Urban and Rural healthcare

Menopause impacts women differently, with variations based on factors like socioeconomic status and healthcare. The objective of this research is to investigate the economic situation and symptoms of menopausal women in Perambalur district. This descriptive research centered on menopausal females living in urban and rural parts of Perambalur district. 55 participants were selected using a purposive sampling technique. Information on demographics, menopausal symptoms, and their impact on everyday activities was gathered using a questionnaire. The findings were interpreted by SPSS software. Prior studies have emphasized the diverse range of menopausal symptoms and underscored the significance of acknowledging their frequency and effects on women's overall well-being. Symptoms like hot flashes, disrupted sleep, and psychological impacts have been observed in various groups, highlighting the importance of personalized treatment plans. The findings reveal that a substantial proportion of females experienced severe symptoms, with hot flashes (81.8%), vaginal dryness (92%), and lack of concentration (85.5%) being particularly prevalent. Notably, 41.8% of participants reported that their daily routines were significantly disrupted. This research emphasizes the importance of specific health interventions and support systems to tackle the difficulties experienced by menopausal women in India.

The pharmaceutical market in urban areas plays an important role in supporting healthcare needs. Urban populations are growing rapidly, and people living in cities often experience different health challenges due to pollution, stress, unhealthy eating habits, and a fast-paced lifestyle. This leads to a higher demand for medicines, especially for diseases such as diabetes, hypertension, respiratory problems, infections, and mental health disorders. This study explores how medicines are used, purchased, and distributed among people living in urban areas. It also looks at the differences between branded and generic drugs and how people make choices based on price, availability, and trust. In urban settings, access to pharmacies, hospitals, and healthcare professionals is generally better compared to rural areas, but there are still challenges such as high costs, lack of awareness, and the influence of advertisements. Information has been gathered from secondary sources like health department reports, pharmaceutical sales records, and market research publications. The study also highlights the growing trend of over-the-counter (OTC) drug use and self-medication practices in cities. Overall, the findings show that while urban populations have better access to medicines, there is a strong need for improving awareness about proper drug use, encouraging the use of affordable generics, and ensuring that quality medicines are available to everyone. The pharmaceutical market in urban areas has great potential to grow further, but it must be supported with strong policies, regulation, and public health education to ensure better healthcare outcomes.

This report examines the persistent disparities in emergency healthcare accessibility in rural Jodhpur, Rajasthan, India, focusing on the geographic, infrastructural, and systemic barriers that delay timely medical response. Rural communities in Jodhpur face prolonged ambulance response times, often exceeding two hours, due to factors such as inadequate road infrastructure, limited health facility coverage, shortage of trained personnel, and communication breakdowns. The study reviews the status of healthcare infrastructure, including PHCs, CHCs, and ambulance services, and highlights the lack of up-to-date, granular data on facility distribution, emergency response intervals, and health outcomes. Emerging innovations such as air and rail ambulances, mobile health units, GIS-based planning, and drone deliveries are assessed for their potential to reduce response times and improve accessibility. However, outcome data remain limited, and implementation faces significant logistical and policy challenges. The report underscores critical evidence gaps, particularly in GIS mapping and rural health metrics, and calls for integrated, data-driven strategies to enhance emergency care delivery in underserved regions. Transparent audits, localized research, and cross-sector collaboration are essential for closing the urban-rural emergency care divide in Jodhpur.

Centrifuges are indispensable tools in the medical industry and have a range of applications in laboratory tests. However, traditional centrifuges can be bulky, expensive, and require electricity, making them unsuitable for use in remote and resource-constrained areas. This study presents a novel solution by designing and developing a hand-held centrifuge prototype that is portable, cost-effective, and easy to use, while performing as well as or better than traditional centrifuges. The researchers utilized experimental design methodologies, simulation testing, and survey research to create a functional and efficient prototype with an output speed of up to 1035 RPM, within the desired range for effective separation. The potential impact of this research is significant, as it can provide medical practitioners and researchers with a portable and efficient centrifugation method in areas with limited access to diagnostic equipment. Furthermore, simulation testing demonstrated that the prototype can effectively separate soil-water and flour-water mixtures, indicating its potential applications in various fields beyond the medical industry. This research provides valuable insights and potential applications for innovative medical equipment and solutions.

