scholarly journals Verbal autopsy of neonatal deaths in Khatauli Block of District Muzaffarnagar, Uttar Pradesh, India

2014 ◽  
Vol 4 (5) ◽  
pp. 423-427
Author(s):  
K Muzammil ◽  
JV Singh ◽  
R Shankar
Keyword(s):  
Verbal Autopsy ◽  
Rural Areas ◽  
Neonatal Jaundice ◽  
Health Workers ◽  
Uttar Pradesh ◽  
Cross Sectional ◽  
Neonatal Deaths ◽  
Medical Certification ◽  
Cause Of Deaths ◽  
At Home

BackgroundVerbal autopsy is a method of inquiry to ascertain the likely cause of death in populations where vital registration of deaths is incomplete and unreliable. Over 75% of deaths in India occur at homes; more than half of these do not have a certified cause. Further, most of the deaths in the rural areas of India occur at home and that is why a medical certification by a qualified practitioner is not possible. Keeping these facts in mind, this study was designed having objectives as to find out the causes of neonatal deaths through verbal autopsy and its feasibility to be used by health workers.Material & Methods:This cross-sectional epidemiological study was conducted in randomly selected rural areas of Khatauli Block of District Muzaffarnagar, Uttar Pradesh, India. Verbal autopsy data was collected by a team of health workers adequately trained for the same well in advance. Data related to reported neonatal deaths in the study area in the specified period of time was collected on structured & pre-tested questionnaire used as study tool by interviewing the parents, relatives or neighbours of the deceased. Data thus collected was verified twice by the coordinator and principal investigator respectively and analyzed by using Epi info statistical package.Results:A total of 24 perinatal deaths were reported, out of which 7 (29.2%) were stillbirth and 17 (70.8%) were neonatal deaths. ANC was received by 14 mothers (58.3%). Half of the deliveries were conducted by untrained Dai. About 20 deliveries (83.3%) were at home and 10 (58.8%) of the deceased were early neonates. The cause of deaths found by means of verbal autopsies were mainly: pneumonia - 4 (23.5%), diarrhoea - 2 (11.8%) neonatal jaundice - 03 (17.6%) etc.Conclusion:Pneumonia, diarrhoea & neonatal jaundice alone constitute about 53% of the total neonatal deaths. The use of the verbal autopsy tool by health workers to find out the cause of neonatal deaths is very much feasible.DOI: http://dx.doi.org/10.3126/nje.v4i5.12019 Nepal Journal of Epidemiology 2014; 4(5):423-27

scholarly journals Verbal Autopsy of Neonatal and Infant Deaths from Bhavnagar Rural and comparison with Recent data

2020 ◽  
Author(s):  
Rajesh Patel ◽  
Jayendra Ratilal Gohil
Keyword(s):  
Verbal Autopsy ◽  
Rural Areas ◽  
Vaginal Discharge ◽  
Health Workers ◽  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Hyaline Membrane Disease ◽  
Neonatal Deaths ◽  
Infant Deaths ◽  
Hyaline Membrane

Background: Infant deaths from Bhavnagar rural areas were studied by using a verbal autopsy tool. Method: Community visit based retrospective study of Bhavnagar rural by WHO verbal autopsy questionnaire. Results: Of the 92 deaths analyzed, 59 % (early), 12% (late), and 29% were during the post Neonatal period. Male deaths were 55 (60%). The most common immediate causes were infection (39%), birth asphyxia (23%), hyaline membrane disease (15%). Underlying causes were: maternal illness with feeding problem (45%), prematurity (26%), meconium aspiration syndrome (9%), and congenital/ genetic anomalies (10%). Infant and neonatal deaths were seen more with illiteracy of mother, age of mother (25-29 y), third parity, anemia, and vaginal discharge; and non-breastfed, low birth weight and preterm. Birth Asphyxia and hyaline membrane disease were associated with early, and meningitis and pneumonia with a postneonatal period. Verbal Autopsy was accurate in 18/ 23 (78%) facility-based deaths where the cause of death was available. Conclusion: Reproductive health education to adolescent girls and mothers, regarding the treatment of fever, vaginal discharge; and breastfeeding counseling. Vitamin B12 should be used as more infant deaths are associated with anemia of mother. Health workers should be skilled in neonatal resuscitation, prematurity management, and early referral, identification of congenital anomaly, an inborn error of metabolism, antenatal screening by USG, and Neonatal metabolic screen. Recent 2018 data obtained from Bhavnagar District Health Authority shows that over a period of eight years, institutional deliveries have increased and home deliveries, early neonatal deaths, HMD, and septicemia have decreased.

