Issues
To review the burden of alcohol use in India, examine current policy initiatives and programs specific to India and provide a roadmap for future actions.
Approach
A literature search was ...undertaken to review available published research papers, unpublished reports and anecdotal media information in the period 2000–2020 to assess the burden and pattern of alcohol use and appraise alcohol control policies in India.
Key Findings
The per‐capita alcohol consumption among individuals aged 15+ years was 5.7 L, which increased over time. Prevalence of alcohol use varied across states with considerable impact on the nation. Regulatory policies and alcohol control programs vary across Indian states, with poor enforcement and implementation. Taxation and pricing policies are revenue oriented. Policies are needed to address the aggressive and innovative marketing strategies of the alcohol industry. The system for regular monitoring of alcohol burden and conducting alcohol policy analysis needs strengthening.
Implications
Alcohol use and its public health impact would continue to increase in India in the absence of effective policy and programs; the country may not achieve its stated goal of relative reduction of alcohol use prevalence by 10% by 2025.
Conclusion
The prevailing alcohol control policies and programs in India have been less than fully effective in controlling the burden of alcohol use and its associated impact. There is a need for comprehensive, evidence‐based and consensus‐driven national alcohol control policy to appropriately guide and support the Indian states in regulating alcohol and reducing the associated burden. Effective implementations of such policies are central to its success.
Abstract
Background
Promoting physical activity in urban India is imperative considering the burden of non-communicable diseases in the country. Planning for improving population level physical ...activity needs sound understanding of availability and quality of resources/facilities for physical activity and knowing people’s perception and practices regarding the physical activity.
Methods
A cross-sectional study was undertaken in Kolar city of Karnataka state in India. All the resources/facilities required for supporting physical activity were mapped and their quality was assessed utilizing adapted version of physical activity resource assessment questionnaire. The information regarding latitude, longitude and approximate size of the resource was obtained using a hand-held GPS tracker. 495 individuals aged ≥ 18 years, selected by two stage cluster random sampling with probability proportionate to population size technique, were interviewed to assess their perception and practices regarding physical activity using semi-structured questionnaire and global physical activity questionnaire.
Results
Kolar city has 36.3 physical activity resources per lakh population and per person availability of park and playground area was 0.4 Sq. meters. Available resources were concentrated in the center of the city. Half of the sports facilities and 14 of the 17 recreational facilities in the city were of poor to mediocre quality. 38.2% of adults in Kolar city were found to be physically active. Only 19.2% of the study participants had accessed sports/fitness facilities/playgrounds in past 3 months and only 18.8% of the study participants accessed parks in the previous 3 months. 28.6% to 59.1% of the participants preferred ‘walking’ for work, college and shopping. Less than 5% of the participants preferred and used cycle as a mode of transport. 1/3
rd
of the study participants felt that Kolar city is safe of walking and 44.6% felt that the city is safe for cycling.
Conclusion
Creating enabling environment by increasing the number and quality of resources/facilities for physical activity along with their equitable distribution is required to promote and improve population level physical activity in Kolar city. Urban planning with a focus on non-motorized transport including walking would contribute to improved people’s perception and practices regarding physical activity in the city.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
A staggering 85% of the global population resides in low- and middle-income countries (LAMICs). India stands as an exemplary pioneer in the realm of mental health initiatives among LAMICs, having ...launched its National Mental Health Program in 1982. It is imperative to effectively evaluate mental health systems periodically to cultivate a dynamic learning model sustained through continuous feedback from mental healthcare structures and processes.
The National Mental Health Survey (NMHS) embarked on the Mental Health Systems Assessment (MHSA) in 12 representative Indian states, following a pilot program that contextually adapted the World Health Organization's Assessment Instrument for Mental Health Systems. The methodology involved data collection from various sources and interviews with key stakeholders, yielding a set of 15 quantitative, 5 morbidity, and 10 qualitative indicators, which were employed to encapsulate the functional status of mental health systems within the surveyed states by using a scorecard framework.
