Assessment on Quality of Healthcare Services during Childbirth: A Community-based Mixed-method Study in the Women of Puducherry

Background

A women's right to a positive childbirth experience should be the heart of any care provided. To assess the quality of childbirth services and mistreatment by healthcare providers among reproductive age group women and to explore factors influencing the same between women and stakeholders.

Material and Methods

A community-based, mixed-method study was conducted from April to September 2021 in field practice areas of a medical college in Puducherry district. The sample size for the quantitative study was 348 and the women were chosen using a multi-stage sampling technique. Women were interviewed with a semi-structured questionnaire. In-depth and key informant interviews between women and stakeholders were done for the qualitative data collection.

Results

Three-fourths (77.0%) of women preferred government tertiary healthcare facilities for obstetric care. Although 69.0% and 75.6% of the participants did not experience any verbal and physical abuse, respectively, the qualitative study results were quite the opposite. While 92.8% of the women complained that no birth companion was allowed during their delivery. Moreover, 79.9% of the women did not have the freedom to choose their comfortable birthing position. The levels of mistreatment in the rural areas were slightly higher than that of the urban areas.

Conclusion

Quality care is a fundamental approach to maternity care. A fair bit of women experiences mistreatment during childbirth in healthcare setups. However, the chief concern here is the perception of such abuse by the mothers as normal due to their lack of knowledge regarding women's rights.

Male involvement as a significant contributor for enhancing maternal and child health-care services: A scoping review

Men have conventionally been excluded from Maternal and Child Health (MCH) services, thereby reinforcing the erroneous notion that pregnancy and the processes leading to childbirth and child-rearing are the preserve of women. Participation of men in MCH is crucial for the reduction of infant and maternal mortality. This scoping review focuses on the contribution of male involvement to MCH care and explores the feasible strategies to improve it. Studies on male involvement in the crucial timelines of the MCH and strategies for implementing and improving male involvement in MCH care in India and other developing countries were obtained through a review of literature in PubMed databases using the medical subject headings (MeSH) terms and unpublished, grey literature during the year 1990-2020. Nearly 50 of the eligible articles were included and synthesized into a scoping review report. Findings revealed that the men's participation had a beneficial impact on all crucial timelines of MCH care. Yet, women perceived low male participation in most of the studies. Several different factors that influence have been identified, including education, socioeconomic status, traditional practices, negative stereotyping among males, and lack of male friendly health-care system. Utilization of community volunteers, male peer educators, workplace-based or mass media education, and men-friendly policy changes or health-care provider initiatives could be crucial in improving male involvement in MCH care. Despite worldwide acceptance as an essential contributor to enhancing MCH care, the scoping review revealed low male involvement levels in developing countries and identified strategies to address this lacuna.

Have we forgotten about the Person with Disabilities for COVID 19 Vaccination – A need of the hour!!!

Persons with disabilities (PwDs) are less likely to access health care facilities, education, and employment in their day-to-day life. They are more likely to experience higher rates of neglect and abuse. The present COVID-19 pandemic situation has further affected the PwDs in terms of physical and social neglect. Moreover, the concept of social distancing, using a face mask, and following cough hygiene, which is fundamental in controlling the spread of COVID 19, is likely to be followed by the person with an intellectual impairment since they are highly dependent on their caretakers for their day to day activities. This scenario is even worse with PwDs who are living in congregate settings like residential camps, nursing facilities, and psychiatric institutions where infectivity is very higher. Thus a pronged approach is needed to assure that PwDs are not left behind during the times of pandemic. This paper argues that PwDs, because of their increased risk for exposure to COVID-19 and its consequences of developing morbidity and even possible deaths, should be prioritized in vaccination strategies. Otherwise, they will be left behind, experiencing disproportionate loss of lives and livelihoods, inaccessible health care services, and disconnection from society.

