Health Care Programs Research Articles

Adequacy of Communication Channels for Maternal Healthcare in Delta State

This study examined the adequacy of communication channels available for maternal healthcare in Delta State. Rationalized by the agenda setting theory, the quantitative and qualitative research designs, the questionnaire was used to extract relevant information from a sample size of 399 respondents. The study found that the level of awareness of the programmes was encouraging for FMHCP and HeFAD. The majority of respondents acknowledged that the communication channels were adequate, and more than half thought they were effective in influencing participation in the maternal healthcare programmes. The stakeholders acknowledged the use of multiple communication channels in spreading awareness of the maternal healthcare programmes. Therefore, the study recommends the continuous usage of communication channels to spread awareness of maternal healthcare programmes.

Knowledge, attitude, and practices of stakeholders involved in healthcare financing programs on economic evaluations in Cameroon.

There are many healthcare financing programs (HFPs) in Cameroon; however, there is a lack of information on these programs' economic effectiveness and efficiency. Involvement of local stakeholders in the economic evaluations (EEs) of HFPs is critical for ensuring contextual factors are considered prior to program implementation. We conducted a cross-sectional study to assess the need for EEs of Cameroonian HFPs. Regular staff in supervisory roles aged 18 years and above were recruited in four Cameroonian cities. Data were collected via face-to-face surveys between June 15 and August 1, 2022. Descriptive analyses summarized participants' knowledge, attitudes, and practices in relation to performing EEs of HFPs. Principal component analyses identified organizational, individual, and contextual factors that could influence participants' involvement. The total sample included 106 participants. On average, 65% of participants reported being aware of the listed HFPs; however, of these, only 28% said that they had been involved in the HFPs. Of the 106 participants, 57.5% knew about EEs; yet, almost 90% reported that the HFP in question had never been subject to an EE, and 84% had never been involved in an EE. Most participants indicated that they had intended or would like to receive EE training. Using principal component analyses, the organizational factors were classified into two components ('policy and governance' and 'planning and implementation'), the individual factors were classified into two components ('training' and 'motivation'), and the contextual factors were classified into three components ('funding,' 'political economy,' and 'public expectations'). The findings of this study highlight the need to invest in EE training to improve participation rates of Cameroonian stakeholders in the EEs of HFPs. Improved knowledge, diversified skills, and increased participation of stakeholders from all levels of the Cameroonian healthcare system are critical to the effective and efficient development, implementation, and EE of the country's HFPs.

Transgender and gender diverse curriculum in medical imaging programs: a case study

BackgroundTransgender and gender diverse (TGD) individuals face barriers, including harassment and discrimination, when accessing healthcare services. Medical imaging procedures require personal information to be shared, such as date of last menstrual cycle and/or pregnancy status; some imaging exams are also invasive or intimate in nature. Terminology is based on binary sex creating an inherently cis-heteronormative environment. TGD patients fear being outed and often feel a need to function as educators and advocates for their care. Incorporation of inclusive healthcare curriculum related to TGD populations is an effective means of educating new health providers and promotes safer and more inclusive spaces in healthcare settings. Educators face barriers which hinder the creation and implementation of TGD content. The purpose of this study was to examine the impacts educators are faced with when creating and delivering TGD content in their medical imaging curriculum.MethodsA case study of medical imaging programs at a Canadian post-secondary institute was undertaken. Data was collected via semi-structured interviews with faculty. Relevant institutional documents such as strategic plans, policies/procedures, websites, and competency profiles were accessed. Framework analysis was used to analyze the data.ResultsThe study found seven themes that influence the development of TGD curriculum as follows: familiarity and comfort with the curriculum and content change process; collaboration with other healthcare programs; teaching expertise; management of course workload and related. duties; connections to the TGD community; knowledge of required TGD content and existing gaps in curriculum; and access to supports.ConclusionsUnderstanding educators’ perspectives can lead to an increased sense of empowerment for them to create and incorporate TGD curriculum in the future. Many post- secondary institutions are incorporating an inclusive lens to educational plans; this research can be used in future curriculum design projects. The goal is improved medical imaging experiences for the TGD population.

Substantial Increases in Healthcare Students' State Empathy Scores Owing to Participation in a Single Improvisation Session.

