Indian healthcare through the global health ethics lens: despite some gains, have we truly progressed?
In: Journal of global ethics, Band 15, Heft 1, S. 76-84
ISSN: 1744-9634
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In: Journal of global ethics, Band 15, Heft 1, S. 76-84
ISSN: 1744-9634
Non-communicable diseases (NCDs) are considered as life-style diseases. School teachers' behavior in this context could be transmitted to students that may act as determining factor of prevention for NCDs at primordial level. Aim of this study is to assess the prevalence of risk factors among teachers and their practices with respect to common NCDs. A cross-sectional study was conducted in Jodhpur among 394 government school teachers. Questionnaire was adopted from WHO STEPS tool and responses were documented which included socio-demographic details, anthropometric measurements and risk factors including diet, hours of physical activity, smoking and alcohol intake. Mean age of participants was 43 years out of which 23% were found to be having blood pressure more than 140/90 mm of Hg at the time of interview. 4.8% consumed alcohol and 1.5% was smokers. Mean body mass index (BMI) was found to be 25.4 while only 13% had their cholesterol checked post 35 years of age. The 23.6% had knowledge of reducing fat by using the right type of cooking oil, 35.7% were engaged in any daily physical activity and 76% knew that excess salt was not good for health. This survey assessed baseline levels by identifying the overall prevalence and associated risk factors that provided first step towards initiating surveillance for NCDs among school teachers in Jodhpur, Rajasthan, whilst delivering the necessary information concerning with developing a suitable framework for determining priorities over intervention.
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Interventions early in life are the need of the hour when it comes to controlling the rising incidence of communicable and non-communicable diseases (NCDs) globally. WHO has issued guidelines towards health promotional initiatives at schools as a part of Global School Health Initiative, and the Government of India has directed many policies and programs to integrate health deep within the school activities. School Health Promotion is an international need with programmes implementing across continents due to numerous documented benefits, to not just the individuals but to the community and country as a whole. Simple teachings like hand hygiene have shown to reduce the incidence diarrhea by more than 50% amongst children (a major cause of mortality in India), thus raising an urgent need of developing a model for health promotion at schools that is replicable, sustainable, and can be modified to the local needs as well. Though the existent programmes have a few documented challenges, a multisectorial involvement of government agencies, educational boards, and health sector along with the school is the way forward to address those challenges and covert the theory of health promoting schools (HPS) into a well-established fact. It presents a scope for the various established and newly emerging Schools of Public Health in the country to come forward and collaborate with these multiple sectors. These collaborations can be the only way to ensure sustainability and incorporation of health promotion into the core academic structure of schools in a diverse and highly populous country like India.
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BACKGROUND: Government of Rajasthan has undertaken a series of e-Health initiatives, especially under various programs of National Health Mission in the past few years. There is a paucity of studies which document and provide appraisal of these initiatives in Rajasthan. AIM: To document ongoing e-Health Initiatives based on technologies and approaches used, coverage by the region and population, services provided and scope. MATERIALS AND METHODS: Primary data collection in form of key-informant interviews while secondary data collection in form of internet-based search of peer and non-peer reviewed literature was conducted to achieve the study objectives. Appropriate documents, records, and reports were reviewed to ensure that all necessary information was obtained. RESULTS: A total of 13 e-Health initiatives were included in the study. The e-Health programs were classified with the use of WHO's classification of Digital Health Interventions v1.0. Most of the initiatives perceived in the study were found to be beneficial to the community, covering the entire population targeted. Supporting agencies, technologies used, and challenges faced during the implementation were identified and documented. Lack of trained manpower, technical and software glitches and deficiency of awareness activities were few obstacles that were found consistent across all user groups. CONCLUSIONS: The overview from this study augmented the knowledge about further scopes and sustainability of these initiatives. Deploying dedicated professionals may improve the functioning of these initiatives. Since e-Health interventions significantly influence healthcare systems, further scale-up of such studies with appropriate evaluation should be planned to guide policy decisions.
