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Introduction: Rabies is an infectious viral disease that isalmost always fatal. It is present on all continents, exceptAntarctica, with over 95% of human deaths occurring in theAsia and Africa regions. Treating a rabies exposure, wherethe average cost of rabies post-exposure prophylaxis (PEP) isUS$ 40 in Africa, and US$ 49 in Asia, can be a catastrophicfinancial burden on affected families whose average dailyincome is around US$ 1–2 per person. Study was conductedwith the objectives to analyse the direct and indirect out ofpocket expenditure of the post exposure prophylaxis ofanimal bites in spite of free supply of anti-rabies vaccine andimmunoglobulin.Material and methods: A cross sectional observational studywas carried out at Anti Rabies Clinic, SMS Hospital Jaipur,Rajasthan from October 2018 to March 2019 to know out ofpocket expenditure of animal bite patients and its determinants.Prior approval from institutional ethics committee andinformed consent were taken and a pre-designed, pre-testedproforma was filled from the persons attending anti rabiesclinic on last visit of post-exposure prophylaxis (PEP). Apartfrom socio-demographic details, information about director indirect out of pocket expenditure due to animal bite wasrecorded and analysis was done using chi square test, ANOVAtest, ‘t’-test and univariate and multivariate regression.Results: Total out of pocket expenditure by 81 studied patientswas Rs. 53201.00, out of which 91.69% i.e. Rs. 48780.00 wereindirect expenses and 5.04% i.e. Rs. 2681.00 was expenditureon medical and surgical management including registrationand consumables. Only 3.27% i.e. Rs. 1740.00 was on postexposure anti-rabies prophylaxis of 81 patients. Mean out ofpocket expenditure was Rs. 656.80±1387.76 ranging from Rs.0.00 to Rs. 8550.00 per patient with median of Rs. 290.00.Conclusion: Despite free supply of anti-rabies vaccine andanti-rabies serum under Mukhyamantri Nishulk Dava Yojna(MNDY) the indirect out of pocket expenditure in animal bitetreatment is still high, which should draw attention for policymakers.
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BACKGROUND & OBJECTIVE: Undernutrition and various morbidities go hand in hand, particularly in children. Nutritional status is a sensitive indicator of community health and nutrition. The present study is an attempt to assess the nutritional status of pre-school children of Gond tribal community in Madhya Pradesh. METHODS: The study was a community-based, cross- sectional survey carried out in tribal preschool children. Anthropometric measurements were taken. Various indices of nutritional status were expressed in standard deviation units (z scores) from the reference median. The children were examined for nutritional deficiencies and other morbidities. The haemoglobin concentration was measured and the children were classified into various grades of nutritional anaemias. Data on socio-cultural and hygienic practices were also collected. RESULTS: More than 60 per cent children were underweight. Micronutrient deficiency disorders such as anaemia and vitamin A deficiency were common among them. Unhygienic personal habits and adverse cultural practices relating to child rearing, breast-feeding and weaning were also prevalent among them. INTERPRETATION & CONCLUSION: The findings of the present study revealed the widespread prevalence of undernutrition among pre-school tribal children and highlight a need for an integrated approach towards improving the child health as well as nutritional status in this area.