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Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB PM-JAY) has enabled the Government of India to become a strategic purchaser of health care services from private providers. To generate base cost evidence for evidence-based policymaking the Costing of Health Services in India (CHSI) study was commissioned in 2018 for the price setting of health benefit packages. This paper reports the findings of a process evaluation of the cost data collection in the private hospitals. The process evaluation of health system costing in private hospitals was an exploratory survey with mixed methods (quantitative and qualitative). We used three approaches-an online survey using a semi-structured questionnaire, in-depth interviews, and a review of monitoring data. The process of data collection was assessed in terms of time taken for different aspects, resources used, level and nature of difficulty encountered, challenges and solutions. The mean time taken for data collection in a private hospital was 9.31 (± 1.0) person months including time for obtaining permissions, actual data collection and entry, and addressing queries for data completeness and quality. The longest time was taken to collect data on human resources (30%), while it took the least time for collecting information on building and space (5%). On a scale of 1 (lowest) to 10 (highest) difficulty levels, the data on human resources was the most difficult to collect. This included data on salaries (8), time allocation (5.5) and leaves (5). Cost data from private hospitals is crucial for mixed health systems. Developing formal mechanisms of cost accounting data and data sharing as pre-requisites for empanelment under a national insurance scheme can significantly ease the process of cost data collection.

Background: Emotional Intelligence (EI) contributes to overall success in life. Our objectives are to explore EI among adolescents and its gender differences as per some parameters of social environments. Material and Methods: Present cross-sectional study was conducted in secondary schools in one of municipal corporations in western Maharashtra EI of adolescents studying in tenth standard in randomly selected secondary schools, was assessed by Schutte's Self-Reported Emotional Intelligence Test with collection of relevant sociodemographic information maintaining confidentiality. Data were analyzed by SPSS 20 software. Results: Total 1060 adolescents in 14-16 years of age participated in the study. Socio-economic status affected EI of adolescent girls more adversely than adolescent boys (P = 0.003, P = 0.036 respectively). Co-educational type of school favored lower EI than gender specific schools (P < 0.001). After gender wise stratification, EI did not differ significantly among boys (P = 0.154) with respect to type of schooling, but differed significantly (P = 0.001) among girls. Conclusion: Apart from continued efforts directed to for improvement in SES, mental health component of school health services needs to take a step forward for assessment and improvement of towards mental health parameters including EI of adolescents. EI training programs commenced in school activities based on gender, socio-economic status and other issues relevant to the situation shall prove beneficial in long run.

Background: Contact tracing (CT) is an effective tool for breaking the chains of transmission in infectious disease outbreaks. This study was conducted to observe the trend of isolation and quarantine, assess the source of infection and contacts, and assess the effectiveness of CT in the early detection of infection among health-care workers (HCWs). Methods: This study was conducted using secondary analysis of routine CT records of HCWs of a tertiary care hospital in Mumbai from April 9, 2020, to December 31, 2020. Details of all HCWs exposed or infected with COVID-19 were collected in a standard format developed for this purpose telephonically. The exposed HCWs were further divided into high-risk (HR)/low-risk (LR) contacts and quarantined. Results: A total of 744 HCWs were isolated during this period and 1486 contacts were quarantined against them. Majority of the HCWs affected from COVID-19 were resident doctors, interns, and nursing staff. More than 81% of the positive HCWs were symptomatic. The overall ratio between isolated HCWs and quarantined HCWs is 1:2. A total of 88 (6%) HCWs tested positive from quarantine. The test positivity rate among HR contacts was 9.01% and among LR contacts was 2.72%. Conclusions: Effective CT of positive HCWs greatly aids in the early identification of contacts and timely quarantine. Over a period of time, the number of HCWs getting isolated or quarantined is found to decrease. This is the true success of CT. This strategy can be implemented among other medical colleges and hospitals too.

