Status of birth preparedness & complication readiness in Rewa District of Madhya Pradesh.

OBJECTIVE: To assess status of birth preparedness & complication readiness among recently delivered and pregnant mothers in Rewa district of Madhya Pradesh. METHODS: A cross-sectional descriptive study was conducted during September-November 2008 among a sample of 2022 study subjects (pregnant women in second/third trimester and/or mothers who have delivered within one year) selected through 30 cluster sampling technique. Investigators collected data using pre-designed schedule by house to house visit. 7 indicators were derived from elements of birth preparedness (BP)/complication readiness (CR). Mean of 7 indicators was taken as BP/CR Index. RESULTS: Among 2022 women, 632 were pregnant and 1390 were recently delivered. BP/CR index was found to be 47.5. BP/CR index was significantly high in above poverty line families (50.9), higher educational level (63.6) and in service and business group (59.3). BP/CR were significantly higher in primi-para (50.9) as compared to multipara (40.1). Some indicators for example knowledge of danger sign (18.6%), about transportation facilities (18.6%) and 1st trimester ANC (24.1%) was very low.

An assessment of functioning of mobile medical units in Jharkhand.

BACKGROUND & OBJECTIVE: A scheme of Mobile Medical Units (MMUs) has been initiated under NRHM in Jharkhand state from the year 2008 in an effort to take healthcare to doorstep of the public in rural areas, especially in underserved areas. The objective of the study was to assess the functioning of Medical Mobile Units in Jharkhand through rapid assessment mode. METHODS: A cross sectional descriptive study was conducted in three selected districts of Jharkhand state during September-December 2008. Data was collected through in-depth interview using semistructured schedules with State Programme Managers, Chief Medical Officers, District programme managers, staff of MMU and beneficiaries. RESULTS: The scheme provided curative and diagnostic facilities like X-ray, ultra sound, and blood test to the poor and under-served areas. More than 90% of clients reported availability of medicines in MMUs. However, more than 90% of them had no prior information about the day and time of visits by the MMUs. Some of the operational difficulties being faced by the scheme were reported to be vibrations of generator disturbing the lab investigations, poor condition of the road, unwillingness of doctors to go in far-off areas and heavy workload. CONCLUSION: The scheme of MMUs has been successful in providing health services to the poor and under-served areas.

Logistics and supply management system of drugs at different levels in Darbhanga District of Bihar.

OBJECTIVES: To understand the logistics and supply management system of drugs at different levels within the district health care delivery system of Dharbanga in Bihar. METHOD: This was a cross-sectional study in 3 Primary Health Centres (PHCs), 3 Additional Primary Health Centres (APHCs) and 6 Subcentres (SCs) during September-December 2008. The study subjects were Civil Surgeon, Pharmacists, Medical Officers, ANMs. Data was collected using qualitative and quantitative techniques from different stakeholders. RESULT: The health centers were severely understaffed and drug stores are managed by unqualified/untrained pharmacists. Drug list available was not fully matching with the need/requirement of the population. The vital and essential drugs required for various health centers were of short supply or unavailable in medical stores. MOs were unaware of budget allocation/allotment for their centers. Demand estimation of the drug items were not done scientifically hence quantity of drugs supplied was not in consonance with community needs. The existing guidelines were not followed as a result drugs like Zinc, Misoprostol and Magsulf were not available at the PHCs or APHCs. The storage and transportation facilities of drugs were found to be poor. Community members were not satisfied with the availability of drugs. CONCLUSION: The logistic and supply system of drugs in Darbhanga district is very weak, hence the needs of the catering population related to medicines was not fully met.