Obstetric Complication Profile in Relation to the Utilization of Maternal Health Services of the Females of Rural and Urban Areas of Aligarh

Introduction: Millions of women are still suffering from pregnancy related complications even after the implementation of a number of health programs relating to mother and child. The utilization of these services is not up to the mark, so a study was done to evaluate the utilization of Maternal and Child health services in relation to the mother who had complications related to them or their children during the last pregnancy. Material and Methods: A community based cross sectional study was performed in the field practice areas of the department of community medicine, the study period was one year and the data was analyzed by SPSS13. Results: It was found that 32% Recently Delivered Women suffered from complications in their last delivery. The most common being Still Birth. Utilization rates for all maternal health services except full ANC package were found to be significantly better in women having had experienced a complication in an earlier pregnancy. Conclusions and Recommendations: Even though we are having so many health programs in place still a majority of women are suffering from pregnancy related complications. The utilization of Maternal health services was high for these women as compared to the ones who had no complications in their last pregnancy. But need of the hour is to further increase the rate of utilization to achieve our MDG goals.

Assessment of Knowledge of Janani Suraksha Yojna among RDWs of Aligarh: A community based cross Sectional study.

Background: Janani Suraksha Yojana (JSY), launched on 12th April, 2005 under the umbrella of NRHM is a safe motherhood intervention. It is a conditional cash transfer scheme aimed to increase the number of institutional deliveries and decrease the maternal and neonatal mortality rates but still the awareness about the scheme is low in women from rural areas and urban slums, especially in low performing states. Aims: To assess the awareness of recently delivered women from rural areas and urban slums regarding JSY and to study the knowledge level of various components of JSY. Methods: A cross-sectional study was carried out in the rural areas and urban slums of field practice areas of Jawaharlal Nehru Medical College, AMU, Aligarh for a period of one year. The prevalence of institutional delivery in UP as found in a study by UNFPA 2008 (50.2%) was used for calculation of sample size. (95% confidence level, 12% relative precision and 8% non response) The yielded sample size was 278, which was rounded off to 300 and selected proportionately. After taking informed consent from the head of the families and targets, the study subjects were interviewed by a pre-designed and pre-tested questionnaire. Statistical analysis used: SPSS 20 and Epi Info software (with Yate’s correction).Results: The awareness of JSY was found to be high (85%) but knowledge regarding benefits covered under the scheme was only limited to cash incentive for institutional deliveries. Knowledge of 108 ambulance was also low(26.6%). Conclusion: There is an urgent need to strengthen IEC campaigns and monitoring strategies.

Prevalence of Iodine Deficiency Disorders - A School Based study in Aligarh

Introduction: Iodine deficiency is one of the most neglected and wide spread of all nutritional deficiencies, constituting a real brake on human development. Deficiency of iodine may result in development of goitre and other Iodine Deficiency Disorders (IDD). Objective: To assess the status of iodine deficiency disorders (IDD) in school children. Methods: This study was conducted among school children of 1st to 5th standard (6–12 yrs.) from 1st January 2009 to 31st December 2013. A total of 950 students of seven schools were included in the study using proportionate to population size (PPS) method. Each child was examined clinically. Statistical analysis was done using SPSS version 20. Result. Age distribution of the study population shows that majority of the students (30.5%) belonged to 11-12 years, and most of the students (56.2%) were males. Only 17 (1.8%) students had goitre. Goitre prevalence was slightly higher (1.9%) in the 6-8 years age group and in females (1.9%). Manifestations of iodine deficiency other than goitre, were retarded growth (0.6%), squint (0.3%), deafness (0.2%), lethargy (0.5%), and mental retardation (0.1%).  Conclusion. In the present study, Aligarh may be classified as non-endemic for iodine deficiency as the goitre prevalence in school children was only 1.8%, below the 5.0%, required for endemicity. Sustained IEC (Information, Education and Communication) activities should be carried out to sensitize the people regarding IDD.

