ABSTRACT
Introduction: Nutrition is fundamental to human health and development. The Take Home Ration (THR) program provides fortified rations for 6 months to 3 years normal children and severely underweight children up to 6 years, adolescent girls, pregnant women, lactating women through Anganwadis (AW). The National Nutrition Missions have targeted to decrease under nutrition by 3% each year. oObjective : T assess the utilization and satisfaction level of beneficiaries regarding THR and to identify challenges faced by AWW related to THR. Method: A cross-sectional study was conducted at 40Aanganwadi Workers ( ) Aanganwadis situated in the urban field practice area of the institute. Interview of all the (40) Anganwadi workers were conducted regarding implementation of THR Program. For assessing the utilization and satisfaction regarding THR, total 200 beneficiaries were selected from five different groups viz; 6 months to 3-year children, severely underweight children up to 6 years, Adolescent girls, Pregnant women and lactating women. Purposive sampling was used for selection of beneficiaries considering availability of beneficiaries at the time of study. Knowledge of AWW regarding THR scheme was good. Out of 200Results: beneficiaries, 97.5% beneficiaries were obtaining THR packets from anganwadis, out of which 66% beneficiaries were using them regularly. Around 36% of beneficiaries weren't satisfied with THR provided to them. Major challenges faced by beneficiaries were: Lack of variety, not possible to make separate food items from THR due to time constraints and lack of knowledge. Utilization of THR amongConclusion: beneficiaries was not satisfactory. Most of the beneficiaries were disappointed with taste of the THR. Beneficiaries strongly recommended for improvement in taste and flavour. Awareness regarding THR scheme was satisfactory among AWW. Biggest challenge faced by AWW was to convince beneficiaries regarding intended benefits of THR and regular usage of the same.
ABSTRACT
Background: Nutritional status of under?5 children in India is not promising and lags far behind the WHO Global Nutrition Targets. Although the Integrated Child Development Services has been continuously delivered through Anganwadi centers since 1975, the burden of malnutrition still persists. Objectives: This study was conducted to estimate the knowledge and practice pattern of Anganwadi supervisors and the effect of capacity building through remote supportive supervision during the COVID-19 pandemic in Assam, India. Methods: A cross-sectional before-after study using a mixed methods approach was used to evaluate the knowledge pattern and service delivery of supervisors from each district of Assam. For qualitative assessment, telephone depth interviews were conducted. Results: Knowledge of supervisors in the beginning was 83.43% which improved by 7.97% at the end of the study. The highest burden of SAM children was in Tinsukia and Barpeta districts. On mapping, most districts with lower burden of SAM had supervisors with higher knowledge levels on Infant and Young Child Feeding practices. Qualitative assessment revealed house?to?house visit for ensuring service delivery and use of online platforms and phone calls for counseling. However, community resistance and lack of transport stood as a main challenge. Conclusion: Supportive supervision done remotely during the pandemic to enhance the performance of health workforce was found effective.
ABSTRACT
Introduction: The Integrated Child Development Services (ICDS) Scheme, the largest program for promotion of maternal and child health nutrition in India, is operational for more than four decades. Objective: To evaluate Integrated Child Development Services Scheme in Kangpokpi District of Manipur in terms of input, process and outcome indicators. A community-based cross-sectional studyMethod: was conducted at a tribal hilly district of Kangpokpi in Manipur. The study included ICDS staff and beneficiaries of 35 randomly selected Anganwadi Centres (AWCs). Data related to ICDS was collected by using interview schedules and checklists. The descriptive data were expressed in terms of mean, standard deviation and percentage. Association between important background characteristics and Anganwadi centre attendance was analysed using chi-square test. Ethical clearance was obtained from the institutional Ethic Committee of JNIMS, Imphal before conducting the study (study period: May 2018 to April 2021) Input indicators: The study found that 86% anganwadi centres were run inResults: anganwadi worker’s own house. Two-thirds of the anganwadi workers (65.7%) were found to have separate toilet and 22.9% had separate kitchen. Process indicators: Even though the proportions of beneficiaries accessing services from anganwadi centres were high, the number of days Supplementary Nutrition (SN) was provided in a month was comparatively low (mean: 2.97 and SD: 0.618 for under-6 children and mean: 1 and SD: 0.000 days for adolescent girls, pregnant women and lactating mother in a month) due to frequent interruption of supplementary nutrition supply. There was no supplementary nutrition stock in 74.3% of the anganwadi centres on the day of visit. Outcome indicators: Regarding the nutritional status 90% of Under-6 children were found to be normal, 9% underweight and 0.6% severely underweight. The Integrated Child Development Services Programme in the study area wasConclusion: found to have several short-comings both in terms of inputs and process. There were not only inadequate facilities and infrastructure, but the anganwadi centres also lacked essential equipment like weighing machines and medicine kits, rendering a vital activity like growth monitoring to be almost completely absent. Supervisory visits were far below satisfactory.
