bluuebunny/crossref_metadata_2025_split huggingface dataset:
IJCM_237A: Assessment of out-of-pocket expenditure amongst admitted patients in a tertiary care centre of Maharashtra: a cross-sectional study.
Authors: Ghoshal Titas , Gattani P. L. , Maidapwad S. L. 
Published: April 2024

Background:
In India, financing health-care majorly constitutes out-of-pocket expenditure. Health expenditure in India accounts for

Objectives:
1. To assess the total out-of-pocket expenditure of patients due to current illness. 2. To assess out-of-pocket health expenditures in a single episode of illness in families of different socio-economic strata. 3. To study association between various specialities and direct out-of-pocket health expenditure incurred after admission. 4. To find the percentage of patients getting benefit of state government health insurance (MJPJAY).

Methodology:
A cross-sectional study was conducted by interviewing 233 patients (or care-takers) admitted in a tertiary-care centre, using a pre-designed semi-structured questionnaire in local language. Expenditures before and after admission (=3 days) due to current illness was documented. Enrolment for MJPJAY benefit was recorded. The data was compiled in MS-excel and analysed using SPSS.

Results:
The median out-of-pocket expenditure for the current illness was Rs.2935 (IQR: Rs.1375 to Rs.8508.75). The median out-of-pocket expenditure in the IVth and Vth social classes according to Modified B.G. Prasad classification, is Rs.3715(IQR: Rs1925 to Rs.9060) and Rs.5210(IQR: Rs.2917 to Rs.8350) respectively. 12.43% (excluding obstetric) patients were enrolled for benefit of MJPJAY at the time of study.

Conclusion:
The out-of-pocket expenditure is found to be high among the patients studied, especially, among those choosing to visit private health facilities pre-admission. Post-admission, as the direct expenditure was more than indirect in most cases, the underlying causes may be unavailability of drugs and investigations required for management. MJPJAY benefits are received post diagnosis, therefore pre-diagnostic investigations contribute to high out-of-pocket expenses. Further studies are required to evaluate the preference towards private health facility.
IJCM_24A: Determinants of unintended pregnancy among women attending Antenatal clinic at AIIMS Patna – a cross-sectional study
Authors: Roy Parvati , Ahmad Shamshad , Kumar Pragya 
Published: April 2024

Background:
Every day 67,385 babies are born in India, that’s around one- sixth of the world’s childbirths. Every minute one of these new-borns dies, with an annual birth rate of 25 million which accounts for nearly one-fifth of the world’s annual childbirth.

Objectives:
1. To find out the proportion of unintended pregnancy among women of reproductive age group attending ANC Clinic of AIIMS Patna USING LUMP SCALE. 2. To determine the Factors contributing to unintended pregnancy.

Methodology:
This was a hospital based cross-sectional study done for 6months (March 2022 to September 2022) conducted in Department of Obstetrics and Gynaecology OPD, AIIMS Patna and included all the pregnant ladies who visited the ANC clinic. Consecutive sampling was done and a sample size of 237 was taken rounding off to 250 with 5% absolute precision, 95% confidence and 10% non-response rate. A predesigned, semi-structured questionnaire was used and the information collected was downloaded from Epicollect5/Google forms in an MS Excel sheet and analysis was done using the IBM SPSS version20.

Results:
Out of 255 participants who were more than 20 years of age 31% (79) participants had unplanned pregnancies compared to 50% (17) out of 34 participants whose age was less than 20. This association was statistically significant with a p-value of 0.027. Out of 289 participants attending the ANC clinic, 32.87% (95) participants had a history of abortion among which only 23.2% (22) participants had an unplanned pregnancy. This association was statistically significant with a p-value of 0.011.

Conclusion:
In our study we found the prevalence of unintended pregnancy to be 33.2% which is comparable with 33% prevalence of unintended pregnancy in African continent study.
IJCM_246A: Estimating the prevalence of seat belt usage in motor cars: A descriptive cross-sectional study in Mangalore
Authors: Jain Animesh , Rathi Priya , Gill Mnnat , Nirgudkar Isha , Hegde Apoorva , Gulati Yuvraj , Khatri Kaavya 
Published: April 2024

Background:
Every year 1.25 million people die of road traffic accidents. Several safety measures can be taken to prevent RTAs. The SDG 2030 set the target to halve the number of global death and injuries from road traffic accidents by the year 2020. The aim of this study is to estimate the prevalence of seat belt use and factors influencing it including driver characteristics, type of car and time of day and distractions while driving.

