The paper outlines the development and assessment of a screening test for broad-based identification of major disabilities in children under 6 years of age. The Disability Screening Schedule (DSS) has been developed which should act as a one time screen for all major disabilities viz. physical, motor, sensory and mental retardation. The DSS was developed after reviewing a number of existing screening instruments. It was pilot tested in 3 phases and suitably modified. Nineteen AWW received a short training and used the DSS to screen children with disabilities in their respective areas. It was field tested by administering it on 3560 children (0-6 years) drawn from nine urban slums of South Delhi. The workers used the DSS and identified 245 children as having an impairment/at risk conditions and 3315 children were reported as normal. The investigator cross checked 219 'impaired' and 536 'normal' children. On the basis of the review exercise, the DSS was validated and was found to have a sensitivity of 0.89 and a specificity of 0.98. The DSS is a short questionnaire, and the administration time is about 5 minutes.
Abstract-Reducing maternal mortality has been a constant struggle globally. Although developed regions have shown a steep decline in maternal deaths, developing world continues to contribute inordinately to the total maternal deaths. The Millennium Development Goal (MDG) 'five' focused on reducing maternal mortality and achieving universal access to reproductive health care. In lieu of that, India has made extensive efforts to achieve the same, which are visible through the sharp increase in the rate of institutional births (NFHS 4), but the concurrent high incidences of maternal mortality present a contradictory picture of the nation's progress in improving maternal health. Despite of the boom in the medical and health sector that India has witnessed in the past decades, progress in reducing maternal mortality at the national level is disappointing. With new Sustainable Development Goal (SDG) to reduce maternal mortality ratio to 70 per 100,000 live births by the year 2030, India needs to move beyond the hospital-based approach in addressing the reproductive health issues. The determinants of maternal mortality need to be studied through the lens of social phenomenon to understand its multidimensional nature. The present review, thus, briefly explores the available evidences to determine the causes of maternal mortality operating from proximate to distant level.
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