Indian Journal of Community Health
type: channel
description: ​The Indian Journal of Community Health (IJCH, ISSN: 0971-7587 (Print); 2248-9509 (Online)), is the official organ & the official journal of the Indian Association of Preventive and Social Medicine (IAPSM) . It is a peer-reviewed journal which is published Bimonthly .
publisher: Indian Journal of Community Health
language: en
publication name: Indian Journal of Community Health
issn: 0971-7587
items: Suicidal Ideation, Emotional Well-being, and Barriers to Help-Seeking Among Medical Students in Western Uttar Pradesh: A Mixed-Methods Cross-Sectional Study
items: Awareness, Attitude, Practice, and Associated Socio-demographic Factors of Breast Self-examination among Women in Urban Slums of Bhubaneswar: a Community-based Cross-Sectional Study
items: Association of Comorbidities with Quality of Life among Patients with Type 2 Diabetes Mellitus in Urban Meerut: A Community-Based Cross-Sectional Study
items: Comparing Compliance and Tolerability of Ferrous Ascorbate versus Ferrous Sulphate in Pregnancy: A Prospective Community-Based Study
items: A Scoping Review on Institutionalization of Packaged Food Consumption in Academic Settings and Its Role in Promoting Diabetes Risk
items: Impact of Antenatal Education on Essential Newborn Care Knowledge among Pregnant Women: A Randomized Controlled Trial from Rural Bihar
items: Psychosocial Determinants of Depression, Anxiety, and Stress among Hostel-Residing Medical Students: A Cross-Sectional Study from Western Uttar Pradesh, India
items: Addressing mental health needs in shelter homes: lessons from a case study in Uttarakhand, India
items: The Digital Health Paradox: Bridging Equity Gaps Through Assisted Digital Models in Primary Care
items: Perceived Awareness Versus Actual Knowledge of E-Waste and Its Disposal Practices Among Medical Students at a Tertiary Care Teaching Institution in Uttar Pradesh, India
items: Prevalence and Determinants of Red Flag Symptoms of Cancer among Adults in rural areas of Puducherry, India: A Community-Based Cross-Sectional Study
items: Stakeholder Perceptions of National Quality Assurance Standards (NQAS) Implementation in Urban Primary Health Centres of Berhampur, Odisha: A Qualitative Study.
items: Knowledge, Attitudes and Practices regarding Dog Bite Management Among First-Year Paramedical Students in Etawah, Uttar Pradesh: A Cross-Sectional Study
items: Wildlife-Livestock-Human-Interface: An Urgent Public Health Concern Demanding Strengthened One Health Action in India
items: Beyond Childhood: The Case for Adult Vaccination in India
items: Impact of Health Education on Menstrual Hygiene among Adolescent Girls in Selected Rural Schools of Bihta Block, Patna, Bihar: A Pre–Post Interventional Study
items: Road Traffic Accidents and Associated Factors among Victims Attending a Tertiary Care Hospital in Rajnandgaon: A Cross-Sectional Study
items: Prevalence of Stress, Anxiety and its association with Sleep Quality among Undergraduate Medical Students in a Medical College in Eastern India: A Cross-Sectional Study
items: From Coverage to Effective Protection: Reading NSS 80, NFHS-6 and National Health Accounts for Viksit Bharat 2047
items: Analysis of Acute Diarrheal Disease in In-Patient Department at a Tertiary Hospital: A Retrospective Study
items: Prevalence of malnutrition among adolescent girls in North Kerala: A cross-sectional study

Suicidal Ideation, Emotional Well-being, and Barriers to Help-Seeking Among Medical Students in Western Uttar Pradesh: A Mixed-Methods Cross-Sectional Study
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description: *]:pointer-events-auto R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id="request-WEB:1cdd3720-0fd7-4325-b268-87d3d5153b0a-0" data-turn-id-container="request-WEB:1cdd3720-0fd7-4325-b268-87d3d5153b0a-0" data-testid="conversation-turn-2" data-turn="assistant"> Background: Medical students experience substantial academic and psychosocial stressors that increase vulnerability to suicidal ideation. Evidence from Indian medical colleges using validated measures and adjusted analyses remains limited. Methods: A convergent mixed-methods cross-sectional study was conducted among 400 medical students at UPUMS, Saifai, Uttar Pradesh. Twelve-month suicidal ideation was assessed using item 2 of the Suicidal Behaviors Questionnaire-Revised (SBQ-R). Emotional well-being was measured using the WHO-5 Well-Being Index. Multivariable logistic regression identified independent predictors of suicidal ideation. Open-ended responses from students reporting suicidal ideation were analyzed thematically to explore barriers to help-seeking. Results: The prevalence of 12-month suicidal ideation was 20.5% (82/400). Lower WHO-5 scores were strongly associated with suicidal ideation (AOR 0.96 per unit increase, 95% CI 0.94-0.97; p<0.001), indicating a protective effect of better emotional well-being. Hostel residence was independently associated with higher odds of suicidal ideation (AOR 1.87, 95% CI 1.02-3.42; p=0.043). Male gender showed a borderline association (AOR 1.61, 95% CI 0.98-2.65; p=0.061). Although 53.5% of students were aware of campus mental health services, only 19.5% had ever used them. Five themes emerged as barriers to help-seeking: stigma, confidentiality concerns, perceived academic consequences, structural access barriers, and emotional avoidance. Conclusions: One in five medical students reported suicidal ideation. Lo…
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creator: Amit Kumar
creator: Anurag Verma
creator: Dr Swati
creator: Nikhil Bharti
creator: Dr. Sandip Kumar
creator: Parul Roy
creator: Hira Kant Sinha Sinha
rights: Copyright (c) 2026 Dr Amit Kumar (Author); Anurag Verma (Corresponding Author); Dr Swati, Nikhil Bharti, Dr Sandip Kumar, Dr Parul Roy, Dr Hira Kant Sinha (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.007

