What affects utilization of malaria control services? A qualitative approach to understanding community perception in highly malarious Gadchiroli district, Maharashtra, India.

National Vector Borne Disease Control Programme (NVBDCP) data have shown that nearly half of all malaria deaths in India occur in tribal-dominated areas. The present study took a qualitative approach to understanding community perceptions and practices related to malarial infection and anti-malarial programmes. Twelve focus group discussions and 26 in-depth interviews of Accredited Social Health Activists (ASHAs) were conducted in nine villages in the district of Gadchiroli, Maharashtra state in India in June 2016. A total of 161 village residents (94 males and 67 females) participated in the focus group discussions and 26 health workers participated in the in-depth interviews. Data were analysed using the content analysis approach. The findings revealed widespread misconceptions about malaria among village residents, and low use of preventive measures and anti-malarial services. Ignorance and treatment by unqualified traditional healers delay effective treatment seeking. Furthermore, failure to maintain drug compliance adds to the gravity of the problem. The study identified the social and behavioural factors affecting treatment uptake and use of treatment facilities in the study area. These should help the development of the behavioural change communication arm of any control strategy for malaria through improving community participation, so improving preventive practices and optimizing utilization of anti-malarial services.

Reaching tribal men to improve awareness to sexual morbidities: experience from Baiga tribe of Central India.

BACKGROUND AND OBJECTIVES: Tribal men's reluctance in sharing responsibilities as supportive partners in reproductive and sexual health matters debar women from their sexual rights coupled with their negligence in health care and lesser utilization of reproductive health facilities. As a matter of fact a large proportion of ill health particularly related to sexually transmitted infections (STIs) suffered not only by men but also by their spouses. The present study was planned among one of the primitive tribes of Madhya Pradesh to understand the knowledge of males about reproductive tract infection (RTI)/STI/HIV/AIDS, RTI symptoms suffered, perception on sexual health, utilization of health services and to improve the knowledge by intervention of need based IEC (information, education, communication) strategy. METHOD: The study was conducted among 400 currently married men in the age group of 15-40 yr in one of the primitive tribes, Baigas of Dindori district of Madhya Pradesh. Eighteen villages were explored in the study. The IEC intervention was made by using quasi-experimental before and after with control design. RESULT: The baseline data generated indicated that Baigas male were poorly informed about RTI (18%), STI (21.5%) and HIV/AIDS (10%). Further, men also projected misconception on different aspects of sexuality. Women's views recorded also suggested a disturbing trend regarding male involvement in reproductive health particularly related to STIs. INTERPRETATION & CONCLUSIONS: After intervention of IEC targeting male population in age group 15 - 40 yr by adopting a before and after with controls design the awareness was improved significantly. The utilization of the health services was also improved significantly. The study recommends replication of the IEC strategy designed in other Baiga villages for improving the reproductive health of the tribe.

A trend in women's health in India--what has been achieved and what can be done.

The health of Indian women is intrinsically linked to their status in society. Research into Indian women's status has found that their family contributions are often overlooked and they are likely to be regarded as an economic burden, especially in rural areas. This attitude has a negative impact on their health status. Poor health has repercussions not only for women, but also for their children and other family members. This commentary focuses on the trend in five key women's issues in India: maternal and child health; violence against women; nutritional status; unequal treatment of girls and boys; and care quality. The discussion is based on data extracted from Indian National Family Health Surveys (NFHS-1, NFHS-2 NFHS-3) spanning the period 1993-2006, and data from the Indian Sample Registration System and National Crime Research Bureau.