Prevalence and Determinants of Low Birth Weight among the Newborns in Dadra and Nagar Haveli: A Community-based Study.

Background: The world is not on track to meet the World Health Assembly (WHA) global target on Low Birth Weight (LBW). To estimate the prevalence and to identify the associated determinants of LBW among the newborns. Material and Methods: We conducted a cross-sectional study among the 364 mothers registered under the all government health facilities of Dadra & Nagar Haveli (DNH) during November 2021 to January 2022. Results: The prevalence of LBW was found to be 39%. On uni-variable logistic regression, live in relationship, caste, weight of mother, Body Mass Index (BMI), weight gain <5 kg in 2nd and 3rd trimester, high-risk pregnancy, complication present in previous pregnancy and preterm delivery, while on multi-variable logistic regression, weight gain <5 kg in 2nd and 3rd trimester (AOR 2, 95% CI 1.007-4.2) and having high-risk pregnancy (AOR 2, 95% CI 1.1-3.0) were found to be the significant predictors of LBW among the newborns. Conclusions: We conclude from the study that the prevalence of low birth weight among the newborn was high. There is a need to address maternal and child health issues like low birth weight, malnutrition and high-risk pregnancy under the RMNCAH+N program through various effective interventions. Future research should evaluate the feasibility of collaborative activities between RMNCAH+N program and the UNICEF in India.

Process Evaluation of COVID-19 Vaccination Sessions in Dadra and Nagar Haveli District During SARS-CoV-2 Pandemic.

Context: Efficient roll out of COVID-19 vaccines requires high-quality preparedness at all levels and robust planning and training regarding COVID-19 vaccination, use of CoWIN software, post-vaccination care and communication for all health functionaries. Aims: The current study attempts to fill the research gap in monitoring of COVID-19 vaccination session sites in tribal areas of UT of Dadra and Nagar Haveli (DNH) during COVID-19 pandemic. Methods and Material: It was a cross sectional observational study conducted from April to May 2021 at 36 purposively selected COVID-9 vaccination session sites. Sites were monitored independently for assessing various parameters like infrastructure, HR status, vaccine, logistics availability, and AEFI management using the WHO Session Site Monitoring Form for COVID-19 Vaccination. Results: Out of 36 session sites observed, three separate designated rooms were available at 21 (58.3%) sites. Almost two-third of the session sites (61.1%) had displayed information, education, communication (IEC) materials. Mean number of team members was 5.1 (SD 1.7). Adequate stock of vaccine vials and AD syringes, AEFI kits or anaphylaxis kits were available and biomedical waste segregation was as per guidelines at all the session sites. Conclusions: Logistics availability, safe injection practices, and COVID-appropriate behavior were adequate; however, infrastructure and post-vaccination care needs strengthening for successful rollout of COVID-19 vaccination.

Mother and child protection card as a resource tool for health care providers on VHND sessions: Providers' views in rural area of Valsad district in south Gujarat, India.

Background: The Mother and Child Protection card (MCP card) is used for tracking of each child right from conception till 3 years of age by community health workers. It is a rich source of information for HCPs about mother and child health. A well-versed health care provider (HCP) can deliver the services efficiently to the beneficiaries. Objectives: To assess knowledge of HCPs about information provided in the MCP card. Methodology: It was a descriptive cross-sectional study carried out in the rural area of Valsad. Nineteen HCPS were interviewed on VHND sessions for their knowledge about health information provided in MCP card. Results: Mean age of HCPs was 38.11 years with mean 9.3 years of work experience. Of these 94.7% were providing the MCP card while registering the beneficiary. Around 78.9% knew growth chart, 68.4% knew vaccination information and nearly half were aware about the various government schemes. About 36.84% could mention five cleans of safe delivery at home. Conclusion: HCPs were aware about vaccination, antenatal care, growth chart but their knowledge about five cleans of home delivery and postnatal care needs to be improved.

Continuing medical education about postexposure prophylaxis of rabies in tribal area medical college hospital of Gujarat, India: One step towards rabies elimination.

