Context: In spite of the high burden of tobacco consumption among migrants, disparities in the awareness of tobacco-related harms, health-seeking behaviors, and intention to switch to lower risk alternatives remain understudied area. Aims: Assess the social determinants in access to tobacco prevention and cessation support services among migrant construction workers in urban Chennai, India. Settings and Designs: A community-based, cross-sectional study design. Materials and Methods: A questionnaire adapted from GATS survey was used among migrants working across 13 construction sites of Chennai during May–September 2019. A counseling session was provided for the migrant workers who were willing to quit. Statistical Analysis Used: Data entered in MS Excel was analyzed using SPSS and multivariate analysis was performed. Results: Among 345 migrants, 338 (98%) were currently using tobacco and smokeless tobacco (57.4%) consumers. In spite of awareness (84.6%) about tobacco ill-effects on health, only 48% care providers enquired of the tobacco use in the previous one year. Pictorial health warnings were seen by 315 migrants (91.3%) in the past one month, but only 110 migrants (34.9%) considered quitting. The majority (341 migrants, 98.4%) have not heard of the lower risk alternatives such as nicotine gums and lozenges and only 89 migrants (26.33%) agreed to try lower risk alternatives for tobacco on trial basis. Migrant construction workers who were using tobacco less than 5 years ( P = 0.001) were more likely to try lower risk alternatives. Conclusions: Reappraising social determinants in access to tobacco prevention and cessation support services to migrant construction workers may be a promising strategy to reduce health harms of tobacco intake.

Background: Providing universal family planning services is an important strategy to reduce maternal morbidity and to control population growth. Worldwide, when contraception is used properly and effectively to avoid unwanted pregnancy it can reduce 25–35% of maternal deaths. The present study aimed at measuring the proportion of married women with unmet need for family planning in an urban area of Puducherry.Methods: A cross sectional study was conducted among 235 married women in the urban field practice area of Sri Venkateshwara Medical College Hospital & Research Centre, Puducherry. Participants were selected based on predetermined eligibility criteria using systematic random sampling method. SPSS version 23.0 was used for statistical analysis. Proportion, Mean, Standard deviation and Logistic regression were applied to interpret the results.Results: Mean age of the participants was 33.3 ±6 years, Nearly 77 %( 181) of the participants reported having used any method of contraceptive at least once and 34.5 %( 81) were found to have unmet need for family planning. The most common reason for unmet need for contraception was fear of side effects (39.5%) and others were infrequent sex (12.3%),insisted by family members (12.3%) and religious reasons (12.3%).Conclusions: Unmet need for family planning was found to be fairly high in our study population. Health care personnel, preferably field staff should be trained to give an informed choice of contraception to the eligible couples to reduce the unmet need for contraception.

Background: Medical leadership, an essential skill for the emerging medical graduates has been rarely studied in India.Methods: A formative research was undertaken among 30 interns selected by purposive sampling method. Triangulation of free listing, pile sorting was done to elicit their perception on leadership attributes. This was followed by a semi-structured focus group discussion to elicit the characteristics and solutions to obtain adequate leadership skills. The data was analysed using Visual Anthropac 4.98.1/X software.Results: Interns perceived communication skills, impartiality, patience, honesty, self-discipline, receptive to others opinions, knowledge of medicine, self-confidence, and guiding teams as major characteristics of effective medical leadership. The respondents admitted they were deficient in the understanding of leadership traits as it was not required of them as medical undergraduates. Internship period provided multiple platforms to develop leadership skills such as demonstrating personal qualities, working with others, goal setting and delivering services individually thereby overcoming a training gap during undergraduate period. Interns suggested that structured training on leadership skills and personality development coupled with exposure to challenging clinical environments during the undergraduate period will help them emerge as confident leaders.Conclusions: Medical education reforms should support the inclusion of leadership training in the MBBS curriculum.

Background: Integrated Child Development Scheme (ICDS) was launched in India during 1975, to tackle the high prevalence of malnutrition among under 5 children. NFHS 3 (2005-06) reports that only 33% of ICDS services were utilized by them. To ensure the effectiveness of the scheme, nutritional status of under 5 children and the form of nutritional supplement - either Hot Cooked Meals (HCM) or Take Home Ration (THR), preferred by the beneficiaries must be assessed. Methods: A Cross sectional study was done among under 5 children in 2015 for a period of 2 months, in three randomly selected villages, Rural Field Practice Area, Sri Venkateshwaraa Medical College Hospital & Research Centre, Puducherry. Weight and Height were measured for all the eligible children using standard procedures. World Health Organization (WHO) growth standards were used to assess their nutritional status. The mothers were enquired about the nutritional supplement utilization, type of nutrition supplement (HCM/THR) utilized by their children and the reasons for preference. Statistical significance was assessed by chi-square test. Results: Among 153 children enrolled, 138 (90%) were consuming HCM and 15 (10%) were THR utilizers. The overall prevalence of under nutrition was 59%. The prevalence of underweight, stunting and wasting were 28%, 28% and 38.5% respectively and it was found significantly (p value <0.05) higher among THR utilizers (74%, 60% and 53% respectively) than those receiving HCM (25%, 36% and 23%). Conclusions: HCM was preferred more than THR. The children receiving HCM were better nourished than THR utilizers.

Background: Global Adult Tobacco Survey-2 (GATS) reveals significant improvements in the decline of tobacco consumption in the past decades, however vulnerable population groups such as migrant construction workers tobacco consumption behaviors in Chennai remain understudied, thus the study was planned to estimate the socio-economic and environmental determinants for high tobacco consumption behaviors among interstate migrant construction workers in Chennai.Methods: A cross sectional survey was undertaken using a pre-tested structured questionnaire adapted from GATS survey questionnaire assessing the socio-demographic and environmental determinants for tobacco use among study population across 13 construction sites in Chennai during May-September 2019. Data was entered in MS-Excel and analysed using SPSS.Results: Among 345 migrant construction workers, mean age of the subjects was 28.42±8.7 years, 338 (98%) were current tobacco users by smoking, chewing, snuffing, of whom 198 (58.6%) used smokeless forms of tobacco like gutkha, khaini, chewing tobacco leaves, betel quid, tobacco snuff, 98 (29%) were smokers and 42 (12.4%) were dual users i.e. both cigarettes and beedis. Khaini (57%) is the dominant form of tobacco used among migrant construction workers. Mean age of initiation of tobacco use was 21.58 years and 21.17, and 22.73 and 19.5 years for smoking, SLT and dual users respectively. The migrant construction workers with no formal literacy(p=0.000), monthly income of more than 10000 (p=0.020) Indian rupees and migrants for less than one year duration (p=0.05)were more likely using the smokeless tobacco than any other socio demographic group.Conclusions: Tobacco prevalence especially smokeless tobacco use is alarmingly high among interstate migrant construction workers to Chennai.