Knowledge of Accredited Social Health Activist (ASHA) Workers Regarding Maternal Health Services: A Comparative Study between Rural and Urban Areas of a Block of Haryana

Introduction: All people, everywhere, deserve the right care, right in their community. In any community, maternal mortality ratio strongly reflects the overall effectiveness of health systems. To increase utilization of existing health services, Accredited Social Health Activist (ASHA) is the key component of the National Rural Health Mission. o assess compare the level of knowledgeO : bjective T any of ASHA workers regarding maternal health services in between rural and urban areas of a block of Haryana. Method: The present cross-sectional, community-based study was conducted in block Barwala, district Hisar of Haryana. The assessment of knowledge of ASHA workers was done on the basis of scoring. Appropriate statistical tests like percentages and chi-square (?2) test were applied. RegardingResult :s maternal health services majority of ASHA workers had good knowledge, assessed by score gained by them and none of them was having poor knowledge about maternal health services. However in rural area score, gained was better than urban area & the observed difference was found to be statistically significant. Knowledge of identification & treatment of anaemia and identification of danger signs during pregnancy were inadequate among ASHA workers of both areas. Knowledge of ASHA workers wasConclusion: inadequate as far as anaemia and danger signs during pregnancy were concerned. Frequent and regular refresher training should be organized in their working area.

Study on knowledge, attitude and practice of ante-natal care among pregnant women attending antenatal tertiary care institution

Background: The primary aim of antenatal care is to achieve a healthy mother and baby. Antenatal care helps to identify the complications and to remove anxiety and dread associated with delivery. Current study designed to assess knowledge, attitude and ante natal care practice among pregnant women attending to antenatal tertiary care hospital.Methods: A cross-sectional study was conducted on 500 pregnant women attending antenatal care centre at department of obstetrics and genecology, Narayana Medical College and Hospital, Nellore during June 2017 to June 2019 under Narayana Mathru Seva Pathakam. Face to face interview was conducted to assess their knowledge, attitude and practice using a structured questionnaire.Results: A total 86% belongs to 20-29 years age group and 71.4% belongs to multiverdia. 20.6% women responded that they had completed 3 antenatal visits, 26.6% are those who thought that at least more than 5 ANC checkup should be done during pregnancy. 96.1% pregnant responded that registration for antennal care and visits is essential. 87.2% responds to take iron and folate during pregnancy and 11% responds does not taken the same. 92% pregnant responded that tetanus toxoid (TT) should be given during pregnancy but 3.2% told don’t know. When they asked about resting period, 24.2% responded 5-6 hours, 35.4% responded 7-8 hours, 35.6% responded > 8 hours per day to rest they are taking. 55.8% pregnant responded that they had taken decision to give birth the baby in the hospital. 71.2% pregnant females reported that they knew about the danger signs during pregnancy. The reasons for not attending antenatal check-up were financial reasons, illiterate (15.4%), transport and unaware about ANC.Conclusions: Information, education and communication activities should be increased on ANC through community campaign and mass media to motivate women to utilize maternal care services.

Awareness of Mother’s Regarding Under Five Danger Signs in a Selected Rural Community of West Bengal, India

@#Introduction: The first five years of life constitute the foundations of the child's physical, mental growth and development. Mortality and morbidity are high during this age group. Early detection of danger signs is very crucial to prevent this. The objectives were to assess the knowledge of mothers regarding under-five danger signs and explore the association between the effects of knowledge with selected factors. Method: A descriptivestudy was conducted in a rural community of West Bengal from Jan’2018 to Sept’2018. Total study sample was 110 mothers having under five children. Door to door data collection was done through interview and data was analyzed both manually and by computer feeding. Results: Out of total study sample, majority (60%) belongs to age group 18-25 years followed by 31% among 26-33 age group, then 16% were more than 33 years. Out of total mothers, majority (40%) belongs to higher educated group, (37%) secondary group, followed by 10% with primary education and 13%were illiterate. Knowledge score was more than 50% among higher educated group (64%). Out of total respondents 61 (55.5%) mothers were not able to identify any danger signs whereas, 35.5 % mothers identified 1-2 danger signs and 9% mothers were able to identify 3-4 danger signs. Knowledge score about danger signs was more who visited antenatal clinic more than 4 times (61%). Conclusion: Awareness regarding under five danger signs are more among higher educated mothers. Number of antenatal visits also influences knowledge score.

