COVID-19 vaccination campaigns have been launched across the globe to mitigate the impact of the COVID-19 disease. However, COVID-19 vaccination campaigns (Vaccination campaigns are the complete process of COVID-19 vaccination campaigns beyond just administrating vaccines.) are a complex multi-stakeholder process, and therefore, it is important to understand the key components and drivers of vaccination campaigns to help devise strategies to increase vaccination coverage for existing and future vaccination efforts. A system dynamics modeling approach was used to trace the vaccination campaign for the Indian state of Madhya Pradesh. The results identified the key stakeholders of the vaccination campaign and their inter-linkages, and the diverse perspectives of stakeholders of vaccination campaigns in Madhya Pradesh were collated in a structured format. Further, system dynamics models were developed to capture all aspects of the vaccination campaign in Madhya Pradesh, including the challenges and innovations. The outcomes of the study can assist academicians, practitioners, and policymakers develop vaccination programs at sub-national, national, and global levels. They will guide decision-makers to take preemptive measures to mitigate possible risks and challenges and provide improved services as part of vaccination campaigns.
Background While immunization programs across the world have made considerable progress, children and communities continue to be beyond the reach of healthcare services. Globally, they are now referred to as zero-dose (ZD) children (those who have not received a single dose of diphtheria, pertussis, and tetanus-containing vaccine). Pre-COVID-19 pandemic analyses suggest that nearly 50% of vaccine-preventable deaths occur among ZD children. Two-thirds of these children live in extremely poor households suffering from multiple deprivations including lack of access to reproductive health services, water, and sanitation. Hence, ZD children have now been prioritized as a key cohort for identification and integration with the health systems as we build back from the pandemic. Methodology Extracting data from the last two National Family Health Survey (NFHS) rounds (NFHS 4, 2015-2016 and NFHS 5, 2019-2021), this study aims to ascertain the status of ZD children aged 12-23 months in India, the challenges, and the necessary action agenda going forward. Data were analyzed for equity determinants such as gender, place of residence, religion, birth order, caste, and mother’s schooling. Key determinants included the change in ZD prevalence at the national, state, and district levels; variations across equity parameters and states with maximum improvements; and disparity across these indicators. A correlation analysis was also conducted to understand the nature of the association between ZD prevalence and critical maternal and child health indicators. Results The overall ZD prevalence between the two rounds was reduced by 4.1% (10.5-6.4%). A total of 26 states in the country reported a ZD prevalence of <10% in NFHS 5 compared to 18 in NFHS 4. In total, 324 districts reported a ZD prevalence of <5%, and 145 districts reported a prevalence of >10%. The equity parameters reflected a slow-footed reduction among ZD for girl children, across urban geographies, firstborn children, mothers with 12 or more years of schooling, and children in families with the highest wealth quintiles. A negative correlation accentuated between the two NFHS rounds was established between first-trimester registration, four or more antenatal visits, institutional deliveries, and ZD prevalence. Conclusions The findings point toward sustained improvement across key equity parameters, however, challenges do exist. Moreover, the impact of the pandemic on immunization programs across the globe and in India is bound to halt and reverse the progress and potentiate further inequities. It is thus imperative that continued and augmented efforts are continued to identify, integrate, and immunize ZD children, families, and communities.
Internet has become the most important part of everyone’s life, especially the youth who are found to be dependent on it for various reasons, which is a direct effect of rapid expansion of technology around the globe. The present study was conducted to assess the magnitude of internet addiction among undergraduate students of health sciences of coastal Karnataka and to find the risk factors for internet addiction among undergraduate students of health sciences of coastal Karnataka. A cross-sectional study was conducted among 1300 students of a private university of coastal Karnataka. A pre-tested semi-structured questionnaire was used to collect data. Young’s Internet addiction test and depression, anxiety and stress test. Descriptive statistics were reported, and Chi-square test was used to assess the relationship between expected outcomes. Out of these 884 (68%) were females and 416 (32%) were males. Among the 1300 participants, 1118 (86%) were normal users, 156 (12%) had mild addiction, 26 (2%) had moderate to severe addiction.
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