ABSTRACT
Introduction: The Integrated Child Development Services (ICDS) Scheme, the largest program for promotion of maternal and child health nutrition in India, is operational for more than four decades. Objective: To evaluate Integrated Child Development Services Scheme in Kangpokpi District of Manipur in terms of input, process and outcome indicators. A community-based cross-sectional studyMethod: was conducted at a tribal hilly district of Kangpokpi in Manipur. The study included ICDS staff and beneficiaries of 35 randomly selected Anganwadi Centres (AWCs). Data related to ICDS was collected by using interview schedules and checklists. The descriptive data were expressed in terms of mean, standard deviation and percentage. Association between important background characteristics and Anganwadi centre attendance was analysed using chi-square test. Ethical clearance was obtained from the institutional Ethic Committee of JNIMS, Imphal before conducting the study (study period: May 2018 to April 2021) Input indicators: The study found that 86% anganwadi centres were run inResults: anganwadi worker’s own house. Two-thirds of the anganwadi workers (65.7%) were found to have separate toilet and 22.9% had separate kitchen. Process indicators: Even though the proportions of beneficiaries accessing services from anganwadi centres were high, the number of days Supplementary Nutrition (SN) was provided in a month was comparatively low (mean: 2.97 and SD: 0.618 for under-6 children and mean: 1 and SD: 0.000 days for adolescent girls, pregnant women and lactating mother in a month) due to frequent interruption of supplementary nutrition supply. There was no supplementary nutrition stock in 74.3% of the anganwadi centres on the day of visit. Outcome indicators: Regarding the nutritional status 90% of Under-6 children were found to be normal, 9% underweight and 0.6% severely underweight. The Integrated Child Development Services Programme in the study area wasConclusion: found to have several short-comings both in terms of inputs and process. There were not only inadequate facilities and infrastructure, but the anganwadi centres also lacked essential equipment like weighing machines and medicine kits, rendering a vital activity like growth monitoring to be almost completely absent. Supervisory visits were far below satisfactory.
ABSTRACT
Introduction: Warranting access to modern family planning methods constitutes a basic human right and globally around 270 million women of reproductive age group have an unmet need for contraception. Objective : To estimate the knowledge, misconceptions and practices related to family planning methods among women of reproductive age group attending primary health centre. Method: A cross-sectional hospital-based study was conducted in four health centers from January to February 2019 among women of reproductive age group (15-49 years). Data regarding socio-demographic characteristics, knowledge, attitude and practices pertaining to family planning methods were collected using a pre-tested interview schedule. Descriptive and analytical statistical analyses like mean, proportions, Chi-square and Multivariable logistic regression were conducted. A p value of less than 0.05 was considered statistically significant. Results: In this study 348 women were enrolled, of which 39.4% had adequate knowledge regarding family planning methods. Most participants had a healthy attitude towards the use of family planning methods and considered them beneficial whereas 59% stated their religious faith and cultural beliefs restricted the use of contraceptives. Unmet need of contraceptives was 60.2% while 39.8% used any one of the modern contraceptive methods. Lower age (AOR-1.26), Primi-parous (AOR-2.76) and women having a lower monthly income (AOR-2.51) were more likely to have an unmet need of contraception. Conclusion: Despite easy accessibility and low cost of the contraceptives, their use was limited. The high proportion of unmet needs mandates the scaling up of activities to increase the awareness regarding modern contraceptives. Additionally, behavioral change communication strategies are in great need for implementation to counter the negative attitudes pertaining to family planning practices.