Awareness, Attitude, Practice, and Associated Socio-demographic Factors of Breast Self-examination among Women in Urban Slums of Bhubaneswar: a Community-based Cross-Sectional Study
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description: Background: Breast cancer is the most common cancer affecting Indian females. Thus, early detection in order to improve the breast cancer outcome and survival remains the cornerstone of breast cancer control. While mammography might be cost-intensive, breast self-examination is feasible and free of cost for screening for early detection of cancer of the breast. This study was conducted to assess the Awareness of BSE and Knowledge, Attitude and Practice of breast self-examination (BSE) and its associated factors. Methodology: Study was conducted in selected 13 urban slums of Bhubaneswar which comes under the field practice area of IMS and SUM Hospital in Department of Community Medicine among 300 women aged 18-70 years. Results: Among 300 participants, 132 (44%) were aware of BSE. Awareness was significantly associated with education above high school, employment, and age group. Only 1.5% of aware participants reported performing BSE every month, and only 45 of 132 women (34%) had ever practiced BSE. Education above high school was significantly associated with ever practicing BSE and remained significant in multivariable analysis. Conclusion: Community-based health education and behavior change communication should focus on improving knowledge of breast cancer, correct BSE technique, and regular practice among women in underserved urban settings.
subject: Original Research Articles
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creator: Ria Ganguly
creator: Lipilekha Patnaik
creator: Trilochan Sahu
rights: Copyright (c) 2026 Lipilekha Patnaik (Corresponding Author); Ria Ganguly, Trilochan Sahu (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.009

Association of Comorbidities with Quality of Life among Patients with Type 2 Diabetes Mellitus in Urban Meerut: A Community-Based Cross-Sectional Study
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description: Background: Type 2 Diabetes Mellitus (T2DM) is frequently associated with multiple comorbidities that adversely affect patients’ quality of life (QoL). Understanding the burden of comorbid conditions and their relationship with QoL is essential for comprehensive diabetes care. Aim & Objectives: To find out the prevalence of comorbidities among patients with T2DM and to determine their association with quality of life. Settings and Design: Cross-sectional study done among Type-2 Diabetes mellitus patients in an urban area of Meerut. Methods and Material: A Community-based cross-sectional study was carried out among 350 T2DM patients. Data regarding socio-demographic profile, presence and number of comorbidities were collected. Quality of life assessment was done using standardized Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Statistical analysis used: Statistical analysis included descriptive statistics, Mann–Whitney U test, and comparison of mean scores across number of comorbidities. Results: Among 350 participants, 67.7% had at least one comorbidity. Obesity (57.4%) was the most common co-morbid condition followed by hypertension (56%). Participants with comorbidities had significantly lower median PCS (50 vs 100), MCS (60 vs 80), and overall QoL scores (60 vs 100) compared to those without comorbidities (p<0.001). Mean QoL scores progressively declined with increasing number of comorbidities. Conclusion: Presence and increasing number of comorbidities significantly impair quality of life among patients with T2DM. Integrated management addressing multiple comorbidities is essential to improve overall wellbeing.
subject: Original Research Articles
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creator: Kraty Singh
creator: Seema Jain
creator: Sanjeev Kumar
creator: Ganesh Singh
rights: Copyright (c) 2026 Kraty Singh, Seema Jain, Sanjeev Kumar, Ganesh Singh (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.011

Comparing Compliance and Tolerability of Ferrous Ascorbate versus Ferrous Sulphate in Pregnancy: A Prospective Community-Based Study
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description: Context/Background: Poor compliance with Iron and Folic Acid (IFA) supplementation, often due to adverse effects from Ferrous Sulphate, severely limits efforts to reduce anaemia prevalence in Indian pregnancy. Aims/Objectives: To compare the patient compliance rates and tolerability profiles of Ferrous Sulphate and Ferrous Ascorbate formulations in an operational community health setting. Methodology: This prospective observational study enrolled 110 pregnant women (55 received Ferrous Sulphate; 55 received Ferrous Ascorbate) from the designated field practice areas of medical college in two districts of Madhya Pradesh. Compliance (primary outcome) and adverse effects were collected over follow-up visits spanning 8-10 weeks. Limitations include the non-randomized allocation of groups and the reliance on self-reported compliance. Statistical analysis included the Chi-square test and logistic regression. Results: Full compliance was significantly higher with Ferrous Ascorbate (78.2%) than with Ferrous Sulphate (56.4%) (p = 0.014). Adverse drug effects were the dominant reason for partial compliance in in both the Ferrous Sulphate group (87.5%) and the Ferrous Ascorbate group (58.3%). The incidence of nausea/vomiting was notably higher with Ferrous Sulphate (56.4% vs. 34.5%, p=0.027). Conclusions: Ferrous Ascorbate is associated with superior tolerability and significantly higher compliance in a community setting compared to standard therapy. Prioritizing a better-tolerated iron formulation is a crucial, modifiable strategy to enhance the effectiveness of national anaemia prevention programs.
subject: Original Research Articles
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creator: Dr Akhil R Nair
creator: Dr Rama Singodiya Lodha
creator: Dr Harshima Sawlani
rights: Copyright (c) 2026 Dr Akhil R Nair, Dr Rama S Lodha, Dr Harshima Sawlani (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.013

