ABSTRACT
Introduction: Correct breast feeding technique, proper position and attachment are very important to get all benefits of breast feeding. Integrated Management of Neonatal and Childhood Illness (IMNCI) has also given utmost importance to the correct breast feeding technique. Objectives: To describe the socio-demographic profile and feeding practices among lactating mothers, to identify factors associated with good breast feeding (attachment) practices and to evaluate the impact of video demonstration on breast feeding practices immediately after and at one month follow up. Methodology: An interventional study was conducted at urban slums of Ahmedabad city, India. Results from 150 lactating mothers were analysed. Interactive sessions in conjunction with video demonstrations of IMNCI regarding correct breast feeding techniques were conducted among 9 groups of lactating mothers. Number of lactating mothers in each group varied from 15 to 20. Good signs of attachment were measured pre IMNCI video sessions, immediately and one month after the session. Results: Mean age of mothers was 26.44 years. Total mothers who had more than 6 antenatal visits were 59.3%. Two-thirds of lactating mothers did not receive any kind of breast feeding related advice. Only 8.0% had initiated breast feeding after 48 hours of delivery. Some kind of pre lacteal feed was given to 41.3% of the newborns. Improvement in all four signs of good attachment (mouth widely open, lower lip turned outward, chin touching the breast and dark skin seen more above than below areola) was seen among lactating mothers while feeding their babies after training session. Mothers from higher social class and with education > 12 standard and mothers who have received advice during antenatal and postnatal period regarding breast feeding were found to have significant positive impact on determining good attachment while breast feeding. Conclusion: Breast feeding related counseling should be continued at frequent interval during post natal period, so that lactating mothers can follow correct breastfeeding practices.
ABSTRACT
Background: Designing health care policies and programmes requires knowledge about health care seeking behaviour, so that appropriate interventions can be implemented. Health care seeking behaviour is influenced by the individual self, diseases, and the availability and accessibility of health services. Dependent on these determinants health care seeking behaviour is a complex outcome of many factors operating at various levels. Aims & Objective: Present study aimed at exploring possible differences in health care seeking behavior in rural and urban Ahmedabad. Material and Methods: A Cross-sectional study was carried out over a period of one year (April 2011-March 2012) in urban and rural area of Ahmedabad district. Total 500 houses from each were surveyed using pre-designed and pre-tested proforma by house to house visits. Head of the family from each household was interviewed. Information regarding morbidity and health seeking behaviour was collected during household survey. Results: Maximum number of respondents belonged to age group 25-39 years in urban (49.8%) and rural (53.8%). Rural people preferred government and trust hospitals (51.1%) more as compared to urban (44.1%). Significant difference was observed in place for treatment of acute illness from faith healers. More rural people (29.2%) took treatment from faith healers than urban (22.8%). Majority of rural people (59.6%) took treatment for chronic illness from private practitioner than urban (51.4%). More urban people (57.4%) were using cash savings for treatment than rural people while borrowing and selling assets for treatment was more in rural people (57.4%) The result was statistically significant. Insurance coverage for illness was significantly low both in urban and rural area. Conclusion: Difference in health seeking behaviour was noticed among urban and rural communities. As far as treatment of chronic illnesses is concerned more infrastructure investments should be made to improve accessibility to government health care facilities, especially in rural areas. There is a need to make the rural people more aware regarding availability of various health insurance schemes.