Multipurpose Health Workers Research Articles

A study to assess knowledge of primary health workers on malaria epidemiology, diagnosis, and treatment in Patiala district, India

Background: India accounts for (4%) of all malaria cases worldwide. The World malaria report 2017 showed that, by 2016, global progress against malaria had stalled and was off track to meet the Global Technical Strategy milestones for 2020. Aims and Objectives: The aim of the study is to assess knowledge of rural medical officers (RMO) and health workers on malaria epidemiology, diagnosis, and treatment as per National Vector Borne Disease Control Program of India guidelines. Materials and methods: A descriptive, observational, and cross-sectional study was done among government health personnel’s using a semi-structured questionnaire. Results: In the present study, 258 health personnel’s participated comprising multipurpose health workers female (MPHW-F), multipurpose health worker male (MPHW-M), and RMO. The standardized score on knowledge of vector biology and epidemiology was 72% and 54% for RMO and (MPHW-M), respectively. On malaria diagnosis, MPHW-M has got median score (53%) as compared to RMO (46%). On national malaria drug policy, there is a marginal difference between median score of RMO (42%) and MPHW-M (40%). Overall, there is incomplete and poor knowledge of treatment of malaria among all health personnel’s with lack of concept about presumptive treatment. Training showed some positive impact on the knowledge of MPHW-F but no impact on MPHW-M. Graduates and experienced workers have got better knowledge than undergraduates and MPHW-M have more knowledge than MPHW-F. There is poor knowledge of reporting formats, and usage of rapid diagnostic kits among all the health personnels. There was no significant impact of education qualification, in service training and work experience on the knowledge of Male health workers. Conclusion: Training needs to be suitably tailored as there is a lot of scope of improvement in the knowledge regarding malaria diagnosis and treatment among health workers.

Exploring ethics in the implementation of the Community Health Worker programmes in India.

The public health machinery in India is largely driven by the frontline community health workers (CHWs), namely the Accredited Social Health Activists (ASHAs), Auxiliary Nurse Midwives (ANMs), Anganwadi Workers (AWWs) and other multipurpose health workers. They play a vital role as intermediaries between the community and the health system. The ANMs perform important tasks such as spreading health promotion messages, supporting behavioural change, surveillance of diseases, delivery of maternal and child health services at the doorsteps of beneficiaries, prevention of common minor ailments and other public health tasks, as and when the need arises [1]. The ASHAs are trained female health workers who mobilise people to utilise health services and also provide basic primary healthcare.

A qualitative study regarding menstrual hygiene in a rural community of Haryana, India.

Adolescent girls face challenges in menstrual hygiene in routine patterns which impacts their education and health. A qualitative study was undertaken to assess the knowledge and practices regarding menstruation in a rural community of Haryana and to identify the barriers to menstrual hygiene. The study was conducted in the month of September 2019 among various stakeholders i.e. adolescent females, adolescent males, Accredited Social Health Activist (ASHA) workers, Anganwadi workers, school teachers and Medical Officers. The stakeholders were mapped with the help of a Multi-Purpose Health Worker and ASHA of the village. Interview guides for focus group discussion (FGD) and in-depth interview (IDI) were prepared from previous literature to understand menstrual health management among the stakeholders. After IDI and FGD, we found that there is a barrier to accessibility of regular sanitary pads, a lack of education on menstrual hygiene among adolescent girls. School absenteeism was a concern due to the unavailability of mechanisms for the disposal of sanitary pads in school and poor maintenance of toilets. Proper implementation of the Adolescent Reproductive Sexual Health program and Menstrual health education can improve the use and reduce stigma and ignorance. Free uninterrupted supply of sanitary pads through school and Anganwadi will help improving accessibility and separate toilets for girls would lead to a reduction in absenteeism.

