scholarly journals Anganwadi worker time use in Madhya Pradesh, India: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anoop Jain ◽  
Dilys M. Walker ◽  
Rasmi Avula ◽  
Nadia Diamond-Smith ◽  
Lakshmi Gopalakrishnan ◽  
...  

Abstract Background Anganwadi Workers (AWWs) are a group of 1.4 million community health workers that operate throughout rural India as a part of the Integrated Child Development Services program. AWWs are responsible for disseminating key health information regarding nutrition, family planning, and immunizations to the women and children in their catchment area, while maintaining detailed registers that track key beneficiary data, updates on health status, and supply inventory beneficiaries. There is a need to understand how AWWs spend their time on all of these activities given all of their responsibilities, and the factors that are associated with their time use. Methods This cross-sectional study conducted in Madhya Pradesh, collected time use data from AWWs using a standard approach in which we asked participants how much time they spent on various activities. Additionally, we estimated a logistic regression model to elucidate what AWW characteristics are associated with time use. Results We found that AWWs spend substantial amounts of time on administrative tasks, such as filling out their paper registers. Additionally, we explored the associations between various AWW characteristics and their likelihood of spending the expected amount of time on preschool work, filling out their registers, feeding children, and conducting home visits. We found a positive significant association between AWW education and their likelihood of filling out their registers. Conclusions AWWs spend substantial amounts of time on administrative tasks, which could take away from their ability to spend time on providing direct care. Additionally, future research should explore why AWW characteristics matter and how such factors can be addressed to improve AWWs’ performance and should explore the associations between Anganwadi Center characteristics and AWW time use.

Author(s):  
Sofia Pappa ◽  
Joshua Barnett ◽  
Ines Berges ◽  
Nikolaos Sakkas

The burden of the COVID-19 pandemic on health systems and the physical and mental health of healthcare workers (HCWs) has been substantial. This cross-sectional study aims to assess the effects of COVID-19 on the psychological wellbeing of mental health workers who provide care to a vulnerable patient population that have been particularly affected during this crisis. A total of 387 HCWs from across a large urban mental health service completed a self-administered questionnaire consisting of socio-demographic, lifestyle and work-based information and validated psychometric scales. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively; sleep problems with the Athens Insomnia Scale (AIS); burnout with the Maslach Burnout Inventory (MBI); and resilience with the Resilience Scale-14 (RS-14). Multivariable logistic regression analysis was performed to determine potential mediating factors. Prevalence of burnout was notable, with 52% recording moderate/severe in Emotional Exhaustion, 19.5% moderate/severe in Depersonalisation, and 55.5% low/moderate Personal Accomplishment. Over half of all respondents (52%) experienced sleep problems; the presence of depressive symptoms was a significant predictor of insomnia. An increase in potentially harmful lifestyle changes, such as smoking, alcohol consumption and overeating was also observed. However, high Resilience was reported by 70% of the samples and the importance of this is highlighted. Female gender was associated with increased levels of depression and emotional exhaustion while those with a history of mental health conditions were most at risk of affective symptoms, insomnia, and burnout. Overall, our study revealed considerable levels of psychological distress and maladaptive coping strategies but also resilience and satisfaction with organizational support provided. Findings can inform tailored interventions in order to mitigate vulnerability and prevent long-term psychological sequelae.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046638
Author(s):  
Sk Masum Billah ◽  
Abdullah Nurus Salam Khan ◽  
S M Rokonuzzaman ◽  
Nafisa Lira Huq ◽  
Marufa Aziz Khan ◽  
...  

Study objectiveTo evaluate the competency of trained health workers in detecting and managing hypertensive disorders of pregnancy during routine antenatal check-ups (ANCs) at primary care facilities in Bangladesh.Study design and settingsCross-sectional study; conducted in 26 primary care facilities.Outcome measuresAccurate diagnosis of the hypertensive disorders of pregnancy.MethodIn total 1560 ANC consultations provided by primary health workers, known as Family Welfare Visitors (FWVs), were observed using a structured checklist between October 2017 and February 2018. All consultations were reassessed by study physicians for validation.ResultOf the ‘true’ cases of gestational hypertension (n=32), pre-eclampsia (n=29) and severe pre-eclampsia (n=16), only 3%, 7% and 25%, respectively, were correctly diagnosed by FWVs. Per cent agreement for the diagnosed cases of any hypertensive disorders of pregnancy was 9% and kappa statistics was 0.50 (p value 0.0125). For identification of any hypertensive disorders by FWVs, sensitivity and positive predictive values were 14% and 50%, respectively. There was a moderate positive correlation between the blood pressure measurements taken by FWVs and study physicians. Only 27% of those who had ‘some protein’ in urine were correctly identified by FWVs. Women diagnosed with any of the hypertensive disorders of pregnancy by FWVs were more likely to be counselled on at least one danger sign of pre-eclampsia (severe headache, blurring of vision and upper abdominal pain) than those without any such diagnosis (41% vs 19%, p value 0.008). All four cases of severe pre-eclampsia diagnosed by FWVs were given a loading dose of intramuscular magnesium sulphate and three among them were referred to a higher facility.ConclusionThe FWVs should be appropriately trained on risk assessment of pregnant women with particular emphasis on accurately assessing the diagnostic criteria of hypertensive disorders of pregnancy and its management.


