volume 1 | issue 1 september 2018 nghjpifapy nghjey nghuie...
TRANSCRIPT
Volume 1 | Issue 1
September 2018
Dept. of Health Research Govt. of India (Mentored by
National Institute of Epidemiology, ICMR-NIE,
Chennai)
Dept of Health & FW Govt. of Tamilnadu
(Partnered by Directorate of Public Health,
Chennai)
Linked to
Tirunelveli Medical College, Tirunelveli (Under the Directorate of Medical Education, Chennai )
………nghjpifapy; nghJey nghUie…… the eternal river of health…….
Pothigai e-news letter of
Model Rural Health Research Unit Kallur, Tirunelveli, Tamilnadu
Model Rural Health Research Unit (MRHRU) located at the Government Primary Health Centre campus, Kallur is linked to the Tirunelveli Medical College (TVMC), mentored by the ICMR-National Institute of Epidemiology and established in partnership with the Department of Public Health, Government of Tamilnadu. MRHRU Kallur was inaugurated on 20th June 2016. This MRHRU is a platform for undertaking product development and health research with view to identify important health problems in the region. The MRHRU houses labs for Molecular biology, Biochemistry, Pathology, Microbiology and has facilities for conducting training and consultation. The Unit is supported by a core team of Scientists, Technical Assistants and field staff. The faculty of TVMCH and Scientists from NIE and other ICMR Institutes are encouraged to utilise this unit for conducting health research. Research Projects will be developed and funding will be sought through competitive process from the National and International funding agencies.
MRHRU – the Family
Dr V.M.Katoch & Dr Sanjay M Mehendale
laid Foundation on 27-8-2014
Inaugurated by Dr.Sowmya Swaminathan
on 20-06-2016
The National Institute of Epidemiology- ICMR performs the role of mentor for the MRHRU in the form of guiding in framing of research questions, provision of human and material resources as well as directing the researchers in obtaining the funds necessary for carrying out the research. The faculty from Tirunelveli Medical College performs the role of researchers taking keen interest in the health problems faced by the local community, planning of research projects, their implementation, translating the results into actions as well as providing point of care clinical services to the community. The Tamilnadu State Health Service collaborates in the research activities by providing access to existing health care infrastructure and manpower as well co-funding projects which are of prime importance to the community. Though the community is majorly a beneficiary of the fruits borne by MRHRU, they also contribute to the research activities by active involvement and participation in all community health education activities and extend their cooperation in various projects from time to time.
MRHRU – the Function 11 October 2017
The MRHRU identified 4 important core areas for concentrated sustained research activity under the MRHRU platform to improve long term gains in the project and increase faculty involvement. The 4 core areas were further stratified into specific priorities and placed with one working group which will actively work towards making specific project proposals and involve in translational research in these areas for some more coming years
FACULTY CONSENSUS MEETING ON RESEARCH IDENTIFYING PRIORITIES
WORKING GROUPS Identification and reduction of risk factors to improve
maternal & neonatal mortality indices CREATE
WORKING GROUPS
School & Adolescent Health Non Communicable Diseases – Cancer, DM, HTN
Communicable Diseases – Seasonal Fevers Geriatric Health
PRIORITIES BASED ON
LOCAL HEALTH SYSTEM
REQUIREMENT AND
FEASIBLITY
STRATIFICATION OF THE WORKING GROUP Observation Studies
Community Based Participatory Research Prevention / Preventive Intervention Studies
Health Systems Research
MRHRU – the Preparation August 2017:Basic Course Workshop in Research Methodology for PG. Participants : PG students TVMC, Total number of Participants 100 November 2017: 2nd Proposal Development Workshop Director NIE presided, Participants : 22 June 2018: Basic Course Workshop on Biostatistics Participants : 45, Resource Persons: Dr R.Ramakrishnan & team March 2018 onwards:Integration of Research training in UG curriculum Weekly Saturday 2 hours devoted to Lectures, Hands on Training and small group discussions on research methods and advances in medical science to develop and conduct Short Term Student projects during the course.
MRHRU – the Way
Forward
CREDIBLE KNOWLEDGE
PARTNER IN THE RURAL HEALTH
SYSTEM
CREATION OF RURAL COHORT
BASED ON DIGITAL TECHNOLOGY
COLLOBORATION WITH NATIONAL AND REGIONAL
INSTITUTES
STARTING A CENTRE OF RURAL
DISEASE REPOSITORY
POINT OF CARE DIAGNOSTIC
SUPPORT TO LOCAL HEALTH SYSTEM
MRHRU-TVMC MOU’s
proposed & in various
stages of
implementation:
Department of Statistics, MS
University, Tirunelveli
Department of Sociology,
Govt. Rani Anna Women’s
College, Tirunelveli.
MRHRU – the Activities
Population
based cohort
in an area or
locality serve
as an ideal
platform for
undertaking
sentinel
demographic
surveillance
activities to
collect data
on
longitudinal
basis to set
health
priorities for
the country.
Developed
countries
have long
established
such cohorts
for understanding and describing trends of
various health events across populations with a
view to develop various health policies.
In India, there are two cohorts; one is Vadu (Pune,
Maharashtra) and another in Vallabhgarh (near
Delhi).