The NMHS MHSA for the year 2015-16 unveiled an array of indices, and the resultant scorecard succinctly encapsulated the outcomes of the systems' evaluation across the 12 surveyed states in India. Significantly, the findings revealed considerable interstate disparities, with some states such as Gujarat and Kerala emerging as frontrunners in the evaluation among the surveyed states. Nevertheless, notable gaps were identified in several domains within the assessed mental health systems.
MHSA, as conducted within the framework of NMHS, emerges as a dependable, valid, and holistic mechanism for documenting mental health systems in India. However, this process necessitates periodic iterations to serve as critical indicators guiding the national mental health agenda, including policies, programs, and their impact evaluation.
This paper describes the methodology of developing and implementation of a youth focused life skills training and counselling services programme (LSTCP) and assessment of factors associated with life ...skills of participants pre-training. Development of all aspects of LSTCP (modules, methods and evaluation) was through a consultative process. Experiential learning based facilitation was decided as the approach for training participants. A quasi-experimental design with pre, post and follow-up assessment post-training was finalised. Data collection was done using specifically developed semi-structured self-administered questionnaire. Multivariable logistic regression with life skills as outcome and various exposure variables was performed. About 2/3.sup.rd of participants had high level of life skills (68%). Increased score of extraversion (AOR = 1.57,95% CI = 1.32-1.85), agreeableness (AOR = 1.42,95% CI = 1.16-1.73), conscientiousness (AOR = 1.9,95% CI = 1.55-2.33), physical (AOR = 1.03,95% CI = 1.01-1.04), environmental (AOR = 1.02,95% CI = 1.004-1.03) and social quality of life (AOR = 1.01,95% CI = 1.006-1.02) were associated with high life skills score. Higher score of neuroticism (AOR = 0.66,95% CI = 0.53-0.79) was associated with low life skills score. The results presented provide an opportunity to understand the evolution of factors affecting life skills during the follow-up of this study. This study throws light on development of LSTCP for apparently healthy population in a setting like India and its states.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
There is no data on the treatment gap and health care utilization for mental disorders from Punjab. The present study reports on the same by using the data collected during the National Mental Health ...Survey.
Multisite, multistage, stratified, random cluster sampling study conducted in four districts, namely Faridkot, Moga, Patiala, and Ludhiana (for urban metro areas). Data were collected from October 2015 to March 2016.
Mini International Neuropsychiatric Interview 6.0.0 and Adapted Fagerstrom Nicotine Dependence Scale were used to diagnose mental and behavioral disorders and tobacco use disorder, respectively. Pathways Interview Schedule of the World Health Organization was applied to persons having any disorder to assess treatment gap and health care utilization. Exploratory focused group discussions (FGDs) were conducted to understand the community perceptions regarding mental and behavioral disorders.
The treatment gap for mental and behavioral disorders was 79.59%, and it was higher for common mental disorders than severe mental disorders and higher for alcohol and tobacco use disorders as compared to opioid use disorders. The median treatment lag was 6 months. Only seven patients out of 79 were taking treatment from a psychiatrist, and the average distance traveled by the patient for treatment was 37.61 ± 45.5 km. Many attitudinal, structural, and other barriers leading to high treatment gaps were identified during FGDs in the community, such as stigma, poor knowledge about mental health, deficiency of psychiatrists, and distance from the hospital.
Vertical as well as horizontal multisectoral integration is required to reduce the treatment gap and improve healthcare utilization. Increasing mental health literacy, providing high-quality mental health services at the primary-healthcare level and human resources development are the need of the hour.
Indian National Mental Health Survey reports an alarming prevalence of 20.9% for tobacco dependence in India. Dependence on smoked tobacco can be prevented by thorough knowledge of the risk factors ...associated with it.
To estimate the prevalence and identify the factors associated with smoked tobacco dependence among participants attending the life skills training and counselling services programme (LSTCSP) across Karnataka from 2017 to 2022.
