Barriers and Solutions Pertaining to Pradhan Mantri Matru Vandana Yojana (PMMVY) Implementation in a Block of West Bengal: A Mixed-Methods Approach

Introduction: Improvement of maternal health care services will not only put a positive impact on maternal health, but also on the health of the new born. Objectives: This study was conducted to estimate the proportion of eligible beneficiaries who received the benefits provided by the scheme, to identify the barriers faced by the beneficiaries and health providers related to the scheme and to find possible solutions to overcome the barriers found as suggested by them in a block of West Bengal. Method: A cross-sectional study with sequential explanatory mixed-method approach was conducted in a block of West Bengal from January-December 2021. Quantitative data was collected from the digital portal of PMMVY. All beneficiaries who had their Last Menstrual Period (LMP) on and after 1st March 2020 up to 31st December 2020 were included. To identify the barriers faced and suggest possible solutions, Focused Group Discussions (FGDs) were held with the beneficiaries, ANMs and ASHAs and Key-Informant Interviews (KIIs) with the Block Medical Officer and Data Entry Operator. Data were analyzed using SPSS version 25.0. Descriptive statistics were used to summarize quantitative data while qualitative data were analyzed in the form of themes, codes and verbatim. Results: Total eligible beneficiaries for the three installments were 1066, 917 and 708 respectively. About 95.5% beneficiaries received the first installment, 93.0% received the second and 98.3% had received the third installment. The broad themes [codes] generated from the FGDs were challenges during antenatal care [ANC refused, home visit preferred, home ANC difficult, lockdown], challenges related to the PMMVY scheme [documents unavailable, incomplete forms, payment issues], possible solutions [prepare pre-requisites beforehand, provide cash]. Widely two main themes emerged from the KIIs: Form related issues and Payment issues. Conclusion: Coverage of PMMVY scheme in the block was satisfactory. However, speeding the payment process and stricter monitoring of the scheme is required

Self-Medication Practices and Health Seeking Behaviour among Residents of Selected Villages in A Block of West Bengal: A Mixed-Methods Study

Introduction: Self-medication can lead to problems such as adverse effects and antibiotic resistance. This study was conducted to estimate the proportion of self-medication practice, to elicit the reasons for practicing self-medication, to find the factors associated with self-medication practice and to assess the health seeking behaviour among a rural community of West Bengal. Method: A study with mixed-methods approach was conducted among 212 households from four selected villages in a block of West Bengal. Focussed Group Discussions were held with respondents who were practising self-medication. Data were analysed using SPSS 25.0 and Atlas ti 7.0. Multivariable logistic regression was performed to find the factors associated with self-medication practice. Results: The proportion of self-medication practice was found to be 41%. Allopathy was most commonly preferred system of Medicine (78.8%). Statistically significant factors associated with self-medication practice were education upto Middle school (aOR 3.59) and Secondary level (aOR 10.71), Class III socio-economic status (aOR 5.03) and presence of acute illness (aOR 28.92). Conclusion: Proportion of self-medication practice among rural population was high. This needs to be addressed and health education should be provided to them.

Impact of vehicular exhaust on ambient air quality of Rohtak city, India.

In the present study, ambient air quality of Rohtak city (Haryana) was monitored by High Volume Sampler .The selected parameters to judge the quality of air were Sulphur dioxide (SO2), Nitrogen dioxide NO2), Ozone (O3) and Suspended particulate matters (SPM) which give a fair idea of pollution load carried by the air. The monitoring data were collected from six sites randomly selected in Rohtak city. Sulphur dioxide was found below the permissible limits of National Ambient Avo Quality Standards (NAAQS) at all the sites. Higher concentration of SO2 was observed during winter in comparison to summer and monsoon seasons. Nitrogen dioxide concentration was found to be above the prescribed standards of NAAQS at four sites in winter season. Ozone concentration was found below the prescribed standards (NAAQS), but its concentration was higher in summer season as compared to winter. Suspended particulate matter concentration was observed above the safety limits at all the sites in all three seasons.

Epidemiological studies on bicycle manufacturing industrial workers.

Studies involving health status of bicycle manufacturing industrial workers exposed to chemicals and unexposed workers of the same industry who formed control were conducted at Sonepatin Haryana State, India. Negligence of industrial hygiene and personal protection affected the health of exposed workers adversely Epidemiological spectrum of exposed subjects showed much variation from control. Some unique disorders, such as nail impairments, nasal septum perforation and metal fume fever were observed in exposed workers against their absence in unexposed workers. Data showed occurrence of following diseases in the order of asthma>skin disorders>allergic disorders>bronchitis>all other respiratory diseases>nail disorders and acute pharyngitis>pulmonary tuberculosis and loss of smell and hearing>nasal septum perforation showing high risk factor for 'all other respiratory diseases' and skin disorders. Importance of occupational health surveillance has been highlighted.

Bioaccumulation of Zn, Cu and Cd in Channa punctatus.

Adult Channa punctatus were acutely exposed to LC50 of zinc (18.62 mg/l), cadmium (11.8 mg/l) and copper (0.56 mg/l) separately for 96 hr The concentration of metals was found maximum in liver and minimum in muscles. The degree of accumulation among the five tissues differed and it was in the order: gill>liver>kidney>blood>muscle in case of Zn, gills>kidney>blood> liver>muscle in case of Cd and gills>kidney>blood>liver>muscle in case of Cu exposure.

Effect of cadmium individually and in combination with other metals on the nutritive value of fresh water fish, Channa punctatus.

Impact of metal cadmium on the nutritive value of Channa punctatus on exposure to a sublethal concentration (1.12 mg/l) of cadmium (Cd2+) for 15 and 60 days has been studied. Among the various parameters selected, the level of moisture in liver and muscle was increased, while decrease was noted in the level of ash, total proteins and inorganic constituents like iron, calcium, inorganic phosphate, sodium and potassium in both liver and muscle in the two types of exposure. The total lipid level of liver increased, while muscle lipid level was decreased. On the other hand, calcium, iron, inorganic phosphate, sodium and potassium levels showed increase in blood. Zinc and selenium decreased the percentage alterations in all the parameters selected for study. In the two types of exposure, zinc was most effective to counteract the cadmium toxicity to fish as in almost all the parameters insignificant alterations were recorded. In combination studies, protection against cadmium toxicity by the two chemicals became more marked with increase in the tenure of exposure.