The Journal of Community Health Management

38-40

Authors: D. Kumar, TB Singh.

Antenatal care is one of the four pillars initiatives of the Safe Motherhood. The aim of this study was to investigate coverage of antenatal care among Baiga women's in M.P. A Cross- sectional community- based study was carried out in Dindori district. The structured questionnaires were used to gather data from women who had been pregnant within the last five year, or currently pregnant. A sample of 380 women investigated for antenatal care coverage 273, (71.8%) women had taken at least one antenatal checkup by different health professionals. Out of them 23% women had taken antenatal care in the first, 43% in second and 34% in third trimester during pregnancy. Care components were measured during and checkup reported by women as weight (63.9%) height (32.2%), blood pressure (41.8%), hemoglobin (23%) and abdomen examination (51.9%). Antenatal care showed a low coverage among Baiga women's due to low awareness, distance to medical facility, etc. Special IEC strategy needed there for creating awareness.

47-49

Authors: D. Kumar, TB Singh.

Stillbirth is one of undesirable outcomes of pregnancy and considerable marker in determining the disease burden for mother and child. The vital registration statistics on stillbirth is inadequate in India due to many reasons understudied, unreported, etc. The causes of stillbirth may be various medical, social and psychological factors contributing to occurrence. It can be reducing by improving counting & reporting of stillbirths at all levels along with by appropriate strategy prior to events for identifying, monitoring and treatments.

53-55

Authors: Vikas Deep Mishra, Abhishek Pratap Singh.

Patients with chronic obstructive pulmonary disease (COPD) have many times under-recognized and untreated depression and anxiety symptoms which lead to harmful effects on physical functioning and social interaction. Depression and anxiety are often difficult to identify in patients of COPD. The causes for these associated diseases in COPD are multifactorial including social, behavioural and biological factors. Less than 35% of COPD patients with these co-morbid diseases are receiving appropriate treatment. The factor for this low treatment rate includes patients perceived barrier e.g. reluctance to receive antidepressant drug therapy, poor treatment compliance and deficiency of standardized diagnostic approach. There are inconclusive evidence to support the efficacy of anti-depressant drug therapy in patients of COPD with comorbid depression and anxiety. Promising results are being noticed in pulmonary rehabilitation, psychological therapy and the collaborative care model in reducing depression and anxiety symptoms in patients with COPD. But, the main limitations are short term follow up period. More research is required to establish the efficacy of these interventions in randomized control trial with larger samples and longer follow up periods.

58-62

Authors: Prabhakar Akurathi, N. Samson Sanjeeva Rao, TSR Sai.

Introduction: The Godavari River’s Mahapushkaram observed from 14th to 25th July, 2015 drew upto 10 lakh people to Rajahmundry city and neighboring towns. Due to the flocking of such masses, many problems were anticipated; traffic congestion, poor sanitation, air pollution due to vehicles, water pollution etc. There was also an increased need for proper food, milk and water. An effective mass management plan requires an assessment of the current system’s capacity and understanding of hazards and risks. A review of such events can enlighten us with good practices and identify gaps which can be addressed in future such events. Materials and Method: This qualitative study involved PRA techniques like transect walk on all the days and interaction with key informants and in depth interviews with officials, workers and pilgrims. Preparations made for the Pushkaram, good practices and gaps in the arrangements were observed and noted. The information was transcribed in MS word and identified themes are presented. Results and Discussion: Observations regarding planning, facilities, food and water, sanitation, communication, transport, crowd flow, security and safety revealed many good practices. However many gaps were also identified. On the first day a stampede took place at pushkar ghat with 29 people losing their lives. The stampede that took place revealed several lacunae in preparedness for mass casualty incidents. Conclusion: The state has a responsibility to make sure that adequate arrangements are made to meet the large inflow of pilgrims. Accommodation, food, water and sanitation needs were adequately met with good public private coordination. Lacunae were; need for better traffic regulations and diversions, addressing basic needs of people stuck in traffic for long hours and an emergency evacuation system in case of untoward incidents. On site health outposts must be of a reasonably higher level to manage causalities.

70-75

Authors: Sanjeev Davey, Anuradha Davey, Santosh Kumar Raghav, Tauseef Alvi, Nirankar Singh, Jai Vir Singh.

Introduction: The data regarding knowledge and experiences of patients using health helplines available in India is lacking in literature, which makes it inevitable to research this area, as attempted by authors in this article. Materials and Methods: This cross-sectional study was carried out in the field practice areas of RHTC & UHTC respectively; attached to a medical college in district Muzaffarnagar from July 1st 2016 to March 31st 2017. All age group of Clients in selected area were studied on 12 important toll free health helplines from a simple random sample of 450 Clients (225 each from RHTC & UHTC area). The data was analyzed by appropriate statistical test such as Chi-square test. Results: The % of health helplines literacy for >than 10 helplines known was 0.9% (RHTC area) and 0.4% (UHTC area) and <5 health helplines known were 83.1% (RHTC area) and 85.8% (UHTC area). The most useful health helpline as perceived by clients were HIV/AIDS in both RHTC area (77.3%) and UHTC area(77.1%). However there were no statistically significant differences (p>0.05) on 3 areas: (a) Utility of 5 Major National health programmes related helplines; (b) The knowledge of helplines among different type of clients & c) Awareness for helplines according to literacy levels. Conclusion: There is an urgent need for focus on many National Health Programme related health help lines in terms of their advertisements at multiple levels and channels, if a sufficient dent needs to be made for improving health care system of India.

83-84

Authors: Vani H C.

Health being multifactorial it’s influenced by various determinants like biological, behavioural, environmental, socio cultural, equity etc. While working as a monitor for the pulse polio programme the author observed various social factors which influenced the children to receive or not to receive the polio vaccine drops. This article describes various social factors influencing the pulse polio programme from a public health specialist point of view.