ABSTRACT
Context: Early childhood caries is one of the most widespread diseases affecting children in urban and rural India. Community health workers can bring about a quantum of change in improving the oral health in children. Aims: The aim of the study was to assess the impact of oral health training imparted to Anganwadi and accredited social health activist (ASHA) workers on improving the oral hygiene of 148 children aged 1–6 years. Settings and Design: The preintervention followed by oral health training and postintervention assessment were done at three Anganwadi and ASHA centers of Rajasthan. Methodology: The preintervention data included Decayed, Missing, and Filled Teeth/decayed, extracted, and filled teeth, oral hygiene indices (Oral Hygiene Index-Simplified [OHI-S] and Oral Hygiene Index Simplified-Modified [OHIS-M]), plaque index, and caries activity using Oratest. The oral health training consisted of PowerPoint presentations, video presentations, live demonstrations on brushing technique, rinsing, plaque disclosure, and flossing technique. They were enlightened on deleterious oral habits, emergency protocol on trauma, etc. The postintervention data included outcome measures consisting of oral hygiene indices (OHI-S and OHIS-M), plaque index, and Oratest after 2 months to evaluate the impact of training. Statistical Analysis used: The data were analyzed using Chi-square test, Fisher's exact test, independent t-test, paired t-test, and one-way analysis of variance test. Results: There was a significant improvement in toothbrushing practices and rinsing (P < 0.05). There was a significant difference in debris index, calculus index, OHI-S/OHIS-M, plaque index, and Oratest after intervention (P < 0.05). Conclusion: Empowering Anganwadi and ASHA workers can be a feasible approach in India, where oral health is not a priority in primary health care as yet.
ABSTRACT
Background: One of the vulnerable groups among the population is pregnant and lactating mothers. Among the women in pregnancy it effects the fetal growth and development. Aim of this study is to assess the dietary pattern of pregnant women and lactating mothers and factors related with adequacy of nutrient intake.Methods: Community based cross-sectional study. Study setting was urban slum dwellers of Siddipet. Study period from September 2019 to November 2019. Study population were pregnant and lactating women up to 6 months registered in Anganwadi centre. Sample size was 91 pregnant and 58 lactating women. Sampling methods was simple random sampling method. Data analysis used was SPSS Version 21.Results: Distribution of women according to intake of nutrients revealed that nearly 90% of the pregnant and 50% of the lactating women were not taking adequate calories and proteins respectively. Mean calorie intake in pregnant and lactating women was 1418±192 and 1600±218 respectively (recommended dietary allowance (RDA) for calories in pregnant and lactating women was 2580 kcal and 2830 kcal respectively). Mean protein intake in pregnant and lactating women was 47±9 and 51±8 respectively (RDA for protein in pregnant and lactating women was 78 gm and 74 gm respectively). Food taboos were prevalent in both pregnant (42%) and lactating women (55%).Conclusions: Interventions for promoting health education in women need to be strengthened, in order to achieve proper nutrition to women and mothers.