scholarly journals COPD awareness in the urban slums and rural areas around Pune city in India

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Deesha Deepak Ghorpade ◽  
Anchala Raghupathy ◽  
Jyoti Deepak Londhe ◽  
Sapna Jitendra Madas ◽  
Nisha Vijay Kale ◽  
...  
Keyword(s):  
Tobacco Smoking ◽  
Rural Areas ◽  
Total Population ◽  
Health Workers ◽  
Urban Slum ◽  
Urban Slums ◽  
Cross Sectional ◽  
Rural Villages ◽  
Disability Adjusted Life ◽  
Life Years

AbstractCOPD is the second leading cause of death and disability adjusted life years (DALYs) in India, yet, it remains poorly recognized. We aimed to study the level of awareness of COPD in urban slums of Pune city in India and its neighboring rural areas. All male and female subjects above the age of 30 years residing in 13 randomly selected slums of Pune city (total population of 3000) and 7 randomly selected neighboring rural villages (total population of 3000) were invited to participate in this cross-sectional community survey. After obtaining written informed consent, 13 trained community health workers (CHWs) administered a questionnaire that captured their level of awareness of COPD. Of the 6000 subjects approached, 5420 residents (mean age ± SD = 48.0 ± 13.5 years; 38% males) consented and answered all questions. The number of people who had ever heard the word COPD was 49/5420 [0.9% (0.6–1.1%); 0.7% (0.5–1.3%) of the urban slum dwellers and 1.15% (0.5–1.3%) of rural residents]. Among those who had never heard the word COPD (n = 5371), when asked what was the name of the disease caused by long-term tobacco smoking, 38% said cancer, 16.7% said asthma, and 4.4% said TB. Among those who had heard the word COPD (n = 49), 6.1% said it was a disease of the heart, and 61% attributed COPD to smoke and dust pollution and 20% to tobacco smoking. The level of awareness of COPD in the Indian community is extremely low, highlighting the need to have nationwide mass awareness programs in India.

scholarly journals Umbilical cord care through community-based distribution of chlorhexidine in rural Sindh, Pakistan

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Shah ◽  
Q Jamali ◽  
F Aisha
Keyword(s):  
Rural Communities ◽  
Data Collection ◽  
Umbilical Cord ◽  
Rural Areas ◽  
Health Workers ◽  
High Rate ◽  
Cord Care ◽  
Community Based ◽  
Sindh Province ◽  
At Home

