ABSTRACT
Background & Objectives: India, with 1.22 billion populations, is the second most populous country in the world. India contributes 17.31% population in the world. Demographers expect India's population to surpass the population of China by 2030. Recent data of NFHS III revealed that 13% of married women have unmet need for family planning in India so this study was planned to estimate the prevalence of unmet need for Family Planning among married women of reproductive age residing at UHTC area Government Medical College Bhavnagar and to find out the determinants of unmet need for Family Planning in the study population. Methods: This was a cross sectional descriptive study conducted in UHTC catchment area of Government Medical College; Bhavnagar from August 2011 to October 2011. The calculated sample size was 140 (P=9.76, L=5%). A total 150 married women of reproductive age group (15-49 years) were interviewed for the same with their informed consent. The data were entered and analysed in software epi.info.3.5.1. Results: The prevalence of unmet need for Family Planning in UHTC catchment area was found to 18.7%. The unmet need was higher for temporary methods of Family Planning (10.0%), in the women age group of 20-29 years (71.5%), Illiterate (42.8%), Muslim women(42.8%), poor knowledge of contraception(82.1%), no advice on Family Planning (57.1%) and no male participation (75.0%). These entire variable were found to be associated with high unmet need for Family Planning (P<0.05). Interpretation & Conclusion: The present study concluded that the percentage of unmet need years, low education and also in Muslim religious women. To decrease unmet need family planning measures should be specifically directed toward this group of women. Health education and strategic behaviour change communication for appropriate target audience is requiring cope up unmet need.
ABSTRACT
Background & Objectives: The desired impact of IMNCI is the reduction of mortality, morbidity and suffering, through assuring children’s access to quality health care in health facilities and improved case management at home. Maintaining the performance of health and village workers is essential to achieve this impact. So objective of this study is to assess IMNCI implementation in Bhavnagar district of Gujarat to strategize for accelerating effective implementation. Methods: A cross sectional study was carried out in March 2012 in Bhavnagar district. Four blocks of Bhavnagar district were purposefully selected out of seven blocks on the basis of immunization coverage of previous year. From each block one best PHC and from selected PHC one best sub-centre and one best Anganwadi were selected purposefully by solely on basis of perception of Medical Officer in charge PHC and BHO for implementation of IMNCI in their area in last one year. The purpose of adopting such method was to evaluate the performance of IMNCI implementation in centres (PHC, SC, AW) that was judged best by their supervisors. After selection, PHC, SC and Anganwadi centre were visited to assess the practice of IMNCI by ANM and Anganwadi Worker. Medical Officer, Health Supervisors and ICDS officers were interviewed to understand overall implementation process. For collecting data pre-tested and predesigned questionnaire was utilized. Results: Basic IMNCI training in Bhavnagar was completed in 90% of health and ICDS workers. More than 87.5% workers said that their knowledge, skill, confidence and credibility among community were increased after IMNCI training. Logistic and drugs supply were insufficient at sub centre and Anganwadi centre. Out of the total 80 filled IMNCI case sheets by the health and ICDS workers, 32(40%) were found accurately complete as the correctly filling of all the column (assessment and classification and treatment) in form considered as complete form. Accurate classification, management and advice of cases according to IMNCI guidelines were 62 (77.5%), 42 (52.5%) and 38 (47.5%) respectively as the accurate classification (assessment, classification and treatment) of the entire column in form correctly. Combination of one correct and other incorrect assessment or classification or treatment considered as partial accurate and inaccurate if all the column were not assessed or not classified or not given the treatment correctly. While observing actual practice of IMNCI, accuracy among health and ICDS workers was found in assessment 5(31.3%), Classification 8(50%) and treatment 7(43.8%). Supportive supervision and feedback mechanism were lacking at all level. Interpretation & Conclusion: Supportive supervision and feedback mechanism are key concern and must address. Proper logistic and drugs planning and management also main concern for IMNCI programme.
ABSTRACT
Research Question: What is the situation of Iodine Deficiency Disorders (IDD) and salt consumption in Porbandar district? Objectives: To assess the magnitude of IDD in Porbandar district and also assess the salt consumption patterns in the region. Design: Cross Sectional Study. Setting: Primary schools in rural areas. Study Tools: Clinical examination of study population for goiter, laboratory assessment of urine samples of study population. Participants: Study was conducted among 2700 school children in the age group of 6-12 years from 30 clusters. Urine samples were collected from 10% of selected children and salt samples from 20% of the selected children. Results: An overall goiter prevalence of 8.8% was observed in the region. Girls had a prevalence of 9.6% and boys had 8.0%. The median urinary iodine excretion in the region was 65 μg/l. 61.9% of children had biochemical iodine deficiency with 25.2%, 14.8% and 21.9% having severe, moderate and mild iodine deficiency respectively. In Porbandar district, only 72.4% households consume salt with Iodine content of more than 15 ppm. Conclusion: Iodine Deficiency is a public health problem in the Porbandar district.
ABSTRACT
Background: Health and Nutrition Day, “Mamta Day”, a concept for interdepartmental convergence having desirable health outcomes of children below five years, antenatal and postnatal women and adolescent girls is being introduced in the State of Gujarat by the Department of Health and Family Welfare. This would provide the first point of contact for essential primary health care and would work as the common platform for convergence amongst service providers of Health, ICDS and the community. Objectives: to identifying gaps in planning and organizing Mamta Day to improve quality of services. Methods: 30 from total 261 Anganwadis (AWs) were selected by Systematic Random Sampling. A structured proforma was prepared for data collection. Results and Conclusion: Anganwadi workers had not prepared/shared list of beneficiaries on the Mamta Day and there was no active tracking of drop outs/ left outs. All children were not being weighed on the day of Mamta day and growth chart and community growth chart were not prepared and updated. The professional performance by PHN/ANMs in urban areas in the provision of antenatal care was found to be unsatisfactory. There was miss opportunity in catering health education to beneficiaries. Recommendation: There is need to improve the quality of antenatal/child care through organisational review and implementation of relevant policies and on the job training to improve the skills of frontline workers. The provision of supplies and equipment and its maintenance should be a priority. There is need to strengthen supportive supervision by Health and ICDS supervisors.