Despite ongoing recommendations to increase male engagement and gender-equity (GE) counseling in family planning (FP) services, few such programs have been implemented and rigorously evaluated. This study evaluates the impact of CHARM, a three-session GE+FP counseling intervention delivered by male health care providers to married men, alone (sessions 1&2) and with their wives (session 3) in India. A two-armed cluster randomized controlled trial was conducted with young married couples (N = 1081 couples) recruited from 50 geographic clusters (25 clusters randomized to CHARM and a control condition, respectively) in rural Maharashtra, India. Couples were surveyed on demographics, contraceptive behaviors, and intimate partner violence (IPV) attitudes and behaviors at baseline and 9 &18-month follow-ups, with pregnancy testing at baseline and 18-month follow-up. Outcome effects on contraceptive use and incident pregnancy, and secondarily, on contraceptive communication and men's IPV attitudes and behaviors, were assessed using logistic generalized linear mixed models. Most men recruited from CHARM communities (91.3%) received at least one CHARM intervention session; 52.5% received the couple's session with their wife. Findings document that women from the CHARM condition, relative to controls, were more likely to report contraceptive communication at 9-month follow-up (AOR = 1.77, p = 0.04) and modern contraceptive use at 9 and 18-month follow-ups (AORs = 1.57-1.58, p = 0.05), and they were less likely to report sexual IPV at 18-month follow-up (AOR = 0.48, p = 0.01). Men in the CHARM condition were less likely than those in the control clusters to report attitudes accepting of sexual IPV at 9-month (AOR = 0.64, p = 0.03) and 18-month (AOR = 0.51, p = 0.004) follow-up, and attitudes accepting of physical IPV at 18-month follow-up (AOR = 0.64, p = 0.02). No significant effect on pregnancy was seen. Findings demonstrate that men can be engaged in FP programming in rural India, and that such an approach inclusive of GE counseling can improve contraceptive practices and reduce sexual IPV in married couples. ClinicalTrials.gov NCT01593943.

Introduction: Emotional intelligence (EI) is the most researched psychological construct in the 21st century. It predicts success and happiness in life and is suggested as a predictor of mental health (MH). We aimed to assess whether low EI among adolescents acts as a precursor of their MH derangements.Materials and methods: A cross-sectional study was carried out in Pune Municipal Corporation in 2021 with all due approvals, consent, and assent. EI and MH of adolescents studying in Xth standard in randomly selected 24 out of 440 secondary schools were assessed by Schutte’s Emotional Intelligence Test (SET) and Depression, Anxiety, and Stress Scale 42 (DASS-42) with collection of socio-demographic information. The presence of symptoms of mild to extremely severe depression, anxiety, and stress was considered as MH derangement. All research instruments were translated into the local language, pre-tested, and validated before use. Class teachers were trained for data collection. Data were imported to SPSS version 20 (IBM Corp., Armonk, NY) data editor for further analysis. After enlisting frequencies and proportions, associations and correlations were tested by the chi-squared test and Spearman correlation coefficient, respectively.Results: A total of 622 participants submitted all research instruments. The mean age was 14.74 (+0.742) years. Boys and girls were 38% and 62%, respectively. The majority were Hindus, belonging to socio-economic classes II and III, residing in urban areas. Symptoms of severe to extremely severe depression and anxiety, but not stress, were associated with low EI (p < 0.0001, 0.001, and 0.229). Also, the EI score had a negative correlation with the depression score (ρ = -0.221, p < 0.0001) and anxiety score (ρ = -0.152, p = 0.001), but not with the stress score.Conclusion: Low EI can be taken as a precursor of MH derangements, especially in the form of depression and anxiety among school-going adolescents.Recommendations: Efforts to improve EI among adolescents will help to decrease MH derangements, subsequent MH disorders, and suicidality, with improvement in academic performance.

Abstract Background: \"CoviSainik Program\" was implemented in collaboration with the Ambuja Cement Foundation and Community Medicine Department in rural districts of eight states of India from May to December 2021 to create a cadre of volunteers. The aim of the present paper is to describe the program and evaluate it so that the findings can be the guiding tool for policymakers to replicate a similar program. Material and Method: A cross-sectional, mixed-method - concurrent study design was adopted to evaluate the program for its short-term outcomes such as gain in the basic knowledge of COVID-19 amongst master trainers and their feedback and program output viz - the proportion of volunteers trained and their profile by census sampling. Motivational factors, experiences of volunteers, and outcomes of COVID-19 work in their villages were explored by purposive with maximum diversity sampling with 62 online in-depth interviews and 8 online focus group discussions (FGDs). Results: There was a statistically significant difference in the pre-test (12.8 ± 5.6) and post-test (25.9 ± 9.3) scores of the Master Training Program evaluation test. Out of 6534 trained volunteers, 5901 worked as volunteers, and amongst those, 47.1%, 35.1%, and 17.8% worked for ≤3 months, 3 to 6 months, and ≥6 months, respectively, in their villages. The major themes generated for motivational factors to join the program were altruism, savior nature, generating awareness, and concern for others. The major outcomes generated by trained volunteers COVID-19 vaccination were in raising awareness on COVID-19 appropriate behavior and early identification of COVID-19 cases in their villages. Conclusion: The \"CoviSainik Program\" was successful in creating cadres of trained volunteers.

