Causes and age of neonatal death and associations with maternal and newborn care characteristics in Nepal: a verbal autopsy study

Background In Nepal, neonatal mortality fell substantially between 2000 and 2018, decreasing 50% from 40 to 20 deaths per 1,000 live births. Nepal’s success has been attributed to a decreasing total fertility rate, improvements in female education, increases in coverage of skilled care at birth, and community-based child survival interventions. Methods A verbal autopsy study, led by the Integrated Rural Health Development Training Centre (IRHDTC), conducted interviews for 338 neonatal deaths across six districts in Nepal between April 2012 and April 2013. We conducted a secondary analysis of verbal autopsy data to understand how cause and age of neonatal death are related to health behaviors, care seeking practices, and coverage of essential services in Nepal. Results Sepsis was the leading cause of neonatal death (n=159/338, 47.0%), followed by birth asphyxia (n=56/338, 16.6%), preterm birth (n=45/338, 13.3%), and low birth weight (n=17/338, 5.0%). Neonatal deaths occurred primarily on the first day of life (27.2%) and between days 1 and 6 (64.8%) of life. Risk of death due birth asphyxia relative to sepsis was higher among mothers who were nulligravida, had <4 antenatal care visits, and had a multiple birth; risk of death due to prematurity relative to sepsis was lower for women who made ≥1 delivery preparation and higher for women with a multiple birth. Conclusions Our findings suggest cause and age of death distributions typically associated with high mortality settings. Increased coverage of preventive antenatal care interventions and counseling are critically needed. Delays in care seeking for newborn illness and quality of care around the time of delivery and for sick newborns are important points of intervention with potential to reduce deaths, particularly for birth asphyxia and sepsis, which remain common in this population.

Social Justice Through BPATC in Bangladesh Under the Shadow of Colonialism

This chapter aims to understand how the Bangladesh Public Administration Training Centre (BPATC) can ensure social justice through its apex and unique training manuals. Qualitatively and by critical discourse analysis, this discussion shows that existing training guidelines and policies have a deep and robust lineage with coloniality, predominating the fundamental legal aspects of Bangladesh through Colonially Inherited Acts, Rules, and Regulations as well as practices. Can the government ensure the SDGs and a just and right productive, autonomous, and accountable citizen-oriented public service? The Government of Bangladesh may imply the recommendations in policies to ensure social justice in public administration through BPATC.

Genetic variance and heritability estimation of hybridized pepper plants (Capsicum annuum L.) F2 progeny for begomovirus resistance in growth stage

Pepper is widely cultivated as a condiment and cash crop in Indonesia. However, Pepper yellow leaf curl disease (PepYLCD) caused by begomovirus is currently seriously affect the domestic pepper production. Breeding for begomovirus resistance material by crossing is currently necessary to overcome the constraint. The present study is aimed to determine the resistance of pepper (C. annuum) plants F2 progenies to begomovirus infection in the growth stage. Two local C. annuum accessions, BaPep-5 as a resistance donor for pepy-1 begomovirus resistance gene (locally called Perintis) and BaPep-4 as a susceptible parent (locally called Kencana) were crossed to generate F2 progenies. The research was conducted in Agricultural Extension Training Centre (BLPP) Saree and Horticulture Laboratory of Syiah Kuala University from February to July 2020. 500 F2 progenies were transplanted to the field along with 15 plants of each parent as control. The result suggested that plant height and crown width had the highest broad sense heritability value, whereas the dichotomous height, stem diameter, secondary branch, and tertiary branch had the lowest broad sense heritability value. Coefficient of genetic variance and coefficient of phenotypic variance from overall characteristics were relatively low which suggest the narrow sense to slightly narrow sense heritability.

Contribution des Techniques Andragogiques au Succês de la Formation Continue : Cas de la Mise en Œuvre des Objectifs de Développement Durable au Benin