A Scoping Review on Institutionalization of Packaged Food Consumption in Academic Settings and Its Role in Promoting Diabetes Risk
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description: Background: The global burden of type 2 diabetes mellitus (T2DM) is escalating at an unprecedented rate, with 536.6 million adults affected worldwide as of 2021, a figure projected to rise to 783 million by 2045. India alone harbours over 77 million adults with diabetes, the second-largest absolute burden globally. Ultra-processed foods (UPFs), classified under the NOVA food system, have emerged as a robust, dose-dependent dietary risk factor for T2DM. Despite this evidence, academic institutions including medical colleges and teaching hospitals remain an overlooked micro-environment where packaged UPF consumption is normalised through routine distribution at seminars, conferences, and grand rounds. This is particularly paradoxical in health-sector institutions whose mandate is chronic disease prevention. Objective: To compile data associating the intake of ultra-processed foods to the risk of type 2 diabetes, investigate the impact of academic institutional food environments on dietary habits, and determine evidence-based approaches for institutional food environment reform in the Indian setting. Methods: This scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines (Tricco et al., 2018; Ann Intern Med). A systematic search was performed across PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar for studies published January 2000 to March 2025. The research question was framed using the Population–Concept–Context (PCC) framework. Two independent reviewers screened records and extracted data using a structured charting form. Thematic synthesis addressed five domains: UPF epidemiology, pathophysiological mechanisms, institutional food environments, India-specific evidence, and policy recommendations. Results: A total of 1,412 records were identified; 68 studies met full eligibility. Evidence consistently demonstrates a hazard ratio of 1.24 (95% CI 1.14–1.34) for the highest versus lowest UPF consumption c…
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creator: Sameena Ahmad
creator: Asra Ahmed
creator: UZMA ERAM
rights: Copyright (c) 2026 Sameena Ahmad (Author); Asra Ahmed (Corresponding Author); DR. UZMA ERAM (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.002

Impact of Antenatal Education on Essential Newborn Care Knowledge among Pregnant Women: A Randomized Controlled Trial from Rural Bihar
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description: Background: Essential Newborn Care (ENC) encompasses key practices such as early and exclusive breastfeeding, thermal protection, hygienic cord care and recognition of danger signs. Despite improvements in institutional delivery coverage, gaps in maternal knowledge regarding ENC remain a major contributor to neonatal morbidity and mortality in rural Bihar. This study assessed the effectiveness of structured antenatal education in improving ENC knowledge among pregnant women. Methods: A single-blind, parallel-group randomized controlled trial was conducted among 132 pregnant women in their third trimester from a rural part of Bihar, India. Participants were randomly allocated to an intervention group or a control group. Baseline ENC knowledge was assessed using a pretested structured questionnaire. The intervention group received structured antenatal education using a flipchart-based module, while the control group received routine antenatal counselling only. Knowledge assessment was repeated two months postpartum. Data were analyzed using appropriate descriptive and inferential statistics, including logistic regression to identify predictors of knowledge improvement. Results: Baseline knowledge scores were comparable between the two groups. At follow-up, the intervention group demonstrated a significant improvement in overall ENC knowledge compared to the control group (p < 0.001). Women receiving antenatal education were nearly fourteen times more likely to demonstrate knowledge improvement (AOR=13.98; 95% CI: 5.56-25.15). Multivariate analysis revealed that antenatal education was the strongest predictor of knowledge improvement. Conclusions: Structured antenatal education using flipcharts significantly improves maternal ENC knowledge. Incorporating such focused educational interventions into routine antenatal services can strengthen maternal preparedness and may improve newborn care practices in resource-limited settings.
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creator: Sundhareshwaran Chandrasekaran
creator: Dharmvir Ranjan Bharati
creator: Sanjay Kumar
creator: Nidhi Prasad
creator: Naveen Hema Rajendran
rights: Copyright (c) 2026 Dr. Sundhareshwaran Chandrasekaran (Corresponding Author); Dr. Dharmvir Ranjan Bharati, Dr. Sanjay Kumar, Dr. Nidhi Prasad, Dr. Naveen Hema Rajendran (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.012

