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   2015| April-June  | Volume 40 | Issue 2  
    Online since March 24, 2015

 
 
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CME6 - LEADERSHIP AND STRATEGIC MANAGEMENT FOR HEALTH PROFESSIONALS
Change Management Skills
Sanjiv Kumar, Neeta Kumar, Vaishali Deshmukh, Vivek S Adhish
April-June 2015, 40(2):85-89
DOI:10.4103/0970-0218.153869  PMID:25861168
  5,638 554 2
ORIGINAL ARTICLES
Making Pregnancy Safer-Birth Preparedness and Complication Readiness Study Among Antenatal Women Attendees of A Primary Health Center, Delhi
Anita Shankar Acharya, Ravneet Kaur, Josyula Gnana Prasuna, Nazish Rasheed
April-June 2015, 40(2):127-134
DOI:10.4103/0970-0218.153881  PMID:25861175
Background: Every pregnancy is a joyful moment for all mothers who dream of a safe pregnancy and a healthy baby. However, every pregnant woman faces the risk of sudden, unpredictable complications that could end in death or injury to herself or to her infant. Birth preparedness and complication readiness (BPACR) is a strategy that encourages pregnant women, their families, and communities to effectively plan for births and deal with emergencies, if they occur. It is a key component of globally accepted safe motherhood programs. Objectives: The objective of our study was to assess the status of BPACR among pregnant women and to study the socio-demographic factors affecting BPACR. Materials and Methods: We conducted a facility-based cross-sectional study among 417 antenatal attendees at a primary health center, Palam, New Delhi from January to April 2012. Knowledge about danger signs, planning for transport, place, and delivery by skilled birth attendant, financial management, and outcome were assessed. BPACR index was calculated. Results: Our study revealed that the BPACR index was very low (41%) although the preparedness level was high. Majority (81.1%) had identified a skilled attendant at birth for delivery. Nearly half of the women (48.9%) had saved money for delivery and 44.1% women had also identified a mode of transportation for the delivery. However, only 179 (42.9%) women were aware about early registration of pregnancy. Only one-third (33.1%) of women knew about four or more antenatal visits during pregnancy. Overall, only 27.8% women knew about any one danger sign of pregnancy. Conclusion: The level of awareness regarding BPACR was very low (41%). Efforts should be targeted to increase the awareness regarding components of BPACR among pregnant women and their families at the Primary Health Center (PHC) as well as at the community level. This will indeed go a long way in reducing morbidity as well as mortality in pregnant women, thus enabling us to reach the millennium development goal.
  5,017 508 16
CME
Models for Primary Eye Care Services in India
Vasundhra Misra, Praveen Vashist, Sumit Malhotra, Sanjeev K Gupta
April-June 2015, 40(2):79-84
DOI:10.4103/0970-0218.153868  PMID:25861167
Blindness and visual impairment continues to be a major public health problem in India. Availability and easy access to primary eye care services is essential for elimination of avoidable blindness. 'Vision 2020: The Right to Sight - India' envisaged the need for establishing primary eye care units named vision centers for every 50,000 population in the country by the year 2020. The government of India has given priority to develop vision centers at the level of community health centers and primary health centers under the 'National Program for Control of Blindness'. NGOs and the private sector have also initiated some models for primary eye care services. In the current situation, an integrated health care system with primary eye care promoted by government of India is apparently the best answer. This model is both cost effective and practical for the prevention and control of blindness among the underprivileged population. Other models functioning with the newer technology of tele-ophthalmology or mobile clinics also add to the positive outcome in providing primary eye care services. This review highlights the strengths and weaknesses of various models presently functioning in the country with the idea of providing useful inputs for eye care providers and enabling them to identify and adopt an appropriate model for primary eye care services.
