ABSTRACT
Background: Although more than one-third of under six year children in Delhi slums are undernourished; but what is the situation in rural areas of Delhi - a capital of India, it is not very clear. Moreover the research in rural area on topic has also not received much focus in past. Methods: The study was done in the Narela area (a Rural ICDS project in Delhi). All the eligible 450 children between the age group 0-5 years as found in the survey register of ICDS project for 2 Anaganwadi Centre’s (AWC-A & AWC-B) at the time of data collection, were included in the study. The prevalence of undernutrition in 2 AWCs was determined and it was compared with records of 2 AWCs. The primary and secondary data was triangulated to confirm pattern scenario of undernutrition. Results: In Rural ICDS Block, the prevalence of underutrition came out 57.8%.The difference in nutritional grades of undernutrition in the study were not statistically significant (P >0.05) as per their the registration status at AWCs in ICDS scheme. The type of family and family income of household however were statistically significantly associated with the nutritional status of child (P <0.01). Conclusions: The undernutrition is prevailing in rural area of Delhi (India), despite the presence of ICDS scheme; suggesting that other host factors in family are also important and service delivery factors in nutrition and health programmes also needs radical relook for tackling undernourished children in Delhi.
ABSTRACT
OBJECTIVES: To understand the perceptions and likely determinants that facilitate or act as barriers in implementing additional strategies for polio eradication: (a) accelerated delivery of mOPV1 (monovalent polio vaccine type 1); (b) use of IPV (inactivated polio vaccine); and (c) provision of incentives. DESIGN: QUALITATIVE. Rapid appraisal procedures (RAP) were adopted to derive the reality by synthesizing multiple sources of information; search for opinions, motivations, behaviors and attitudes of key stakeholders within their organizational and socio-cultural matrix. SETTING: Two districts of Uttar Pradesh - Moradabad and J P Nagar. SUBJECTS: Total 244 interactions were conducted; 33 interviews and 4 focussed group discussions (FGD) conducted with providers; 33 mothers (<5 years) and 10 leaders were interviewed; 8 FGD were conducted with mothers of under-fives. Informal interactions (156) were also conducted with village pradhans, religious leaders, parents, businessmen, journalists (Hindi and Urdu media), mobilizers, vaccinators and supervisors. RESULTS: Providers expressed reservation regarding accelerated rounds of OPV; scientific rationale of accelerated rounds is not clear to parents and leaders. Although technical advantages of introducing IPV exist, issues of logistical difficulties and injection safety emerged strongly. Providers and communities indicated a clear 'no' to the cash incentives but argued for developmental issues. Resistance to the program has declined over time but still the program is perceived as the "government's need, not ours". CONCLUSION: The polio eradication program is critically poised, an opportunity to intensify efforts for reducing inequities in health services and improve access of all children to the PHC services. Ongoing dialogue with local communities and strong political commitment would be essential to translate the technological innovations into a sustainable program.