| 1. |
- Gour, Priyanka, et al.
(författare)
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Experience of Elderly People Regarding the Effect of Yoga/Light Exercise on Sedentary Behavior : A Longitudinal Qualitative Study in Madhya Pradesh, India
- 2020
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Ingår i: Geriatrics. - : MDPI. - 2308-3417. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- This study is set on the background of a randomized control trial (RCT) in which intervention was carried to observe the effects of yoga/light exercise on the improvement in health and well-being among the elderly population. A longitudinal qualitative study was conducted as part of RCT interventions to explore the experience of the elderly practicing yoga/light exercise in relation to sedentary behavior in the Ujjain district of Madhya Pradesh, India. Participants of the RCT were selected for this study. Eighteen focus group discussions were conducted-six during each phase of RCT interventions (before, during, and after). The findings regarding motivating and demotivating factors in various phases of intervention were presented in three categories: experience and perception of the effects of yoga/light exercise on sedentary behavior (1) before, (2) during, and (3) after intervention. This study explores the positive effect of yoga/light exercise on sedentary behavior and subjective well-being on the elderly population. They were recognized to have undergone changes in their physical and emotional well-being by consistently practicing yoga/light exercise. The main driving factors were periodic health check-ups and the encouragement of qualified trainers without any cost. This study concludes with the notion that these interventions should be encouraged in the community to use physical exercise as a method to better control the physical and social effects of aging.
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| 2. |
- Kalyanasundaram, Madhanraj, et al.
(författare)
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Composition analysis (pick analysis) of waste generated from household: A pilot study in Ujjain city, India
- 2023
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Ingår i: Heliyon. - 2405-8440. ; 9:9
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Tidskriftsartikel (refereegranskat)abstract
- Waste segregation is an essential function in improving waste management. Waste segregation not only facilitates recycling and reduces waste going to landfills, rather it can benefit our environment and human in various ways. A pick analysis of waste composition is used to characterize the household waste stream and thus can analyze the segregation rate among the residents. In addition, it can measure the actual waste sorting behaviour at the household/community level. The objective of the study was to assess feasibility of a large-scale waste composition study, identify methodological and operational challenges, and estimate the resources needed to conduct the main waste composition study in order to obtain and get indicative figures about waste generation, composition, and miss-sorted proportions. The study team went door-to-door to collect waste in colour coded bags. We also collected the socio-demographic data of the households. The collected waste was weighed and segregated to analyze the waste composition. The analysis was done among 45 households, and it was found that the per capita waste generation per day is 0.25 kg (0.24 kg from slum and 0.27 kg from non-slum). Challenges identified in conducting waste composition study were lack of standard waste fraction classifications, difficulty in recruitment of personnel to conduct study due to social taboo around waste, challenge in co-coordinating with Ujjain Municipal Corporation waste collection vehicle for collection of waste. 53 household activities were completed in 5 and half hours with INR 24685 (USD 300.5). Pick analysis could be adopted by the Ujjain Municipal Corporation after cost effective analysis to generate precise estimate of waste generation, resource recovery, efficient resource allocation and will help in future interventions and informed policy decision making to improve segregation.
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| 3. |
- Khare, Shweta, et al.