  5,090 312 7
ORIGINAL ARTICLES
Dengue Fever Outbreak in Delhi, North India: A Clinico-Epidemiological Study
Nishat Hussain Ahmed, Shobha Broor
April-June 2015, 40(2):135-138
DOI:10.4103/0970-0218.153884  PMID:25861176
Background: Dengue viruses, single-stranded positive polarity ribonucleic acid (RNA) viruses of the family Flaviviridae, are the most common cause of arboviral disease in the world. We report a clinico-epidemiological study of the dengue fever outbreak of 2010 from a tertiary care hospital in Delhi, North India. Objectives: Objectives of the study were to know the incidence of laboratory-confirmed dengue cases among the clinically suspected patients; to study the clinical profile of dengue-positive cases; and to co-relate the above with the prevalent serotype and environmental conditions. Materials and Methods: Four thousand three hundred and seventy serum samples from clinically suspected cases of dengue infection were subjected to μ-capture enzyme-linked immunosorbent assay (ELISA) for detection of dengue-virus-specific IgM antibodies. Virus isolation was done in 55 samples on C6/36 cell mono-layers. Clinical and demographic details of the patients were obtained from requisition forms of the patients or from treating clinicians. Results: Out of the 4,370 serum samples, 1,700 were positive for dengue-virus-specific IgM antibodies (38.9%). Prevalent serotype was dengue virus type-1. Thrombocytopenia and myalgia was seen in 23.1% and 18.3% of the 1,700 dengue IgM-positive patients, respectively. Also, 10.3% of 1,700 were dengue hemorrhagic fever (DHF) patients; and the mortality in serologically confirmed dengue fever cases was 0.06%. Conclusions: A change in the predominant circulating serotype, unprecedented rains, enormous infrastructure development, and increased reporting due to improved diagnostic facilities were the factors responsible for the unexpected number of dengue fever cases confronted in 2010.
  3,596 555 14
EDITORIAL
Sugar, Salt, Fat, and Chronic Disease Epidemic in India: Is There Need for Policy Interventions?
Rajib Dasgupta, Rakesh Pillai, Rakesh Kumar, Narendra K Arora
April-June 2015, 40(2):71-74
DOI:10.4103/0970-0218.153858  PMID:25861165
  3,451 449 2
ORIGINAL ARTICLES
Prevalence of Malnutrition and Relationship with Scholastic Performance among Primary and Secondary School Children in Two Select Private Schools in Bangalore Rural District (India)
MR Rashmi, BM Shweta, Farah Naaz Fathima, Twinkle Agrawal, Moulik Shah, Randell Sequeira
April-June 2015, 40(2):97-102
DOI:10.4103/0970-0218.153871  PMID:25861170
Background: Malnutrition is a serious problem among children in developing countries. In India; a school meal program is in place to combat malnutrition, but only in government schools. This study is an attempt to assess the prevalence of malnutrition in primary and secondary school children in private schools and to also assess the relationship between malnutrition and academic performance. Materials and Methods: All 582 students from class 1-7 from two select schools in rural Bangalore, India were included in the study. Information on age of study subjects were collected from school records. Height and weight measurements were taken. BMI was calculated. Children were clinically examined for pallor. Data on height, weight and BMI was transformed into WHO 2007 Z scores and then was categorized as < -3 SD, -2 to -3 SD, > -2 SD, > 2 SD. Mathematics and English scores of the previous two class tests were taken, average scores were calculated. Statistical tests used were Chi square test, Odd's ratio, Chi square for trend. Results : A total of 582 students participated in this study. Males were 54% (315) and females were 46% (267). One hundred and fifty-nine (27%) of the children had pallor, 81 (20%) had under nutrition, 38 (7%) had stunting, 197 (34%) had thinness and 5 (1%) were found to be obese. Positive relationship was found between weight for ageZscores and English as well as Maths; Height for age Z scores with English. Conclusion : Hence we conclude that the prevalence of malnutrition is high among children in private schools also; and the nutritional status of the children is strongly associated with their academic performance.
