1
|
Farooqui H, Zodpey S. Utilization trend of paediatric vaccines in the private sector in India (2010 and 2015): A descriptive time series analysis. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
2
|
Affiliation(s)
- V K Paul
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - R Kumar
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - S Zodpey
- Indian Institute of Public Health Delhi, Public Health Foundation of India, Delhi, India
| |
Collapse
|
3
|
Abstract
The rapid population growth in urban India has outpaced the municipal capacity to build essential infrastructures that make life in cities safe and healthy. Local and national governments alike are grappling with the challenges of urbanization with thousands migrating from villages to cities. Thus, urbanization in India has been accompanied by a concentration of poverty and urban public healthcare has emerged as one of the most pressing priorities facing our country. Newborn mortality rates in urban settings are lower than rural areas, early neonatal deaths account for greater proportion than late neonatal deaths. The available evidence suggests that socio-economic inequalities and poor environment pose major challenges for newborn health. Moreover, fragmented and weak public health system, multiplicity of actors and limited capacity of public health planning further constrain the delivery of quality and affordable health care service. Though healthcare is concentrated in urban areas, delay in deciding to seek health care, reaching a source of it and receiving appropriate care affects the health outcomes disproportionately. However, a few city initiatives and innovations piloted in different states and cities have brought forth the evidences of effectiveness of different strategies. Recently launched National Urban Health Mission (NUHM) provides an opportunity for strategic thinking and actions to improve newborn health outcomes in India. There is also an opportunity for coalescence of activities around National Health Mission (NHM) and Reproductive, Maternal, Newborn and Child Health+Adolescent (RMNCH+A) strategy to develop feasible and workable models in different urban settings. Concomitant operational research needs to be carried out so that the obstacles, approaches and response to the program can be understood.
Collapse
Affiliation(s)
- J Sharma
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, New Delhi, India
| | - D Osrin
- UCL Institute for Global Health, University College London, London, UK
| | - B Patil
- Saving Newborn Lives, Save the Children, India
| | - S B Neogi
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, New Delhi, India
| | - M Chauhan
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, New Delhi, India
| | - R Khanna
- Saving Newborn Lives, Save the Children, India
| | - R Kumar
- Ministry of Health and Family Welfare, Govt. of India, New Delhi, India
| | - V K Paul
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - S Zodpey
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, New Delhi, India,Indian Institute of Public Health Delhi, Public Health Foundation of India, Plot No. 47, Sector-44 Institutional Area, Gurgaon 122002, New Delhi, India. E-mail:
| |
Collapse
|
4
|
Neogi SB, Khanna R, Chauhan M, Sharma J, Gupta G, Srivastava R, Prabhakar PK, Khera A, Kumar R, Zodpey S, Paul VK. Inpatient care of small and sick newborns in healthcare facilities. J Perinatol 2016; 36:S18-S23. [PMID: 27924106 PMCID: PMC5144116 DOI: 10.1038/jp.2016.186] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Neonatal units in teaching and non-teaching hospitals both in public and private hospitals have been increasing in number in the country since the sixties. In 1994, a District Newborn Care Programme was introduced as a part of the Child Survival and Safe Motherhood Programme (CSSM) in 26 districts. Inpatient care of small and sick newborns in the public health system got a boost under National Rural Health Mission with the launch of the national programme on facility-based newborn care (FBNC). This has led to a nationwide creation of Newborn Care Corners (NBCC) at every point of child birth, newborn stabilization units (NBSUs) at First Referral Units (FRUs) and special newborn care units (SNCUs) at district hospitals. Guidelines and toolkits for standardized infrastructure, human resources and services at each level have been developed and a system of reporting data on FBNC created. Till March 2015, there were 565 SNCUs, 1904 NBSUs and 14 163 NBCCs operating in the country. There has been considerable progress in operationalizing SNCUs at the district hospitals; however establishing a network of SNCUs, NBSUs and NBCCs as a composite functional unit of newborn care continuum at the district level has lagged behind. NBSUs, the first point of referral for the sick newborn, have not received the desired attention and have remained a weak link in most districts. Other challenges include shortage of physicians, and hospital beds and absence of mechanisms for timely repair of equipment. With admission protocols not being adequately followed and a weak NBSU system, SNCUs are faced with the problem of admission overload and poor quality of care. Applying best practices of care at SNCUs, creating more NBSU linkages and strengthening NBCCs are important steps toward improving quality of FBNC. This can be further improved with regular monitoring and mentoring from experienced pediatricians, and nurses drawn from medical colleges and the private sector. In addition there is a need to further increase such units to address the unmet need of facility-based care.
