A STUDY OF MEASLES VACCINATION COVERAGE BY LOT QUALITY ASSURANCE SAMPLING TECHNIQUE AND FACTORS RELATED TO NON-VACCINATION IN BELLARY DISTRICT

Background: Measles is a leading cause of childhood morbidity and mortality accounting for nearly half the global burden of vaccine preventable deaths. In 2007, there were 197000 measles deaths globally nearly 540 deaths every day or 22 deaths per hour. According to NFHS-3 2005 – 06 total measles vaccination coverage in Karnataka was 72%. Objectives: 1) To find out measles vaccination coverage in Bellary District. 2) To know the reasons for non-vaccination. Material and Methods:   A Cross sectional study was conducted from May 2010 to April 2011 at areas covered by PHC/PHU of Bellary district by using Lot Quality Assurance Sampling (LQAS) method. Total sample size was 1007(53X19). Bellary district has 47 primary health centers (PHC) and 6 primary health units (PHU), all of which were studied in which each PHC/PHU is considered as a lot. The data was collected from parents of children aged 12-23 months using a pretested semi structured questionnaire. Results: Out of 53 PHC’s/PHU’s we accepted 41 (77.35%) and vaccination coverage in these lots was considered as more than 85% and overall coverage in Bellary district was 69.41% and  53.62% had received Vitamin A supplementation. The reasons for non vaccination were lack of awareness, ignorance, ill health of the child, fear of side effects & lack of health services. Conclusion: Measles vaccination coverage was 69.41% and the reasons for non vaccination were lack of awareness, ignorance, ill health of the child, fear of side effects and lack of health services

Implementing the WHO Labour Care Guide to reduce the use of Caesarean section in four hospitals in India: protocol and statistical analysis plan for a pragmatic, stepped-wedge, cluster-randomized pilot trial

Plain language summary The new WHO Labour Care Guide (LCG) is an innovative partograph that emphasises women-centred, evidence-based care during labour and childbirth. Together with clinicians working at four hospitals in India, we will develop and test a strategy to implement the LCG into routine care in labour wards of these hospitals. We will use a randomised trial design where this LCG strategy is introduced sequentially in each of the four hospitals, in a random order. We will collect data on all women giving birth and their newborns during this period and analyse whether the LCG strategy has any effects on the use of Caesarean section, women’s and newborn’s health outcomes, and women’s experiences during labour and childbirth. While the trial is being conducted, we will also collect qualitative and quantitative data from doctors, nurses and midwives working in these hospitals, to understand their perspectives and experiences of using the LCG in their day-to-day work. In addition, we will collect economic data to understand how much the LCG strategy costs, and how much money it might save if it is effective. Through this study, our international collaboration will generate critical evidence and innovative tools to support implementation of the LCG in other countries