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 Study on the Pattern of Self-reported Tobacco Addiction in Hypertensive Patients in Gujarat, India

Background: Both hypertension (HTN) and tobacco addiction pose a threat to the health, environment, and socioeconomic status (SES) of the people. When tobacco use disorder exists in people with HTN, it hastens the disease progress and causes early complications. The present study aimed to study the knowledge and practice of tobacco addiction in patients with HTN and find out the correlates of knowledge and practice of tobacco addiction. Methods: A cross-sectional study was conducted for a period of one year in the Jamnagar District of Western Gujarat, India. Out of total 400 samples, 50% were collected from the five selected Community Health Centers (CHCs) by random sampling and the rest from non-communicable disease (NCD) clinics at the tertiary care hospital of the district. Findings: Most of the patients were in their fifties or above (67.0%), women (57.0%), and married (86.5%). Only 12.0% had awareness about the hazards of tobacco addiction and the prevalence of tobacco addiction was 11%. It was found that use of smokeless tobacco (SLT) among samples was the highest (72.7%) followed by dual consumption, i.e., SLT and smoking (20.5%). The frequency of consumption was ≥ 5 times/day in 54.5%, 70.4% were addicted for > 10 years, and only 15.9% had ever tried to quit tobacco while only 11.4% had successfully quit it. It was seen that those who were aged < 50 years, men, literates, employed, and those belonging to higher SES and urban residence had better knowledge of the health hazards. This was found to have significant statistical association. Conclusion: The results provide valuable insight into the tobacco addiction in patients with HTN on which non-pharmacological treatment of HTN can be based

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 study of precancerous lesions for oral cancer in Jamnagar city

Introduction: Oral cancer is a common malignancy, ranking first among all cancers in Western and Asian countries. It is preceded by some benign lesions or conditions, which are termed precancerous. Only one-third of people at the precancerous stage of disease succumb to cancer, it would be of practical importance to identify individuals at risk among them. Objectives: The aim of the present study was to evaluate high risk factors for oral cancer, to evaluate clinical features and correlate various factors to precancerous lesions and to determine incidence rate and magnitude of precancerous lesions in general population. Methods: In the study, 17,692 residents from different wards of Jamnagar city are clinically assessed for presence of precancerous lesions and interviewed by cross-sectional study. Results: It was found that prevalence rate of leukoplakia was found 0.93% while of OSMF was 1.75% in study population. All persons with precancerous lesions have addictions like tobacco chewing/smoking. Out of 5,652 persons with poor oral hygiene, leukoplakia was found in 2.54%, while OSMF in 1.67%. Conclusion: This study concluded that prevalence rate of precancerous lesion in general population of Jamnagar city is high. It is associated with habits of tobacco chewing and cigarette smoking

Compliance to medical advice among patients having non-communicable disease in Jamnagar, Gujarat

Background: The low compliance by patients with non-communicable diseases to treatment and medical advice is a major therapeutic challenge. WHO study estimates that only 50% of patients suffering from chronic diseases in developed countries follow treatment recommendations. Aims &amp; Objective: To estimate compliance to medical advice among patients with non-communicable diseases and to find out association between various socio-demographic factors and compliance to medical advice. Materials &amp; Methods: It was a community based cross sectional study. Total 450 subjects (225 each from Urban and rural areas of the district) were studied using pre-tested and semi-structured questionnaire. Result: Medicines were taken as prescribed by 71.78% participants. Dose was missed on previous day and once in previous week by 26% and 35.78% participants respectively. Adherence to medical advice was found among 43.33% participants. Proportion of adherence was significantly low among participants more than 50 years of age (38.40%), among males (35.74%), among financially dependent (39.30%) and those having disease since 6years or more (36.92%). Conclusion: Large number of study subjects were found to be non-compliant to medical advice and also the compliance was lower in participants more than 50 years of age, among males and among those who were financially dependent. These risk groups may be targeted through counselling or health education sessions to increase compliance

A lay epidemiological study on coexistent stress in hypertension: Its prevalence, risk factors, and implications in patients' lives

Introduction: Hypertension poses a global challenge in terms of morbidity and mortality. Worldwide prevalence of hypertension is over 40%. Management of hypertension targets blood pressure control to prevent disease complications. Though stress and hypertension are closely related, stress management is often overlooked in the treatment of hypertension. Aims: (1) To estimate the prevalence of stress in hypertensive patients and (2) to study the associated risk factors of stress and its implications in disease management. Materials and Methods: It was a hospital-based, cross-sectional study done in Western India for 1 year. Data were collected from 400 hypertensive patients attending the selected health institutions using a pretested questionnaire. Chi-square tests were done using Medcalc 10.4.8.0. Results: The prevalence of stress in hypertensive patients was found to be 84.3%. Only 2.4% of these patients sought help from any health professional for stress. The most common stressors found in the patients were financial dependence on others, living in rented house, having a daughter of marriageable age because of associated dowry, death of a loved one, sleep-related problem, and owing a debt among others. Significant statistical association (P < 0.05) of stress was observed with the type of family and socioeconomic status. A highly significant association (P < 0.001) of stress with religion and residential area (whether urban non-slum, slum, or rural) was observed. Stress in individuals leads to poorer compliance with treatment and blood pressure control. Conclusion: Coexistent stress should be diagnosed and managed in patients of hypertension for proper disease management and control