ABSTRACT
Background: The change in strategy of India's National Program for the prevention and control of nutritional blindness due to Vitamin A deficiency during 2006, aims for all children aged 9 months to 5 years to receive biannual pulse dose of Vitamin A with a total nine mega doses of Vitamin A. Micronutrient initiative (MI) was providing technical assistance to the State Health department of Karnataka in implementing the new bi-annual strategy, in partnership with UNICEF during the period 2006 to 2010.Methods: During July 2006, the Investigator evaluated its coverage in Gulbarga district. This study assessed the factors influencing the uptake of pulse Vitamin A supplementation (VAS) among children from impoverished background. Using oral questionnaires, a total of 30 Parents (Mothers) of these children, 12 childcare workers (AWWs), 12 peripheral health workers (ANMs) were interviewed regarding barriers towards implementing this Program and assessment of the facilities (12 Anganwadi centres) were conducted.Results: Only 28% of the facility had some IEC display regarding VAS. 75% of ANMs were aware that either green leafy vegetables or fish or fruits are the main source of micronutrients. A similar number of ANMs knew that Vitamin A deficiency causes night blindness, >90% of AWW had informed parents about the program during the monthly mother meetings. <20% of parents were aware of the current pulse VAS program and a similar number were aware of the next round of supplementation.Conclusions: Regular interaction with families, monitoring the activities of field level health workers and supportive supervision will enable uptake of VAS Program. Future action should prioritize sub-district level units ' blocks and villages, with higher concentration of poor households.
ABSTRACT
Background: The task of using the growth chart by Anganwadi Workers (AWWs) for growth monitoring requires technical skill. It was hypothesized that skill up-gradation can make a difference in the performance of AWWs in regard with growth monitoring. The aim of the study was to evaluate the effect of intervention in improving skill of AWWs regarding growth chart plotting and interpretation.Methods: It was a field based interventional study, which was conducted in rural areas of Varanasi district, India. A total of 66 AWWs each from Chiraigaon (intervention) and Cholapur (control) community development blocks of Varanasi district was selected for the study. Each AWW was provided 3 weight readings of different ages for plotting and 4 filled growth charts for interpretation. Chi square test has been applied to assess the significant difference.Results: Only around 10% of AWWs could correctly plot all 3 growth charts and similar proportion of AWWs could also correctly interpret all 4 filled growth charts. The planned intervention could significantly improve their skill of growth chart plotting and interpretation and during end line survey 41% and 77% of AWWs could correctly plot all 3 growth charts and interpret all the four growth charts, respectively.Conclusions: The developed hypothesis is proved, and intervention was found effective in significantly improving the skills of AWWs in regard with growth monitoring.
ABSTRACT
Background: The integrated childhood development services (ICDS) scheme, launched on 2nd November 1975 is India’s foremost program imparting comprehensive and cost-effective services for children and maternal health through designated anganwadi centers (AWCs). AWCs deliver services right at the doorsteps of the beneficiaries to ensure their maximum participation.Methods: This was a cross sectional descriptive study conducted in 37 AWCs of the urban area in Kathua district from March to May 2019. A checklist was used to assess the physical infrastructure of AWC and logistics available.Results: A total of 37 AWCs were visited. Majority of the AWCs (94.5%) were running in a rented building and had only room. and 86.4% have pucca type of center. Almost half (51.3%) of the anganwadi workers had >10 years of experience. 32.4% of the AWWs received education up to 12th standard. Weighing machines were available in 89.1% of the centers whereas Salter weighing machine was present only in 23 centers.Conclusions: Present case study unveils deficiencies in infrastructure and logistics at the centers. Emphasis should be given to strengthen the basic infrastructure of AWCs which would further help in delivering quality services to the beneficiaries
ABSTRACT
Background: The anganwadi worker (AWW) is the backbone of integrated child development services (ICDS) for delivering the services of the program. Being a key functionary, her level of knowledge regarding various components of ICDS is linked to the ultimate outcome of the ICDS program. Thus, this study was aimed to assess the level of knowledge among AWW regarding services of ICDS.Methods: This was a cross sectional study in which level of knowledge regarding ICDS among anganwadi worker was assessed using structured questionnaire. The primary outcome of the study is the knowledge of AWW about ICDS component services. Descriptive statistics was presented as frequency and percentage for categorical variable. The knowledge of AWW was assessed by knowledge score made under all the themes of the questionnaire and was presented as mean and median score. Analysis was done in STATA version 14.2.Results: Nearly 55% of the respondents were not aware about ICDS services. Whereas majority had knowledge on growth monitoring and immunization respectively, above the median score, only 39% of AWW had knowledge on nutritional supplementation above median score. The variables such as education level and training of AWW showed significant association with the knowledge of ICDS components.Conclusions: There is need for improving knowledge and awareness about various ICDS components and the training quality provided to AWWs.
