Srishti Singh

Review of Under-Five Deaths through Verbal Autopsy in a Rural Block of Haryana

Under-five Mortality rate (U5MR) indicates the probability of dying between birth and exactly five years of age, expressed per 1,000 live births, if subject to current mortality rates.1 The U5MR is an indicator of health and socio-economic status of a given population and assesses the impact of various intervention programmes aimed at improving the child survival.2 Nearly 6 million children under the age of five died in 2015.3 The risk of a child dying before completing five years of age is highest in the WHO African Region (81 per 1000 live births) followed by Southern Asia.4 According to SRS 2014, the under-five mortality rate in India was 45 per 1000 live births (51 per 1000 live births in rural areas).5 The MDG 4 sole target was specifically aimed to bring down the under-five mortality by two thirds between 1990 and 2015. The proposed SDG target 3.2 aims to end preventable deaths of children under five years of age by 2030 to 25 per 1,000 live births.6 Most child deaths are caused by diseases that are readily preventable or treatable with proven, cost-effective and quality-delivered interventions. Infectious diseases and neonatal complications are responsible for the vast majority of U5 deaths globally.7 Amongst all under 5 deaths in India, prematurity and Low Birth Weight (29.8%), pneumonia (17.1%) and diarrheal disease (8.6%) are the most common causes of deaths.8 Verbal autopsy, a method of obtaining information about a deceased person by asking questions from family and others who can describe the mode of death and circumstances preceding death9 can be used as an alternative method for collecting mortality data and establish the cause of death retrospectively. The verbal autopsy, in simpler words, is a tool to identify delay in seeking care, delay in transport or the delay in providing appropriate care at facility and community levels that contributed to childhood illnesses and mortality. Knowledge about causes of death and any vital event is important for public health planning and resource allocation. Knowledge about causes of death and any vital event is important for public health planning and resource allocation. There is considerable lacuna in vital registration as well as in reporting of the cause of death.10 This study was conducted with the objective to compare the various socio-demographic determinants and socio-cultural factors causing delay and contributing to deaths of infants and children under five years of age.

Assessment of unmet need for family planning and its determinants in a rural block of Haryana

Unmet need for family planning is a valuable concept that is widely used for advocacy, development of family planning policies, implementation and monitoring of family planning programmes worldwide. Women with unmet need are those who are fecund and sexually active but are not using any method of contraception, and report not wanting any more children or wanting to delay the next child. Once derived, the figure of unmet need for family planning can be broken down into unmet need for spacing (women who want a child after two or more years) and unmet need for limiting (women who want no more children).

Study to Assess the Knowledge, Attitude and Practices of Biomedical Waste Management among Healthcare Personnel at a Tertiary Care Hospital in Haryana

Background: Biomedical Waste (BMW) collection and proper disposal has become a significant concern for both the medical and general community. It is estimated that 10-25% of healthcare waste is hazardous, with the potential xa0to create a variety of health problems. Handling, segregation, mutilation, disinfection, storage, transportation and final disposal are vital steps for safe and scientific management of biomedical waste in any establishment. Objectives: To assess the knowledge, attitude and practice among healthcare personnel working in a tertiary care centre. Methods: A hospital based cross sectional study was conducted in the months of February and March 2015. Study participants included resident doctors, interns, nursing staff, laboratory technicians, ward boys and sweepers working in the institute who deal with biomedical waste xa0and were selected randomly to make the sample size of 200 with equal representation in each category. A pretested semi-structured questionnaire was used. Results: The study showed gaps in the knowledge of all categories of respondents. The knowledge of the existence of biomedical waste management was better among doctors (96%) as compared to nurses (88%), paramedical staff (70.9%) or the cleaning staff (16.9%). The knowledge of practical aspects of BMW management was better in nurses, paramedical staff and cleaning staff. Conclusion: The present study highlighted the lack of knowledge at every level. Waste management is everybody’s concern. The need of a comprehensive training for all the categories of hospital staff is highly recommended.

Maternal near-miss audit: Lessons to be learnt

Mother and child constitute a large, vulnerable, and a priority group as the risk is involved with childbearing in women and of growth and development in children. For every woman who dies from pregnancy or childbirth-related causes, it is estimated that twenty more suffer from pregnancy-related illness or experience other severe complications. These women who nearly escape death are categorized under “near miss” which has been defined as “a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.” Maternal near-miss audits give us an opportunity to study the cases which were almost similar to those where maternal deaths happened; thus, their review may give concrete evidence of reasons/deficiencies in health care leading to severe complications and even grave consequences as maternal deaths. Near-miss audits will allow the care of critically ill women to be analyzed, deficiencies in the provision of care to be identified, and comparison within and between institutions and, ultimately, improve the quality of obstetric care and further reduce maternal morbidity and mortality.