ABSTRACT ObjectivesIn tribal areas of India, the coverage of antenatal care service is poor and r... more ABSTRACT ObjectivesIn tribal areas of India, the coverage of antenatal care service is poor and rate of home delivery is very high Moreover, most of these deliveries are either unattended or attended by unskilled traditional birth attendants. Evidences suggest that the rate of neonatal mortality is also very high in these areas. The aim of the current study was to explore maternal factors, explicitly focusing on antenatal care and maternal health seeking pattern in relation to neonatal health in tribal areas of Andhra Pradesh, India. Study designThis community based study was conducted in two phases: the first phase involved use of qualitative methods and aided in obtaining relevant information in the quantitative phase from mothers who had delivered in the one year period prior to the study. MethodsInformation from analysis of qualitative data was used to construct a questionnaire, which was administered in the subsequent quantitative phase wherein a population-based survey was undertaken. Reported infant deaths were investigated through verbal autopsy. Multi-stage systematic random sampling was used to identify study participants. The study recruited 230 subjects for the quantitative study. All women of the reproductive age group (15 – 45 years) in the tribal areas of Vizianagaram district of Andhra Pradesh state were eligible for the study. ResultsAmong the 230 women studied, 74% utilized public health facilities for antenatal care (ANC) and the provision of ANC services was good with high coverage of Tetanus toxoid (97%) and excellent provision of IFA tablets (93%). Our results also show that 56% of women delivered at home, 38% at a public health facility and 5.2% could avail private facility. Qualified doctors conducted only 10% of deliveries and 29% were conducted by ANM. Age of mother, total number of women in the house, total number of children born to the mother, year since marriage, mother’s smoking status and alcohol use, were all significantly associated with neonatal deaths. ConclusionsIn our study, both the proportions of pregnant women having ANC checkups and undergoing deliveries at home were high. Currently, while appropriate emphasis is being given in promotion of institutional deliveries under NRHM, it is still in a phase of transition and relevant policies are needed to be implemented more stringently. Our study underlines the importance of not neglecting safe home deliveries, especially in inaccessible tribal areas. Alternatively, better communication trainings to local health workers can address cultural values and taboos for convincing tribal women to deliver at hospitals.
... 4. Giridhara R Babu , Jorn Olsen , Sayantee Jana ,Siddhartha Nandy, Muhammad Farid , SM Sadha... more ... 4. Giridhara R Babu , Jorn Olsen , Sayantee Jana ,Siddhartha Nandy, Muhammad Farid , SM Sadhana. Immunization cards or Parental recall: Which one is better for evaluating Immunization coverage in developing countries. ...
There is famous story wherein several blind men were asked what is the elephant is like. While on... more There is famous story wherein several blind men were asked what is the elephant is like. While one of them said it is like a pillar, another man said “snake” and each talked of it differently as they felt it. 1 In epidemiology, many of the hypotheses being evaluated in the interpretation of studies can be seen as auxiliary hypothesis in the sense that each blind person is feeling the elephant and describing individual experience. Particularly, each observation is independent of the presence, absence or direction of any causal connection between the study exposure and the disease. Much of the interpretation of epidemiological studies amounts to the testing of such auxiliary explanations for observed associations. 2 Hence, it is important to understand that all epidemiological studies are only the testing parts of the observed association given that a whole set of factors (sociological, economic, environmental) are acting in the actual causal mechanism. 3 Similar to visualize the elep...
... Available from: http://www.bit.ly/cdAnWa . 2. Puliyel JM, Madhavi Y. Vaccines: Policy for pub... more ... Available from: http://www.bit.ly/cdAnWa . 2. Puliyel JM, Madhavi Y. Vaccines: Policy for public good or private profit? ... 1962;9:16–9. Proceedings of the XIXth Tuberculosis and Chest Diseases Workers' Conference, Delhi, 138. 8. Narayanan PR, Garg R, Santha T, Kumaran PP. ...