Collapse
Affiliation(s)
- S B Neogi
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, Delhi, India
| | - R Khanna
- Saving Newborn Lives, Save the Children, India
| | - M Chauhan
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, Delhi, India
| | - J Sharma
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, Delhi, India
| | - G Gupta
- UNICEF, Country Office, New Delhi, India
| | - R Srivastava
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - P K Prabhakar
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - A Khera
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - R Kumar
- Ministry of Health and Family Welfare, Government of India, New Delhi, India,Ministry of Health and Family Welfare, Govt of India, Nirman Bhawan, New Delhi 110011, India. E-mail:
| | - S Zodpey
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, Delhi, India
| | - V K Paul
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
5
|
Abstract
About 0.75 million neonates die every year in India, the highest for any country in the world. The neonatal mortality rate (NMR) declined from 52 per 1000 live births in 1990 to 28 per 1000 live births in 2013, but the rate of decline has been slow and lags behind that of infant and under-five child mortality rates. The slower decline has led to increasing contribution of neonatal mortality to infant and under-five mortality. Among neonatal deaths, the rate of decline in early neonatal mortality rate (ENMR) is much lower than that of late NMR. The high level and slow decline in early NMR are also reflected in a high and stagnant perinatal mortality rate. The rate of decline in NMR, and to an extent ENMR, has accelerated with the introduction of National Rural Health Mission in mid-2005. Almost all states have witnessed this phenomenon, but there is still a huge disparity in NMR between and even within the states. The disparity is further compounded by rural-urban, poor-rich and gender differentials. There is an interplay of different demographic, educational, socioeconomic, biological and care-seeking factors, which are responsible for the differentials and the high burden of neonatal mortality. Addressing inequity in India is an important cross-cutting action that will reduce newborn mortality.
Collapse
Affiliation(s)
- M J Sankar
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - S B Neogi
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, Delhi, India
| | - J Sharma
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, Delhi, India
| | - M Chauhan
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, Delhi, India
| | - R Srivastava
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - P K Prabhakar
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - A Khera
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - R Kumar
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - S Zodpey
- Indian Institute of Public Health (Delhi), Public Health Foundation of India, Delhi, India
| | - V K Paul
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
6
|
Kumar B, Shrivastava J, Satyanarayana S, Reid AJ, Ali E, Zodpey S, Agnani M. How effective is the integration of facility and community-based management of severe acute malnutrition in India? Public Health Action 2015; 3:265-70. [PMID: 26393044 DOI: 10.5588/pha.13.0058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/14/2013] [Indexed: 11/10/2022] Open
Abstract
SETTING All children admitted to two nutritional rehabilitation centres (NRCs) during 2011-2012 in Madhya Pradesh, India. OBJECTIVE To determine 1) adherence to in-patient care and follow-up visits, 2) attainment and maintenance of target weight gain, and 3) association with the children's demographic characteristics. DESIGN A retrospective record review. The 74-day programme included 14 days of in-patient care, with subsequent home-based care and four follow-up visits to the NRC at 15-day intervals. The first three visits were part of the treatment, while the fourth was for assessment of sustained weight gain. RESULTS Of the 1027 children admitted, 900 (88%) completed in-patient care. Of these, 685 (76%) attended the first three follow-up visits, 482 (70%) of whom gained >15% of their admission weight. Of these, 409 (85%) completed four visits, 314 (77%) of whom were able to sustain their weight gain. Those unable to gain >15% weight by the third visit had a significantly lower proportion of sustained weight gain at the fourth visit. Children aged ⩾6 months had significantly higher odds (OR 4.5, 95%CI 3.1-6.2, P < 0.05) of completing in-patient care. CONCLUSION In-patient care combined with community-based follow-up was effective in adherence to follow-up visits; however, there is still room for improvement in attaining and sustaining the target weight.
