ABSTRACT
BACKGROUND: The prevalence of depression among elderly people varies across different setups such as old age homes (OAHs), community, and medical clinics. AIMS: The aim of this study was to compare the epidemiological factors pertaining to depression among elderly residents of OAHs and community, using a new Gujarati version of the Geriatric Depression Scale-Short Form (GDS-G). SETTINGS AND DESIGN: A cross-sectional, epidemiological study conducted in an urban setup of Western India. MATERIALS AND METHODS: All the eligible 88 elderly residents of all the six OAHs and 180 elderly residents from the same city were administered a pretested semistructured questionnaire having the GDS-G form. STATISTICAL ANALYSIS: Descriptive statistics, odds ratio, Spearman's rank correlation test. RESULTS: The elderly of OAHs were more depressed compared to those of community (odds ratio = 1.84; 95% confidence interval = 1.09-3.06). Older age, females, weaker family ties, economic maladies, poorer self-perception of health status, presence of chronic ailments, absence of recreational activity, lack of prayers, impaired sleep, history of addiction emerged as the predictors of depression in both the setups. More health complaints and a later self-perception of visit to a doctor were found among the depressed than the nondepressed in both the setups. CONCLUSIONS: Depressive symptoms were quite high among the elderly in both the setups. Special attention should be given toward health checkups of depressed persons in the OAH and improvement of family ties among depressed persons of the community.
ABSTRACT
BACKGROUND: Urban Social Health Activists (USHAs) are the grass root health care workers of urban areas. There are 290 USHAs distributed in various Urban Health Centers (UHCs) of Rajkot city. OBJECTIVES: To compare the (i) effectiveness of the training received by the USHAs on their knowledge and counseling skills (ii) knowledge and counseling skills of USHAs on the awareness and utilization of Maternal and Child Health (MCH) care services by their beneficiaries. METHODS: This cross-sectional study involved 32 USHAs and 416 beneficiaries served by the same USHAs. 32 USHAs serving in the same field practice area for more than two years were randomly selected. The beneficiaries were those mothers who had a child between 1-2 years age, and who had availed their antenatal and postnatal services in the same area. A scoring system was used to assess the knowledge and counseling skills of the USHAs and the knowledge and utilization of services by their beneficiaries. RESULTS: The utilization of health services was significantly more in the beneficiaries who were serviced by USHAs having comparatively better knowledge (72.7% vs. 35.3%) and counseling skills (62.2% vs. 30.6%). The median score for knowledge (41 vs. 30) and counseling skills (20 vs. 16) of the USHAs was found to be more (P < 0.05) in those who had undertaken induction training. CONCLUSIONS: Induction training helped the USHAs to improve their knowledge and counseling skills. Utilization of MCH services was more in those areas served by USHAs having better knowledge and counseling skills.
