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1 – 10 of over 2000Twenty-first century has dawned with substantial achievements in population health outcome indicators in India. However, very little is known on patterns in causes of death in…
Abstract
Purpose
Twenty-first century has dawned with substantial achievements in population health outcome indicators in India. However, very little is known on patterns in causes of death in India. The paper aims to discuss this issue.
Design/methodology/approach
In this paper, data was drawn from two sources namely, National Family Health Survey (NFHS-1, 1992-1993 and NFHS-2, 1998-1999) and published reports of Survey of Cause of Death (Rural). Three-years moving average causes-of-death estimates were calculated based on World Health Organization classification of causes of death. Negative binomial regression models were fitted to capture the effect of socio-demographic and behavioural determinants of patterns in causes of death.
Findings
The leading causes of death were heart diseases, tuberculosis, asthma, paralysis, prematurity and cancer. Three-fifth of the deaths to children under the age of ten was from communicable, maternal, perinatal and nutritional conditions. On the other hand, about two-third persons aged 45 years and above were dying from non-communicable diseases. Female were at greater risk of dying from non-communicable diseases (IRR: 1.22, 95 per cent CI: 1.11-1.34, p < 0.001).
Research limitations/implications
The epidemiologic transition in India has produced a shift in mortality from communicable, maternal, perinatal and nutritional conditions to non-communicable diseases, with little or no role played by injuries regardless of the level of all-cause mortality. Coupled with the effects of population age structures, other factors were also responsible for the bulk of the inter-regional disparities. These factors include differences in the populations’ health risks associated with the natural or built environments, prevalence of behavioural risk factors, or gaps in the capacities of health systems to respond to specific disease challenges, social stratification and others.
Originality/value
This paper described the trends, patterns and geographic variability in India’s causes-of-death profile in terms of communicable diseases, non-communicable diseases and injuries, and socio-economic and demographic determinants of patterns in the profile.
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In the same period, the share of deaths from communicable (or infectious) diseases has fallen from 30% to 23%. Yet there has been no corresponding shift in global development…
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DOI: 10.1108/OXAN-DB214124
ISSN: 2633-304X
Keywords
Geographic
Topical
Afshin Mehrpouya and Rita Samiolo
Through the example of a “regulatory ranking” – an index produced with the aim to regulate the pharmaceutical market by pushing companies in the direction of providing greater…
Abstract
Through the example of a “regulatory ranking” – an index produced with the aim to regulate the pharmaceutical market by pushing companies in the direction of providing greater access to medicine in developing countries – this chapter focuses on indexing and ranking as infrastructural processes which inscribe global problem spaces as unfolding actionable territories for market intervention. It foregrounds the “Indexal thinking” which structures and informs regulatory rankings – their aspiration to align the interests of different stakeholders and to entice competition among the ranked companies. The authors detail the infrastructural work through which such ambitions are enacted, detailing processes of infrastructural layering/collage and patchwork through which analysts naturalize/denaturalize various contested categories in the ranking’s territory. They reflect on the consequences of such attempts at reconfiguring global topologies for the problems these governance initiatives seek to address.
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Richard A.E. North, Jim P. Duguid and Michael A. Sheard
Describes a study to measure the quality of service provided by food‐poisoning surveillance agencies in England and Wales in terms of the requirements of a representative consumer…
Abstract
Describes a study to measure the quality of service provided by food‐poisoning surveillance agencies in England and Wales in terms of the requirements of a representative consumer ‐ the egg producing industry ‐ adopting “egg associated” outbreak investigation reports as the reference output. Defines and makes use of four primary performance indicators: accessibility of information; completeness of evidence supplied in food‐poisoning outbreak investigation reports as to the sources of infection in “egg‐associated” outbreaks; timeliness of information published; and utility of information and advice aimed at preventing or controlling food poisoning. Finds that quality expectations in each parameter measured are not met. Examines reasons why surveillance agencies have not delivered the quality demanded. Makes use of detailed case studies to illustrate inadequacies of current practice. Attributes failure to deliver “accessibility” to a lack of recognition on the status or nature of “consumers”, combined with a self‐maintenance motivation of the part of the surveillance agencies. Finds that failures to deliver “completeness” and “utility” may result from the same defects which give rise to the lack of “accessibility” in that, failing to recognize the consumers of a public service for what they are, the agencies feel no need to provide them with the data they require. The research indicates that self‐maintenance by scientific epidemiologists may introduce biases which when combined with a politically inspired need to transfer responsibility for food‐poisoning outbreaks, skew the conduct of investigations and their conclusions. Contends that this is compounded by serious and multiple inadequacies in the conduct of investigations, arising at least in part from the lack of training and relative inexperience of investigators, the whole conditioned by interdisciplinary rivalry between the professional groups staffing the different agencies. Finds that in addition failures to exploit or develop epidemiological technologies has affected the ability of investigators to resolve the uncertainties identified. Makes recommendations directed at improving the performance of the surveillance agencies which, if adopted will substantially enhance food poisoning control efforts.
