Background Coronavirus disease 2019(COVID-19) pandemic is recognized as a major threat to human health in 2020. As the disease is new and spreading quickly, the scientific community is reporting new information daily to address this issue. The public is well informed and is ready to adopt the protective and preventive measures suggested by the authorities. Aim & objective This study is aimed at understanding the perception towards the pandemic using the Health Belief Model (HBM) approach, preparedness measures adopted, opinion and confidence towards various Governmental activities and control measures. Methods and material A Cross-sectional survey was conducted among adults across the Kerala state using modified WHO Cosmo protocol and questionnaires implemented through google forms in late April during the preparedness phase of the disease. Statistical analysis The results were explained using descriptive and Binary Logistic Regression analysis using SPSS version 22. Results Among the 680 participants, 675 (99.3%) were aware about COVID-19 and 598 (88%) had good knowledge. Behavioural change was observed in 638 (93.8%) and variables in Health Belief Model showed a significant association with behavioural change. Conclusions Most people living across Kerala approached the COVID-19 pandemic in a similar manner, irrespective of age, education, or relation to the healthcare field. Perceptions of the community as explained by Health Belief Model was greatly influenced by the primary health care approach by the government and for the subsequent behavioural change.

ASHAHealth system a b s t r a c t Non-communicable diseases (NCDs) have emerged as a major public health challenge in India and more so in Kerala. Realizing this, NRHM conducted a pilot intervention programme in Neyyattinkara Taluk of Thiruvananthapuram district through the existing health system. A process evaluation of the pilot programme can bring out unbiased gaps in the implementation and necessary modification can be suggested.Aims: To evaluate the NCD control pilot programme.Methods: qualitative methods e Fifty-five in-depth interviews (IDI) and 8 Focus Group Discussions (FGD) were conducted.Results: The programme proceeded with an action plan as there was no written programme document. Training was good in terms of clinical aspects; but sensitization regarding the programme was inadequate. The quality of data from the field surveys by Accredited Social Health Activists (ASHA) varied from place to place. The detection camps were overcrowded. Programme was well supported (Funds, Logistics) by NRHM, All patients who were examined by doctors were given medicines for one month and were kept under close follow up by ASHA, and enabled to gain confidence of the community. Conclusions:The programme could change the attitude of community regarding health care delivery. The study points to the need for pro-activeness in program management and a clear programme guideline to all the supervisors and implementers. People should be made aware of the program services and benefits through social mobilization campaigns.Quality medicines & equipments should be made available for the detection camps. ASHA can play an important role in controlling NCDs at the community level.

Even though pregnant women are more prone to have severe COVID 19, few studies have been conducted on their protective behaviours against this disease in our country during the COVID-19 pandemic. Fear of getting COVID infection may prevent antenatal women from visiting hospitals for routine antenatal checkups and utilization of telemedicine may be an alternative to get connected with their health care providers during the pandemic. Aims: To evaluate the protective behaviour adopted by pregnant women during the COVID pandemic and their utilization of teleconsultation for antenatal care. Methods: A cross- sectional study was conducted among pregnant women attending three selected hospitals in Trivandrum District in Kerala during May to August 2020. The data was collected from a random sample of 252 pregnant women registered in these hospitals using a self-administered semi-structured questionnaire. Results: Around 89% of pregnant women had adopted good practice to protect themselves against the COVID 19. About 94% wore a mask whenever they went outside. About 72% completely avoided crowded place. About 72% had rated themselves to have good or very good knowledge regarding protective measures of COVID 19. Among the pregnant women, 61(24.2%) missed their scheduled antenatal visit once, 32(12.7%) missed twice and 8(3.2% missed three or more times during the pandemic period. Half of the pregnant women utilized telemedicine facility during the pandemic to stay connected with their doctors. But 31% were not aware of telemedicine facility in hospitals, while 1.6% does not have an internet access. Higher age group, current employment status and area of residence was found to be associated with poor practice. Conclusions: Nearly 89% pregnant women adopted good protective measures against COVID19. Measures need to be taken to improve the availability of telemedicine facility in hospitals for antenatal women and to improve awareness about it among public which may help the antenatal women to stay connected with their health care providers during this pandemic.

Introduction: As the pandemic of COVID-19 stretches, its wings across the different parts of the world over the past few months, it is very likely that mental health problems increase, particularly among the health-care workers who have higher risk of exposure to the disease and also to sufferings of the people affected with the disease. Objective: To assess the prevalence and factors associated with depression, anxiety, and stress among health-care workers from Kerala during the COVID-19 pandemic. Materials and Methods: A cross-sectional study among 544 health-care workers from Kerala was conducted by a self-administered online questionnaire in Google Forms by chain referral sampling with Depression, Anxiety, and Stress Scale-21 scale during initial phase of the COVID-19 pandemic. The tests of significance used were Mann–Whitney U-tests and Kruskal–Wallis tests. Odds ratios and 95% confidence interval are estimated. Results: During the early pandemic period, 9.7% of health-care workers had mild depression and 13.3% had moderate-to-severe depression. While 4% had mild anxiety and 3.5% had moderate-to-severe anxiety, about 6.8% had mild stress and 6.4% had moderate-to-severe stress. The anxiety symptoms were significantly higher among nurses compared to doctors. Emotional and social support from higher health authorities is a significant protective factor against stress and depression. Frontline workers have 84% higher risk to have depression. Conclusions: Frontline health-care workers who are directly involved in the screening, diagnosis, treatment, and care for patients with COVID-19 are at higher risk of experiencing poor mental health outcomes. Emotional and social support from higher health authorities is a significant protective factor against depression and stress among health-care workers.

Introduction: In this modern era of technology, Information and Communication Technology (ICT) has made a very big revolution. Telemedicine is an emerging concept in health care services in Kerala, its implementation has not been satisfactory and successful. It is cost effective and provides easy access to healthcare services for people anywhere and especially during pandemic situations like this. A study is required in the domain of awareness and skill of doctors to facilitate its adoption and implementation. There was an urgent need to devise means for patients to consult doctors during Coronavirus Disease 2019 (COVID-19) pandemic. Aim: To assess the level of awareness and skill among doctors practicing modern medicine during COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted among 535 modern medicine doctors of Kerala from June 2020 to May 2021, using a structured self-administered questionnaire designed for the study. The total scores of awareness and skill calculated and categorised as poor, moderate, and good. Data was analysed by Statistical Package for the Social Sciences (SPSS) version 20.0 software by IBM. The Chi-square test/ Fisher’s-Exact test was used as test of significance. Results: Mean age of the study participants were 40.44±10.66 years, with majority 326 (60.94%) been females. Among the 535 doctors participated, 68.22% had moderate skill, 27.85% have good skill and only 3.92% have poor skill. Years of experience of doctors ranged from 1 to 48 with mean of 13.47±10.46 years. In majority, 431 (80.56%) of the participants, had moderate awareness about the telemedicine practice. Poor awareness was present in 19 (3.55%) doctors. 46.54% believes that specific software training is required for practicing telemedicine. Conclusion: The study showed that 15.89% had good awareness, while 80.56% of the participants had moderate awareness about the telemedicine. Only 27.85% of doctors had good skill, while 68.22% had moderate skill. Even though, awareness and skill of doctors practicing modern medicine are favourable, more webinars or workshops are needed to improve their knowledge.