International Journal of Health Systems and Implementation Research

Caring For Older Caregivers: Managing Depressive Symptoms and Stress among Family Caregivers of Persons with Severe Mental Illnesses (PwSMI)

Sat, 28 Dec 2024 00:00:00 +0000

The global rise in mental health issues, with approximately 970 million people affected, has contributed to a significant burden on caregivers, particularly those supporting Persons with serious mental illnesses (PwSMIs) such as depression, anxiety, and schizophrenia. In India alone, 197.3 million people suffer from mental disorders, with depression being the leading contributor to the disease burden. Caregivers, often family members, provide essential emotional and practical support, but this responsibility is accompanied by considerable stress and depressive symptoms. The emotional, physical, and financial toll of caregiving leads to a phenomenon known as caregiver burden, which can severely impact the well-being and quality of life of those involved, particularly older caregivers. Cultural factors, particularly in South and Southeast Asia, influence caregiving roles and can either alleviate or intensify stress. Coping strategies play a pivotal role in mitigating this burden, with maladaptive coping linked to negative outcomes for both caregivers and patients. Effective interventions, such as psycho-education, community support, and healthcare system resources are essential to reduce caregiver burden and improve the care provided to individuals with SMIs. Addressing caregiver needs is crucial for enhancing both caregiver health and patient recovery outcome.

Digitalization of ASHA Work: Challenges and Way Forward

Anand Dixit — Tue, 31 Dec 2024 00:00:00 +0000

The digitalization of the work of Accredited Social Health Activists (ASHAs) represents a pivotal step towards modernizing healthcare delivery at the grassroots level in India. This paper explores the impact of digital tools on ASHA performance, with a specific focus on non-communicable disease (NCD) screening using the Community-Based Assessment Checklist (CBAC) form. While digitalization holds immense potential for improving efficiency, data accuracy, and transparency, challenges such as limited digital literacy, data integrity, and incentive structures must be addressed to fully harness its benefits. This review discusses the opportunities and limitations posed by digitalization, emphasizing the need for comprehensive support systems to ensure the success of this transformation.

From Tubewell to Tap: The Persistent Challenge of Safe Drinking Water in Rural India

Adhish Kumar Sethi, Navneet Gupta, Arun Kumar Aggarwal, Tanvi Kiran — Tue, 31 Dec 2024 00:00:00 +0000

Ensuring universal access to safe water remains a challenge across rural India. In this viewpoint, we reflect on our observations regarding drinking water quality in a village in Haryana in northern India. We discuss how the issues we face are part of larger systemic issues in rural administration and healthcare. Despite a robust policy framework and several programmes over the decades, almost one-fourth of rural households still lack functional tap water connections, and there are wide regional inequalities. We attempt to dissect the social, administrative and environmental factors which contribute to these gaps. Improving water supply and quality in Indian villages can go a long way in achieving Sustainable Development Goal 6, and enhancing the health of millions of people. This needs coordinated efforts from various stakeholders, including community members, local administrations, state and central governments and healthcare professionals. In particular, we advocate for broader involvement of the health sector in water-related health across India, going beyond the traditional roles of quality monitoring, medical interventions and surveillance.

The Growing Burden: Workload on Community Health Officers

Anand Dixit — Tue, 31 Dec 2024 00:00:00 +0000

Community Health Officers (CHOs) are essential in delivering primary healthcare services particularly in rural and underserved areas. However, the increasing workload on CHOs poses significant challenges to their efficiency and well-being. This commentary explores the expanded responsibilities of CHOs, including clinical duties and extensive administrative tasks, which contribute to their growing burden. Additionally, it addresses the lack of support from Auxiliary Nurse Midwives (ANMs) in Health and Wellness Centres (HWCs), leading CHOs to assume tasks typically managed by ANMs. To mitigate this issue, it is crucial to establish clear roles and responsibilities for both CHOs and ANMs, ensuring accountability through block authority oversight, the implementation of structured guidelines, inclusion of ANMs in review meetings and display of Information Education and Communication (IEC) materials.

