ABSTRACT
Background: Anemia is a major public health problem especially in adolescent age group because of its intergenerational impact. The Ministry of Health and Family Welfare, India launched the weekly iron and folic acid supplementation programme for adolescent girls and boys. The objectives of the study were to study the awareness of the weekly iron and folic acid supplementation in preventing anemia in the study subjects; to assess the implementation of the weekly iron and folic acid supplementation in government schools and anganwadi centres.Methods: A cross-sectional study was carried out in the 4 government schools and 11 anganwadi centres of the urban field practising area of a tertiary health care centre, Osmania Medical College, Hyderabad. All the students who were present at the time of study, the teachers and anganwadi workers, who gave consent were included. The study was carried out for a period of 3 months (August to October, 2018) using a pretested schedule.Results: A total of 313 students, 21 teachers and 10 anganwadi workers had participated in the study. Among school students, only 15% had awareness of anemia. Girls had better knowledge than boys (p<0.05). The benefits of iron folic acid tablets were known to 17% students and 67% teachers. Most commonly side effects were nausea, vomiting and stomach pain. Irregular supply of tablets and poor maintainence of records was seen.Conclusions: The supply and distribution of tablets was found to be not in accordance with the guidelines of the programme.There is need of regular orientation to the teachers and anganwadi workers and nutrition education meetings for behaviour change communication to the parents.
ABSTRACT
Background: Tuberculosis is a major public health problem and is among top ten causes of deaths worldwide. People with diabetes are three times at higher risk of getting infected with tuberculosis. Globally 10.4 million TB cases exists of them 10% are linked to diabetes. In India 13% of Tuberculosis cases were diabetic. DM has been reported to modify the clinical features of TB. The objectives were to study the prevalence of diabetes mellitus among adult tuberculosis patients registered in DOTS centre in tertiary health care centre, Hyderabad and to study the clinical profile of tuberculosis in study subjects.Methods: A cross sectional study was conducted in 4 DOTS centres under tertiary health care facility, Hyderabad. Sample size 200 was calculated using formula 4PQ/L2. Study subjects were registered adult tuberculosis patients attending DOTS centre and undergoing anti tuberculosis treatment. Data from study subjects was obtained by interview method using semi structured questionnaire consisting of socio-demographic parameters and clinical parameters.Results: Out of 200 patients, the prevalence of DM was found to be 18% (n=36). Increasing age (p<0.000), male sex (p=0.04), low BMI (p=0.02), family history of TB (p=0.017), Sputum positive severity (p=0.0008) are significantly associated with DM-TB comorbidity and clinical manifestations like bilateral involvement (p=0.151), multi lobes (p=0.243), other associated lung diseases (p=0.154), treatment category (p=0.8203) are not significantly associated with DM-TB comorbidity.Conclusions: Bidirectional screening of TB and DM will detect early and prevent complications of comorbiditiy.
ABSTRACT
Background: According to WHO, responsiveness is an important goal of the health system, in addition to the two predominant goals of improving health and fairness of financing. Responsiveness includes non-medical aspects of health care. As the progress to universal health coverage is gaining pace, the present study has attempted to study the domains of responsiveness in the government and private health services and health care providers.Methods: A community based cross-sectional study for a period of 3 months in the households of the urban field practising area. Sampling technique was simple random sampling. Assuming the prevalence of 50% and allowable error of 5%, 400 households were surveyed. KISH table method was used at household level. Study tool was World Health Survey responsiveness module questionnaire for the eight responsiveness domains-prompt attention, dignity, communication, autonomy, confidentiality, choice, quality of basic facilities and social support (for inpatients).Results: The mean age (yrs) of the study subjects is 46.078±13.998. 68.25% (273) were males.31.75% (127) were females. 46.25% (185) were using government services and 53.75% (215) were using private services. The mean waiting time (min) in the public health facilities was 135.2±111.2 which was more than private facilities, 62.4±40.8.Conclusions: All the responsiveness domains (except confidentiality) were found to be positively associated (p<0.05) with the government health services. Proportion of people rating the responsiveness domains from most important to the least important showed prompt attention (52%) and dignity (30%) as the most important domains.