Background: Women and children are the most essential assets on earth. To achieve complete development of human resource, it is essential to improve the health and well-being of women and child. POSHAN ABHIYAAN launched in 2018 as governments National Nutrition Mission aims to bring forth a convergence system for the country's response to malnutrition. The study objective was to assess the level of POSHAN ABHIYAAN utilisation and dietary pattern of pregnant and postpartum mothers registered in the Anganwadi centers, Raigad district , Maharashtra. Mother and child together form the majority of the population in developing countries. Method: A community based study employed a multistage sampling technique to select 80 participants from anganwadi centers, Raigad district, between February 2021 and April 2021. Socio-demographic profile, components of POSHAN ABHIYAAN utilisation, dietary intake and nutrient adequacy ratio were assessed. Results: The study participants were between 20 and 44 years of age group. The utilisation of POSHAN ABHIYAAN services was average (10-18) among 52 (65%) and poor (0-9) among 28 (35%) pregnant and post-partum mothers. Mothers living in a joint family and mainly non-vegetarian dietary pattern had good dietary intake with statistically significant association. Conclusion Deficient nutritional status of pregnant mothers can be enhanced by reinforcing nutritional guidance in each trimester of pregnancy with active community based health workers to escalate utilisation of services

Globally, there has been a decline in the Maternal Mortality Ratio (MMR) by 34 percentfrom 342 death to 223 deaths per 100,000 live births from 2000-2020 1. This translates into an average annual rate of reduction of 2.1 percent. While substantive, this is about one third of the 6.4 percent annual rate needed to achieve the Sustainable Development Goal (SDG) of 70 maternal deaths per 100,000 live births by 2030 1 .The Maternal Mortality Ratio (MMR) is defined as the number of maternal deaths during a given time period per 100,000 live births. The Maternal Mortality Ratio (MMR) of India has improved

"Background: High-risk pregnancies (HRPs) significantly contribute to maternal and neonatal morbidity and mortality in India. However, many pregnancies remain unclassified as high-risk. To address this, the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) was launched to improve the quality and coverage of antenatal care (ANC). This study aimed to estimate the proportion of HRPs and their correlates among PMSMA beneficiaries in a rural block of Purba-Bardhaman district, West Bengal.
Methodology: A cross-sectional study was conducted over six-month period at Pradhan-Mantri- Surakshit-Matritva (PMSM) Clinic among 190 women were selected by simple random sampling. Data were collected by reviewing records as well as from selected study subjects using a pre-designed schedule and analysed using Jamovi v-2.4.8.
Results: Data analysis revealed that 65.3% of pregnancies were high-risk, with 75% of these involving a single high-risk factor and 25% having multiple factors. The leading contributors were hypothyroidism (19.6%), previ-ous Caesarean-section (14.2%), and pregnancy-induced hypertension (13.7%). Statistically significant associa-tions were found between HRPs and caste, occupation, and ANC-registration status.
Conclusions: The findings highlight the importance of improving antenatal care by enhancing screening and interventions. Future research and healthcare policies should focus on comprehensive strategies to identify and manage risks, improving maternal and infant health outcomes."