To determine whether the 12-item state empathy scale could be modified reliably to measure empathy in healthcare professions students and to detect changes in their empathy owing to a single improvisation (improv) session. Three cohorts of students from two healthcare professions programs (total = 165 students) participated in an improv session. During the session, one of the researchers (BS) tasked the students with several improv activities. Participants' self-reported state empathy scores were assessed at three time points (pre-improv, post-improv, and end of semester) using revised, in-class paper versions of the State Empathy Scale. The exploratory factor analysis revealed a single factor solution for the revised scale, justifying the creation of an overall state empathy score from the questionnaire. Cronbach's alpha reliability values averaged 0.87. Students' mean empathy scores were higher directly after the improv session than directly prior to the session (p < 0.0001; effect size = r = 0.67, 0.55, and 0.79 for cohorts 1, 2, and 3, respectively). These findings show that a single one- or two-hour improv session can foster substantial increases in healthcare professional students' state empathy for one another. Greater healthcare professional empathy and compassion foster better healthcare team cooperation and patient outcomes, so healthcare professionals and their students should engage in such empathy-enhancing activities at regular intervals throughout their training and careers.

The Relationship Between Employment Status and Prior Education to Academic and Clinical Success for Diagnostic Medical Sonography or Radiography Students

Objective: It has been reported that employment during student enrollment, in rigorous health care programs, impedes college success and may be a barrier to successful graduation. Furthermore, student’s prior education is typically viewed as a positive predictor of success in college. The aim of this study was to examine whether a relationship exists between employment status and prior education, compared with academic and clinical success for Diagnostic Medical Sonography (DMS) or Radiography (RT) students, in a large community college. Materials and Methods: There were 26 imaging student participants consented to this study. This convenient sample included 10 DMS and 16 RT students, enrolled in an associate degree in applied sciences program. A survey was administered that collected demographic data on the students in both programs. Data collection began at the start of each respective program and again one year later. Student academic and clinical grades were examined over a period of three college semesters. Results: The analysis of the findings did not show a significant relationship between employment status, prior education, student academics, and clinical success among the participating DMS or RT students. Conclusion: The results of this study provide limited evidence that there was no significant relationship between employment status, prior education, and academic and clinical success among this cohort of DMS or RT students. These findings also suggest that students’ employment did not impede success for these DMS and RT students. In addition, this research shows that students’ prior education had no effect on their success in their DMS and RT programs. Further research should be conducted to investigate whether these findings are similar in other imaging programs.

Current and Projected Mortality and Hospitalization Rates Associated With Conditional Cash Transfer, Social Pension, and Primary Health Care Programs in Brazil, 2000-2030

