ABSTRACT
Background: India today has over 61 million people residing in urban slums. Slums, on one hand, lack the basic requirements of housing, sanitation, and water supply that are detrimental for good health and on the other hand subject its residents to extreme poverty, unemployment and stress. Exposure to these environmental factors is expected to cause a distinct sort of morbidity pattern, which this study seeks to explore.Methods: This cross-sectional study was a secondary data analysis of aggregated data of patients who availed health services at the mobile medical unit (MMU) of the Ujjivan program run by Piramal Swasthya in the last one year. The project has a fleet of MMUs that makes at least one predestined monthly visit to each service point in urban slums of Bangalore (42 sites), Pune (18 sites) and Mumbai (19 sites).Results: Musculoskeletal disorders (30.69%) and cardiovascular diseases (25.56%) together accounted for 56.25% of the total disease burden. The analysis of blood pressure readings of all the registrations showed that the mean systolic and diastolic pressures were 129.71 and 84.92 mmHg respectively. 51.58% of all individuals had hypertension and 23.51 % had diabetes.Conclusions: According to the study a major proportion of urban populous seeking healthcare at the MMU are women and elderly and do so for non-communicable diseases. Hypertension and diabetes are major health threats among them. MMU could be used as an effective mode of service delivery for women and the elderly especially, for chronic diseases
ABSTRACT
Background: Haemophilus influenza type b (Hib) causes significant morbidity and mortality among young children in India. Hib vaccines are safe and efficacious; nevertheless, their introduction to India’s national immunization programme has been hindered by resistance from certain sectors of academia and civil society. We aimed to ascertain the attitudes and perceptions of Indian paediatricians towards Hib disease and vaccination. Materials and Methods: A cross‑sectional survey of knowledge, attitude and practices on Hib and vaccines was undertaken among 1000 Indian paediatricians who attended 49th National Conference of Indian Academy of Pediatrics in 2012 through use of a 21‑point questionnaire. Results: 927 (93%) paediatricians completed the survey. 643 (69%) responded that Hib is a common disease in India. 788 (85%) reported prescribing Hib vaccine to their patients and 453 (49%) had done so for the past 5–15 years. Hib vaccine was used in combination with other vaccines by 814 (88%) of the participants. 764 (82%) respondents thought Hib vaccine effective while 750 (81%) thought it to be safe. Fever, pain and redness were the most frequently reported post vaccination side‑effects. 445 (48%) paediatricians ranked universal use of Hib vaccine in the national immunization programme as the most important strategy to prevent and control Hib disease in India. Conclusion: The excellent profile as reported by a large number of paediatricians from throughout India further strengthens evidence to support expanded use of currently available Hib vaccines. These findings should encourage the Government of India to initiate mass use of this vaccine nationwide.
ABSTRACT
Background: In Bihar State, proportion of fully immunized children was only 19% in Coverage Evaluation Survey of 2005. In October 2007, a special campaign called Muskaan Ek Abhiyan (The Smile Campaign) was launched under National Rural Health Mission to give a fillip to the immunization program. Objectives: To evaluate improvement in the performance and coverage of the Routine Immunization Program consequent to the launch of Muskaan Ek Abhiyan Intervention: The main strategies of the Muskaan campaign were reviewing and strengthening immunization micro-plans, enhanced inter-sectoral coordination between the Departments of Health, and Women and Child Development, increased involvement of women groups in awareness generation, enhanced political commitment and budgetary support, strengthening of monitoring and supervision mechanisms, and provision of performance based incentive to service providers. Methods: Immunization Coverage Evaluation Surveys conducted in various states of India during 2005 and 2009 were used for evaluation of the effect of Muskaan campaign by measuring the increase in immunization coverage in Bihar in comparison to other Empowered Action Group (EAG) states using the difference-indifference method. Interviews of the key stakeholders were also done to substantiate the findings. Results: The proportion of fully immunized 12-23 month old children in Bihar has increased significantly from 19% in 2005 to 49% in 2009. The coverage of BCG also increased significantly from 52.8% to 82.3%, DPT-3 from 36.5 to 59.3%, OPV-3 from 27.1% to 61.6% and measles from 28.4 to 58.2%. In comparison to other states, the coverage of fully immunized children increased significantly from 16 to 26% in Bihar. Conclusions: There was a marked improvement in immunization coverage after the launch of the Campaign in Bihar. Therefore, best practices of the Campaign may be replicated in other areas where full immunization coverage is low.