Background : In March 2018, the Government of India launched a direct benefit transfer (DBT) scheme to provide nutritional support for all tuberculosis (TB) patients in line with END TB strategy. Here, the money (@INR 500 [~8 USD] per month) is deposited electronically into the bank accounts of beneficiaries. To avail the benefit, patients are to be notified in NIKSHAY (web-based notification portal of India’s national TB programme) and provide bank account details. Once these details are entered into NIKSHAY, checked and approved by the TB programme officials, it is sent to the public financial management system (PFMS) portal for further processing and payment. Objectives : To assess the coverage and implementation barriers of DBT among TB patients notified during April–June 2018 and residing in Dakshina Kannada, a district in South India. Methods : This was a convergent mixed-methods study involving cohort analysis of patient data from NIKSHAY and thematic analysis of in-depth interviews of providers and patients. Results : Of 417 patients, 208 (49.9%) received approvals for payment by PFMS and 119 (28.7%) got paid by 1 December 2018 (censor date). Reasons for not receiving DBT included (i) not having a bank account especially among migrant labourers in urban areas, (ii) refusal to avail DBT by rich patients and those with confidentiality concerns, (iii) lack of knowledge and (iv) perception that money was too little to meet the needs. The median (IQR) delay from diagnosis to payment was 101 (67–173) days. Delays were related to the complexity of processes requiring multiple layers of approval and paper-based documentation which overburdened the staff, bulk processing once-a-month and technological challenges (poor connectivity and issues related to NIKSHAY and PFMS portals). Conclusion : DBT coverage was low and there were substantial delays. Implementation barriers need to be addressed urgently to improve uptake and efficiency. The TB programme has begun to take action.

Background: Elderly or senior citizens are the people who are of the age 60 and above. With the increase in ageing population, there is an increase in the prevalence of chronic diseases associated with old age. There is growing evidence that chronic diseases may lead to depression and vice versa. Objective: To assess the burden of depression among the elderly in the urban field practice area of a medical college and to study the association of depression with various socio-demographic variables and co-morbidities. Materials and Methods: It was a Community-based cross-sectional study, conducted among 229 elderly aged 60 years and above residing in the urban field practice area of a medical college of Mangalore. The study was conducted for a period of 3 months. Information regarding depression was obtained using pre-designed and pre-tested questionnaire, Geriatric depression rating scale (GDS-30) and information regarding socio-demographic variables were also obtained. The data obtained was analysed using SPSS 16.0. Result: Prevalence of depression was found to be 75.5% among the elderly population. Out of the total individuals with depression, mild depression was found to be present in 84.97%. Age and gender were the statistically significant predictors of depression (p<0.05). 53.3%, 49.8%, and 34.5% of the study participants were having diabetes mellitus, hypertension, and musculo skeletal problems, respectively and that were found to have statistically significant association with depression (p<0.05). Conclusion: Prevalence of depression was high among the study participants, necessitating stringent efforts towards creating awareness, early identification, and management.

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Background. Active case finding (ACF) for tuberculosis (TB) is a promising tool to enhance early case detection among marginalized populations. As opposed to passive case finding, it involves systematically searching for TB in individuals who would not spontaneously present for care. The National TB Program (NTP) of India has initiated ACF for TB through the existing general health system since the end of 2017. However, prior to scale-up, there is need for exploring the implementation challenges and solutions to improve the efficiency of this program. Objectives. (1) To explore the enablers and challenges in the implementation of ACF for TB by NTP in the Bengaluru rural district of Karnataka, South India, and (2) to explore the perceived solutions to improve the efficiency of ACF activity. Methods. A qualitative descriptive study was conducted in the Bengaluru rural district during July 2018. In-depth interviews using purposively selected health care providers involved in active case finding (n = 9) and presumptive TB patients (n = 8) were conducted. Manual content analysis was conducted by two independent researchers to generate categories and themes. Results. The challenges in conduct of ACF were as follows: inadequate training of health care workers, shortage of staff, indifferent attitude of community due to stigma, lack of awareness about TB, illiteracy, inability to convince patients for sputum test, and delay in getting CBNAAT results. The field staff recommended the installation of mobile CBNAAT machine, involvement of general health staff in activity, training of health workers on counseling of patients, and issue of identity cards for community health workers/volunteers so that people recognize them. Conclusion. The health system challenges in conduct of ACF need to be addressed by training the health staff involved in activity and also improving the access to TB diagnostics.

BACKGROUND: Adolescence is a vital stage of growth and development; however, many adolescents do die prematurely due to accidents, suicide, violence, poor mental stability, depression, and other illnesses that are either preventable or treatable. Life skills are important for the promotion of well-being of adolescents and to develop positive attitude and values to lead a healthy life. OBJECTIVES: The study was conducted to assess the change in life skills postintervention and study the association between different variables and the postintervention life skills score. MATERIALS AND METHODS: A quasi-experimental study was conducted among 137 adolescents each in urban and rural schools. Life skills training module based on ten domains of life skills given by the World Health Organization was implemented using interactive teaching–learning methods. After 6 months of implementation of life skills training sessions, a postintervention assessment was done using the life skills assessment scale, and the differences in the scores were measured. RESULTS: Higher life skills score was observed postintervention, and this difference was statistically significant ( P < 0.001). Higher postintervention mean score (above 15) was seen in critical thinking (19.58), self-awareness (18.03), creative thinking (15.78), and interpersonal thinking (15.15). CONCLUSION: Increase in the postintervention scores using an educational intervention module and interactive teaching–learning methods suggests effectiveness of the life skills education program. Implementing this health promotion module on life skills in the school curriculum will address the overall development of the personality of the school students.