INTRODUCTIONIn the public sector, a sub-health centre (sub-centre) is the most peripheral and first point of contact between the primary health care system and the community. A Subcentre provides interface with the community at the grass-root level, providing all the primary health care services. As sub-centres are the first contact point with the community, the success of any nationwide programme would depend largely on the well-functioning sub-centres providing services of acceptable standard to the people. The purpose of the health sub-centre is largely preventive and promotive, but it also provides a basic level of curative care. As per population norms, there shall be one sub-centre established for every 5000 population in plain areas and for every 3000 population in hilly/tribal/desert areas.1 The health planners in India have visualized the PHC and its sub-centres (SCs) as the proper structural units to provide health services to the rural population. The current level of functioning of the sub-centres is much below the expectations. In order to provide quality care in these sub-centres, Indian public health standards ABSTRACT Background: In the public sector, a sub-health centre (sub-centre) is the most peripheral and first point of contact between the primary health care system and the community. The current level of functioning of the Sub-centres is much below the expectations. Objective: To assess sub-centres of Belagavi District according to Indian public health standards 2012 guidelines. Methods: A facility based cross-sectional study was conducted in Belagavi district of Karnataka. forty SCs, four SC from each of the 10 Talukas of Belagavi district were selected by simple random sampling. Study period: 1 st January to 31 st December 2014. Data collected -using a predesigned and structured questionnaire for IPHS facility survey. Results: The study showed 35% of SCs were catering the services for population as per the norms. Services like antenatal clinics, post-natal clinics and immunization sessions were conducted regularly in all the SCs. About 33% of SCs had no buildings. A deficiency worth highlighting in the present study was the absence of residential facilities for the staff in half of the SCs. Proper supervision and monitoring of the service delivery activities of the SC staff was done only in 70% of SCs. Conclusions: IPHS guidelines are not being followed at SC level in the district. Recruitment of SC staff especially the Health Worker Male post should be filled at all the SCs for efficient functioning of the SCs. The SC should be periodically surveyed to identify the deficiency and necessary action could be taken to correct it.
Between 1990 and 2016 the number of adolescents with anemia world-wide increased by 20% to almost one in four. Iron deficiency in adolescence results in compromised growth, decreased cognitive function, and depressed immune function, and can increase the risk of negative outcomes in pregnancy, especially in the case of young adolescents. In India, despite several decades of governmental investment in anemia prevention and treatment, more than half of women of reproductive age are anemic, with rates even higher in the adolescent population. Although awareness of adolescence as a nutrition-sensitive developmental stage is increasing, there is a lack of qualitative research on the perspectives of adolescents and families on anemia and related services. In this study, we explored the issues influencing adolescents’ awareness of anemia in three rural areas of Karnataka. Sixty-four in-depth interviews and six focus group discussions were conducted with adolescents (those who had never been pregnant, pregnant adolescents, and young mothers), community members, and nutrition-related service providers in the health and education sectors. An inductive analytical approach was used. We found that adolescent girls, particularly those who have not experienced pregnancy or motherhood, had very low awareness of anemia. State programs including school-based distribution of iron and folic acid supplements and nutrition talks were not seen to be resulting in knowledge and acceptance of the importance of preventing anemia. Pregnancy represents a turning point in which adolescents are systematically tested for anemia as part of routine antenatal care, increasing their awareness of, and access to, treatment for the condition. At the same time, pregnancy represents to family and community a period to insist on a nutritious diet. For progress in anemia reduction to be made, improved age-appropriate measures specific for adolescence are required. Improving school-based nutrition outreach is an important opportunity to reach adolescents.
Objective: To understand the extent to which adolescent
awareness of and attitudes about anaemia and anaemia prevention can be
changed by nutrition messages received at school. Design:
Mixed-methods pre–post intervention study Setting: Three Government
schools in Bagalkot, Belagavi and Raichur districts of Karnataka, India
Population or Sample: Students of grade six and seven and
teachers involved in implementing the intervention. Methods: An
education intervention was co-developed by school teachers and nutrition
experts using locally adapted resource materials that consisted of
lectures, role play and practical demonstrations. Seven half-hour
educational sessions were delivered by school teachers over seven weeks
to 455 students. Pre- and post-intervention tests measured changes in
adolescents’ knowledge about anaemia. In-depth interviews with teachers
and focus groups with students explored reactions to the intervention.
Main outcome measures: Knowledge score related to anaemia
Results: The percentage of children with correct scores increased by 7.3
- 49.0 percentage points for the tested questions after implementation
of the intervention. The mean knowledge score increased by
3.67±0.17(p<0.01). During interviews, teachers and students
highlighted high acceptance of the intervention and materials, an
increase in awareness, a positive attitude towards changing behaviour
around diet, an increase in the demand for iron folic acid supplements
and improved sharing of messages learned with peers and families.
Challenges expressed included need for further training, time
limitations and hesitancy in teaching about menstruation and pregnancy.
Conclusions: Educational interventions carried out for
adolescents by teachers in schools are effective in improving awareness
and attitude related to anaemia.
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