Psychosocial Determinants of Depression, Anxiety, and Stress among Hostel-Residing Medical Students: A Cross-Sectional Study from Western Uttar Pradesh, India
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description: Background: Medical students are widely recognized as a high-risk population for psychological distress; however, existing research has predominantly emphasized academic stressors, often overlooking the combined influence of residential and familial psychosocial environments. Moreover, region-specific evidence from North India remains limited. Objective: This study aimed to evaluate the psychological environment and mental well-being of hostel-residing MBBS students and to examine the relative contribution of hostel- and home-related psychosocial factors to depression, anxiety, and stress. Methods: An institution-based analytical cross-sectional study was conducted among 140 second-year MBBS students residing in hostels of a tertiary care teaching medical college in Western Uttar Pradesh. Mental well-being was assessed using the validated Depression Anxiety Stress Scale–21 (DASS-21). Psychosocial variables related to hostel and home environments were analyzed using multivariate logistic regression to identify independent associations. Results: The prevalence of depression, anxiety, and stress was 59.29%, 66.43%, and 35.00%, respectively. Moderate depression and extremely severe anxiety were most frequently observed. Hostel-related interpersonal conflicts and communication avoidance were significantly associated with depression and anxiety, while feelings of uneasiness within the hostel environment were linked to stress. Conclusion: By integrating hostel and home psychosocial domains within a single analytical framework, this study provides context-specific evidence highlighting non-academic determinants of medical student mental health.
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creator: Varsha Chaudhary
creator: Dr Rijul Ranjan
creator: Pawan Parashar
creator: Anshul Kumar
creator: Vansh Malohtra
creator: Anjali Sharma
creator: Himan Yadav
rights: Copyright (c) 2026 Dr Rijul Ranjan (Corresponding Author); Varsha Chaudhary, Pawan Parashar, Vansh Malohtra, Himan Yadav, Anjali Sharma, Anshul Kumar (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.016

Addressing mental health needs in shelter homes: lessons from a case study in Uttarakhand, India
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description: Mental health is increasingly recognized as integral to overall well-being, yet stigma, systemic neglect, and limited access to services remain major barriers in India, where nearly 197 million people are affected. Homeless individuals, particularly women, face compounded challenges, with shelter homes often lacking adequate medical and psychosocial support. This case study from Mahila/Kishori/Kishor Kalyan Kendra in Kedarpur, Uttarakhand, highlights how targeted reforms transformed a women’s shelter home into a rehabilitative space. Initiatives between 2016–17 improved safety, sanitation, nutrition, medical care, and psychosocial engagement. Structured activities, vocational training, and financial inclusion promoted empowerment, while family tracing and reunification efforts restored dignity and social belonging. Outcomes included significant reductions in acute psychosis, improved physical rehabilitation, and over 450 successful reunifications, including cross-border cases. The Uttarakhand model demonstrates that low-cost, comprehensive interventions can break the cycle of homelessness and mental illness, aligning with global frameworks such as WHO’s Mental Health Action Plan. Scaling such approaches across India could reposition shelter homes as transitional spaces fostering recovery, reintegration, and long-term resilience.
subject: Case Report/ Case Series
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creator: Bhupinder Kaur Aulakh
rights: Copyright (c) 2026 Bhupinder Kaur Aulakh (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.018

The Digital Health Paradox: Bridging Equity Gaps Through Assisted Digital Models in Primary Care
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description: Digital health has emerged as a transformative force in healthcare delivery, offering opportunities to improve access, efficiency, and continuity of care. However, a paradox persists: while digital infrastructure and connectivity have expanded rapidly, equitable utilization of digital health services remains limited, particularly among socially and economically disadvantaged populations. This digital health divide is increasingly recognized as a consequence of broader social determinants, including economic constraints, limited digital literacy, language barriers, and concerns related to privacy and trust. As healthcare systems continue to adopt telemedicine and other digital innovations, there is a risk that existing health inequities may be further amplified if these barriers are not addressed. This viewpoint argues for the integration of an assisted digital health model within primary care systems, wherein frontline health workers such as ASHAs, ANMs, and community volunteers facilitate access to digital services, support digital navigation, and build community trust. By combining technological solutions with human assistance, assisted digital models can enhance accessibility, inclusiveness, and service utilization among vulnerable populations. Such an approach aligns with the principles of equitable primary healthcare and can strengthen continuity of care, particularly for chronic disease management and preventive services. Bridging the digital health divide requires moving beyond infrastructure-focused interventions toward people-centered strategies that address the social determinants of digital exclusion. Assisted digital health represents a pragmatic and scalable pathway for ensuring that the benefits of digital transformation are shared equitably across populations.
subject: Perspectives/ View point
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creator: Veena G Dev
rights: Copyright (c) 2026 Veena G Dev (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.019

