A study of sociodemographic determinants, reasons and decision maker of medical termination of pregnancy in urban slums of Jamnagar, India

Background: Medical termination of pregnancy is defined as “willful termination of pregnancy before the age of viability of the foetus. The objective was to study the socio-demographic & obstetric profile and the reasons for procuring an abortion & choice of health care provider.Methods: A Cross-sectional study was done in urban slum in Jamnagar municipal corporation area by using 30 clusters sampling technique. Every women in the reproductive age group (15-49 years) was included in the study till the sample size of 15 was completed in each cluster and thus total 450 women were interviewed. 48 women out of the total of 450 ever married women in the reproductive age group who had ever undergone induced abortion were studied in detailResults: In the present study out of 450 eligible women, 48 (10.67%) had undergone an induced abortion and once only. 72.91% (35/48) of the women belonged to the age group 25-34 years and 89.59% (43/48) of the women were Hindus. Almost half of the total women (45.83%) had primary education, higher proportion of women were housewife 77.09% (37/48). According to Modified Prasad’s classification, 54.17 % of women belonged to lower social class (IV and V). One third (33.33%) of the women who underwent MTP had 1 living child. Majority 79.16% of the women preferred government hospital and in 45.83% cases both husband and wife acted as decision maker for MTP. Most common reason given for terminating the pregnancy was “birth spacing”. (52.09%) Other reasons given were, “family completed” (22.91%), “medical” (14.58%) & social (4.17%). Majority of the women (70.83%) accepted post abortion contraception.Conclusion: There is need to counsel women of reproductive age group that MTP is not a way to control unwanted birth and it is not free from risk. They should be motivated for various methods of contraception.

Assessment of utilization of child health services (under RCH program) and incorrect practices related to perinatal events in Jamnagar district, Gujarat, India

Background: India contributes to 25% of the over 6.9 million under-five deaths occurring worldwide every year with nearly half of them in neonatal period .This study is related indirectly with the causes of U5MR (e.g. Neonatal sepsis, prematurity-LBW) through focusing on service utilization related to perinatal events & incorrect practices of essential Newborn care (e.g. initiation of breast feeding and exclusive breastfeeding). Objectives: (1) Assess utilization of child health services related to perinatal events (2) Assess incorrect practices related to perinatal events (3) Assess effect of demographic variables on service utilization and association of these variables with practices.Methods: A cross-sectional study of 400 children (12 to 59 months) was done using multistage sampling technique in Jamnagar district. 120 children were selected from urban and 280 from rural areas as urban: rural ratio is 3:7 in India.Results: 93.55% children having umbilical infection. Birth weights were taken in majority of children (95.75%), 15.83% of those weighed were having low birth weight (LBW). Application on umbilical cord after birth was seen in 10.25% & prelacteal feed in about 1/3rd children. Breastfeeding immediately or within 4 hours after birth was seen in 3/4th, exclusive breastfeeding in 2/3rd children.Conclusions: Children having umbilical infection were treated indicating better utilization of curative services. Taking of birth weights in majority of children indicating good functioning of healthcare professionals but some of those weighed were having low birth weight (LBW) indicating underutilization of preventive-antenatal services indirectly affecting child health. Incorrect practices like application on umbilical cord after birth and prelacteal feed were seen in children. Recommended practices like breastfeeding immediately or within 4 hours after birth, exclusive breastfeeding were seen in children. Colostrum giving was more prevalent and low birth weight was less prevalent in rural areas compared to urban areas which indicated better health care utilization in rural areas.

Pregnancy-related Factors Responsible for Delivering Low Birth Weight Babies: An Institutional-based Cross-sectional Study, Jamnagar, Gujarat

BACKGROUND: The WHO defines LBW as Birth weight less than 2500 grams regardless of gestational age. Being born with a low birth weight also incurs enormous economic costs, including higher medical expenditures and social service expenses, and decreased productivity in adulthood. OBJECTIVE: To study distribution of newborns\u27 according to pregnancy related factors and its association with newborns\u27 birth weight. METHODS: An institutional based cross-sectional study. New-borns delivered at study institute were considered as study participants. Estimated final sample size was 500. Guardians (mothers) were face-to-face interviewed and also recorded data were collected from the case file and Mother and Child Protection Card. RESULTS: Prevalence of LBW newborns was higher in mothers with late ANC registration,visits, chronic medical conditions, infection during pregnancy, PIH, anemia, consuming tobacco, exposure to second hand smoke, LSCS/Assisted delivery, in female newborns\u27, current pregnancy birth order number more than 2, in pre term newborns\u27 and mothers with bad obstetric history. CONCLUSION: Create awareness and adoption of suitable family planning methods. Need to do early (within 12 weeks) ANC registration with minimum four ANC visits for better pregnancy outcome. Effective tracking and suitable intervention provided to improve current pregnancy outcome. Health care professional should pay special attention to high-risk pregnancy. Develop social culture in such a way that females are neither addicted nor exposed to any tobacco containing products in their life

A COMMUNITY BASED CROSS-SECTIONAL STUDY TO ASSESS THE UNMET NEED OF FAMILY PLANNING IN URBAN SLUMS AND IT’S DETERMINANTS IN WESTERN PART OF INDIA

Context: Unmet need is a valuable indicator of National Family Planning Programme. It shows how well the programme achieves the key mission of meeting the population’s felt need of family planning. It is added to the 5th MDG as an indicator concerned with maternal health. Aims: To find out 1.) Unmet need of family planning and 2.) Its determinants. Settings and Design: A community based cross sectional study was done among married women of age 15-45 years of urban slums in Jamnagar city. Methods and Material: total 200 study participants were selected by systemic random sampling and interviewed by using pretested semi-structured Performa. Statistical analysis used: Microsoft excel was used for data entry and analysis done by software Epi-info. Results: overall level of unmet need was 20.50%. It was found to be influenced by various socio-demographic factors (age of women, gender of last child and accessibility to the service providers) and these associations were found statistically significant. Number of living children, occupation, and period of active married life, religion and collective decision had no any effect on unmet need. (No statistically significant associations). Major reasons for not using any methods were inconvenience (51.22%), refusal by spouse/family members (21.95%) and lack of knowledge (19.51%) Conclusions: unmet need was higher in more fertile age-group therefore program should focus more on this agegroup. Female education contributes significantly in reduction of unmet need. By encouraging inter-spousal communication and male participation for family planning decision-making is important in bridging the gap between met and unmet need

A Community Level KAP Study on Mosquito Control in Jamnagar District

Background: The vectors borne diseases poses an immense public health concern and are major impediments in the path of socio-economic development. Objective: To assess domestic environment as well as community level KAP on mosquito control measures in Jamnagar district. Methods & statistics: It was a cross-sectional survey of 450 household by a pre-tested proforma analyzed by Microsoft excel office 2007. It was carried out in urban, urban slum and rural areas of Jamnagar district. Results: Rural domestic environment was favorable for mosquito breeding. Most of the respondents were unaware about the places where mosquito bred. The knowledge regarding vector, routes and symptoms of malaria was good, while majority were unaware about types of malaria and other mosquito borne diseases. Active malaria surveillance activity was totally lacking in urban area (94%), while it was very poor in rural and slum area. The preferred treatment providers in the community neither screened malaria nor imparted health education about mosquito control. 56% of the respondents were practicing at least one personal protective and larvae control measure, but less efficient one. Conclusion: Community participation in term of KAP regarding vector control is deficient at places & needs to be addressed for effective mosquito control