Process of Developing the Online Certification Tests for Research Project Trainees and Assessing the Feasibility for Adaptation in Maternal and Child Health Projects.

An innovation launched by Datta Meghe Institute of Medical Sciences emphasized on promoting early child development through govt. Anganwadi centers under the project ‘Stepping Stones’. The innovation includes delivery of Enhanced Anganwadi Curriculum and Parenting Sessions through home visits by trained Anganwadi Workers with support from Community Health Workers. A system of computerized online and of training certification test was developed. This paper outlines the results of feasibility and acceptance of this system by Community Health Workers in maternal and child health programs.METHODSPre-tested questionnaire with questions on different aspects of certification test and responses with Likert-type scoring scale was provided to 30 randomly selected community health workers trained by DMIMS. Weighted means of total scores for agreement/disagreement for feasibility and acceptability questions was calculated.RESULTSAverage Weighted Mean of 4.07 demonstrated a strong agreement by all participants towards the feasibility and acceptability of this test. 47.67% candidates showed strong agreement.CONCLUSIONSSuch type of tests can be framed and utilized as, time saving screening, and certification test, for different types of community healthcare cadre.

Stimulating Home Environment for Early Childhood Development by Household Play Materials for Under 5 Rural Children in Forest Buffer Zone of Wardha District.

Home Environment of a child comprises of toys, books and stimulating play materials which are critical for promoting early development. Parents, family and atmosphere at home play a key role in stimulating child’s physical, cognitive and socio-emotional developments. This assessment was done in rural settings of forest buffer zone of Bor Tiger Sanctuary in Vidarbha to have a baseline picture about availability of play materials at households that promote child development and parent’s view about these play materials.METHODSThis was a cross-sectional survey which included assessment of 894 households in 45 villages from Seloo block of Wardha district. Survey tools included pretested questionnaire and home observation checklist which was administered at home visit and during interviews of parent-child dyads. Data was collected in android based ODK app and exported to server. Data imported from server was analysed using STATA-11.RESULTSAvailability of play materials as represented by Mean Item Availability Score (MIAS) was significantly associated with family structure, wealth index and parent’s education and occupation. Though 84.2% households had materials for moving around and outdoor play, only 26.9% households had materials for promoting coordinated gross-motor movements, 41.6% households had materials meant for stacking, constructing. Only 19.8% households had materials for learning shapes and colours, 29.8% households had picture books/charts, 32.4% households had materials for drawing and writing and only 11.3% children had materials promoting counting.CONCLUSIONSObvious gap can be seen in terms of paly materials available for under 5 children in rural and urban settings. Remote rural areas in this region need a well framed parenting program to sensitise parents about Early Child Development that can be blended with the existing ICDS program

Accreditation of public health education in India: Enhancing quality, competence and trust.

With an increase in the number of institutes offering public health education, there is a need for discussion on future directions and challenges. The World Health Report 2006 identified the need to improve the quality of public health education. There are various mechanisms and bodies that look after accreditation issues in several countries. The Council on Education for Public Health in the USA assists in the accreditation of schools of public health, as well as public health programmes. The Australian Network of Academic Public Health Institutions is actively engaged in discussions to improve the quality of its programme and institutions. In Europe, the European Agency for Accreditation in Public Health Education is responsible for accreditation. The South-East Asia Public Health Education Institutes Network facilitates accreditation of public health education in the region. In India, public health education varies across institutes. India needs an accreditation system to ensure that public health education is of the desired quality. Certain initiatives, such as conferences, consultation and the Calcutta Declaration, have been taken in the past two decades. However, the ideas mooted have yet to be translated into reality. The broad framework for accreditation may entail an institutional self-assessment against set standards, preparation of a database, cataloguing, and site visits by a peer team. There is a need for an apical body with all stakeholders participating in the process. Accreditation has specific benefits, but there are critical challenges as well. For example, the autonomy of the institutions needs to be protected, the accreditation bodies should exhibit professionalism and substantial financial resources are required. Before tackling specific criteria for accreditation, it is necessary to define a collective vision for schools of public health in India.

Role of Ghrelin in regulation of growth hormone secretion by Ghrelin-Pituitary-GH axis linkage.