  3,052 570 3
Role of Directorates in Promoting Nursing and Midwifery Across the Various States of India: Call for Leadership for Reforms
Rajni Bagga, Vaishali Jaiswal, Ritika Tiwari
April-June 2015, 40(2):90-96
DOI:10.4103/0970-0218.153870  PMID:25861169
Background: While the roles and responsibilities of nursing professionals have multiplied over the years, but there are huge concerns with regard to the development of the nursing workforce and human resources (HR) issues for their career growth. The major lacuna is in not involving the nursing professionals in policy framing and decision-making. As a result, there is a leadership crisis of the nursing workforce across India. Objectives: The paper, is part of the WHO supported study, entitled "Study on Nursing and Midwifery in India: a critical review", is developed with the objective to review the current organizational and management structure for the nursing positions at the State Directorates in India and obtain a Leadership perspective to strengthen nursing management capacities to address maternal health issues. Materials and Methods: The study descriptive and qualitative in nature and the sources of information were both primary and secondary collected from 16 states of India. Results: Since none of the states have neither a Nursing Cell nor the post of Director Nursing, final decision-making powers rest with state health secretaries and medical directors. The nursing management structure majorly managed by senior policy makers from the medical fraternity, and provides very little scope for nursing professionals to participate in policy decision making to bring about reforms. There is no uniformity on HR issues concerning career graphs and pay structures across the states. Conclusions: In order to strengthen nursing as a profession and for facilitating their role at the policy level, more powers and autonomy needs to be given to them and this requires HR policy guidelines for nurses. Setting up a separate nursing directorate, to be headed by a senior nursing professional, is suggested in every state along with a strong nursing division at the National level. This total paradigm shift will empower nursing professionals to take up the leadership role at the policy level to bring about necessary reforms. Across the country, nursing professionals repeatedly echoed one requirement: To reframe nursing leadership at all levels.
  3,071 191 -
VIEW POINT
Revisiting the district level human resources for health architecture in Department of Public Health in Maharashtra
Nitin Natthuji Ambadekar, Kavya Sharma, Sanjay Zodpey, Shubhnagi Prakashrao Lanjewar
April-June 2015, 40(2):75-78
DOI:10.4103/0970-0218.153864  PMID:25861166
  2,773 194 2
ORIGINAL ARTICLES
Prevalence and Association of Physical Activity with Obesity: An Urban, Community-Based, Cross-Sectional Study
Shavinder Singh, Rajesh Issac, Anoop Ivan Benjamin, Seema Kaushal
April-June 2015, 40(2):103-107
DOI:10.4103/0970-0218.153873  PMID:25861171
  2,183 629 2
Predictors of Sexually Transmitted Infections among Female Sex Workers (FSWs) in a City of Northern India
Pallavi Shukla, Jamal Masood, JV Singh, VK Singh, Abhishek Gupta, Asuri Krishna
April-June 2015, 40(2):121-126
DOI:10.4103/0970-0218.153878  PMID:25861174
Introduction: Sexually transmitted infections (STIs) and Reproductive tract infections RTIs are important public health problems in India. The prevalence of these infections is considerably higher among high risk groups (HRGs) ranging from 20-30%. It is high time that a study should be conducted to explore different factors and conditions responsible for the practice of unsafe sex among female sex workers (FSWs) in Uttar Pradesh (UP) and the impact of this on social life and health of FSWs. As Lucknow provides a comprehensive opportunity in terms of tourism, occupation, and economy, it becomes a potential hub for sex work. Studying FSW in Lucknow can thus be considered as a yardstick for the entire FSW population of UP population. The present study was thus planned with the objective of knowing the STI prevalence and its determinants among FSWs. Materials and Methods: A cross-sectional descriptive study was conducted on FSWs registered with Targeted Intervention-Non-government Organization (TI-NGO), registered with Uttar Pradesh State Acquired Immuno Deficiency Syndrome (AIDS) Control Society (UPSACS) of Lucknow city. Total 288 subjects were studied. Results: The average age of FSWs was 31 years. FSWs were mostly Hindus and illiterate. The overall prevalence of STI as per Syndromic diagnosis was found to be 35.8%. However, the percentage of FSWs with STI was higher in street-based (50.6%) than home-based (29.8%). Majority (42.7%) of sex workers with STI had non-regular partners only while majority (52.4%) of sex workers without any STI had only regular partners. Condom usage with regular partners was poor. However, with the non-regular partners the condom usage was better. On multivariate analysis being single, having sex work as a sole means of earning, duration of sex work > 2 years, having pallor, and giving in to client's demand for unsafe sex were found to be significant in causing STI. Conclusions: Prevalence of STI among the female sex workers as per Syndromic diagnosis was found to be 35.8%. Unemployment, anemia, and having sex without condom for extra money, failure to persuade the client and not doing anything were found to be important predictors for presence of STI.
