Depression, anxiety, stress, and stressors among rural adolescents studying in Pune and a rural block of Nanded district of Maharashtra, India

Adolescent population is the major demographic and economic force of a nation. Adolescent mental health not only affects overall health at present but also in future life. In this cross-sectional study, 461 rural adolescent students studying in Pune city and the rural area from a block in Nanded district, Maharashtra, were administered a prevalidated, pretested Marathi depression anxiety and stress scale-21 tool including correlated factors to assess the magnitude of depression, anxiety, and stress and its stressors. The prevalence of depression, anxiety, and stress among these students was 54%, 60%, and 44%, respectively. Rural students in Pune city were having significantly higher levels of stress than the students studying in the rural area. Disturbed family, harsh parenting, past adverse event experiences, negative feeling about academic performance and tobacco use were significantly associated with higher rates. Findings indicate that the mental health status of these students is alarming needing prompt measures.

Evaluation of Janani Suraksha Yojana (JSY) in Maharashtra, India: Important Lessons for Implementation.

Aims: The study was conducted to estimate the proportion of eligible women for Janani Suraksha Yojana and to understand the factors affecting receipt of benefits in Maharashtra State, India. Methodology: It was as comparative observational study conducted in Maharashtra State having a population of 112.37 million. Each district was divided into five strata tribal, rural, Municipal Council, slum and non-slum in Municipal Corporation. In each district about 2400 household were surveyed comprising proportionate quotas from each stratum. Surveying unit from each stratum was randomly selected. The study population consisted women delivered in 2008-2009 year. Firstly Head of household was interviewed for confirming child delivery in the reference period. Then delivered woman was interviewed for checking eligibility to JSY and then details of receipt of benefits were obtained from her. Receivers and non-receivers of benefits were compared with respect to some variables. The study was undertaken with the help of Community Medicine Department from Government Medical Colleges. Results: In the reference period 4,544 women delivered children and 41.15% were found eligible for the scheme. But only 52.57% certainly received cash benefits. About 24% surely did not receive and 23% were not sure about receipt or the scheme and hence included in non-receiver group for further analysis. Non-earning women, not delivered in public health care institutions and un-aware about the scheme were unlikely to receive the benefits. Ante Natal Care visits, immunization, receipt and consumption of Iron and Folic Acid tablets were better among beneficiaries then non-receivers of the benefits. The benefits were not received immediately after delivery. About 10% women had problems in receiving the benefits, particularly requirement of certain certificates. Conclusion: The uptake of the scheme may be slightly higher than 53% and there are many factors responsible for not reaching to entire eligible population. Modifiable risk factors like delivery in government health institution and awareness about the scheme are playing major role in receiving the benefits.

Community Based Monitoring under National Rural Health Mission (NRHM) at Village Level in the State of Maharashtra, India.

Background: Government of India, under National Rural Health Mission has established Village Health Sanitation Nutrition Committees (VHSNCs) and appointed Accredited Social Health Activists (ASHAs) in all the villages. Government of India also started Community Based Monitoring (CBM) project through Non-Governmental Organizations (NGOs). State of Maharashtra was one of the nine states selected for implementation of the pilot project. Objectives: To assess the effect of training and implementation of CBM on Knowledge, Attitude and Practices of VHSNC members including ASHAs. Design: It is a descriptive study using comparison group. Settings: The study was carried out in 90 villages, 45 each from study and comparison group, in the State of Maharashtra, India. Interventions: The study was conducted with the help of the Community Medicine Departments from nearby Medical Colleges. From each village one ASHA and three members of VHSNC were interviewed. An assessment instrument was developed having some parameters. Based upon responses to each parameter, a scoring system was also developed. Then comprehensive score was calculated for each respondent. Main Variable: Comprehensive score obtained by the interviewed individual was studied. Results: Only 41% ASHAs and 28% VHSNC members were trained in CBM by the concerned NGOs. The Mean score of ASHAs’ was 7.52. The mean score was 6.55 for trained members of VHSNC and 5.00 for un-trained members. Discussion: The interviewed members were lacking in core areas. The members are not ready to take ownership and to monitor services. Conclusions: The training and implementation of CBM did not have any difference in awareness and active participation of ASHAs. This may be due to improper coverage of training. The training helped VHSNC members in improving score but actual implementation of project did not improve the score.

Impact of single round of indoor residual spray with lambda-cyhalotrin 10% WP on Plasmodium falciparum infection in Akola district, Maharashtra State.

Lambda-cyhalothrin 10% WP (ICON 10WP) was sprayed from 5th November 1997 at a dose of 25 mg/m2 as indoor residual spray in 74 high risk villages. The spray was completed within 10 days in most of the villages. The monthly entomological monitoring showed nil density of Anopheles culicifacies and Aedes and very low density of non-vector Anopheles and Culex. The impact of Lambda-cyhalothrin spray was discernible right in the month of November 1997 showing 52% reduction in P. falciparum cases as compared to the same month of preceding year. The reduction of P. falciparum cases in three months post-spray period was 77% (from 47 cases to 11 cases) as compared to similar months of preceding year and overall reduction of total malaria cases was 50% during the same period. Since the major part of transmission of P. vivax infection was over by the time Lambda-cyhalothrin spray was taken up, obviously the impact on P. vivax infection was not markedly high as compared to P. falciparum infection. Neither cerebral malaria cases nor deaths due to malaria were recorded in the sprayed villages.

Social classification and maternity practices in Aurangabad, India.

A population of 3870 individuals constituting 823 families residing in five different localities of Aurangabad city was surveyed by house to house visits. The objectives of the study were to assess the validity of social classification by residence in certain localities. The variable used in the study was maternity practices. Family members and children under five years of age were recorded. Mothers of children were asked occupation of the head of the family and delivery details pertaining to these children. Social class was decided by residence in particular localities of the city, classified according to easily ascertainable characteristics of housing. Validity of such classification was judged by comparing it with classification by well known variable like occupation. The findings indicate that the system provides an inexpensive and rapid method of social classification. A total of 661 deliveries were recorded. A total of 67.62% deliveries were conducted in Government or Private Institutions. The remaining deliveries were home deliveries conducted by untrained personnel. Indigenous dais (traditional birth attendants) conducted 20.27% and senior female relatives 10.89% of the total deliveries. The findings, thus, stress the need of identifying and training dais in urban areas.