Health systems and polices have a critical role in determining the manner in which health services are delivered, utilized and affect health outcomes. ‘Health' being a state subject, despite the issuance of the guidelines by the central government, the final prerogative on implementation of the initiatives on newborn care lies with the states. This article briefly describes the public health structure in the country and traces the evolution of the major health programs and initiatives with a particular focus on newborn health.

Background: Tobacco use is the single, largest preventable cause of death and disability worldwide. Area-specific community-based epidemiological studies on tobacco use are required to quantify the problem, identify the determinants and their distribution. The objectives were to find out the prevalence, patterns and socio-demographic correlates of tobacco use in Davangere taluka, Karnataka, India.Methods: This was a community-based, cross-sectional study of 2008 subjects (>10 years of age) in urban and rural areas of Davangere taluka, Karnataka. Interviews were conducted by using a structured, pre-tested questionnaire by house-house visits.  Results are presented using percentages, chi-square test, odds ratio and multiple logistic regression analysis.Results: The prevalence of tobacco use was 30.7%. Among urban males it was 39.5%, rural males 39.6%, rural females 26% and urban females 18.5%. Tobacco use was significantly associated with sex, locality, religion, caste, marital status, family type, occupation, and tobacco use in family or friends. There was direct relationship of tobacco use with age and inverse relationship with education and socio-economic status. Mixed tobacco use was higher in rural areas compared to urban areas. About 73.9% of 10-29 years persons had started before the age of 18 years. Among older participants there was higher frequency of consumption and duration of use.Conclusions: Tobacco use is common and it is influenced by various local socio-demographic factors. Addressing these factors and providing tobacco cessation services should be included as key strategies in tobacco control.

Background: Rabies disease continues to be most feared of all communicable diseases. Rabies is a zoonotic disease & transmitted by animal bites, mainly dogs. India accounts for 59.9% of rabies deaths in Asia and 35% of deaths globally. One of the important factors associated with successful treatment is the knowledge of the care giver in the correct management of animal bites and vaccination against rabies. Objectives: i) To assess the knowledge towards animal bite management, and (ii) To study the knowledge, attitude & practices regarding pre and post-exposure prophylaxis (PEP) of rabies amongst interns in a D. Y. Patil Medical College, & Hospital, Kolhapur, Maharashtra, a tertiary care teaching hospital. Material and Methods: i) Study design - An observational - cross sectional, knowledge, attitude & practices (KAP) study. ii) Tools used - Predesigned, pretested, structured questionnaire based survey in interns on animal bite wound management and pre & post-exposure prophylaxis for rabies. iii) Study population – Interns working in D. Y. Patil Hospital, Kolhapur during study period, iv) Statistical tests – mean, percentage and other statistical analysis was conducted by using Microsoft- Excel.

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Introduction: Metabolic surgery is a treatment option for the Type-2 Diabetes (T2D) patients with high BMI. Are T2D patients aware or willing to undergo metabolic surgery needs to be answered. Objectives: The objectives of the study were assessment of the level of knowledge of effectiveness of metabolic surgery in T2D treatment, remission and its acceptance as part of diabetes management; AND finding the determinants of the knowledge and acceptance of this procedure among T2D patients with BMI ≥ 30 kg/m 2 in Primary heath care centers (PHCCs) of Jeddah, Saudi Arabia. Materials and Methods: A cross-sectional study, with a total of 455 interviews, was conducted using standard Likert-type questionnaire, among T2D patients with BMI ≥ 30 kg/m 2 , who attended five randomly selected PHCC's in Jeddah. Binary logistic regression analysis was done to identify the determinants of knowledge and acceptance of metabolic surgery. Results: The majority were Saudi citizens (83.7%) and females (55.6%). The mean age was 47.6 ± 9.6 years (23-65 years) and the mean BMI was 34.3 ± 3.3 kg/m 2 (30-45.8 kg/m 2 . About 41.1% had no clear opinion for the question on effectiveness of metabolic surgery. Among the remaining (268), 63.1% felt it is effective in T2D treatment and 60.6% in T2D Remission. Out of 348 patients, 49.1% were willing for metabolic surgery and 40.3% not willing. The adjusted determinants of willing to undergo metabolic surgery were age, (54 years plus vs 36 years or less: OR=0.230; 95% CI=0.069-0.769); education (bachelor degree vs illiterates: OR=0.025; 95%CI=0.001-0.890); 5000-15000 SR/month vs less than 5000 SR/month: OR=6.910; 95% CI=2.890-16.519); marital status (widower vs singles: OR=0.027;95%CI= 0.003-0.219); and A1c level (A1c level 10 or more vs A1c level ≥ 5 -<10: 0R=3.274; 95%CI=1.736-6.174). Only 7.7% of T2D patients were offered metabolic surgery as a treatment option by the treating physician at PHCCs. Conclusion:The good knowledge of metabolic surgery among participants did not enhance to willingness to accept it as T2D management. Age, marital status, education level, income and A1c level determine the willingness for metabolic surgery among T2D patients with BMI >30 or more.