Dr N. Devadasan was invited by the ITM Antwerp to help coach their MPH students on local health systems. He was there for the whole month of Sept 2015.
It was a great learning opportunity as he was able to interact with health professionals from 25 different countries (4 continents).
Recently food security provisions in India has improved and not surprisingly the country is operating one of the largest food safety nets in the World. However regarding figures related to malnutrition particularly chronic malnutrition, the country is at very poor level. There are many challenges in implementation of food security schemes which hinders achieving desired outcomes of reducing malnutrition and the benefits reaching the actual poor.
Link to Manoj’s blog in Global Food Security….Click here
After successfully managing three consecutive batches for the online course in Public Health Management (e-PHM), we kick started the fourth batch on 19th of August 2015. This batch brings along with it 31 amazing students from diverse backgrounds working across the country and internationally as well!
For the first time, we have five participants from Universitas of Gadjah Mada, Yogyakarta who are working in the department of public health. The diverse work backgrounds of the participants include UNICEF, National Institute of Epidemiology, St.John’s Research Institute, Bangalore Baptist Hospital, Department of Environmental Science and various NGO
s like JANANI and SAATHI.
We also have participants who are pursuing their PG in the field of community medicine and hospital & healthcare management. The course consists of eight modules and each module consists of four units. Each unit will have one to two classrooms that is a PowerPoint presentation with audio recording and corresponding exercises. Each module ends with a final module test based on the content covered. The students are expected to complete these units and based on their completion we are presenting their progress. Based on the feedback provided, this new batch has new features to make the learning experience more interesting and fun. Keeping in mind the work backgrounds of our participants who have to travel constantly and have limited internet access, we have introduced a new feature called “Learn on the go”. This feature allows them to download MP3 versions of our classrooms and listen to them on the go! Out of 31 students, 30 have logged in and viewed our course. The number of students who have managed to complete Module – 1 are 19, which is about 61% of the total students.
We are currently in the process of identifying any challenges faced by the participants and address them as we move forward in the course. We look forward to providing a good learning experience to the participants!
In India, tuberculosis (TB) is still a major public health problem. In this blog, the author reflects on the stigma and discrimination faced by TB patients and how it affects their health seeking behaviour.
Link to Munegowda CM blog in BMJ can be found here
Many of us are aware that the importance of breastfeeding in child growth and nutrition.But have we ever wondered, in a developing country like India where many mothers are now into formal or informal work, why is it important to have a mother-friendly workplace. World Health Organisation recommends exclusive breastfeeding for the first six months of baby’s life and early initiation of breastfeeding for protecting the child from various types of malnutrition.But unfortunately, breastfeeding has never been a central agenda in long history of health reform in India. Results are obvious. India houses larger number of malnourished children , twice as large as of Sub-Saharan Africa and five times larger than our neighbor China. Here is a blog which discusses what barriers exist and what can be done to bring back good breastfeeding practices into the list of larger sustainable goals for the country.
Link to Manoj Pati’s blog in BioMed Central can be found here
In India, only 20% people with minor illness, and only 50% people with serious illness come to Government hospitals. Thus, there is a need to understand the reasons influencing health care seeking practices to generate demand for health programmes. Amongst rural and tribal communities in Madhya Pradesh, it has been generally noticed that the first point of contact for any illness is a private provider, many-a-times an untrained practitioner, since they are easily accessible. Literacy level is quite low in the state, particularly in rural and tribal communities, resulting in being unaware of the basic symptoms of Tuberculosis (TB) and availability of free treatment and diagnostics at Government health facilities. Some TB patients also discontinue treatment, due to lack of awareness. At times these people also get required medications from a local pharmacist, since they have low faith in Government health system and when condition worsens (both in terms of health as well as finances), they visit a Government health facility. Also these communities are generally dependent on daily labour, leading to delayed TB diagnosis and treatment, in fear of loss of wages. Alcoholism & tobacco use of all forms is predominant in these communities, thus affecting the treatment adherence.
Barriers & constrain
ts
With reference to the programme delivery, a number of barriers play a role in influencing health care seeking behaviour of rural and tribal communities of Madhya Pradesh, such as unavailability of health staff, poor accessibility due to distance, unavailability of medicines and other requirements, to name a few. A major proportion of rural and tribal communities are residing far off from the Government health facilities, and thus even if the PHC is open and there are health staff providing services round the clock, it is difficult for a sick person to reach the PHC.
Beliefs influencing TB health seeking behaviour
Rural people in India and tribal populations in particular, have their own beliefs and practices regarding health. Some tribal groups still believe that a disease is always caused by hostile spirits or by the breach of some taboo. They therefore seek remedies through magic and religious practices.
Amongst tribals in Madhya Pradesh, evil spirits are attributed to be the cause of TB. The belief that TB occurs due to supernatural powers lead to the concept of seeking relief through magic, keeping the allopathic medical practitioner as a last resort. There are also beliefs that they cannot get TB, hence leading to delayed treatment seeking.
Lessons learnt and way forward
To summarize, there are many reasons for people to go to a particular health provider. Most important reasons include awareness, money, distance and availability of staff. These factors play a role in creating demand for any health programme, particularly the Revised National TB Control Programme (RNTCP). Hence, there is a need to address the issues that influence TB health seeking behavior such as improving the availability of trained staff at health facilities, enhance level of awareness amongst the community about TB – IEC activities to be increased, regular patient provider meetings to ensure treatment adherence as well as improved faith in Government health system. Also in RNTCP, there is a scope for involvement of NGOs in the programme – since most of the rural and tribal habitations are quite interior, Sputum collection centres can be established through NGOs nearer to these communities.
Moumita Biswas was a student of e-learning course in Public Health Management(ePHM) conducted by Institute of Public Health, Bangalore, India.
Disclaimer: IPH blogs provide a platform for ePHM students to share their reflections on different public health topics. The views expressed here are solely those of the authors and not necessarily represent the views of IPH.