Background: Despite the reduction in the maternal mortality ratio, Obstetric care service (OCS) barriers remain the signi cant risk factor for adverse maternal and perinatal outcomes in India. This review is relevant because it covers all three obstetric care components (ANC, child delivery, and PNC services) and identi es multiple barriers from provisioning to utilization of OCS in India. We conducted a systematic review to address the barriers in utilization and provisioning of OCS in India using a mixed-method review. Methods: PubMed, Scopus, Web of Science, Google scholar, and Science direct databases were searched from 1st January 2000 to 30th June 2022. The methodological quality of included studies was assessed using appropriate tools. We have included 56 studies (33 quantitative, 18 qualitative, and 5 mixed method studies) after 164 full texts review. All the barriers are classi ed into ve major themes, i.e. (i) individual and interpersonal barriers, (ii) social and cultural barriers, (iii) structural barriers, (iv) logistical barriers, and (v) organization barriers. Thematic synthesis approach was used to present the ndings from included studies. Results: Lack of knowledge and awareness, and less family support in availing the required OCS were key individual and interpersonal barriers. Negative social and cultural practices such as belief in traditional herbs/healers, dietary restrictions, and discarding colostrum were frequently reported barriers especially in rural settings. Poor economic status and high health service costs were the most reported barriers to low institutional delivery and delayed ANC services. Additionally, long distances to health facilities and poor road conditions were the most frequent logistical barriers. On the provisioning side, poor quality of treatment, shortage of drugs and equipment and non-cooperative attitude of health professionals were the most signi cant barriers. Conclusion: Governments should take necessary steps to tackle the mentioned barriers and encourage women to make their own health decisions.

"Introduction: The MCP card is a tool for pregnant women, young mothers and family members to learn understand and achieve good health practices. It contains information about antenatal care, danger signs, preparation for delivery, newborn care, immunization and growth chart.
Objective: The study conducted to assess the use of MCP card by beneficiaries attending VHND sessions in rural Valsad.
Methodology: It was a cross sectional study. Total 43 pregnant and lactating mothers were interviewed to know the use of MCP card by them. Their knowledge was checked by asking open  ended questions about information provided in MCP card.
Results: 65.1% mothers had read the MCP card. 86.5% of the mothers could tell at least one use of Mamta card of which major- ity (86.49%) used it as immunization record of the child while 67.57% used it for information. 88% mothers brought the card at every visit to the health center. Mothers were quite aware about emergency signs, but knowledge about vaccination, growth moni- toring, hygiene and various government schemes was poor.
Conclusion: Effective use of MCP card is still lacking by beneficiaries. Advocacy by health care providers may improve the knowledge of beneficiaries about various health information provided already in MCP card."

Naskah presentasi oral yang disampaikan pada konferensi ICM ke-33 di Bali, Indonesia tahun 2023. Naskah ini membahas tentang sharing experience akan kegiatan unggulan pendidikan kebidanan pada Prodi Diploma-III Kebidanan Poltekkes Kemenkes Malang dengan judul: COMMUNITY EMPOWERMENT THROUGH “THE INTEGRATED ADOLESCENT HEALTH CARE COMMUNITY MOVEMENT” (GEMPAR) IN ADDRESSING ADOLESCENT, MOTHER, AND CHILD HEALTH.

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution Non Commercial Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Maternal and child health is one of the eight Millennium Development Goals. Maternal and child mortality can be reduced by promoting institutional deliveries. To achieve this, the Indian government has introduced some maternity benefit schemes. The utilisation of schemes depends on the awareness among the beneficiaries. We conducted this study to estimate the awareness about government maternity benefit schemes among women attending antenatal clinic. A cross sectional study was carried out among women attending antenatal clinic in a rural hospital, Karnataka using a structured interview schedule. The maximum awareness was for maternal nutrition supplements under Integrated Child Development Services (ICDS) (83.6%). The awareness of the schemes was significantly associated with education of mother, socio economic status of family, gestational age and parity index. Source of information was mainly from health personnel (health workers, health professionals), followed by friends and fa...

Objectives We estimated the utilisation, determinants and equity of full antenatal care (ANC), defined as 4 or more antenatal visits, at least one tetanus toxoid (TT) injection and consumption of iron folic acid (IFA) for a minimum of 100 days, in India. Methods We used data from India’s National Family Health Survey-4. Concentration curves and concentration index were used to assess equity in full ANC utilisation. Multivariable binary logistic regression model was used to examine the factors associated with full ANC utilization. Results In India, 21% of pregnant women utilised full ANC, ranging from 2.3% - 65.9% across states. Overall, 51.6% had 4 or more ANC visits, 30.8% consumed IFA for atleast 100 days, and 91.1% had one or more doses of tetanus toxoid. Registration of pregnancy, utilisation of government’s Integrated Child Development Services (ICDS) and health insurance coverage were associated with higher odds of full ANC utilisation. Lower maternal education, lower wealth q...

