ABSTRACT
Background: India’s National Rural Health Mission (NRHM) introduced Accredited Social Health Activists (ASHA) at the community level. Their vital role is to promote antenatal care and increase the utilization of the existing health services. The objectives were to find out utilization of ASHA services by the pregnant women and to study its determinants in rural area of Tripura, India. Methods: A community based cross-sectional study was conducted during February – April 2015 using a validated interview schedule among 306 recently delivered women residing in Mohanpur block of Tripura, chosen by multistage sampling. Results: Utilization rate of ASHA services by pregnant women was found to be 89.7%. Pregnancy registration rate was 95% and 90% of these registrations were facilitated by ASHA. Adequate antenatal check-up rate facilitated by ASHA was 76.69%. Regarding Iron and Folic Acid prophylaxis, 67.88% of the adequate recipients were facilitated by ASHA. For laboratory tests, 80.23% of the women were motivated by ASHA. About 90% of the study women have heard about Janani Suraksha Yojona (JSY) scheme from ASHA and 70% of them got the benefit through ASHA. Literacy, parity, community, economic class, home visit by ASHA and family decision maker were identified as the significant determinants of utilization of ASHA services by the pregnant women. Conclusions: Utilization rate of the ASHA services by the pregnant women needs improvement. Apart from IEC activities, active home visits by ASHA, empowering couples to make their own fertility decisions, improvement in female literacy etc. may enhance utilization of ASHA services by this community which will intern enhance maternal health care utilization.
ABSTRACT
Background: Cervical cancer is the commonest malignancy among women in developing world and is considered to be preventable. Knowledge in this regard and timely screening is crucial for prevention. Methods: This hospital based cross-sectional study was conducted during April to May 2014, using a validated interview schedule among a representative sample of 289 women attendees of a tertiary care centre of Tripura chosen by systematic random sampling. Descriptive statistics and χ2 test were used to present data. P value ≤0.05 was considered statistically significant. Results: Cervical cancer was known as preventable by 61.9% women, 59.2% knew multiple sex partners, 42.6% knew early sexual intercourse, 72.7 % knew poor personal hygiene, 26.0% knew it as a familial disease, 16.3% knew that vaccine is available for preventing cervical cancer, 41.2% knew early diagnose is possible, 59.86% knew it as a treatable disease, 31.5% knew surgery as the main mode of treatment, 15.57% have heard about PAP smear test, 10.38 % underwent PAP smear test, lack of medical advice was the commonest reason for not undergoing PAP smear test and media was the main source of information for them. Conclusions: Despite knowing cervical cancer as common among Indian women, knowledge regarding its early diagnostic methods, preventability and treatability is found to be low. Regarding the sources of information, health functionaries played poorer role than media and others. Health functionaries should gear up extensive IEC and BCC activities for making people aware and motivated regarding screening for cervical cancer to minimize preventable deaths in this community.