ABSTRACT
Background. The Government of India has been conducting multiskills training programmes to address the shortage of specialized human resources in gynaecology and anaesthesia for maternal and child healthcare. There has been little evaluation of the operation of these programmes, though several years have passed since their introduction. Methods. We did a cross-sectional study to assess some aspects of the multiskills training programmes in gynaecology and anaesthesia, and the utilization of human resources trained under this scheme in Rajasthan. The analysis was primarily based on a review of records of postings of doctors obtained from the Department of Health and Family Welfare, Government of Rajasthan. Information was also obtained through qualitative interviews with 122 doctors from 14 districts of the state, irrespective of their training status. Results. In 2012, a total of 302 anaesthetists and 480 gynaecologists were posted in various public health facilities in Rajasthan. Of these, 128 (42%) anaesthetists and 69 (14.4%) gynaecologists had received multiskills training. However, only 57% of trained doctors were posted at health facilities for which they were trained. The acceptance of multiskills training among doctors was found to be low. Conclusion. Posting and deployment of personnel who had received multiskills training was often inappropriate, leading to suboptimal utilization of the skills acquired during such training and suboptimal delivery of public health services. Accreditation of the multiskills training programmes by regulatory bodies such as the Medical Council of India may improve the acceptance of such training among MBBS doctors and their colleagues. There is a need to review multiskills training programmes.
ABSTRACT
Estudio realizado en consulta privada de los 17 médicos participantes, en 150 pacientes con vulvovaginitis, de los que se reportan 148 casos provenientes de tres principales ciudades del Ecuador (Guayaquil, Quito y Cuenca).Tipo de estudio: Abierto, multicéntrico, no comparativo.Objetivo: Evaluar la eficacia y tolerancia de una solución limpiadora suave con contenido de Bardana, en el período previo al tratamiento específico, como ayuda en el control del prurito y eritema presentes en las vulvovaginitis.Material y método: Se utilizó una solución limpiadora suave con contenido de Dinafitoles de Bardana y nivel de pH 8. Fueron reclutadas 150 pacientes de acuerdo a los criterios de inclusión, no inclusión y exclusión. La sintomatología fue evaluada al inicio y al final del estudio. Se recomendó el uso del producto en higiene local dos veces al día por siete días mientras se esperaba el resultado del examen cito bacteriológico vaginal.Resultados:98.0% de mejoría y desaparición del prurito.96.5% de mejoría y desaparición del eritema.En cuanto a la tolerancia al producto utilizado, el 95.3% reportó la calificación de buena.Conclusión: Se logró demostrar la utilidad de la solución limpiadora suave con pH8 y contenido de Dinafitol de Bardana, concluyendo que su utilización está justificada en los casos de vulvovaginitis y que, gracias a la tolerancia y aceptación de las pacientes se puede recomendar también su uso cotidiano en la higiene íntima y corporal. Por los resultados obtenidos, podemos considerar el uso de esta solución limpiadora como de primera elección en el manejo de las patologías relacionadas con el prurito y eritema y como un excelente coadyuvante en el tratamiento etiológico de las vulvovaginitis en las que con frecuencia advertimos la presencia de esta sintomatología.
Study carried out in the private consultation of 17 doctors selected to participate in the study that included 150 patients with vulvovaginitis, of which 148 cases are reported from in the three main cities of the Ecuador, (Guayaquil, Quito and Cuenca). Type of study: Open, multicentral, not comparative. Objective: To evaluate the effectiveness and tolerance of a mild cleansing solution, containing Bardana, during the period prior to a specific treatment, in order to help the control of pruritus and erythema present in the vulvovaginitis. Material and method: A mild cleansing solution with a pH level 8 was used. 150 patients were recruited according to the inclusion and exclusion criteria of the study. The symptoms were evaluated at the beginning and at the end of the study. The use of the product was recommended twice a day for seven days while expecting the results of the bacteriological vaginal exam.Results:98.0% of improvement and disappearance of pruritus.96.5% of improvement and disappearance of erythema. As for the tolerance to the use of product, 95.3% of the patients reported it as good. Conclusion: It was possible to demonstrate the how important is the use of the mild cleansing solution with a pH 8. We conclude that its use is justified in the case of vulvovaginitis and that thanks to its tolerance and the patients' acceptance, it may also be recommended to be used daily in the intimate and corporal hygiene. With the reported results, one can consider the use of this mild cleansing solution as the first election in the handling of pathologies related with pruritus and erythema and as an excellent help for etiological treatment of the vulvovaginitis in those that frequently notice the presence of this symptoms.