Pretraining data of 3104 participants from training programmes between 2017 and 2022 were utilised. Univariate and multivariable logistic regression analysis was performed based on a conceptual framework with various hypothesised exposure variables and smoked tobacco dependence as outcome.
The overall prevalence of smoked tobacco dependence among LSTCSP participants who used smoked tobacco products was 59.4%. Ever use of smokeless tobacco products (Adjusted odds ratio (AOR) =2.05, 95% CI: 1.11-3.78) and screening positive for symptoms of generalised anxiety (AOR = 2.53, 95% CI: 1.32-4.84) significantly increased the odds of smoked tobacco dependence, whereas making decisions collectively in the family (AOR = 0.35, 95% CI: 0.18-0.66) and individuals with increased score for neurotic personality traits (AOR = 0.64, 95% CI: 0.44-0.93) were the factors associated with reduced odds of smoked tobacco dependence.
The identified risk factors associated with smoked tobacco dependence are important to develop tobacco control programmes as well as in preventing its onset. With the risk factors for smoked tobacco dependence identified, the results of this study have implications for health promotion and prevention programmes as well as cessation programmes related to smoked tobacco dependence, within India and similar countries.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background & objectives: Substance use disorders are a major public health concern in Punjab. However, reliable estimates of prevalence of substance use disorders are not available for the State. The ...present study reports estimates of prevalence of substance use disorders in Punjab, conducted as part of National Mental Health Survey, India.
Methods: Using multistage stratified random cluster sampling, 2895 individuals from 719 households of 60 clusters (from 4 districts of Punjab) were interviewed. Mini International Neuropsychiatric Interview and Fagerstrom nicotine dependence scale were used to assess substance use disorders.
Results: The sample comprised almost equal numbers of males and females. Nearly 80 per cent had less than or equal to high school education, and 70 per cent were married. The weighted prevalence of alcohol and other substance use disorders was 7.9 and 2.48 per cent, respectively. The prevalence of tobacco dependence was 5.5 per cent; 35 per cent households had one person with substance use disorder. The prevalence was highest in the productive age group (30-39 yr), urban metro and less educated persons. The prevalence of alcohol and other substance use disorders was much higher in Punjab as compared to other States where survey was done. Tobacco dependence was lowest in Punjab. Majority (87%) of the persons with substance use disorders did not suffer from any other mental disorder. Treatment gap was 80 per cent.
Interpretation & conclusions: Punjab has a high burden of substance use disorders. The estimates will help clinicians and policymakers to plan the strategies against the menace of substance use disorders effectively.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Context: Occupational health surveillance in India, focused on notifiable diseases, relies heavily on periodic medical examination, and isolated surveys. The opportunities to identify changes in ...morbidity patterns utilizing data available in workplace on-site clinics is less explored in India context. Aims: Present paper describes longitudinal assessment of morbidity patterns and trends among employees seeking care in occupation health clinic (OHC). The study also intends to explore associations between work department, clinic visits and morbidity pattern. Materials and Methods: Record-based analysis was undertaken on data available (for the period 2010-2014) from two OHCs in a leading automobile industry in India. The doctor, examining every employee, documented the provisional diagnosis in specific software which in turn provides summary diagnosis based on affected body organ system as per ICD-10 categories. This information was used to assess the morbidity pattern and trend among workers. Chi-square test of significance and Extended Mantel-Haenszel chi square test was used assess the association and its linear trend. Results: Respiratory, musculoskeletal and digestive system related diseases were the top three reasons for employees visit to OHC. The nature of morbidity varied across different departments in the industry. There was a significant increase in proportion of employees visiting OHC during 2010-2014. Conclusion: A clinic visit record, with its own strengths and limitations, provides information on morbidity pattern and its trends among workers. Such information will help plan, implement and evaluate health preventive, promotive, and curative services.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Youth are consideren to be most vulnerable to health and lifestyle issues (HLS) in India. The current study aims to investigate the factors that contribute to health and lifestyle issues among youth ...attending mental health promotion clinics (YMHP) in Karnataka.