The health outcomes of increased poverty and inequalities in low- and middle-income countries (LMICs) have been substantially amplified as a consequence of converging multiple crises. Brazil has some of the world's largest conditional cash transfer (Programa Bolsa Família [PBF]), social pension (Beneficio de Prestacão Continuada [BPC]), and primary health care (Estratégia de Saúde da Família [ESF]) programs that could act as mitigating interventions during the current polycrisis era of increasing poverty, slow or contracting economic growth, and conflicts. To evaluate the combined association of the Brazilian conditional cash transfer, social pension, and primary health care programs with the reduction of morbidity and mortality over the last 2 decades and forecast their potential mitigation of the current global polycrisis and beyond. This cohort study used a longitudinal ecological design with multivariable negative binomial regression models (adjusted for relevant socioeconomic, demographic, and health care variables) integrating the retrospective analysis from 2000 to 2019, with dynamic microsimulation models to forecast potential child mortality scenarios up to 2030. Participants included a cohort of 2548 Brazilian municipalities from 2004 to 2019, projected from 2020 to 2030. Data analysis was performed from September 2022 to February 2023. PBF coverage of the target population (those who were poorest) was categorized into 4 levels: low (0%-29.9%), intermediate (30.0%-69.9%), high (70.0%-99.9%), and consolidated (≥100%). ESF coverage was categorized as null (0), low (0.1%-29.9%), intermediate (30.0%-69.9%), and consolidated (70.0%-100%). BPC coverage was categorized by terciles. Age-standardized, all-cause mortality and hospitalization rates calculated for the entire population and by age group (<5 years, 5-29 years, 30-69 years, and ≥70 years). Among the 2548 Brazilian municipalities studied from 2004 to 2019, the mean (SD) age-standardized mortality rate decreased by 16.64% (from 6.73 [1.14] to 5.61 [0.94] deaths per 1000 population). Consolidated coverages of social welfare programs studied were all associated with reductions in overall mortality rates (PBF: rate ratio [RR], 0.95 [95% CI, 0.94-0.96]; ESF: RR, 0.93 [95% CI, 0.93-0.94]; BPC: RR, 0.91 [95% CI, 0.91-0.92]), having all together prevented an estimated 1 462 626 (95% CI, 1 332 128-1 596 924) deaths over the period 2004 to 2019. The results were higher on mortality for the group younger than age 5 years (PBF: RR, 0.87 [95% CI, 0.85-0.90]; ESF: RR, 0.89 [95% CI, 0.87-0.93]; BPC: RR, 0.84 [95% CI, 0.82-0.86]), on mortality for the group aged 70 years and older, and on hospitalizations. Considering a shorter scenario of economic crisis, a mitigation strategy that will increase the coverage of PBF, BPC, and ESF to proportionally cover the newly poor and at-risk individuals was projected to avert 1 305 359 (95% CI, 1 163 659-1 449 256) deaths and 6 593 224 (95% CI, 5 534 591-7 651 327) hospitalizations up to 2030, compared with fiscal austerity scenarios that would reduce the coverage of these interventions. This cohort study's results suggest that combined expansion of conditional cash transfers, social pensions, and primary health care should be considered a viable strategy to mitigate the adverse health outcomes of the current global polycrisis in LMICs, whereas the implementation of fiscal austerity measures could result in large numbers of preventable deaths.

Features of organizing the provision of emergency medical care on-site in the city of Saint Petersburg

Special attention is paid to the development of primary health care and emergency medical care in our country, since timely prevention of the development of diseases and early provision of medical care to citizens is a priority task facing the domestic healthcare system. National projects and programs in healthcare are aimed at improving the provision of medical care, preventing diseases and promoting a healthy lifestyle. Providing emergency medical care is undoubtedly associated with all types of medical care and is an effective factor. Timely provision of emergency medical care contributes to a favorable outcome for each patient. That is why the need to analyze the experience of organizing the provision of emergency medical care on-site in a medical organization providing primary health care is of utmost importance. The purpose of the study is to analyze the organization of emergency medical care on-site in the city of St. Petersburg and identify its features. The research materials included analyzed orders of the Russian Ministry of Health, orders of the Health Committee of the city of St. Petersburg, open literary sources, medical documentation of the emergency department of a medical organization providing primary health care. As a result of the analysis and based on the data obtained, proposals were developed to improve the organization of emergency medical care on-site in the city of St. Petersburg, taking into account the existing shortcomings.

Primary Health Care Interventions for Potentially Preventable Ear, Nose, and Throat Conditions in Rural and Remote Areas: A Systematic Review.

Background:Primary and secondary level preventive primary health care programs providing early detection and timely management of ear, nose, and throat (ENT) conditions in rural and remote regions are fundamental to preventing downstream impacts on health, social, and educational outcomes. However, the range and quality of evidence is yet to be reviewed. Objectives: The study objectives were to identify and synthesize the evidence of primary health care interventions for detection and management of ENT conditions in rural and remote areas, and evaluate the quality of the research and effectiveness of interventions. Methods: A systematic literature search of 6 databases (February 2023). The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, and the quality appraisal of studies was evaluated using the Mixed Methods Appraisal Tool (initial screening questions: Are there clear research questions? Do the collected data allow to address the research questions?). Results: Ten studies met the inclusion criteria. The results describe interventions for detection and management of respiratory tract infections, otitis media, and ear disease in primary health care settings. No studies met the inclusion criteria for tonsillitis. The role of community-based programs and allied health workers in the detection and management of ENT conditions was found to be effective in rural and remote regions. Only 2 of the studies met the screening criteria for quality appraisal. Conclusions: The study findings may inform future programs and policy development to address detection and management of ENT conditions in rural and remote primary care settings, and supports the need for further research on innovative models of care targeting potentially preventable hospitalizations through primary and secondary level prevention.

