Awareness regarding Janani Shishu Suraksha Karyakram among pregnant women of Marathwada, Maharashtra, India

Background: Government of India has launched “Janani Shishu Suraksha Karyakram” on 1st July 2011, to assure free and cashless services (including free transport) to all pregnant women and sick neonates accessing public health institutions.  The objective of the study was to find out level of awareness regarding JSSK entitlement in pregnant women and to examine the association between different socio-demographic factors and awareness level.Methods: This was a cross sectional study was conducted in the Department of Obstetrics and Gynaecology. Govt. Medical College and Hospital, Aurangabad involving 1000 pregnant women attending antenatal clinic between September 2015 to March 2016. Questionnaire was given to assess the awareness about JSSK entitlements and if it was known to them, then the source of information was noted. Information regarding socio-demographic characteristics was noted. The study subject was considered as aware of the scheme, if she had heard about the scheme and had knowledge about certain key points of the scheme. One point each was given to all the correctly answered questions and mean was calculated. Subjects whose correctly answered questions were more than the mean value were considered to have good awareness level. Analysis was done usingSPSS version 20. Chi-square test for association between awareness level and different socio-demographic factors. Significance level was considered at p value <0.05.Results: Among 1000 antenatal women, good awareness level regarding JSSK entitlements was seen in only 472 (47.2%) study subjects. Maximum awareness regarding JSSK entitlements was noted to be for Free vaginal delivery in 869 (86.90%) followed by free drugs and consumables to mother (73.4%) and free treatment for sick infants 662 (66.2%) and least awareness was noted for free drop back of sick infant from health facility to home (9%) and free caesarean section (9.6%). Not even a single woman answered all the 17 entitlements correctly. Only 13 (1.3%) women were able to answer 16 questions correctly. Advancing age, increasing level of education, member of nuclear family, increasing number of conception (gravidity) and advanced gestational age are significantly associated with the level of awareness. However, religion, socioeconomic status and occupation did not have any statistical significant association with the level of awareness regarding various entitlements of JSSK in antenatal women. Regarding the source of information, the most common source of information was from health personnel, followed by friends and family. None of the women reported that Radio, TV, Newspaper had contributed as a source of information.Conclusions: Awareness level of JSSK entitlements in the pregnant women in our study is low. Maximum awareness was noticed for the provision of free vaginal delivery whereas awareness for provisions like free caesarean section, free drop back facility to home, free provision of blood is very low. Further efforts are needed to increase the overall awareness of various entitlements of JSSK among pregnant women to increase the utilization of the benefits of the scheme and thus indirectly helping in reducing MMR and IMR

Evaluation of the validity of risk malignancy index in clinically diagnosed ovarian masses and to compare it with the validity of individual constituent parameter of risk malignancy index

Background: Pre-operative knowledge regarding the nature of ovarian mass is necessary in order to plan surgery.  Risk malignancy index (RMI) is a simple scoring system based on three factors serum CA 125, USG score & menopausal status. The RMI was interpreted as 1) score > 250 = high risk, 2) 25-250 =intermediate risk, 3) score <25 = low risk. The objective of the study was, 1) to evaluate risk malignancy index (RMI) in pre-operatively clinically diagnosed ovarian mass, 2) to compare the validity of individual parameter in RMI i.e. menopausal status, serum CA 125 & USG score with validity of RMI as a comprehensive index .Methods: This was an observational study conducted at department of obstetrics and gynaecology, GMCH Aurangabad from October 2012 to 2014 with sample size of 102 cases with clinical diagnosis of ovarian mass admitted for laparotomy. The validity of RMI and validity of individual parameter was calculated and compared.Results: RMI showed better sensitivity of 85.71%, specificity of 85.07% and ppv of 75%, npv of 91.93% and accuracy of 82.29% as compared to validity of individual parameters.Conclusions: RMI is simple, valuable & highly reliable in pre-operative differentiation of malignant & benign lesion. Simplicity and applicability of this method in the primary evaluation of patients with pelvic masses makes it a good option in daily clinical gynaecological practice.