Perceived Awareness Versus Actual Knowledge of E-Waste and Its Disposal Practices Among Medical Students at a Tertiary Care Teaching Institution in Uttar Pradesh, India
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description: Introduction: The rapid expansion of electric devices has subsequently led to rise in e-waste, posing significant environmental and public health challenges due to hazardous substances and unsafe disposal practices. Medical students represent an important group as future public health professionals, still evidence on their objective knowledge and practices remains limited. Objective: To assess perceived awareness, actual knowledge, and disposal practices related to e-waste among medical students. Methods: It’s a cross-sectional study among medical students in Uttar Pradesh, India using a pretested questionnaire including sociodemographic characteristics, awareness, knowledge, perceptions, and disposal practices of e-waste. Data were analysed using descriptive and non-parametric tests. McNemar test was used for differences between perceived and actual knowledge, and Spearman’s correlation for relationship between knowledge and disposal practices. A p-value < 0.05 was considered significant. Results: Among 256 medical students, self-reported awareness of e-waste was high (91.8%); however, objective knowledge was limited across domains, including hazardous materials (12.1%), health risks (5.9%), environmental effects (9.8%), and regulatory provisions (0.8%). A substantial gap between perceived and actual knowledge was observed across all domains (p < 0.001). Unsafe disposal practices were common, particularly batteries with domestic garbage (51.2%). A weak positive correlation of borderline statistical significance was observed between knowledge and safe disposal practices (Spearman’s ρ = 0.125; p = 0.045). Conclusions: Despite higher awareness, knowledge gaps and unsafe methods of disposing e-wastes among the students was prevalent. Strengthening environmental competencies in education and establishing institutional e-waste management mechanisms is essential to mitigate long-term environmental and public health risks.
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creator: Anubhav Agrawal
creator: Reema Kumari
rights: Copyright (c) 2026 Anubhav Agrawal (Author); Dr Reema Kumari (Corresponding Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.014

Prevalence and Determinants of Red Flag Symptoms of Cancer among Adults in rural areas of Puducherry, India: A Community-Based Cross-Sectional Study
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description: Background: Cancer is a leading cause of morbidity and mortality globally. Majority of cases in India are diagnosed in an advanced stage due to low awareness and lack of screening. Early identification of cancer at community level can facilitate early diagnosis and treatment. This study aimed to determine the prevalence of red flag symptoms of cancer among adults in rural Puducherry, and to examine its associated factors. Methods: A community-based cross-sectional study was conducted among adults aged ≥30. A total of 418 participants were recruited using multistage random sampling. Data were collected through a validated semi-structured questionnaire, which captured sociodemographic details, cancer risk factors, and red flag cancer symptoms in the past two months. Prevalence was reported with 95% confidence interval (CI). Log-binomial regression was used to identify predictors of red flag symptoms. Results: The prevalence of at least one red flag symptom of cancer was 15.8% (95%CI: 12.4%–19.6%). Persistent unexplained pain (6.9%) and changes in bowel habits (6.5%) were the most frequently reported symptoms. Higher prevalence of red flag symptoms were seen in male compared to females (aPR: 1.63, 95%CI: 1.09–2.44), socioeconomic class III (aPR: 3.46, 95%CI: 1.90–6.30) and class IV (aPR: 2.22, 95%CI: 1.09–4.51) compared to class I and participants with a NCD risk of CBAC score >4 than those with lower risk (aPR: 3.06, 95% CI: 1.43–6.54). Conclusion: Nearly one-sixth of the rural adult population reported cancer-related red flag symptoms, highlighting the need for targeted community-level screening and awareness initiatives to facilitate early cancer detection.
subject: Original Research Articles
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creator: Malar Ilango
creator: Anlin Jenisha
creator: Nivedhitha
creator: Sindu
creator: Premkumar
rights: Copyright (c) 2026 Malar Ilango, Anlin Jenisha, Nivedhitha, Sindu (Author); Premkumar (Corresponding Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.015

Stakeholder Perceptions of National Quality Assurance Standards (NQAS) Implementation in Urban Primary Health Centres of Berhampur, Odisha: A Qualitative Study.
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description: Objectives: To explore stakeholder perceptions and experiences regarding NQAS implementation in UPHCs of Berhampur, Odisha; identify key facilitators and barriers; and propose strategies to strengthen quality improvement initiatives. Methodology: A qualitative study was conducted between April and September 2023 in selected UPHCs of Berhampur, Odisha. Purposive sampling was used to recruit stakeholders with direct experience of NQAS implementation and service utilization. A total of 38 participants were included, comprising healthcare providers (medical officers, nurses, pharmacists and laboratory technicians), quality assessors and programme managers, a state consultant/UNICEF representative, and patients attending various health services. Data were collected through in-depth interviews and focus group discussions using semi-structured guides. Thematic analysis was performed through open, axial and selective coding. Data collection continued until thematic saturation was achieved and reported in narrative style. Results: Six major themes emerged: (1) Infrastructure and Resources, (2) Staff Training and Development, (3) Patient-Centred Care, (4) Stakeholder Awareness, (5) Leadership and Management, and (6) Continuous Quality Improvement. Facilitators included leadership commitment, availability of training opportunities, supportive supervision, and recognition of the importance of quality improvement. Major barriers included inadequate infrastructure, overcrowding, staff shortages, irregular training, limited stakeholder awareness, weak patient engagement, and challenges in documentation and monitoring. Conclusion: Implementation of NQAS in urban primary healthcare facilities is influenced by a complex interplay of organizational, resource-related, and behavioural factors. Strengthening infrastructure, workforce capacity, stakeholder awareness, patient engagement, and continuous quality improvement mechanisms may enhance sustainable implementation of NQAS and contri…
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creator: Madhumita Bhakta
creator: Durga Madhab Satapathy
creator: Somen Kumar Pradhan
creator: Jasmin Nilima Panda
creator: Pramila Marandi
creator: Jyotirmayee Mishra
creator: Abhimanyu Behera
creator: Amaresh Sahoo
rights: Copyright (c) 2026 Madhumita Bhakta (Corresponding Author); Durga Madhab Satapathy, Somen Kumar Pradhan, Jasmin Nilima Panda, Pramila Marandi, Jyotirmayee Mishra, Abhimanyu Behera, Amaresh Sahoo (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.008