Evaluation of the Implementation of WHO Infection Prevention and Control Core Components Among Health Care Facilities

Programs for infection prevention and control comprise a range of action plans, including antiseptic regulations, a healthcare worker training program, and the monitoring of healthcare-associated infections. The purpose of the study is to evaluate the World Health Organization’s implementation of infection prevention and control programs level in Ranya tertiary and healthcare facilities. A cross-sectional study was conducted at Eight healthcare institutions in the Ranya administration in the Kurdistan Region of Iraq from February 2023 to the end of August 2023 using the World Health Organization Infection Prevention and Control Assessment Framework (IPCAF) checklist. The IPCAF consists of eight segments and each part has a score of 100, hence with the greatest score of 800. The respondents in this study were the heads of facilities and employees engaged in IPC-related tasks. The results show that 6 Healthcare staff (75%) had basic IPC levels, and they scored 235, 207.5, 222.5, 330, 362.5, and 347.5 out of 800 points respectively. Further, 2 Healthcare staff (25%) had inadequate IPC levels, and they scored 200 and 180 points. In addition, among the 8 IPC core components, the built environment and materials/equipment at the facility level (C8) had the highest scores, while minimum scores were observed in education, training (C3) and healthcare-associated infection surveillance (C4). In conclusion, the Ranya HCF facilities have certain working IPC aspects without appropriate implementation; further, practically all components need significant improvement.

Occupational balance and associated factors among students during higher education within healthcare and social work in Sweden: a multicentre repeated cross-sectional study

ObjectiveThe aim was to explore whether occupational balance is associated with health, health-promoting resources, healthy lifestyle and social study factors among students during higher education within healthcare and social work.DesignThe...

A multiobjective approach for weekly Green Home Health Care routing and scheduling problem with care continuity and synchronized services

Home Health Care (HHC) services are essential for delivering healthcare programs to patients in their homes, with the goal of reducing hospitalization rates and improving patients’ quality of life. However, HHC organizations face significant challenges in scheduling and routing caregivers for home care visits due to complex criteria and constraints. This paper addresses these challenges by considering both caregiver assignments and transportation logistics. The objective is to minimize the total travel distance and CO2 emissions while ensuring a balanced workload for caregivers, meeting patients’ preferences, synchronization, precedence, and availability constraints. To tackle this problem, we propose a multiperiodic Green Home Health Care (GHHC) framework. In the first stage, we utilize multiobjective programming and the NSGA-II algorithm to generate Pareto front solutions that consider travel distance and CO2 emissions. In the second stage, a Mixed-Integer Linear Programming (MILP) model is proposed to balance caregivers’ workload by assigning them to the patient routes generated in the first stage. The results highlight the trade-off between shorter routes and lower emissions. Furthermore, we examine the impact of prioritizing continuity of care and patient satisfaction. This research provides valuable insights into addressing the scheduling and routing challenges in HHC services, contributing to a more efficient and environmentally friendly healthcare delivery.

Fostering engagement in virtual anatomy learning for healthcare students

BackgroundThe use of virtual learning platforms is on the rise internationally, however, successful integration into existing curricula is a complex undertaking fraught with unintended consequences. Looking beyond medical and pedagogic literature can provide insight into factors affecting the user experience. The technology acceptance model, widely used in software evaluation, can be used to identify barriers and enablers of engagement with virtual learning platforms. Here, the technology acceptance model was used to scaffold the exploration of the factors that influenced students' perceptions of the virtual anatomy platform, Anatomage and how these shaped their intention to use it.MethodsFocus groups identified factors influencing students use of the Anatomage tables. Interventions were rolled out to address these findings, then further focus groups and the technology acceptance model identified how factors including self-efficacy, enjoyment, and social norms influenced students’ intention to use the Anatomage table in the future.ResultsStudents raised significant concerns about understanding how to use the Anatomage table. Moreover, students who considered themselves to be poor at using technology perceived the Anatomage table as more complicated to use. The subjective norm of the group significantly altered the perceived ease of use and usefulness of the Anatomage. However, enjoyment had the greatest impact in influencing both perceived usefulness and perceived ease of use. Indicating that enjoyment is the largest contributing factor in altering technology engagement in healthcare cohorts and has the biggest potential to be manipulated to promote engagement.ConclusionsFocus groups used in tandem with the technology acceptance model provide an effective way to understand student perceptions around technology used in the healthcare curricula. This research determined interventions that promote student engagement with virtual learning platforms, which are important in supporting all healthcare programmes that incorporate technology enhanced learning.

