RÉSUMÉ
Background: Rabies is an acute viral disease, which causes encephalomyelitis in virtually all the warm blooded animals, including man. Almost 20000 deaths occur in India. The present study conducted with objective to analyze the delays and compliance for anti-rabies vaccination as per schedule and its some factors among the animal bite cases. Methods: Retrospective cross sectional record based study of cases attended Anti-Rabies Vaccination (ARV) clinic during the period of April 2012 to March 2013. The data extracted from records included socio-demographic variables, animal bite history treatment received and completion of ARV schedule. Data entered and analyzed using SPSS 21. Results: Total of 3548 animal bite cases attended the ARV clinic. Out of these cases, 18.2 %, 20.3% and 14.2% of cases not reported on scheduled date for 2nd, 3rd & 4th dose of ARV respectively. Only 34.3% of cases completed the schedule. Delay for receiving ARV among women, cases from rural area & class II animal bite was statistically significant. Conclusions: Counselling regarding follow up of ARV schedule at the time of first visit to the anti-rabies vaccine clinic must be strengthened to avoid poor compliance and delaying of schedule.
RÉSUMÉ
Background and objectives: Biomedical waste has been a growing concern due to increased awareness in public regarding HIV/AIDS, hepatitis B and exposure to other potential infectious diseases. Good BMW disposal practices lead to reduction in medical expenditure, unsightly scenes at various disposal bins and dumping sites. Improper biomedical waste management practices and indiscriminate disposal of hospital waste causes spread of illness leading to financial burden to society. The money saved by reduction in hospital acquired infections is much more than spent on control of hospital acquired infections. Therefore it is necessary to educate the staff, patients and community about the management of the infectious waste. The present study was designed to assess the awareness regarding biomedical waste in health care workers at a tertiary care Government hospital, Dhule (Maharashtra). Methods: Shri Bhausaheb Hire Government Medical College and Hospital is a 545 bedded tertiary care teaching Government hospital situated in rural area of Maharashtra at Dhule where per day approximately 90 Kg biomedical waste is generated .The present cross-sectional study was conducted during 1st August 2011 to 30th September 2011. Knowledge and practices about BMW was assessed among 153 health care workers (81 nursing staff, 35 laboratory technicians and 37 sweepers) handling BMW in the tertiary care Government hospital at Dhule. Results: It was found that only 70.6% of the health care workers were aware of biomedical waste management and 50.3 % had undergone training. 72.5 % of the health care workers were aware of 3 color coded bags used for collection of BMW. In the study only 41.8% of the workers were vaccinated against shepatitis B and 81.7% had received tetanus toxoid vaccine. Conclusion: For proper handling and disposal of BMW, all health care providers must undergo regular training in BMW management.
RÉSUMÉ
Inequity and poverty are the root causes of ill health. Access to quality health services on an affordable and equitable basis in many parts of the country remains an unfulfilled aspiration. Disparity in health care is interpreted as compromise in 'Right to Life.' It is imperative to define 'essential health care,' which should be made available to all citizens to facilitate inclusivity in health care. The suggested methods for this include optimal utilization of public resources and increasing public spending on health care. Capacity building through training, especially training of paramedical personnel, is proposed as an essential ingredient, to reduce cost, especially in tertiary care. Another aspect which is considered very important is improvement in delivery system of health care. Increasing the role of 'family physician' in health care delivery system will improve preventive care and reduce cost of tertiary care. These observations underlie the relevance and role of Primary health care as a key to deliver inclusive health care. The advantages of a primary health care model for health service delivery are greater access to needed services; better quality of care; a greater focus on prevention; early management of health problems; and cumulative improvements in health and lower morbidity as a result of primary health care delivery.