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Mishra BK, Kanungo S, Panda S, Patel K, Swain S, Dwivedy S, Karna S, Bhuyan D, Som M, Marta B, Bhattacharya D, Kshatri JS, Pati S, Palo SK. Access to Maternal and Child Health Services during the COVID-19 Pandemic: An Explorative Qualitative Study in Odisha, India. Indian J Community Med 2023; 48:459-464. [PMID: 37469922 PMCID: PMC10353676 DOI: 10.4103/ijcm.ijcm_285_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 04/15/2023] [Indexed: 07/21/2023] Open
Abstract
Background Maternal and child health (MCH) care is one of the essential routine healthcare services, which got affected during the coronavirus disease 2019 (COVID-19) pandemic. Modeled projections had anticipated an 8.3%-38.6% rise in maternal mortality from different countries globally. In view of limited studies pertaining to issues related to accessing MCH services in the event of a pandemic, this study was carried out on pregnant and postnatal mothers in Odisha, India. Methods An explorative qualitative study through 36 in-depth interviews (IDIs) was conducted among 16 (44.4%) antenatal and 20 (55.5%) postnatal mothers in six of thirty districts of Odisha, India, from February to April 2021. The districts and blocks were randomly selected for better representativeness. The IDIs were conducted using a predesigned and pretested guide among mothers who had undergone delivery or availed of antenatal, postnatal, or child health services from October 2020 to April 2021. The IDIs were conducted till data saturation. The data were analyzed using MAXQDA software. Results The average age of mothers was 27.6 (+/- 2.2) years. Among the participants, 16 (44.4%) were antenatal and 20 (55.6%) were postnatal mothers; 19 (52.8%) were primipara and 17 (47.2%) were multipara. The majority explained that they received enormous support including door-to-door services from the community health workers (CHWs) even during the difficult times of the pandemic. Reduced transportation facility and fear of contracting the infection were reasons behind the unwillingness to visit health facilities and preference for home delivery. Furthermore, the pandemic had physical, mental, social, and financial impacts among pregnant and postnatal women. Conclusion The unprecedented COVID-19 pandemic has affected access to MCH services by antenatal and postnatal mothers. Health system preparedness and appropriate strategies including better community engagement and participation could avert such challenges in the future.
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Affiliation(s)
| | | | | | - Kripalini Patel
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Swagatika Swain
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Sonam Karna
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Dinesh Bhuyan
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | | | | | - Jaya S. Kshatri
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Subrata K. Palo
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
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Patel K, Palo SK, Kanungo S, Mishra BK, Pati S. Health literacy on hygiene and sanitation, nutrition, and diseases among rural secondary school children - Findings from a qualitative study in Odisha, India. J Family Med Prim Care 2022; 11:5430-5436. [PMID: 36505650 PMCID: PMC9731048 DOI: 10.4103/jfmpc.jfmpc_2166_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/03/2022] [Accepted: 03/30/2022] [Indexed: 11/07/2022] Open
Abstract
Context Health literacy among school children is a priority to promote their health, hygiene, and nutrition behaviours and practices. Although in schools they learn from their peers and teachers, their domestic and social conditions also contribute to learning and adopting in practice. The level of health literacy is also influenced based on socio-demographic features. Aims It is imperative to explore and understand the practices including existing gaps and challenges for future improvement. Methods and Material A qualitative study consisting of 17 focus group discussions (FGDs) among students and teachers in six rural secondary schools was carried out in a rural block of the Cuttack district, Odisha. All FGDs were audio-recorded; transcribed and compiled data were imported into Atlas.ti for analysis. Results An existing gap in health literacy and healthy practices with respect to hygiene and sanitation, nutrition, and diseases was observed. A low socio-economic status, inaccessibility to clean and safe drinking water, toilet facility, and nutritional food items were major factors preventing their health literacy and practice. Many schools have adopted measures such as poster presentation, practical teaching and demonstration, school play, and competitions at the school and in the community, which were found to be effective for creating awareness. Improving infrastructural facilities, ensuring availability of essential commodities, and having more health-promotional activities are required for improving health literacy and practice. Conclusions There is an urgent need to improve the health literacy and practice among rural school children. Innovative practical-oriented education at schools and improved awareness among parents and community people would achieve better adherence to healthy practices.