Implications of cannabis legalization for the US federal budget

AbstractFederal legislation to legalize, regulate, and tax cannabis could have significant impacts on the federal budget. While the specific details of any potential cannabis legalization legislation are unknown at present, such reforms are likely to affect both tax receipts and federal outlays through a wide range of mechanisms including excise tax collections, changes in the size and composition of the labor force, and the major federal health care programs. We identify the main federal budgetary implications of legalizing cannabis and estimate their likely magnitude where possible.

Suicidal ideation, attempt and associated factors among prisoners in Northwest Ethiopia: A cross-sectional study.

Suicide is a prominent source of harm and death globally, and it is the leading cause of premature death among prisoners. Therefore, the main aim of this study was to determine the prevalence and factors associated with suicidal ideation and attempt among prisoners in Northwest Ethiopia. An institution-based cross-sectional study design was performed from May 23 to June 22, 2022. After proportional allocation to the three correctional institutions, a total of 788 study participants were randomly recruited. The World Health Organization Composite International Diagnostic Interview (CIDI) was used to evaluate suicide ideation and attempt. To determine factors associated with suicidal ideation and attempt, multivariate logistic regression analyses were conducted. At a 95% confidence interval (CI) of P-value <0.05, statistical significance was declared. The prevalence of suicidal ideation and attempt among prisoners was 23.6% and 10.7%, with 95% CI (20.76, 26.70) and (8.68, 13.02), respectively. Female sex (AOR = 2.38, 95% CI: 1.12, 5.05), family history of mental illness (AOR = 3.09, 95% CI: 1.93, 4.88), depression (AOR = 2.04, 95% CI: 1.43, 2.98), poor social support (AOR = 2.76, 95% CI: 1.56, 4.85) and previous incarceration (AOR = 1.84, 95% CI: 1.18, 2.86) were significantly associated with suicidal ideation. However, being single (AOR = 2.58, 95% CI: 1.47, 4.54), family history of suicide (AOR = 2.43, 95% CI: 1.18, 5.01), depression (AOR = 2.62, 95% CI: 1.59, 4.31) and previous imprisonments (AOR = 2.11, 95% CI: 1.20, 3.69) were associated with suicidal attempt. The prevalence of suicidal ideation and attempt among prisoners were found to be high. Therefore, the findings of this study recommend that early detection and design of prison mental health services should be delivered to develop mental health care, prevention, and intervention programs for incarcerated people to improve suicidal behavior in prison.

The use of positive deviance approach to improve health service delivery and quality of care: a scoping review

BackgroundQuality has been a persistent challenge in the healthcare system, particularly in resource-limited settings. As a result, the utilization of innovative approaches is required to help countries in their efforts to enhance the quality of healthcare. The positive deviance (PD) approach is an innovative approach that can be utilized to improve healthcare quality. The approach assumes that solutions to problems are already available within the community and identifying and sharing those solutions can help others to resolve existing issues. Therefore, this scoping review aimed to synthesize the evidence regarding the use of the PD approach in healthcare system service delivery and quality improvement programs.MethodsArticles were retrieved from six international databases. The last date for article search was June 02, 2023, and no date restriction was applied. All articles were assessed for inclusion through a title and/or abstract read. Then, articles that passed the title and abstract review were screened by reading their full texts. In case of duplication, only the full-text published articles were retained. A descriptive mapping and evidence synthesis was done to present data with the guide of the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews checklist and the results are presented in text, table, and figure formats.ResultsA total of 125 articles were included in this scoping review. More than half, 66 (52.8%), of the articles were from the United States, 11(8.8%) from multinational studies, 10 (8%) from Canada, 8 (6.4%) from the United Kingdom and the remaining, 30 (24%) are from other nations around the world. The scoping review indicates that several types of study designs can be applied in utilizing the PD approach for healthcare service and quality improvement programs. However, although validated performance measures are utilized to identify positive deviants (PDs) in many of the articles, some of the selection criteria utilized by authors lack clarity and are subject to potential bias. In addition, several limitations have been mentioned in the articles including issues in operationalizing PD, focus on leaders and senior managers and limited staff involvement, bias, lack of comparison, limited setting, and issues in generalizability/transferability of results from prospects perspective. Nevertheless, the limitations identified are potentially manageable and can be contextually resolved depending on the nature of the study. Furthermore, PD has been successfully employed in healthcare service and quality improvement programs including in increasing surgical care quality, hand hygiene practice, and reducing healthcare-associated infections.ConclusionThe scoping review findings have indicated that healthcare systems have been able to enhance quality, reduce errors, and improve patient outcomes by identifying lessons from those who exhibit exceptional practices and implementing successful strategies in their practice. All the outcomes of PD-based research, however, are dependent on the first step of identifying true PDs. Hence, it is critical that PDs are identified using objective and validated measures of performance as failure to identify true PDs can subsequently lead to failure in identifying best practices for learning and dissemination to other contextually similar settings.

