Search

Introduction: In an era of increasing accountability throughout our society, it is not surprising that questions about the efficacy and efficiency of our health care system are also being raised. Both functional and technical qualities have to be monitored and managed effectively. Objectives: To enhance service effectiveness CHC/PHC health delivery systems. To evaluate the quality of care rendered by CHC, PHCs, Sub centres, AWCs by IPHS guidelines, Likert’s scale and WHO Assessment tool. To assess the health workforce in their capabilities. Patient satisfaction in the quality of care. Methodology: Out of the thirteen districts of Uttarakhand, the district of Dehradun has six blocks of which Doiwala is the largest block. A qualitative study design: One Community Health Centre namely CHC Doiwala, which has five Primary Health centres were studied using three different tools. (i) IPHS standards (ii) SARA (WHO) (iii) Likerts scale for patient satisfaction. However, in the COVID scenario some limitations have been considered in the study. Results: The quality of health care in the healthcare delivery system has been assessed as per scale and has been found that factors of patient satisfaction, infrastructure and outcomes for assessment of quality are strong contending variables. Conclusion: The PPP model has upgraded the healthcare system with substantial contribution from the private sector.

Context: The Bhore Committee in 1946 gave the concept of PHC as comprehensive primary health care to the community and maintain an acceptable standard of quality of care. The study was conducted to assess the implementation of National Health Programmes at PHCs in Uttarakhand. Methodology: An observational cross-sectional study was conducted at two PHCs (Thano and Raiwala) from March 2019 to April 2019. Interviews of health functionaries and beneficiaries of national health programmes were done based on standard Indian Public Health Standards (IPHS) guidelines and check list, for both PHCs. Beneficiaries under each programme were also observed. Result: Various programmes such as Universal Immunization Programme, School Health Programme, and Pulse Polio Programme, National nutrition Programme, National family welfare Programme, NPCDCS and Jansankhya Niyantran Yojna were implemented successfully at both PHCs. Although knowledge among peripheral health workers was found to be little inadequate. Conclusion: The functioning and execution of some of the National Health Programs at PHCs Thano and Raiwala were found to be inclined with IPHS guidelines.

Introduction: ICDS scheme was launched on October 2nd 1975 to address high infant mortality, malnourishment and poor learning outcomes. Since its inception was playing its role effectively, but still there were some shortcomings which were needed to be addressed. Uttarakhand was one among the states with poor health indicators with respect to child and mother, there is need to search for reasons effecting the implementation of programs intended for woman and child development. The present study aims to asses functioning of ICDS scheme in select Uttarakhand. Methodology: A cross sectional study was conducted selected areas of Uttarakhand state during October 2018 to June 2019, among 16 anganwadi centers from urban and rural areas of Dehradun and Haridwar districts. Results were expressed in percentages and proportions with 95% confidence interval. Relevant statistical tested applied wherever necessary. Results: Functioning of ICDS scheme in Uttarakhand varied for different services provided under it. Supplementary nutrition service was uninterrupted but medicine kits and referral slips were not supplied to anganwadi centers at the time of study. Conclusions: Study identified various insufficiencies regarding the functioning of ICDS scheme. There is a need to improve facilities at anganwadi centers for proper implementation of ICDS scheme.

Background: Our country is adding to one-fifth of live births globally and an enormous number of neonatal deaths (

Context: Under nutrition has long been a major public health concern in developing country like India as a leading cause of child morbidity and mortality. The study was aimed to assess the malnutrition and factors associated with it. The study was conducted to assess under nutrition in under five children and various associated factors affecting it. Methodology A community based cross sectional study was conducted among 400 under five children of rural and urban Rishikesh. Multistage sampling method was used to select the areas and systematic random sampling was used to select households. A predesigned, pre tested & semi structured questionnaire was used to collect information on various associated factors and status of under nutrition in study participants. Data was entered into excel sheets and analyzed using SPSS utilizing appropriate statistical test. Results: The prevalence of underweight was 37.3%, stunting was 43.3% and wasting was 24.5% respectively. Socio-demographic factors, child birth weight and birth order, hand washing practice by mother and common morbidity emerged as significant predictors of under nutrition. Conclusion: The burden of common morbidities and prevalence of malnutrition among under-five children in this community is very high. Our policies should aim to improve child health nutrition and growth.

