Nirankar Singh

A comparative evaluation of public health centers with private health training centers on primary healthcare parameters in India: a study by data envelopment analysis technique

Background: The evaluation of primary healthcare services provided by health training centers of a private medical college has not been studied in comparison with government health facilities in Indian context. Data envelopment analysis (DEA) is one such technique of operations research, which can be used on health facilities for identifying efficient operating practices and strategies for relatively efficient or inefficient health centers by calculating their efficiency scores. Materials and Methods: This study was carried out by DEA technique by using basic radial models (constant ratio to scale (CRS)) in linear programming via DEAOS free online Software among four decision making units (DMUs; by comparing efficiency of two private health centers of a private medical college of India with two public health centers) in district Muzaffarnagar of state Uttar Pradesh. The input and output records of all these health facilities (two from private and two from Government); for 6 months duration from 1st Jan 2014 to 1st July 2014 was taken for deciding their efficiency scores. Results: The efficiency scores of primary healthcare services in presence of doctors (100 vs 30%) and presence of health staff (100 vs 92%) were significantly better from government health facilities as compared to private health facilities (P < 0.0001). Conclusions: The evaluation of primary healthcare services delivery by DEA technique reveals that the government health facilities group were more efficient in delivery of primary healthcare services as compared to private training health facilities group, which can be further clarified in by more in-depth studies in future.

Impact of Indian public health standards for rural health care facilities on national programme for control of deafness in India: The results of a cohort study

Introduction: In National Programme for Prevention and Control of Deafness (NPPCD), the management of ear diseases of rural India is now guided by Revised Indian Public Health Standards (IPHS) for Rural Health Facilities for providing quality ear care. However, despite the IPHS existence, coverage and quality ear care is questionable. Moreover, this issue has not yet been studied till now in the Indian context. The objective of the study was to assess the role of Private Medical College Training Center (Rural Health Training Centre [RHTC]) in augmenting quality of ear care services in NPPCD at district level by adopting IPHS Standards. Materials and Methods: A combined retrospective and prospective cohort study was done at RHTC of a Medical College in West Uttar Pradesh from January 1, 2013, to December 31, 2017, by retrospective approach of selecting all ear patients (n = 3840) and prospective way of assessing the impact of IPHS for ear care. The semi-structured Pro forma was used in exploring the coverage and quality of ear care. The data were analyzed by Epi Info version 7.2. Results: Out of total 4817 ear, nose, and throat (ENT) patients, the majority of ear patients (n = 3840) were initially dissatisfied with coverage and quality of ear services provided by ENT specialists at RHTC. However, when IPHS exposure was given from July 1, 2015 to December 31, 2017, not only majority of patients were satisfied (n = 3110, 81%) but also ear curative treatment was significantly higher (n = 2120, 68.1% vs. n = 130, 17.8%, odds ratio = 9.8, RR = 1.5, P < 0.00001). Conclusions: Adherence to IPHS in NPPCD is essential for delivering better ear care by RHTC through primary health-care approach.

Predictors and consequences of “Phubbing” among adolescents and youth in India: An impact evaluation study

BACKGROUND: “Phubbing” phenomenon, in the frequent use of a smartphone, describes the habit of snubbing someone in favor of a mobile phone. Its predictors and consequences are few in developed countries, but the literature lacks information on its actual occurrence and impact on adolescents and youth in a developing country such as India. MATERIALS AND METHODS: This impact evaluation study was carried out as part of the Phubbing Project of the University of Poland for 6 months (November 15, 2016”May 15, 2017) on a sample of 400 adolescents and youth selected randomly from the five colleges in the district of Muzaffarnagar of Uttar Pradesh state in India. Data were collected through the Internet using e-questionnaires sent to all students. The phubbing predictors and consequences scales available in literature were used and data were analyzed by a mixed method to get the study findings. RESULTS: The prevalence of phubbing was 49.3%. The most important predictors associated with phubbers were Internet addiction (p < 0.0001, Odds Ratio 2.26), smartphone addiction (OR 25.9), fear of missing out (OR 18.8), and the lack of self-control (p < 0.0001, OR = 0.73”1.72) . Phubbing also had significant consequences on their social health, relationship health, and self-flourishing, and was significantly related to depression and distress. Logistic regression analysis showed significant impact of phubbing predictors on phubbing consequences in phubbers, especially in depressed and distress status. CONCLUSION: Adolescents and youth of India need special guidance from government adolescent clinics or colleges or even families to control this habit in order to promote better physical, mental, and social health.

Community-oriented Primary Care Services Model: Can it improve Morbidity Status in India? An Impact Evaluation Study

8 ABSTRACT Introduction: The community-oriented primary care (COPC) services model is an approach prescribed by the Medical Council of India for existing medical colleges in India from their respective urban and rural health training centers (RHTCs). However, the evidence of whether it is better as compared with pure primary health care approach in the Indian context is lacking in the literature. Therefore, it becomes imperative to study this area for its further expansion.

Study of effect of trainings on knowledge, perceptions and practices on vector borne diseases management among staff of health training center's in India

Background: In vector-borne diseases (VBDs) management; the effect of refresher trainings given to the staff of health training centers of the budding private medical colleges in India, has not been explored so far in Indian context and hence it becomes necessary to understand this area due to its future implications. Materials and Methods: A prospective training evaluation based study was carried out (on refresher training imparted of 6 days in every quarter) on the whole health training centers staff from July 1, 2013 to July 1, 2014 of two health training centers (rural and urban) attached to the private medical college in district Muzaffarnagar of India. Training responses in both pretraining and posttraining categories on knowledge, perceptions and practices were scaled, and these responses were tested for any significance by Chi-square test. Results: The basic qualifications and work experiences of health training centers staff were not sufficient enough to practice VBDs management in their area. The differences in training scores on knowledge, perceptions and practices among both training centers staff existed (e.g. lab-technician- χ 2 = 0.32 and 0.14, pharmacist- χ 2 = 0.11, 0.32 and 0.75), but they were not significant in any category of staff ( P > 0.05). Conclusions: Better qualified paramedical staff of health training centers in private medical colleges of India needs to be appointed and their refresher trainings also needs to be of high quality; in order to have their role in proper VBDs management practices in their area, so further research in this field is suggested in future, in order to get a better picture.