"It's Like A Partnership": Exploring the Primary Care Experiences and Patient-Defined Goals of People Who Use Drugs.

Primary care is an important yet underutilized resource in addressing the overdose crisis. Previous studies have identified important aspects of primary care for people who use drugs (PWUD) and have found patient involvement in healthcare decisions and goal-setting to be especially critical. However, there has been limited research describing the primary care goals of PWUD. In harm reduction settings, where it is imperative that PWUD set their own goals, this research gap becomes especially relevant. To explore how PWUD navigate primary care with a focus on understanding their primary care goals. A qualitative study using semi-structured interviews. PWUD currently engaged in primary care at the Respectful and Equitable Access to Comprehensive Healthcare (REACH) Program, a harm reduction-based primary care program in New York City. Between June 2022 and August 2022, we conducted 17 semi-structured interviews. Informed by phenomenology, transcripts were coded using both inductive and deductive codes and themes were developed using thematic analysis approaches. Phenomenological analysis identified four core components that, together, created an experience that participants described as "a partnership" between patient and provider: (1) patient-provider collaboration around patient-defined healthcare goals; (2) support provided by harm reduction-based approaches to primary care anchored in incrementalism and flexibility; (3) care teams' ability to address healthcare system fragmentation; and (4) the creation of social connections through primary care. This holistic partnership fostered positive primary care experiences and supported participants' self-defined care goals, thereby facilitating meaningful care outcomes. To best meet the primary care goals of PWUD, these findings underscore the importance of primary care providers and programs facilitating such partnerships through organizational-level support anchored in harm reduction. Future research should explore how these experiences in primary care affect patient health outcomes, ultimately shaping best practices in the provision of high-quality primary care for PWUD.

Development of diabetes complications within coordinated and structured primary health care: a 10-year retrospective cohort study in Germany.

Diabetes mellitus is a growing, costly, and potentially preventable public health issue. In 2004, Germany introduced the GP-centred healthcare programme to strengthen primary care. To assess the hazards of the most common diabetes-related complications in patients enrolled in GP-centred health care in comparison with usual primary care. A retrospective cohort study based on German claims data (4 million members) from 2011-2020. In total, 217 964 patients with diabetes were monitored from 2011-2020. Endpoints were blindness, amputation, myocardial infarction, stroke, coronary heart disease, dialysis, hypoglycaemia, and all-cause mortality. Cox proportional-hazards regression models were used for multivariable analysis and adjusted for sociodemographic, practice, and disease-specific characteristics. Compared with usual care (n = 98 609 patients), GP-centred health care (n = 119 355 patients) showed a relative risk reduction of blindness of 12%, and amputation of 20% over 10 years. The estimated impact of GP-centred health care on myocardial infarction, stroke, coronary artery disease, dialysis, and all-cause mortality is significantly favourable in comparison with usual care. However, the proportional risk of hypoglycaemia (+1.2%) in the interventional group is higher than in usual care. Enrolment in GP-centred health care appears to result in a consistent reduction of the relative risk of diabetes-related complications over 10 years. The significant difference in contrast to usual care may be explained by robust, structured primary care provision, including the diabetes disease management programme, and improved coordination and networking of care within primary and secondary care.