Three-year first-visit data from beneficiaries (aged 15-35 years) attending YMHP clinics in Karnataka between 2017 and 2020 were analyzed. Multivariable logistic regression analysis included beneficiaries reporting any HLS issue as the outcome and a host of 57 hypothesized variables as exposures.
Overall, 2,615 (25%) beneficiaries reported HLS issues. Years of schooling (AOR 5-7 years = 0.89; 95% confidence interval CI =0.60-1.31), (AOR 8-10 years = 0.65; 95% CI = 0.46-0.91), (AOR >10 years = 0.67; 95% CI = 0.49-0.93), unemployed youth (AOR = 0.52; 95% CI = 0.45-0.61) business and salaried workers (AOR = 1.69; 95% CI = 1.33-2.13), and other occupations (AOR = 2.11; 95% CI = 1.73-2.56), junk food consumption (AOR = 0.76;95% CI = 0.68-0.84), having issues related to relationships with parents (AOR = 3.01; 95% CI = 2.47-3.68) and intergenerational issues (AOR = 1.71; 95% CI = 1.19-2.45), self-development issues (AOR low-self-awareness = 1.57; 95% CI = 1.33-1.85), (AOR low-self-esteem = 1.29; 95% CI = 1.062-1.57), (AOR emotional issues = 1.57; 95% CI = 1.31-1.89), education and academics (AOR = 1.23; 95% CI = 1.09-1.39), safety issues (AOR = 4.11; 95% CI = 3.07-5.50), gender sex and sexuality issues (AOR = 2.44; 95% CI = 1.43-4.15), suicidal ideation (AOR = 1.91; 95% CI = 1.44-2.54), substance use (AOR tobacco chewing = 1.45; 95% CI = 1.09-1.93), (AOR tobacco-smoking = 1.66; 95% CI = 1.18-2.32), (AOR smoking = 4.94; 95% CI = 3.52-6.93) and experiencing emotions (AOR feel anxious = 1.63; 95% CI = 1.41-1.88), (AOR forgetfulness = 1.50; 95% CI = 1.41-1.98), (AOR difficulty in concentration = 1.37; 95% CI = 1.035-1.81), (AOR anger = 1.61; 95% CI = 1.25-2.07), (AOR feel worthless = 2.21; 95% CI = 1.71-2.86) were associated with HLS issues among beneficiaries.
This analysis addresses an important but neglected component of HLS issues among youth highlighting the importance of early intervention among youth to prevent the development of diseases later in life. The study has important implications for youth health promotion in India and countries such as India.
A record analysis of contributing factors among beneficiaries attending Youth Mental Health promotion clinics (Yuva Spandana Kendras) in Karnataka, India.
About 14% of the global mental health burden is contributed by India. However, there exists a disparity in mental health patterns, utilization, and prioritization among various Indian states. The ...state of Madhya Pradesh is a low performer among Indian states, ranking lower than the national average on the Human Development Index, Hunger Index, and Gross Domestic Product (GDP). The state also performes poorly on other health-related indicators. Objectives of Study: To estimate the prevalence and patterns of mental illnesses in the state of Madhya Pradesh, India.
This study used the multistage, stratified, random cluster sampling technique, with selection probability proportionate to size at each stage. A total of 3240 individuals 18 years and older were interviewed. The mixed-method study that was employed had both quantitative and qualitative components. The Mini International Neuropsychiatric Interview along with 10 other instruments were used.
The overall weighted prevalence for any mental illness was 13.9%, with 16.7% over the lifetime. The treatment gap for all of the mental health problems is very high (91%), along with high suicidal risk and substance use in the state.
This study provides evidence of the huge burden of mental, behavioral, and substance use disorders as well as the treatment gap in Madhya Pradesh. This information is crucial for developing an effective prevention and control strategy. The high treatment gap in the state calls for coordinated efforts from all stakeholders, including policy makers, political leaders, health care professionals, and the society at large to give mental health care its due priority. These findings also highlight the need for multi-pronged interventions rooted in health policy directed at reducing the treatment gap in the short term and disease burden in the long run.
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