Impact of Training of Traditional Birth Attendants on Maternal Health Care: A Community-based Study.

OBJECTIVE: To study the impact of Training of Traditional Birth Attendants (TBAs) on maternal health care in a rural area. METHODS: An interventional study in the Primary Health Center area was conducted over 1-year period between March 2006 and February 2007, which included all the 50 Traditional Birth Attendants (30 previously trained and 20 untrained), as study participants. Pretest evaluation regarding knowledge, attitude, and practices about maternal care was done. Post-test evaluation was done at the first month (early) and at the fifth month (late) after the training. Analysis was done by using Mc. Nemer's test, Chi-square test with Yates's correction and Fischer's exact test. RESULTS: Early and late post-test evaluation showed that there was a progressive improvement in the maternal health care provided by both the groups. Significant reduction in the maternal and perinatal deaths among the deliveries conducted by TBAs after the training was noted. CONCLUSION: Training programme for TBAs with regular follow-ups in the resource-poor setting will not only improve the quality of maternal care but also reduce perinatal deaths.

Impact of training of traditional birth attendants on the newborn care.

OBJECTIVE: To study the impact of training of Traditional Birth Attendants (TBAs) on the Newborn care in resource poor setting in rural area. METHODS: A community based study in the Primary Health Center (PHC) area was conducted over one year period between March 2006 to February 2007. The study participants were 50 Traditional Birth Attendants (TBAs)who conduct home deliveries in the PHC area. Training was conducted for two days which included topics on techniques of conducting safe delivery and newborn care practices. Pre-test evaluation regarding knowledge and practices about newborn care was done. Post-test evaluation was done at first month (early) and at fifth month (late) after the training. Analysis was done by using Mc. Nemer's test, Chi- square test with Yates's correction and Fischer's exact test. RESULTS: Pre-test evaluation showed that, knowledge and practices about newborn care services provided by the previously trained TBAs and untrained TBAs were poor. Early and late post-test evaluation showed that, there was a progressive improvement in the newborn care provided by both the groups. Preintervention period (one year prior to the training) and postintervention period (one year after the training) showed that, there was a statistically significant (p<0.05) reduction in the perinatal deaths (11 to 3) and neonatal deaths (10 to 2) among the deliveries conducted by TBAs after the training. CONCLUSION: Training programme for TBAs with regular reinforcements in the resource poor setting will not only improve the quality of newborn care but also reduces perinatal deaths.

Drape estimation vs. visual assessment for estimating postpartum hemorrhage.

OBJECTIVE: To compare (1) visual estimation of postpartum blood loss with estimation using a specifically designed blood collection drape and (2) the drape estimate with a measurement of blood loss by photospectrometry. METHODS: A randomized controlled study was performed with 123 women delivered at the District Hospital, Belgaum, India. The women were randomized to visual or drape estimation of blood loss. A subsample of 10 drape estimates was compared with photospectrometry results. RESULTS: The visual estimate of blood loss was 33% less than the drape estimate. The interclass correlation of the drape estimate to photospectrometry measurement was 0.92. CONCLUSION: Drape estimation of blood loss is more accurate than visual estimation and may have particular utility in the developing world. Prompt detection of postpartum hemorrhage may reduce maternal morbidity and mortality in low-resource settings.

Salmonellosis in Goa.

During the period 1982-86, a total of 657 Salmonella strains were isolated from various clinical samples processed in the Microbiology laboratory of Goa Medical College, Bambolim, Goa. The strains were distributed amongst 23 different Salmonella serotypes. The commonest serotypes encountered were S.typhimurium (66%) and S.typhi (24%), the other serotypes were S.bareilly (5.4%), S.paratyphi B (1.2%), S.newport (1.2%) and S.chester (0.8%). Stool samples yielded the maximum Salmonella isolates of which the S.typhimurium was the highest followed by S.bareilly.

Exposition of the status of girl child in urban area.

A study was undertaken to determine the sex discrimination in child rearing in an urban low socio-economic chawl type of community. Totally 1101 children in the age group of 0-14 years (631 females and 470 males) in 346 families selected at random were studied. It was found that educational and nutritional status of both the sexes were comparable but partial coverage or non-coverage of immunisation was observed in more girls as compared to boys. Majority of parents (93.9%) expressed that they would get their daughter married after 18 years of age.