Background: Six diverse Demographic Development and Environmental Surveillance System (DDESS) sites were established in urban slum, urban resettlement, peri-urban, rural, and tribal areas located in Northern, North-East, Eastern, and Southern regions of India from June 2020 to March 2022. Understanding the community dynamics and engaging people in the community is critically important in the process of establishing DDESS. We ascertained the barriers, challenges, and facilitators during the establishment of multiple DDESS sites across India. Methods: This was a cross-sectional descriptive mixed-methods study. Results: Multiple barriers and challenges encountered were reported in the process of community engagement (CE), such as geographical inaccessibility, language barriers, adverse weather, non-responsiveness due to perceived lack of individual benefit or financial gain, fear of contracting COVID-19, COVID-19 vaccine hesitancy, etc. Facilitators in the CE process were pre-existing links with the community, constitution of community advisory boards, community need assessment, concomitant delivery of outreach health services, and skill-building facilities. Conclusion: Most community barriers in the development of DDESS sites in resource-limited settings can be overcome through a multipronged approach, including effective community engagement by focusing on demonstrating trust at the local level, enlisting community mobilization and support, utilizing pre-existing community linkages, initiating community diagnosis, and meeting perceived community health needs.
Background: Hypertension in women of reproductive age group is of special concern because of the vulnerability of women to pregnancy-induced hypertension apart from socio-cultural vulnerability. Aim: The objective of the study was to identify the predictors for hypertension among Indian women and to develop a risk score which would provide an opportunity for early detection and appropriate action. Material and Methods: This study was based on the data collected in National Family Health Survey in 2015–2016. Women in India of 15–49 years were the study population. Data were analysed using SPSS v17. Logistic regression analysis was carried and expressed as odds ratio with 95% confidence intervals to identify predictors of hypertension. The risk score for hypertension was developed after shrinkage of variables and by using regression coefficients obtained by standard Logistic Regression Model. Results: Among 6,87,230 women between 15 and 49 years, 77,788 (11.3%) were hypertensive. The study results revealed that there was an increasing trend in the prevalence of hypertension (26.5%) with increasing age, and with increasing weight (23.4%). Urban areas (12.3% vs 10.9%), alcoholics (19.2%) and various forms of tobacco users (14.8%) had more prevalence of hypertension. Conclusion: Age, residing in urban area, consuming tobacco products, consumption of alcohol, non-vegetarian diet and overweight, were found to be the significant predictor variables, and were used to develop the Risk Prediction score using logistic regression model.
BACKGROUND The status of maternal health in developing countries is often described in terms of maternal mortality alone. Data on maternal morbidity is inadequate as there is no proper reporting system. Improving maternal health and reducing maternal mortality has been the critical concerns of the international community. So, the present study was undertaken to identify and determine the factors associated with early postpartum morbidity among mothers in the rural field practice area of Rural Health Center (RHC), Simhachalam, Visakhapatnam. METHODS A cross-sectional study was conducted among post-partum mothers in the early postpartum period, registered with Rural Health Centre (RHC), Simhachalam, from March 2019 to November 2019 using a pre-tested semi structured questionnaire. Study was conducted among 335 postnatal mothers. List of antenatal mothers registered in RHC Simhachalam was obtained. Antenatal mothers who had their expected date of delivery (EDD) between April 2019 and Aug 2019 and were available in Simhachalam in the post-partum period were contacted after getting information about their delivery from local Multipurpose Health Worker (MPHW). The mothers were visited and interviewed between day 7 and day 10 at their home and information on morbidity was obtained. RESULTS Most common complaints seen in the early postpartum period among the study participants were easy fatigability [214 (63.7 %)], headache in 140 (41.66 %), pedal oedema [131 (39 %)] and facial oedema [27 (8.0 %)]. Almost 67.85 % of mothers were anaemic. Among the obstetric related complaints, lower abdominal tenderness was the most common [196 (58.3 %)] followed by heavy vaginal bleeding [138 (41.1 %)], episiotomy wound swelling / pain [90 (26.8 %)] and postpartum haemorrhage (PPH) [46 (13.7 %)]. Episiotomy wound infection [24 (7.12 %)] and Caesarean wound infection [12 (3.57 %)] were seen together constituting around 10. 7 % among mothers. CONCLUSIONS The incidence of morbidity in the early postpartum period was high with 82.5 % of the mothers presenting with one or more morbidities. KEYWORDS Maternal Morbidity, Early Postpartum Morbidity, Post-Natal Mothers
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