Assessing the time use and payments of multipurpose community health workers for the various roles they play—a quantitative study of the Mitanin programme in India

BackgroundCommunity health workers (CHWs) are crucial human resources for health. While specialist CHWs focus on a single disease vertically, the generalist or multipurpose CHWs perform wider functions. The current study was aimed at examining the time multipurpose CHWs spend on performing their different roles. This can help in understanding the importance they attach to each role. Since CHWs in many developing countries are classified as part-time volunteers, this study also aimed to assess the adequacy of CHW payments in relation to their time use.MethodsThe study covered a well-established CHW programme in India's Chhattisgarh state. It had 71,000 multipurpose part-time CHWs known as Mitanins. Data collection involved interviews with a representative sample of 660 rural and 406 urban Mitanins. A semi-structured tool was designed and field tested. It included 26 pre-coded activities of CHWs placed under their six purposes or roles. Prompting and triangulation were used during interviews to mitigate the possibility of over-reporting of work by CHWs. The recall period was of one week. Descriptive analysis included comparison of key indicators for rural and urban Mitanins. A multi-variate linear model was used to find the determinants of CHW time-use.ResultsThe rural and urban Mitanins respectively spent 25.3 and 34.8 h per week on their CHW work. Apart from location (urban), the total time spent was associated with size of population covered. The time-use was well balanced between roles of service-linkage, providing health education and curative care directly, COVID-19 related work and action on social determinants of health. More than half of their time-use was for unpaid tasks. Most of the cash-incentives were concentrated on service linkage role. The average payment earned by Mitanins was less than 60% of legal minimum wage.ConclusionThe time-use pattern of Mitanins was not dictated by cash-incentives and their solidarity with community seemed be a key motivator. To allow wide ranging CHW action like Mitanins, the population per CHW should be decided appropriately. The considerable time multipurpose CHWs spend on their work necessitates that developing countries develop policies to comply with World Health Organisation's recommendation to pay them fairly.

Factor Structure of the Telugu Version of the COVID-19 Pandemic-Related Perceived Stress Scale (PSS-10-C) Administered on Grassroots Frontline Health Care Workers of Rural Telangana.

Background:During the COVID-19 pandemic, perceived stress is an important determinant of mental health problems, especially in health care workers (HCW). By and large, regional language tools to assess perceived stress in the context of the pandemic have not been validated in India. We aim to explore the factor structure of the Telugu translated version of the COVID-19 pandemic-related Perceived Stress Scale (PSS-10-C) administered on grassroots frontline HCW of rural Telangana, India.Methods:Data relating to 311 grassroots frontline HCW consisting of accredited social health activists (ASHA), multipurpose health workers (MPHW), and auxiliary nurse and midwives (ANMs) working in rural primary health centers (PHC) in five districts of Telangana were analyzed. An exploratory factor analysis was conducted to identify latent factors. Convergent validity was assessed by computing Pearson product-moment correlations between the scores of PSS-10-C and Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scales.Results:The principal component analysis showed that the 10 items of the scale were significantly loaded by two latent factors with eigen values of 2.792 and 2.009, respectively. Factor solution showed that six and four items correlated with each of the two factors, respectively. Significant correlations between PSS-10-C, GAD-7, and PHQ-9 scores showed convergent validity. The two factors may represent substantive factors “perceived self-efficacy” and “perceived helplessness.” There may be an influence of the reverse-coded method on the factor solution.Conclusion:The Telugu translated version of PSS-10-C holds fair-to-good psychometric properties.

Health related quality of life among rural elderly using WHOQOL-BREF in the most backward district of India.

Background:In India, the population of above 60 years was approximately 8.2% in 2011, which is expected to rise to 11.6% by 2026. Due to epidemiological transition of diseases, morbidity of chronic nature will increase with increase of elderly population and it will affect the elderly quality of life (QOL).Aim:This study made an attempt to capture health-related quality of life HRQOL and its correlates among elderly subjects in most backward district of India.Methods:This cross-sectional study was conducted in Nagina for a duration of 4 months and included 430 elderly (60 years or above) dwelling in the same place for more than 1 year as participants. The information on sociodemographic details, WHOQOL-BREF scale details and history of chronic diseases or disorders was collected by multipurpose health workers female using a pretested, predesigned, standardized questionnaire. An association between variables and poor quality of life was significant if the P value was less than 0.05.Results:Nearly half of study participants were living in joint families (45.3%) and 67.7% of elderly gave history of chronic morbidity. There were nearly half of participants (48.8%) with poor QoL in physical health domain. Multiple linear regression analysis revealed that older age, male, no schooling, without spouse, lower economic status and chronic disorder were independently associated with low QOL score.Conclusion:The study reported that nearly half of the elderly (46.7%) had poor health QoL. The family physicians shall provide preventive and promotive measures to reduce the chronic morbidity among elderly to improve QOL.