Birth preparedness and complication readiness among women attending Immuno-Prophylaxis Centre, Dr. S. C. Government Medical College, Nanded

Background: As signatory to United Nation’s Sustainable Development Goals, India is striving hard to achieve these goals by end of 2030, especially for goal number 3 with targets related to maternal and child health. Birth-preparedness and complication-readiness (BPCR) is a tool to promote maternal and neonatal survival. This study was conducted to assess the perception and practices of recently delivered women on BPCR with its correlates.Methods: Hospital-based cross-sectional study was conducted at Immuno-prophylaxis centre of Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra. Women attending IPC along with their baby within two to four months of delivery for immunization of their babies during the month of March 2014 constituted study subject of this study. After obtaining informed consent, data was obtained on socio-demographic characters like age, caste, religion, education, parity, ANC registration and questions regarding birth preparedness and complications readiness in their last pregnancy.Results: Total 117 women found to be eligible as study subject. Overall BPCR index of the study population was 67.28. Proportion of women who received first antenatal check-up within first trimester, four or more antenatal checkups, saved money for childbirth and had institutional delivery were 87.18%, 86.32%, 51.28% and 100% respectively. Around 23.08% women had knowledge of at least 3 key danger signs of pregnancy while only 19.65% identified blood donor. Awareness regarding danger signs of pregnancy and arrangement for blood donor was found poor in comparison to other indicators in study subject.Conclusion: There is need of increasing awareness regarding BPCR so that perception and practices in the community increased.

Birth preparedness and complication readiness among pregnant and recently delivered women in villages of a block of Ganjam, Odisha, India: a community based cross-sectional study

Background: Globally approximately 830 women die from pregnancy and child birth every day. Most of deaths can be prevented by proper planning like birth preparedness and complication readiness (BPCR). The aim of study was to assess awareness and practice regarding BPCR among pregnant women and recently delivered women and to identify socio-demographic factors affecting it.Methods: A community based cross sectional study was conducted from September to December 2018 in villages of Chhatrapur block of Ganjam District among pregnant women (completed 24 weeks) and recently delivered women (12 months) regardless of newborn outcome. Sample size was calculated to be 96. Multi stage random sampling was adopted and PPS (Probability proportional to size) method was used. A questionnaire was used which contained socio-demographic information and set of 11 indicators to determine BPCR index. All data were analysed in SPSS.Results: BPCR index was 44.6% and it was higher (61%) in recently delivered women. 26% can be said to be well prepared and 45.8%, 27%, 32.3%, 37.5% knew at least one key danger sign in pregnancy, delivery, post partum and about new born respectively. A significant association was found between maternal education, age and pregnancy with awareness regarding BPCR.Conclusions: BPCR index in study area was low and a low proportion of participants were well prepared. Awareness about danger signs was quite low. So health workers at grassroots level should be encouraged to explain BPCR components to women and educational activities should be carried out to promote women to make plan a priori.

Assessment of awareness regarding obstetric and newborn danger signs among pregnant women and recently delivered mothers in urban slums of Raipur city, Chhattisgarh

Background: Knowledge regarding danger signs has been found helpful to reduce delays in seeking, reaching and obtaining care during obstetric emergencies. Aims & Objectives: To assess the awareness regarding obstetric and newborn danger signs among pregnant and recently delivered mothers residing in urban slums of Raipur city. Material & Methods: Observational study was conducted among 160 pregnant and 70 recently delivered women residing in urban slums. The assessment of awareness regarding danger signs was done by adding the marks obtained in various phases. Appropriate statistical tests were applied for any association between knowledge score and socio-demographic variables. Results: Subjects knowing at least one key danger sign during pregnancy, labour, postpartum and newborn period was 54.3%, 51.9%, 7.4%, and 11.3 % respectively. Those with age more than 20 years (p value 0.000), joint family (p value 0.000), educated more than 5 years (p value 0.009), and having married and getting first time pregnant after 20 years (p values 0.001 and 0.022 respectively) were found to have significantly more knowledge about danger signs. Conclusions: Knowledge regarding danger signs should be given at the time of every ANC visit and also at follow up visit after delivery.

