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Background: India has the maximum number of diabetic patients in the world and this had given the country the dubious distinction of being the “diabetic capital” of the world. It is evident that the urban poor living in slums and slum like areas adopt a more urbanized lifestyle which places them at a higher risk for non-communicable diseases and have poor access to healthcare, partly related to their poor purchasing ability. Women slum dwellers are particularly vulnerable to negative health outcomes. The study was conducted with objectives to assess prevalence, determine factors and know treatment and control status.Methods: This is a cross sectional study conducted among 405 slum women of age 35 years or more in Rajkot city. Interview, anthropometric measurements and selective clinical examinations i.e., blood sugar estimation were done for all participants.Results: In present study, total 64 (15.80%) women were diagnosed with diabetes. A statistically significant association was found between body mass index, remaining busy in household work, walking, practicing healthy habits, parental history, sibling history and diabetes. Out of 64 women who were diagnosed with diabetes, about half i.e., 36 (56.25%) were aware of their diabetic status. Out of those aware, 29 (80.66%) were on treatment. Among those on treatment, about half i.e., 16 (55.17%) had their blood sugar under control.Conclusions: Studied population high prevalence and inadequate control of diabetes.
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Introduction :The National Population Policy 2000 and the Reproductive and Child Health (RCH) Programme Phase II emphasize the importance of achieving population stabilization and attaining the goal of replacement-level fertility. Sterilization services are largely being provided through a network of public and private sector facilities Objective:To assess the infrastructure and logistics at various health facilities of Rajkot District where Sterilization services provided Method:A cross-sectional study was conducted by Community Medicine department, PDU Government Medical College, Rajkot, during February-March 2015. All health facilities of Rajkot district where Laparoscopic Tubal Ligation (Lap TL) camps were organized including 4 Community Health Centers (CHCs), 5 Sub-District Hospital (SDHs) 1 district hospital, and 1 medical college and hospital were selected for the study. A standard checklist was used for infrastructure and logistics available at various facilities. The data entry was done in Microsoft Office Excel 2007 and analysis was done using the same software Results:Majority of places; infrastructure and facilities are available as well as clean.Storage facility for contraceptives was adequate at all the 11 facilities. All the 11(100.0%) facilities have vehicle/ambulance in running condition. At 3(27.27%) facilities there were no boards displaying service timings. Availability of staff as per sanctioned posts was at 3(27.27%) places and various categories of staff for the activities were present at 6(54.55%) facilities Conclusion:Improvement isrequired in displaying of IEC materials and sitting arrangement for beneficiaries.
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Background: The Integrated Child Development Services (ICDS) scheme has been operational for more than three decades in India. Objective: To evaluate the various aspects of the ICDS program in terms of inputs, process and outcome (coverage), utilization, and issues related to the ICDS program. Methods: A total of 130 Anganwadi centers (AWCs) were selected including 95 AWCs from rural areas and 35 AWCs from urban areas from April 2012 to March 2015, from 12 districts of Gujarat and the union territory of Diu. Information was collected for infrastructure, baseline characteristics of AWWs, provision, coverage and utilization of various ICDS services, and various issues related to program operation. Results: A majority of pregnant (94.7%) and lactating (74.4%) mothers, and adolescent girls (86.6%) were availing ICDS services. In 96.9% of the AWCs, a growth chart was available and 92.3% AWWs were using it accurately. A total of 14.9% children were underweight including 13.5% moderately and 1.4% severely malnourished children. Two-third (66.2%) children were covered by supplementary nutrition (SN). Only 14.6% of the AWCs reported 100% preschool education (PSE) coverage among children. More than half (55.4%) of the AWCs reported an interruption in supply during the last 6 months. Various issues were reported by AWWs related to the ICDS. Conclusion: The study has reported gaps in terms of infrastructure facility, different trainings, coverage, supply, and provision of SN, status of PSE activities in AWCs, and provision of different services to the beneficiaries.
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Background: Despite significant progress in improvement of Government health care delivery system over past decade, community is reluctant to accept it because of substandard level of quality. “5S” is one of the strategies used to improve the physical quality and work efficiency of organization. 5S stands for five Japanese words which can be translated in English as Sort, Set in order, Shine, Standardize, and Sustain. Rajkot Municipal Corporation has adopted 5S strategy within its health centers with the aim to improve image of public health care facility among community and thereby to increase coverage of health services. This study was conducted to assess 5S implementation status at all Urban Heath Centers under health department of Rajkot Municipal Corporation, Gujarat, India. Methods: “5S” was implemented by the corporation in campaign mode in 18 Urban Health Centers in July 2014. Campaign included training, baseline assessment, and observing 5S week. A cross sectional study was carried out by personal observation and interview to assess the implementation of 5S campaign. Standard audit check list recommended by the State Quality Assurance Cell, Gujarat was used to evaluate. Results: Overall; all five components of 5S showed significant improvement (p<0.001) with highest improvement in Sorting and Setting in order. Significant improvement in utilization of Out Patient, laboratory services, immunization, family planning services etc were observed in comparison to previous year’s corresponding period. Conclusions: Significant improvement in utilization in major health care services was noted in the study after implementation of 5S. ‘5S’ practice can be sustained with sincere and continuous efforts.
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Objective: To evaluate Integrated Child Development Services (ICDS) program in terms of infrastructure of Anganwadi centers, inputs, process, coverage and utilization of services, and issues related to program operation in twelve districts of Gujarat, India. Design: Facility (Anganwadi) based study. Setting: Twelve districts of Gujarat, India (April 1, 2012 to March 31, 2013). Participants: ICDS service providers (60 Anganwadi workers from 46 rural and 14 urban Anganwadi centers) and their beneficiaries. Main Outcome measures: Coverage of supplementary nutrition, pre-school education, immunization and referral services. Results: Supplementary nutrition coverage was reported in 48.3% in children. Interruption in supply of supplementary nutrition during last six months was reported in 61.7% Anganwadi centers. Only 20% centers reported 100% pre-school education coverage among children. Immunization of all children was recorded in only 10% Anganwadi centers, while in 76.7% centers, no such records were available. Regular health checkup of beneficiaries was done in 30% centers. Referral slips were available in 18.3% Anganwadi centers and referral of sick children was done from only 8.3% centers. Conclusion: There are program gaps in coverage of supplementary nutrition in children, its regular supply to the beneficiaries, in pre-school activities coverage, recording of immunization, and regular health check-up of beneficiaries and referral of sick children.
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Objective: To compare prevalence of goitre in primary school children; to determine median urinary iodine concentration in children; and, to assess level of salt iodization at retail trader level. Design: 30 cluster survey study. Settings: Primary schools of Kutch district, Gujarat, India. Methods: Total 70 students including five boys and five girls from 1st to 7th standard, present in class on the day of visit were selected randomly for Goitre examination (n=2100). Urine sample was collected from one boy and one girl from each standard in each cluster. From the community, 28 children, including two boys and two girls from each standard in the same age group were examined, and salt samples were tested from their households. From each village, one retail shop was visited and various salts available were purchased and tested for iodine on the spot with spot kit. Results: Goitre prevalence of 11.2% was found among primary school children (grade 1- 8.6% and grade 2- 2.6%). As the age increased, the Goitre prevalence also increased except in age group of 8 years. Median urinary iodine excretion level was 110 μg/L. Iodine level more than 15 ppm was found in 92.3% salts samples tested at the household level. Conclusion: Present study showed mild goitre prevalence in primary school children in Kutch district of Gujarat.