Non-Adherence to Anti-Tuberculosis Treatment among Newly Diagnosis Tuberculosis Patients Treated under DOTS in District Raipur, Chhattisgarh

Vinod Patel, Jaya Tiwari, Shweta Sharma — Tue, 31 Dec 2024 00:00:00 +0000

Chhattisgarh is currently facing several challenges with communicable and non-communicable diseases. Tuberculosis is one of the most common communicable diseases in Chhattisgarh. The non-adherence to anti-tuberculosis treatment (ATT) among tuberculosis patients is a big concern in Chhattisgarh. Objective: This study identifies the reasons for non-adherence to anti-tuberculosis treatment among newly diagnosed patients. Methods: The study was a cross-sectional descriptive community-based exploratory study, conducted in selected The DOTS centres had been selected according to convenience and accessibility DOTS centers in Raipur district, Chhattisgarh, from January to April 2018. A total of 47 non-adherent patients were interviewed and data was collected using a self-structured questionnaire. Data was entered and analyzed by using an Excel worksheet and SPSS version 20.0 statistical software. Results: A total of 47 non-adherent patients were interviewed, a total of 47 participants, 91.5% were males and 8.5% were females out of them 91.5% were males and 8.5% were females. The mean age of participants was 40.44 years. 76.6% of non-adherent patients heard about tuberculosis before diagnosis. The main source of information about TB was health workers (42.6%), majority of the patients 75.5% said that Tuberculosis is an infectious disease. About the mode of transmission of disease, a maximum of 25.5% of patients replied as coughing and sneezing. The most important reasons for non-adherence to ATT were side effects of drugs 27.7% followed by alcohol consumption 23%, feel better 21.3%, do not believe in government hospitals 6.4%, co-morbidity 4.3%, migration 8.5%, do not have a disease 6.4%, and accident 2.1%. One of the most contributing factors for non-adherence is the existence of anti-tubercular side effects. Conclusions: The present study revealed that most patients have heard of tuberculosis (TB), however, there is a considerable knowledge gap among TB patients about disease transmission, preventive measures, and duration of the treatment. The most common regions for stopping anti-tuberculosis treatment were adverse effects of anti-tubercular drugs, alcohol consumption, feeling better after a few months of treatment, and migration of patients either to their native place or hunting for new work.

A Formative Study to analyse Awareness, Knowledge, and Utilisation Gap about ABHA (Ayushman Bharat Health Account) at a Tertiary Care Health Setting

Swati Chauhan, Arun Kumar Aggarwal, Tanvi Kiran — Tue, 31 Dec 2024 00:00:00 +0000

Ayushman Bharat Health Account (ABHA) is a 14-digit unique digital identity for people of India under the aegis of the ‘Ayushman Bharat Digital Mission’ launched on 27th September 2021. It aims for the integration of healthcare services, patient record accessibility, and pan- India portability for achieving universal health coverage through digitalisation. Objective: To assess awareness regarding enrolment and usage of ABHA among people in the outpatient department and in proximal areas of PGIMER, Chandigarh, which is a tertiary care educational and research hospital. Methodology: It is a short cross-sectional study conducted in PGIMER from 9th November to 9th December 2024 with a purposive sampling technique with a sample size of twenty. Direct face-to-face interviews were conducted with interviewer- administered questionnaire. Results: 68 crore ABHA IDs have been created, latest till 20th November 2024 in India. In Chandigarh, 8.6 lakh ABHAs have been created out of 12.4, lakh which is 70% of the total population. According to our study, 65% of people have an ABHA ID but the usage percentage is 0%. There is a perceived confusion among 70% of people about different health cards, and 85% of people desired information to be disbursed through social media to cover the knowledge gap. Conclusion: The usage of ABHA ID is 0% although 8.6 lakh ABHA IDs have already been made in Chandigarh. There is a lack of awareness and information about the usage and benefits of ABHA among the patients as well as in the general population; therefore, future studies are warranted to further explore this issue.