Author(s):  
Ruth D Neill ◽  
Carolyn Blair ◽  
Paul Best ◽  
Emily McGlinchey ◽  
Cherie Armour

Abstract Aim As individuals adjust to new ‘norms’ and ways of living during the COVID-19 lockdown, there is a continuing need for up-to-date information and guidance. Evidence suggests that frequent media exposure is related to a higher prevalence of mental health problems, especially anxiety and depression. The aim of this study was to determine whether COVID-19 related media consumption is associated with changes in mental health outcomes. Methods This paper presents baseline data from the COVID-19 Psychological Wellbeing Study. The cross-sectional study data was collected using an online survey following the Generalised Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire (PHQ-9), with some other basic information collected. Logistic regression analysis was used to examine the influence of socio-demographic and media specific factors on anxiety and depression. Results The study suggested that media usage is statistically significantly associated with anxiety and depression on the GAD-7 and PHQ-9 scales with excessive media exposure related to higher anxiety and depression scores. Conclusion This study indicated that higher media consumption was associated with higher levels of anxiety and depression. Worldwide it should be acknowledged that excessive media consumption, particularly social media relating to COVID-19, can have an effect on mental health. However, as this was a cross-sectional study we cannot infer any directionality as we cannot infer cause and effect; therefore, future research involving longitudinal data collection and analyses of variables over time is warranted.


Author(s):  
Rosália Páscoa ◽  
Andreia Teixeira ◽  
Micaela Gregório ◽  
Rosa Carvalho ◽  
Carlos Martins

Lifestyle interventions are recognized as essential in the prevention and treatment of non-communicable diseases. Previous studies have shown that Portuguese patients tend to give more importance to diagnostic and laboratory tests than to lifestyle measures, and seem unaware that behavioral risks are the main modifiable risk factors. The study aimed to analyze patients’ perspectives about lifestyle behaviors and health in the context of family medicine in Portugal. A population-based cross-sectional study was carried out in Portugal (the mainland). A total of 900 Portuguese patients aged ≥20 years, representative of the population, were surveyed using face-to-face questionnaires. Participants were selected by the random route method. Descriptive statistics and non-parametric tests were performed to evaluate differences between the personal beliefs and the personal behavior self-assessment, as well as between the level of importance given to the family doctor to address health behaviors and the reported approach implemented by the family doctor, and its association with bio-demographic variables. The results indicate that the vast majority of this Portuguese cohort has informed beliefs regarding lifestyle behaviors, tends to overestimate their own behavior self-assessment, and strongly agrees that it is important that their family doctor asks/advises on these lifestyle behaviors, although the proportion of those who totally agree that their family doctor usually does this is significantly lower. Differences concerning bio-demographic variables were found. Future research directions should focus on the politics, economics, and policy aspects that may have an impact in this area. It will also be important to understand more broadly the relationships between lifestyle behaviors and clinical, physical, and sociodemographic variables.


BMJ Open ◽  
2017 ◽  
Vol 7 (4) ◽  
pp. e012974 ◽  
Author(s):  
Kristoffer Landstedt ◽  
Ashish Sharma ◽  
Fredrik Johansson ◽  
Cecilia Stålsby Lundborg ◽  
Megha Sharma

2021 ◽  
Vol 9 (01) ◽  
pp. 74-86
Author(s):  
Sharmila Pokharel ◽  
Ram Krishna Maharjan

Antenatal care is one of the most effective measures to reduce maternal mortality in Lower Middle-income Countries. The study aims to assess the utilization of antenatal care and related factors by breastfeeding mothers in Chitwan district of Nepal. A cross-sectional study was carried out in Bharatpur municipality in April 2020, among all women of the reproductive age group (15-49) who have had a birth child in the last 12 months before the survey date. A census sampling technique was used to select respondents. The vaccination period was two weeks. All the mothers who came to the vaccine center to vaccinate their children were the respondents of this study. The data were collected by using an interview schedule. The collected data were managed using SPSS Version 20. The study found that 84.31 percent of respondents attended more than four antenatal care utilization. The educational level of the respondents and the occupation of their partners were linked to the use of antenatal care. The number of pregnancies, the number of live births, the place of delivery, and the educational level and occupations of the birth attendees were also significantly linked to the use of antenatal care. Community mobilization and intensive use of community health workers are essential factors to improve the use of antenatal care.


2008 ◽  
Vol 15 (04) ◽  
pp. 524-532
Author(s):  
MUHAMMAD ANWAR SULEHR ◽  
AYUB `ALI

Objectives: To assess the performance of Lady Health Workers (LHWs) in collection, storage & distribution of drugs andevaluate their effectiveness regarding TB suspect identification, referral, directly observing the intake of medicine, default identification andhealth education in TB-DOTS program. Design: A cross-sectional study. Setting: In district Toba Tek Singh. Period: From January to Sep2006. Materials & Methods: One hundred and Two LHWs were selected randomly and interviewed using a structured pre-tested questionnaire.Results: Among 102 LHWs, 76.5% were trained in TB-DOTS. Sixty four (62.7%) had qualification matric and above. Collection of the drugswas being performed properly by 87.3%, while 83.4% were storing the anti-TB drugs at proper places. Anti-TB drugs were being distributedto patients daily by 95.1%. Under the direct supervision of LHWs 69.6% of TB patients had completed treatment. In the areas of 58.8% LHWs,TB patients were declared cured after 8 months treatment. Defaulted TB cases were present, in the areas of 19.6% LHWs, while 12.8% of theLHWs had relapsed TB cases in their areas. Most of the LHWs (85.3%) had proper record of medicine and of the patients (84.3%). Conclusion:The experienced and TB-DOTS trained LHWs of urban areas, in the age group of 41-50 years had overall good performance. The LHWs havingqualification matric and above had better performance than the LHWs having middle qualification. TB-DOTS program in district Toba Tek Singhwas working successfully and it should be continued with some improvements and innovations.


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