Dans cet article, le travail a consisté à mesurer l’atteinte des objectifs de la formation et à analyser la perception que les participants ont de leurs acquis de formation. Ainsi, cette recherche a pour but d’apprécier le recours aux techniques andragogiques dans la formation des formateurs d’adultes dans un centre de formation professionnelle continue. La démarche méthodologique adoptée est mixte. Le recensement exhaustif des 12 formateurs en Objectifs de Développement durable (ODD) conviés au renforcement de leurs capacités est fait. Il y en a eu 10 qui ont accepté de participer à l’enquête. La collecte des données a été réalisée grâce à un questionnaire (fiche d’évaluation de la formation) ayant servi à voir leur niveau de satisfaction et un guide d’entretien pour connaître la perception des participants sur l’atelier de formation. L'analyse catégorielle a permis de traiter les données qualitatives et de répartir les différentes réponses dans des ensembles en fonction de leur signification et de leur interprétation contextuelle. Majoritairement, les participants formateurs sont totalement satisfaits des modules de formation en andragogie qui, avec les notions enseignées en ODD, permettront l’amélioration de leurs pratiques. Plus de 70% des participants ont aimé l’organisation matérielle et plus de 80% ont nettement apprécié le déroulement de la formation. Il importe donc de former les formateurs à l’approche andragogique pour renforcer leurs capacités dans la compréhension et l’interprétation des ODD comme stratégie pour l’atteinte des objectifs de formation. In this article, the work consisted of measuring the achievement of training objectives and analyzing participants' perception of their training outcomes. Thus, the purpose of this research is to assess the use of andragogic techniques in the training of adult trainers in a continuing vocational training centre. The methodological approach adopted is mixed. The exhaustive census of the 12 trainers in the Sustainable Development Goals (SDGs) invited to strengthen their capacities is done. There were 10 who agreed to participate in the survey. Data collection was carried out through a questionnaire (training score sheet) used to see their level of satisfaction and an interview guide to find out how participants perceived the training workshop. Categorical analysis made it possible to process qualitative data and to divide the different responses into sets according to their meaning and contextual interpretation. For the most part, the training participants are completely satisfied with the training modules in andragogy which, together with the concepts taught in the SDGs, will allow the improvement of their practices. More than 70% of the participants liked the material organization and more than 80% clearly appreciated the course of the training. It is therefore important to train trainers in the andragogic approach to strengthen their capacities in understanding and interpreting the SDGs as a strategy for achieving training objectives.

Is hydronephrosis a risk factor for complications in conventional percutaneous nephrolithotomy?

Objective: To assess Hydronephrosis as a Risk Factor for complications in Conventional Percutaneous Nephrolithotomy. Study Design: Cross Sectional Descriptive study. Setting: Kidney Centre Post Graduate Training Centre, Karachi. Period: January to December 2020. Material & Methods: This study was done to know post-operative complications including bleeding, infection, and incomplete stone clearance in patients with or without hydronephrosis undergoing percutaneous nephrolithotomy. After applying the inclusion/ exclusion criteria it was found that the patients with hydronephrosis had less bleeding as compared to the no hydronephrosis group. In the same way, they also had fewer nephrostomy tubes placed, and chest drain insertion. All other complications were approximately the same in each group. Patients were selected using non-probability consecutive sampling technique. Percentage and frequencies were determined for quantitative variables. Mean and standard deviation were determined for quantitative variables. Results: Total 300 cases were studied fulfilling inclusion criteria. There were 70.07% male and 29.3% female cases. Age range of the patients was 18-60 years. There were 52.7% cases with hydronephrosis, placed in one group and 47.3% cases were without hydronephrosis placed in other group. Most common complication was postoperative bleeding reported in 48.9% cases with hydronephrosis as compared to 56.2% cases without hydronephrosis. Mean operative time was 115.7 ± 41.9 minutes in patients with hydronephrosis and 135 ± 35.4 minutes in patients without hydronephrosis. Conclusion: Patients with hydronephrosis experienced less postoperative complications, after PCNL as compared to those without hydronephrosis.

Tobacco consumption patterns amongst recruits at a training centre

Background: Approximately 3 million premature deaths occur every year due to tobacco. Gaps were observed in the scientific knowledge about tobacco consumption practices among armed forces personnel in our country. Keeping in view the paucity of studies in this field workers chose to undertake the present study.Methods: A cross-sectional study was conducted among service personnel across a training centre to determine prevalence of tobacco consumption. The sample size was calculated to estimate 95% confidence interval for prevalence of tobacco consumption with 5% absolute precision. The minimum sample size was calculated to be 250, however, 285 personnel were included in the study. “Personal interview technique” was used for data and standard statistical methods were utilized for data analysis.Results: The mean age (standard deviation) of the study subjects was 20.80 years (1.23). The overall prevalence of currently using tobacco in any form was 9.82%, mean (SD) of number of years of tobacco use was 2.33 years (1.27). Mean (SD) of number of cigarettes/bidis smoked per day was 7.52 (6.71). Average amount spent on tobacco consumption per month was Rs310.95 (2.42% of monthly salary). The commonest reasons for smoking is peer pressure, to relax and feel like hero.Conclusions: Our study has helped to fill in the existing gaps in the scientific knowledge about tobacco consumption practices among armed forces personnel in our country.

