ABSTRACT
Background: Community participation is one of the core principles of Primary Health Care. VHNSC is example of community participation and is formed to take collective actions on health issues and its social determinants of health (SDH). It is envisaged as being central to local level community action to support decentralized health planning. Work on actual participation of VHSNC on SDH is almost negligible. Therefore, the present research study was conducted to find out the participation of VHNSC on SDH. Aim: To assess the involvement of VHNSC on SDH. Methods and Material: Knowledge on SDH and health actions of VHNSCs were studied using a questionnaire which was pretested and suitably modified. The study was conducted in all the 83 VHNSCs under 4 PHCs namely Waiphad, Anji, Kharangana Gode and Talegaon were choosen as per feasibility. Results: Members of all VHNSCs had knowledge about access to safe drinking water, sanitation and nutrition as SDH. Members from 6 (7.2%) VHNSCs could not relate literacy with health. Most had to be probed regarding knowledge about addiction to tobacco and alcohol; social deprivation and availability of emergency transport. Conclusions: VHNSC are moving in the right direction however they require continuous support, hand holding and monitoring from government and other NGOs.
ABSTRACT
Objective: To review the Mid-upper arm circumference (MUAC) cut-off currently being usedto identify Severe Acute Malnutrition (SAM) as currently defined using Weight-for-Height.Methods: Cross-sectional study conducted in 24 villages of a Primary Health Centre inWardha district of Maharashtra among 2650 children between the ages of 6 to 59 months.Results: For identifying SAM, sensitivity of MUAC was 23.5% and specificity was 99.7% forcut-off <11.5 cm. Using Youden index, best Mid-upper arm circumference cut-off point toidentify SAM was <13 cm with sensitivity of 74.5% and specificity of 92.7%. Using Receiveroperating characteristics curve, best MUAC cut-off point was 12.8 cm with 74.5%sensitivity and 92.7% specificity. Area under curve was 0.88 (95%CI: 0.85-0.91).Conclusion:The current MUAC cut-off of <11.5 cm for detecting SAM needs to beincreased to ensure that children, who need referral for management of malnutrition, are notmissed.
ABSTRACT
Background: The phenomenon of population ageing is inevitable. United Nations has defined Population 'ageing or graying nation' where 7% of total population is over 60 years of age. India already has crossed the bar with 8% population above 60 years of age as per census 2011. To address ever growing needs of geriatric population, the first step is to identify and assess those needs. Present study is conducted with objective to assess the health, psychosocial and financial needs of geriatric population in rural Wardha. Methods: This is a community based cross sectional study using mix methods. The Present mix method study had two components - a. Quantitative component: comprising of details on socio-demography, psychosocial needs and financial dependency measured in all 60 participants using predesigned questionnaire and b. Qualitative component: comprises of 10 In Depth Interviews (2 IDI per ward) of elderly participants in community and 5 exit interviews of elderly participants those availed services at PHC. Content analysis of qualitative data was done manually while quantitative data is reported using frequency and percentages. Results: PHC was the first point of contact for 65% of elderly, but most of them were not satisfied with the services and the reason for dissatisfaction was long queue for OPD registration, long waiting period, no sitting arrangement while waiting, frequent non- availability of medicine. Irregular availability of medicine was reported as reason for skipping medicines and out of pocket expenditure. Financial dependency on children limits elderly in healthcare decision making. The recreational activities were limited to taking care of their grand-children, watching TV, and engaging in household activities. Conclusions: Elderly have very basic needs that can be addressed in present setting like a separate queue for registration, adequate sitting arrangement in waiting area, regular availability of medicines. Complete Healthcare insurance of elderly may be a solution to prevent out of pocket expenses.