Exploring Demographic Factors Influencing Acceptance of Family Planning Methods in Aligarh

Introduction: Population of India has jumped to 1,290,974,613 (1.29 billion) on Dec 07, 2015. There are certain demographic factors, which affect the acceptance of family planning methods. Therefore this study was conducted to determine the extent of felt need of family planning methods and to assess the demographic factors influencing the contraceptive acceptance. Materials and Methods: This cross-sectional study was conducted in J.N. Medical College, AMU, Aligarh, for a period of two and half year. Only the mothers in the post partum period were interviewed. Those mothers who had already accepted family planning methods were not included in the study. 1383 mothers were interviewed. Data were tabulated and analysed using SPSS version 20. Chi-square test (χ2) was applied to know the statistical significance. Results: Significant number of mothers (39.6%) had planned to adopt family planning methods. Majority of the mothers (71.4%) were in the age group of 21-30 years. In this age group, 39.7% mothers wanted to adopt family methods. As the age of the mothers increased, the acceptance rate also increased. Majority of mothers (52.9%) admitted in the hospital were Hindus. Among Muslims, 40.3 per cent mothers had felt need of family planning methods. Mostly the mothers were illiterate (50.8%). 30.8 per cent of these illiterate mothers wanted to accept family planning methods. Similar felt need (36.4%) was observed in mothers with education up to primary level (V standard). As the birth order increased, felt need also increased. Conclusion: It may be concluded that significant number of mothers had planned to adopt family planning methods. Though the campaign to promote family planning methods in our country is being carried out, the message should be given more vigorously through information, education and communication (IEC) activities and involvement of non-governmental organisations (NGO). Concerted efforts are needed to find out the reasons for unmet need and its solution

Influence of Behavioral Determinants on the Prevalence of Overweight and Obesity among School Going Adolescents of Aligarh.

Obesity has reached epidemic proportions globally and the prevention of adult obesity will require prevention and management of childhood obesity. A study was conducted to determine the prevalence and behavioral determinants of overweight and obesity in school going adolescents. A total of 660 adolescents from affluent and nonaffluent schools were taken. Overweight and obesity was defined as per World Health Organization 2007 growth reference. Prevalence of overweight and obesity was 9.8% and 4.8%, respectively. Prevalence of both overweight and obesity was higher among males. Statistically significant difference was found in prevalence of overweight and obesity among affluent schools (14.8% and 8.2%) and nonaffluent schools (4.8% and 1.5%). Important determinants of overweight and obesity were increased consumption of fast food, low physical activity level and watching television for more than 2 h/day. The prevalence of obesity is high even in small cities. Dietary behavior and physical activity significantly affect weight of adolescent children.

Distribution Pattern of the Psychosocial Problems according to the Academic Assessment of Adolescent Male Students.

Background: Many studies have reported psychosocial problems among adolescents. Methodology: A study of distribution pattern of psychosocial problems was conducted according to academic assessment among the adolescent males aged 10 – 19 years students selected from all rural and urban schools situated within 1 KM of urban and rural health training centers of the department of Community Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh. The study population comprised of 2347 students out of which 410 students were selected for study out which 390 students cooperated in the study. Semi-structured schedule for the record of psychosocial history, 35 items pediatric symptoms check list (YPSC) to screen psychosocial problems where applied and class teacher was requested for academic assessment of the student to grade according to 4 – points Likert scale that graded each student as (1) Excellent (2) Very Good (3) Average (4) Poor. Diagnosis was made as per criteria of ICD-10 (1999). Results: 17.9% students showed psychosocial problems. The problems were mere in students graded as poor in studies.

Determinants of Vitamin A Deficiency amongst Children in Aligarh District, Uttar Pradesh.