Background: Antibiotic consumption (ABC) surveillance is a critical component of the strategic priority response to the increasing antibiotic resistance threat. Levels of ABC at the national and provincial levels in South Africa are unknown because of inadequate ABC surveillance systems and literature. Antibiotic consumption in the public sector of Limpopo province, South Africa, 2014-2018 Methods: This retrospective study used sales data retrieved from a pharmaceutical warehouse distribution database to quantify ABC. Antibiotic consumption was measured by the defined daily dose (DDD) per 1000 inhabitants per day (DID) and 75% drug utilisation index (DU75%). Change in consumption was measured by the compound annual growth rate (CAGR). Results: Between 2014 and 2018, the mean ABC was 4.6 ± 1.0 DID, with an overall decrease of 1.6% in the CAGR. Penicillins (2.3 ± 0.8; 50.0%), sulphonamide and trimethoprim combinations (1.4 ± 0.3 DID; 30.4%) were the most consumed antibiotics. Macrolides had the highest relative increase in consumption during the study period, with a CAGR of 18.5%. In contrast, tetracyclines had the highest relative decrease in consumption, with a CAGR of 100.0%. The CAGR ratio for broad-to narrow-spectrum increased by 39.3%, from 0.4 in 2014 to 2.1 in 2018. The DU75% comprised amoxicillin (28.4%), sulphamethoxazole and trimethoprim (SMX-TMP) (27.2%), doxycycline (12.3%) and azithromycin (9.2%). Conclusion: While ABC remained relatively stable throughout the study, there was an increase in broad-spectrum ABC that requires further investigation. Contribution: This study contributes ABC surveillance data in Southern Africa, described by ATC classification, which is essential for monitoring and evaluating antibiotic stewardship programmes.

The use of antibiotics is the most important modifiable risk factor for the development of microorganism resistance. A cross-sectional study of outpatients receiving antibiotic prescriptions registered in a population database in Colombia was conducted. The characteristics of the consumption in capital cities and small municipalities was studied and the AWaRe classification was used. AWaRe classifies antibiotics into three stewardship groups: Access, Watch and Reserve, to emphasize the importance of their optimal use and potential harms of antimicrobial resistance. A total of 182,397 patients were prescribed an antibiotic; the most common were penicillins (38.6%), cephalosporins (30.2%) and fluoroquinolones (10.9%). ‘Access’ antibiotics (86.4%) were the most frequently prescribed, followed by ‘Watch’ antibiotics (17.0%). Being 18 or older, being male, living in a municipality, having one or more comorbidities and urinary, respiratory or gastrointestinal disorders increased the proba...

Background: Safe motherhood initiatives was a worldwide effort launched by WHO in 1987 with an aim to reduce the number of deaths of women associated with pregnancy and childbirth. Appropriate antenatal care (ANC) is one of the pillars of this initiative and an important component of reproductive and child health. The present study was conducted to assess the utilization of antenatal care services, its contributing factors and its impact on birth weight of new-born.Methods: A community based cross-sectional study was conducted for a period of 3 months at Ankuli, field practice area of urban health training centre, Department of Community Medicine. A total of 138 mothers (delivered within 2 years) were included by cluster sampling. Women who were sick and did not give consent were excluded from the study.  A pre-designed and pre-tested questionnaire was used for data collection and analysed in SPSS version 16. Chi-square test and bivariate logistic regression was applied at p value &...