Rural community health workers' readiness for mobile-phone based telemedicine uptake in India.

Objective: Healthcare services using mobile-phone based telemedicine provide simple technology that does not require sophisticated equipment. This study assessed community health workers’ knowledge, attitude, and practice (i.e., their readiness) at the village level for uptake of mobile-phone based telemedicine.Materials and Methods: This cross-sectional study was conducted among 80 community health workers, including Auxiliary Nurse Midwives, Multipurpose Health Workers and Accredited Social Health Activists working in a rural health block of India. A pre-tested, semi-structured, interviewer-assisted, self-administered questionnaire was used to assess their mobile-phone based telemedicine readiness.Results: Sixty (75.0%) health workers owned mobile phones. The median readiness score for mobile-phone based telemedicine was 109.0. The Accredited Social Health Activists showed a better attitude toward mobile-phone based telemedicine than others. There was a significant moderate positive correlation (r=0.67) between knowledge and practice domains. Community health workers who had smartphones showed a significantly better attitude than those who did not.Conclusion: Training programs on telemedicine service delivery, focused on Auxiliary Nurse Midwives/ Multipurpose Health Workers, can improve their attitudes towards telemedicine. A better attitude of the Accredited Social Health Activists must be leveraged to initiate mobile-phone based telemedicine services on a pilot basis initially and later scaled up in other settings.

Health system readiness for roll out of the Ayushman Bharat Health and Wellnes Centres - Early experiences from Punjab State.

Background:The Government of India launched the Ayushman Bharat (AB) program in 2018 which aims to transform 150,000 existing Sub Health Centres and Primary Health Centres into Ayushman Bharat Health and Wellness Centres (HWCs). In this study, we assessed health system readiness for establishment of HWCs.Methods:The assessment comprised of a cross sectional facility assessment and a knowledge assessment of community health officers (CHOs) and female multipurpose health workers also known as auxiliary nurse midwives (ANMs), in 26 HWCs in one community development block of Punjab state. HWCs were assessed for key input and process parameters such as a human resource, physical infrastructure, supplies, capacity building etc., and processes including health promotion, community participation, digitization of management information system, and service delivery.Results:It was observed that only 7 of the 26 HWCs had all human resources as per guidelines. The median knowledge score of CHOs and ANMs was 54% and 51% respectively. 11 of the 26 HWCs were co-located with Zila Parishad SHCs. Out of the 15 standalone HWCs, while 9 had independent buildings, 5 were located in buildings of other community level institutions. 50 percent of the HWCs were not able to perform diabetes screening due to lack of glucometers or testing supplies. While services for non-communicable diseases were available, a two-way referral tracking system for patients was missing. The mean job satisfaction rated by the newly appointed CHOs was 3.12 on a scale of 1 to 5, where 5 represented very high job satisfaction.Conclusion:The operationalization of HWCs requires State and local level interventions for strengthening of existing physical infrastructure, ensuring a regular supply of medicines and consumables, development of referral mechanisms for patients and enhancing community participation.

