Implementation challenges of Pradhan Mantri Jan Arogya Yojana: A Cross- Sectional study in Meerut, Uttar Pradesh

Background: Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana has been launched to provide financial protection expenditure to nearly 500 million vulnerable Indians. For expanding the coverage under the scheme, it is necessary to understand the perspective of health care service providers involved in the scheme. Aim & Objective: To find out the bottlenecks in implementation of PMJAY scheme using empanelled hospitals’ perspective Settings and Design: Cross sectional study Methods and Material: 8 Public and 23 Private hospitals were selected through Simple Random Sampling from the list of PMJAY empanelled hospitals. The PMJAY Medical Officer co-ordinators in the empanelled hospitals were interviewed using a predesigned and pretested questionnaire. Statistical analysis used: Data was analysed using descriptive statistics in Epiinfo software. Results: Among the 31 empanelled hospitals studied, 93.5% were satisfied with the process for empanelment under PMJAY. 64.5% hospitals were not satisfied with the Health Benefit Packages. 77.4% hospitals perceived the PMJAY to be poorer as compared to private health insurance with reasons being poor grievance reprisal, poor claim processing and settlement, denial of reimbursement of health packages, poor rates of health packages and little information about the scheme. Conclusions: Various hurdles are being faced in the implementation of the scheme. There definitely remains a huge scope for further improvements so as to enhance the insurance coverage in the country.

Impact of Supplementary Nutrition on Undernourished Children In An Urban Area Of Meerut- A Longitudinal Study

Background: Infants and pre-school are most susceptible to undernutrition. Integrated Child Development Services is the programme focussing undernourished children by providing them supplementary nutrition. Aim& Objective: To study prevalence of undernutrition in 0-6 year old children and to study factors associated with it. To study impact of supplementary nutrition on undernourished children. Settings and Design: A longitudinal study. Methods and Material: The present longitudinal study was conducted in randomly selected Anganwadis of urban Meerut. Children found to be suffering from under nutrition were followed up at interval of six months to see the impact of supplementary nutrition provided to them at the anganwadi centre. A detailed history of relevant underlying factors responsible for causation of under nutrition were taken from mothers of these children. Statistical analysis used: chi square test was used to find out association between risk factors and undernutrition. Risk factor found statistically significant were further analysed using step wise multiple logistic regression analysis. The impact of supplementary nutrition was assessed using paired t test. Results: Iron folic acid supplementation during pregnancy, exclusive breast feeding in children, immunization and time of initiating complementary feed were found statistically significant on both chi-square and multiple logistic regression analysis. No impact of supplementary nutrition was found on anthropometric measurements of children. Conclusions: The main focus for fighting undernutrition in children (0-6 years) should be on preventing risk factors associated with mothers in antenatal period and during child rearing practices

Myths and misbelieves regarding COVID vaccines in India

Background: - COVID-19 is the most important public health problem of recent time. Many people require hospitalization after infection. COVID vaccination is the most effective way to prevent the disease. Due to extensive negative publicity through social media channels/platforms,significant number of individuals are not coming forward for vaccination. Therefore, study is needed to evaluate adverse effects associated with different vaccines available in India. Objectives: - To assess the adverse effects associated with COVID-19 vaccination and compare the side effect of two most commonly used COVID vaccines in India. Methods:- In the current report, a cross sectional study was conducted among beneficiaries of COVID-19 vaccines at the vaccination center of the LLRM Medical college, India. After institutional ethical clearance and informed consent, patients were asked about the symptoms they experienced after vaccination. A very simple random sampling approach was used to select beneficiaries. Information was collected on predesigned Google form and total 391 patients submitted the responses. Results:- Out of total respondents 77 % individuals reported one or more symptoms. Fever was reported to be most common problem (59.3%) followed by body ache (57.5%). Out of total beneficiaries, 68.3% experienced mild symptoms while 23% remain asymptomatic. Only few subjects reported moderate adverse effects (8.7%). None of the respondent reported severe and serious adverse effect. Conclusions:- Vaccine associated adverse effects were found less than 3 days and of mild variety in most of the beneficiaries. There was no difference in adverse effect profile of two commonly used vaccines in India. People must come forward for vaccination in mass without fearing of adverse effects of vaccines.

