ABSTRACT
Background: Adolescents are at the peak of growth velocity and warrant special consideration as they undergo enormous psychological, physical as well as cognitive changes. The Government of India implemented friendly adolescent reproductive and sexual health (ARSH) clinics to improve healthcare services all over the country. However, there is lack of information on the sustainability of the programme.Methods: Community workers and public health workers from randomly selected twenty sub centres for intervention from West Tripura district and control from the adjacent Khowai district were selected. Knowledge prior and post intervention at both sites of the health workers was assessed by a self-administered questionnaire on 0 day, at 3, 6 and 12 months. Difference of knowledge score was analysed by paired t-test.Results: The mean knowledge score significantly differed at pre-intervention and immediately post intervention (p<0.01). The knowledge score was sustained even after 12 months of intervention among public (14.63±3.01) and community health workers (12.53±2.91). However, at the control site, a gradual decrease was noted over duration of 12 months. Intervention also considerably increased the utilization of ARSH clinics by both male and females in comparison to previous year’s data.Conclusions: The intervention and increased sustainability of acquired knowledge over 12 months seem to enhance the capacity for the adolescent clinics. Therefore, training the health workers to manage various sexual and reproductive health issues along with creating a friendly environment for adolescents is indispensable in the present setting.
ABSTRACT
Glycosylated hemoglobin (HbA1c), a marker of chronic hyperglycemia, has been recommended for use, in the diagnosis of diabetes. Objective: To assess the mean HbA1c level among reproductive age women in Tripura and to study the factors associated with high HbA1c level (≥ 6.5 %). Material & Methods: This cross-sectional study was conducted in Tripura among 2000 reproductive age women selected by Cluster sampling using PPS technique. Results: The present study revealed that the mean HbA1c level was 5.29 + 0.83% among the reproductive age women with 3.95% participants having HbA1c level of ≥ 6.5%). Multiple logistic regression analysis revealed that the age group and income of the family had a significant effect on the HbA1c status. Scheduled tribe women had 0.43 odds (0.22-0.81) of having high HbA1cstatus compared to women from general caste. Conclusion: The present study provided the reference values for HbA1c distribution among reproductive age women in Tripura and may be useful in the early identification of at-risk individuals.
ABSTRACT
Background: India’s National Rural Health Mission (NRHM) introduced Accredited Social Health Activists (ASHA) at the community level. Their vital role is to promote antenatal care and increase the utilization of the existing health services. The objectives were to find out utilization of ASHA services by the pregnant women and to study its determinants in rural area of Tripura, India. Methods: A community based cross-sectional study was conducted during February – April 2015 using a validated interview schedule among 306 recently delivered women residing in Mohanpur block of Tripura, chosen by multistage sampling. Results: Utilization rate of ASHA services by pregnant women was found to be 89.7%. Pregnancy registration rate was 95% and 90% of these registrations were facilitated by ASHA. Adequate antenatal check-up rate facilitated by ASHA was 76.69%. Regarding Iron and Folic Acid prophylaxis, 67.88% of the adequate recipients were facilitated by ASHA. For laboratory tests, 80.23% of the women were motivated by ASHA. About 90% of the study women have heard about Janani Suraksha Yojona (JSY) scheme from ASHA and 70% of them got the benefit through ASHA. Literacy, parity, community, economic class, home visit by ASHA and family decision maker were identified as the significant determinants of utilization of ASHA services by the pregnant women. Conclusions: Utilization rate of the ASHA services by the pregnant women needs improvement. Apart from IEC activities, active home visits by ASHA, empowering couples to make their own fertility decisions, improvement in female literacy etc. may enhance utilization of ASHA services by this community which will intern enhance maternal health care utilization.