Background: Continuing Medical Education (CME) is an essential feature of the clinical practice and helps to improve the health care provider's ability to provide quality patient care. The World Health Organization has given a global strategic plan to end human deaths from dog-mediated rabies by 2030 known as "Zero by thirty." Methodology: A CME session was organized for staff nurses working in a tertiary medical care hospital of Valsad district about anti rabies vaccination. Ninety-one participants were administered the questionnaire about antirabies vaccine (ARV) and related practical aspects before and after the CME session. Results: Mean pre- and post-CME Score of the participants was 5.38 and 8.68 out of 10, respectively which was statistically significant. The majority of the participants could score from 5 to 6 (33, 36.2%) before CME which rose to 9 to 10 after CME (58, 63.7%). A total of 52 participants (57%) showed improvement in total score by more than 5 points after attending CME, whereas 13 (14%) showed no improvement. The maximum improvement (52.1%) was found in the fact that currently available vaccine vials are the same for intradermal (ID) and intramuscular (IM) regimes, followed by the need for immunoglobulins in category III animal bites (44.3%). Conclusion: CME showed significant improvement in knowledge regarding rabies and antirabies vaccination. The knowledge regarding the similar schedule for both adults and children needs improvement. Subsequent CME programs should focus on these aspects for the effective management of animal bite patients.

Study on prevalence of obesity using different scales and its association with hypertension among the elderly in a district of Gujarat.

Introduction: In older adults, excess weight is associated with a higher prevalence of cardiovascular disease, metabolic disease, several important cancers, and numerous other medical conditions. Several indices such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) are used to classify general. Some studies also reported that WC and WHR is a better indicator of cardiovascular disease (CVD) risk than BMI and WHR. Aims and Objective: 1. To estimate the prevalence of obesity among the elderly using three scale viz. BMI, WHR, and WHtR 2. To compare the results of these three-scale used for assessment of obesity 3. To determine the presence of association between obesity and hypertension if any. Material and Methods: For selection of the area, in both the urban and rural areas, the sampling units were enumerated and samples were collected from them. The estimated geriatric population combined in both Urban and Rural areas amounted to 12,220 (7% of geriatric population as per Census 2001), out of which 5% was selected as sample. This came out to be 611 elderly subjects which were selected equally from both urban and rural areas. For assessment of obesity BMI, WHR, and WHtR were measured. Assessment of hypertension was as per JNC classification. Result: Prevalence of obesity as per BMI in the urban area was found to be 40%, whereas that in rural areas was found to be 47.4%. WHR and WHtR showed higher prevalence in rural areas (70%) and also in urban areas (60%). BMI and WHR were significantly associated with hypertensive status of elderly. Conclusion: Anthropometric assessments of obesity like WHR and WHTR are more sensitive indicators of obesity among the elderly. BMI is found to be significantly associated with hypertension as well in the present study. Logistic regression showed that the association of BMI with hypertension was higher than other obesity assessments.

Study on Factors Associated with Depression among Elderly and Comparison of Two Scales Used for Screening.

BACKGROUND: Depression is one of the most frequent illnesses found among the elderly. ICD-10 scale and Geriatric Depression Scale (GDS) are used commonly for screening and hence it is important to identify the scale which can be used more effectively in community settings. OBJECTIVES: (1) To analyze the factors responsible for the elderly depression and (2) to compare two scales used for the screening (ICD-10 and GDS). MATERIALS AND METHODS: A cross-sectional house-to-house survey was carried in Sayla taluka of Surendranagar district by directly questioning the subjects after oral and written consent. The selection of taluka was done using simple random sampling and sample size was calculated on the basis of estimated geriatric population. 306 subjects were interviewed using a predesigned, pretested, and validated questionnaire. RESULTS: GDS showed the prevalence of 16% whereas ICD-10 showed 22%. The factors associated with depression were physical health, poor economical situation, and avoidance by family members. The agreement between the 2 scales using Cohen's kappa statistic showed excellent agreement. CONCLUSION: Community-based multiphasic screening programs is needed for early diagnosis of geriatric depression. ICD-10 having lesser number of questions can be used in the 1st phase of screening and those found positive can then be tested by GDS.