Maternal anaemia: a persistent problem in rural Tamil Nadu.

BACKGROUND: The incidence of maternal anaemia continues to be high (over 70%) in India in spite of a major nationwide intervention programme. This study was carried out in June 1996 on a representative sample of pregnant women from K.V. Kuppam and Gudiyatham blocks of Vellore district, Tamil Nadu, India. METHODS: Haemoglobin (Hb) estimations were done in a sample of 895 pregnant women in both the blocks while serum ferritin (SF) levels were estimated on a subsample of 445 pregnant women. RESULTS: The prevalence of maternal anaemia (Hb < 11 g/dl) was 69.3% (35.8% moderately anaemic, 30.2% mildly anaemic and 3.3% severely anaemic). The mean Hb was 10.1 g/dl. Prevalence of iron deficiency was 36.3% [SF < 12 micrograms/L, mean SF 24.3 micrograms/L (range: 1.5-153 micrograms/L)]. Iron deficiency anaemia as defined by Hb < 11 g/dl and SF < 12 micrograms/L was 29.5%. CONCLUSION: The prevalence of maternal anaemia and iron deficiency anaemia continues to be high in spite of planned interventions implemented at the national level.

Morbidity pattern, health care utilization and per capita health expenditure in a rural population of Tamil Nadu.

BACKGROUND: Information on the existing morbidity pattern, pattern of health care utilization and the per capita health expenditure is essential to provide need-based health care delivery to a rural population. To obtain this information we performed a study in the K.V. Kuppam Block, North Arcot Ambedkar District, Tamil Nadu. METHODS: We did a cross-sectional study, interviewing respondents from 300 households, from 3 panchayats using a multistage sampling technique. Information relating to 1440 persons was collected. The morbidity data was obtained initially for the week prior to the day of interview, followed by one week to one month and then for two months to one year. RESULTS: During 1990-91, 825 of the 1440 persons (57.3%) did not have any illness. Sex had no bearing on the number of illnesses. Of the 60 children less than 2 years of age, 42 (70%) had one or two illnesses. The period prevalence of infective and parasitic diseases was found to be 21.9% with an average of 3 episodes. Services rendered by private practitioners (registered, non-registered and indigenous) were utilized by 59% of the households and 79% of the households had used allopathic treatment at some time. The average per capita per annum health expenditure was Rs 89.9 (Rs 449 per household). This increased significantly with increase in the household size (p < 0.001) and per capita income (p < 0.01). CONCLUSION: The health-seeking behaviour of this population can be changed if efficient services are rendered through government primary health centres and subcentres. This would allow the existing voluntary agency to withdraw without much change in the per capita health expenditure.