Factors affecting the participation and utilization of breast cancer screening services among health care workers Kolar: a qualitative study

Background: India is going through epidemiologic transition with a shift of disease burden from communicable to non-communicable diseases. There is no organized screening programme for breast cancer in the country. Hence, a large proportion of women with cancer of the breast present in advanced stages of cancer. The integrated cancer control programme calls for early detection of cancer, opportunistic screening and cancer outreach camps that are to be promoted and carried out by health care providers. The objective of this study was thus designed to understand the various factors preventing the participation and utilisation of breast cancer screening. Methods: It was a qualitative method with two groups. The study was conducted between two taluks out of 6, Kolar and Bangarpete. All Angawadi workers and helpers aged more than 30 years were invited and those who have history of breast cancer and family history of breast cancer were excluded from the study. All the subjects who did not attend the screening were included to elicit the reasons for non-attendance. Results: The theme ‘barriers to screening uptake’ were broadly divided into three main categories- namely ‘worry’, ‘transport’ and ‘work commitment’. The sub-category ‘anxiety’ (31.9%) was reported to be the highest barrier and least was in the sub-category ‘no replacement’ (4.3%). The frequency of response categorized into different sub-categories. Conclusions: The reasons were identified by using ‘single question’ interview guide, and were categorized into ‘worry’, ‘transport’ and ‘work-commitment’. Barrier in ‘worry’ category was found to be highest.

An assessment of facilities and services at anganwadi centers under the integrated child development service scheme in urban area of Kathua district, Jammu and Kashmir

Background: The integrated childhood development services (ICDS) scheme, launched on 2nd November 1975 is India’s foremost program imparting comprehensive and cost-effective services for children and maternal health through designated anganwadi centers (AWCs). AWCs deliver services right at the doorsteps of the beneficiaries to ensure their maximum participation.Methods: This was a cross sectional descriptive study conducted in 37 AWCs of the urban area in Kathua district from March to May 2019. A checklist was used to assess the physical infrastructure of AWC and logistics available.Results: A total of 37 AWCs were visited. Majority of the AWCs (94.5%) were running in a rented building and had only room. and 86.4% have pucca type of center. Almost half (51.3%) of the anganwadi workers had >10 years of experience. 32.4% of the AWWs received education up to 12th standard. Weighing machines were available in 89.1% of the centers whereas Salter weighing machine was present only in 23 centers.Conclusions: Present case study unveils deficiencies in infrastructure and logistics at the centers. Emphasis should be given to strengthen the basic infrastructure of AWCs which would further help in delivering quality services to the beneficiaries

Comparing infrastructure of anganwadi centres under integrated child development services of urban and rural Bangalore: a cross sectional study

Background: Anganwadi centres under integrated child development services is the largest Project in India to improve not only child health but reproductive, maternal and adolescent health. The aim of the present study is to compare the infrastructure of urban and rural anganwadi which is one of the basic need to provide quality services.Methods: A total of 30 anganwadi centres are involved in our study in which 20 are from rural and 10 are from urban field practice area of Department of Community Medicine, Bangalore Medical College and Research Institute, Bangalore. This study employed interview method with anganwadi worker’s and observation of anganwadi centre using pre-designed, semi structured questionnaire and checklist.Results: 85% of rural and 60% urban anganwadi centres have their own buildings to carry out the services. 20% of rural anganwadi centres lack fixed name boards compared to urban anganwadi centres. 55% of rural anganwadi centres and 90% of urban anganwadi centres lack separate storage for raw food materials. 15% of rural anganwadi centres lack functional toilet facility. 40% of rural anganwadi centres lack functional weighing machine.Conclusions: Anganwadi centres are remote contact point of health care system within the community. The infrastructure of anganwadi centre such as type of building, space for cooking and activities, availability of functional equipments ensure the quality service deliveries which in turn are enhanced by timely supervision from higher authorities.

A cross sectional study to assess the infrastructure and logistics available at Anganwadi centres in a rural area

Background: ICDS is running from about last four decades in our Country sponsored by Central Government. For achievements of ICDS objectives Anganwadi Centres need to be well equipped in infrastructure and logistics as they are the main source of services provided under ICDS. To find out available infrastructure and logistics at Anganwadi Centers (AWCs), to study the bio-social profiles of Anganwadi Worker (AWWs) and to assess the factors affecting the organizing ‘matriya samiti’ meeting by AWWs at AWCs.Methods: A cross sectional observational study conducted in a rural area of district Bareilly in 22 Anganwadi Centres selected by multi-stage sampling technique. Selected Anganwadi Centres were visited and selected Anganwadi workers and beneficiaries were interviewed.Results: Majority of AWCs were having pucca type of construction but only 18% were having toilet facility. 60% of AWCs were having regular supply of supplementary nutrition, 72% of AWCs do not have any cooking utensils, around 55% were having growth charts, only 32% were having complete non formal pre-school education kit, less than 40% were having complete medicine kit and only 13% were having referral slips.Conclusions: Most of the AWCs were not having adequate infrastructure and logistics as requires.

An evaluative study on integrated child development services in urban slums of Jamnagar City, Gujarat.

Background: Integrated Child Development Services (ICDS) is one of the world’s largest community based schemes running in India for over three decades. Frequent evaluations of the scheme have been conducted to make it more effective to promote early childhood care. Objectives: Comprehensive assessment of services provided under ICDS in urban slums of Jamnagar city of Gujarat state. Methods: It was decided to study 15% of the total 297 AWCs of the city through Simple Random Sampling technique. The AWCs visited were evaluated with respect to infrastructure facility of the centre, record keeping activity & knowledge of AWWs, availability of essential drugs & logistics. Results: A total of 48 centers were evaluated. 24 centers operated from Kutcha or semi-pucca buildings and toilet facilities were lacking at 20 of the centers. Only about 44% of the enrolled 3-6 years children were present at the AWC on the day of visit. Nearly 40% of the enrolled children had varying grades of malnutrition. Unavailability of medicine kits & other logistics, was observed. Three fourth of the AWW described providing non-formal preschool education & supplementary nutrition as their only responsibilities forgetting other essential components of their service. One fourth of the AWW did not know proper time to initiate Breast Feeding and over one third (37.5%) of them did not know the Universal Immunisation Program schedule fully. Less honorarium & poor quality of supplementary food were their main difficulties. Conclusion: the AWC currently acts merely as a food distribution centre with minimal provision of other services. Regular growth monitoring of the children along with supervision of the services provided would be far more effective in improving the nutritional status of the children than supplementary nutrition alone.