The study findings show that PHR use had minimal impact on intermediate health outcomes and no significant impact on patient engagement among CAD patients.
Background/ObjectiveChildren and women comprise vulnerable populations in terms of health and are gravely affected by the impact of economic inequalities through multi-dimensional channels. Urban areas are believed to have better socioeconomic and maternal and child health indicators than rural areas. This perception leads to the implementation of health policies ignorant of intra-urban health inequalities. Therefore, the objective of this study is to explain the pathways of economic inequalities in maternal and child health indicators among the urban population of India.MethodsUsing data from the third wave of the National Family Health Survey (NFHS, 2005–06), this study calculated relative contribution of socioeconomic factors to inequalities in key maternal and child health indicators such as antenatal check-ups (ANCs), institutional deliveries, proportion of children with complete immunization, proportion of underweight children, and Infant Mortality Rate (IMR). Along with regular CI estimates, this study applied widely used regression-based Inequality Decomposition model proposed by Wagstaff and colleagues.ResultsThe CI estimates show considerable economic inequalities in women with less than 3 ANCs (CI = −0.3501), institutional delivery (CI = −0.3214), children without fully immunization (CI = −0.18340), underweight children (CI = −0.19420), and infant deaths (CI = −0.15596). Results of the decomposition model reveal that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical factors contributing to economic inequalities in maternal and child health indicators. The residuals in all the decomposition models are very less; this implies that the above mentioned factors explained maximum inequalities in maternal and child health of urban population in India.ConclusionFindings suggest that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical pathways through which economic factors operate on inequalities in maternal and child health outcomes in urban India.
Despite the existence of several policies and programs, anemia among pregnant and lactating women continues to be a serious concern for public health policy in India. The main objective of this study is to examine the prevalence and determinants of anemia among pregnant and lactating versus nonpregnant nonlactating (NP-NL) women for priority setting in health policies of the country. Data from the National Family Health Survey (NFHS3) conducted in 2005-2006 has been used for the analyses of this study. The results revealed that the prevalence of anemia was higher among lactating women (63%), followed by pregnant women (59%) than NP-NL women (53%). Younger lactating (71%) and older pregnant women (67%) had a higher burden of anemia. Along with socioeconomic factors, demographic indicators such as children ever born and program factors like nutrition advice and supplementary nutrition during anti natal care and postnatal care emerged as significant predictors in the case of anemia among both pregnant and lactating women, while socioeconomic indicators emerged as critical factors in the case of anemia among NP-NL women. Hence, targeting demographic and program factors, along with key socioeconomic and demographic factors in public health policy, is critical in reducing anemia among lactating and pregnant women, while targeting significant socioeconomic factors is the key for reducing anemia among NP-NL women.
Directly observed therapy (DOT) for monitoring tuberculosis (TB) treatment is intended to reduce disease transmission, mortality and acquired drug resistance by facilitating treatment adherence and support. Synchronous (S-VOT) and asynchronous (A-VOT) video observed therapy are mHealth solutions for remotely monitoring medication ingestion. This paper synthesizes literature through December 2018 to describe existing VOT approaches, summarize evidence, identify knowledge gaps, evaluate VOT strengths and weaknesses, and examine patient and provider factors influencing VOT feasibility and acceptability. High rates of adherence and patient acceptance were obtained using both VOT methods. VOT reduced travel time for TB program staff and/or patients, improving program efficiency compared to in-person DOT while maintaining high patient satisfaction. The impact of VOT on TB treatment outcomes, such as cure and relapse, require further study with longer follow-up. Individual patient, provider and program factors should be considered in selecting either or both VOT approaches for provision of patient-centered care.
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