Introduction: Janani Sishu Suraksha Karyakram (JSSK) is a flagship program of India to reduce out of pocket expenditure (OOPE) of the families during childbirth and neonatal sicknesses. Objectives: To assess the utilization of JSSK while availing services for childbirth and newborn care in a secondary care hospital in Southern India; estimate the OOPE in services covered by JSSK and identify the associated factors with OOPE. Methods: 228 mothers who delivered in the previous 2 days, were recruited from a secondary-level government hospital in Chittoor. Expenditure incurred under various components of JSSK was asked during the recruitment and subsequently through telephonic interviews. Results: All components of JJSK, except transport, were fully utilized by the families. 138 mothers (60.5%, 95% CI: 54.0, 67.0), and all sick children ( n = 138, 100%) who visited government hospital, incurred OOPE in the form of transport cost. The median expenditure of transport (from home to hospital and hospital to home) of the mothers was 250 INR (IQR: 100-513 INR). Transport expenditure was greater for the rural families (300 INR) than the urban families (100 INR) ( p < 0.05). In multiple logistic regression, nuclear families were associated with high OOPE (AOR- 2.0, 95% CI: 1.1- 3.7). Though education of the mother showed high association (AOR- 2.7, 95% CI: 1.0- 7.8), it was not statistically significant ( p = 0.05). Conclusion: The families utilize most of the components of JSSK, except transport. Family-centric counselling of the beneficiaries during antenatal check-ups and home visits by the healthcare workers can reduce transport-related OOPE.

Background Intra-regional cultural and linguistic differences are common in low- and middle-income countries. To sensitise undergraduate medical students to the social and contextual determinants of health to achieve the ‘health for all’ goal, these countries must focus on innovative teaching methods. The early introduction of a Community Orientation Program (COP) as a Community-based Medical Education (CBME) method could be a game changing strategy. In this paper the methods, evaluation, and implication of the COP in an Indian setting are described. Methods The curriculum of the COP was developed based on the analysis, design, development, implementation, and evaluation (ADDIE) model for educational intervention. In this learner-centric and supervised educational program, the key aim was to focus on developing students’ communication skills, observation power and enhancing their motivation for learning through collaborative learning. To meet the objectives of the COP, a situated learning model under the constructivism theory was adopted. Results Between 2016 and 2019, 557 students were trained through the COP by visiting more than 1300 households in ten villages. To supplement the students’ observations in the community, more than 150 small group discussions, a health education programme for the community and summary presentations were conducted. The students’ feedback indicated the need to improve the clinical examinations demonstration quality and increase the number of instruments for clinical examinations. More than 80% of students felt that the program would assist them to improve their communication skills, their understanding of the various socio-demographic factors associated with the common diseases, and it will enable them to respect the local culture during their clinical practice. Conclusions Early initiation of the COP as a CBME method in the undergraduate medical curriculum in an Indian setting has shown promising results. Further evidence is required to adopt such a program routinely for under-graduate medical teaching in the low- and middle- income settings.

BACKGROUND: The 2019-novel coronavirus (2019-nCoV) started as an epidemic later transformed into a pandemic causing a threat to public health globally. Any community to fight the COVID-19 pandemic requires adequate knowledge, attitude of the people, and practice of the government-imposed laws and regulations. Based on these factors, we framed the objectives to find the sociodemographic profile of the study group and to assess their knowledge, attitude, and practice (KAP) toward COVID-19. These results will help the health planners and administrators in each state to find out the gap in health education efforts. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted on South Indian population to know KAP toward COVID-19. A convenient sampling technique was used to collect the data using Google forms, and analysis was done using the SPSS software version 21. The questionnaire includes sociodemographic information, KAP questions toward COVID-19, and perception toward national and community responses. RESULTS: A total of 1644 were participated; the average knowledge score was 17.5 (+1.9). Most of them (92.9%) respondent's perceived that early detection will have a better outcome from COVID-19, whereas the knowledge compared with practice, there is a significant difference Pearson correlation (0.404) P is < 0.001. CONCLUSIONS: Although a high level of knowledge on COVID-19 in the public gradually decreasing the practice of preventive measures, the government should continue the consistent efforts to change the behavioral communication and motivate the public social responsibility to adhere to the health protocols, masking, hand hygiene, social distancing, and vaccination to prevent expected COVID-19 subsequent episodes.

Background: Nutrition rehabilitation centers (NRCs) were started to control severe malnutrition and follow-up of children with severe acute malnutrition is essential because mortality rate of 10-30% has been reported after discharge from hospital.Methods: A community based cross sectional study with the objectives to assess the current health status of the children discharged from the NRC and to assess the healthy practices learned by mothers during their stay at NRC. We included children those discharged from May to October 2013. The children were approached house to house visit and assessed for their health status with a pretested semi structured questionnaire. Mothers of the children were also interviewed for the knowledge and practices of the dietary and child care.Results: Among 67 children, 8 (11.9%) children could not be traced and 7 (10.4%) were reported dead, 52 were included 27 were boys and 25 were girls with a mean age of 35 months. The current nutritional status was 71.2% were not in very low weight, 17.3% were moderately underweight, and 11.5% were still severely underweight. Children who had more number of follow-ups had a better nutritional status which was significant (p<0.0001). 94% of the mothers had knowledge about correct feeding practices and food preparations; 86.5% were aware of good hygiene; 75% aware of the danger signs. Only 59.5% of the mothers could recollect the structured play therapy.Conclusions: Community based followup of the children following discharge from NRC and appropriate feedback to the mothers is very much essential for sustained results.

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