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Non-communicable diseases (NCDs) are a global challenge towards diminishing quality of life. Health related quality of life (HRQoL) is a widely accepted measure of burden of disease for individuals with chronic conditions. Due to paucity of data in Western Rajasthan, India, this study was planned to assess the HRQoL due to NCDs in Jodhpur, India. A descriptive cross-sectional study was planned in government NCD center of Jodhpur. Convenience sampling was used to select 398 respondents and socio demographic data was collected. Short Form–36 (SF-36) questionnaire was used to measure perceived effects due to NCDs across eight domains of analyzed using descriptive and inferential statistics. High combined mean scores were obtained in domains of Social Functioning (77.87) and Mental Health (75.36%) and lowest scores for General Health (54.70%), Bodily Pain (60.06%) and Role Emotional (60.33%). Males recorded higher mean scores than females across all domains with high statistical significance for Bodily Pain, Vitality, Role Physical and Mental Health. Findings suggested worst and least affected domains of regular life functions due to NCDs. Greater focus on emotional distress, active inclusion of females in national health programmes and integration of NCD control program with Mental Health Program would aid to improve overall HRQoL in affected individuals.
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In: Annals of work exposures and health: addressing the cause and control of work-related illness and injury, Band 66, Heft 9, S. 1162-1172
ISSN: 2398-7316
Abstract
Objectives
"Silicosis" is a leading cause of occupational morbidity globally. In Rajasthan, India silicosis has been recognized as an epidemic, resulting in the development of a new pneumoconiosis policy in 2019. This study was conducted to provide an overview of the policy implementation regarding the detection, prevention, and control of silicosis.
Methods
A qualitative study was carried out in the Jodhpur district of Western Rajasthan in which stakeholders were interviewed. Themes were identified regarding prevention, detection, diagnosis, and certification, and organized by stakeholder role. Data were retrieved from the Silicosis Grant Disbursement Portal of the Government of Rajasthan to present an overview of the existing system for detection, prevention, and control of silicosis and to determine the delays in various aspects.
Results
A total of 35 stakeholders were interviewed. There was low awareness regarding the prevention, detection, diagnosis, and rehabilitation of silicosis amongst multiple stakeholders. There is a need for robust enforcement in mining units regarding silicosis prevention and screening. Unregistered mining activities and migration of mineworkers are major challenges in the detection of silicosis cases. Misdiagnosis and low notification rates prevent workers from accessing resources. There are myriad reasons for delays in workers receiving diagnosis and benefits, which have systemic roots but can be uprooted through rigorous implementation of the legislative provisions.
Conclusion
There are several well-established pieces of legislation to protect the rights of mineworkers; however, there are gaps in the effective implementation of various provisions that require immediate attention to address the challenges faced during the prevention, detection, diagnosis, and rehabilitation of workers with silicosis.
For the poorest of our world, non-communicable diseases and injuries (NCDIs) account for more than a third of their burden of disease; this burden includes almost 800000 deaths annually among those aged younger than 40 years, more than HIV, tuberculosis, and maternal deaths combined. • Despite already living in abject poverty, between 19 million and 50 million of the poorest billion spend a catastrophic amount of money each year in direct out-of-pocket costs on health care as a result of NCDIs. • Progressive implementation of affordable, cost-effective, and equitable NCDI interventions between 2020 and 2030 could save the lives of more than 4·6 million of the world's poorest, including 1·3 million who would otherwise die before the age of 40 years. • To avoid needless death and suffering, and to reduce the risk of catastrophic health spending, essential NCDI services must be financed through pooled, public resources, either from increased domestic funding or external funds. • National governments should set and adjust priorities based on the best available local data on NCDIs and the specific needs of the worst off. • International development assistance for health should be augmented and targeted to ensure that the poorest families affected by NCDIs are included in progress towards universal health care.
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