Background:The under-five children are a vulnerable age group; their mortality reflecting a country's overall development. Timely and appropriate healthcare seeking behavior, if practiced by caregivers, can have a significant impact on survival. The slum dwellers have poor health-seeking behavior due to their lower socioeconomic status, prevailing malnutrition, poor immunization status, overcrowding, poor sanitation, personal and cultural practices, beliefs, and attitude toward healthcare providers.Objectives:(1) To assess the health-seeking behavior among caregivers of under-five children during acute childhood illness (2) To find out the factors associated with their treatment-seeking behavior.Materials and Methods:A community-based cross-sectional study, among 260 caregivers, in the field practice area of Urban Health and Training Centre of a medical college was undertaken from September 1, 2016 to February 28, 2017, using a pretested semistructured questionnaire after obtaining a list of under-fives from the female health worker.Results:In total, 260 caregivers with mean of 26.61 ± 4.31 years participated in the study, 77.69% reported of some health morbidity. Around 21.92% of the caregivers gave primary care at home, 33.46% visited a chemist, and 33.08% attended health facility nearby. About 79.23% sought healthcare immediately following illness. Of the remaining 20.77% who did not seek medical advice, 75.93% used home remedies. Significant association was found between the age of the mother, educational status of the mother, religion, birth order of the child and socioeconomic status of the caregivers, and appropriate treatment seeking behavior during an episode of acute illness.Conclusion:This study attempted to identify health-seeking behavior of caregivers for children under-five and the determinants of appropriate treatment-seeking behavior. The knowledge of signs and symptoms of ill-health can reduce morbidity and mortality; however, continuous education of caregivers for recognition of symptoms and the need to seek appropriate medical care is needed. Government facility was the preferred choice for the population in the sampled slum. Treatment-seeking behavior was good among the respondents with majority having appropriate behavior. Measures can be taken to help promote awareness among those who did not have appropriate treatment seeking behavior.

Background: Multidrug resistance has emerged as a challenge in health care settings. Again increasing prevalence of multidrug resistant (MDR), extensively drug resistant (XDR) and pan drug resistant (PDR) gram negative bacteria is making the condition more critical because of limited options of antibiotics, increasing morbidity, mortality and hospital stay of the patients. The present study is carried out with an aim to estimate the prevalence of MDR, XDR, PDR gram negative bacteria in a tertiary care hospital.Methods: Total of 912 gram negative bacterial isolates obtained from various samples of indoor patients in a tertiary care hospital, were studied over a period of six months. The bacteria were identified by conventional methods. Antibiotic sensitivity testing was done by Kirby Bauer disc diffusion method. Minimum inhibitory concentration (MIC) of antibiotics for the resistant isolates were detected by Vitek-2 automated method. MDR, XDR and PDR were determined according to the definitions suggested by European Centre for Disease Prevention and Control (ECDC), and Centers for Disease Control and Prevention (CDC). Prevalence of extended spectrum beta lactamase (ESBL) producers was estimated.Results: Out of 912 isolates, prevalence of MDR, XDR and PDR were 66.12%, 34.32% and 0.98% respectively. Prevalence of MDR and XDR were higher in ICUs than clinical wards (p<0.0001). Prevalence of ESBL producers was 48.4%.Conclusions: The study highlights increased prevalence of multidrug resistant and extensively drug resistant strains in our hospital. Stringent surveillance, proper implementation of hospital infection control practices and antimicrobial stewardship will help in limiting the emergence and spread of drug resistant strains.

INTRODUCTION:Breast milk provides nutritional, immunological, behavioral, and economic benefits and helps to build mother-infant bonding. Antenatal mothers need to be sufficiently aware about the benefits of breastfeeding.OBJECTIVES:The aim of this study is to assess the awareness and perception of breastfeeding among antenatal mothers and to find out any association between sociodemographic factors and breastfeeding awareness.METHODOLOGY:A cross-sectional study was conducted among 250 antenatal women residing in the urban slums of field-practice area of urban health and training center; using a predesigned, pretested, semi-structured interview schedule. Antenatal checkup followed by one to one counseling for the women regarding breastfeeding was provided. Data were represented by frequencies, proportions, and associations using Chi-square, and the P < 0.05 was considered statistically significant.RESULTS:Most (55.6%) of the women were in the age group of 18–24 years. The mean age at marriage was 19.2 ± 2.5 years. 81.2% of them were Hindus, 13.2% had adequate, 49.6% had moderately adequate, whereas 37.2% women had inadequate awareness about breastfeeding. About 100% intended to breastfeed their children, but only 64% said that they intended to exclusively breastfeed. 66.4% knew about the importance of colostrum. Age-group, religion, literacy, occupation, type of family, gravida, and number of antenatal visits showed highly significant (P < 0.001) association with awareness of breastfeeding.CONCLUSION:Nearly one-third of the antenatal mothers lacked awareness on breastfeeding practices. Although all intended to breastfeed, still only 64% knew about exclusive breastfeeding. These gaps need to be addressed by awareness generation activities during antenatal counseling.

Background:India records 5 lakh child-deaths annually due to vaccine preventable diseases. As a strategic endeavor, the Ministry of Health and Family Welfare, Government of India, launched Mission Indradhanush in December 2014 to achieve more than 90% full immunization coverage by the year 2020.Objectives:To assess the awareness of the respondents about Mission Indradhanush, to assess their attitude and practices regarding childhood immunization, and to determine the association between knowledge and practice with selected variables.Materials and Methods:A cross-sectional study was undertaken from June to September 2017 among mothers with children aged 12–23 months in urban slums under field practice area of Community Medicine Department, Kalinga Institute of Medical Sciences, Bhubaneswar.Results:Mean age of the children was 17.23 ± 3.43 months; 65% were males and 35% females. Mean age of the respondents was 24.48 ± 3.97 years; 68% were literate and 94% were Hindus. Majority (76%) belonged to upper-lower Kuppuswamy socio-economic status scale. Only 10% had heard about Mission Indradhanush; health worker (90%) being the most common source of information. A total of 91% believed that vaccination prevented disease. A total of 96% believed that immunization was important for their children. A total of 73% had the maternal and child protection card with them. A total of 72% of children were fully immunized. Of the 28% partially vaccinated children, only 12.5% had heard about Mission Indradhanush. Reasons stated for partial immunization were mother too busy, child illness, and lack of information.Conclusion:Very few participants had heard about Mission Indradhanush in this study although most of them were aware of immunization services. Strengthening of Information, Education, Communication (IEC) activities regarding the program—Mission Indradhanush—needs attention. The immunization coverage was satisfactory.

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