  2,284 225 1
Barriers to Improving Patient Safety in India: Focus Groups with Providers in the Southern State of Kerala
John Landefeld, Remadevi Sivaraman, Narendra Kumar Arora
April-June 2015, 40(2):116-120
DOI:10.4103/0970-0218.153875  PMID:25861173
Objective: To understand the perceptions of health care providers about barriers to improved patient safety in the Indian state of Kerala. Materials and Methods: Five focus group discussions were held with 16 doctors and 20 nurses across three institutions (primary, secondary and tertiary care centers) in Kerala, India. Transcripts were analyzed by thematic analysis. Setting: One rural primary care clinic, one secondary care hospital and one tertiary care center in Kerala, India. Participants: 16 doctors and 20 nurses participated in five focus groups. Results: Overall, there were 129 unique mentions of barriers to patient safety; these barriers were categorized into five major themes. 'Limited resources' was the most prominent theme, followed by barriers related to health systems issues, the medical culture, provider training and patient education/awareness. Conclusions: Although inadequate resources are likely a substantial challenge to the improvement of patient safety in India, other patient safety barriers such as health systems changes, training, and education, could be addressed with fewer resources. While initial approaches to improving patient safety in India and other low- and middle-income countries have focused on implementing processes that represent best practices, this study suggests that multifaceted interventions to also address more structural problems (such as resource constraints, systems issues, and medical culture) may be important.
  2,136 282 -
LETTERS TO EDITOR
Curious Case of Accidental Kerosene Aspiration in an Adolescent Girl and Blue Colored Carbonated Soft Drinks
Thirunavukkarasu Arun Babu
April-June 2015, 40(2):139-140
DOI:10.4103/0970-0218.153885  PMID:25861177
  1,936 109 -
ORIGINAL ARTICLES
HIV-Risk Behavior Among the Male Migrant Factory Workers in a North Indian City
Rizwan Suliankatchi Abdulkader, Kiran Goswami, Sanjay K Rai, Puneet Misra, Shashi Kant
April-June 2015, 40(2):108-115
DOI:10.4103/0970-0218.153874  PMID:25861172
Background: Male migrants act as a bridge for transmitting infection from core risk groups to general population and hence this group becomes essential for the HIV control program. Migrant workers constitute a large proportion of workforce in India and HIV/AIDS epidemic in them would cause huge economic losses. Objectives: The aim of this study was to ascertain the HIV-risk behavior among male migrant factory workers. Materials and Methods: This was a cross-sectional facility based survey conducted in 2011. Male migrant workers aged ≥18 years, who were born outside Haryana, who had moved to current location after 15 years of age, who had worked in the current factory for at least one year, who were willing to participate and able to give valid consent were eligible. A consecutive sampling was done. Descriptive, bivariate and multiple logistic regression analyses were done. Results: A total of 755 male subjects completed the interview. About 21.5% had experienced non-spousal sexual intercourse in last one year. Nearly 60% did not use a condom at the last non-spousal sex. Factors associated with recent non-spousal sex were being unmarried, younger age at migration, recent migration to Haryana, greater number of places migrated and lesser total duration of migration and those associated with non-use of condom at the last non-spousal sex were older age, lower education, lesser number of places migrated and lower level of HIV/AIDS knowledge. Conclusion: Unprotected, recent non-spousal sex was common among male migrants, which could increase their HIV/AIDS vulnerability.
  1,606 233 6
LETTERS TO EDITOR
Catch Them Young for Healthy Future
Abhishek Sharma
April-June 2015, 40(2):141-142
DOI:10.4103/0970-0218.153887  PMID:25861178
  1,430 137 2
Snoring: An Annoyance or a Serious Health Problem (Obstructive Sleep Apnea)?
Simranjeet Kaur, Varun Baslas, Himanshi Aggarwal, Pradeep Kumar, Pooran Chand
April-June 2015, 40(2):143-144
DOI:10.4103/0970-0218.153889  PMID:25861179
  1,402 155 -
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  2007 - Indian Journal of Community Medicine | Published by Wolters Kluwer - Medknow
  Online since 15th September, 2007