Methodology:
This Descriptive cross-sectional study was set on the major roads and intersections of Mangalore, recruiting the drivers and front-seat passengers in the motor cars at the time and site of observation.

Results:
A total of 6165 motor cars were observed. 15 (0.2%) of these cars had completely tinted car windows, therefore out of the total, 6150 motor cars could be properly observed. 70.91% (4361) of drivers were wearing seat belts. Seat belt usage among drivers was found to be higher on highways (76.6%) as compared to on residential and city roads (69.3%). In vicinity of traffic police, 76.5% of drivers were observed to be wearing seat belts in contrary only 67.8% of them were wearing seatbelts in the absence of traffic police. Prevalence of mobile phone use and other distractions amongst drivers was 2.1%. Out of 2646 adult front seat passengers observed, only 10.9% were wearing seat belts.

Conclusion:
Among drivers, type of motor car, traffic zone and type of road and presence of traffic police in vicinity are significantly associated factors with seatbelt usage. Among adult front seat passengers, type of motor car, traffic zone, type of road and presence of traffic police in vicinity are significantly associated. Among front seat child passengers, type of road and traffic zone are significantly associated with seat belt usage.
IJCM_25A: Effect of one-to-one counselling of mothers attending an immunization clinic on breastfeeding among infants- A Randomised Controlled Trial
Authors: Maiti Urmimala , Maroof Khan Amir , Bhasin S K , Shah Dheeraj 
Published: April 2024

Background:
To improve breastfeeding practices, many interventions have been studied at various critical contact points. Our study aimed to improve exclusive breastfeeding by integrating a limited number of counselling sessions with routine immunization visits.

Objective:
To find out the effect of one-to-one counselling on six months of exclusive breastfeeding among infants attending immunization clinic.

Methodology:
An open-labelled, randomised controlled trial was conducted from September 2022 in the Immunization clinic at the Urban Health Training Centre of Dept of Community Medicine, UCMS, at Ghazipur, New Delhi. Mother-Child dyads visiting the clinic (child between 1 ½ to 3 ½ months) were recruited for the study based on certain appropriate inclusion and exclusion criteria. One-to-one counselling on breastfeeding and complementary feeding were provided, respectively, in the first visit (at the time of Pentavalent 1 or 2 vaccination,) and the second visit (at the time of Pentavalent 3 vaccination) to the intervention group. The control group received routine care. In the follow-up visit at 9 months for measles vaccination, a final assessment was done for both the groups. Analysis was done based on Intention to treat and per protocol approaches.

Results:
92 Mother-child dyads were recruited in the study, of which 46 were randomized each in the intervention and control group. 6 were lost to follow-up on the second visit and 13 on the third (follow-up) visit. At the first visit, 56.5% of the mothers in the intervention group and 63% of mothers in the control group were exclusively breastfeeding. The proportion of mothers who exclusively breastfed their infant till six months of age were 65.2% in the intervention and 39.1% in the control group with an OR of 2.92(1.25, 6.81).

Conclusion:
One-to-one counselling at an immunization clinic has an effect on increasing rates of exclusive breastfeeding for 6 months.
IJCM_250A: Awareness and utilization of Ayushman Bharat Pradhan Mantri Jan Arogya Yojna in Chhattisgarh State - A cross Sectional study
Authors: Sahu Dinesh Kumar , Verma Nirmal , Sharma Mini , Jaiswal Prashant , Dengani Monika 
Published: April 2024

Background:
Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (PM-JAY) is the worlds largest health insurance/ assurance scheme fully financed by the government. It provides a cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empaneled hospitals in India. Over 12 crore poor and vulnerable entitled families are eligible for these benefits. As of now, the total number of ration cards allotted to the people of Chhattisgarh are 57,14,798.

