RESUMEN
Background: Family planning plays a major role in improving the financial, nutritional, educational, social well-being of a family as a unit. To study the level of knowledge, attitude and practices of various family planning methods in eligible couples. Methods: Prospective Qualitative study was carried out from June 2021 - December 2022 on data of 180 eligible couples selected randomly from Well-Baby Clinic, collected through pretested and validated standardized questionnaire. Sample size was estimated scientifically. Results were arrived by descriptive statistical tests and correlational statistics using software’s like excel, SPSS. Results: The level of knowledge of contraceptive methods was 89.44% for OC pills, 67.08% depot medroxyprogesterone, 97.22% condoms, 84.03%, IUCD, 93.56% for female and 98.04% for male sterilization. Overall acceptance of any type of contraception was 55%, most commonly used method being condoms i.e.78.49%, OC pills 12.90%, IUCD 6.35%, depot 1.37% and 45% were using natural methods. Major factors affecting acceptance were desire to have more children, hesitancy to seek, lack of knowledge, decision making power of a woman in the family. Conclusions: Since our research finds contraceptive acceptance at 55% much lower than state average, we look into components of gender dynamics and offer array of choices to couples so that a well informed choice free of gender bias is taken. Continuity of personalized and dignified couple counseling from preconceptional, antenatal to postnatal period is emphasized to increase contraceptive acceptance. We recommend well baby clinics as effective point of delivery for family welfare activities using gender sensitive cafe-teria approach.
RESUMEN
Background: The Indian public health standard and Kayakalp guidelines are the main driver for continuous improvement in quality and bench mark for assessing the functional and cleanliness status of health facilities. Objectives were to assess PHC on IPHS and Kayakalp standard for continuous quality improvement. To conduct baseline and peer assessment of quality parameters using Indian public health standards and Kayakalp standard at primary health centre. To perform gap analysis and suggest quality improvement measures for meeting accreditation standards. To establish public private partnership for strengthening health services at PHC level. Methods: Descriptive observational study was conducted from September 2022 to June 2023 at Ajiwali PHC-Panvel taluka was selected using simple random sampling technique. Sample size of 83 patients was calculated as per the monthly case load of PHC. IPHS and Kayakalp assessment checklist, patient satisfaction forms were used for the survey. Various statistical tests like frequency, mean, percentage, S.E of difference between two proportions and two means were applied. Results: Kayakalp checklist baseline assessment score was 52.5% while post assessment score 72.5% showing significant improvement. Patient satisfaction survey pre and post assessment shows significant improvement where p value was <0.001 which was highly significant. IPHS survey shows partial improvement in training and quality parameters while other indicator remained the same. Conclusions: Regular quality assessment and accreditation leads to continuous quality improvement. Training and capacity building of PHC staff should be undertaken at regular intervals. Public private partnership modelling for various departments or service delivery components should be undertaken.
RESUMEN
Background: An impaired nutritional status in preschool children significantly Impacts their overall childhood development. Early detection of undernutrition at an early age is crucial for early intervention. Objectives of the study were to conduct nutritional status assessments of preschool children, to detect the overall prevalence and various patterns of undernutrition in these children by applying a composite index of anthropometric failure (CIAF) indicator. Methods: A community-based, cross-sectional study was conducted in January 2019 to March 2020. The sample size of 8542 was computed by formula n=4pq/L2, by randomly selecting 132 Anganwadi. Nutritional status assessment of the children was done by anthropometrics and clinical examinations. Conventional indices (underweight, stunting, and wasting) and CIAF classification were used to assess. The prevalence of undernutrition. Statistical analysis was done by Microsoft Excel and SPSS version 27 and statistical tests were applied. Results: 50.6% of children were detected for “anthropometric failure” by the CIAF method. The conventional indices showed the prevalence of underweight at 32.9%, stunting at 35.7%, and wasting at 16.4%. The 13 to 25-month age group was more significantly affected (57%) than its counterparts for undernutrition. Statistically, no significant difference was found between genders across all age groups for undernutrition (?2=9.8, ?tab=11.08). Chronic undernutrition seemed highly prevalent than acute one in preschool children. Conclusions: A more comprehensive policy program is needed to identify and cover single as well as multiple anthropometrical failure children. Special attention is needed towards the 13 to 25 months old children.