Burden of needle stick injuries among healthcare workers in primary health centers of Mandya district, Karnataka

Background: Needle stick injuries (NSIs) are wounds caused by sharps such as hypodermic needles, blood collection needles, intravenous cannulas or needles. The health care workers (HCW’s) are at an increased risk of accidental needle stick and sharps injuries, because of the environment in which they work. About 30 diseases like hepatitis B, hepatitis C, HIV can be transmitted by NSI. The incidence of NSI is considerably higher than current estimates, due to gross under-reporting. The objectives of present study was to determine the burden of NSIs among various categories of health care workers (HCWs) at primary health centres (PHC’s) of Mandya district, to determine the factors influencing NSIs and to assess awareness regarding NSIs among various categories of HCWs. Methods: This cross-sectional study was conducted at PHC’s of Mandya district for a period of 6 months. Interview method was used to collect information regarding socio demographic details, occurrence of NSI, factors influencing NSI and awareness regarding NSI by using a pretested semi-structured questionnaire on HCWs. Results: Of the 621 HCWs working during the study period, 366 participated in the study. 93 (25.41%) of the HCWs had at least one episode of NSI in the past 1 year. The common category of HCWs who experienced NSI was the medical officers 39 (41.94%). Majority 48 (51.61%) of NSI’s occurred while vaccine/drug administration followed by withdrawing of drug from the bottle 23 (24.73%). The medical officers and staff nurses had better knowledge regarding the diseases spread through NSI. Conclusions: Among the HCW’s, doctors and nurses are more prone for NSI. Vaccine/drug administration and withdrawing of drug from the bottle are circumstances where NSIs commonly occur hence education regarding safe injection practices are necessary.

Spatial Differences in Quality of Maternal Health Service in Primary Health Centers of Enugu State, Nigeria.

Aim: The aim of the study was to determine how adequate were the resources, (equipment and personnel), process (client-provider interaction), and outcome components of quality of maternal health service in urban and rural primary health centers of Enugu state, Nigeria. Study Design: Cross-sectional analytical study design. Place and Duration of Study: Primary health centers in Enugu State, Nigeria, between January and March 2013. Methodology: A three stage sampling method was used to select 540 clients in18 of 440 primary health centers in the state. The clients were women who attended antenatal and postnatal care in the health centers. Outcome measure was clients true satisfaction with maternal health service also denoted as satisfaction index. It was assessed by proportion of clients who were satisfied with antenatal, and postnatal care, were ready to use the health centers again, and willing to recommend them to others for same services. Results: No health center had adequate equipment, 16.7% of health centers had adequate health manpower and 16.7% had good client provider interaction. Only a minor proportion of clients, (urban 7%; rural 24.1%) delivered in the health centers. On part of clients, 64.8% in urban were truly satisfied, as compared to 75.6% in rural. Predictors of clients true satisfaction included being a client in urban, (AOR=0.6, 95% CI: 0.4- 0.9), client unmarried, (AOR=0.3, 95% CI: 0.1- 0.5), and being unemployed/housewife, (AOR=2.0, 95% CI: 1.3- 4.5). Conclusion: The structure and process components of quality of maternal health service in primary health centers in the study area were deficient. Also, utilization of health centers for delivery services was poor. The clients of maternal health service seem to focus more on providers of healthcare and their interactions with them than the health system and its deficiencies hence were easily satisfied with the services received. To reduce the maternal death burden in Nigeria there is need for adequate attention on rural areas, the primary health care system and the provision of client oriented health services at all levels of care. More health workers should be employed, and more equipment supplied in-order to improve the quality of maternal health service in the primary health centers.

Healthcare Professionals’ Perspective of Support from Public Health Department: A Study in the Primary Health Centers of Tamil Nadu.

Background: Perceived organizational support (POS) measures the employee perception of support from the organization and helps to understand the employer-employee relationship better. The aim of the study is to understand the healthcare professionals’ perception of support from public health department and to examine thehealthcare professionals’ difference in perception of support across various demographics variables. Methods: A survey is conducted among healthcare professionals including medical offi cers and staff nurses working in primary health centres (PHC) in the state of Tamilnadu. In the study, public health department refers to the Directorate of Public Health and Preventive Medicine. Mann Whitney U test and Kruskal Wallis H test are used to assess the difference in POS across demographic variables. Results: The results of the study indicated that the healthcare professionals perceive a moderate levelof support from public health department. The healthcare professionals’ POS is found to differ across their age, role and total work experience but not across gender and work experience in the current PHC. Further, the POS of healthcare professionals is found to differ with respect to PHC location and does not differ with respect to PHC type. Conclusion: The results emphasize the need to enhance POS of healthcare professionals. The health policy makers and mangers have to consider the difference in POS of healthcare professionals and make amendments in the human resource policies related to selection and training.

Community Based Monitoring Under National Rural Health Mission in Maharashtra: Status at Primary Health Centers.

This study compares the implementation of community-based monitoring (CBM) in 45 primary health centers (PHCs) in the pilot phase in Maharashtra with the equal number of randomly selected PHCs not implementing CBM (non- CBM) from the same districts. Information was collected by teams from Community Medicine Departments by visiting selected PHCs. Establishment of monitoring committees and training of medical offi cers (MOs) had been completed as required but only 36.36% MOs were trained. Only 43.18% MOs received the facility report card. Most of the MOs (90.90%) attended Jansunwai and opined that it had increased community awareness and the barriers between the people and PHC staff were broken. There was no difference in fund utilization and meetings of Rugna Kalyan Samittees. Percentage of Institutional deliveries and women receiving Janani Suraksha Yojana benefi ts among home deliveries was more in the non-CBM group of PHCs.

Study on the availability of physical infrastructure and manpower facilities in sub-centers of Chittoor district of Andhra Pradesh.

The sub-centers (SCs) are under constant criticism for their inability to deliver quality services due to the nonavailability of adequate infrastructure, manpower and supply of drugs.A cross-sectional study was conducted in Chittoor District of Andhra Pradesh to assess the availability of physical infrastructure and manpower in the SCs. A total of 34 SCs were selected by multistage and stratified random sampling technique. The data was statistically analyzed by using Microsoft Excel. The deficiency in the availability of health workers male and female were found to be 67.7% and 27.5%, respectively. The residential facility for health workers was available only in 26.4% SCs. Only 20.6% of SCs had stethoscope and B.P apparatus. The physical infrastructure and manpower availability at the SCs needs considerable improvement as per the Indian Public Health Standard (IPHS). Facilities to conduct the normal delivery and 24-hours emergency referral services need to be addressed at the earliest.