Suchergebnisse

INTRODUCTION: Tobacco smoke affects the health of non-smokers by exposure to second-hand smoke (SHS). The Indian Cigarettes and Other Tobacco Products (COTPA) Act 2003 Section 4 aims to reduce exposure to SHS. Awareness and compliance to COTPA are key to achieving its intended outcome. We assessed: a) awareness among persons responsible for compliance (PRC) and authorized officers (AO), and b) compliance of public places to COTPA in South Bengaluru, India. METHODS: A cross-sectional assessment of public places in South Bengaluru was conducted using time-location sampling. The Johns Hopkins Bloomberg School of Public Health's observational and interview checklist was used to assess compliance of public places to COTPA and awareness of COTPA among PRC/AO, respectively. RESULTS: Among 359 public places, one-third of the public places showed complete (1.9%) or partial compliance (28.1%). The majority (93%) of the PRCs and all AOs were aware of COTPA. However, they lacked information on the different provisions of the Act. Violations like persons smoking (3.9%), visible ashtrays (6%) and cigarette butts (13%) were noted more among eateries compared to other public places. Among those public places supposed to have designated smoking-areas, only 19% complied. CONCLUSIONS: This is the first representative survey of awareness and compliance of COTPA in Bengaluru City. Low compliance, coupled with the lack of appropriate awareness among PRCs and AOs about COTPA, demands a comprehensive strategy to enhance awareness. Comprehensive efforts towards making all stakeholders understand the health impacts of smoking, and strict enforcement, might facilitate effective implementation of COTPA.

In Karnataka, India only one-third of HIV-infected pregnant women received antiretroviral prophylaxis at delivery in 2007 through the state government's prevention of parent-to-child HIV transmission (PPTCT) program. The current qualitative study explored the role of HIV-associated stigma as a barrier to accessing PPTCT services in the rural northern Karnataka district of Bagalkot using in depth interviews and focus group discussions with HIV-infected women who had participated in the PPTCT program, male and female family members, and HIV service providers. Participants discussed personal experiences, community perceptions of HIV, and decision-making related to accessing PPTCT services. They described stigma towards HIV-infected individuals from multiple sources: healthcare workers, community members, family and self. Stigma-related behaviors were based on fears of HIV transmission through personal contact and moral judgment. Experience and/or fears of discrimination led pregnant women to avoid using PPTCT interventions. Government, cultural and historical factors are described as the roots of much the stigma-related behavior in this setting. Based on these formative data, PPTCT program planners should consider further research and interventions aimed at diminishing institutional and interpersonal HIV-associated stigma experienced by pregnant women.

Background: Suicidality among youth is one of the most challenging public health issues. A thorough understanding of the risk factors that contribute to youth suicidality is necessary. The main aim of the study is to estimate the proportion of suicidality and understand factors associated with suicidality amongst clients attending youth mental health promotion clinics in Karnataka, India. Methods: A retrospective cross-sectional case record analysis was performed utilising data from real-time digitised management information system specifically developed for the programme. All case records of clients aged 15 to 35 years who received mental health promotion (MHP) services between January 2017 and December 2020 across 30 districts of Karnataka were included in this analysis. Multivariate logistic regression analysis was performed with suicidality among clients as outcome. Socio-demographic characteristics, issues reported, feelings/emotions that indicate underlying mental health issue/crisis, being aware of suicidality among friends and family and personal habits (smoking/chewing tobacco and drinking alcohol) were considered potential exposure variables. Findings: Overall proportion of suicidality among youth presenting to youth mental health promotion clinics in Karnataka was 3.5% (357/10,340). Among factors associated with suicidality, the strongest association was found among those clients who reported attempted suicide among friends (AOR 8.94; 95% CI 5.95–13.45), family members (AOR 5.50; 95% CI 3.66–8.29), being anxious (AOR 4.90; 95% CI 3.43–6.99), inability to trust anyone (AOR 4.07; 95% CI 2.75–6.03), had issues of Gender, Sex and Sexuality (AOR 3.16; 95% CI 1.93–5.17) and relationship issues (AOR 2.77; 95% CI 2.05–3.73). Conclusion: The results alert all institutions, organisations and departments that cater to services and development of youth, to be sensitive towards risk factors of suicidality. The study advocates youth mental health promotion clinics to be equipped with measures/interventions to identify and manage such risk factors. This study has implications for Youth mental health promotion in India and other similar South-East Asian countries.