Abstract Background Unsafe practices such as cutting umbilical cord with unsterilized instruments and application of harmful substances, are in practice in many rural areas of Pakistan, and associated with high risk of neonatal sepsis and mortality. Methods We conducted an implementation research in 2015 in Tharparkar district, in Sindh province of Pakistan to understand the feasibility and acceptability of community-based distribution of chlorhexidine (CHX) in rural Pakistan. For this cohort group-only study, 225 lady health workers (LHWs) enrolled 495 pregnant women. Enrolled women received 4% CHX gel and user’s instructions for newborn cord care. The LHWs also counseled women on the benefits and correct use of CHX. Study enumerators collected data from CHX receiving women 3 times: at around 2 weeks before delivery, within 24 hours after delivery, and on the 8th day after delivery. We implemented this study jointly in collaboration with Ministry of Health in Sindh province, Pakistan. Results Among enrolled participants, 399 women (81%) received only the first visit, 295 women (60%) received first two visits and 261 women (53%) received all three visits by enumerators. Among 399 women, who received CHX gel, counseling on its use and were respondent to the first round data collection, 78% remembered that the CHX gel to be applied to cord stump and surrounding areas immediately after birth; but less than a third (29%) forgot the need to keep the cord clean and dry. Among 295 respondents in the first two rounds of data collection, who delivered at home, 97% applied CHX to cord stump on the first day. Conclusions Community-based CHX distribution by LHWs, along with counseling to recipient women, resulted in a high rate of cord care with CHX among newborn delivered at home. Results from this study may help program implementers to consider expanding this intervention for improving newborn cord care on the first day of life in Pakistan. Key messages Community-based distribution of chlorhexidine for newborn cord care appears as highly acceptable and feasible in rural communities in Pakistan. Relevant program policy supporting community-based CHX distribution along with counseling by LHW may help expanding coverage of newborn cord care in rural communities in Pakistan.

scholarly journals A study of knowledge and practice of contraception in a rural area of Bareilly, Uttar Pradesh

2021 ◽  
Vol 8 (3) ◽  
pp. 1430
Author(s):  
Alpana Saxena ◽  
S. B. Gupta ◽  
Atul K. Singh ◽  
Meenakshi Singh ◽  
Huma Khan
Keyword(s):  
Family Planning ◽  
Rural Area ◽  
Health Workers ◽  
Uttar Pradesh ◽  
Modern Contraceptive ◽  
Postpartum Contraception ◽  
Cross Sectional ◽  
Important Indicator ◽  
Mortality And Morbidity ◽  
Knowledge And Practice

Background: It is very critical to understand that awareness of family planning and proper utilization of contraceptives is an important indicator for reducing maternal and neonatal mortality and morbidity. It also plays an important role in promoting reproductive health of the women in an underdeveloped country. Objective was to assess knowledge and practice of modern contraception in rural area.Methods: A community based cross sectional study. A cross-sectional descriptive study was carried out in the in a   rural area of Bareilly, Uttar Pradesh. 458 randomly selected eligible couples were included in the study. A pre-structured questionnaire was used to collect information about family planning methods knowledge, source of knowledge and   current practices and reasons of nonuse. The appropriate statistical analysis was done to present the results.Results: 48.03% eligible couples had adopted one or the other current modern contraceptive measure. Female sterilization was the most common method used.Conclusions: Overall usage of postpartum contraception was low need to focus at every step to contact with health facility or health workers.

scholarly journals Feasibility of a Mobile Health Tool for Mothers to Identify Neonatal Illness in Rural Uganda: Acceptability Study

10.2196/16426 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e16426
Author(s):  
Shababa B Matin ◽  
Allison Wallingford ◽  
Shicheng Xu ◽  
Natalie Ng ◽  
Anthony Ho ◽  
...  
Keyword(s):  
Health Workers ◽  
Health Assessment ◽  
Care Seeking ◽  
Wearable Sensor ◽  
Middle Income ◽  
Neonatal Deaths ◽  
Danger Signs ◽  
Study Team ◽  
And Training ◽  
At Home