Td Vaccination Campaign - Overview from an Urban Slum of Cuttack District of Odisha

Background: World Health Organization (WHO) has recommended replacement of TT vaccine by Td vaccine since 1998. Based on this and several other recommendations, the Government of India introduced Td vaccination for children aged 10 and 16 years as well as for pregnant women on 14th August 2019.1 Objective: Monitoring of Td vaccination drive campaign and identification of shortcomings in an urban slum of Cuttack, Odisha. Methodology: A community-based cross-sectional study was carried out by visiting all the session sites on the day of the vaccination drive covering 10 schools and 3 community outreach sessions from 1st to 15 th September 2019. 281 children studying in classes 5th and 10th i.e., aged 10 and 16 years respectively were vaccinated with Td Vaccine during the campaign. Session sites were selected by simple random sampling method and data was collected by interviewing ASHAs and ANMs using a checklist for monitoring of session sites available at the MoHFW website. Result: All session sites were conducted according to micro-plan. Supervisors visited 16% of session sites during the campaign. All the logistics were available in sufficient quantities at all the session sites. None of the session sites used a zipper pouch for storing the vaccine vials, or tally sheets for marking, or a register for keeping the count of used vials. In 20% of the session sites, recapping of the needle was done by the Multipurpose Health Worker (female). Conclusion: Although the arrangements for conducting the vaccination drive at session sites including schools were commendable but a few lacunas were observed.Most of the schools did not maintain a register of the absentees for tracking them in the community session sites by the social mobilizers (ASHA). All the observed shortcomings could have been overcome with proper microplanning.

Public Health Proficiency of Fresh Indian Medical Graduates &Ways and Means of Enhancing it

Ministry of Health and Family Welfare, Government of India is committed to achieving Universal Health Coverage (UHC) for its entire 1.4 billion population living in our 6.6 lakh plus villages and nearly 3000 towns/ cities. Delivery of UHC is predominantly dependent upon our primary health care system of which human resources for health (HRH) forms a crucial component. The HRH responsible for delivering primary health care comprises of a team of about 40 individuals consisting of two Health Assistants, ten to twelve Multipurpose Health Workers (Female and Male) and about thirty ASHA Volunteers besides one or two Medical Officer/s.Â

English

BACKGROUND The status of maternal health in developing countries is often described in terms of maternal mortality alone. Data on maternal morbidity is inadequate as there is no proper reporting system. Improving maternal health and reducing maternal mortality has been the critical concerns of the international community. So, the present study was undertaken to identify and determine the factors associated with early postpartum morbidity among mothers in the rural field practice area of Rural Health Center (RHC), Simhachalam, Visakhapatnam. METHODS A cross-sectional study was conducted among post-partum mothers in the early postpartum period, registered with Rural Health Centre (RHC), Simhachalam, from March 2019 to November 2019 using a pre-tested semi structured questionnaire. Study was conducted among 335 postnatal mothers. List of antenatal mothers registered in RHC Simhachalam was obtained. Antenatal mothers who had their expected date of delivery (EDD) between April 2019 and Aug 2019 and were available in Simhachalam in the post-partum period were contacted after getting information about their delivery from local Multipurpose Health Worker (MPHW). The mothers were visited and interviewed between day 7 and day 10 at their home and information on morbidity was obtained. RESULTS Most common complaints seen in the early postpartum period among the study participants were easy fatigability [214 (63.7 %)], headache in 140 (41.66 %), pedal oedema [131 (39 %)] and facial oedema [27 (8.0 %)]. Almost 67.85 % of mothers were anaemic. Among the obstetric related complaints, lower abdominal tenderness was the most common [196 (58.3 %)] followed by heavy vaginal bleeding [138 (41.1 %)], episiotomy wound swelling / pain [90 (26.8 %)] and postpartum haemorrhage (PPH) [46 (13.7 %)]. Episiotomy wound infection [24 (7.12 %)] and Caesarean wound infection [12 (3.57 %)] were seen together constituting around 10. 7 % among mothers. CONCLUSIONS The incidence of morbidity in the early postpartum period was high with 82.5 % of the mothers presenting with one or more morbidities. KEYWORDS Maternal Morbidity, Early Postpartum Morbidity, Post-Natal Mothers

