Determinants of anaemia among adolescent girls in rural Varanasi, Uttar Pradesh

Background: India is home to 253 million adolescents 10-19 years of age, among the largest cohorts globally. This age group comprises of individuals in a transient phase of life requiring nutrition, education, counselling and guidance to ensure their development into healthy adults. Adolescent girls are the most vulnerable group of population due to different reasons especially anaemia. Anaemia is a major public health problem worldwide. The aim of this study was to assess the prevalence of anaemia and associated factors among adolescent girls (10-19 years) in rural Varanasi, Uttar Pradesh. Methods: The present study was a community-based cross-sectional study conducted among 369 adolescent girls in rural Varanasi with a semi-structured and pretested questionnaire. Results: Study shows that the overall prevalence of anaemia among adolescent girls was 67.8% out of which 41.5% and 24.4% were mild and moderately anaemic respectively. Anaemia was significantly associated with age groups, birth order, menarche status, no. of days of menstruation, gap between two cycles, use of clothes/sanitary pads and no. of pads used during menstrual cycle. Conclusions: Study found some preliminary factors significantly associated with anaemia like low socio-economic status, higher birth order, and knowledge about menstrual hygiene practices. Anaemia continues to be a major public health problem in India despite multiple initiatives to address it among adolescent girls

IS EDUCATIONAL LEVEL OF ASHA MATTERS FOR THEIR EFFECTIVE FUNCTIONING? A CROSS- SECTIONAL STUDY IN EASTERN UTTAR PRADESH

Background: The actualisation of the goal of NRHM depends on the functional efficacy of the ASHA as the grassroot health activist. Methods: This is cross sectional study, based on a sample of 135 ASHA working in different areas of Chiraigaon Block of Varanasi in eastern Uttar Pradesh (UP). ASHA were interviewed to ascertain the role of educational level on their effective functioning. Results: In the present study about one third of ASHA had schooling up to class eight, 36.6% High School and 22.2% intermediate, and 10.4 % were graduates. Statistically significant association was observed between educational level & practices undertaken by ASHA in the community. At the same time the findings also indicate that ASHA educated up to class eight faces difficulty in filling Village Health Index Register provided to them. Conclusions: The study recommends that if it is difficult to upgrade the minimum educational level for the appointment of ASHA, there is a strong need of regular training & monitoring of ASHA from other functionaries. Village Health Index Register should be simplified so that they can maintain the record properly. Otherwise, if women with good education have joined come forth to work as ASHA, this would certainly improve the service delivery

Challenges in involvement of male spouse in family planning program in rural areas of Varanasi

Background: Globally, men have not shared equally with women the responsibility for fertility regulation. While family planning efforts have been directed almost toward women, the lack of male involvement may also reflect the limited options available to men. Current methods for men are condom, withdrawal, or permanent, such as vasectomy. The success of family planning depends on the involvement of couples but this hardly happen especially in rural areas. It is the belief, though erroneously among most males that the practice of family planning should be the sole responsibility of the female. The present study was a community based cross sectional study with the objective to assess challenges in involvement of male spouse in family planning program in rural areas.Methods: This is a community based and cross-sectional study was undertaken in randomly selected 4 villages of Kashi vidyapeeth block, Varanasi. Total enumeration of women from the selected villages delivered within last 3 years was done and their husbands were interviewed by using a pre-designed, pre-tested interview schedule. Chi-square test was applied to find out any association between the variables. P<0.05 was considered to be statistically significant, data was analyzed with statistical package for the social sciences (SPSS) 20 trial version.Results: These preliminary findings are part of thesis shows that out of 130 interviewed respondents, majority (89.5%) had aware about family planning and two third (66.2%) of the respondents said that either they or their wives are using family planning. More than half of the respondents were aware about male sterilization but none of them were using male sterilization. Majority (77.7%) of the respondents said that human immunodeficiency virus-acquired immune deficiency syndrome (HIV-AIDS) and 45.4% were said that sexually transmitted diseases or sexually transmitted infections (STDs/STIs) can be prevented by use of condom. More than half (53.8%) of the respondents were sole of the decision maker regarding the use of family planning.Conclusions: The present study concludes that the majority of the respondents were awareness about the family planning but practices of family planning is low in the study area. Health workers should educate the eligible couples for use of contraceptive methods. Promotion of male contraceptive usage should be done by intense awareness campaigns

An exploratory study using the OMI scale to assess the opinion toward mental illness among young adults

Background: Public perception of mental illness is critical for successful treatment seeking behaviour as well as for early diagnosis and surveillance of disease. Two hundred eleven young patients were interviewed at Department of psychiatry, Sir Sunderlal Hospital, Varanasi with the help of consecutive sampling method. Objective: To assess the opinion towards mental illness among young adults by using the opinion on mental illness scale (OMI). Methods: Data was collected using the opinion about mental illness scale (OMI) which consists of 51 questions out of which, 15 questions directly related to the cause, care, and management of mental illness were randomly selected and analyzed. Analysis was done showing Percentage and chi-square tests to see the significance of scores between the respondents. Results: The finding shows that more than 70% of respondents believe that mental illness is a consequence of bad behavior, lack of willpower, or negative beliefs and gap in the treatment seeking behavior and understanding the cause of disease was found. Conclusions: Opinions on Mental health have received increasing attention as a useful strategy to promote early identification of mental illness, reduce stigma and enhance help-seeking behaviors. As part of the National Mental Health Programme, there is a need to raise awareness in order to enhance understanding of mental illness in facilitating early diagnosis and treatment of disease