ABSTRACT
Background: Anganwadi centres under integrated child development services is the largest Project in India to improve not only child health but reproductive, maternal and adolescent health. The aim of the present study is to compare the infrastructure of urban and rural anganwadi which is one of the basic need to provide quality services.Methods: A total of 30 anganwadi centres are involved in our study in which 20 are from rural and 10 are from urban field practice area of Department of Community Medicine, Bangalore Medical College and Research Institute, Bangalore. This study employed interview method with anganwadi worker’s and observation of anganwadi centre using pre-designed, semi structured questionnaire and checklist.Results: 85% of rural and 60% urban anganwadi centres have their own buildings to carry out the services. 20% of rural anganwadi centres lack fixed name boards compared to urban anganwadi centres. 55% of rural anganwadi centres and 90% of urban anganwadi centres lack separate storage for raw food materials. 15% of rural anganwadi centres lack functional toilet facility. 40% of rural anganwadi centres lack functional weighing machine.Conclusions: Anganwadi centres are remote contact point of health care system within the community. The infrastructure of anganwadi centre such as type of building, space for cooking and activities, availability of functional equipments ensure the quality service deliveries which in turn are enhanced by timely supervision from higher authorities.
ABSTRACT
Background: The beneficiaries under the scheme are children in the age group of 0-6 years, pregnant women and lactating mothers, women in the age group of 15-44 years and adolescent girls in selected blocks. Irrespective of caste, religion, socioeconomic status all beneficiaries are eligible for availing of services under the Integrated Child Development Services (ICDS) scheme. BPL is not a criterion for registration of beneficiaries under ICDS2. Present study is to recognize whether all categories of people are utilizing the services or not irrespective of economic status, religion etc.Methods: Descriptive observational study done for period of one year, sampling done by multi stage (random) method. Study conducted in ICDS centers in the field practicing area of Kakatiya medical college Warangal, Telangana, India. 622 children from 31 anganwadi centres of 0 to 6 year age were included.Results: Majority (71.7%) were belongs to ‘0 to 3’ years of age group, male (50%) and female (50%) were equally in distribution. majority (78.3%) were Hindus. Majority parents (father-84.9, mother 84.2) were literates and mothers were unemployed/housewives, fathers were skilled workers (28%) followed by farmers (22%). Majority were (35.4%) belonged to middle, followed by lower middle (30.2%) level of socio economic status.Conclusions: There were less number of 3 to 6 years age category population in the study, means that age group is not getting covered properly by ICDS. Two extremes (higher and lower categories) of education, occupation, socio economic status parents were not properly utilising the ICDS services for their children.
ABSTRACT
Background: Integrated Child Development Services (ICDS) today represents one of the world’s largest programmes for early childhood development. The Anganwadi workers and Anganwadi Helpers are the grass root level functionaries responsible for delivery of services.Methods: A field based cross sectional observational study was conducted in Mangalagiri rural ICDS project to assess the knowledge levels and the socio-demographic profile of the Anganwadi workers, all the Anganwadi workers who are working in Mangalagiri rural ICDS project area have been included in the study.Results: Out of 212 AWWs, majority of AWWs were from the age group of between 30-49 years; 123 (58%) AWWs have education qualification from 6th class to 10th class standard and 135 (63.7%) workers had an experience of more than 10 years. About 142 (67%) AWWs had a good knowledge assessment score. They had best knowledge about immunization (96.7%), referral services (93.4%), growth monitoring (82.5%), health check-ups (75.1%) and nutrition and health education (70%). AWWs complained problems like infrastructure related, excessive work overload and record maintenance.Conclusions: The majority of the AWWs are in the age group of 30 to 49 years. More than half of them belong to lower middle socio-economic class. Maximum number of workers has experience of 10 years or more. All the AWWs in our study had 50% and above knowledge about Anganwadi services. Best knowledge is seen regarding immunization followed by referral services. Least knowledge is seen regarding supplementary nutrition. Major problems reported were excess work and record maintenance.