(författare)
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Determinants and pathways of healthcare-seeking behaviours in under-5 children for common childhood illnesses and antibiotic prescribing : a cohort study in rural India
- 2021
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:12
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To explore the healthcare-seeking pathways, antibiotic prescribing and determine the sociodemographic factors associated with healthcare-seeking behaviour (HSB) of caregivers for common illnesses in under-5 (U-5) children in rural Ujjain, India.Study design Prospective cohort study.Study setting and study sample The cohort included 270 U-5 children from selected six villages in rural demographic surveillance site, of the R.D. Gardi Medical College, Ujjain, Madhya Pradesh, India. A community-based cohort was visited two times weekly for over 113 weeks (August 2014 to October 2016) to record the HSB of caregivers using HSB diaries. Sociodemographic information was also solicited.Primary and secondary outcome measures Primary outcomes: first point of care, healthcare-seeking pathway and quantify antibiotic prescribing for the common acute illnesses.Secondary outcome HSB risk factors were determined using mixed-effects multinomial logistic regression.Results A total of 60 228 HSB follow-up time points for 270 children were recorded with a total of 2161 acute illness episodes. The most common illnesses found were respiratory tract infections (RTI) (69%) and gastrointestinal tract infections (8%). No healthcare was sought in 33% of illness episodes, mostly for RTIs. The most common healthcare-seeking pathway was to informal healthcare providers (IHCPs, 49% of illness episodes). The adjusted relative risk for obtaining no treatment, home treatment and treatment by IHCPs was higher for RTIs (aRR=11.54, 1.82 and 1.29, respectively), illiterate mothers (aRR=2.86, 2.38 and 1.93, respectively), and mothers who were homemakers (aRR=2.90, 4.17 and 2.10, respectively). Socioeconomic status was associated with HSB, with the highest aRR for no treatment in the lowest two socioeconomic quintiles (aRR=6.59 and 6.39, respectively). Antibiotics were prescribed in 46% (n=670/1450) illness episodes and the majority (85%, n=572/670) were broad spectrum.Conclusion In our rural cohort for many acute episodes of illnesses, no treatment or home treatment was done, which resulted in overall reduced antibiotic prescribing. The most common healthcare-seeking pathway was to visit IHCPs, which indicates that they are major healthcare providers in rural areas. Most of the antibiotics were prescribed by IHCPs and were commonly prescribed for illnesses where they were not indicated.
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| 4. |
- Khare, Shweta, et al.
(författare)
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Understanding Internal and External Drivers Influencing the Prescribing Behaviour of Informal Healthcare Providers with Emphasis on Antibiotics in Rural India : A Qualitative Study
- 2022
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Ingår i: Antibiotics. - : MDPI AG. - 2079-6382. ; 11:4
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Tidskriftsartikel (refereegranskat)abstract
- Globally, Antibiotic resistance is a major public health concern, with antibiotic use contributing significantly. Targeting informal healthcare providers (IHCPs) is important to achieve universal health coverage and effective antibiotic stewardship in resource-constrained settings. We, therefore, aimed to analyse the internal and external drivers that influence IHCPs' prescribing behaviour for common illnesses in children under five, with an emphasis on antibiotic use in rural areas of India. A total of 48 IHCPs participated in focus group discussions. Thematic framework analysis with an inductive approach was used, and findings were collated in the theoretical framework based on knowledge, attitude, and practice model which depicted that the decisions made by IHCPs while prescribing antibiotics are complex and influenced by a variety of external and internal drivers. IHCPs' internal drivers included the misconception that it is impossible to treat a patient without antibiotics and that antibiotics increase the effectiveness of other drugs and cure patients faster in order to retain them. Formal healthcare providers were the IHCPs' sources of information, which influences their antibiotic prescribing. We found when it comes to seeking healthcare in rural areas, the factors that influence their choice include 'rapid cure', 'cost of treatment', 'distance' and '24 h availability', instead of qualification, which may create pressure for IHCPs to provide a quick fix. Targeted and coordinated efforts at all levels will be needed to change the antibiotic prescribing practices of IHCPs with a focus on behaviour change and to help resolve misconceptions about antibiotics.
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| 5. |
- Krishnan, Kavya, et al.
(författare)
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Feasibility assessment of crowdsourcing slogans for promoting household waste segregation in India: a cross-sectional study
- 2023
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Ingår i: Frontiers in Public Health. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Crowdsourcing is an emerging technique to engage or access a wider set of experts and multiple stakeholders through online platforms, which might effectively be employed in waste management. Therefore, we assessed the feasibility of the crowdsourcing method to provide an alternative approach that can improve household waste segregation using an “online-slogan-contest”.Methods: The contest was promoted via targeted emails to various governmental and non-governmental organizations and through social media platforms for around 4 weeks (25 days). The entries were received through a Google form. The slogans were assessed by the experts and analyzed using content analysis methods.Results: Total 969 entries were received from different geographic regions in India. Of that, 456 were in English and 513 in Hindi. Five themes of waste segregation emerged from the received slogans: (1) Community awareness, responsibility, and support, (2) Significance of household waste segregation, (3) Use of separate dustbins, (4) Health and well-being, and (5) Environment and sustainability.Discussion: Crowdsourcing approaches can be used by local authorities for improving waste management approaches and are recommended as these involve a wider audience within a short time frame. Moreover, this approach is flexible and integrating crowdsourcing approaches strengthens our understanding of existing waste management activities.
