ABSTRACT
Background: Hypertension is a major public health problem in India and considered as a silent killer disease. The national program for prevention and control of cancer, diabetes, CVD and stroke (NPCDCS) recommended opportunistic screening for hypertension at all levels health facility. The present study was conducted with the objectives to estimate the magnitude of hypertension among the General OPD attendees aged 18 years and above in tertiary care hospital in a district of West Bengal and to find out the factors influencing hypertension among them.Methods: The study was a hospital based observational, descriptive study with cross sectional design and conducted among 244 study participants in 2018. Study variables included socio demographic factors and both modifiable and non-modifiable risk factors for hypertension.Results: In this study 40.2% subjects had normal blood pressure, 18.4% were known hypertensive and 101 (41.3%) people were newly diagnosed as having high blood pressure. Among known hypertensive, 75% had poor control of hypertension. Age, religion, family history of hypertension, body mass index (BMI) and central obesity had significant association with hypertension.Conclusions: The study recommended strengthening of opportunistic screening of all patients for hypertension at all levels of health care, especially through the village health nutrition day platform and providing treatment free of cost. Awareness generation and counselling for lifestyle modification should also be strengthened.
ABSTRACT
Objectives: Due to rapid urbanization and the absence of an urban health policy until 2013, India's large and rapidly growing urban poor has very limited access to health and nutrition services. The Government of Madhya Pradesh sought assistance to systematically increase coverage of bi-annual Vitamin A supplementation in urban slums of Bhopal - a city of 2.37 million people. The objective was to improve access to and utilization of services provided during biannual VAS rounds in urban-poor settings. Methods: Formative research was undertaken to identify factors affecting utilization of services. Mapping exercises identified new delivery points and staffing needs across under-served slum areas. Based on findings, community awareness generation activities were carried out to reach care-givers and service-providers. Health workers and managers were reoriented on biannual child health round and trained on demand generation, counseling, estimation and management of supplies, program review, monitoring and reporting. Private practitioners were oriented to participate in VAS campaigns. Results: Eight new delivery points in two administrative zones were identified and staffed with trained VAS distributors. VAS coverage by government monitoring systems was 65% in August 2013, a substantial increase from the 22% measured in the November 2012 survey. Conclusions: Mapping, identifying and establishing additional service delivery sites, and capacity building of service providers resulted in improved access to and utilization of Vitamin A services in urban slums. Based on preliminary successes, various components of the program were replicated in other locations of Bhopal city and were included in government plans and budget.