International Journal of User-Driven Healthcare, 2012
ABSTRACT The number of diabetic people in India is increasing. A vast gap of health service need ... more ABSTRACT The number of diabetic people in India is increasing. A vast gap of health service need and provision exists. However, the proposed agenda of promotion and recognition of diabetes educators may translate into diabetes effective management at individual level to the maximum possibility. Managing diabetes is a unique and ongoing process. As such, self-management of the disease is crucial. Diabetes patients should receive support to help them to manage diabetic condition as effectively as possible. This study proposes conceptual approach to diabetes self-management education. This framework further articulates the short term and long term outcomes. DSME promotion through educational intervention in a sustained manner has long-term benefits. DSME in an Indian context as optimally trained, effective, efficient, viable health human resource allocation across different levels is not a feasible solution in a low resource setting. This study proposes that a need exists for further research in an Indian context about the scientific credibility of DSME, financial feasibility, cultural acceptability and operation stability of the policy initiative.
This is a review of the manner in which the Revised National Tuberculosis Control Programme (RNTC... more This is a review of the manner in which the Revised National Tuberculosis Control Programme (RNTCP) is being implemented, with a focus on the attention being paid to ethical principles and the incorporation of these into the programme. The article elucidates how ethical principles can be applied to protect the rights of the potential beneficiaries of the RNTCP. The authors consider the RNTCP in the light of a framework that is usually applied in research to evaluate ethical principles in public health practice. The three key principles of the framework are: respect for persons, beneficence and justice. The authors propose that this framework be used to make an ethical evaluation of other pu health programmes at several levels, since this could bring far-reaching benefits to society.
Asian Pacific journal of cancer prevention : APJCP, 2011
Breast cancer is the second most common cancer amongst women, in Iran comprising 21.4% of female ... more Breast cancer is the second most common cancer amongst women, in Iran comprising 21.4% of female cancers. There are several screening modalities for breast cancer including breast self-examination, clinical breast examination and mammography. This research reviews the literature surrounding the implementation of these screening approaches in the Islamic Republic of Iran. After initial results produced approximately 208 articles, a total of 96 articles were included because they specifically addressed epidemiological characteristics of breast cancer, culture, religion, health seeking behavior, screening programs and the health system in Iran. Literature showed that breast self-examination and clinical breast examination were most common as there is no population-based mammography screening program in Iran. Additionally, most women appear to obtain information through the mass media. Results also indicate that Islamic beliefs and preventative medicine are very much aligned and can be ...
ABSTRACT ObjectivesIn tribal areas of India, the coverage of antenatal care service is poor and r... more ABSTRACT ObjectivesIn tribal areas of India, the coverage of antenatal care service is poor and rate of home delivery is very high Moreover, most of these deliveries are either unattended or attended by unskilled traditional birth attendants. Evidences suggest that the rate of neonatal mortality is also very high in these areas. The aim of the current study was to explore maternal factors, explicitly focusing on antenatal care and maternal health seeking pattern in relation to neonatal health in tribal areas of Andhra Pradesh, India. Study designThis community based study was conducted in two phases: the first phase involved use of qualitative methods and aided in obtaining relevant information in the quantitative phase from mothers who had delivered in the one year period prior to the study. MethodsInformation from analysis of qualitative data was used to construct a questionnaire, which was administered in the subsequent quantitative phase wherein a population-based survey was undertaken. Reported infant deaths were investigated through verbal autopsy. Multi-stage systematic random sampling was used to identify study participants. The study recruited 230 subjects for the quantitative study. All women of the reproductive age group (15 – 45 years) in the tribal areas of Vizianagaram district of Andhra Pradesh state were eligible for the study. ResultsAmong the 230 women studied, 74% utilized public health facilities for antenatal care (ANC) and the provision of ANC services was good with high coverage of Tetanus toxoid (97%) and excellent provision of IFA tablets (93%). Our results also show that 56% of women delivered at home, 38% at a public health facility and 5.2% could avail private facility. Qualified doctors conducted only 10% of deliveries and 29% were conducted by ANM. Age of mother, total number of women in the house, total number of children born to the mother, year since marriage, mother’s smoking status and alcohol use, were all significantly associated with neonatal deaths. ConclusionsIn our study, both the proportions of pregnant women having ANC checkups and undergoing deliveries at home were high. Currently, while appropriate emphasis is being given in promotion of institutional deliveries under NRHM, it is still in a phase of transition and relevant policies are needed to be implemented more stringently. Our study underlines the importance of not neglecting safe home deliveries, especially in inaccessible tribal areas. Alternatively, better communication trainings to local health workers can address cultural values and taboos for convincing tribal women to deliver at hospitals.