ABSTRACT
Background: ICDS is running from about last four decades in our Country sponsored by Central Government. For achievements of ICDS objectives Anganwadi Centres need to be well equipped in infrastructure and logistics as they are the main source of services provided under ICDS. To find out available infrastructure and logistics at Anganwadi Centers (AWCs), to study the bio-social profiles of Anganwadi Worker (AWWs) and to assess the factors affecting the organizing ‘matriya samiti’ meeting by AWWs at AWCs.Methods: A cross sectional observational study conducted in a rural area of district Bareilly in 22 Anganwadi Centres selected by multi-stage sampling technique. Selected Anganwadi Centres were visited and selected Anganwadi workers and beneficiaries were interviewed.Results: Majority of AWCs were having pucca type of construction but only 18% were having toilet facility. 60% of AWCs were having regular supply of supplementary nutrition, 72% of AWCs do not have any cooking utensils, around 55% were having growth charts, only 32% were having complete non formal pre-school education kit, less than 40% were having complete medicine kit and only 13% were having referral slips.Conclusions: Most of the AWCs were not having adequate infrastructure and logistics as requires.
ABSTRACT
Background: Anganwadi centres (AWCs) remain hub for promoting nutrition in children. For an effective functioning of programs, Anganwadi workers (AWWs) need to have a sound knowledge and perception regarding under-nutrition. A qualitative study (Focus Group Discussion) was conducted with aim to assess perceptions and knowledge of AWWs regarding under-nutrition in 6 domains like about term under-nutrition in children, its causes, identification of it, its community management, advices to be given to parents and knowledge of program related to under-nutrition in their locality.Methods: 2 Focus group discussions (each consisted of 12 members and took around 40-45 minutes) were conducted in December 2018 among AWWs of Berhampur through purposive sampling. One author played role of facilitator who carried out discussions, another acted as recorder who took notes and sociograms were recorded by another author. Audio-visual recordings were done. Data were analysed and a report was created based on grounded theory.Results: Participants had fair knowledge of term under-nutrition. They had good knowledge of causes of under-nutrition in children and knew how to identify. But none of them had proper knowledge of community management of malnutrition (CMAM) in children. Though most of them have knowledge of screening of malnourished children and referral to Nutritional rehabilitation centre, they were unaware of other key components of CMAM. Many AWWs didn’t know much about programs for combating malnutrition; however they were well acquainted with ICDS and VHND.Conclusions: Quality training programs and more sensitisation should be done for Anganwadi workers. Specific training on CMAM should be carried out for them.
ABSTRACT
Background: Antenatal care and supplementary nutrition are evidence-based strategies to improve neonatal outcomes and birth weight, and are currently provided free of cost by the government in every village through the ICDS. This study aims to assess the utilization of Anganwadi services by pregnant and lactating mothers in a rural area and the various barriers to utilization of Anganwadi services.Methods: A hospital-based, cross-sectional study was conducted among pregnant women (more than 28 weeks gestation) and lactating mothers (up to 6 months after delivery) availing maternal and child health services at a maternity hospital in a rural area of Ramnagara district in South Karnataka, using a pre-tested questionnaire.Results: Awareness regarding Anganwadi services available for pregnant and lactating mothers like IFA, calcium and deworming tablets, TT and health check-ups was found to be poor. While more than half of the women had received health education from Anganwadi teacher, important topics like dangers signs, birth preparedness and essential antenatal care were not discussed.Conclusions: Utilization of health care services at the Anganwadi was poor among the subjects. Supplementary nutrition was not utilized by 54% of pregnant women and 43% of lactating mothers. Those who had been visited by Anganwadi teacher at home and those who received nutrition education by the Anganwadi teacher had significantly higher consumption of supplementary nutrition. The common barriers to utilization were lack of awareness of services and perception of poor quality and hygiene of the supplementary nutrition.
ABSTRACT
Background: Anemia is a major public health problem especially in adolescent age group because of its intergenerational impact. The Ministry of Health and Family Welfare, India launched the weekly iron and folic acid supplementation programme for adolescent girls and boys. The objectives of the study were to study the awareness of the weekly iron and folic acid supplementation in preventing anemia in the study subjects; to assess the implementation of the weekly iron and folic acid supplementation in government schools and anganwadi centres.Methods: A cross-sectional study was carried out in the 4 government schools and 11 anganwadi centres of the urban field practising area of a tertiary health care centre, Osmania Medical College, Hyderabad. All the students who were present at the time of study, the teachers and anganwadi workers, who gave consent were included. The study was carried out for a period of 3 months (August to October, 2018) using a pretested schedule.Results: A total of 313 students, 21 teachers and 10 anganwadi workers had participated in the study. Among school students, only 15% had awareness of anemia. Girls had better knowledge than boys (p<0.05). The benefits of iron folic acid tablets were known to 17% students and 67% teachers. Most commonly side effects were nausea, vomiting and stomach pain. Irregular supply of tablets and poor maintainence of records was seen.Conclusions: The supply and distribution of tablets was found to be not in accordance with the guidelines of the programme.There is need of regular orientation to the teachers and anganwadi workers and nutrition education meetings for behaviour change communication to the parents.