Objectives: To determine the prevalence and determinants of xerophthalmia among children aged 0-60 months . Methods: This cross-sectional study included 3571 children under 5 years of age from six villages and four periurban areas. Children with xerophthalmia were identified and severity graded using the WHO classification. The main outcome measures were sociodemographic, nutritional and comorbidity related risk factors of xerophthalmia. A pretested questionnaire carrying information on the above factors was administered to the caregivers. Univariate and multivariate binary logistic regression analyses were performed to examine the association of each of these factors with xerophthalmia. Results: The overall prevalence of xerophthalmia was of serious public health importance at 9.1%. Prevalence of both mild (night blindness, and Bitot’s spots) and severe forms (corneal changes) of xerophthalmia increased with age. Bitot’s spots and night blindness were the commonest manifestations. Rural dwelling, lower social class, maternal illiteracy and occupation outside home were significant antecedent socio-demographic risk factors on univariate analysis. Multivariate analysis revealed low intake of proteins and vitamin A containing foods as well as predominant maize diet to be significant dietary factors. Nutritional wasting and a preceding history of measles were significant comorbid determinants (P<0.05). None of the socio-demographic variables emerged significant on multivariate analysis. Conclusions: Vitamin A deficiency remains a significant public health problem in Aligarh district.The proximal factors in a child’s mileu viz nutrition and comorbidities were more significantly associated with xerophthalmia than the distal socio-demographic factors, thereby making a case for their cost effective prevention.The high magnitude of the problem calls for intensification of existing prophylactic measures in these areas.

Pattern of Sexual Development and Anthropometry in Adolescent Males.

Background : The significance of staging the sexual development becomes apparent on observing a group of adolescents of similar age but with great variability in size, shape and level of pubertal maturation. Objectives: To study the pattern of sexual maturation and anthropometry in adolescent males. Methods: The cross-sectional study was done in school having a total of 2347 male adolescents, out of which 390 students cooperated in the study. Probability proportionate to size sampling was used. Sexual Maturity Rating (SMR) was done by showing pictorial representation to the adolescents. The data obtained were tested statistically by percentages and Chi-square Test using SPSS version 10.0 for windows. Results: SMR-1 ranged from age 10 – 13 yrs, SMR-2 ranged from 10-16yrs, SMR-3 started from age 11yrs and ended gradually at 18yrs. Similarly SMR-4 started from 13 yrs and SMR-5 at 14 yrs. The mean weight and height increased from lower age groups to higher age groups within the same stage of sexual development. Within the same age group the mean weight as well as height also increased according to the current stage of sexual development. Conclusion: There is great variability in the timings of onset of puberty and the progression of the sexual maturity among the adolescents. The anthropometry indices for somatic growth in adolescent are influenced by both the chronological age and the sexual maturity of the adolescents. Thus calculating the anthropometric indices in adolescent according to the age alone will not be of much use as the somatic growth also depends on the sexual maturity of the adolescents.

Global developmental delay and its determinants among urban infants and toddlers: A cross sectional study.

Objective To estimate the prevalence of global developmental delay among children under 3 years of age and study the determinant factors. Methods Cross sectional descriptive study was conducted in field practice areas of the Department of Community Medicine, JN Medical College, Aligarh, India. A total of 468 (243 boys and 225 girls) children aged 0–3 years were included. Developmental screening was performed for each child. A multitude of biological and environmental factors were analysed. Results As many as 7.1% of the children screened positive for global developmental delay. Maximum delay was observed in the 0–12 months age group (7.0%). Undernutrition and prematurity were the two most prevalent etiological diagnoses (21% each). Stunting and maternal illiteracy were the microenvironmental predictors on stepwise binary logistic regression while prematurity and a history of seizures emerged significant biological predictors. Conclusions Developmental delay can be predicted by specific biological and environmental factors which would help in initiating appropriate interventions.

Knowledge of diarrhea management among rural practitioners.

OBJECTIVE: To determine diarrhea management in rural practitioners. METHODS: This study was conducted among the RMP's of 4 blocks of Aligarh. Pre-coded questionnaire was completed and educational programme followed. 91% were prescribing ORS in various combinations, but only 9.8% were advising ORS and feeding as standard management of diarrhea. Only 12.8% could name a WHO ORS brand and 50% were giving wrong instructions for preparation. 95% were advising inadequate amounts of ORS. Only 43.5% were advising feeding during diarrhea but 86.6% were advising to continue breastfeeding. On an average every 3rd to 4th patient was administered IVF's. 52% felt that drugs should be prescribed. RESULTS: 90% and 55.3% of RMPs could identify diarrhea and key signs of dehydration. CONCLUSION: There is a need for hands on training for the practitioners and education of the masses regarding proper management of diarrhea.