Grover M.,Immunization Technical Support Unit |
Chauhan H.,Center for Epidemiology and Parasitic Diseases
Annals of Tropical Medicine and Public Health | Year: 2016
Background: The recent Ebola outbreak notified in West Africa recorded 6,553 cases and 3,083 deaths till 30th September 2014. This is the longest reported outbreak, suggesting poor preparedness and inadequate public health response. Learning from these experiences can help taking future disease-control measures in West Africa and elsewhere. Materials and Methods: This scoping study was done to summarize a range of evidences available on the current 'Ebola Viral Disease' (EVD) outbreak. All articles in English language related to the epidemiology of Ebola in humans, published between 1st March and 30th September 2014, were considered for review. Search engines, such as PubMed and Google Scholar, were used to search for the following keywords: 'Ebola,' 'Ebola Virus,' 'Ebola Viral Disease,' and 'Ebola Hemorrhagic Fever.' Snowballing using cross-references was done to find related literature on EVD. Related websites, blogs, and published news articles were reviewed. Studies of varying designs were considered without any quality assessment. Results: This is the first ever Ebola outbreak affecting large urban communities. Factors that worsened the outbreak were as follows: Weak health systems, unfavorable cultural practices, poverty, illiteracy, mistrust for the government, extensive cross-border movement, slow response from international agencies, and lack of tested treatment and prevention strategies. Simple measures of universal precaution, isolation and tracking of contacts, supportive treatment, and appropriate burial practices were difficult to implement. Conclusions: The outbreak in West Africa illustrates serious weaknesses in the ability of the international communities to respond to these outbreaks. Cost of setting up an infrastructure for early effective response is insignificant compared to the huge social and economic cost of the outbreak. Strong health system, improved preparedness, and effective community participation are imperative for control. © 2016 Annals of Tropical Medicine and Public Health | Published by Wolters Kluwer - Medknow.
PubMed | Jawaharlal Institute of Postgraduate Medical Education & Research, Maastricht University and Immunization Technical Support Unit
Type: Review | Journal: The National medical journal of India | Year: 2017
Human resource for health is critical in quality healthcare delivery. India, with a large rural population (68.8%), needs to urgently bridge the gaps in health workforce deployment between urban and rural areas.We did a critical interpretative synthesis of the existing literature by using a predefined selection criteria to assess relevant manuscripts to identify the reasons for retaining the health workforce in rural and underserved areas. We discuss different strategies for retention of health workforce in rural areas on the basis of four major retention interventions, viz. education, regulation, financial incentives, and personal and professional support recommended by WHO in 2010. This review focuses on the English-language material published during 2005-14 on human resources in health across low- and middle-income countries.Healthcare in India is delivered through a diverse set of providers. Inequity exists in health manpower distribution across states, area (urban-rural), gender and category of health personnel. India is deficient in health system development and financing where health workforce education and training occupy a low priority. Poor governance, insufficient salary and allowances, along with inability of employers to provide safe, satisfying and rewarding work conditions-are causing health worker attrition in rural India. The review suggests that the retention of health workers in rural areas can be ensured by multiplicity of interventions such as medical schools in rural areas, rural orientation of medical education, introducing compulsory rural service in lieu of incentives providing better pay packages and special allowances, and providing better living and working conditions in rural areas.A complex interplay of factors that impact on attraction and retention of health workforce necessitates bundling of interventions. In low-income countries, evidence- based strategies are needed to ensure context-specific, field- tested and cost-effective solutions to various existing problems. To ensure retention these strategies must be integrated with effective human resource management policies and rural orientation of the medical education system.
PubMed | Sikkim Manipal Institute of Medical science, Assam Medical College, Mata Gurji Memorial Medical College and Immunization Technical Support Unit
Type: Journal Article | Journal: Annals of medical and health sciences research | Year: 2014
The nature of continuous exposure to the street and its associated life-styles make street children vulnerable to the use of psychoactive substances.The aim of the present study is to study some social factors of street children in Guwahati city and to ascertain the substance use behavior of the street children.A population based cross-sectional study conducted during September 2008 to August 2009 among 215 street children between the ages of 5 and 18 years of Guwahati City Assam. The main outcome measures were substance use and its related risk factors prevalent among street children. The data collected were analyzed in Microsoft Office and percentages and Chi-square tests were used to analyze the variables.Around 174/215 (80.9%) of study participants were substance abusers. It is noteworthy that as the age increases substance use was more common when compared to younger age group. The risk of substance abuse was 1.26 times relatively higher among those who had never been to school and 1.12 times more common in those from a joint family when compared to others. However the correlations were not found to be statistically significant. Substance abuse was 1.19 times more common in case of deaths of both parents and the association was found to be statistically significant (P = 0.02). Presence of step parents and substance use in the family was seen to be a risk factor for substance abuse and the association was highly significant (P < 0.001). The association of substance abuse with duration of street life was found to be highly significant. Majority of the substance users 152/174 (87.4%) were in the habit of sniffing glue and this was followed by smoking 147/174 (84.5%).Substance abuse is an important concern affecting street children. Street and its associated life-styles make street children vulnerable to the use of psychoactive substances. Non- government organizations and Government should come forward to curb this problem and save millions of vulnerable lives.