Who could be One Health Activist at the community level?: A case for India

BackgroundCommunity health workers (CHWs) are the mainstay of the public health system, serving for decades in low-resource countries. Their multi-dimensional work in various health care services, including the prevention of communicable diseases and health promotion of non-communicable diseases, makes CHWs, the frontline workers in their respective communities in India. As India is heading towards the development of One Health (OH), this study attempted to provide an insight into potential OH activists (OHA) at the community level. Thus, this case study in one of India’s western cities, Ahmedabad, targeted identifying OHA by exploring the feasibility and the motivation of CHWs in a local setting.MethodsThis case study explores two major CHWs, i.e., female (Accredited Social Health Activists/ASHA) health workers (FHWs) and male (multipurpose) health workers (MHWs), on their experience and motivation for becoming an OHA. The data were collected between September 2018 and August 2019 through a mixed design, i.e., quantitative data (cross-sectional structured questionnaire) followed by qualitative data (focus group discussion with a semi-structured interview guide).ResultsThe motivation of the CHWs for liaisoning as OHA was found to be low; however, the FHWs have a higher mean motivation score [40 (36–43)] as compared to MHWs [37 (35–40)] out of a maximum score of 92. Although most CHWs have received zoonoses training or contributed to zoonoses prevention campaigns, their awareness level was found to be different among male and female health workers. Comparing the female and male health workers to act as OHA, higher motivational score, multidisciplinary collaborative work experience, and way for incentive generation documented among the female health workers.ConclusionASHAs were willing to accept the additional new liaison role of OHAs if measures like financial incentives and improved recognition are provided. Although this study documented various systemic factors at the individual, community, and health system level, which might, directly and indirectly, impact the acceptance level to act as OHA, they need to be accounted for in the policy regime.

A time-and-motion analysis of multipurpose healthcare workers from Kashmir.

Background:A multipurpose health worker (MPHW) is the pivotal functionary and the first point of contact in health care sector. This study explores the work-related activity of MPHWs in the different domains and also assesses their time utilization pattern.Methods:A time and motion study was conducted among 12 multipurpose health care workers (MPHWs) from 10 different Subcenters of block Hazratbal. Participants self-reported their daily activities on a time measurement sheet for 6 days. Data were entered in Microsoft Excel and analyzed using SPSS v25.0. Calculations are based on a total of 544.5 person-hours of observation by ANMs.Results:Time utilization pattern revealed that ANMs spent one-fourth of their time on maintaining registers. Observations on self-reporting were comparable with that of observations made by external observers.Conclusions:This study reflects the workload in different domains of MPHWs’ activities and nature of their work, relevance of their job responsibilities in the context to Indian public health standards for their job.

Evaluation of impact of national leprosy eradication programme in a community health centre in Eastern India

Background & Aim: Leprosy a chronic infectious public health challenge is caused by a slowly multiplying acid fast bacillus Mycobacterium leprae. An untreated leprosy-affected person is the only known source of infection. Our aim was to study the trend in the prevalence of leprosy in the health care facility, to compare the leprosy burden in urban and rural field practice area under the health facility, to identify any gaps/loopholes in the implementation of the NLEP and to recommend remedial measures to address the gaps. Materials and Methods: A cross sectional study was conducted at Community Health Centre Jatni, Khordha, Odisha during the year 2018-19. A pre-designed questionnaire, personal interview with multipurpose health worker male and review of leprosy records of different years was used as study tool. Results: Majority i.e., 78.6% of the leprosy patients were from rural areas. Overall male predominance of the cases was found both in urban & rural areas. More numbers of cases were registered during 2014-15 & 2015-16 which was declined in 2016-17, but again increased in the subsequent years i.e., 2017-18 and 2018-19. 61.8% diagnosed leprosy cases had successfully undergone treatment and got cured and 24.4% of the cases were the defaulters to MDT. Conclusion: Defaulter cases are the major source of continuous transmission of infection in the community. Active surveillance for Leprosy is to be strengthened in both rural and urban areas with special focus on IEC and BCC activities along with proper counseling of the family members with involvement of community people. Keywords: NLEP, MDT, LCDC.