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P. Padma Sri Lekha, E.P. Abdul Azeez and Ronald R. O'Donnell
Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming…
Abstract
Purpose
Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming popular in the Western world, its presence in the global context is not promising. This paper aims to explore the need for IBH in India and address its barriers to implementation and possible solutions.
Design/methodology/approach
We analyzed the case of IBH and its potential implications for India using the current evidence base, authors' reflections and experience of implementing similar programs.
Findings
This paper identifies contextual factors, including increased instances of non-communicable diseases and psychosocial and cultural determinants of health, that necessitate the implementation of IBH programs in India. The key features of different IBH models and their applicability are outlined. The current status of IBH and potential challenges in implementation in India in terms of human resources and other factors are delineated. We also discuss the potential models for implementing IBH in India.
Originality/value
Integrating behavioral health in primary care is considered an effective and sustainable model to promote health and well-being across various target populations. Towards this end, this paper is the first to discuss the contextual factors of IBH in India. It is a significant addition to the knowledge base on IBH and its possible implementation barriers and strategies in low- and middle-income countries.
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The 2003 global outbreak of Severe Acute Respiratory Syndrome (SARS) was an abrupt reminder that infectious diseases pose a continuing threat to human health. In 1967, U.S…
Abstract
The 2003 global outbreak of Severe Acute Respiratory Syndrome (SARS) was an abrupt reminder that infectious diseases pose a continuing threat to human health. In 1967, U.S. Surgeon General William H. Stewart declared “it was time to close the book on infectious diseases” (Garrett, 1994, citing W.H. Stewart, “A Mandate for State Action,” presented at the Association of State and Territorial Health Officers, Washington, DC, December 4, 1967). In the latter half of the twentieth century, many shared this bold view that medical science had vanquished infectious disease. As a result, public health struggled to remain relevant in the face of advances in pharmaceuticals, surgery, genetics and other areas that were becoming increasingly dominant in the quest to extend and enhance human life. SARS forced many to rethink the significance of public health and the crisis, though relatively short-lived, (for commentary on the disparities between the responses to HIV and SARS, see e.g. Altman (2003)) underscored the need to rebuild public health capacity that had been allowed to slip down the health system priority list.
Evangelia Tsagaki-Rekleitou, Vasiliki Oikonomou, Archonto-Dimitra Boukouvala, Maria Tsatsou, Theodora Skreka and Constantina Skanavis
There is no doubt that global climate change poses a threat to human health in a number of ways. Globally, 23% of all deaths in 2012 were attributed to the environment and an…
Abstract
There is no doubt that global climate change poses a threat to human health in a number of ways. Globally, 23% of all deaths in 2012 were attributed to the environment and an additional 250,000 potential deaths per year from 2030 to 2050 due to the effects of climate change. Heat waves, storms, droughts and floods pose an immediate risk of infectious diseases in humans. Temperature affects the survival rates of pathogens. Some populations and some areas are more vulnerable to infectious diseases due to their lack of ability to respond effectively to the stresses of high temperatures. Excessive rainfall could cause sewage to overflow and promote the onset and spread of infectious diseases ranging in severity from mild gastroenteritis to life-threatening illnesses such as cholera, dysentery and other diseases. Infectious diseases are a category of health problems that are particularly affected by climate change. Infections that occur are air-borne, water-borne and zoonotic. They are affected by the increase of the temperature, but also by the increase of the viral load in the water due to changes in the rainfall. Transmission can also take place through the migration of environmental refugees. Such an important topic could be the subject for students learning English. The purpose of this study will be to highlight the association of climate change with infectious-communicable diseases in order to take action and to create the structure by which students could learn English by studying these definitions.
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Saddaf Naaz Akhtar and Nandita Saikia
There is limited evidence on the determinants of hospitalisation and its causes in India. This study aims to examine the differential in the hospitalisation rates and its…
Abstract
Purpose
There is limited evidence on the determinants of hospitalisation and its causes in India. This study aims to examine the differential in the hospitalisation rates and its socioeconomic determinants. This study also examines the causes of diseases in hospitalisation among the elderly (≥60 years) in India.
Design/methodology/approach
This study used data from the 75th round of the National Sample Survey Organizations, collected from July 2017 to June 2018. The elderly samples in this survey are 42,759, where 11,070 were hospitalised, and 31,689 were not hospitalised in the past year or 365 days. This study estimated hospitalisation rates and carried out binary logistic regression analysis to examine the associations of hospitalisation with the background variables. The cause of diseases in hospitalisations was also calculated.
Findings
The hospitalisation rate was lower among elderly female compared to elderly male. Elderly who belongs to middle-old aged groups, non-married, North-Eastern region, Southern region, general caste, health insurance, partially and fully economically dependent have a higher chance of being hospitalised. About 38% elderly were hospitalised due to communicable diseases (CDs), 52% due to non-communicable diseases (NCDs) and 10% due to injuries and others (IO). Nearly 40% elderly were hospitalised in public hospitals due to CDs, whereas 52% were hospitalised in private hospitals due to NCDs and 11% due to IO.
