Résumé
Background: An infant’s birth weight is a reliable index of intrauterine growth and a sensitive predictor of newborn chances of survival, growth and long-term physical and psychosocial development. Low birth weight has been defined as birth weight <2.5 kg regardless of gestational age. The incidence of low birth weight (LBW) in India varies between 25–30% and of which 60–65% are because of intrauterine growth retardation. Aim & Objective: To determine the incidence and various determinants of low birth weight among babies delivered at rural tertiary care hospitals in central Uttar Pradesh. Methods and Material: The study was conducted at UPUMS, Saifai, Etawah, among pregnant women who delivered babies from 1st January 2018 to 31st December 2018. Details regarding age of the mother, gravida, parity, gestation period, presence of complications, the procedure for delivery and birth weight of the newborn were recorded and analyzed using SPSS software (version 23) Results: A total of 7615 deliveries were conducted (53.2% were males, 46.8% were females). The mean birth weight of babies was 2.65 Kg with S.D ± 0.52. Preterm babies were 32% while 67% were term babies and 23% of babies were low birth weight. There was a statistically significant association between birth weight of babies and factors like age of mother, parity of mother, gestation period, and presence of complications during the antenatal period. Conclusions: Prompt identification of high-risk factors, prevention of premature delivery, increasing the use of health services during pregnancy and management of the risk factors would reduce the incidence of low birth weight.
Résumé
Introduction: An organized and systematic drug procurement process based on well-established scientific principles effectively ensures the availability of right medicines in the right quantities, at reasonable prices, and at recognized standards of quality. It ensures ‘value for money’ and ‘economies of scale’ to the best possible extent. Methods: This study was carried out to evaluate various drug procurement and tendering practices prevalent at three tertiary care public health facilities of District Srinagar, the summer capital of J&K state. One children’s tertiary care hospital (CH), one Govt. Medical College Hospital (MCH), one district hospital (DH) was selected for the study. Two different pharmaceutical supply chains were involved in procurement of medicines for the study hospitals. A set of 149 qualitative and 15 quantitative indicators were developed to evaluate drug procurement practices in these healthcare settings. Results: Qualitative indicator based assessment revealed that a centralised procurement and decentralised distribution practice was being followed by both the supply chains studied. Procurement funds were found to be grossly inadequate whereas pre-qualification of suppliers was undertaken. Competitive e-tendering method was followed using double envelope system. However, rate contracts were not regularly updated and there were no means available to check and determine the quality of drugs effectively. Available pool of human resource was found to be inadequate and there were no standard procedures in place to monitor the performance of procurement and supply system on regular basis. Conclusion: Appropriate measures need to be taken for proper selection, quantification, forecasting and procurement of medicines in accordance with well established guidelines to make the supply chain more efficient. Allocation and disbursement of funds for procurement should also be sufficient and timely to cater to the needs of individual hospitals across all levels of care.