Pattern of time utilization by multipurpose health workers male in district Sonipat, Haryana

Background: A multipurpose health worker is the key functionary in a sub centre. They associate with the community at grass-root levels. This study explores time utilization pattern of multipurpose health workers in the multifarious domains of their activities.Methods: A time motion study conducted among health workers (HWs) male of all subcentres of district Sonipat, Haryana. Participants self‑reported their daily activities on a time measurement workbook for one month. Data were entered in Excel and analyzed using statistical package for social studies software.Results: Time utilization patterns revealed that HWs spent nearly one third (31.5%) of their time on national vector born disease control programme. Documentation constituted nearly 16.3% of their time. Others activities include maternal and child health (7.4%), service for minor ailment (6.7%), revised national tuberculosis control programme (6.7%) and meetings (4.5%). They spent 13.9% of their time on non-productive activities. The proportion of time spent on field-based activities was 63.2% and on sub center based activities was 22.9% of the total working time. A negative correlation of field-based activities was found with age, job experience and residing in joint family.Conclusions: The study reflects the time spent by HWs male in various domains of activities in relations to their job responsibilities and the multipurpose nature of their works. Some of the health programmes were ignored by HWs and were also found to be spending significant time on non-productive works.

Ensuring TB Services During Major Floods - Kerala, India, August 2018.

Ensuring the successful treatment of tuberculosis (TB) is an essential public health responsibility of national TB programs. This case study describes how the Department of Health and Family Welfare, Kerala state, successfully prevented the disruptions in TB treatment when an unprecedented massive flood, declared as "a calamity of severe nature," completely disrupted normal operations in the state during August 2018. Unanticipated floods led to the displacement and relocation of more than 1.5 million citizens. The state has ensured continuity of TB treatment for all notified drug sensitive and drug-resistant TB patients (9608 and 434, respectively), including those who were displaced and relocated. A real-time web-enabled, case-based patient management information system has helped preserve the entire patient information, available at multiple levels. Routine strength of the program, including good rapport with patients, frontline multipurpose health workers and treatment supporters, high literacy rate of general population, and well-integrated primary health care system delivering TB services, enabled ensuring continuity of care during the disaster situation. The success of the post-flood TB control measures in Kerala affirms the importance of maintaining an integrated and strong TB control component with general health system ownership.

A cross sectional study on factors influencing the quality of primary health care services provided by multi-purpose health workers in Tiruvallur district, Tamil Nadu

Background: Primary health care definition extends beyond physical aspect to mental and social wellbeing. Health care providers starting from physicians till basic level workers, play a vital role in identifying and meeting client’s health care needs. Quality care is the ability of to meet the health related needs of the population consistent with local and national goals, as well as resource constraints and considered as complex variable encompassing both tangibles and intangibles. Multipurpose workers are the frontline workers were the health problems were sorted out or referred to the next level of health care.Objective: The objective of the study is to identify enablers to a quality primary health care service in Tiruvallur district, state Tamil Nadu.Methodology: This is an analytical cross sectional study carried out on 149 Multi-purpose Health Workers calculated assuming maximum variability and 80% power. The study area Thiruvallur was selected through random sampling and five blocks namely Kadambathur, Minjur, Ellapuram, Tiruvalangadu and Tirutani were selected using lottery method. Parks The study was carried out during the period between January 2019 and June 2019. A structured questionnaire was used to elicit responses. Data were entered on MS Excel sheet. Statistical analysis was done with SPSS 17 version.Results and Discussion: Out of the total 149 Multi-purpose worker included in the study, 98 (65.77%) were females. Majority of them (34.90%) fall within the age group of 3 to 31-40 years. Among them 49.66% have completed their higher secondary level education. Around 57.04% have completed more than 15 years of service. Their structural indicators were below the expected standards compared to process and outcome indicators.Conclusion: Majority of the works were done properly except some defects in the structural level. Resources and Budgets should be reassessed and reallocated. Accredited activities should be made mandatory and should be considered as achievement by the entire health team. Regular audit and appraisal sessions are necessary. MPHW and client satisfaction survey should be done periodically to ensure the quality of services.

Barriers to childhood vaccination as perceived by accredited social health activists and multipurpose health workers in Mewat, Haryana (India): A qualitative research.