Research limitations/implications
Firstly, this study is based on cross-sectional survey due to which temporal ambiguity averted to draw causal inferences. Secondly, other significant factors can also predict hospitalisations and provide insightful results, such as lifestyle factors, behavioral factors, obesity, mental state and several personal habits such as smoking cigarettes, drinking alcohol, consuming tobacco or other harmful substances. But this information was not available in this study. Even with these limitations, the hospitalisation issues among the elderly are beneficial to understand the current circumstances of CDs, NCDs and injury and other diseases for India and its states to formulate health policy.
Practical implications
Early screening and early treatment for NCDs are needed, which are non-existent in almost all parts of India. It is essential to necessitate and identify the important factors that best predict hospitalisation or re-visit of hospital admission. Although, the medical advances in India have made rapid strides in the past few decades, it is burdened none the less, as the doctor–patient ratio is very low. It is important to develop preventive measures to minimize the accidents and causalities to avoid substantial cost associated with elderly health care.
Social implications
Raising awareness, promotion of healthy life style and improving the quality of good health-care provisions at primary level is a necessity.
Originality/value
The findings, practical and social implications provide a way forward for the health policymakers to potentially alter the future research to reduce associated comorbidities, unnecessary hospitalisations and other medical complications.
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Joseph Bick, Gabriel Culbert, Haider A. Al-Darraji, Clayton Koh, Veena Pillai, Adeeba Kamarulzaman and Frederick Altice
Criminalization of drug use in Malaysia has concentrated people who inject drugs (PWID) and people living with HIV into prisons where health services are minimal and HIV-related…
Abstract
Purpose
Criminalization of drug use in Malaysia has concentrated people who inject drugs (PWID) and people living with HIV into prisons where health services are minimal and HIV-related mortality is high. Few studies have comprehensively assessed the complex health needs of this population. The paper aims to discuss these issues.
Design/methodology/approach
From October 2012 through March 2013, 221 sequentially selected HIV-infected male prisoners underwent a comprehensive health assessment that included a structured history, physical examination, and clinically indicated diagnostic studies.
Findings
Participants were mostly PWID (83.7 percent) and diagnosed with HIV while incarcerated (66.9 percent). Prevalence of hepatitis C virus (90.4 percent), untreated syphilis (8.1 percent), active (13.1 percent), and latent (81.2 percent) tuberculosis infection was several fold higher than non-prisoner Malaysian adults, as was tobacco use (71.9 percent) and heavy drinking (30.8 percent). Most (89.5 percent) were aware of their HIV status before the current incarceration, yet few had been engaged previously in HIV care, including pre-incarceration CD4 monitoring (24.7 percent) or prescribed antiretroviral therapy (ART) (16.7 percent). Despite most (73.7 percent) meeting Malaysia’s criteria for ART (CD4 <350 cells/μL), less than half (48.4 percent) ultimately received it. Nearly one-quarter (22.8 percent) of those with AIDS (<200 cells/μL) did not receive ART.
Originality/value
Drug addiction and communicable disease comorbidity, which interact negatively and synergistically with HIV and pose serious public health threats, are highly prevalent in HIV-infected prisoners. Interventions to address the critical shortage of healthcare providers and large gaps in treatment for HIV and other co-morbid conditions are urgently needed to meet the health needs of HIV-infected Malaysian prisoners, most of whom will soon transition to the community.
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Oluwafolahan Oluwagbemiga Sholeye, Victor Jide Animasahun, Albert Adekunle Salako and Adebisi Dare Oduwole
The rising incidence of non-communicable diseases in the developing world has remained a cause of concern for health workers. Childhood and adolescent obesity is on the increase…
Abstract
Purpose
The rising incidence of non-communicable diseases in the developing world has remained a cause of concern for health workers. Childhood and adolescent obesity is on the increase as a result of several issues including dietary habits. This paper aims to assess the pattern of snacking and sweetened beverage consumption among in-school adolescents in Sagamu, Nigeria.
Design/methodology/approach
A cross-sectional study was carried out among 620 in-school adolescents, selected via multi-stage sampling, using a semi-structured, self-administered questionnaire. Data were analyzed using SPSS 20.0. Relevant descriptive and inferential statistics were calculated, with p < 0.05.Participation was fully voluntary and strict confidentiality ensured.
Findings
All respondents consumed sugar-sweetened beverages, at different regularity; 78.5 per cent preferred carbonated drinks; 44.2 per cent consumed energy drinks, with a significant difference between males and females regarding the pattern of consumption of sweetened beverages (p = 0.042) and reasons for the choice of drinks (p = 0.009). Almost all (95.3 per cent) respondents snacked at varying frequencies, with more women (97.2 per cent) snacking than men (p = 0.008). Over 51.7 per cent of respondents snacked daily with no significant difference (p = 0.147) between males and females respondents regarding frequency of snacking. Pies and pastries were most frequently consumed. There was a significant difference (p = 0.007) between the preferences of male and female respondents.
Originality/value
The consumption of refined sugars was high among respondents, indicating presence of unhealthy dietary habits. Concerted efforts at nutrition education through the school system should be made to reduce the risk of non-communicable diseases among adolescents.
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