Profile, Quality of Life and the Client Satisfaction of Beneficiaries Registered under Rashtriya Bal Swasthya Karyakram (RBSK) at an Urban Primary Health Centre, Ahmedabad: A Retrospective Cohort Study.

Background: Under Rashtriya Bal Swasthya Karyakram (RBSK), children (0-18 years) are screened for a spectrum of 30 health conditions, categorized under 4D's namely defect (birth), disease (chronic), deficiency disorders, and developmental delay, and referred for treatment at higher centers. The aim of this study is to document demographic, clinical profile of children detected with any of 4D's during 2018-20 at one Urban Primary health center to assess their Quality of Life (QOL) and client satisfaction. Materials and Methods: A total of 102 children <18 years were selected as per Probability Proportionate to Size for different 4D's; within each category required participants were selected randomly. Information was gathered on designed semi-structured proforma. For QOL, customized World Health organization Quality of Life Brief (WHO-BREF) Questionnaire tool was used. Client satisfaction about the RBSK was assessed among RBSK users (N = 46) with Likert scale. Result: Out of 102 cases, 97 were covered including 8 with more than 1 type of 4Ds. Majority beneficiaries were male (53.1%), from 5 to 10 years age (43.8%), and middle social class (52%). Congenital defects (48.5%) especially heart defects were the most common followed by deficiency disorders (40.2%) mostly severe anemia and/or severe acute malnutrition. Out of 46 who availed RBSK services, 82.6% rated service as very good or good. Most children (81.7%) had good QOL. Conclusion: Most detected 4D's belonged to school going age and middle class. They rated program as very good or good. Congenital defects, specifically heart defects were the most common. Overall, most children (81.7%) had good QOL.

An Outcome-Based Follow-up Study of Cured Category I Pulmonary Tuberculosis Adult Cases from Various Tuberculosis Units under Revised National Tuberculosis Control Program from a Western Indian City.

CONTEXT: Despite the nationwide implementation of the Revised National Tuberculosis Control Program in India, adverse outcome after treatment is on rise. Program guidelines propose follow-up of cured patients for 2 years which is rarely done. OBJECTIVES: The main objectives of this study is (1) To find the response of treatment in terms of failure and drug resistance (recurrence of symptoms and mortality experience) and (2) Collect client perspective about the program and suggest the same to program managers. SUBJECTS AND METHODS: Community-based tracking of 365 cured adult Category I pulmonary tuberculosis (TB) cases drawn from three nearby TB units was done with a structured designed questionnaire. It was done to record the adverse events after 1-3 years of completion of treatment and also to record the client perspective about the program. In case of nonsurvivors, verbal autopsy was conducted by interviewing the next available relative. RESULTS: A total of 365, only 226 (60%) could be covered mainly due to wrong/incomplete address and 35 cases did not survive. Of 191 survivors who were tracked, 94.7% had sputum microscopy at the completion of treatment. Total 54 (23.9%) cases had adverse outcomes, including 31 with symptoms suggestive of TB and 23 died directly/indirectly due to TB. This cohort of cured cases, posttreatment, observed 15 times (annualized) high mortality than their counterparts. Clients or relatives largely rated the program as good/very good. CONCLUSIONS: Post-treatment tracking is must to detect an adverse outcome which is high. Most survivors and relatives of expired cases rated the program as good to very good.