ABSTRACT
BACKGROUND: Universal Health Coverage refers to health care system that provides health care and financial protection to all the citizen. Rashtriya Swasthya Bima Yojna as National Health Insurance Scheme initiated in Chhattisgarh State in 2009 for below poverty line families. Second scheme is Mukhyamantri Swasthya Bima Yojna initiated in 2012, which covers non below poverty line families. OBJECTIVES: To assess socio demographic factors among women residing in slum of Rajnandgaon, to find their universal health insurance coverage under RSBY/ MSBY and to assess the extent of concerned treatment under RSBY/MSBY. METHODS: It was a community based cross sectional study, conducted in the urban slum area of Rajnandgaon amongst 188 women above 18 years of age who were hospitalized 6 months prior to the study using snow ball technique as a sampling method. They were interviewed using semi structured questionnaires by the investigator with the help of anganwadi worker. RESULT: 77.65% respondents/study subjects were enrolled under the universal health insurance (RSBY card/ MSBY card). Subjects belonging to Lower socio-economic status and having BPL card were enrolled under scheme more than upper socio-economic group. Out of 146 smart card holders, a mere 1.36% subjects incurred catastrophic OOPE. Out of 42 respondents not having smart card, 40.47% subjects incurred catastrophic OOPE. CONCLUSION: The RSBY card reduced the inpatient OOPE. RSBY card prevented catastrophic OOP in most of the respondent. RSBY has made health services accessible to all sections of community at minimal cost.
ABSTRACT
BACKGROUND: Immunization coverage in Chhattisgarh has never been abysmal but the improvement is rather insignificant over the years. Some more interventions are essential to strengthen different aspects of immunization services such as micro-planning, cold-chain and logistics management, monitoring/supportive supervision, and community mobilization. The present study was considered as a part of ongoing UNICEF funded Project on Supportive Supervision of Routine Immunization in Rajnandgaon district undertaken by the Department of Community Medicine, Government Medical College, and Rajnandgaon CG with the objectives to observe key quality parameters at Ice Lined Refrigerator (ILR) points and to assess knowledge and practice of Vaccine Cold Chain Handler (VCCH). METHODS: A facility-based, cross-sectional study (repeat survey) was conducted from May 2017 to June 2018 in the Rajnandgaon district of Chhattisgarh. First phase of the study was conducted from May 2017 to November 2017 and repeat survey was conducted from December 2017 to June 2018. Structured questionnaires as a part of standard tool prescribed by Government of India was used for the collection of required data. RESULTS: The cumulative score status out of all the 50 centres in Rajnandgaon district showed improvement in 35 centres. The score of important components such as vaccine management, equipment maintenance, temperature monitoring, and monitoring and supervision information improved, but that of background information and human resource component decreased. CONCLUSION: Supportive supervision strategy can be more beneficial in improving the cold chain maintenance process provided that components such as logistic, infrastructure, and manpower are in place to enhance service delivery. Supportive supervision is a continuous process, so regular follow-up and monitoring visits are essential to achieve the targets.
ABSTRACT
BACKGROUND: Cold chain and vaccine logistic is a key driver of immunization program. It has been observed that besides intensification of routine immunization, more strategic interventions are essential to strengthen the different aspects of immunization services like cold-chain management and monitoring/supportive supervision. The present study was considered as a part of ongoing UNICEF funded Project on Supportive Supervision of Routine Immunization in Rajnandgaon and Bilaspur districts undertaken by the Department of Community Medicine, Government Medical College, and Rajnandgaon with the objectives to assess the background information about cold chain points (CCPs), to observe the vaccine storage and handling practices, and to study the knowledge and practices of VCCH. MATERIALS AND METHODS: A cross-sectional facility based study was conducted from August 2017 to February 2018. Among60 CCPs, 48 from Rajnandgaon and 12 from Bilaspur district were considered for analysis. Structured questionnaires as a part of standard tool prescribed by Government of India was used for the collection of required data. RESULT: In 92% CCPs, the temperature of cold chain equipment (CCE) was recorded twice a day. In 93% CCPs, vaccines were correctly stored in ILR. In 75% CCPs, icepacks were correctly stored in DF, 90% vaccine cold chain handler (VCCH) could correctly demonstrate temperature reading from thermometer, 91% could tell about stages of VVM correctly. CONCLUSION: Most CCPs in both districts are doing good enough, and there is a scope of improvement in all the parameters by means of ongoing project of Strengthening of Supportive Supervision of Routine Immunization in both districts. It was evident that Rajnandgaon district scored more than Bilaspur in some parameters related to vaccine storage and handling practices.