The mandate of this Unit is to undertake research
on disease identified as priority in the
district/region and establishing this cohort will
serve as a platform to undertake various studies
that provides understanding of demography,
socio-economic and health issues and set health
priorities and policies for the area in particular
and for the district or state or nation in general,
based on longitudinal evidence in this platform.
Therefore MRHRU field practice area is an ideal
setting for developing household cohort and is
currently being implemented since 2014.
RURAL COHORT
DIGITAL DATA & GPS MAPPING
ROAD MAP: Diseases wise registers – will be utilized for longitudinal follow-up of different types of
diseases over years as well as help in planning of research projects and health policies.
61%
39%
HOUSEHOLD
ENUMERATION
STATUS (N=10951)
Households
enumerated
Households
pending to be
enumerated
54% 46%
POPULATION
ENUMERATION
STATUS (N=40368)
Population
enumerated
Population
pending to be
enumerated
HEALTH EDUCATION ACTIVITIES
SCHOOL CAMPAIGNS Health education program focusing on hygiene practices, balanced diet and menstrual hygiene for adolescent girls are conducted routinely
MASS CAMPAIGNS Mass Health campaigns for young women, new mothers and general public regarding dangers of anemia and methods to prevent nutritional anemia
FAST FACTS
38.8% Of the adolescent girls in the MRHRU field area were found to be anemic and 40% never took de-worming tablets
30.4% Of the Under Five children were found to be Underweight
38% Of the antenatal women were found to have Hemoglobin less than 10gm%
The ICMR Task force Nutritional Anemia project is a multi-centric study implemented across nine centers with MRHRU, Kallur as one of the centers. The study is being implemented as three phase; phase 1 involves collection of baseline data among adolescent girls, pregnant women and under-five children. Phase 2 is about intervention to improve the health status of the community and phase 3 involves the assessment of impact of the health intervention. At MRHRU, Kallur, phase 1 has
been successfully completed and
baseline data collected. Phase 2
is currently being carried out in
the form of various activities
such as:
1. Targeted Door to Door Health Education: 22 volunteers from 10 villages were trained to do house to house Health Education on nutrition.
2. School Health Campaign: Adolescent children were given Health Education & Training on nutrition, personal
hygiene and environmental sanitation by experts from NIE
3. Mass Village Health Education
& Training campaign
4. Healthy Cooking: 8 cooking competitions to enhance public participation and awareness of healthy, low cost, locally available hygienic food preparation practices.
5. Identification of malnourished children under each HSC and provision of expert advice on improving nourishment and preventing diseases.
PRELIMINARY OBSERVATION
Adolescent Girls: Girls with Anemia 38.8%
Mild Anemia (11.9-10gms) 63.8%
Underweight for age (BMI<20) 31.5%
Low Ferritin levels 35.5% 31.5%<15mg/ml
26.6%<12ng/ml
Low Selenium 24.9%
Low B12 Level 33.6%
No Health insurance 35%
Hand wash after defecation 77.5%
Not in Mid-day Meal Program 63.6%
Not availing ICDS services 94.6%
Never received de-worming tabs 40%
Not received IFA tablets 27%
Not aware of Govt. Programs 92%
Age-
Group
Total
Pregnant
Women
Anemic
Women
12-20
Years 27 17 (62.9%)
20.01-25
Years 116 48 (41.4%)
25.01-30
Years 76 31 (40.8%)
Above 30
Years 21 10 (47.6%)
MULTI COMPONENT HEALTH INTERVENTION
FIELD PHOTOS
Healthy cooking competition in progress at a village
anganwadi center. Around 100 women have
participated in the cooking competition so far from 6
villages and the program is ongoing. The women were
motivated to cook healthy dishes from locally available
healthy and less expensive raw materials in a hygiene
kitchen.
Drawing competition and elocution competition
was conducted on the theme Swachh Bharath
among school children. Initial screening was
done in each school and for the final round,
around 150 students participated
enthusiastically. Drawing kits were provided
free of cost for the children and health
education was given at the end of the
competition
Health education on personal hygiene and
balanced diet being given to school students
by Faculty from Tirunelveli Medical College.
8
In 2014, a base line survey was conducted on the Toilet Use and Defecation practices amongst
adolescent girls in the study area under Kallur Government Primary Health Centre in Tirunelveli District,
Tamilnadu. Nearly 39.4 % (92/ 233) girls reported the practice of open air defecation due to various social,
economic and personal reasons. 135 of the 233 Households had toilets. While majority (88/98) of the
households did not have toilets, and practiced OAD, 4 households having toilets practiced OAD.
A follow-up survey was conducted among the same adolescent population in early 2018 and
prevalence of OAD has reduced to 24.1% from 39.4% and it is found to be a statistically significant
reduction in the prevalence. 100% of all households in Tirunelveli district now have IHHL now. This district
has achieved the 2019 target of Swachh Bharat Gramin programme of the Government of India as on date.
Though there has been an increase individual household having their own latrine, people have other social
factors which have prevented them from stopping from open air defecation. A detailed study will provide
with data regarding these factors and help to formulate plans to alleviate the identified social factors.
100% of all households in Tirunelveli district have IHHL
OAD has dropped to 24.1% from 39.4%
Art from Drawing competition
conducted at Kallur in the theme
“Swachh Bharat”