An unabated growth of street dwellers in the city of Calcutta is reported to be due to twin reasons like, migration of rural poor people as well as uncontrolled fertility among these poor settlers of the city. A community-based study on reproductive health, fertility and related care seeking behaviour was studied among a sample of women of child bearing age living on streets of Calcutta. Besides, the quite common conditions like leucorrhoea (28.5%), menstrual irregularities (12.3%), infertility (2.5%) and STDs (1.3%) were also reported. But most of these illnesses (three-fourth) were uncared for, and the remaining one-fourth sought treatment from govemment institutions, private agencies or even from untrained practitioners (quacks). The reproductive behaviour of street dwelling women was characterised by early marriage, teenage pregnancies, and scarce use of contraceptives (32%) as well as frequent abortions (2.8%). Very few pregnant women received adequate antenatal care (3.8%). Coverage of tetanus toxoid immunisation (68.5%) and proper iron and folic acid supplementation (16.7%) were also poor. Whereas, antenatal care was received mostly from government health institutions (71%), home delivery (ie, on street) was a common practice and conducted mostly by untrained birth attendants (51.8%).
"Bangladesh has experienced one of the highest rates (>6% per year) of urban population growth in the last three decades compared to the national population growth rate of about 1.5% per year
[1-4]. The numbers of the urban poor and street-dwellers are likely to increase at least in proportion to the overall population growth
[Show abstract][Hide abstract] ABSTRACT: Background
In almost every major urban city, thousands of people live in overcrowded slums, streets, or other public places without any health services. Bangladesh has experienced one of the highest rates of urban population growth in the last three decades compared to the national population growth rate. The numbers of the urban poor and street-dwellers are likely to increase at least in proportion to the overall population growth of the country. The street-dwellers in Bangladesh are extremely vulnerable in terms of their health needs and healthcare-seeking behaviours. In Bangladesh, there is no health service-delivery mechanism targeting this marginalized group of people. This study, therefore, assessed the effectiveness of two models to provide primary healthcare (PHC) services to street-dwellers.
This study of experimental pre-post design tested two models, such as static clinic and satellite clinics, for providing PHC services to street-dwellers in the evening through paramedics in Dhaka city during May 2009-April 2010. Both quantitative and qualitative techniques were used for collecting data. Data were analyzed comparing before and after the implementation of the clinics for the assessment of selected health and family-planning indicators using the statistical t-test. Services received from the model l and model 2 clinics were also compared by calculating the absolute difference to determine the relative effectiveness of one model over another.
The use of healthcare services by the street-dwellers increased at endline compared to baseline in both the model clinic areas, and the difference was highly significant (p < 0.001). Institutional delivery among the female street-dwellers increased at endline compared to baseline in both the clinic areas. The use of family-planning methods among females also significantly (p < 0.001) increased at endline compared to baseline in both the areas.
As the findings of the study showed the promise of this approach, the strategies could be implemented in all other cities of Bangladesh and in other countries which encounter similar problems.
Health Research Policy and Systems 06/2012; 10(1):19. DOI:10.1186/1478-4505-10-19 · 1.86 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A hospital-based retrospective study on a sample of 228 nurses involved in patient care, in two medical college hospitals of West Bengal, showed that 61.4% of them sustained at least one Needle Stick Injury (NSI) in last 12 months. The risk of such injuries per 1000 nurses per year was found to be 3,280. Out of the most recent injuries among 140 nurses, 92.9% remained unreported to appropriate authorities; in 52.9% events hand gloves were worn by the nurses; only 5% of those nurses received hepatitis B vaccine, 2.1% hepatitis B immunoglobulin and none of them received post exposure prophylaxis for HIV.
Indian journal of public health 01/2008; 52(3):150-2.
[Show abstract][Hide abstract] ABSTRACT: This community-based cross-sectional study was conducted in Dhaka city over a 12-month period from June 2007 to May 2008. The study population included ever-married females and males aged 15-49 years. Data for the study were collected through a community survey and exit interviews. Both bivariate and multivariate analyses were done. Seventy-two per cent of female and 48% of male street-dwellers interviewed were sick at the time of data collection. Twenty-one per cent of deliveries were conducted on the street. Eighty-nine per cent of the street-dwellers reported that their children aged less than 5 years had more than one symptom associated with acute respiratory infection during the last 2 weeks. Thirty-seven per cent of the females and 34% of the males interviewed reported that their accompanied children had diarrhoea. A few street-dwellers sought services for their health problems, and most went to the nearest pharmacy and to mobile clinics run by a non-governmental organization at night. Eighty-eight per cent of the female and 88% of the male street-dwellers used open space for their defecation. The street-dwellers are extremely vulnerable in terms of their health needs and health-care-seeking behaviours. There is no health service delivery mechanism targeting this marginalized group of people. Although the health, nutrition and population sector programme of Bangladesh designed programmes to ensure equitable essential services to all, this marginalized group of people was not targeted. The Ministry of Health and Family Welfare and private sectors should, thus, should focus future programmes to meet the needs of this extremely vulnerable group. Mobile and static clinics at night for street-dwellers may be potential programmes. Action research to assess the effectiveness of programmes is essential before large-scale implementation.
Health Policy and Planning 07/2009; 24(5):385-94. DOI:10.1093/heapol/czp022 · 3.47 Impact Factor
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