ABSTRACT
Background: Reproductive health of the tribal women in India is less studied and the present study attempts to fill the gap by understanding the reproductive health of women in the matrilineal tribes in Meghalaya. The objective of the study was to study the reproductive health status of tribal women.Methods: A field-based quantitative study was conducted among randomly chosen 900 tribal women in their reproductive age from the 142 villages selected randomly across 15 PHCs functional in five districts. We used a semi-structured validated questionnaire consisting of the socio-demographic profile, reproductive health status, blood pressure and haemoglobin level.Results: Median age of the 900 respondents was 28.9 years, 83% had primary education and 82% got married between 13-18 years. Over 96% lived with their spouse, and 80% had a monthly income ?Rs. 5000. Their mean age at menarche was 14.3 years, 10% reported menstrual issues: stomach ache, back pain and vomiting. Though 58% planned their pregnancy, 77% had their first pregnancy before 18 years, and 10.3% of respondents had three deliveries within a four-year period. 76% had poor self-rated health, 83% had abnormal blood pressure and 95% reported anaemia. Out of 81 deaths, 69% were infants and 33.3% did not avail medical service from PHC.Conclusions: Reproductive health risks, anaemia and abnormal blood pressure were found among women in Garo tribes. Mitigating the ill effects of reproductive health issues through indigenous interventions as part of the NRHM program is needed.
ABSTRACT
Background: ASHAs were appointed by NRHM to provide preventive, promotive and curative healthcare services in the rural including tribal villages in Meghalaya. However, their social acceptance and job satisfaction remain less studied. Hence our study aimed at it.Methods: A cross-sectional study was conducted among 140 ASHAs from randomly sampled 142 villages across 15 PHCs in five districts. To collect data, we used a semi-structured back-translated and validated questionnaire consisting socio-demographic profile of ASHAs, level of perceived social acceptance and job satisfaction. Data were analysed using SPSS version 22.0.Results: Mean and median age of ASHAs were 33.29 and 32.00 years respectively. Over 63% belonged to Garo tribes, 67% studied high school, and 91% married. Village elders selected 76% of ASHAs, and 81% were as ASHAs for at least eight years. About 86% were trained in a minimum of three modules and all found their training effective. While 92% had the medical kit always filled, 100% had registers updated, and 94.3% facilitated VHND and FHD meetings. About 97% accompanied the pregnant women, 96.4% attended PHC meetings regularly and 83.6% organized VHSNC meeting. Though 93.5% reported a high acceptance of ASHAs' services, social acceptance of ASHAs was rather to some extent for 36.4%. Almost 52% of ASHAs were dissatisfied with job and 61% were unhappy with their performance-based remuneration.Conclusions: Community must be aware of ASHAs’ role, and their job satisfaction has to be increased with a corresponding increase in incentives while developing strategies to ease the process of payments.