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Affiliation(s)
- Kripalini Patel
- Department of Public Health, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Subrata K. Palo
- Department of Public Health, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India,Address for correspondence: Dr. Subrata K. Palo, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha - 751023, India. E-mail:
| | - Srikanta Kanungo
- Department of Public Health, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Bijaya K. Mishra
- Department of Public Health, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Sanghamitra Pati
- Department of Public Health, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
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Patel K, Mishra BK, Kanungo S, Bhuyan D, Som M, Marta B, Pati S, Palo SK. Community response towards health care providers delivering health care services during COVID-19 pandemic: A strategy framework based on findings of a qualitative study in Odisha, India. J Family Med Prim Care 2022; 11:5417-5422. [PMID: 36505618 PMCID: PMC9730974 DOI: 10.4103/jfmpc.jfmpc_2162_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 02/03/2022] [Accepted: 03/30/2022] [Indexed: 12/15/2022] Open
Abstract
Context While there are studies on peoples' behaviour toward health professionals (doctors and nurses) during the Coronavirus diesease (COVID-19) pandemic in hospital settings, there is limited literature on Community Health Workers (CHWs). Our study attempted to explore the behaviour of community people towards CHWs during the pandemic and its underlying reasons. Material and Method A qualitative study using In-depth interviews (IDI) and focus group discussions (FGD) was conducted among CHWs and community people from six districts of Odisha from February to April 2021. The researchers transcribed the audio recordings in the vernacular language of the Odisha province, i.e., Odia, and later translated them into English. A qualitative content analysis method was used to prepare the detailed report using Max Weber Qualitative Data Analysis (MAXQDA) software. Result The study found two major categories-Reflection on community behaviour towards CHWs during the COVID-19 pandemic and reflection on availing health care services by community people during a pandemic. Many CHWs revealed that the community people acknowledged their work and dedication and extended all sorts of co-operation and support. However, few community people were non-cooperative and non-supportive. Community reluctance owing to perceptions that the CHWs might be infected, was the significant cause that they faced a lack of support from the community. Further, to create awareness of COVID-19 infection among community people, CHWs adopted different strategies such as door-to-door visits, wall painting, poster display, and awareness through mikes. Conclusion The efforts made by the CHWs during health emergencies need to be recognized and appraised.
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Affiliation(s)
- Kripalini Patel
- MPH, Research Assistant, Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Bijaya K. Mishra
- Obstetrics and Gynecology, Scientist-C, MD Community Medicine, Scientist-C, Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Srikanta Kanungo
- Obstetrics and Gynecology, Scientist-C, MD Community Medicine, Scientist-C, Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Dinesh Bhuyan
- Project Manager, Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Meena Som
- Health Specialist, UNICEF, Bhubaneswar, Odisha, India
| | - Brajesh Marta
- MPH, Health Officer, UNICEF, Bhubaneswar, Odisha, India
| | - Sanghamitra Pati
- Community Medicine, MPH, Director, Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Subrata K. Palo
- Community Medicine, Scientist-D, Regional Medical Research Centre, Bhubaneswar, Odisha, India,Address for correspondence: Dr. Subrata K. Palo, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar - 751 023, Odisha, India. E-mail:
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Turuk J, Palo SK, Rath S, Subhadra S, Sabat J, Sahoo PK, Panda S, Pati S. Viral characteristics and clinical presentation in dengue co-infection- Findings from a facility based observational study in Odisha, India. J Family Med Prim Care 2021; 10:2958-2963. [PMID: 34660431 PMCID: PMC8483126 DOI: 10.4103/jfmpc.jfmpc_2380_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/21/2021] [Accepted: 03/23/2021] [Indexed: 01/20/2023] Open
Abstract
