ABSTRACT
BACKGROUND: The WHO asserts every school should be a Health Promoting School (HPS) and laid a framework. The WHO is constantly working on expanding the number of schools modelled on it. The status of the level of health promotion needs to be explored to understand the local issues to identify key priority areas for policy making towards positive health. The study aims to explore the challenges in implementing the HPS framework in Government-run schools in Odisha. Method: A qualitative study was conducted with grounded theory using an inductive approach. In-depth interview was done among nine teachers from six government schools in the Khordha district who were selected through purposive sampling. A semi-structured open-ended interview was conducted using an interview guide among school science teachers and principals (n=9) regarding the challenges in implementing the HPS framework. Codes were generated from the transcript using the inductive approach from the WHO-HPS framework. Thematic analysis by Braun and Clarke model was using Quirkos software. RESULTS: Five themes with 12 codes were identified with the transcript. The respondents had little knowledge about the WHO-HPS framework. Their perception of health promotion was restricted to organizing health camps for school children. The themes were School health policy (inconsistent teachers recruitment policy, partial implementation of tobacco-free schools, outdated science syllabus), Coordination with the local community, Healthy school needs (lack of interactive and repetitive health-related training for school teachers, first aid box in schools and lack of supplementation of micronutrients like WIFS), Sanitation (inadequate funding for maintenance of sanitation) and an emerging issue of increased use of social media were reported in our findings. Conclusion: Our findings suggest that implementation of health-promoting schools requires imparting the skills to teachers by orientation and expanding the existing health services, backed with adequate funding and a firm policy commitment at the state level.
ABSTRACT
Introduction: Interaction between TB and DM shows that 10% of the TB cases globally are linked to DM. The weaker immunity of patients with chronic diseases like DM is at higher risk of progressing from latent to active TB. A large portion of DM and TB patients remain undiagnosed or get diagnosed later. TB-DM comorbidity complication appears and leads to high treatment costs and out-of-pocket expenditure. Glycemic control in TB patients can improve treatment outcomes. All TB patients diagnosed and registered under RNTCP will be referred for screening for diabetes. The present study was conducted to describe the continuum of TB-DM care among TB patients. Material and Methods: Retrospective record reviews in three randomly selected TU, which included all the patients registered during October 2017-March 2018. Results: A total of 145 patients' treatment cards were available for review and analysis. More than half, i.e., 52%, were in the 14-44 age-group. During the anti-tuberculosis treatment (ATT), 46.2% were unemployed. 15.9% of patients were not screened for DM, ten patients were known cases of DM, 11 TB patients were found to be newly diagnosed as having DM, and out of them, only two patients could be initiated with DM treatment. So, in the present study, 21 out of 145 TB patients, 14.5% had DM. Conclusions: It is evident from this study that TB patients with DM, either known case or newly diagnosed, are not receiving the proper DM care that they should receive as per the program provision.
ABSTRACT
CONTEXT: Progress of any nation depends on the health status of the population. A nation's health directly and indirectly depends on the quality of health-care facilities and how healthy the health care workforce is in that country. To achieve the health for all goal and to provide for most of the health services like maternal health services, child health services, nutrition, vaccination, and family planning services, the Indian health system have multipurpose health workers (female and male) and Accredited Social Health Activist to provide these services at the grass-root level. There is a paucity of literature revealing the health problems or the health status of grassroot level primary health care worker in India or abroad. METHODS AND MATERIAL: All the grass-root level health workers, i.e., MPHWF and ASHAs in the BMC area were included in this cross-sectional study. Data was collected using a semi-structured interview schedule, followed by general examination and anthropometry using standard procedures. RESULTS: Half of the study participants 111 (50.2%) were having some or other kind of health issues during the data collection time; among them, 107 (48.4%) had a chronic disease condition. 10% of them had diabetes mellitus. More than half of the study participants 141 (63.8%) were found to be obese and hypertension was found in 27 (12.2%) study participants. 21 (9.5%) study participants were under high depression. One-fourth of the health workers among those who could conceive had not gone for antenatal check-ups and more than one-third (33.5%) never consumed iron and folic acid (IFA) tablets during their first pregnancy. 19.1% have children with incomplete immunization as per age. One-fifth of the participants know about the balanced diet and half of them could not ensure that their family eat a balanced diet and in the majority, the diet was calorie deficient as per the daily requirement. CONCLUSIONS: There is an urgent need to formulate a policy to improve the health of the primary care grass-root level health-care workers and regular on-the-job training on nutrition needs to be given to them.
