Gap between awareness and practices regarding maternal and child health among women in an urban slum community.

OBJECTIVE: To investigate the knowledge of ever-married women regarding maternal and child health and to assess existing gap between awareness and practice levels of lactating mothers. METHODS: Community based cross sectional study with 283 ever-married women in the reproductive age. RESULTS: Low levels of awareness and practice of TT immunization (74.2% awareness, 58.1% practice), five-cleans (31.9% awareness and 14.4% practice), trained birth attendant (69.6% awareness 39.1% practice), and post-natal care (75.4% awareness and 51.0% practice) among lactating mothers. Knowledge regarding optimal infant and young child feeding practices was very poor: initiation of breast-feeding within six hours (17.4%), colostrum feeding (34.8%), exclusive breastfeeding (5.8%) and significant gaps between knowledge and practice were observed. Highly significant difference (P<0.001) between proportions of women aware of ICDS (59.4%) and of beneficiaries (21.7%). High levels of awareness regarding reproductive health parameters except for contraception: desire for two children (81.6%), legal ages at marriages for girls (84.5%), desired birth interval of three or more years (71.7%). CONCLUSION: Wide gaps exist between awareness and practices related with MCH due to non-adoption of knowledge into actual practice, except some selected components lacking in both knowledge as well as practice. Need for bridging the existing gaps avoiding socio-cultural barriers and misconceptions prevailing in the community and by promoting and protecting healthy MCH care practices.

Surveillance of communicable diseases in tertiary health care system in Chandigarh, UT.

BACKGROUND: Communicable disease surveillance is to have baseline data which will be helpful for planning and also for identifying epidemics under non-evident conditions. OBJECTIVE: To delineate the pattern of occurrence of communicable diseases so as to enable early identification, followed by appropriate and timely response to outbreaks. MATERIALS AND METHODS: Reports of listed communicable diseases from various departments and centers of Government Medical College, Chandigarh, involved in clinical care and laboratory diagnosis, were collected by the Department of Community Medicine on a weekly basis. Analysis of surveillance data was done for a period of 1 year--including reports from March 2005 to February 2006. STATISTICAL ANALYSIS: Percentage, normal test of proportions, time series analysis. RESULTS: Out of 19,378 cases of various communicable diseases, 11,575, i.e, more than half, were dealt with by health centers. Thus maximum cases of acute respiratory infections (ARIs) [8,278 (71.87%)] and acute diarrheal diseases (ADDs) [3,148 (54.4%)] were dealt with by health centers. Of 19,378 cases, 11,518 (59.44%) were of ARIs, 5,786 (29.86%) of ADDs and 550 (2.84%) of pulmonary tuberculosis. There was no significant difference in the incidence of either disease between two sexes. Most, i.e, 4,413 (38.31%), cases of ARIs and 512 (86.49%) cases of pneumonia were reported in winter; ADDs--2,607 (45.05%) in summer; and typhoid--94 (41.04%) in the monsoon season. CONCLUSION: Maximum workload of common communicable diseases was borne by health centers. The most common morbidity was ARIs, followed by ADDs and pulmonary tuberculosis. No significant gender predilection was seen. Overall reporting of communicable diseases observed in three different seasons was found to show a gradual increase from winter to summer through monsoon. Some specific seasonal trends were demonstrated by various morbidities.