Danger signs of acute respiratory tract infections in under-five children: awareness among mothers in the urban slums of Hyderabad, its relation to treatment seeking behaviour

Background: Sustainable development goals (SDGs) proposes to all countries an aim to reduce under-five mortality to 25 per 1000 live births by 2030. Acute respiratory tract infections including pneumonia are the leading cause of death among the children less than five years in India. Identification of severe respiratory infections from non-severe forms necessitates that care-givers, especially mothers are aware of danger signs. An attempt is made to study the awareness of danger signs among the Mothers and see its relation to treatment seeking behaviour.Methods: Community based cross-sectional survey was conducted involving 344 mothers of under-five children living in the urban slums of Hyderabad.Results: The awareness of mothers about the danger signs of ARI is poor. Very few knew that fast breathing (11 percent), wheezing (4.7 percent), convulsions (1 percent), lethargy (1 percent) are major danger signs of ARI requiring urgent medical attention. A majority of mothers took the child with ARI to private hospital (42 percent) while few approached Govt. Hospital or dispensary (4.7 percent). Many mothers (77 percent) were aware that vaccination against diseases might protect the children against ARIs. The prevalence of acute respiratory infections among the children in the current study (59.3 percent) is much higher that previous studies elsewhere.Conclusions: A very high proportion (44 percent) of the mothers were ignorant of any danger sign of ARI. The significant association between awareness and positive health care seeking behaviours, like consulting allopathic doctor or govt. hospital or private hospital establishes the evidence that awareness levels are the prerequisite for the positive health care behaviour.

Conocimientos y prácticas sobre signos de alarma de las gestantes atendidas en el Hospital Nacional Docente Madre-Niño San Bartolomé, Lima, Perú

Introducción: De acuerdo a los objetivos del milenio, nuestro país debe reducir la mortalidad materna en 75%. El Plan estratégico nacional para la reducción de la mortalidad materna y perinatal considera reducir las posibilidades de complicaciones durante el embarazo, parto y puerperio. Esto es posible mediante la identificación de los signos de alarma. Objetivos: Determinar el nivel de conocimientos y prácticas sobre signos de alarma en gestantes. Diseño: Estudio descriptivo transversal. Lugar: Hospital Nacional Docente Madre-Niño San Bartolomé, Lima, Perú. Pacientes: Gestantes en hospitalización y consulta externa, durante junio del 2013. Intervenciones: Encuesta sobre conocimientos y prácticas de los signos de alarma durante la gestación. Se realizó análisis bivariado utilizando la prueba de chi cuadrado; la fuerza de asociación se calculó con odds ratio. Principales medidas de resultados: Con/ sin conocimientos y prácticas Resultados: Conocimientos: 93% de las gestantes consideró los signos de alarma como indicadores de peligro para la madre y el feto; el 100% sabía que debe acudir a un centro de salud de inmediato. Prácticas: Los signos por los cuales la mayor proporción de gestantes acudió a emergencia fueron convulsiones (100%), no crecimiento de barriga conforme a la gestación (100%), ardor al orinar (86,1%), sangrado vaginal (84,4%) y fiebre (84,2%). Conclusiones: La mayoría de pacientes consideró a los signos de alarma como peligro; de presentarse algunos de estos signos, todas conocían que deben acudir a un centro de salud inmediatamente y siempre acudirían. Se requiere estudios cualitativos para determinar las causas por las cuales, a pesar del conocimiento, algunas gestantes no acuden a tiempo.