Assessment of Accessibility and Quality of Emergency Obstetric Care services: A cross sectional study in rural Varanasi

Background: Emergency Obstetrics care is an integrated strategy developed by the WHO, UNFPA and UNICEF that aims to equip health facilities with the capacity to provide evidence based, cost effective interventions to attend the leading causes of maternal mortality. Methods: A community based cross sectional study was conducted between April 2019 - July 2020. A total of 201 women who delivered in the last 6 months and had complications during their pregnancy were interviewed to find out accessibility and quality emergency obstetric Care (EmOC) services. Facility assessment was also done at two health facilities of Chiraigaon block for the assessment EmOC. Results: Findings show that only 41.8% respondents were able to reach the government health facilities in less than half-an-hour. Out of the total respondents who utilized government health facilities for EmOC, only 19% were attended by the health providers within 1 hour. Conclusion: Low percentage of respondents with complications were reaching the health facility within 30 minutes. Therefore, there is a strong need for strengthening of basic EmOC services at health facilities

A study on delayed cord clamping and early skin-to-skin contact and its effects on neonatal outcome

Background: Previous study conducted against immediate tying and cutting of the umbilical cord and suggested waiting until the child had taken repeated breaths and the pulsation in the cord had ceased to prevent potential weakness in the child.  A comparative study between delayed cord clamping (DCC) and early cord clamping (ECC) was carried out on a select group of primigravida without any high-risk factor and delivering at term. The objective of the study was to identify the effects of delayed cord clamping and early skin to skin contact on new born infant’s physiological parameters (temperature, weight, SpO2= saturation of peripheral oxygen, Apgar score= appearance, pulse, grimace, activity, and respiration, Hb=haemoglobin level). Methods: Study sample consisted of 300 mothers and their new born after gaining mother’s acceptance. They were divided into 2 groups of 150 each. Group A underwent delayed cord clamping and early skin to skin contact and group B early cord clamping. Newborns monitored 24 hours for hypothermia, apnoea, oxygen needs. Results: The findings of the present study were equivalent among both groups regards the mean neonatal haematological parameters were comparable and slightly elevated hemoglobin level and weight status among late cord clamping compared to early cord clamping group with significant difference was observed at 24 hour later. Conclusions: This study was found that DCC does have a beneficial effect on temperature, Apgar score, SpO2, Hb level and weight status of new born. Therefore, it is believed that DCC and early skin to skin contact (ESSC) provides effective thermal control with a reduced risk of hypothermia

Visceral Leishmaniasis Clinical Management in Endemic Districts of India, Nepal, and Bangladesh

Background. National VL Elimination Programs in India, Nepal and Bangladesh face challenges as home-based Miltefosine treatment is introduced. Objectives. To study constraints of VL management in endemic districts within context of national elimination programs before and after intervention. Methods. Ninety-two and 41 newly diagnosed VL patients were interviewed for clinical and provider experience in 2009 before and in 2010 after intervention (district training and improved supply of diagnostics and drugs). Providers were assessed for adherence to treatment guidelines. Facilities and doctor-patient consultations were observed to assess quality of care. Results. Miltefosine use increased from 33% to 59% except in Nepal where amphotericin was better available. Incorrect dosage and treatment interruptions were rare. Advice on potential side effects was uncommon but improved significantly in 2010. Physicians did not rule out pregnancy prior to starting Miltefosine. Fever measurement or spleen palpation was infrequently done in Bangladesh but improved after intervention (from 23% to 47%). Physician awareness of renal or liver toxicity as Miltefosine side effects was lower in Bangladesh. Bio-chemical monitoring was uncommon. Patient satisfaction with services remained low for ease of access or time provider spent with patient. Health facilities were better stocked with rK39 kits and Miltefosine in 2010

Knowledge and prevention of vertical transmission of hepatitis B infection: A cross-sectional study among pregnant females in Varanasi, India

Background: 300 million individuals worldwide suffer from chronic HBV infection. India, an intermediate endemicity zone, has a 3-4% HBsAg prevalence in the general population and 0.9-11.2% among pregnant women. As 95% of infantile infections progress to chronicity, vertical transmission is a vital intervention area. To assess the knowledge of pregnant women and post-natal mothers concerning Hepatitis-B infection transmission and prevention. Material and Methods: A cross-sectional study was conducted with 143 participants (124 pregnant females and 19 postnatal mothers) attending the antenatal clinic at the rural block primary health center. A semi-structured questionnaire was used. Blood samples were evaluated for HBsAg using RAPIKIT. SPSS-22 was utilized for descriptive statistical analysis. Results: 91.6% of respondents had heard of Hepatitis. 1.4% stated that it can be caused by a virus, whereas 40% identified consumption of oily, spicy, and unhygienic food as causative. 67.1% of respondents underwent blood tests but could not specify what they were screened for. 5.2% were HBsAg positive. ~40% were aware of vertical transmission. 59.4% of respondents were unaware of any preventive modality, and 7.7% said vaccination is preventive. 97.9% had never been counseled during their antenatal period by health workers. 41.1% said that their newborns were vaccinated within 24 hours of birth. Conclusion: Findings emphasize the paucity of knowledge possessed by pregnant women and post-natal mothers concerning Hepatitis B causation, transmission, and prevention regardless of age, education, or socioeconomic status. Misconceptions were prevalent, and counseling was inadequate