Background A shortage of community health workers to triage sick neonates and poor recognition of neonatal illness by mothers contribute significantly toward neonatal deaths in low- and middle-income countries. Providing low-resource communities with the tools and knowledge to recognize signs of neonatal distress can lead to early care-seeking behavior. To empower and educate mothers to recognize signs of neonatal illness, we developed a neonatal health assessment device consisting of a smartphone app and a wearable sensor (the NeMo system). Objective The aim of this study was to determine if mothers in rural Uganda were willing and able to use the NeMo system during the first week of their infant’s life. We also assessed mothers’ responses to the device’s recommendation to seek care. Methods A total of 20 mothers were enrolled in the study after giving birth in the Iganga District Hospital. Each mother was trained to use the NeMo system to assess her infant for signs of illness before leaving the hospital and was given the NeMo system to use at home for 1 week. Throughout the week, the smartphone tracked the mothers’ usage of NeMo, and the study team visited twice to observe mothers’ ability to use NeMo. Each mother was interviewed at the end of 1 week to gather qualitative feedback on her experience with the NeMo system. Results In total, 18 mothers completed the study; 2 mothers were withdrawn during the week because of extenuating health circumstances. Moreover, 1 day after enrollment and training, 75% (15/20) of mothers used NeMo properly with no mistakes. 3 days after enrollment and training, only 1 mother placed the wearable sensor improperly on her infant. On the final study day, only 1 mother connected the device improperly. Mothers used NeMo an average of 11.67 (SD 5.70) times on their own at home during the 5 full study days. Although the frequency of use per day decreased from day 1 to day 5 of the study (P=.04), 72% (13/18) of mothers used NeMo at least once per day. In total, 64% (9/14) of mothers who received an alert from the NeMo system to seek care for their infants either called the health care professional working with the study team or reused the system immediately and found no danger signs. All 18 mothers agreed or strongly agreed that the NeMo system was easy to use and helped them know when to seek care for their babies. Conclusions NeMo is a feasible and acceptable tool to aid mothers in rural Uganda to assess their infant’s health.

Factors Influencing Choice of Delivery Place among Mothers in Rukungiri and Kanungu Districts, South Western Uganda: A Cross Sectional Study

2020 ◽  
Author(s):  
Richard Mugambe ◽  
Habib Yakubu ◽  
Solomon Wafula ◽  
Tonny Ssekamatte ◽  
Simon Kasasa ◽  
...  
Keyword(s):  
Health Facility ◽  
Rural Areas ◽  
Health Workers ◽  
Public Health Facility ◽  
Facility Delivery ◽  
Health Facilities ◽  
Public Facility ◽  
Cross Sectional ◽  
Western Uganda ◽  
Delivery Place

Abstract Background: Child birth in health facilities is generally associated with lower risk of maternal and neonatal mortality. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we examined the determinants of mothers’ decision of the choice of child delivery place in Western Uganda.Methods: Cross-sectional data was collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data was collected on the place of delivery for the most recent child, mothers’ sociodemographic characteristics, health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of mothers’ choice of delivery place as well as determinants for the choice of private versus public facility for delivery at 95% confidence intervals. Results: Majority of mothers (90.2%) delivered in health facilities. Non-facility deliveries were attributed to fast progression of labour (77.3%), lack of transport (31.8%) and high cost of hospital delivery (12.5%). Being engaged in business as an occupation [APR = 1.06, 95% CI (1.01 – 1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02 – 1.17)] favoured facility delivery while higher parity of 3 – 4 [APR = 0.93, 95% CI (0.88 – 0.99)] was inversely associated with facility delivery as compared to parity of 1-2. Choice of private facility over public facility was influenced by how mothers valued factors such as high skilled health workers [APR = 1.15, 95% CI (1.05 – 1.26)], higher quality of WASH services [APR = 1.11, 95% CI (1.04 – 1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78 – 0.92)] and availability of caesarean services [APR = 1.13, 95% CI (1.08 – 1.19)].Conclusion: Utilization of health facility child delivery services was high. Health facility delivery service utilization was influenced by engaging in business, belonging to wealthiest quintile and being multiparous. Choice of private versus public health facility for child delivery was influenced by health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.

scholarly journals Assessment of relevance and effectiveness of community health workforce (CHW) development system in Bangladesh

2015 ◽  
Vol 5 (2) ◽  
pp. 332-335
Author(s):  
Md Humayun Kabir Talukder ◽  
BH Nazma Yasmeen ◽  
Rumana Nazneen ◽  
Md Zakir Hossain ◽  
Ishrat Jahan Chowdhury
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workforce ◽  
Rural Areas ◽  
Ethical Issues ◽  
Health Workers ◽  
Care Delivery ◽  
Cross Sectional ◽  
Development System ◽  
Audiovisual Aids

