Apurba Sinhababu

Prevalence of diabetes mellitus, impaired fasting glucose, impaired glucose tolerance, and its correlates among police personnel in Bankura District of West Bengal.

A cross-sectional study was conducted among police personnel (N = 1817) in Bankura District, West Bengal, India to estimate the prevalence of diabetes mellitus (DM), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and its correlates during July-November, 2011. Participants were enquired about their age, gender, physical activity, and predominant occupational activity. Diagnosis of DM, IFG, and IGT was based on a history, fasting, and 2-h post-load blood glucose estimation as per World Health Organization (WHO) criteria. Body mass index, waist circumference (WC), and blood pressure (BP) were estimated. Out of 1817 subjects, DM was found in 15%, 1.1% had IFG and 5.7% had IGT. Age >50 years, family history of diabetes, hypertension, and abdominal obesity were found to be significantly associated with DM and IGT, whereas IFG was significantly associated with the family history of diabetes and hypertension. High prevalence of diabetes and pre-diabetic condition warrants early effective intervention to keep the police force healthy and agile.

Assessment of Nutritional Status by Composite Index for Anthropometric Failure: A Study Among Slum Children in Bankura, West Bengal

A community-based cross-sectional study was conducted to find out the prevalence of composite index of anthropometric failure (CIAF) among 117 slum dwelling under-five children in Bankura town, West Bengal and its relation with some common socio-economic factors. Among study population, the prevalence of underweight was 41.6%, whereas CIAF was 80.3%. CIAF gave a near complete estimation of undernutrition unlike underweight. Children who were unimmunized, with more number of siblings, living in a nuclear family, or with illiterate mothers were more likely to be undernourished.

Association of child feeding practices with nutritional status of under-two slum dwelling children: a community-based study from West Bengal India.

A cross-sectional study was conducted among 245 under-two slum-dwelling children in Bankura town, West Bengal, to assess their feeding practices and its association with nutritional status. Childs gender, number of family members, standard of living (SLI), and household food security (HFS) were assessed through interview of mothers/ caregivers. Child feeding practices were measured with Composite Child Feeding Index comprising of age-appropriate, multiple, infant and young child feeding (IYCF) indicators and expressed in standardized IYCF score. Weight and length of the children were measured and the nutritional status was assessed using World Health Organization Growth Standard 2006. Standardized IYCF score was significantly lower in undernourished children than those with normal grades. Per unit increase in standardized IYCF score was likely to reduce the prevalence of underweight, stunting and wasting by 2-3% after adjusting for other variables. Low/ very low HFS, low SLI and female gender were associated with underweight and stunting.

Are the Adolescent Behaviors too Risky? A School-based Study in a District of West Bengal, India

A cross-sectional study was undertaken among 2068 school-going adolescents of a subdistrict area of West Bengal, India for assessment of entire array of risk behaviors and their correlates. Aggressive, suicidal, substance use and sexual risk behaviors were measured using a self-administered, multi-item, validated questionnaire in the local vernacular. Prevalence of physical fights, weapon carrying in the last 30 days and gang fights in the last 12 months were 27.1%, 7.3% and 13.0%, respectively. Current users of tobacco, alcohol and illicit substances were 7.1%, 3.4% and 2.0%, respectively. Suicidal ideation and attempts were reported by 11.7% and 3.5% of students. Almost one-tenth of respondents had premarital sexual intercourse. Male gender, low subjective economic status, exposure to electronic media and poor academic achievements were associated with most of the studied risk behaviors, except that females showed more propensities to suicidal behavior. The magnitude and pattern of adolescent risk behaviors, though less studied in India, warrants urgent, coordinated actions.

Does Janani Shishu Suraksha Karyakram ensure cost-free institutional delivery? A cross-sectional study in rural Bankura of West Bengal, India

BACKGROUND Janani Shishu Suraksha Karyakram (JSSK) was launched in India to ensure cost-free institutional delivery. OBJECTIVES 1) To assess the awareness of recently delivered women regarding JSSK 2) To estimate the cost of institutional delivery and its differentials. MATERIALS AND METHODS A community-based, cross-sectional study was conducted in a rural community in Bankura, West Bengal, India in 2013, among 210 women who delivered babies in the last 12 months. Information regarding sociodemographic and health service-related variables as well as item-wise costs incurred for institutional delivery were collected. Costs were expressed in Indian National Rupee (INR). A nonparametric, bivariate analysis was performed to examine the difference in median cost. RESULTS All components of JSSK were known to 12.9% women; the highest (77.1%) for admission and lowest (29.0%) for blood transfusion. The median (±IQR) costs of delivery in the Block level Primary Health Center (PHC), medical college, and private facilities were INR 205.0 (±825.0), 900.0 (±1013.0), and 6600.0 (±16195.0), respectively. Median cost of normal delivery in a private facility (INR 2750.0) was 3.6 times of that in a government facility (INR 765.0). Median direct cost of caesarian section (CS) in a government facility (INR 1100.0) was nearly one-fifteenth of that in a private facility (INR 16,350.0). Cash incentives under Janani Suraksha Yojana for poor and socially marginalized women could not cover the cost of CS delivery in a government facility. CONCLUSION Gaps existed in the awareness of beneficiaries regarding entitlement under JSSK. Drugs and transport were two major causes of out-of-pocket (OOP) expenditure in public health facilities.

A study on care seeking behavior of chest symptomatics in a slum of Bankura, West Bengal.

A cross-sectional, community based study was undertaken in Patpur slum of Bankura to determine the prevalence of chest symptomatics, their health care seeking Behavior and its correlates. Prevalence of chest symptomatics (cough for 3 weeks or more) was found to be 5.5%, three fourths of whom sought relief from a health care provider. Among them, 70.8% did so within 2 weeks, median being 7 days. No preference for either government or private health care provider was seen in first visit, where the major reason for choosing facilities was advice by family & friends (43.8%). Most of the chest symptomatics (75%) were retained in the same facility. Shift from private to government facility for subsequent visits (33.3%) was higher than from government to private facility (16.7%). The main reason (50%) for changing health facility was expectation for better service.

Access to and utilization of voucher scheme for referral transport: a qualitative study in a district of West Bengal, India

Background: Lack of motorized transport in remote areas and cash in resource-constrained settings are major obstacles to women accessing skilled care when giving birth. To address these issues, a cashless voucher transport scheme to enable women to give birth in a health-care institution, covering poor and marginalized women, was initiated by the National Rural Health Mission in selected districts of India in 2009. Methods: The access to and utilization of the voucher scheme were assessed between December 2010 and February 2011 through a qualitative study in the district of Purulia, West Bengal, India. Data were collected from in-depth interviews and focus group discussions with women, front-line health-care workers, programme managers and service providers. Results: The main factors influencing coverage and utilization of the scheme were: reliance on ill-prepared gram panchayats (village councils) for identification of eligible women; poor birth preparedness initiatives by health-care workers; over-reliance on telephone communication; restricted availability of vehicles, especially at night and in remote areas; no routine monitoring; drivers’ demand for extra money in certain situations; and low reimbursement for drivers for long-distance travel. Conclusion: Departure from guidelines, ritualistic implementation and little stress on preparedness of both the community and the health system were major obstacles. Increased enthusiasm among stakeholders and involvement of the community would provide opportunities for strengthening the scheme.