Background: Internet Addiction (IA) and Internet Gaming Disorder (IGD) may provide significant challenges for medical students as it is linked to sleep and mental health can obstruct academic pursuits, affect long-term professional aspirations and yield extensive adverse effects on society at large. Objectives: To find the prevalence of IA, IGD, insomnia and depression amongst medical undergraduates and to examine their correlation. Materials and Methods: A mixed-methods study was conducted amongst 402 undergraduate medical students at a rural medical college. Data were gathered by a semi-structured, self-administered questionnaire encompassing socio-demographic information, the Young Internet Addiction Test, the short form of the Internet Gaming Disorder Scale (IGDS-SF), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire. Focus group discussions were done with 56 students chosen for their high scores in IA and IGD. Thematic analysis was employed to discern patterns and themes within the qualitative data. Data triangulation was conducted to interpret and elucidate the quantitative results using qualitative observations. Results: The mean age of the study participants was 20.39 ± 1.43 years. IA was present in 41.04%, gaming disorder in 20.89%, insomnia in 36.56% and depression in 14.42% participants. Year of study and hostel stay had a statistically significant association with all (P < 0.002). There was a strong and statistically significant association found between IA and IGD with depression and insomnia (P < 0.0001). Furthermore, a statistically significant correlation was found between scores and grades of IA and IGD; and insomnia and depression. Conclusion: Internet usage amongst medical students was notably high (40%) and showed a significant association with insomnia and depression. Hence, early identification of students at risk for IA and IGD is crucial, as these addictions often overlap with other psychological issues.

Cyberbullying has emerged as a pervasive issue, particularly within educational settings, where its effects can be particularly damaging. Among vulnerable populations, medical students face unique pressures that can exacerbate the impact of cyberbullying. Research indicates that cyberbullying can lead to severe psychological consequences, including anxiety, depression, low self-esteem, and decreased academic performance. The anonymity and reach of digital platforms can facilitate bullying behaviors, leading to a culture of silence and fear. This study was done to explore the nature and scope of cyberbullying and its impact on self-esteem among medical students. A mixed-method study was carried out among 453 undergraduate medical students at a rural medical college between September 2023 and February 2024. Data were collected using a semi-structured, self-administered questionnaire, which included socio-demographic details, the Cyberbullying Aggressor Scale, and Rosenberg's Self-Esteem Scale. Focus group discussions (FGDs) were conducted with 56 students who were selected due to a higher prevalence of cyberbullying and its impact on self-esteem. Thematic analysis was used to identify patterns and themes in the qualitative data. Data triangulation was performed to contextualize and explain the quantitative findings through qualitative insights. Among 453 participants, 154 (34%) were identified as victims of cyberbullying, while 95 (21%) were found to engage in cyberbullying others (offenders). Of the victims, 92 (59.74%) were males and 62 (40.26%) were females. However, among those who cyberbullied others, 87 (91.57%) were males and 8 (8.42%) were females. Low self-esteem was observed in 135 (29.80%) of students, with approximately 110 (72%) of cyberbullying victims reporting lower self-esteem. The fast-paced nature of online interactions was recognized as a factor that can escalate conflicts. Many students noted that misunderstandings and misinterpretations of messages contribute to the occurrence of cyberbullying. Additionally, academic pressure was cited as a significant cause of harmful online interactions, including harassment related to grades or clinical performance. This study concluded that students who experienced cyberbullying both as victims and offenders exhibited diminished self-esteem. The sociocultural perspective underscored the role of institutional culture and peer dynamics, highlighting the importance of creating a supportive environment that encourages open communication and reduces stigma around seeking help.