Impact of infant & young child feeding & caring practices on morbidity

Background: Around 5.9 million children still die every year before reaching their fifth birthday. Child morbidity and mortality due to preventable causes remains high in developing countries. Aim & Objective: To find out the relationship of morbidity with child rearing practices and sociodemographic characteristic. Material and Methods: To cover a sample size of 400 in urban health center area population under 5 children every alternate family was selected by systematic random sampling from the total of 1867 registered families at urban health center. The data was obtained by the interview of mothers and examination of children using predesigned and pretested Questionnaire. The data thus collected, was first coded and then transferred to a master chart on Microsoft Excel sheet, from which distribution as well as co-relation tables were prepared, analyzed and statistically evaluated by SPSS version 20.0.Result: In the present study, the overall fortnightly incidence of morbidity among under 5 children was found to be 65.3% (boys – 64.2%, girls – 66.5%). Exclusive breastfeeding (p < 0.001); time of initiation of breastfeeding (p < 0.001); complementary feeding (p < 0.05) and hand washing practices (p < 0.001) are statistically significant predictors of child morbidity Conclusion: We need comprehensive child health care programme having all three promotive, preventive and curative services.

Treatment practices in pulmonary tuberculosis by private sector physicians of Meerut, Uttar Pradesh.

Background. Majority of the qualified medical practitioners in the country are in the private sector and more than half of patients with tuberculosis (TB) seek treatment from them. The present study was conducted with the objective of assessing the treatment modalities in pulmonary tuberculosis by the private physicians in Meerut City, Uttar Pradesh, India. Methods. A cross-sectional study was carried out covering all the private physicians (graduates and postgraduates in Medicine and Chest Diseases) registered under the Indian Medical Association, Meerut Branch (n=154). The physicians were interviewed by a pre-designed and pre-tested questionnaire about the treatment modalities practiced by them. Results. Only 43.5% private physicians had attended any Revised National Tuberculosis Control Programme (RNTCP) training in the past five years. Only 33.1% of them were aware of the International Standards of Tuberculosis Care (ISTC). Fifty-three different regimens were used to treat the patients. Majority of physicians (76%) prescribed daily regimens while 24% administered both daily and intermittent treatment. None of the private physicians prescribed exclusive intermittent regimen. Eighty-seven different treatment regimens were used for the treatment of multidrug-resistant TB (MDR-TB) with none of them prescribing standard treatment under RNTCP. Conclusion. As majority of private practitioners do not follow RNTCP guidelines for treating TB, there is an urgent need for their continued education in this area.

Awareness about pulse polio immunization among the general population in Delhi.

A study was conducted in three intensive pulse polio immunization (IPPI) centres in Delhi on 24th September, 2000 to assess the awareness about poliomyelitis and the IPPI programme. A structured questionnaire was used to elicit the information from 182 accompanying persons (41 males and 141 females) by qualified medical doctors. Majority (92.9%) of the respondents knew that the administered drops were polio vaccine. Major sources of information were television (32.9%), relatives or friends (24.2%), health staff (20.9%), poster or leaflets (15.9%). Only 18.1% knew the next IPPI day. Out of 43 claiming to know the number of subsequent IPPI days during 2000, only 22 could tell correctly. A large number of respondents (86.2%) knew that IPPI would help in preventing polio in children. Paralysis of limbs as a clinical feature of polio was known to 70.3%, 45.6% knew that polio cannot be cured and 21.9% perceived that polio could also lead to death. The nationwide intensive awareness campaign for polio eradication was found to be partially effective in disseminating the information.