Objective:
To assess awareness and utilization of Ayushman Bharat Pradhan Mantri Jan Arogya Yojna in Chhattisgarh State.

Methodology:
This community based cross-sectional study was conducted among the eligible beneficiaries in Chhattisgarh state. Multis stage cluster sampling used to select eligible beneficiaries. One district each from all five divisions of Chhattisgarh will be selected then 5 clusters (3 urban and 2 rural area) will be selected from each district. Data was collected face to face interview by using semi structured questionnaire. Data was managed in MS- Excel and analysed using suitable statistical software (SPSS v21) and P Value

Results:
The study shows 300 (80.9%), and 68(18.3%) participants are BPL & APL card holders respectively and 3(.8%) do not have any card. Out of 371 participants, 92(24.8%) are not enrolled in the scheme. Among study participants, only 90% were aware of the AB-PMJAY, and only 197 (53%) utilized the scheme and get benefitted.

Conclusion:
This study concluded that despite AB-PMJAY potentially providing cashless financial protection to beneficiaries, some of the study population is still unaware of AB-PMJAY. A quarter of the participants were not enrolled in the scheme, indicating potential gaps in the implementation or accessibility of the program.
IJCM_252A: An Assessment of Functioning of Health and Wellness Centres - Sub Health Centres (HWC-SHC) in Raipur District.
Authors: Thakur Barkha , Jain Kamlesh , Sinha Ashish , Chandrakar Aditi 
Published: April 2024

Background:
The National Health Policy 2017 has envisioned the integration of Health and Wellness Centers (HWCs) into India’s healthcare system as part of Ayushman Bharat. In February 2018, the Indian Government declared the transformation of 1,50,000 existing Sub Health Centers and Primary Health Centers into Health and Wellness Centers (HWCs) to provide Comprehensive Primary Health Care (CPHC). Health and Wellness Centres have an important role in the prevention of several diseases and health promotion and in undertaking public health functions in the community to strengthen the frontline workers and community platforms.

Objective:
To assess the availability of Infrastructure and 12 comprehensive primary health care services in study centres (HWC-SHC) in Raipur district

Methodology:
This is a cross-sectional observational study conducted in the 32 Health and wellness centre-sub centres of Raipur district, Chhattisgarh. In the Raipur district, there are 4 blocks and from each block, 25% of the study centres (HWC-SHC) are selected by simple random sampling. Semi- structured assessment tool with the reference of Government of India Operational Guidelines was used which consisted of checklist regarding Physical Infrastructure, Human Resource, Medicine, Diagnostic, IT component and 12 comprehensive primary health care services. The data was collected and analysis is being done by using SPSS software.

Results:
Out of 32 HWC-SHCs, 6 (18.75%

)
were catering the services for the population as per the norms i.e. 3000- 5000. In the present study, 19 (59.4%) boundary wall, and 21 (65.6%) of SCs had wellness space. There were 31 (96.9%) of SCs had labor room, and 14 (43.8 %) had newborn care corner (NBCC). In this study, 21.9% Grievance board and 100% of IEC were present at the studied subcentres. It was observed that 31(96.9%) SCs had water, 27 (84.4%) had electricity supply and 1 (3.1%) of SCs had power backup. Separate public utilities for males and females were available in 2(6.3%) of the study centres. Out of the study sub-centre, 28 (87.5%) residential facilities were available, out of which 24 (85%) were occupied. For diagnostic services, 53.1 % of study centres have sickle- cell rapid tests and none of the centres have VIA for Screening of cervical cancer.

