Information, Education, and Communication Services in MCH Care Provided at an Urban Health Center

Assessing the Utilization of Postnatal Services Among Mothers: A Cross-Sectional Study

BACKGROUND

Women in the postnatal period are a special group with a high risk to health. Providing good quality postnatal care can help reduce maternal morbidity and mortality and improve the quality of life. The objective of the study was to assess the utilization of the postnatal services provided to mothers and to find the factors affecting the utilization of these services.

MATERIALS AND METHODS

A cross-sectional study where 154 mothers from Patiala were interviewed regarding postnatal services using a pretested semi-structured questionnaire.

RESULTS

A total of 92.9% of mothers (95%CI=88.76-97.04) availed postnatal care with a multi-purpose health worker-female (MPHW-F) and an accredited social health activist (ASHA (U)) as the main providers. Only 47.4% of mothers (95%CI=39.35-55.45) had visited a doctor for a postnatal check-up. Mother's education, type of family, place, and type of delivery were significantly associated with the number of visits to the doctor during the postnatal period. Thirty-nine (25.3%) mothers (95%CI=18.3-32.3) reported a health problem in the period, out of which only 32 mothers had taken treatment for their health problems. Mothers who were visited by MPHW-F in the postnatal period had fewer morbidities as compared to those who were not visited by MPHW-F (χ2=7.697; df=2; p value=0.02).

CONCLUSIONS

Working women with cesarean section delivery in the private sector reported more utilization of postnatal services. These women had higher education levels and belonged to joint families. More visits by MPHW-F were associated with fewer health problems. A multi-pronged approach, targeting individuals, families, and communities, may be necessary to improve postnatal care service utilization rates.

Evaluation of input and process components of quality of child health services provided at 24 × 7 primary health centers of a district in Central Gujarat

CONTEXT

With the critical Indian challenge on child survival and health, time is ripe to initiate focus on quality of services apart from measuring coverage, to bring about improvements.

AIMS

To assess the quality of child health services provided at 24 × 7 Primary Health Centers of Vadodara District in Gujarat in terms of Input and Process Indicators.

SETTINGS AND DESIGN

The study was carried out in 12 randomly chosen 24 × 7 Primary Health Centers (PHCs) of Vadodara district using a modified quality assessment checklist of the Program on District Quality Assurance for Reproductive and Child Health (RCH) services with use of scores from May 2010 to June 2011.

SUBJECTS AND METHODS

Inputs assessment was done by facility survey. Process assessment for the four child health service components used actual observation of service, review of records and interview of service providers and clients.

RESULTS

The mean obtained score for facilities in Input section was 65%. Highest score was obtained for Drugs and Consumables (86%) followed by Equipments and Supplies (74%). The score obtained for Infrastructure facility was 65%, Personnel and training was 56% and Essential protocols and guidelines scored 43%. The mean obtained score in the process section was 55%. Highest scores were obtained for immunization at 76%. This was followed by newborn care (52%), growth monitoring (52%). management of sick child (41%).

CONCLUSION

Quality improvement efforts should focus not only on resource-intensive structural improvements, but also on cost-effective measures at improving service delivery process, especially adherence to service guidelines by providers.

The health information seeking behaviour and needs of community health workers in Chandigarh in Northern India

This article represents two-firsts for the feature--it is the first to report on a study outside the UK and the first to examine the health information needs of community health workers. Sonika Raj is pursuing PhD at the Centre for Public Health, Panjab University, Chandigarh, in India and she conducted her research in Chandigarh. The article outlines the important role that health workers at community level play in determining health outcomes in the developing world, including Chandigarh. It demonstrates that while those workers recognise their information needs, there are many issues affecting their ability to access health information effectively, not least their limited access to appropriate technology and training. AM.

Quality of antenatal care in primary health care centers of bangladesh

OBJECTIVE

To find out the quality of ANC in the Upazila Health Complexes (PHC centres) of Bangladesh.

MATERIALS AND METHODS

This cross sectional study was done in purposively selected three upazilas among the clients receiving antenatal care (ANC). Data were collected with questionnaire cum checklist in the context of two aspects of quality issues, namely assessment of physical arrangements for ANC (input) and services rendered by the providers (process).

RESULTS

The mean age of respondents was 24.6±4.5 years. Majority of the respondents were with primary level education (60.3%). About half (52.8%) of the families had monthly income ranging from 3000-5000 taka (38-64 US$). Nearly half (48.9%) had no child, little more than one third (42.3%) were primigravida and 528 (57.7%) were multigravida. Out of 528 multigravid respondents 360 (68.2%) took ANC in their previous pregnancy whereas 168 (31.8%) did not take ANC Pregnancy outcome was found to be associated with receiving ANC (χ(2)=73.599; p=0.000). Respondents receiving ANC had more good pregnancy outcome. The mean waiting time for receiving ANC was 0.77±.49 hours. Out of the 13 centers, only 3 (23.1%) have sufficient instruments to render ANC services. Findings showed that where the modes of ANC service delivery in the ANC centers are fairly satisfactory. Though some of the points of standard operation procedures (SOPs) on ANC are not covered by some ANC centers, those were not considered necessary. But, regarding the physical facilities available for rendering ANC services, it is seen that facilities are not quite satisfactory. Number of doctors and nurses are not very satisfactory. One of the centers under this study has no doctor, where ANC services are given by nurses.

CONCLUSION

It can be concluded that the ANC services at the primary health care level is not adequate in Bangladesh. To ensure further improvement of the quality of ANC services, instruments used in logistics and supplies should be enhanced.