A Cross-Sectional Study Exploring Postpartum Depression at a Tertiary Care Center in Eastern Uttar Pradesh, India.

Background Postpartum depression (PPD) is a significant public health concern globally characterized by a spectrum of mood disturbances ranging from mild mood swings to severe depressive episodes initiating within four weeks post childbirth and potentially persisting up to 12 months. Besides affecting the mother, it also affects the mental health and development of the babies born to affected mothers. Despite its considerable burden and potential adverse effects on both maternal and child well-being, PPD often goes undetected and untreated. Materials and methods A cross-sectional study was conducted from January 2024 to March 2024 at a tertiary care center in Gorakhpur to assess PPD in 280 postpartum women. The Edinburgh Postnatal Depression Scale (EPDS) score≥ 10 was used to confirm depression. Data collection involved a pretested, structured questionnaire. Data were analyzed using SPSS version 22 (IBM Corp., Armonk, NY). A p-value < 0.05 was considered statistically significant. Results The prevalence of PPD was 12.14%. Age and education were significant sociodemographic risk factors (p < 0.05). In psychosocial factors, adverse life events (p < 0.001), wishing for a male child but giving birth to a female (p = 0.01), domestic violence (p = 0.005), relationship issues, an alcoholic spouse (p = 0.01), and poor in-law relations (p < 0.001) were found to be linked to PPD. Obstetric factors such as complicated antenatal history, physical illness, cesarean section, complicated intranatal history, and postpartum complications were also found to be important factors. Conclusion PPD affects many women, emphasizing the need for effective measures. Initiatives like the appointment of healthcare counselors and PPD screening programs in healthcare settings are essential to detect and support affected mothers.

THE FAR-REACHING EFFECTS OF POVERTY ON CHILDREN: IMPACTS ON HEALTH, EDUCATION, AND FUTURE OPPORTUNITIES

This article explores the profound impact of poverty on children's health, education, and future opportunities. Children living in poverty face disparities in health outcomes, including higher rates of chronic conditions and mental health disorders. Educational barriers such as attending under-resourced schools and facing external challenges impede academic success and limit future prospects. The long-term consequences of poverty on children's future opportunities underscore the need for comprehensive strategies to address systemic inequities. By investing in early childhood education, healthcare, and social support programs, society can mitigate the effects of poverty on vulnerable children and create a more equitable future for all.

IJCM_331A: Helping beyond the Helpline – Experience from a Unique Model for Mental Health Care among Frontline workers during COVID – 19 Pandemic in Andhra Pradesh

Background: Psychological issues among Health Care Workers (HCWs) in COVID-19 stem from the fact that normal people are being exposed to extraordinary situations. Facing this critical situation, it is essential to ensure that these personnel are identified early and offered appropriate intervention. Hence, AIIMS Mangalagiri partnering with UNICEF started a project to reach out to all frontline workers in the state of Andhra Pradesh. Objectives: To set up a Psycho-Social Counselling (PSC) system for healthcare &amp; other front-line workers in the state of Andhra Pradesh to handle stress due to COVID–19 To conduct capacity-building programs for health care &amp; other front-line workers to prevent psycho-social conditions arising due to COVID–19 Methodology: A simple Mental Health Screening Questionnaire (MHSQ) was developed and validated in the local language. After getting prior approvals, a Google form link of the MHSQ was sent via email, SMS, and WhatsApp to every frontline worker in the state. Consenting participants with scores above 6 were contacted personally by the psychologists for further detailed evaluation. A helpline number for counseling was publicized and psychologists conducted sessions on mental health awareness and coping strategies in various institutes across the state. Results: About 8,217 respondents attempted the MHSQ out of which detailed mental health evaluation (GAD-7, PHQ-9, CAGE, AUDIT, and PSQI) was done for 392 respondents. The most common issues identified were Anxiety (45%), Insomnia (42%), Depression (12%), and Substance Abuse (2%). Also, as a part of the mental health capacity-building campaign around 4,500 healthcare workers like nurses, Anganwadi teachers, and ANMs were trained offline across the state, along with the District Mental Health team. Conclusion: Mental health can have a significant impact on the competence of frontline workers. In addition to existing interventions available, confidential mental health intervention and service provision are the need of the hour.