Knowledge, Attitudes and Practices regarding Dog Bite Management Among First-Year Paramedical Students in Etawah, Uttar Pradesh: A Cross-Sectional Study
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description: Abstract: Background: Dog bites constitute a critical public health concern across India. Paramedical, nursing, and pharmacy trainees form a significant part of the future healthcare workforce, and their preparedness plays a vital role in rabies control and management. Aims & Objectives: To evaluate the knowledge, attitudes, and practices (KAP) concerning dog bite management among first year paramedical students enrolled at a tertiary level teaching institution in Etawah, Uttar Pradesh. Study Settings & Design: A cross sectional study design was adopted at a tertiary care teaching hospital in Etawah, with first year paramedical students constituting the target population. Materials & Methods: All eligible first year paramedical students were invited using a complete enumeration approach, and KAP levels were categorized as good/poor using a ≥50% domain specific cut off score using a pre validated semi structured questionnaire via Google Forms. Statistical Analysis: Statistical analyses were performed using SPSS version 24.0. Descriptive statistics done to present the study variables, while chi-square/Fisher’s exact test evaluated associations. A p-value below 0.05 was taken as the threshold for statistical significance. Results: Of the 197 participants, 47.2% exhibited adequate knowledge, 44.7% demonstrated favourable attitudes, and 41.6% reported appropriate practices to dog bite management. No statistically significant associations were detected between sociodemographic characteristics and KAP levels. Conclusion: Although general awareness of rabies and its transmission was at an acceptable level, notable deficiencies persisted in knowledge and practices concerning post exposure management. Focused educational programmes and curriculum integrated training are warranted to strengthen the preparedness of future healthcare professionals.
subject: Original Research Articles
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creator: Arunima Sharma
rights: Copyright (c) 2026 Arunima Sharma (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.017

Wildlife-Livestock-Human-Interface: An Urgent Public Health Concern Demanding Strengthened One Health Action in India
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description: India faces escalating zoonotic disease risks at the wildlife-livestock-human interface, driven by extraordinary biodiversity, one of the world's largest livestock populations, rapid urbanisation, and widespread deforestation. Nearly 60% of human infectious agents are zoonotic in origin, and 75% of emerging and re-emerging diseases share this characteristic. Over the past two decades, India has witnessed major outbreaks including Nipah Virus, Kyasanur Forest Disease, H1N1 influenza, and COVID-19. Ecological disruption, shrinking wildlife habitats, and livestock grazing within wildlife reserves facilitate pathogen spillover, while pastoralist and livestock-rearing communities bear a disproportionate burden from diseases such as brucellosis, scrub typhus, and anthrax. Recent outbreaks of Lumpy Skin Disease and Avian Influenza have compounded public health and economic losses. India has responded institutionally through the National One Health Mission and a pioneering ICMR inter-ministerial surveillance initiative employing Next Generation Sequencing across three states. However, institutional momentum must translate into ground-level action; integrating surveillance systems, strengthening primary healthcare capacity, improving community risk communication, and embedding One Health education in medical curricula. Multidisciplinary preparedness within a One Health framework is essential. The question is not whether another spillover will occur, but whether India will be prepared.
subject: Letter to The Editor
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creator: Aishwarya Ohri
creator: Swati Ghonge
creator: Dr. Kajal Shrivastava Shrivastava
creator: Soveli Khuntia
rights: Copyright (c) 2026 Aishwarya Ohri (Author); Dr. Swati Ghonge (Corresponding Author); Dr. Kajal Shrivastava, Dr. Soveli Khuntia (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.020

Beyond Childhood: The Case for Adult Vaccination in India
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subject: Short Communication Paper
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creator: Gayatri R Nair
creator: S Adithya Prasad
rights: Copyright (c) 2026 Gayatri R Nair (Author); S Adithya Prasad (Corresponding Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.021

