Evaluation of training manuals for health workers in India in context of kangaroo mother care

Background: Kangaroo mother care is an efficacious intervention in preventing mortality in low birth weight babies. With increasing focus on providing home based newborn care in India, it is pertinent to train the frontline healthcare workers in necessary skills for care of low birth weight babies. Objective: The current review was undertaken to evaluate the content of training manuals of frontline health workers in context of care of low birth weight (LBW) babies and Kangaroo Mother Care (KMC). Methods: A systematic extensive internet search was performed to identify training manuals available in public domain, and a targeted search was also done in the websites of Ministry of Health and Family Welfare, Government of India, National Institute of Health and Family Welfare, and National Health System Resource Centre. Manuals published in or after the year 2000 and those in the English language were included in the review. A quality assessment tool was devised and the manuals were finally classified as “poor”, “fair”, “good” quality. Results: The initial search yielded 107 potentially eligible documents, however, a total of eight training manuals were finally found to be eligible for content evaluation. The mean average score for all the eight manuals was 17.0 (out of a total score of 48) and thus they were “fair” quality (aggregated per cent score of 35.4). Out of the eight training manuals, six had separate section on care of the LBW babies, though content on breastfeeding and skin-to-skin contact was variable. None of the manuals provided case studies/ scenarios or introduced challenges to effective initiation and continuation of KMC. Conclusion: Current training manuals lack quality content on care of LBW babies and KMC and need to be upgraded with evidence-based information

Needle Stick Injuries among Healthcare Waste Handlers in a Tertiary Care Hospital of Delhi

Introduction: World Health Organization (WHO) reports in the World Health Report 2002 that of the 35 million HCWs, 2 million suffer percutaneous exposure to infectious diseases each year. Healthcare waste handlers who are responsible for handling and collection of healthcare wastes are vulnerable to the hazards of occupational exposure to biomedical waste (BMW) as a consequence of improper disposal practices of the waste generators.Objective: The study was conducted to determine the prevalence of Needle stick injury (NSI) among the study subjects, and to study the knowledge and practice regarding Needle stick injury (NSI) among the study subjects.Methodology: A Hospital-based, cross-sectional study was conducted among healthcare waste handlers in a tertiary care hospital of Delhi. Of 390 healthcare waste handlers, 199 Bio-medical waste handlers were chosen on the basis of convenience according to their work shift.Results: Sixty two (31.1%) workers had knowledge that NSI during BMW handling can cause hepatitis and 127 (63.8%) had knowledge that it can lead to HIV infection among them. The prevalence of NSI came to be 14.6% within the past six months.Conclusion: A gap between knowledge and practice regarding action after NSI was found; therefore, measures to increase awareness are definitely required

Prevalence of Hypothyroidism in Pregnant Women in India: A Meta-Analysis of Observational Studies

Introduction. This meta-analysis was conducted to estimate the prevalence of hypothyroidism among pregnant women in India. Methods. We searched PubMed, Web of Science, Scopus, Google Scholar, and Shodhganga (Indian thesis repository) for observational studies, providing prevalence of hypothyroidism among pregnant women in India. Systematic study selection and data extraction procedures were followed. Quality assessment of each study was done using JBI critical appraisal checklist. The random effects model was used for pooling the effect sizes. Publication bias was assessed using the funnel plot and rank correlation test. I2 statistics was used to measure heterogeneity across the studies. Heterogeneity in the pooled estimates was further explored with subgroup analyses and meta-regression analysis. Results. Sixty-one studies were found eligible and included in this review. The pooled estimate of the prevalence of hypothyroidism in pregnant women was 11.07% (95% CI: 8.79–13.84, I2 = 99%). Pooled prevalence estimates of subclinical and overt hypothyroidism are 9.51% (95% CI: 7.48–12.04, I2 = 98%) and 2.74% (95% CI: 2.08–3.58, I2 = 94%). Conclusion. We documented 11.07% pooled prevalence of hypothyroidism in pregnant women in India