Awareness regarding Janani Shishu Suraksha Karyakram among pregnant women of Marathwada, Maharashtra, India

Background: Government of India has launched “Janani Shishu Suraksha Karyakram” on 1st July 2011, to assure free and cashless services (including free transport) to all pregnant women and sick neonates accessing public health institutions.  The objective of the study was to find out level of awareness regarding JSSK entitlement in pregnant women and to examine the association between different socio-demographic factors and awareness level.Methods: This was a cross sectional study was conducted in the Department of Obstetrics and Gynaecology. Govt. Medical College and Hospital, Aurangabad involving 1000 pregnant women attending antenatal clinic between September 2015 to March 2016. Questionnaire was given to assess the awareness about JSSK entitlements and if it was known to them, then the source of information was noted. Information regarding socio-demographic characteristics was noted. The study subject was considered as aware of the scheme, if she had heard about the scheme and had knowledge about certain key points of the scheme. One point each was given to all the correctly answered questions and mean was calculated. Subjects whose correctly answered questions were more than the mean value were considered to have good awareness level. Analysis was done usingSPSS version 20. Chi-square test for association between awareness level and different socio-demographic factors. Significance level was considered at p value &lt;0.05.Results: Among 1000 antenatal women, good awareness level regarding JSSK entitlements was seen in only 472 (47.2%) study subjects. Maximum awareness regarding JSSK entitlements was noted to be for Free vaginal delivery in 869 (86.90%) followed by free drugs and consumables to mother (73.4%) and free treatment for sick infants 662 (66.2%) and least awareness was noted for free drop back of sick infant from health facility to home (9%) and free caesarean section (9.6%). Not even a single woman answered all the 17 entitlements correctly. Only 13 (1.3%) women were able to answer 16 questions correctly. Advancing age, increasing level of education, member of nuclear family, increasing number of conception (gravidity) and advanced gestational age are significantly associated with the level of awareness. However, religion, socioeconomic status and occupation did not have any statistical significant association with the level of awareness regarding various entitlements of JSSK in antenatal women. Regarding the source of information, the most common source of information was from health personnel, followed by friends and family. None of the women reported that Radio, TV, Newspaper had contributed as a source of information.Conclusions: Awareness level of JSSK entitlements in the pregnant women in our study is low. Maximum awareness was noticed for the provision of free vaginal delivery whereas awareness for provisions like free caesarean section, free drop back facility to home, free provision of blood is very low. Further efforts are needed to increase the overall awareness of various entitlements of JSSK among pregnant women to increase the utilization of the benefits of the scheme and thus indirectly helping in reducing MMR and IMR

Evaluation of the validity of risk malignancy index in clinically diagnosed ovarian masses and to compare it with the validity of individual constituent parameter of risk malignancy index

Background: Pre-operative knowledge regarding the nature of ovarian mass is necessary in order to plan surgery.  Risk malignancy index (RMI) is a simple scoring system based on three factors serum CA 125, USG score &amp; menopausal status. The RMI was interpreted as 1) score &gt; 250 = high risk, 2) 25-250 =intermediate risk, 3) score &lt;25 = low risk. The objective of the study was, 1) to evaluate risk malignancy index (RMI) in pre-operatively clinically diagnosed ovarian mass, 2) to compare the validity of individual parameter in RMI i.e. menopausal status, serum CA 125 &amp; USG score with validity of RMI as a comprehensive index .Methods: This was an observational study conducted at department of obstetrics and gynaecology, GMCH Aurangabad from October 2012 to 2014 with sample size of 102 cases with clinical diagnosis of ovarian mass admitted for laparotomy. The validity of RMI and validity of individual parameter was calculated and compared.Results: RMI showed better sensitivity of 85.71%, specificity of 85.07% and ppv of 75%, npv of 91.93% and accuracy of 82.29% as compared to validity of individual parameters.Conclusions: RMI is simple, valuable &amp; highly reliable in pre-operative differentiation of malignant &amp; benign lesion. Simplicity and applicability of this method in the primary evaluation of patients with pelvic masses makes it a good option in daily clinical gynaecological practice.