A study on prevalence of anemia among antenatal females registered at rural health training centre, Budhi in district Kathua

Background: Anemia has been recognized as the most common form of nutritional deficiency worldwide, particularly in developing countries like India. Anemia is a public health problem in both developed and developing countries. It affects 1.62 billion people globally, which corresponds to 24.8% of the world population. Though anemia is easily treatable and preventable disease, it continues to be significantly associated with pregnancy. The aims of the study were to determine the magnitude of anemia in pregnant women according to severity and to find out association of anemia with different variables.Methods: The present study was a retrospective type of study which was conducted over a period of 2 years. A total of 109 antenatal females were registered over the period of 2 years.Results: The most common age group seen was 26-30 years (45%), majority of females were Hindu (95.4%) and belonged to lower socio-economic status (52.3%). The obstetrics history of the antenatal females’ shows, majority of them registered themselves in their 1st trimester (73.4%) and around 22.1% of the females had birth interval between 2-3 years, followed by 1-2 years. Majority of them had moderate anemia (82%), followed by mild anemia (10%). Only 1% of females had severe anemia while rest had no anemia (7%).Conclusions: This study revealed a high prevalence of anemia in antenatal females, irrespective of religion, socio-economic status, etc. anemia is found to be endemic in this region, due to various unfavorable socio-demographic factors. Strengthening of the existing adolescent and maternal health interventions focusing towards anemia screening and prevention among reproductive age group.

A study on the morbidity profile of children under 5 years of age and knowledge of parents regarding their health seeking behavior

To study the morbidity profile of children under 5 years of age and knowledge of parents regarding their health seeking behavior. The study was a community based cross-sectional study. The study was conducted in the Field practice area of Rural Health Training Centre (RHTC) of Hind Institute of Medical Sciences, Barabanki. Families with at least one under five-year child, all family willing to participate and consenting and families residing in the study site for the minimum last 1 year were included in the study. A total of 400 subjects were included in the study. Door to door visit was done for data collection. Morbidity was almost nil in 0-2 months preceding the interview. Diarrhoea was most common morbidity during 2 months – 5 years preceding the interview. Government hospital for treatment was preferred by 53.5% of the respondents. Treatment at government hospital was taken by 55% of the respondents. Secondary level of care was available in 50.2% of the respondents. Only 2.2% of the respondents reported any problem with the treatment. Hospital was visited by 65% of the respondents for the treatment. Child’s last illness was 3-6 months in 52.8% of the respondents and Diarrhoea was the most common type of illness. 62.8% of the respondents visited government hospital for the treatment of child. More than one third of respondents visited health facility by bicycle (42.8%) and 24.5% approached by walking. Time taken to reach health facility was 15-30 minutes in 51% of the respondents. The main reason to choose particular health facility was Trust over the provider of the facility (41.5%). This study demonstrates the importance of maternal perception of illness severity in determining facility based care seeking for childhood illness in rural area.

A COMMUNITY BASED CROSS-SECTIONAL STUDY ON MORBIDITY PATTERN OF ELDERLY IN RURAL AREA OF JHALAWAR, RAJASTHAN

Objectives: The aim of the study was to study the morbidity pattern and burden among the elderly residing in the field practice area of Rural Health Training Centre Mandawar. The aim of the study was to identify the various factors associated with morbidity among the study population. Assessment of the morbidity profile will help in the application of interventions, to improve the health status and the quality of life of the elderly. Methods: Therefore, a total of 880 elderly were selected. Multiple house visits were done and data were collected by interviewer method, observation, and clinical examination of the study population. Diagnosis of the disease was made on the basis of history, investigations, clinical examination, and treatment report. Statistical analysis was done using Statistical Package for the Social Sciences 25 trial version. Results: Out of 880 elderly, 83.9% belonged to the age group of 60–74 years, the majority (87.4%) were found to be Hindus, 44% lived in three generation families. The most of the elderly were illiterate (46.7%) and the majority (44.2%) belonged to class IV socio-economic status. The morbidity load was 2370. The average morbidity per person was 1.56. The majority of the elderly (32%) had two morbidities. Visual impairment was the most common morbidity and it was more common in males. The association of morbidity was found to be statistically significant with gender, age category, and financial status. Conclusion: The present study revealed that the prevalence of morbidity among the elderly is very high.