Impact of Health Education on Menstrual Hygiene among Adolescent Girls in Selected Rural Schools of Bihta Block, Patna, Bihar: A Pre–Post Interventional Study
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description: Background: Menstrual hygiene plays a pivotal role in safeguarding the health and dignity of adolescent girls. In rural settings, inadequate awareness and persistent misconceptions often influence menstrual hygiene behaviours. This study examined baseline menstrual hygiene knowledge and practices among school-going adolescent girls and evaluated the impact of a structured educational intervention. Materials and Methods: A pre-post interventional study was conducted among 300 menstruating adolescent girls aged 12–17 years enrolled in selected government and private schools of rural Bihta block of Patna. Participants were selected using a multistage random sampling technique. Baseline information on menstrual knowledge and hygiene practices was collected using a pre-tested structured questionnaire. Subsequently, a planned health education session was conducted. The same tool was administered after two months to assess changes attributable to the intervention. Median scores were computed. McNemar’s test and Wilcoxon signed-rank test were applied for statistical analysis. Results: Post-intervention assessment demonstrated a marked improvement in menstrual hygiene knowledge and a modest but statistically significant improvement in hygiene practices. Both knowledge and practice scores improved significantly following the intervention, with median scores increasing from 7.0 to 10.0 and 8.0 to 8.5, respectively (p < 0.001). However, the results should be interpreted in light of the reliance on self-reported hygiene practices which may be prone to reporting bias. Conclusion: Structured educational sessions can effectively improve awareness related to menstruation and contribute to healthier menstrual hygiene behaviours among adolescent girls. However, sustained behavioural change may require continued educational reinforcement with supportive social and environmental conditions.
subject: Original Research Articles
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creator: GEETIKA SINGH
creator: ANIMESH GUPTA
creator: Priyanka Gupta
rights: Copyright (c) 2026 DR. GEETIKA SINGH, DR. ANIMESH GUPTA, DR. PRIYANKA GUPTA (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.006

Road Traffic Accidents and Associated Factors among Victims Attending a Tertiary Care Hospital in Rajnandgaon: A Cross-Sectional Study
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description: Background:Road traffic accidents (RTAs) remain a major public health problem in India, contributing significantly to morbidity and mortality. Chhattisgarh has similarly experienced rising RTA cases, largely due to inadequate awareness, poor compliance with traffic rules and environmental and vehicular risk factors. Methods:A hospital-based cross-sectional study was conducted over six months among 190 RTA victims attending BRLSABVMMC, Rajnandgaon. Data was collected using a semi-structured questionnaire and medical records. Socio-demographic variables, knowledge, attitude and practice (KAP) toward traffic rules and contributory factors were assessed. Results:Most participants were males (87.5%) and belonged to the 20–40-year age group (55.1%). Adequate knowledge, attitude and practice regarding traffic rules were observed in 57.0%, 52.0% and 49.0% of participants respectively, indicating a gap between awareness and actual compliance. Logistic regression showed significant associations between injury severity and human factors. Vehicle-related factors including condition of the vehicle (p = 0.038) and involvement of opposite vehicle (p = 0.016) were also significant. Environmental factors—poor road conditions (p = 0.004), and unusual animal behaviour (p = 0.001)—were strongly associated with RTA outcomes. Conclusion:The study highlighted that inadequate compliance with traffic rules, risky human behaviour, poor vehicle maintenance and adverse environmental conditions collectively contributed to RTAs.
subject: Original Research Articles
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creator: Dhiraj Bhawnani
rights: Copyright (c) 2026 Dhiraj Bhawnani (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.010

Prevalence of Stress, Anxiety and its association with Sleep Quality among Undergraduate Medical Students in a Medical College in Eastern India: A Cross-Sectional Study
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description: Background and Objectives: Stress is a widespread and well-recognised problem among medical students globally, with reported prevalence varying from 21% to 94%. Sleep problems are similarly widespread and linked to emotional distress. However, data from medical colleges in Eastern India remain limited. This study aimed to assess stress and anxiety, and their association with sleep quality among undergraduate medical students. Study design and Methods: A cross-sectional study was conducted among MBBS students (18–25 years) at a medical college in Eastern India. Students with chronic physical or psychiatric illness were excluded. Data were collected using a pretested anonymous questionnaire incorporating the Perceived Stress Scale-10 (PSS-10), Generalized Anxiety Disorder-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI). Data were analysed using SPSS v20 with chi-square tests, t-tests, and multivariable logistic regression; p<0.05 was considered statistically significant. Results: Of the 278 participants, the mean age was 21.18 ± 1.75 years, and 65.8% were females. Moderate stress was reported by 63.4% and severe stress by 23.7%. Mild, moderate, and severe anxiety were present in 35.9%, 25.1%, and 12.2% of students, respectively. Poor sleep quality (PSQI ≥ 5) was observed in 81.5% of participants. Poor sleep was significantly associated with higher stress and anxiety and was more common among females and younger students. In adjusted analyses, moderate stress, moderate anxiety, and severe anxiety remained independent predictors of poor sleep. Conclusion: Stress, anxiety, and poor sleep are highly prevalent among undergraduate medical students in Eastern India. Moderate stress, moderate and severe anxiety were associated with poor sleep.
subject: Original Research Articles
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creator: Sandhya Gupta
creator: Srishti Agarwal
creator: Venkatarao Epari
rights: Copyright (c) 2026 Sandhya Gupta, Sristi Agarwal (Author); Venkatarao Epari (Corresponding Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.005

