Background: Maternal health is of paramount concern all over the world and has been a priority in India as well with the maternal health programs evolving over the time, addressing new arenas and overcoming challenges to reach the Maternal mortality ratio (MMR) target with quality. (1) In tribal areas various barriers in health seeking behavior are impediments towards maternal health.Methods: An explorative qualitative study was undertaken in a tribal area of Srinagar, Kashmir, which is a rural field practice area of the Department of Community Medicine Government Medical College, Srinagar. Focus group discussion (FGD) and in-depth interviews were conducted. Thematic analysis was used to analyze the FGD and in-depth interview data.Results: The data analysis generated following five themes: Theme 1: Perceptions and practices among tribal pregnant women in Faqir Gujree area. Theme 2: Socio-cultural influences, attitude and beliefs. Theme 3: Health system related barriers. Theme 4: Community related barriers. Theme 5: Cultural barriers among the pregnant women.Conclusions: There is a need of continuous behaviour change communication (BCC) with pregnant women and community members. In addition to addressing these issues, the health system related issues need to be addressed and improved in order to improve access to health care facilities by these pregnant women. Thus, a comprehensive tribal-sensitive health care system incorporating the above cultural issues is required to improve the health care access among these vulnerable ANC patients.
Background: The distinctive morphology of the human hip bone makes it of interest from anatomical, anthropological and forensic point of view. Thus, by using visual criteria, metric techniques and discriminant function analysis we can estimate the age, sex and race of an individual. Objective was to do the morphometry of 60 dry human hip bones in Kashmiri population in order to evaluate the various parameters of the hip bone.Methods: The study was done on 60 randomly collected Kashmiri adult unpaired hip bones of unknown sex to analyse and evaluate the weight, length, width and the Coxal index of hip bone. All the hip bones selected were dry, complete and showed normal anatomical features. Specimens showing osteoarthritic changes, evidence of any previous trauma or skeletal disorders was excluded from the study.Results: The raw data obtained was statistically analysed. Range, mean, standard deviation and standard error of mean were determined for each parameter. All values were compared with series of other workers to draw the conclusions.Conclusions: From this study, it was concluded that right hip bone has larger parameters and greater strength of skeletal elements. The difference seen between the values of present study and that of other workers could be explained on the basis of ethnic and racial variations.
Background: Children inherently want to remain engrossed in the activities as easily as possible within their ecological environment and academic curricular ambit. Covid-19 adversely affected our physical, social, and mental conditions and children were no exception. Objectives: To understand the experiences of teachers who have been doing virtual teaching to children during COVID-19; To understand the impact of virtual teaching and COVID-19 on physical and mental health of children. Materials and Methods: The qualitative study was conducted in the Kashmir valley and school teachers teaching students from class Ist to class 8 th were involved in the study. Participants were selected purposefully based on the inclusion criteria. One-to-one in-depth interviews were conducted with sixteen (16) school teachers, using a preformed interview guide. Data analysis was performed using the thematic analysis method. Results: Data analysis yielded four overarching themes and twelve subthemes viz:- 1) Attitudes towards online sessions among teachers (2) factors affecting the physical and mental health of children (3) Effectiveness of online classes for individual lines of children’s mental development (4) External and internal factors impacting child development and pedagogy. Conclusion: The study result explicitly showed mental and physical health of children got considerably affected by online teaching during the Covid-19 pandemic. Online teaching especially to children is less yielding in terms of effective academic consequences. Nevertheless, blending online teaching with pedagogy can enhance certain multidimensional capabilities of the children.
Introduction:Immunization is one of the splendid public health interventions that remarkably reduced child morbidity, mortality, and disability. Despite attaining substantial immunization coverage in Kashmir, assessment of the immunization system is quintessential for sustaining the gains and exploring the gaps. Objective: To assess the gaps in the delivery of routine immunization services in Kashmir Valley. Method: In-depth face-to-face interviews were conducted with thirty-two (32) important stakeholders, who were purposively selected as they play an active role in the planning and implementation of the Immunization Program and devise strategies at different levels of healthcare delivery. At the state level, SEPIO and SMO were interviewed at the District level, DIO/Deputy CMO was interviewed in all ten (10) districts of Kashmir Valley. From all ten Districts, two Medical-Blocks were selected from each District, and one Block Medical Officer and one Medical Officer were interviewed alternatively from each Medical-Block. Results: The thematic qualitative analysis approach was used and the analysis process generated five themes. Each of these themes included many sub-themes. 1. Factors facilitating the implementation of Routine Immunization (RI), 2. Limitations and deficits related to knowledge, attitude, monitoring, 3. Constraints encountered in the implementation of (RI) program, 4. Difficulties in the implementation of RI revealed by respondents, 5. Transformational steps to bridge gaps in the delivery of Immunization (RI) Conclusion: There were visible deficits related to knowledge, attitude, and monitoring among health professionals. Certain constraints encountered in the implementation of the program were financial constraints in the training of health care professionals and human resources constraints. The study showed the need for transformational steps to bridge gaps in the delivery of the Immunization (RI), which included regular monitoring and review meetings, teamwork and peer learning, training, and improvement in cold chain maintenance.
Background: Active acute flaccid paralysis (AFP) cases surveillance in children under 15 years is ongoing till reaching eradication of poliomyelitis in the globe. As there is always a high risk of importation of wild poliovirus (WPV) from the endemic countries, accurate surveillance for AFP cases to detect WPV circulation and to maintain our achievement is thoroughly essential. Objectives: To evaluate the performance of the AFP surveillance system in Kashmir Valley. To identify gaps, if any, in AFP surveillance. Materials and Methods: The Mixed Methods study was conducted in the Kashmir valley from March 2018 to March 2019. An explorative qualitative design using individual, face-to-face interviews with thirty-two (32) different stakeholders from the State, District, Medical Block, and PHC levels. To complement the qualitative study, a quantitative door-to-door survey was done in two Districts, Srinagar and Ganderbal, which consist of five and four Medical Blocks respectively. Results: The thematic qualitative analysis approach was used, and the analysis process resulted in five themes. 1. Stakeholders’ description of AFP surveillance. 2. Perception and awareness, appraisal of AFP Surveillance among stakeholders 3. Barriers in reporting AFP cases 4. Forging stronger linkages, improved planning in the health system to address gaps in AFP surveillance. 5. Enhancement of activities for sensitive AFP surveillance. In door to door survey of households in different sub-centre areas, a total of n = 1304 families were visited in which maximum (n = 647) families had two <15 years’ children. In the survey, only one AFP case was recorded from Sub-Centre Kurag. Conclusion: There is a need for sensitive AFP surveillance by working on various factors, including training, behavioural change of health workers, improving reporting of cases, especially efforts are needed for the formation of effective AFP surveillance system by forging cooperation with different segments of the health system.
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