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| 6. |
- Mungai, Isaac Gikandi, et al.
(författare)
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Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers-a cross-sectional study from Ujjain, India
- 2020
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Ingår i: BMC Health Services Research. - : BMC. - 1472-6963. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to look for association of IHCPs knowledge score with: the practitioners' age, years of experience, number of patients treated per day, and whether they attended children in their practice. Results Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean +/- SD score achieved was 22.3 +/- 7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75(th) and q90th) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90(th)). Conclusions The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon by future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population in the study setting and to improve neonatal care services.
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| 7. |
- Pathak, Ashish, 1973-, et al.
(författare)
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Incidence, Risk and Protective Factors for Unintentional, Nonfatal, Fall-Related Injuries at Home : A Community-Based Household Survey from Ujjain, India
- 2020
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Ingår i: Pediatric Health, Medicine and Therapeutics. - : DOVE MEDICAL PRESS LTD. - 1179-9927. ; 11, s. 65-72
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood injury is an increasing public health burden and considered a major cause of childhood morbidity and mortality worldwide. In this study, we identified the distribution and risk factors for fall-related child injuries at home in Ujjain, India. Methods: A community-based, cross-sectional study was conducted in 2017 in Ujjain, India, which included 6308 children up to 18 years of age living in 2518 households. Data were collected using a pretested, semi-structured, proforma from the parents of the included children. Results: The overall incidence of home injury was 7.78% (95% confidence interval [CI]: 7.12-8.84) in the last 1 year, ie, 2015-16. The incidence was significantly higher at 5-10 years of age (odds ratio [OR]: 2.91, 95% CI: 1.75-4.85; P < 0.001), followed by 1-5 years (OR: 2.66, 95% CI: 1.59-4.45; P < 0.001). The incidence of injuries was higher in boys than in girls (adjusted odds ratio [aOR]: 1.73, 95% CI: 1.43-2.10; P < 0.001). Other risk factors associated with unintentional fall injuries at home were residence (rural vs urban; aOR: 1.25, 95% CI: 1.03-1.51; P = 0.018), number of family members (<= 4 vs 5-10 and <= 4 vs >10; aOR: 0.69, 95% CI: 0.56-0.86; P < 0.001 and aOR: 0.67, CI: 0.48-0.94; P < 0.023, respectively), cooking area (combined vs separate; aOR: 0.82, 95% CI: 0.68-1.00; P = 0.057), and whether mother is alive vs not alive (aOR: 2.09, 95% CI: 1.10-3.94; P = 0.023). Conclusion: The incidence of fall injuries among children at home in Ujjain, India, was similar to other resource constraint settings. The incidence was higher in rural areas, in the age group of 5-10 years, and in families in which the mother was not alive. By contrast, large and combined families had a lower incidence of falls.
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| 8. |
- Pathak, Ashish, 1973-, et al.