The COVID-19 pandemic is expected to have profound effects on healthcare systems, but little evidence exists on service provision, utilisation, or adaptations. This study aimed to (1) examine the changes to health and nutrition service delivery and utilisation in urban Bangladesh during and after enforcement of COVID-19 restrictions and (2) identify adaptations and potential solutions to strengthen delivery and uptake. We conducted longitudinal surveys with health care providers (n = 45), pregnant women (n = 40), and mothers of children <2 years (n = 387) in February 2020 (in-person) and September 2020 (by phone). We used Wilcoxon matched-pairs signed-rank tests to compare the changes before and during the pandemic. Services delivery for women and children which require proximity were severely affected; weight and height measurements fell by 20-29 percentage points (pp) for pregnant women and 37-57 pp for children, and child immunisations fell by 38 pp. Declines in service utilisation were large, including drops in facility visitations (35 pp among pregnant women and 67 pp among mothers), health and nutrition counselling (up to 73 pp), child weight measurements (50 pp), and immunisations (61 pp). The primary method of adaptation was provision of services over phone (37% for antenatal care services, 44%-49% for counselling). Despite adaptations to service provision, continued availability of routine maternal and child health services did not translate into service utilisation. Further investments are needed to provide timely and accurate information on COVID-19 to the general public, improve COVID-19 training and provide incentives for health care providers and ensure availability of personal protective equipment for providers and beneficiaries.

Purpose of Review Antimicrobial stewardship (AS) programs are expanding efforts across the entire healthcare continuum. Antimicrobials are commonly overused in outpatient care locations, which have not received the same intensity of AS intervention as inpatient settings. Guidance for AS programs is needed on how to implement interventions and monitor for improvement. Recent Findings Antimicrobials prescribed in the outpatient setting are inappropriate in 23-76% of cases. Factors associated with inappropriate prescribing include older adult patients, advanced practice practitioner prescribers, and urgent care clinics. Indications such as upper respiratory infections and asymptomatic bacteriuria are common conditions in which antibiotics should not be used yet they are major contributors to inappropriate antibiotic use. Promising interventions include peer comparison and clinical decision support, but gaps remain. There is little evidence for how to limit the use of fluoroquinolones and newly approved antibiotics. Summary Improving antibiotic use is needed in the outpatient setting and poses unique challenges for AS programs. Defining problems unique to designated outpatient centers and implementing proposed interventions targeting these problems is an effective strategy. Collaboration with State Health Departments, health insurers, and healthcare systems will be essential. Keywords Outpatient antimicrobial stewardship. Antibiotic inappropriateness. Antibiotic use in ambulatory care, improving outpatient antimicrobial use This article is part of the Topical Collection on Healthcare Associated Infections

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License Dear Sir, During the 13 th Conference of Central Council of Health and Family Welfare (CCCHFW) in New Delhi, the Central Government on 10 th October 2019 launched the Surakshit Matritva Aashwasan (SUMAN) scheme, aiming at zero preventable maternal and newborn deaths in India under which pregnant women, mothers up to 6 months after delivery and all sick newborns will be able to avail free health care benefits. The Website for the scheme-SUMAN and grievance redressal portal was also launched during the event. [1]

The COVID-19 pandemic is expected to have profound effects on healthcare systems, but little evidence exists on service provision, utilisation, or adaptations. This study aimed to (1) examine the changes to health and nutrition service delivery and utilisation in urban Bangladesh during and after enforcement of COVID-19 restrictions and (2) identify adaptations and potential solutions to strengthen delivery and uptake. We conducted longitudinal surveys with health care providers (n = 45), pregnant women (n = 40), and mothers of children <2 years (n = 387) in February 2020 (in-person) and September 2020 (by phone). We used Wilcoxon matched-pairs signed-rank tests to compare the changes before and during the pandemic. Services delivery for women and children which require proximity were severely affected; weight and height measurements fell by 20-29 percentage points (pp) for pregnant women and 37-57 pp for children, and child immunisations fell by 38 pp. Declines in service utilisation were large, including drops in facility visitations (35 pp among pregnant women and 67 pp among mothers), health and nutrition counselling (up to 73 pp), child weight measurements (50 pp), and immunisations (61 pp). The primary method of adaptation was provision of services over phone (37% for antenatal care services, 44%-49% for counselling). Despite adaptations to service provision, continued availability of routine maternal and child health services did not translate into service utilisation. Further investments are needed to provide timely and accurate information on COVID-19 to the general public, improve COVID-19 training and provide incentives for health care providers and ensure availability of personal protective equipment for providers and beneficiaries.