Health Promoting Behavior Among School Going Adolescents in Puducherry-A Cross-Sectional Study

Background: Health promotion is considered as a process that strengthens health conditions, shapes attitudes, supports behavioural changes to attain the utmost physical and mental health, and organizes the social and physical environment of a person. Aim & Objective: To identify the level of health-promoting behaviour and the associated socio-demographic factors among school-going adolescents in Puducherry. Settings and Design: A cross-sectional analytical study was conducted among 705 school-going adolescents of standard IX-XII from five government and private schools in rural and urban areas. Methods and Material: Multistage sampling was used to select the subjects and the Adolescent Health Promotion Score (AHP 40) was used to assess the health-promoting behaviour of an adolescent. The data was entered in MS Excel and analysed using SPSS v16. Statistical analysis used: Mean ± SD were used to summarize the Total Adolescent Health Promotion Score. Multiple linear regression model was used to assess the association between socio-demographic variables and Adolescent health promotion behaviour. Results: Among the 705 participants, the mean age of the students was 14.9 (±1.4). The mean AHP score of the students was 147.78(±20.59). It was observed that the majority of the students (53%) had a high health promoting behaviour. The number of siblings and father’s profession significantly predicted higher scores of adolescent health promoting behaviour. Conclusions: More than half of the student population had high level of health promoting behaviour. The family and school related variables had significant association with the health promoting behaviour of adolescents

Problems faced and coping strategies adopted by parents of the children with special needs in Pondicherry: A mixed method study

Background: The parents of a special child face different set of problems and needs to adopt different coping strategies that helps to eliminate, modify or manage a stressful event or crisis situation. Aims & Objectives: To determine the various problems faced and the coping strategies adopted by the parents of special children in Puducherry. Material & Methods: A cross-sectional study was conducted in the selected special schools of Puducherry during May 2017 to June 2017. Quantitative component included pre-tested semi structured and self-reported “F-COPES” (Family Crisis Oriented Personal Evaluation Scale) questionnaire after obtaining informed consent. Focus group discussions (qualitative data) were conducted among parents for more information on their problems and coping strategies adopted. Data was entered in EpiData 3.1 and analyzed using Epidata 2.2.2.182 software. Results: Among 187 participants, 70.6% were mothers. Majority of them reported problems like depression (69%) followed by economical issues (26.7%) and emotional disturbances (23.5%). The two most coping strategies used by the parents were having the strength within the family to solve problems (80.2%) and accepting that difficulties occur unexpectedly (78.6%). Conclusion: Depression was one of the major problems faced. Reframing and acquiring social support were the most commonly used coping strategies.

Knowledge, attitude and practices regarding swine flu among para-medical workers in a tertiary care hospital in Pondicherry

Para-medical workers (PMWs) are first contacts for suspected Swine flu patients and also the media to spread key messages regarding its prevention and control strategies. Present study was conducted to ascertain knowledge, attitude and practices regarding Swine flu among para-medical workers in a tertiary care hospital. A hospital based cross-sectional study was conducted among PMWs during May-July, 2010. KAP regarding Swine flu was collected through pre-designed questionnaire and information on attitude towards Swine flu was also collected through FGD-free list analysis. Data was analysed using Epi_Info and Anthropac software. A total of 237 PMWs responded. Majority of the PMWs knew about signs and symptoms (89.03%), mode of transmission (91.56%) and route of transmission (91.98%) of Swine flu. Television (67.51%) was the major source of information. 75.53% and 58.65% PMWs respectively knew about organ of the body chiefly affected and type of specimen to be collected during Swine flu. 196 (82.7%) and 191 (80.59%) PMWs respectively knew about availability of vaccine and treatment against Swine flu. 94.09% PMWs stated that extra precautions such as use of face mask, frequent handwashing, use of gloves etc. should be taken while handling any suspected Swine flu case and 73.84% PMWs do take such precautions. 80.17% PMWs opined that epidemic of Swine flu can be halted at current stage. In the present study, PMWs possessed good knowledge, attitude and practices regarding Swine flu and this fact should be utilized while designing and guiding containment strategies against existing Swine flu epidemic.