The Journal of Community Health Management

138-142

Authors: Sunita Sreegiri, M Shyamala Gouri, B Devi Madhavi.

Introduction: Cold chain system plays a crucial part in maintaining the potency of the vaccines under the Universal Immunization Programme. Each year full immunization prevents approximately 4 lakh deaths among children under five years of age from vaccine preventable disease in India. Due to accessibility issues among others, cold chain management & immunization related issues are quite common in tribal areas. Methodology: A cross sectional study was conducted in 8 PHCs located in the tribal areas of Visakhapatnam during April May 2015 to assess the cold chain system. Out of 36 tribal PHCs, 8 were selected using simple random technique. Information about the cold chain at the PHC as well as the outreach session sites was obtained using routine immunization monitoring formats provided by the Ministry of Health & Family Welfare. Results: ILRs and DFs were present and placed properly in all the PHCs with functional thermometer. Frost of > 5 mm was observed in the ILRs in 62.5% of PHCs. At all the session sites (100%), vaccine vials and diluents were placed in a plastic cover (zipper bag). Conditioned ice packs were seen in one session site only. Conclusion: The cold chain management is satisfactory in the tribal areas of Visakhapatnam, although there are certain gaps and issues which can be overcome by regular supervision by the in charge officer & monitoring at the outreach site etc.

148-152

Authors: A Rohit, PS Balu, MP Poornima, SK Raghavendra.

Aim: To identify the self-screening and periodic health check-up practice among government health personnel. Materials and Methods: A cross sectional study was carried out among qualified allopathic government doctors regarding self-care practices like measuring of blood pressure, blood sugar estimation, visiting dentist , breast self-examination and undergoing cancer cervix screening and self-medication practices. Results: Among the 52 subjects who took part in the study, majority of the study subjects [n=21, 40.4%] said that they got their blood sugar examined once in 12 months at least, more than 90% of the study subjects got their blood pressure checked once in a year or more [n=49, 94.2%] and majority had rarely visited the dentist [n=27, 51.9%]. Among the 15 female subjects, majority did breast self-examination [BSE] done at least once in a year or more [n=45, 86.5%] but majority said that they rarely [n=10, 66.7%] underwent screening for cancer cervix screening in their lifetime. Regarding self-medication, all study subjects said that had self-medicated and when sick, majority said that they rarely [n=37, 71.2%] consulted another doctor, majority said that they have rarely [n=19, 36.5%] practiced isolation when sick with infectious disease and have sometimes gone to work when sick [n=26, 50%]. Conclusion: There is need for improving knowledge of self-care and self-medication among medical practitioners, which will influence their attitudes, behaviours toward personal and patient level screening. A self-care workbook for doctors can be developed with on-going training, support and evaluation.

156-163

Authors: Male frontline health workers, Health manpower, Multi-purpose health worker, MPHW, Time and motion study, India.

Introduction: In India, there is a critical shortage of frontline health staff while requirements for new programs are increasing. Role of by male-multipurpose health workers (MPHWs) is less specified. Materials & Methods: A cross-sectional mixed methods study was conducted in South-India to examine the time utilization and various factors affecting it. We directly observed six male-MPHWs for six continuous days using time and motion approach followed by interviews of participants and officials. We analysed quantitative data for time spent per male-MPHW and qualitative data by thematic content analysis and computed Smith’s score. Results: Male-MPHWs spent median 7.5 hours in a day, which includes three hours on total travel on any day. They spent median 5.4 hours on job and, excluding within field travel they spent median 4.2 hours on actual work per day. They spent median 16.6 hours per week on programmatic activities, 5.0 hours on programme support and 6.1 hours in other activities. Male-MPHWs were mostly involved in programs on communicable diseases, seasonal diseases, non-communicable diseases. Male-MPHWs helped female-MPHWs in outreach activities and special health camps. Support from coworkers and supervisors was mentioned as facilitating factors. The adhoc and non-standardised nature of their work and, absence of recognition and incentives were impeding factors. Conclusion: Male-MPHW provided services for only limited components of health programs and they stay largely underutilized. Amidst critical shortage of community health workers (CHWs), especially male-MPHWs, it is required to devise optimal interventions with proactive policy to define specific roles and better utilize them in health service delivery.

170-174

Authors: Sudha Bala, MLS Prabha, G. Sudeera.

Introduction: Increased life expectancy women live an average of two to three decades in postmenopausal period, which is one third of their lives. During this period, as a result of decreased oestrogen they are vulnerable and prone to menopause related health problems. Aim and objectives: To determine the prevalence of various Menopause related health problems and their relationship with socio-demographic, biological and lifestyle variables. Material and Methods: This was a cross sectional study undertaken in the urban field practice areas of Osmania Medical College, Hyderabad. A total of 430 post menopausal women were interviewed using predesigned and pre tested questionnaire consisting of socio demographic, biological and lifestyle variables. Menopause related health problems were enumerated using modified menopause rating scale. Results: The Prevalence of any of the Somatic problems were 77%, any of the psychological Problems were 37.4% and Uro genital problems were 32.1%. There was statistically significant association of age, parity, duration of menopause and lifestyle with any of the short and intermediate health problems. Conclusions: Menopausal health problems need to be addressed as it poses a major public health problem and are also amenable for preventive strategies