Background: Ghrelin is the endogenous ligand of the growth hormone (GH) secretagogue receptor and is the first hormone linking gastrointestinal-pituitary axis. Actions of ghrelin on GH secretion provide a strong force for envisioning that one of the major role of ghrelin could be the regulation of secretion of GH. Aims & Objective: To explore the intriguing dimensions on the possible physiological role of the Ghrelin /GHRP system. Materials and Methods: The search was performed in electronic databases (Medline, Embase, Cochrane, Google scholar) and by hand searching by 2 reviewers. Clinical trials (Randomised and non-randomised trials), review articles, systematic reviews, conference proceedings and meta-analysis were included in the study. Results: Ghrelin stimulates strong increase in circulating GH levels both in vitro and in vivo in a dose-dependent manner. Human or animal ghrelin was found to be significantly more potent than a synthetic GHS, hexarelin. The regulation of GH by Ghrelin is influenced by various other factors like autonomic nervous system, GHRH, IGF-1, anterior pituitary hormones, obesity, etc. Conclusion: Ghrelin is a specific endogenous ligand for the GHS receptor and suggests the existence of a GHS–GHS receptor signaling system in the regulation of GH secretion. Stomach-ghrelin - pituitary-GH axis links nutritional intake to regulation of GH secretion. However, the mechanism underlying the feedback actions of GH on the regulation of ghrelin remains unanswered. Under physiological conditions, ghrelin administered either centrally or peripherally, exerts a potent, time-dependent stimulation of pulsatile secretion of GH by ghrelin-pituitary-GH axis.

Prevalence and determinant of early childhood caries among the children attending the Anganwadis of Wardha district, India.

Background: Dental caries is one of the most common chronic diseases of early childhood. Dental problems in early childhood have been shown to be predictive of future dental problems, growth and development by interfering with comfort, nutrition, concentration, and school participation. Aim: To find out the prevalence of Early childhood caries (ECC) among the children attending the Anganwadis of Wardha district, to determine the feeding habits and their relationship to early childhood caries. Materials and Methods: Community-based cross-sectional study among the selected Anganwadis children of 2-5 years of Wardha district. Result: A total 330 subjects, 105 children were found to be having ECC, 47 (30.92%) males and 58 (32.58%) females. Total 215 children belonged to 43-60 months age group. Out of these, 72 (33.48%) children were having ECC. A significant association was found between the history of bottle-feeding and ECC (P = 0.0218). Prevalence of ECC was more among those who were bottle-fed than those who were not bottle-fed. Conclusion: Future health promotion and education programs in Anganwadis should include oral health issues and the risk factors for ECC, and its consequences should be addressed. Public-funded oral health program should be started and targeted at children from lower socioeconomic status. Effective strategies should be developed to promote use of brush and paste for cleaning teeth and discouraging inappropriate bottle-feeding, discouraging on demand consumption of chocolates and sugars.

Predictors for antenatal services and pregnancy outcome in a rural area: A prospective study in Wardha district, India.

Background :Antenatal care is essential to reduce morbidity and mortality among newborn babies and pregnant women. Aims: To study the pattern of utilization of antenatal services and to find out the potential predictors, their distributions and their association with antenatal care utilization and pregnancy outcomes. Settings and Design :A prospective longitudinal study was conducted in Deoli, a rural teaching area of a medical college of Wardha district, Maharashtra state. Materials and Methods : Medical social workers contacted all the registered 305 pregnant women in 1 month. A total of 274 women were included in the study. The response rate was 89.83%. Statistical Analysis Used : Percentages, rate ratio. Results : Mean age at marriage was 19.8±3.6 years, and the average age at first pregnancy was 21.6± 4.5 years. Of the 274 pregnant women, 156 (56.9%) were pregnant for the first time (gravida 1), and the remaining 118 (43.1%) pregnant women, gravida 2 and above, had an average of 2.1 living sons and 1.9 living daughters. Only 92 (33.6%) women had undergone the minimum recommended antenatal checkup during their current pregnancy, and 188 (68.6%) women had institutional deliveries. A large proportion of women in Deoli do not receive proper health care during pregnancy and childbirth. Conclusion : In Deoli, antenatal services, in spite of being essential to the care of pregnant women, are being poorly delivered.