ABSTRACT
Background: About 30% of blind population of India loses their eyesight before the age of 20 years and many of them are under 5 when they become blind. Childhood blindness will have serious impact on development, education and quality of life. Therefore it is essential that ocular morbidity is detected and treated at an early stage.Methods: A cross-sectional study was conducted among 120 children aged 3-5 years attending 6 anganwadi centres of Hubballi taluk which were selected by stratified random sampling. Data was collected using pretested semi-structured questionnaire. Ocular examination was conducted to identify ocular morbidity. Test for visual acuity, colour blindness and refractive status was done using lea chart, ischihara charts and plusoptix mobile vision screener respectively. Nutrition status was assessed by clinical examination and anthropometry. Statistical analysis was done using SPSS package.Results: Out of 120 children 51.7% were male. Majority, 63.3% were residing in urban area and 40% belonged to class IV of modified B G Prasad classification of socio-economic status scale. The prevalence of ocular morbidity was found to be 20%. 15.8% of children had refractive error, 2.5% had vitamin A deficiency and 1.7% had squint. No statistically significant association was found between ocular morbidity and any risk factors.Conclusions: Refractive error was found to be the most common ocular morbidity among pre-school children. This if detected early can be corrected. Therefore it is important to screen for refractive error at the preschool age itself and to create awareness among parents and anganwadi teachers regarding common ocular symptoms.
ABSTRACT
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.
ABSTRACT
Background: Integrated Child Development Services (ICDS) is one of the world’s largest community based schemes running in India for over three decades. Frequent evaluations of the scheme have been conducted to make it more effective to promote early childhood care. Objectives: Comprehensive assessment of services provided under ICDS in urban slums of Jamnagar city of Gujarat state. Methods: It was decided to study 15% of the total 297 AWCs of the city through Simple Random Sampling technique. The AWCs visited were evaluated with respect to infrastructure facility of the centre, record keeping activity & knowledge of AWWs, availability of essential drugs & logistics. Results: A total of 48 centers were evaluated. 24 centers operated from Kutcha or semi-pucca buildings and toilet facilities were lacking at 20 of the centers. Only about 44% of the enrolled 3-6 years children were present at the AWC on the day of visit. Nearly 40% of the enrolled children had varying grades of malnutrition. Unavailability of medicine kits & other logistics, was observed. Three fourth of the AWW described providing non-formal preschool education & supplementary nutrition as their only responsibilities forgetting other essential components of their service. One fourth of the AWW did not know proper time to initiate Breast Feeding and over one third (37.5%) of them did not know the Universal Immunisation Program schedule fully. Less honorarium & poor quality of supplementary food were their main difficulties. Conclusion: the AWC currently acts merely as a food distribution centre with minimal provision of other services. Regular growth monitoring of the children along with supervision of the services provided would be far more effective in improving the nutritional status of the children than supplementary nutrition alone.
ABSTRACT
In the the present study patients were divided into three study groups of thirty patients each, group 1 included Infertility patients, group 2 comprised of patients undergoing laparoscopy for ovarian cyst, chronic pelvic pain, fibroid uterus, adnexal mass etc. and group 3 had patients undergoing laparoscopic sterilization without any symptoms. Prevalence of endometriosis was found to be 12.2%.Highest being in Group 1(23.3%), followed by Group 2 (13.3%) and no cases of endometriosis were detected in Group 3. Peritoneum was involved in maximum cases with commonest lesion being subtle red lesion (71.4%).On comparing ultrasound with laparoscopy in endometriosis diagnosis, sensitivity of ultrasound was only 9%. Thus it is recommended that diagnostic laparoscopy in gold standard for the diagnosis of endometriosis.