From Coverage to Effective Protection: Reading NSS 80, NFHS-6 and National Health Accounts for Viksit Bharat 2047
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description: Abstract India’s recent release of three major health datasets—the NSS 80th Round on health, National Family Health Survey-6, and National Health Accounts 2022–23, offers an important opportunity to reassess the direction of health policy. Read together, these datasets show that India has made strong gains in institutional delivery, immunisation, fertility stabilisation, and selected maternal and child health indicators. At the same time, they highlight persistent gaps in financial protection, continued dependence on private outpatient and inpatient care, and high household spending on medicines and diagnostics. The central policy message is that India must now move from coverage expansion to effective protection. The next phase of reform should strengthen primary care, assure essential medicines and diagnostics, integrate PM-JAY with public health systems, improve district-level planning, build a stronger health workforce, and regulate quality and costs across public and private sectors. For Viksit Bharat 2047, India needs a health system that provides timely, continuous, affordable and dignified care without financial hardship.
subject: Editorial
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creator: K Madan Gopal
creator: Suneela garg
creator: Manish Kumar Singh
rights: Copyright (c) 2026 K Madan Gopal, Prof Suneela Garg, Manish Kumar Singh (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.001

Analysis of Acute Diarrheal Disease in In-Patient Department at a Tertiary Hospital: A Retrospective Study
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description: Background: Acute diarrheal disease (ADD) remains a frequent cause of preventable morbidity in India. Tertiary hospitals need local, decision-relevant evidence — burden, seasonality, length of stay (LOS) and service concentration (departmental case-load distribution) — to plan beds, staffing, supplies and dehydration care and to support preparedness. Methods: This retrospective observational study analyzed de-identified inpatient records from 23 December 2023 to 20 December 2025 at a 970-bed tertiary-care teaching hospital. ADD cases were identified using expanded diagnosis keywords. Prolonged stay (LOS of 8 inpatient-days or more) was examined using chi-square tests and multivariable logistic regression, with a strict-versus-broad case-definition sensitivity analysis. Results: Among 24,100 admissions, 816 were ADD (3.4%). Mean age was 42.4 ± 21.4 years and the sexes were balanced. General Medicine handled 78.1% of cases. Median LOS was 3.0 days; 89.7% were discharged within 7 days and prolonged stay occurred in 84 patients (10.3%). Age group was associated with prolonged stay, but on multivariable analysis documented renal comorbidity was the strongest independent predictor (adjusted odds ratio 3.17, 95% CI 1.91–5.27), whereas the age ≥65 association attenuated (1.66, 0.97–2.84). Dehydration severity was documented in only 48.0% of records. Monsoon contributed 45.8% of admissions. Conclusions: ADD produced a sustained, seasonal inpatient burden concentrated in General Medicine, with predominantly short stays. Prolonged stay was driven mainly by documented comorbidity, notably renal disease, rather than age alone. The findings support pre-monsoon surge preparation, standardized dehydration documentation, comorbidity-sensitive triage and coding-quality improvement.
subject: Original Research Articles
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creator: Siddalingaiah H S
creator: Harshitha KS
creator: Kavyashree S Pujari
rights: Copyright (c) 2026 Siddalingaiah H S, Harshitha KS, Kavyashree S Pujari (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.004

Prevalence of malnutrition among adolescent girls in North Kerala: A cross-sectional study
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description: Background: Nutritional status of adolescent girls have important role in having a healthy womanhood in future. Malnutrition retards pubertal changes, impairs scholastic performance, and increases risk for infectious diseases. National Nutrition Mission was started in 2017 in India with the goal of improving the nutritional status of children. In this context, the present research was conducted to assess the nutritional status of adolescent girls in North Kerala as a baseline study. Methods: A cross-sectional study was conducted during May 2019 to March 2020 in Kannur, Kasargod, Wayanad and Malappuram districts of Kerala to assess malnutrition among adolescent girls in terms of anemia and body mass index (BMI). Results: A total of 395 adolescent girls participated in the study. Their age ranged from 10 to 19 years, with a mean of 13.8 years and standard deviation 2.5 years. The present study observed that 28% had malnutrition. The prevalence of anemia among adolescent girls (n=388) was found to be 40%. Proportion of anemia among those who attained menarche (51.8%) was significantly high compared to those who didn’t attain menarche (24.4%). A significantly high proportion of those who didn’t take iron and folic acid (IFA) tablets weekly were thin (16.5%) compared to those who took IFA tablets weekly (9.9%). Conclusion: The present study observed that anemia and malnutrition are significant problems among adolescent girls and specific measures need to be initiated to tackle the situation.
subject: Original Research Articles
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creator: Dr A K Jayasree
creator: Dr Anitha S S
creator: Dr Usha K
creator: Dr Binoo Divakaran
creator: Dr Asma A Rahim
creator: Dr Sudarshan B P
rights: Copyright (c) 2026 Dr A K Jayasree, Dr Anitha S S, Dr Usha K, Dr Binoo Divakaran, Dr Asma A Rahim, Dr Sudarshan B P (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2026-06-30
publication date: 2026-06-30
doi: 10.47203/IJCH.2026.v38i03.003