Knowledge of Maternal and Newborn Care Among Primary Level Health Workers in Kapilvastu District of Nepal.

BACKGROUND: Higher maternal and neonatal deaths are common in low- and middle-income countries; due to less access to skilled help. Adequate knowledge and skills on maternal and newborn care (MNC) of community health workers can improve maternal and newborn health. AIMS: To identify the knowledge of primary level health workers on some components of MNC. SUBJECTS AND METHODS: Respondents were selected using simple random sampling method. For collecting the data, enumerators visited health institutions for 2 months from 1(st) October to 31(st) November 2012, and structured interview schedule was used to gather the information. A cross-sectional study was conducted in a total of one hundred and thirty-seven primary level health workers in Kapilvastu district, Nepal. The Chi-square test was employed to examine the association between the knowledge of health workers on MNC and designation and work experience. Data were analyzed using SPSS version 17. RESULTS: In a total of 137 primary level health workers, more than half 53.2% (73/137) were senior auxiliary health workers/health assistant. Health workers having correct knowledge on contents of MNC were-registration 32.1% (44/137), major components of antenatal care 57.7% (79/137), danger signs of pregnancy 39.4% (54/137), five cleans 59.1% (81/137), postnatal health problems 54.0% (74/137), majority to health action to newborn care, newborn bath and meaning of exclusive breastfeeding. There was a statistical association between designation of health workers and above-mentioned components of MNC (P < 0.05). CONCLUSIONS: The differentials in the knowledge of MNC among primary level health suggest improving knowledge of the grass root level health workers with appropriate training and development programs.

People's perspective on access to health care services in a rural district of Nepal.

INTRODUCTION: Over the past several decades, Nepal has attempted to increase the access of health care services, however progress toward achieving high coverage of health care services in rural communities is still low. Therefore this study attempts to provide a perspective on access to basic health care services in government health facility. METHODS: Descriptive cross-sectional study with quantitative and qualitative methods was designed and applied to identify the access to health care services. The study population were people who were sick within three months prior to the study where basic sampling unit was household. Total sample size was 96 through the application of simple random sampling method. Bivariate analysis with 95% confidence interval was used to identify the association of variables with access to health care services. RESULTS: Among the total population, 28% of households in the study area received health care services at government health facility. The reasons for not accessing health care were insufficient drugs (61%), distance (22%), staff unavailability (19%), sickness (9%), money (7%), and facility hours (4%). Sex, ethnicity and distance were found significantly associated with access to health care services. CONCLUSIONS: Less than one third of households had access to health care services in government health facility. Addressing the important factors such as drug problems, staff unavailability, long distance to health institutions and inconvenient health facility hours may help to increase access to health care services at government health facility.

Development of bronchus-associated lymphoid tissue in goats.

Development of bronchus-associated lymphoid tissue (BALT) was studied in clinically healthy and diseased Assam local goats. Animals were sacrificed before term as well as at different postnatal periods to screen lung sections for the presence of BALT. In a retrospective study sections prepared from pneumonic lungs were examined for any alteration of BALT. No BALT-like structure was found in neonatal goats. Bronchial lymphoid structures appeared in half of the animals from 1 month of age onward. The frequency of the BALT/4.5 cm2 of lung section ranged from one to two in 1-month-old and three to six in 1-year-old goats. In pneumonic lungs BALT became hyperplastic, and the size was also increased. The incidence of BALT was increased in lungs with fibrotic pneumonia. The number of BALT/section was high (five to eight/4.5-cm2 area) in mesenchymal cell proliferation. The present study shows that BALT did not develop in prenatal periods. But in the presence of potent antigens lymphoid aggregates appeared in the bronchial lamina propria of normal and diseased lungs.