Background: Expansion of maternal health service coverage is crucial for the survival and wellbeing of both mother and child. To date, limited literature exists on the measurement of maternal health service coverage at the sub-national level in India. The prime objectives of the study were to comprehensively measure the maternal health service coverage by generating a composite index; map India by categorizing it into low, medium and high zones and examine its incremental changes over time. Methods: Utilising a nationally representative time series data of 15 key indicators spread across three domains of antenatal care, intranatal care and postnatal care, we constructed a novel ‘Maternal Health Service Coverage Index’ (MHSI) for 29 states and 5 union territories of India for the base (2017-18) and reference (2019-20) years. Following a rigorous procedure, MHSI scores were generated using both arithmetic mean and geometric mean approach. We categorized India into low, medium and high...

For any individual to utilize the healthcare system falling sick is an entry point. But not every individual standing at this entry point is able to seek the facility provided. Despite of the government’s commitment to provide equity in access to healthcare, the utilization of health services is still below the acceptable standard. This study investigates various factors associated with the utilization of healthcare services. This was a cross-sectional study conducted in Haridwar district of Uttarakhand. A total of 450 samples were selected. A descriptive research design was employed for the study. The study indicates that 70.4% of the respondents agreed that they had utilized the health facility while 29.6% of the respondents failed to utilize the health facility. This study further explores various factors responsible for the inequity in access to healthcare.

In recent decades, Shopping experiences of customers in Online marketing Channels play key role in customer satisfaction. Experiences are derived from many factors and differ from one customer to another. This research is aimed to track various customer experiences in online trading through systematic review of literatures. For this purpose, bibliometric data of 313 documents were retrieved from Scopus data base. Retrieved data have been analysed to build network between authors, co-authors, country, keyword, sources, themes, citations and Journal. Based on the analysis, most cited authors papers were reviewed. Soft wares namely, biblioshiny and VOS viewer were used for building network diagram. Such network analysis assisted in identifying top thematic clusters, Coupling links between publications. Bibliometric analysis pave the way for future research in online shopping experience.

Note: This early-online version of the article is an unedited manuscript that has been accepted for publication. It has been posted to the website for making it available to readers, ahead of its publication in print. This version will undergo copy-editing, typesetting, and proofreading, before final publication; and the text may undergo minor changes in the final version.

The use of antibiotics is the most important modifiable risk factor for the development of microorganism resistance. A cross-sectional study of outpatients receiving antibiotic prescriptions registered in a population database in Colombia was conducted. The characteristics of the consumption in capital cities and small municipalities was studied and the AWaRe classification was used. AWaRe classifies antibiotics into three stewardship groups: Access, Watch and Reserve, to emphasize the importance of their optimal use and potential harms of antimicrobial resistance. A total of 182,397 patients were prescribed an antibiotic; the most common were penicillins (38.6%), cephalosporins (30.2%) and fluoroquinolones (10.9%). ‘Access’ antibiotics (86.4%) were the most frequently prescribed, followed by ‘Watch’ antibiotics (17.0%). Being 18 or older, being male, living in a municipality, having one or more comorbidities and urinary, respiratory or gastrointestinal disorders increased the proba...