Background : Community Health Workforce (CHW) development has a rich history in South East Asian Region (SEAR). The first Community Health Unit was established in Sri Lanka in 1926 and then practiced over many of the regional countries like, Thailand, Mayanmar and India. Community Health Workers are in the fore front workforce to bring about change through community health programmes to national levels. In Bangladesh, there are also different categories of health workforce serving in the health care delivery system.Objectives : To assess relevance and effectiveness of community health workforce (CHW) development system in Bangladesh.Methods : This cross sectional study was conducted from 1st November 2010-30th April 2011 by purposive sampling technique. Study population were directors, administrators, principals, teachers of different institutes/ organizations and community health workers working in different corners of Bangladesh. Study places were different divisional towns of Bangladesh. Previously developed questionnaire & checklist were used for the collection of data from the institutes/ organizations by data collectors. These data were edited, processed and was analysed by using SPSS soft ware and a small portion by manually. No strong ethical issues were involved in this activity.Results : Study revealed that all the respondents (100%) are in favour of production of CHW in Bangladesh through formal academic institutional or pre service education (61.4%) .Most of the respondents (56.8%) viewed that there are scopes of utilisation of produced CHW in rural areas and most of the respondents (63.6%) also viewed that terminal/marginalized/underprivileged peoples of hard to reach areas at least can be served by CHW. Regarding the competency of produced CHW few of the respondents (43.2%) viewed positively. Most of the respondents (86.4%) viewed that both govt. & non govt. sectors should produce CHW with a very good coordination and co-operation. Study revealed the institutional capacities or situations about physical facilities, ongoing course, audiovisual aids, library, manpower and assessment procedure.Conclusion : Study revealed that there is strong & logical relevance present for the production of CHW in Bangladesh. So the existing Human Resource for Health (HRH) policy is to be revised & revisited as a time felt need to develop more competent CHW for Bangladesh to serve the marginalized, terminal, people of remote, rural & hard to reach areas.Northern International Medical College Journal Vol.5(2) 2014: 332-335

scholarly journals Neonatal Deaths in Rural Southern Tanzania: Care-Seeking and Causes of Death

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Mwifadhi Mrisho ◽  
David Schellenberg ◽  
Fatuma Manzi ◽  
Marcel Tanner ◽  
Hassan Mshinda ◽  
...  
Keyword(s):  
Verbal Autopsy ◽  
Birth Asphyxia ◽  
Household Survey ◽  
Care Seeking ◽  
Neonatal Deaths ◽  
Rural Districts ◽  
Common Causes ◽  
Large Household ◽  
Quantitative Results ◽  
At Home

Introduction. We report cause of death and care-seeking prior to death in neonates based on interviews with relatives using a Verbal Autopsy questionnaire. Materials and Methods. We identified neonatal deaths between 2004 and 2007 through a large household survey in 2007 in five rural districts of southern Tanzania. Results. Of the 300 reported deaths that were sampled, the Verbal Autopsy (VA) interview suggested that 11 were 28 days or older at death and 65 were stillbirths. Data was missing for 5 of the reported deaths. Of the remaining 219 confirmed neonatal deaths, the most common causes were prematurity (33%), birth asphyxia (22%) and infections (10%). Amongst the deaths, 41% (90/219) were on the first day and a further 20% (43/219) on day 2 and 3. The quantitative results matched the qualitative findings. The majority of births were at home and attended by unskilled assistants. Conclusion. Caregivers of neonates born in health facility were more likely to seek care for problems than caregivers of neonates born at home. Efforts to increase awareness of the importance of early care-seeking for a premature or sick neonate are likely to be important for improving neonatal health.

scholarly journals Combating non-communicable diseases in rural Lucknow: Are the skills and knowledge of female health workers adequate?