Introduction: There are various problem which have harmful impact on health, these problem are mainly behavioural with multifunctional causation. Amongst such problem, addiction of substance abuse is on rising trend, overall globally. The study conducted to determine the prevalence of substance abuse in the community. Methods: A community based cross sectional study was conducted in Rishikesh Tehsil. People of age group between 15-60 years residing in study area were recruited as study participants. Total sample size covered in this study was 804.Since the population of urban and rural area is almost equal, so to get equal representative from urban and rural area, 402 study participant were selected from each strata as rural and urban area respectively. The validated interview schedule were then analysed using appropriate statistical techniques like percentage, chi-square test and p-value. Results: overall prevalence of substance abuse was found to be 37.4% out of which the prevalence of current users was 31.34% respectively. Conclusion: The study revealed that in spite of having strict law for prohibition of substance abuse, people are still addicted. There is a need to change either in law or in behaviour of people at large.

Context: Elderly have increased frequency of awakenings of longer durations, lower sleep efficiency, early bedtimes and wake times as compared to younger subjects. The study was conducted to assess the quality of sleep using Pittsburgh Sleep Quality Index (PSQI), sleeping habits and changing sleep pattern among elderly and their associated factors. Material and Methods: A cross-sectional study was conducted for a period of 3 months among all the elderly population residing in village Thano situated in Raipur block of district Dehradun, Uttarakhand. A total of 96 elderly were surveyed. Data was collected on sociodemographic characters of elderly as well as questions on Quality of sleep was asked based on PSQI questionnaire. Data was collected using Epi-collect5 application on phone. Data was analysed and presented utilizing appropriate statistical methods. Results: Among the 96 elderly, 57.3% of the participants were females and 40.6% were from 60-69-year age group. The mean PSQI score was 5.6±1.9. Sleep quality was poor among females, smokers, widow and those with no physical activity. With advancing age sleep quality came out to be significantly poor. Conclusions: Sleep disturbances are commonly seen among the elderly. Treatment of primary sleep problems can improve the quality of life.

Context: Janani Suraksha Yojana (JSY), launched on 12th April,2005 under the umbrella of NRHM has shown it’s impact in terms of increase in number of institutional deliveries and decrease in maternal and neonatal mortality rates but still the awareness about the scheme is low in women from rural areas and urban slums, especially in low performing states. Aims: To assess the differences in awareness of married women from rural areas and urban slums regarding JSY and to study the effect of socio-demographic factors on the level of awareness. Settings and Design: A cross-sectional study was carried out in the rural areas and urban slums of field practice areas of Himalayan Institute of Medical Sciences, Dehradun, for a period of one year. Methods and Material: all the married women (15-49 years) of reproductive age group were included in the study. After taking informed consent from the head of the families and targets, the study subjects were interviewed by a pre-designed and pre-tested questionnaire. Statistical analysis used: SPSS 10 and Epi Info software (with Yate’s correction). Results: Awareness was more among women belonging to rural areas i.e 79%.Age, educational status, occupation, socio-economic status and place of residence showed a significant statistical association with the level of awareness. Conclusions: There is an urgent need to strengthen IEC campaigns and monitoring strategies.

Background: Janani Suraksha Yojana (JSY) –a new maternity benefit scheme - was launched by Govt. of India in April 2005 with the objective of reducing maternal and neonatal mortality by promoting institutional deliveries by providing cash incentive to beneficiaries as well as promoter. Ante –natal services are one of the most important component of JSY. Study was designed to assess the ante-natal characteristic of JSY beneficiaries. Materials and Methods: A cross-sectional study was conducted under rural health training centre and urban health training centre of the field practice area of department of Community Medicine, HIMS, Dehradun. Results: A total of 2221 married women (15-49 years) were interviewed out of which 1290(58.08%) women were from urban slums and 931(41.92%) women belonged to rural areas. Out of the total number of married women who delivered at govt. hospital i.e. 227 (75.17%), majority (78.42%) of the women were registered with the some health personals. Out of these, 74.15% women were registered with ASHA .Only 29.21% women went for three or more ANC visits. Only 48.31% women consumed hundred IFA tablets and the proportion was high (79.41%) in rural women. All the women received complete TT immunization. Conclusion: It was found that registration of the women with some health personnel was influenced by women’s religion and socio-economic status the level of education and socio-economic status was found to have a positive effect on the number of ANC visits. The consumption of IFA tablets was also found to be influenced by the educational status of the women.