Introduction: According to the millennium development goals, our country must reduce maternal mortality rate in 75%, and the Strategic National Action Plan for Reduction of Maternal and Perinatal Mortality considers reducing the possibilities of complications during pregnancy, labor and puerperium by recognizing the danger signs during pregnancy. Objectives: To determine the level of knowledge and practices on danger signs in pregnant women. Design: Descriptive study. Setting: Hospital Nacional Docente Madre-Niño San Bartolome, Lima, Peru. Patients: Pregnant women in hospitalization and outpatient consultation during June 2013. Interventions: A survey was administered to evaluate knowledge and practices on danger signs during pregnancy. Chisquare test bivariate analysis was used; odds ratio assessed association strength. Main outcome measures: With/without knowledge and practices. Results: Knowledge: 93% of patients considered danger signs as an indicator of risk for both mother and fetus; 100% knew that they should immediately go to a health care center if they showed any of the danger signs. Practices: Patients attended the health care center when they presented seizures (100%), small abdominal growth according to gestational age (100%), dysuria (86.1%), vaginal bleeding (84.4%) and fever (84.2%). Conclusions: The majority of patients considered danger signs as a risk and in case of presenting any of these, they knew they should attend a health care center immediately and they would do it. Further studies are recommended to determine why even when knowing danger signs some women do not go to a health center in time.

IMCI approach in tertiary hospitals, India.

Objective. This study was conducted to compare physicians’ diagnosis with Integrated Management of Childhood Illness (IMCI) algorithm generated diagnosis in hospitalized children aged 2 – 59 months. Methods. Recruited were patients aged 2-59 months admitted with one or more IMCI danger signs. IMCI and physician's diagnosis were noted and compared. Results. In 222 included subjects, mean duration of illness was 9.4 (SD: 16.5) days. Among those with cough or difficult breathing, 44 (19.8%) and 66 (29.7%) were diagnosed as either severe pneumonia or mild to moderate pneumonia by physicians and IMCI algorithm, respectively (p= 0.015). Among 146 presenting as fever, 140 (95.9%) were diagnosed as very severe febrile disease by the IMCI algorithm, whereas physicians diagnosed these as either malaria in 10/146 (6.7%), pyogenic meningitis in 47/146 (32.2%), sepsis in 31/146 (21.3%), tuberculous meningitis in 17/146 (11.6%), encephalitis in 5/146 (3.4%), measles in 3/146 (2.1%) or others in 24/146 (16.4%). Conclusion. As there was a low concordance between physician and IMCI algorithmic diagnosis of pneumonia (Kappa value= 0.74, 95% CI: (0.64 – 0.84)) and since very severe febrile disease is not a diagnosis made by the physicians, the IMCI algorithms have to be refined for appropriate management of these conditions.

Awareness and health care seeking for newborn danger signs amongmothers in Peri-Urban Wardha.

Objective. To find out awareness of mothers about newborn danger signs and their health care seeking behavior for sick newborns in the peri urban field practice area of Urban Health Centre in Wardha. Methods. Triangulated study of quantitative (survey) and qualitative (mapping, pair-wise ranking exercise) methods were undertaken. 72 identified mothers of children (0-11 months) in social mapping exercise were interviewed by trained social workers using pre-designed and pre-tested questionnaire and by paying house to house visits. The structured questionnaire covered information on newborn danger signs, health care seeking and socio-demographic information. The data was analyzed by using Epi_info software package. A pair-wise ranking exercise for assessment of preferred health care facility for sick newborn was undertaken with the group of purposively selected mothers. Results. Out of 72 mothers, 29 (40.3%), 16 (22.2%) and 10 (13.9%) identified difficulty in breathing, poor sucking and lethargy/unconsciousness as newborn danger signs respectively. Only 7(9.7%) and 2 (2.8%) identified convulsion and hypothermia as newborn danger signs respectively. About 27 (37.5%) babies were sick during newborn period. About 11(15.3%) and 8 (11.1%) were reported to have poor sucking and difficulty in breathing respectively. All sick newborns with danger signs were taken to the doctor and only two mothers consulted faith healer for treatment. Conclusion. Considering the poor awareness of mothers regarding newborn danger signs, there is need for raising awareness building which required for early recognition and prompt treatment. Apart from strengthening government health facilities, the capacity of intermediate non government health care providers should be developed for newborn care.