(författare)
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Stable high frequencies of sulfadoxine-pyrimethamine resistance associated mutations and absence of K13 mutations inPlasmodium falciparum3 and 4 years after the introduction of artesunate plus sulfadoxine-pyrimethamine in Ujjain, Madhya Pradesh, India
- 2020
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Ingår i: Malaria Journal. - : BMC. - 1475-2875. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Artesunate plus sulfadoxine-pyrimethamine (ASP) is first-line treatment for uncomplicatedPlasmodium falciparummalaria in most of India, except for six North-eastern provinces where treatment failure rates were high. In Ujjain, central India, the frequency of mutations associated with increased drug tolerance, but not overt resistance to sulfadoxine and pyrimethamine were 9% and > 80%, respectively, in 2009 and 2010, just prior to the introduction of ASP. The frequency of drug resistance associated mutations in Ujjain in 2015-2016 after 3-4 years of ASP use, are reported. Methods Blood samples from patients withP. falciparummono-infection verified by microscopy were collected on filter-paper at all nine major pathology laboratories in Ujjain city. Codonspfdhfr16-185,pfdhps436-632 and K13 407-689 were identified by sequencing.PfcrtK76T andpfmdr1N86Y were identified by restriction fragment length polymorphism. Results Sulfadoxine-pyrimethamine resistance-associatedpfdhfr108 N and 59R alleles were found in 100/104 (96%) and 87/91 (96%) samples, respectively.Pfdhps437G was found in 10/105 (10%) samples. Double mutantpfdhfr59R + 108 N were found in 75/81 (93%) samples. Triple mutantpfdhfr59R + 108 N andpfdhps437G were found in 6/78 (8%) samples. Chloroquine-resistance-associatedpfcrt76T was found in 102/102 (100%).Pfmdr1N86 and 86Y were identified in 83/115 (72%) and 32/115 (28%) samples, respectively. Conclusion The frequency ofP. falciparumwith reduced susceptibility to sulfadoxine-pyrimethamine remained high, but did not appear to have increased significantly since the introduction of ASP. No polymorphisms in K13 associated with decreased artemisinin susceptibility were found. ASP probably remained effective, supporting continued ASP use.
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| 9. |
- Sahoo, Krushna Chandra, et al.
(författare)
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Dynamics of Household Waste Segregation Behaviour in Urban Community in Ujjain, India : A Framework Analysis
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:12
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Tidskriftsartikel (refereegranskat)abstract
- Waste segregation practices must be socially acceptable, affordable, context-specific, and participatory, which is essential for promoting waste segregation. Therefore, this study explored the urban community members’ motivation, opportunity, and household waste segregation ability. We performed a qualitative study in Ujjain city, India. Ten focus group discussions and eight in-depth interviews were conducted with female and male household members in residential and slum areas. All interviews were digitally recorded, transcribed, and translated. We used the thematic framework technique using the Motivation-Opportunity-Ability-Behaviour theory for analysis. Three themes were constructed: motivation, where household members are motivated to sort waste yet fear the consequences of improper sorting; ability, where household waste segregation is rapidly gaining acceptance as a social norm; and opportunities, involving convenient facilities and a social support system for household members towards waste segregation. This study contributes to developing a knowledge base on waste segregation behaviour and a repertoire to facilitate evidence-based management and policymaking. There is a need for educational intervention and women’s self-help groups’ involvement to develop community orientation and waste segregation literacy. Finally, this study emphasizes the importance of all three behavioural change components, i.e., motivation, opportunity, and ability, in managing sustainable waste segregation practices.
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| 10. |
- Trushna, Tanwi, et al.
(författare)
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Interventions to promote household waste segregation: A systematic review
- 2024
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Ingår i: Heliyon. - 2405-8440. ; 10:2
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Forskningsöversikt (refereegranskat)abstract
- Waste segregation at source, particularly at the household level, is an integral component of sustainable solid waste management, which is a critical public health issue. Although multiple interventions have been published, often with contradictory findings, few authors have conducted a comprehensive systematic synthesis of the published literature. Therefore, we undertook a systematic review to synthesize all published interventions conducted in any country in the world which targeted household-level waste segregation with or without additional focus on recycling or composting.Following PRISMA guidelines, Web of Science, Medline, Global Health, and Google Scholar were searched using a search strategy created by combining the keywords ‘Waste’, ‘Segregation’, and ‘Household’. Two-stage blinded screening and consensus-based conflict resolution were done, followed by quality assessment, data extraction, and narrative synthesis.8555 articles were identified through the database searches and an additional 196 through grey literature and citation searching. After excluding 2229 duplicates and screening title abstracts of 6522 articles, 283 full texts were reviewed, and 78 publications reporting 82 intervention studies were included in the data synthesis.High methodological heterogeneity was seen, excluding the possibility of a meta-analysis. Most (n = 60) of the interventions were conducted in high-income countries. Interventions mainly focused on information provision. However, differences in the content of information communicated and mode of delivery have not been extensively studied. Finally, our review showed that the comparison of informational interventions with provision of incentives and infrastructural modifications needs to be explored in-depth. Future studies should address these gaps and, after conducting sufficient formative research, should aim to design their interventions following the principles of behaviour change.
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