Conclusion:
The finding of the study shows that there is a scarcity in the physical infrastructure, Human resource and lab-diagnostic services at the studied centres. The major factor contributing to the non-utilization of health services at the SCs was the lack of adequate infrastructure, and logistics available at these centres.
IJCM_253A: A cross sectional study to assess the coverage, impact and reasons for non- utilisation of supplementary nutrition among ICDS beneficiaries in the field practice area of a tertiary medical college in Mangalore
Authors: Poonja Rima S , Subramanian A Akshay , Sushantha P , Badiger Sanjeev 
Published: April 2024

Background:
Integrated Child Development Services (ICDS) scheme is world’s largest community-based Programme

Objective:
To assess the coverage, impact, and reasons for non-utilization of supplementary nutrition among ICDS beneficiaries

Methodology:
To assess the coverage, impact, and reasons for non-utilization of supplementary nutrition among ICDS beneficiaries

Results:
66 % of the beneficiaries are aware of the supplementary nutrition availability, while only 52% of them acquire the services. Only 24% of the adolescents are aware of the supplementary nutrition being given in ICDS and none of them are availing it. 28.7 % of the beneficiaries are getting.

Conclusion:
52% of the study participants were utilizing the services and the major reason for non-utilization was inferior quality of the grains and unawareness, mainly among adolescent females. Positive impact could be seen with reduction in SAM cases, immunization updation but nutrition education needs to be upgraded.
IJCM_254A: A Study on Level of Satisfaction among Beneficiaries Under Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) in Rural Field Practice Area Of Guntur Medical College. Guntur, Andhra Pradesh: A Cross-sectional Study
Authors: Subbaiah V. Venkata , Rao M. Nageswara , Nandan K. Vishnu , Rama A. Sita 
Published: April 2024

Background:
With 30,000 estimated maternal deaths in a year across the country, high MMR remains a matter of grave concern, and thus it is paramount to ensure quality ANC to each pregnant woman, identify the high risk pregnancies (HRPs) and track these for counselling, management birth preparedness and referral till the outcome to close the loop. Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) was launched in 2016, as a fixed-day, assured, comprehensive quality ANC service on the 9th of every month to every pregnant woman across the country. Screening, identification, line listing and appropriate management of high-risk pregnancies by OBGY/CEmOC/ BEmOCspecialist and referral to appropriate higher facilities are some of the fundamental elements of PMSMA

Objective:
To determine the level of satisfaction among beneficiaries under PMSMA scheme

Methodology:
A cross-sectional study was done among 300 pregnant women who were delivered within 6 months from the date of the study and who had registered & availed the Ante-Natal Care (ANC) services under Rural field Practice area of Guntur Medical college. Guntur. Andhra Pradesh. The data thus collected were entered into Microsoft-Excel spreadsheet and was analyzed using IBM SPSS software Version 24.0

Results:
Out of 300 beneficiaries, 237(79%) were satisfied with the cleanliness of wards & toilets followed by 278(92.69%) with Adequate privacy During Examination, 287(97.67%) with basic laboratory investigation, 166(55.34%) with transport facilities during discharge. The majority of study participants were in the age group of 20-30 years i.e. 269 (89.70%) and most of their educational status above intermediate i.e. 207(69%)

Conclusion:
If every pregnant woman in India is examined by a Medical Officer/Specialist and Investigated appropriately at least once during the PMSMA, the Abhiyan can play a crucial role in reducing the number of maternal deaths & High-Risk Pregnancy (HRP) in our country
IJCM_259A: Non-communicable disease (NCD) programme -factors influencing awareness and utilization of the services among adults of Madurai district, Tamil Nadu- a community based cross-sectional study.
Authors: Harini  , Hemamalini B. , Priya S. 
Published: April 2024

Background:
Healthcare at people’s doorstep called Makkalai Thedi Maruthuvam (MTM) scheme was launched by Tamil Nadu Government in 2021 to further improve the access to NCD care by ensuring door step blood sugar & blood pressure screening, drug delivery by designated trained manpower called Women Health Volunteers (WHV). Assessing the programme awareness and its utilization at this juncture is the need of the hour. Hence, the present study was conducted.

Objectives:
1. To assess the awareness about MTM scheme among adults >30 years in the field practice area, Madurai district 2. To determine the factors influencing awareness and utilization of MTM services

Methodology:
A community based cross-sectional study was done among 165 adults of >30 years in field practice area of our department in October 2023. By cluster sampling, participants were interviewed using a pre-structured validated questionnaire containing socio-demographic details and data to assess awareness and factors influencing awareness and utilization of MTM services. Data were entered in MS Excel and analysed using SPSS.

