Nutritional Status of Under-five Siblings of Severely Wasted Children in Bhopal.

OBJECTIVE: To study the prevalence and associated factors of undernutrition in siblings of children with severe acute malnutrition (SAM). METHOD: It was a community-based cross-sectional study of under-five year siblings of children with SAM. RESULTS: A total of 128 under-five years siblings were studied, 30% had SAM whereas 20% had moderate acute malnutrition (MAM). More than 7 members in a family (OR=4.23, CI 1.9-9.6, P<0.001), underweight mothers (OR=5.2, CI 2.08-13.0, P<0.001), children who received pre-lacteal feeds (OR=3.24, CI 1.33-7.87, P=0.007), and Muslim religion (OR=4.44, CI 1.78-11.1, P<0.001) were significantly associated with finding of another child with SAM in the family. CONCLUSION: There was high proportion of severe malnutrition in siblings of children with SAM. Consideration should be given to actively screen all under-5 children in the family of a newly diagnosed child with SAM for undernutrition.

Prescription Audit of Treatment of Diarrhoea and Pneumonia Amongst Paediatrician In Bhopal.

BACKGROUND: A prescription by a doctor may be taken as a reflection of physician's attitude to the disease. Inappropriate prescription has always been a serious problem in developing countries. OBJECTIVES: The objective was to observe the current prescription practices for the management of diarrhea and pneumonia in Bhopal. SETTINGS AND DESIGN: This was a cross-sectional study. MATERIALS AND METHODS: The study was conducted at the clinics and hospitals of Bhopal over 4 months. The prescription of under-5 children with a diagnosis of acute respiratory tract infection and/or acute gastroenteritis attending the outpatient departments was included in the study. Data were recorded and analysis was done. STATISTICAL ANALYSIS USED: Epi Info was used for statistical analysis. RESULTS: A total of 513 prescriptions of pneumonia and 417 of diarrhea were observed under the study. Among pneumonia, signs were mentioned on 15.6%, 74% as cold and cough with 95.5% prescriptions with antimicrobials. Seventy-three percent of diarrhea prescriptions did not mention any signs. Oral rehydration salt and zinc were prescribed in majority of the prescriptions along with around 64% use of antibiotics as well for the treatment of diarrhea. CONCLUSION: There is a huge need of improvement in prescribing patterns in areas of complete prescriptions with clinical features, follow-up advice along with rational choice of drugs with dose, and duration.

Addressing Maternal Mortality in Selected Districts of Madhya Pradesh, India - A Human Rights-based Approach.

BACKGROUND: Maternal mortality is an indicator of state of maternal health services, status of women, women's health, and above all developments of nation. OBJECTIVES: The objectives of the study were to identify the patterns and causes, medical as well as sociocultural, of maternal death as well as consider and list out the rights realization perspective of the mothers, their immediate families and the community at large. MATERIALS AND METHODS: A cross-sectional study was conducted in three districts of Madhya Pradesh, India, for 1 year. One hundred and two maternal deaths were covered, and verbal autopsy was conducted. Human right perspective was assessed using questionnaire. RESULTS: Majority (64.7%) of maternal deaths occurred between 18 and 25 years of age. About 50.9% were primigravida, and postpartum hemorrhage was the most common cause. Nearly 53.9% had visited more than one facility before death. CONCLUSION: Poor antenatal care and lack of human resources posed major reasons for death in all facilities. Rights realization among the beneficiaries was found to be very poor.

Comparison of Performance of Digital Hemoglobinometer over Automated Hematology Analyzer for Hemoglobin Estimation and Its user-friendliness among the Pregnant Women in Selected District Hospitals of Madhya Pradesh.

CONTEXT: There is a need for a simple screening method for the detection of anemia that can be used by public health workers in the field. AIMS: The aim of this study was to compare two methods for hemoglobin estimation, i.e., automated hematology analyzer and Digital Hemoglobinometer, and to find out the sensitivity and specificity of Digital Hemoglobinometer for the estimation of hemoglobin. SUBJECTS AND METHODS: A hospital-based cross-sectional study was carried out for 6 months from April to September 2017 in a District Hospital of five High Priority Districts of Madhya Pradesh. Two hundred and sixty antenatal females per district were selected for the study. RESULTS: The mean hemoglobin by autoanalyzer is 10.19, and that by Digital Hemoglobinometer device is 9.89. Overall, sensitivity of Digital Hemoglobinometer for hemoglobin estimation was calculated to be 89.4% and specificity was calculated to be 63.6%. Positive predictive value was found to be 82.6% and negative predictive value was 75.8% compared against AutoAnalyser (gold standard). CONCLUSIONS: As the Digital Hemoglobinometer device has high sensitivity and specificity and good diagnostic accuracy, it must be used at the community level in resource-poor setting for hemoglobin estimation. In primary health-care conditions, Digital Hemoglobinometer can significantly reduce misdiagnosis of anemia compared with clinical assessment alone.

How Non Consumers Differ from Consumers: A Qualitative Approach to Synthesize the Attributes of Iron Folic Acid End Users.

INTRODUCTION: Anaemia continues to be a major hurdle to achieve optimum health in Indian population context. Although government continues to promote Iron Folic Acid (IFA) supplementation as one of the key strategies to combat with burden of anaemia, the expected level of IFA consumption and subsequent anaemia reduction could not be achieved. This study tries to investigate those influences, concerns, experiences and behaviour from an end user perspective through a qualitative methodology which may affect the IFA consumption ambi-directionally. AIM: To explore and understand the several aspects related with anaemia and IFA supplementation with special emphasis to reveal the contributory factors behind low level of IFA consumption at consumer end. MATERIALS AND METHODS: A community based qualitative study was conducted in clusters identified through multileveled stratification from a state of central India. A conceptual construct was made in priory for this study. As the research question was related with policy, this study adapted a framework technique for making interview topic guides. Two consumers and two non consumers from each identified cluster were interviewed in depth. The data obtained through 160 in depth interviews (from 80 consumers and 80 non consumers) was utilized for thematic framework, linkage association and to typify the phenomenon. RESULTS: Ignorance, difficult intake, meaninglessness, misconceptions and discontentment with the system were the major dimensions (sub themes) associated with discontinuation. All these sub themes were further converged into major theme of informational discontinuity. Investigators further typified the users/non users into persistent user, potential defaulters, impending defaulters and absolute non users. CONCLUSION: Informational gap seems to be the fundamental factor behind sub optimum IFA consumption. On a policy perspective, all the attempts should be done to instigate arise felt need' among target groups for IFA consumption.