aware about presence of guidelines, none of them knew its contents. About 20% opined that meetings were not being conducted regularly. All members said that they had problems in attending meeting regularly, take decisions if at least 10 (67%) members are present and fund was not adequate for 1 year period. One-third of local residents did not know the committee formation process and none of them aware about guidelines. Formation and decision making process of VWSC should be improved to tackle the sanitation problem.
  5,162 669 5
Anti-inflammatory effect of vitamin D on gingivitis: A dose response randomised controlled trial
Vishwanath P Hiremath, C Bhasker Rao, Vijaya Naiak, K.V.V. Prasad
January-March 2013, 57(1):29-32
DOI:10.4103/0019-557X.111365  PMID:23649140
  3,800 37 2
Gender-violence and health care: How health system can step in
Suneela Garg, Ritesh Singh
January-March 2013, 57(1):4-7
Gender-violence also known as domestic violence, domestic abuse, spousal abuse or intimate partner violence, can be broadly defined as a pattern of abusive behaviors by one or both partners in an intimate relationship such as marriage, dating, family, friends or cohabitation. It can manifest as physical aggression, sexual abuse, emotional abuse, intimidation, stalking and economic and food deprivation. In most countries gender violence is a crime; though scope of the domestic or gender violence act and severity of punishment varies considerably between the countries.
  3,150 523 2
Hypertension: The prevention paradox
Madhumita Dobe
January-March 2013, 57(1):1-3
  2,823 582 1
Suicide an Emerging Public Health Problem: Evidence from Rural Haryana, India
Harshal Salve, Rakesh Kumar, Smita Sinha, Anand Krishnan
January-March 2013, 57(1):40-42
Analysis of annual mortality data for year 2002-2009 of twenty eight villages in Ballabgarh block of rural Haryana was carried out to calculate suicide rates per 100,000 population. In addition, informal discussions were carried out amongst health providers to understand their perceptions regarding suicides. In a period of 8 years, out of total 4552 deaths, 163 (3.5%) deaths were attributed to suicides giving a suicide rate of 24.4/100,000 population (95% CI 24.1- 24.7). Mean years of productive life lost for males and females were estimated to be 44.4 (SD 1.1) years and 39.9 (SD 1.4) years respectively. Poisoning (41.1%) was the most common mode of suicide followed by hanging (36.8%) and burns (14.7%). Health workers also perceived suicide as major problem in the community and marital confl ict was identifi ed as major cause for suicides. There is need to address the complex issue of suicide by public- health approach at the community level.
  2,963 423 2
Characteristics of childhood tuberculosis patients registered under RNTCP in Varanasi, Uttar Pradesh
Ruchi , Harshad P Thakur
January-March 2013, 57(1):36-39
Childhood tuberculosis (TB) reflects on-going transmission. Data on childhood TB from TB registers under Revised National Tuberculosis Control Program of 2008 and 2009 in Varanasi district was analyzed. Proportion of childhood TB was 8.3% of total registered cases 12,242. It was lower than estimated 10-20% in endemic areas. In rural Tuberculosis Units childhood case detection was poor. Case detection in ≤5 years was very less. The childhood cases were detected mainly in adolescent age group. Thus, childhood TB is remaining a under diagnosed/under reported disease in India. It needs attention to increase the detection of childhood TB cases to control TB in general population.
  2,164 406 1
Optimizing the routes and locations for primary healthcare clinics using network analysis: A geographic information systems application
Mark Rohit Francis, Jayanth Devasundaram, Vinohar Balraj
January-March 2013, 57(1):47-48
  1,750 255 -
Role of public health dentist towards domestic violence
H Mythri
January-March 2013, 57(1):50-50
  1,658 298 -
Acceptance of vaccination against the 2009 pandemic influenza a among health-care workers in Pune, Maharashtra
Ravishekar N Hiremath, SM Atul Kotwal, Renuka Kunte, Sandhya Hiremath, Dasarath Basannar, Sandeep Bhalla
January-March 2013, 57(1):48-49
  1,663 202 4
Obituary: Dr. Ranadeb Biswas

January-March 2013, 57(1):51-51
  791 125 -