Results:
Mean age was 54±13.60 years. 60% were females, 83% were literates,63% were employed.80% were aware about the scheme and 74% awareness was through healthcare workers,98% preferred door to door services. Awareness regarding lifestyle modifications, breast, cervix and oral cancer screening were 56%,40%,39% and 20% respectively. There is statistically significant association between MTM awareness and age, occupation, blood sugar and blood pressure check-up in the last one year. By multiple logistic regression, awareness among those 50 yrs. Those with awareness had 2.62 times odds of utilization of services as compared to those without awareness.

Conclusion:
There is a good awareness and utilization of MTM services. To sustain this, IEC activities can be done at regular intervals with special emphasis on cancer screening.
IJCM_262A: Digital Health Boon or Bane: From Community Health Worker’s Perspective in an Aspirational District
Authors: Thakur Anshuman , Reshmi B , Mithra Prasanna , Sekaran Varalakshmi Chandra , Kumar Shuba 
Published: April 2024

Background:
Digital health technologies are pivotal for achieving Universal Health Coverage (UHC) and Sustainable Development Goal 3. This study investigates Community Health Workers (CHWs) perspectives on digital health platforms in an aspirational district in India, aligning with the World Health Organization’s emphasis on fostering an enabling environment for digital health adoption.

Objectives:
To assess CHWs’ current practices and knowledge of digital health applications/platforms and to understand their perceptions regarding the need and use of digital health platforms in the public health system.

Methodology:
A mixed-methods approach was utilized, involving 95 CHWs in quantitative surveys and 30 CHWs in qualitative interviews and focus group discussions. The study was conducted in Muzaffarpur, Bihar, India’s most populated aspirational district, using stratified random sampling and purposive sampling methods.

Results:
Findings reveal varied app usage patterns among CHWs, with challenges like non-functional government-provided devices. Qualitative insights highlight the importance of peer support and training quality alongside concerns about device accessibility and app rationalization. Despite government provision of smartphones, CHWs face obstacles in utilizing digital health tools effectively.

Conclusion:
This research illuminates the availability and utilization of digital health applications among CHWs, emphasizing the need to address challenges and tailor digital tools to enhance healthcare delivery in aspirational districts.
IJCM_263A: Vaccine Hesitancy in Tribal Communities: A Study on Parents of children under 5 years of age
Authors: Vishakan A S , Shaji Shibin M , Aswathy S 
Published: April 2024

Background:
People who delay or refuse vaccines for themselves or their children are presenting a growing challenge for countries seeking to close the immunization gap.

Objective:
To determine the proportion of vaccine hesitancy and associated factors among informants of children under five years of age (U-5) within tribal communities in Wayanad.

Methodology:
A cross sectional study was carried out in tribal colonies of Kalpetta taluk of Wayanad District. Sample size was calculated to 168 based on a study on vaccine hesitancy conducted among tribals at Murshidabad where the prevalence of vaccine hesitancy was 36.9% with an absolute error (d) = 7%. Out of the 175 colonies in the taluk of Kalpetta, 11 colonies were randomly selected. Informants of children ages < 5 years Vaccine hesitancy among parents and guardians was assessed individually for each child in the household. If the informants were hesitant to give any vaccine included in the national immunization schedule they were listed as vaccine hesitant. A total of 208 U-5 children informants were interviewed. Vaccine hesitancy was assessed by adopted SAGE questionnaire.

Results:
Mean age of the informants was 30.3 + 7.90 and of U-5 children were 2.87 years + 1.45. Majority of the informants were mothers of U-5 children (88.5%), more than 3/4th of the informants belonged to Paniya tribe, most of the participants were unemployed (64.9%). Vaccine hesitancy to any of the vaccine in the immunization schedule was found among 23 participants (11%), majority were hesitant to take Pentavalent vaccine 12(5.76%). Fear of needles, too many vaccinations at 1 sitting and adverse effects following vaccinations were common reasons for being hesitant.

Conclusion:
The vaccination program is driven by health workers reducing vaccine hesitancy, however with greater motivation and awareness among the community vaccine hesitancy can be further reduced.