2020 ◽  
Vol 7 (9) ◽  
pp. 3480
Author(s):  
Arunima Saini ◽  
Monika Agarwal
Keyword(s):  
Health Workers ◽  
Uttar Pradesh ◽  
Cross Sectional Study ◽  
Communicable Diseases ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Grass Root ◽  
Grass Root Level ◽  
The Government ◽  
Essential Knowledge

Background: India is facing the surging trend of non-communicable diseases (NCD). Forecasting the burden for NCDs, the Government of India (GOI) initiated a program in 2010 across the country, i.e., National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke. The GOI has envisaged the female health workers (FHW) for the last mile delivery of health services under the programme. Available literature shows that FHWs lack essential knowledge regarding chronic diseases. This study attempts to fill these gaps by studying knowledge and skills regarding NCDs among FHWs in rural Lucknow. Objectives were to explore the knowledge about NCDs among ASHAs and ANMs in rural Lucknow and to assess of skills related to NCD screening among ANMs in rural Lucknow.Methods: It was a cross-sectional study conducted among FHWs of Lucknow, Uttar Pradesh from June 2019 to August 2019.Results: Among the FHWs, knowledge about NCDs was found to be higher for those with the age more than 40 years, with the education of higher secondary and above and also amongst those who had received previous training for NCDs.Conclusions: Majority of the respondents were found to have poor knowledge regarding NCDs. Additionally, older age, training and higher education are found to be associated with good knowledge; there is a need of training of grass root level workers for them to correctly identify the symptoms and risk factors of various NCDs.

scholarly journals Associations between community health workers’ home visits and education-based inequalities in institutional delivery and perinatal mortality in rural Uttar Pradesh, India: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e044835
Author(s):  
Andrea Katryn Blanchard ◽  
Tim Colbourn ◽  
Audrey Prost ◽  
Banadakoppa Manjappa Ramesh ◽  
Shajy Isac ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Institutional Delivery ◽  
Health Workers ◽  
Uttar Pradesh ◽  
Home Visits ◽  
Public Facility ◽  
Third Trimester ◽  
Cross Sectional ◽  
Education Levels ◽  
Lower Education

IntroductionIndia’s National Health Mission has trained community health workers called Accredited Social Health Activists (ASHAs) to visit and counsel women before and after birth. Little is known about the extent to which exposure to ASHAs’ home visits has reduced perinatal health inequalities as intended. This study aimed to examine whether ASHAs’ third trimester home visits may have contributed to equitable improvements in institutional delivery and reductions in perinatal mortality rates (PMRs) between women with varying education levels in Uttar Pradesh (UP) state, India.MethodsCross-sectional survey data were collected from a representative sample of 52 615 women who gave birth in the preceding 2 months in rural areas of 25 districts of UP in 2014–2015. We analysed the data using generalised linear modelling to examine the associations between exposure to home visits and education-based inequalities in institutional delivery and PMRs.ResultsThird trimester home visits were associated with higher institutional delivery rates, in particular public facility delivery rates (adjusted risk ratio (aRR) 1.32, 95% CI 1.30 to 1.34), and to a lesser extent private facility delivery rates (aRR 1.09, 95% CI 1.04 to 1.13), after adjusting for confounders. Associations were stronger among women with lower education levels. Having no compared with any third trimester home visits was associated with higher perinatal mortality (aRR 1.18, 95% CI 1.09 to 1.28). Having any versus no visits was more highly associated with lower perinatal mortality among women with lower education levels than those with the most education, and most notably among public facility births.ConclusionsThe results suggest that ASHAs’ home visits in the third trimester contributed to equitable improvements in institutional deliveries and lower PMRs, particularly within the public sector. Broader strategies must reinforce the role of ASHAs’ home visits in reaching the sustainable development goals of improving maternal and newborn health and leaving no one behind.

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