ABSTRACT
Background: Lack of motorized transport in remote areas and cash in resourceconstrained settings are major obstacles to women accessing skilled care when giving birth. To address these issues, a cashless voucher transport scheme to enable women to give birth in a health-care institution, covering poor and marginalized women, was initiated by the National Rural Health Mission in selected districts of India in 2009. Methods: The access to and utilization of the voucher scheme were assessed between December 2010 and February 2011 through a qualitative study in the district of Purulia, West Bengal, India. Data were collected from in-depth interviews and focus group discussions with women, front-line health-care workers, programme managers and service providers. Results: The main factors influencing coverage and utilization of the scheme were: reliance on ill-prepared gram panchayats (village councils) for identification of eligible women; poor birth preparedness initiatives by health-care workers; overreliance on telephone communication; restricted availability of vehicles, especially at night and in remote areas; no routine monitoring; drivers’ demand for extra money in certain situations; and low reimbursement for drivers for long-distance travel. Conclusion: Departure from guidelines, ritualistic implementation and little stress on preparedness of both the community and the health system were major obstacles. Increased enthusiasm among stakeholders and involvement of the community would provide opportunities for strengthening the scheme.
ABSTRACT
A cross-sectional study was conducted among 245 under-two slum-dwelling children in Bankura town, West Bengal, to assess their feeding practices and its association with nutritional status. Child’s gender, number of family members, standard of living (SLI), and household food security (HFS) were assessed through interview of mothers/ caregivers. Child feeding practices were measured with Composite Child Feeding Index comprising of age-appropriate, multiple, infant and young child feeding (IYCF) indicators and expressed in standardized IYCF score. Weight and length of the children were measured and the nutritional status was assessed using World Health Organization Growth Standard 2006. Standardized IYCF score was signifi cantly lower in undernourished children than those with normal grades. Per unit increase in standardized IYCF score was likely to reduce the prevalence of underweight, stunting and wasting by 2-3% after adjusting for other variables. Low/ very low HFS, low SLI and female gender were associated with underweight and stunting.
ABSTRACT
Context: Birth Preparedness and Complication Readiness (BPCR) is crucial in averting maternal morbidity and mortality. Objectives: To fi nd out awareness and practices regarding BPCR among pregnant and recently delivered women in Uttar Dinajpur, West Bengal. Materials and Methods: This is a cross-sectional, community-based, mixed methods study. Two-stage, 40 cluster sampling technique was used to select three pregnant and six recently delivered women separately. Information on socio-demographic variables as well as awareness and practices regarding BPCR were collected through semi-structured interview. In-depth interviews with one respondent per cluster were also conducted. For statistical analysis Z test was used. Results: Around 50% of the respondents planned for fi rst antenatal checkup (ANC) within 12 weeks, four or more ANCs and institutional delivery. Proportion of women aware of at least one key danger sign each of pregnancy, labor, postpartum, and newborn ranged from 12.1% to 37.2%, whereas 58.3% knew at least one key component of essential newborn care. Around two-thirds and one-third of women, respectively, especially those from backward and below poverty line (BPL) families knew about cash incentive and referral transport schemes. Proportions of women with fi rst ANC within 12 weeks, four or more ANCs, institutional delivery, saving money, identifying transport, and blood donor were 50.4%, 33.6%, 46.2%, 40.8%, 27.3%, and 9.6%, respectively. Hindu religion, backward castes, BPL status, and education 5 years infl uenced the practices except for two regarding ANC. Overall BPCR index of the study population was 34.5. Conclusion: Preparedness in health system, ensuring competence, and motivation of workers are needed for promoting BPCR among the study population.
ABSTRACT
A community-based cross-sectional study was conducted to find out the prevalence of composite index of anthropometric failure (CIAF) among 117 slum dwelling under-five children in Bankura town, West Bengal and its relation with some common socio-economic factors. Among study population, the prevalence of underweight was 41.6%, whereas CIAF was 80.3%. CIAF gave a near complete estimation of undernutrition unlike underweight. Children who were unimmunized, with more number of siblings, living in a nuclear family, or with illiterate mothers were more likely to be undernourished.
ABSTRACT
A community-based, cross-sectional descriptive study was conducted during June-July 2008 to assess the infant- and young child-feeding (IYCF) practices in Bankura district, West Bengal, India. In total, 647 children aged less than two years selected through revised 40-cluster sampling using the indicators of the Integrated Management of Neonatal and Childhood Illness (IMNCI) and World Health Organization. The proportions of infants with early initiation of breastfeeding (13.6%) and exclusive breastfeeding under six months (57.1%) and infants who received complementary feeding at the age of 6-8 months (55.7%) were low. Appropriate feeding as per the IMNCI protocol was significantly less among infants aged 6-11 months (15.2%) and children aged 12-23 months (8.7%) compared to infants aged less than six months (57.1%), which could be attributable to low frequency and amount of complementary feeding. The main problems revealed from the study were late initiation of breastfeeding, low rates of exclusive breastfeeding, and inappropriate complementary feeding practices.