Background:As compared to other parts of the country, vaccination coverage and literacy rate in district Mewat, State Haryana (India) had been low, that is, 20.8–27% and 54%, respectively. National immunization program of the country was being implemented primarily through the field workers, and accredited social health activists (ASHAs) were one of the key grass root level link workers.Aims:Hence, this study was carried out with the objective to identify barriers to childhood vaccination by field staff in field practice area of SHKM Govt Medical College Nalhar, Mewat as perceived by ASHAs and health workers.Methods and Material:The current study was a qualitative research which was conducted in the field practice area attached to SHKM Government Medical College Nalhar Mewat. Focus Group Discussions (FGDs) were carried out among health workers (MPHW-F/M) and ASHAs.Statistical analysis used:None.Results and Conclusions:The barriers to childhood vaccination as identified in the study are pain during vaccination and other side effects, additional expenditure on treatment of side effects, worsening of interpersonal relations of the functionaries (workers/ASHAs) with the beneficiaries, extra work burden, unawareness of the benefits of vaccination, myth/belief of potential risk of impotency in adulthood, denial by elders, lack of cash benefits, inaccessibility to vaccination services due to remote work places, people's beliefs in supernatural causes of childhood diseases, delayed BCG vaccination, etc., The barriers to childhood vaccination from the perspective of ASHAs and health workers are explored and identified which can be utilized in tailoring the efforts and strategies to improve the vaccination coverage.

How healthy is our primary health care workforce? A cross-sectional study.

Context:Progress of any nation depends on the health status of the population. A nation's health directly and indirectly depends on the quality of health-care facilities and how healthy the health care workforce is in that country. To achieve the health for all goal and to provide for most of the health services like maternal health services, child health services, nutrition, vaccination, and family planning services, the Indian health system have multipurpose health workers (female and male) and Accredited Social Health Activist to provide these services at the grass-root level. There is a paucity of literature revealing the health problems or the health status of grassroot level primary health care worker in India or abroad.Methods and Material:All the grass-root level health workers, i.e., MPHWF and ASHAs in the BMC area were included in this cross-sectional study. Data was collected using a semi-structured interview schedule, followed by general examination and anthropometry using standard procedures.Results:Half of the study participants 111 (50.2%) were having some or other kind of health issues during the data collection time; among them, 107 (48.4%) had a chronic disease condition. 10% of them had diabetes mellitus. More than half of the study participants 141 (63.8%) were found to be obese and hypertension was found in 27 (12.2%) study participants. 21 (9.5%) study participants were under high depression. One-fourth of the health workers among those who could conceive had not gone for antenatal check-ups and more than one-third (33.5%) never consumed iron and folic acid (IFA) tablets during their first pregnancy. 19.1% have children with incomplete immunization as per age. One-fifth of the participants know about the balanced diet and half of them could not ensure that their family eat a balanced diet and in the majority, the diet was calorie deficient as per the daily requirement.Conclusions:There is an urgent need to formulate a policy to improve the health of the primary care grass-root level health-care workers and regular on-the-job training on nutrition needs to be given to them.

A study to identify the factors associated with nosocomial infection among health workers

- Abstract: Good health depends on the part of safe environment at practices or techniques that control or prevent transmission of infection which helps to protect the clients and health care workers from disease. Nosocomial infections, also known as hospital-acquired infections are newly acquired infections that are contracted within a hospital environment. Objective: 1.To identify the factors associated with nosocomial infection. 2. To associate the factors associated with nosocomial infection with demographic variable. Materials and Methods: The study was conducted at Shenoy Nagar Health Centre, Chennai. Descriptive research design and explorative research approach was used. Samples of 20 Multi-Purpose Health worker were selected using Non-Probability convenient sampling technique on the basis of inclusion criteria. Data was collected by using Modified infection control assessment tool. Results :The overall study reveals that the factors standard precautions and pre and post-operative practices were moderately associated with nosocomial infection (80%) whereas the factor labour room practices was also moderately associated with nosocomial infection but it is (75%). Conclusion: The study findings concluded that all the three factors standard precautions, labour room practices, pre and post-operative practices are moderately associated with hospital acquired infection.