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License Dear Sir, During the 13 th Conference of Central Council of Health and Family Welfare (CCCHFW) in New Delhi, the Central Government on 10 th October 2019 launched the Surakshit Matritva Aashwasan (SUMAN) scheme, aiming at zero preventable maternal and newborn deaths in India under which pregnant women, mothers up to 6 months after delivery and all sick newborns will be able to avail free health care benefits. The Website for the scheme-SUMAN and grievance redressal portal was also launched during the event. [1]

Village Health and Nutrition Days (VHND) were introduced by the National Rural Health Mission (NRHM) to improve access to essential maternal, newborn, child health and nutrition services at village level. Purpose of the study was to assess awareness of VHND services among rural mothers in Kamrup district of Assam and to estimate utilization of the services in beneficiaries and any gap(s) thereof. A cross-sectional study with multistage random sampling design was undertaken in rural areas of Kamrup from August 2013 to July 2014 among 387 mothers with infants. They were interviewed using a pre-designed and pre-tested semistructured interview schedule. 86% of the respondents were aware of services provided in VHND, 73% respondents ever attended a session, 76% attendees availed antenatal check-up in VHND. Only 44% availed postnatal check-up. 77% of the infants were reportedly weighed in VHND. Only 48% infants had their weights plotted in growth chart. 47% beneficiaries attended Nutrition Health Education Counselling and Demonstration (NHED) sessions. Services in VHND were not utilized to the optimal extent by beneficiary mothers in rural Kamrup. Gaps in utilization of services were found mainly in relation to postnatal care, growth monitoring, counselling for family planning and NHED.

Antimicrobials are the most frequently prescribed drugs in long-term care facilities (LTCF). Antibiotic stewardship programs (ASP) are coordinated interventions promoting the responsible use of antibiotics to improve patient outcomes and reduce antibiotic resistant bacterias. The objectives are to evaluate the effectiveness of a pharmacist-led ASP in a LTCF, to characterise antibiotic therapy and assess the appropriateness of antibiotic prescriptions. A prospective quasi-experimental study to implement an ASP in a LTCF. Antibiotic prescriptions for suspected infections initiated in any setting for LTCF residents were included. We assessed appropriateness and prospective audits and feedback of each inappropriate antimicrobial prescription were carried out. Associations of variables with appropriate antibiotic prescribing were estimated using logistic regression. A total of 416 antibiotic prescriptions were included. The mean consumption of antibiotics was reduced from 63.2 defined da...

The use of antibiotics is the most important modifiable risk factor for the development of microorganism resistance. A cross-sectional study of outpatients receiving antibiotic prescriptions registered in a population database in Colombia was conducted. The characteristics of the consumption in capital cities and small municipalities was studied and the AWaRe classification was used. AWaRe classifies antibiotics into three stewardship groups: Access, Watch and Reserve, to emphasize the importance of their optimal use and potential harms of antimicrobial resistance. A total of 182,397 patients were prescribed an antibiotic; the most common were penicillins (38.6%), cephalosporins (30.2%) and fluoroquinolones (10.9%). ‘Access’ antibiotics (86.4%) were the most frequently prescribed, followed by ‘Watch’ antibiotics (17.0%). Being 18 or older, being male, living in a municipality, having one or more comorbidities and urinary, respiratory or gastrointestinal disorders increased the proba...

Health can be accounted as a parameter for socioeconomic transformation of different segments of people. The effect works in a vicious cycle and transfers from one generation to another. Maternal and child health is a very important aspect if we talk about socioeconomic development of a particular community. Here we are examining different government policies which have been introduced for transforming the maternal and child health landscape in India through socioeconomic interventions. The factors such as education, family income, health-care access etc will be scrutinised to posit the importance of women empowerment at the forefront of making a difference to maternal and child health in India. The inequalities in health-care and nutritional access when it comes to antenatal care, reproductive care, sanitation facilities, diet pattern etc are being ameliorated by various government policies. The social intervention schemes those are at work

Antibiotic overprescribing is one of the main drivers of the global and growing problem of antibiotic resistance, especially in primary care and for respiratory tract infections (RTIs). RTIs are the most common reason for patients to consult out-of-hours (OOH) primary care. The COVID-19 pandemic has changed the way general practitioners (GPs) work, both during office hours and OOH. In Belgian OOH primary care, remote consultations with the possibility of issuing prescriptions and telephone triage were implemented. We aimed to describe the impact of COVID-19 on GPs’ antibiotic prescribing during OOH primary care. In an observational study, using routinely collected health data from GP cooperatives (GPCs) in Flanders, we analyzed GPs’ antibiotic prescriptions in 2019 (10 GPCs) and 2020 (20 GPCs) during OOH consultations (telephone and face-to-face). We used autoregressive integrated moving average (ARIMA) modeling to identify any changes after lockdowns were implemented. In total, 388...