Background: Dengue has affected many countries globally. Two-fifths part of the world is at risk, which can be affected by dengue disease. In India, the dengue incidence has increased in the recent past and emerged as an important health problem in many states including Odisha. Dengue disease presents with atypical clinical symptoms when associated with other co-infections. Materials and Methods: A facility-based longitudinal study was carried out over a period of 1 year to determine the dengue co-infection and its outcome. The suspected cases were clinically assessed following a standard case report format and serological investigations including serotyping were carried out. Results: 33.6% samples were dengue positive of which 78.5% were positive for NS1 Ag, 26.6% positive for dengue IgM and 5.1% to both. Among the dengue positive cases, 60.9% were male and mean age was 31.52 (±17.03) years. High occurrence of cases was during May to November with maximum in August. Among the 975 dengue positives, 57 (5.8%) were found to have co-infection. Chikungunya was the most common co-infection in 71.9%, followed by herpes simplex (HSV) (7%) and other diseases. Fever was the most common presenting symptom (98.2%), followed by myalgia (91.2%), retro orbital pain (91.2%), pain abdomen (12.3%), rash/lesion (8.8%), burning micturition (5.3%), petechiae (1.7%) and pruritus (1.7%) among the co-infected cases. Conclusions: All the four dengue serotypes were found to be circulating with DEN 2 as the most predominant one. About 5.8% of dengue cases have co-infection (mainly with Chikungunya) and clinically present with atypical signs and symptoms.
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Affiliation(s)
| | - Subrata K Palo
- Department of Public Health, ICMR-RMRC Bhubaneswar, Odisha, India
| | - Sonalika Rath
- VRDL, ICMR-RMRC Bhubaneswar, Nalco Square, Odisha, India
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Bhattacharya D, Parai D, Rout UK, Dash P, Nanda RR, Dash GC, Kanungo S, Palo SK, Giri S, Choudhary HR, Kshatri JS, Turuk J, Mishra BK, Lenka RK, Dash S, Pati S. Saliva for diagnosis of SARS-CoV-2: First report from India. J Med Virol 2020; 93:2529-2533. [PMID: 33295640 DOI: 10.1002/jmv.26719] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/16/2020] [Accepted: 12/07/2020] [Indexed: 12/15/2022]
Abstract
There are very few studies in search of an alternate and convenient diagnostic tool which can substitute nasopharyngeal swab (NPS) specimen for detection of SARS-CoV-2. In the study we analyzed, the comparison and agreement between the feasibility of using the saliva in comparison to NPS for diagnosis of SARS-CoV-2. A total number of 74 patients were enrolled for this study. We analyzed and compared the NPS and saliva specimen collected within 48 h after the symptom onset. We carried out real-time quantitative polymerase chain reaction, gene sequencing for the detection and determination SARS-CoV-2 specific genes. Phylogenetic tree was constructed to establish the isolation of viral RNA from saliva. We used the Bland-Altman model to identify the agreement between two specimens. This study showed a lower cycle threshold (CT ) mean value for the detection of SARS-CoV-2 ORF1 gene (mean, 27.07; 95% confidence interval [CI], 25.62 to 28.52) in saliva methods than that of NPS (mean 28.24; 95% CI, 26.62 to 29.85) specimen although the difference is statistically nonsignificant (p > .05). Bland-Altman analysis produced relatively smaller bias and high agreement between these two clinical specimens. Phylogenetic analysis with the RdRp and S gene confirmed the presence of SARS-CoV-2 in the saliva samples. Saliva represented a promising tool in COVID-19 diagnosis and the collection method would reduce the exposure risk of frontline health workers which is one of the major concerns in primary healthcare settings.
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Affiliation(s)
- Debdutta Bhattacharya
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Debaprasad Parai
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Usha K Rout
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Pujarini Dash
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Rashmi R Nanda
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Girish C Dash
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Srikanta Kanungo
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Subrata K Palo
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Sidhartha Giri
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Hari R Choudhary
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Jaya S Kshatri
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Jyotirmayee Turuk
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Bijay K Mishra
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Rajesh K Lenka
- Department of Microbiology, IMS & SUM Hospital, Bhubaneswar, India
| | - Saroj Dash
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
| | - Sanghamitra Pati
- Department of Microbiology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Bhubaneswar, India
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