Collapse
Affiliation(s)
- B Kumar
- Indian Institute of Public Health Delhi, Public Health Foundation of India, New Delhi, India
| | | | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease, New Delhi, India
| | - A J Reid
- Medical Department, Operational Research Unit, Operational Centre Brussels, Médecins Sans Frontières, MSF-Luxembourg, Luxembourg
| | - E Ali
- Medical Department, Operational Research Unit, Operational Centre Brussels, Médecins Sans Frontières, MSF-Luxembourg, Luxembourg
| | - S Zodpey
- Indian Institute of Public Health Delhi, Public Health Foundation of India, New Delhi, India
| | - M Agnani
- Government of Madhya Pradesh, Bhopal, India
| |
Collapse
|
7
|
Sawleshwarkar S, Singh A, Zodpey S, Hillman RJ. P14.11 Developing sustainable, international partnerships model to build capacity in hiv and stis. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
8
|
Zodpey S, Farooqui HH, Chokshi M. Pediatrician's Perspective On Pneumococcal Conjugate Vaccines In India: An Exploratory Study. Value Health 2014; 17:A685. [PMID: 27202539 DOI: 10.1016/j.jval.2014.08.2564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- S Zodpey
- Public Health Foundation of India, Gurgaon, India
| | - H H Farooqui
- Public Health Foundation of India, Gurgaon, India
| | - M Chokshi
- Public Health Foundation of India, New Delhi, India
| |
Collapse
|
9
|
Kulatilaka H, Smith J, Zodpey S, Tikyani Singh S. Building a center of reference for monitoring and evaluation in health
program in South East Asia: A partnership between MEASURE Evaluation and
Public Health Foundation of India. Ann Glob Health 2014. [DOI: 10.1016/j.aogh.2014.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
10
|
Patil V, Wahab SN, Zodpey S, Vasudeo ND. Development and validation of risk scoring system for prediction of cancer cervix. Indian J Public Health 2006; 50:38-42. [PMID: 17193760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
A Hospital based group matched case-control study was conducted to devise a risk scoring system for the prediction of cancer cervix at the Gynecology Clinic, Government Medical College Hospital, Nagpur, India. The study consisted of 230 cases of cancer cervix (histopathologically confirmed) and equal number of controls, group matched for age. The risk factors considered were Illiteracy, long duration of married life (>25 years), Early Menarche (<13 years), marital status (widow, separated, divorcee), multiparity (> 3), h/o abortion, h/o tobacco use, h/o passive smoking, poor genital hygiene, (grade III & IV) and low socioeconomic status. Statistical Analysis included unconditional multiple logistic regression analysis Receiver Operating Characteristic (ROC) curve analysis. The overall predictive accuracy was calculated by Wilcoxon statistic as an equivalent of area under ROC curve. Five risk factors, illiteracy, poor genital hygiene, long duration of married life, multiparity and early menarche were identified to be significantly associated with cancer cervix. These factors were given statistical weights of 13, 10, 7, 5 and 5 respectively. A total score of 21 was found to be the best cut off for prediction and the overall predictive accuracy of the risk scoring system was calculated to be 0.74(0.67 - 0.81). In case of consistent further validation using other data sets this additive risk scoring system can be used for reducing the cost of universal screening by subjecting only high-risk subjects to laboratory screening procedure (Pap smear) in population setting.
Collapse
Affiliation(s)
- V Patil
- Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, USA.
| | | | | | | |
Collapse
|
11
|
|