The research aims: To provide comprehensive midwifery services to mothers since pregnancy, childbirth, newborns and contraception services. Research methods: The research design used is descriptive, with a clinical case study method. Research result: From the results of the assessment of Mrs. M aged 23 and the comprehensive midwifery care that had been given and it was found that everything was in normal condition. After doing Comprehensive Midwifery Care at Independent Practice Midwives/ BPM Nurkhairiyah, comprehensive midwifery care has been given. The client says he is satisfied and understands the care he has received, and provides great benefits for the client and the baby and family and for the client in providing family planning care, the client has not decided to choose a contraceptive will be used.. Conclusion: From the midwifery care obtained, the mother said she felt satisfied and appreciated, both in the care of pregnancy, childbirth, postpartum, newborn and the period o...

Coronavirus disease 2019 (COVID-19) has spread globally and is currently having a damaging impact on nearly all countries in the world. The implementation of stringent measures to stop COVID-19 dissemination had an influence on healthcare services and associated procedures, possibly causing antibiotic consumption fluctuations. This paper aims to evaluate the immediate and long-term impact of the COVID-19 pandemic on antibiotic prescribing trends in outpatient care of the Portuguese public health sector, including in primary healthcare centers and hospitals, as well as on specific antibiotic groups known to be closely associated with increased resistance. Segmented regression analysis with interrupted time series data was used to analyze whether the COVID-19 pandemic had an impact in antibiotic prescribing tendencies at a national level. The outcomes from this quasi-experimental approach demonstrate that, at the beginning of the pandemic, a significant, immediate decrease in the over...

Abstract: For any individual to utilize the healthcare system falling sick is an entry point. But not every individual standing at this entry point is able to seek the facility provided. Despite of the government’s commitment to provide equity in access to healthcare, the utilization of health services is still below the acceptable standard. This study investigates various factors associated with the utilization of healthcare services. This was a cross-sectional study conducted in Haridwar district of Uttarakhand. A total of 450 samples were selected. A descriptive research design was employed for the study. The study indicates that 70.4% of the respondents agreed that they had utilized the health facility while 29.6% of the respondents failed to utilize the health facility. This study further explores various factors responsible for the inequity in access to healthcare.

Keywords: Socio-economic, healthcare, utilization, chi-square.

The use of antibiotics is the most important modifiable risk factor for the development of microorganism resistance. A cross-sectional study of outpatients receiving antibiotic prescriptions registered in a population database in Colombia was conducted. The characteristics of the consumption in capital cities and small municipalities was studied and the AWaRe classification was used. AWaRe classifies antibiotics into three stewardship groups: Access, Watch and Reserve, to emphasize the importance of their optimal use and potential harms of antimicrobial resistance. A total of 182,397 patients were prescribed an antibiotic; the most common were penicillins (38.6%), cephalosporins (30.2%) and fluoroquinolones (10.9%). 'Access' antibiotics (86.4%) were the most frequently prescribed, followed by 'Watch' antibiotics (17.0%). Being 18 or older, being male, living in a municipality, having one or more comorbidities and urinary, respiratory or gastrointestinal disorders increased the probability of receiving 'Watch' or 'Reserve' antibiotics. Penicillin and urinary antiseptic prescriptions predominated in cities, while cephalosporin and fluoroquinolone prescriptions predominated in municipalities. This analysis showed that the goal set by the WHO Access of mainly using Access antibiotics is being met, although the high use of Watch antibiotics in municipalities should be carefully studied to determine if it is necessary to design specific campaigns to improve antibiotics use.