Background Vaccine acceptance and hesitancy among the general population and health care workers play an important role in successfully controlling the Coronavirus Disease (COVID)-19 pandemic. While there is evidence for vaccine hesitancy across the globe, wide variation in factors influencing vaccine acceptance has been reported, mainly from High-Income Countries (HIC). However, the evidence from Low- and Middle-Income Countries (LMICs) remains unclear. The objective of this review was to describe the determinants of vaccine acceptance and strategies to address those in an LMIC context. Methods The World Health Organization’s (WHO) Measuring Behavioral and Social Drivers of Vaccination (BeSD) Increasing Vaccination Model was employed to identify factors that influenced vaccine acceptance. All evidence related to supply-side and demand-side determinants and social and health system processes were examined. A comprehensive search for published literature was conducted in three databases and grey literature in relevant websites of government, multinational agencies, and COVID-19 resource aggregators, followed by a narrative synthesis. Results Overall, the results showed that the vaccine acceptance rates differed across LMICs, with a wide variety of reasons cited for vaccine hesitancy. Vaccine acceptance was reportedly greater among males, those with higher education, elevated socio-economic status, the unmarried, those employed as health care workers. Evidence suggested that exposure to misinformation about COVID-19 vaccines and public concerns over the safety of vaccines may contribute to lower acceptance rates. Strategies to increase vaccine acceptance rates included direct engagement with communities through influencers, including community leaders and health experts; clear and transparent communication about COVID-19 vaccines, financial and non-financial incentives; and strong endorsement from health care workers. Trust in government was identified as a significant enabler of vaccine acceptance. Conclusions There is a need for measures to address public acceptability, trust and concern over the safety and benefit of approved vaccines. Local context is essential to consider while developing programs to promote vaccine uptake. The governments worldwide also need to strategize to develop plans to address the anxiety and vaccine related concerns of community regarding vaccine hesitancy. There is a need for further research to evaluate strategies to address vaccine hesitancy in LMIC.

Background Stroke is one of the most debilitating conditions contributing to significant disability and death globally. Identifying risk factors for quality of life (QoL) will enable to improve home-based rehabilitation in post-stroke phase. Objective This study was aimed to identify the risk factors of QoL in stroke patients in the sub-Himalayan region. Materials and Methods A cross-sectional hospital-based study assessed the QoL among stroke patients within a week after the onset of acute stroke and then re-evaluated at 3 months. World Health Organization QoL-BREF, Beck Depression Inventory, the Barthel Index, and Montreal Cognitive Assessment (MOCA) were used to seek data on QoL, depression, cognitive, and functional dependence status, respectively. Appropriate statistics were used to compute the results. Results In total, 129 stroke patients recruited, out of which 102 returned to a 3-month follow-up. QoL, MOCA, disability index, and depression score were compared using Wilcoxon Singed-rank test. In multivariate analysis, depression and disability together predicted 60% of the variance for physical QoL (p < 0.0001). Similarly, poststroke depression and disability together predicted 61% of the variance for psychological QoL (p < 0.0001) in stroke patients. Conclusion Findings indicated that depression and disability are leading risk factors of QoL in stroke patients. Early identification of poststroke depression and functional dependence status is, therefore, essential to devise screening procedure and to develop targeted intervention to improve rehabilitation outcomes.

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The Indian health system utilized the extenuating circumstances as an opportunity to understand key limitations and repurpose and strengthen the health system. In other words, it showed resilience.

Background: Coronavirus diesease (COVID-19) led to increased demand on the Indian health system due to the pandemic as well as other communicable and non-communicable diseases. Guidance was thus issued by the Ministry of Health and Family Welfare (MoHFW), India, in April 2020 to maintain the delivery of essential health services. Objectives: To determine the extent of disruptions of essential healthcare services, identify associated factors, and establish pertinent correlations to address specific needs. Methods: The Mother and child tracking facilitation centre (MCTFC) conducted a telephonic survey with the front-line workers (FLWs) and beneficiaries in 21 Indian states. The sample size was determined using the infinite population sample size formula, and respondents were selected through a computer-generated random sequence technique. Data were quantitatively analysed using STATA-16. Descriptive univariate analysis was conducted using the Chi-square test. Findings: The majority of the essential health services were being satisfactorily delivered by FLWs ( N = 1596; accredited social health activist (ASHA) = 798, auxiliary nurse midwife (ANM) = 798), where most of the beneficiaries ( N = 1410; Pregnant Women = 708, Postnatal Women = 702) continued accessing services with minor issues concerning referral transport. FLWs reported issues in the provisioning of medicines (P = 0.000 ) for patients with non-communicable diseases and more ANMs than ASHAs reported it. FLWs commonly experienced challenges in extending services due to community resistance and unavailability of general health services at healthcare facilities, where a greater number of ASHAs faced it ( P = 0.000). Both FLWs and beneficiaries ( N = 3006; FLWs = 1596, beneficiaries = 1410) demonstrated appropriate COVID-19 knowledge and behavior. Conclusion: Although overwhelmed, the Indian health system performed satisfactorily well during pandemic in terms of essential health services.

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A BSTRACT The global share of elderly persons (60 years and above) is expected to rise from 13.4% in 2020 to 21.3% by 2050. In India, the elderly population accounts for 8.6% of the total population. A large share of responsibility on ensuring the health and well-being befalls on the government. Driven by the vision of healthy ageing , the National Programme for the Health Care of Elderly (NPHCE) was launched in 2011 by the Ministry of Health and Family Welfare. Yet, its effective implementation is challenged by the changing landscapes and epidemiological transitions. This review article explores the progress of elderly care with NPHCE, with a special focus on its implementation status, service delivery, and human resources to provide future directions for the program. It primarily uses the Common Review Mission Reports (2007–2019), archival sources from government websites, and relevant literature from PubMed, MEDLINE, and Google Scholar to provide an informed perspective of elderly care in India. We conclude that NPHCE requires strengthening through collaborative action between the relevant stakeholders. Strong implementation of appropriate policies and programs to address health care challenges of the ageing population is of crucial importance for India to achieve the health care needs of its elderly. As the elderly population is set to grow dramatically in the next few decades, this review article reveals areas needing urgent attention to strengthen elderly care through NPHCE in India.

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