ABSTRACT
Background: Community participation is one of the core principles of Primary Health Care. VHNSC is example of community participation and is formed to take collective actions on health issues and its social determinants of health (SDH). It is envisaged as being central to local level community action to support decentralized health planning. Work on actual participation of VHSNC on SDH is almost negligible. Therefore, the present research study was conducted to find out the participation of VHNSC on SDH. Aim: To assess the involvement of VHNSC on SDH. Methods and Material: Knowledge on SDH and health actions of VHNSCs were studied using a questionnaire which was pretested and suitably modified. The study was conducted in all the 83 VHNSCs under 4 PHCs namely Waiphad, Anji, Kharangana Gode and Talegaon were choosen as per feasibility. Results: Members of all VHNSCs had knowledge about access to safe drinking water, sanitation and nutrition as SDH. Members from 6 (7.2%) VHNSCs could not relate literacy with health. Most had to be probed regarding knowledge about addiction to tobacco and alcohol; social deprivation and availability of emergency transport. Conclusions: VHNSC are moving in the right direction however they require continuous support, hand holding and monitoring from government and other NGOs.
ABSTRACT
Objective: To review the Mid-upper arm circumference (MUAC) cut-off currently being usedto identify Severe Acute Malnutrition (SAM) as currently defined using Weight-for-Height.Methods: Cross-sectional study conducted in 24 villages of a Primary Health Centre inWardha district of Maharashtra among 2650 children between the ages of 6 to 59 months.Results: For identifying SAM, sensitivity of MUAC was 23.5% and specificity was 99.7% forcut-off <11.5 cm. Using Youden index, best Mid-upper arm circumference cut-off point toidentify SAM was <13 cm with sensitivity of 74.5% and specificity of 92.7%. Using Receiveroperating characteristics curve, best MUAC cut-off point was 12.8 cm with 74.5%sensitivity and 92.7% specificity. Area under curve was 0.88 (95%CI: 0.85-0.91).Conclusion:The current MUAC cut-off of <11.5 cm for detecting SAM needs to beincreased to ensure that children, who need referral for management of malnutrition, are notmissed.
ABSTRACT
OBJECTIVES: The objectives of the present study were to study the pattern of tobacco use among rural adolescents (15-19 years) and to find out reasons for use and non use of tobacco products. MATERIALS AND METHODS: In the present community-based research, triangulation of qualitative (free list, focus group discussions) and quantitative methods (survey) was undertaken. The study was carried out in surrounding 11 villages of the Kasturba Rural Health Training Centre, Anji during January 2008 where 385 adolescents were selected by simple random sampling and interviewed by house to house visits. After survey, six focus group discussions were undertaken with adolescent boys. RESULTS: About 68.3% boys and 12.4% girls had consumed any tobacco products in last 30 days. Out of boys who had consumed tobacco, 79.2% consumed kharra, and 46.4% consumed gutka. Among boys, 51.2% consumed it due to peer pressure, 35.2% consumed tobacco as they felt better, and five percent consumed tobacco to ease abdominal complaints and dental problem. Among girls, 72% used dry snuff for teeth cleaning, 32% and 20% consumed tobacco in the form of gutka and tobacco & lime respectively. The reasons for non use of tobacco among girls were fear of cancer (59%), poor oral health (37.9%). Among non consuming boys it was fear of cancer (58.6%), poor oral health (44.8%) and fear of getting addiction (29.3%). According to FGD respondents, few adolescent boys taste tobacco by 8-10 years of age, while girls do it by 12-13 years. Peer pressure acts as a pro tobacco influence among boys who are outgoing and spend more time with their friends. They prefer to consume freshly prepared kharra which was supposed to be less strong (tej) than gutka. Tobacco is being used in treatment of some health problems. Tobacco is chewed after meals for better digestion, given to ease toothache, pain in abdomen and to induce vomiting in suicidal insecticide poisoning. CONCLUSION: The current consumption of any tobacco products among rural adolescents was found very high. Hence, the multi-pronged intervention strategy is needed to tackle the problem.