... 4. Giridhara R Babu , Jorn Olsen , Sayantee Jana ,Siddhartha Nandy, Muhammad Farid , SM Sadha... more ... 4. Giridhara R Babu , Jorn Olsen , Sayantee Jana ,Siddhartha Nandy, Muhammad Farid , SM Sadhana. Immunization cards or Parental recall: Which one is better for evaluating Immunization coverage in developing countries. ...
There is famous story wherein several blind men were asked what is the elephant is like. While on... more There is famous story wherein several blind men were asked what is the elephant is like. While one of them said it is like a pillar, another man said “snake” and each talked of it differently as they felt it. 1 In epidemiology, many of the hypotheses being evaluated in the interpretation of studies can be seen as auxiliary hypothesis in the sense that each blind person is feeling the elephant and describing individual experience. Particularly, each observation is independent of the presence, absence or direction of any causal connection between the study exposure and the disease. Much of the interpretation of epidemiological studies amounts to the testing of such auxiliary explanations for observed associations. 2 Hence, it is important to understand that all epidemiological studies are only the testing parts of the observed association given that a whole set of factors (sociological, economic, environmental) are acting in the actual causal mechanism. 3 Similar to visualize the elep...
... Available from: http://www.bit.ly/cdAnWa . 2. Puliyel JM, Madhavi Y. Vaccines: Policy for pub... more ... Available from: http://www.bit.ly/cdAnWa . 2. Puliyel JM, Madhavi Y. Vaccines: Policy for public good or private profit? ... 1962;9:16–9. Proceedings of the XIXth Tuberculosis and Chest Diseases Workers' Conference, Delhi, 138. 8. Narayanan PR, Garg R, Santha T, Kumaran PP. ...
International Journal of User-Driven Healthcare, 2012
ABSTRACT The number of diabetic people in India is increasing. A vast gap of health service need ... more ABSTRACT The number of diabetic people in India is increasing. A vast gap of health service need and provision exists. However, the proposed agenda of promotion and recognition of diabetes educators may translate into diabetes effective management at individual level to the maximum possibility. Managing diabetes is a unique and ongoing process. As such, self-management of the disease is crucial. Diabetes patients should receive support to help them to manage diabetic condition as effectively as possible. This study proposes conceptual approach to diabetes self-management education. This framework further articulates the short term and long term outcomes. DSME promotion through educational intervention in a sustained manner has long-term benefits. DSME in an Indian context as optimally trained, effective, efficient, viable health human resource allocation across different levels is not a feasible solution in a low resource setting. This study proposes that a need exists for further research in an Indian context about the scientific credibility of DSME, financial feasibility, cultural acceptability and operation stability of the policy initiative.
This is a review of the manner in which the Revised National Tuberculosis Control Programme (RNTC... more This is a review of the manner in which the Revised National Tuberculosis Control Programme (RNTCP) is being implemented, with a focus on the attention being paid to ethical principles and the incorporation of these into the programme. The article elucidates how ethical principles can be applied to protect the rights of the potential beneficiaries of the RNTCP. The authors consider the RNTCP in the light of a framework that is usually applied in research to evaluate ethical principles in public health practice. The three key principles of the framework are: respect for persons, beneficence and justice. The authors propose that this framework be used to make an ethical evaluation of other pu health programmes at several levels, since this could bring far-reaching benefits to society.
Asian Pacific journal of cancer prevention : APJCP, 2011
Breast cancer is the second most common cancer amongst women, in Iran comprising 21.4% of female ... more Breast cancer is the second most common cancer amongst women, in Iran comprising 21.4% of female cancers. There are several screening modalities for breast cancer including breast self-examination, clinical breast examination and mammography. This research reviews the literature surrounding the implementation of these screening approaches in the Islamic Republic of Iran. After initial results produced approximately 208 articles, a total of 96 articles were included because they specifically addressed epidemiological characteristics of breast cancer, culture, religion, health seeking behavior, screening programs and the health system in Iran. Literature showed that breast self-examination and clinical breast examination were most common as there is no population-based mammography screening program in Iran. Additionally, most women appear to obtain information through the mass media. Results also indicate that Islamic beliefs and preventative medicine are very much aligned and can be ...
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