Papers by Koshy M Cherian
International Journal Of Community Medicine And Public Health, 2020
Background: Community capacity is superior in Kerala, making the people identify, mobilize, and a... more Background: Community capacity is superior in Kerala, making the people identify, mobilize, and address public health problems. The state of Kerala in South India was devastated by the 2018 August flood with cumulative rainfall of 2307 mm, 41% above the average rainfall received. Community participation helped to restore health with minimal post-flood morbidity. This paper intends to demonstrate the role of community participation in prophylaxis against Leptospirosis.Methods: As a part of post-flood recovery activity to prevent communicable diseases, the health system sought community health volunteers, local teachers, and philanthropic organizations. Training was given to volunteers to do preventive measures like chlorination of well water, provide leptospirosis prophylactic drugs based on the guidelines and promote the use of boiled water as well as personal and environmental hygiene. The health workers supervised preventive activities in the areas designated to the volunteers. M...
Indian Journal of Tuberculosis, 2021
BACKGROUND Despite many serious and organized efforts worldwide, Tuberculosis (TB) remains one of... more BACKGROUND Despite many serious and organized efforts worldwide, Tuberculosis (TB) remains one of the major public health concerns in many countries. India accounts for more than one quarter of global TB cases and deaths each year. India's National Tuberculosis Elimination Programme (NTEP) is the largest TB control program in the world, placing more than 100,000 patients on treatment every month. There have been so many revisions in the programme guidelines in the last 5 years. As we are gearing up for TB elimination in India, knowledge regarding the barriers is very crucial in the successful undertaking of these revised guidelines. Exploring perceptions of health care workers, both from the private and public sector will help to design appropriate strategies at the field level. OBJECTIVE To explore the barriers and facilitators among health care workers in the implementation of revised NTEP guidelines in a selected district of central Kerala. METHODOLOGY This qualitative study was conducted among health care workers from all levels involved in the implementation of NTEP from private and public sector. Qualitative data was collected through Focus Group Discussions (FGD) and Key Informant Interviews using a topic guide till data saturation. All discussions were audio recorded with the consent of participants. Sociogram was plotted to confirm equal participation of interviewees. A total of 4 FGDs (2 from each sector) and 12 Key informant interviews (7 from public sector and 5 from private sector) were conducted after obtaining written consent from the participants. RESULTS Overall awareness about revisions was found to be good. However, the study identified a "Gap between planners and implementers". Frequent nature of revisions without understanding the practical difficulties in the field, additional job responsibilities, inadequate knowledge among grass root level workers/private practioners in small clinics and increased side effects were the major barriers identified. In addition to that, insufficient logistics, not enthusiastic in learning revisions, fear of losing patients, delay in communication, decreased compliance with new regimen, increased out of pocket expenditure and grey areas in the current guidelines were also adversely affecting the successful implementation At the same time, facilitators like positive attitude and commitment of health care workers, introduction of M-health technology, strong public private partnership, inclusion of costly investigations in the revised guidelines, good administrative support, financial assistance, innovative initiatives like Treatment Support Groups (TSGs) and concept of Family Directly Observed Treatment Short-Course increased the effectiveness of the programme to a large extent. CONCLUSION The study identified gaps in knowledge, attitude and practice of revised guidelines at the field level. Gap between 'Planners and implementers could impede the successful implementation of TB Elimination programme and needs to be addressed.
Indian Journal of Occupational and Environmental Medicine, 2021
Background: Domestic squalor refers to households that are extremely cluttered, in a filthy condi... more Background: Domestic squalor refers to households that are extremely cluttered, in a filthy condition, and where the accumulation of items such as personal possessions, rubbish, excrement and decomposing food creates an environment that jeopardizes the health and wellbeing of the occupant(s). In India, an estimated 258 million are migrants. They are more likely to live in squalor due to inferior socio-economic status and no permanent residence. This poses a threat to the health of the migrants and the neighbors. Objective: To assess the squalor and morbidity pattern among the migrants of Migrant colonies in Thiruvalla using Rapid survey technique. Methodology: The state of squalor in migrant colonies was assessed by Lot Quality Assurance Sampling Methodology using the Environment Cleanliness and Clutter Scale (ECCS). The sample size for each lot/colony was '14' dwellings according to LQAS table. The details were collected from 14 inhabitants of different dwellings of the sam...
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Papers by Koshy M Cherian