Barriers and Solutions Pertaining to Pradhan Mantri Matru Vandana Yojana (PMMVY) Implementation in A Block of West Bengal: A Mixed-Methods Approach

Introduction: Improvement of maternal health care services will not only put a positive impact on maternal health, but also on the health of the new born. Objectives: This study was conducted to estimate the proportion of eligible beneficiaries who received the benefits provided by the scheme, to identify the barriers faced by the beneficiaries and health providers related to the scheme and to find possible solutions to overcome the barriers found as suggested by them in a block of West Bengal. Method: A cross-sectional study with sequential explanatory mixed-method approach was conducted in a block of West Bengal from January-December 2021. Quantitative data was collected from the digital portal of PMMVY. All beneficiaries who had their Last Menstrual Period (LMP) on and after 1st March 2020 up to 31st December 2020 were included. To identify the barriers faced and suggest possible solutions, Focused Group Discussions (FGDs) were held with the beneficiaries, ANMs and ASHAs and Key-Informant Interviews (KIIs) with the Block Medical Officer and Data Entry Operator. Data were analyzed using SPSS version 25.0. Descriptive statistics were used to summarize quantitative data while qualitative data were analyzed in the form of themes, codes and verbatim. Results: Total eligible beneficiaries for the three installments were 1066, 917 and 708 respectively. About 95.5% beneficiaries received the first installment, 93.0% received the second and 98.3% had received the third installment. The broad themes [codes] generated from the FGDs were challenges during antenatal care [ANC refused, home visit preferred, home ANC difficult, lockdown], challenges related to the PMMVY scheme [documents unavailable, incomplete forms, payment issues], possible solutions [prepare pre-requisites beforehand, provide cash]. Widely two main themes emerged from the KIIs: Form related issues and Payment issues. Conclusion: Coverage of PMMVY scheme in the block was satisfactory. However, speeding the payment process and stricter monitoring of the scheme is required

Depression among type-II diabetes mellitus attending a tertiary hospital, Kolkata, evaluated by patient health questionnaire-9

Back ground and Objectives: India has the largest number of diabetic patients turning it a capital for Diabetes in recent days. Depression is a major public health problem associ¬ated with chronic disease like diabetes and co existence of Diabetes and depression is as¬sociated with significantly increases risk of morbidity and mortality. This study was conducted to determine the prevalence and the level of depression and to identify the associated factors related with the disease among the study population attending the Diabetic OPD of SSKM Hospital. Methodology: A cross-sectional study was conducted among 406 diabetic patients attending diabetic OPD of SSKM Hospital using a pre-designed, pre-tested, structured schedule by face-to-face interview method and reviewing of investigation records. Data were analysed using SPSS v16.0. Multi-variable binary logistic regression was performed to find the factors associated depression. Results: The prevalence of depression among adult diabetic patient in this study was found to be 44.4 %. Statistically significant factors associated with depression were fasting sugar, post pandial sugar, HbA1c, medication socioeconomic class, gender and duration of diabetes. Conclusion: This study confirms the link between depression and Diabetes where the prevalence of depression was inevitable as a co-morbid condition with Diabetes. Universal screening for depression and management of depres¬sion in Diabetes can improve the health status and reduce the economic burden of the community

UDP-Glucose 4-epimerase from Saccharomyces fragilis. Involvement of sulfhydryl group(s) at the active site

UDPglucose 4-epimerase (EC 5.1.3.2) from Saccharomyces fragilis is inactivated by 0.1 mM 5,5'-dithiobis-(2-nitrobenzoate) in 6 min. Unlike p-chloromercuribenzoate-inactivated or heat-inactivated enzymes, the dithiobisnitrobenzoate-inactivated enzyme retains the dimeric structure and NAD is not dissociated from the protein moiety. Inactivation of the enzyme by dithiobisnitrobenzoate can not therefore be attributed to any subsequent loss of structural integrity or to be detachment of the cofactor from the apoenzyme. The inactivated enzyme can be almost fully reactivated in the presence of mercaptoethanol and characteristic properties of native enzyme are regained. The inactivation by dithiobisnitrobenzoate can be substantially protected by UDPglucose or UDPgalactose indicating a possible critical involvement of one or more sulfhydryl groups at the active site

Nutrient adequacy and its correlation in a sub-Himalayan region of West Bengal, India

Introduction: Nutrient adequacy is the level of intake of an essential nutrient in relation to the nutrient requirement for adequate health, which is expressed as the percentage of recommended dietary allowance. To develop an effective nationwide preventive program to combat malnutrition, it is necessary not only to assess the nature and magnitude of the problem of nutrient inadequacy but to identify factors affecting it especially at the household level. Objective: To estimate the prevalence of nutrient adequacy in a sample of households in a rural area of Darjeeling district and to find out the factors associated with nutrient adequacy. Materials and Methods: A community-based cross-sectional study was carried out from January 2014 to December 2014 in 821 households of Darjeeling district, India. The major dependent variable used in this study was the mean nutrient adequacy ratio of a household and the independent variables were number of family members, number of under-five children in the family, literacy of head of the family, literacy of the wife of the head of the family, income of the family, and percentage expenditure on food. Results: The prevalence of nutrient adequate households was found to be 35.3% among the study households. It was observed that the percentage expenditure on food had the highest contribution toward nutrient adequacy, followed by number of under-five children in the family and literacy of the wife of the head of the family. Undernutrition was found to be prevalent in 56.6% of the households. Conclusion: Majority of the study population had a diet less than the required amount and expectedly, undernutrition was also present in huge proportions

‘Violence against Women’: Evidence from a Cross Sectional Study in Urban Area of North Bengal

Background: Violence against women has emerged as the most pressing and intractable social problem across regional, social and cultural boundaries; with long term impact on physical, sexual, social health and mental well being. Objectives: The study was carried out to estimate the prevalence of different types of ‘life time’ violence against women (VAW) among women of reproductive age group, and to find out specific violent behaviour as well as to identify the related consequences of the affected women and help seeking following violence. Methodology: A cross-sectional observational study was undertaken by interviewing 284 women of reproductive age group residing in two urban wards under Siliguri Municipal Corporation with a pre-designed and pre-tested schedule. Data was analysed by simple proportion. Results: out of 284 women 52.1% had ever faced physical violence. The most common form of violence was slapping, kicking, choking, and punching followed by ‘insisted on knowing where she was at all times’ (48.9%). Among of 222 abused, 54.5% suffered from mental problem followed by 39.2% were experienced to physical injury. Only 4.9% consulted physician and 3.6% have reported to police. Conclusion: Little progress in reducing levels of violence may be achieved without significant changes in prevailing individual and community attitudes toward violence

Physical injury: A profile among the municipal primary school children of Siliguri, Darjeeling District

A cross sectional study was conducted from February - May 2009 with the objectives to find out profile of injuries among municipal primary school children in Siliguri, West Bengal and to identify the related factor associated with injury. 20% of total primary schools under municipal corporation of the town were selected and a pre-designed, pre-tested schedule was used to assess the profile of injury and associated factors. The Chi square test was usedto determine statistical significance at the 0.05 significance level. Out of 956 participants, a significantly higher injury was observed among males (68%). Open wound injuries were commonest (59.6%) occurring mainly at the extremities. Falls were mainly responsible for overall injuries. Injury at home (41.8%) was also found to be more. Mother education, number of siblings and presence of caregiver were significant related factors to injury