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Dr. Akanksha Verma

The document provides a community profile of Bithauli Khurd village in Lucknow, Uttar Pradesh. It summarizes that the village has a total population of 1738 people from 291 households. Most residents belong to scheduled caste or other backward castes. Literacy rates are 52.4% overall, with males at 58% and females at 44%. The village has one sub-center for health that is not open 24/7 and lacks proper facilities. Access to resources like the public distribution system and BPL cards is uneven across socioeconomic groups in the village.

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shubh verma Community Profile of Bithauli Khurd village Chinhat Block Lucknow Uttar Pradesh
TATA INSTITUTE OF SOCIAL SCIENCES MUMBAI SCHOOL OF HEALTH SYSTEM STUDIES MASTER OF PUBLIC HEALTH IN SOCIAL EPIDEMIOLOGY 2014-16 RURAL INTERNSHIP REPORT INTERNSHIP ORGANISTION VATSALYA LUCKNOW DISTRICT, UTTAR PRADESH SUBMITTED TO: PROF. ANIL KUMAR SUBMITTED BY AKANKSHA VERMA- M2014PHSE002 HARINDER KUMAR- M2014PHSE010
Acknowledgement At this juncture of the completion of my internship presentation and report writing I would like to take this opportunity to express my heartfelt gratitude to thank each and everyone who helped me during this internship First of all I would like to thank the Almighty for always showering his blessings on me and giving me this life and all the other blessings. I would also like to thank all the internship coordinators for giving us this opportunity in the form of this rural internship to explore the new facts and get new experiences in a rural setting. I would also take this opportunity to sincerely thank Prof.Anil Kumar sir for providing his valuable guidance and support throughout the period of internship and helping me shape my vision and improve my skills and also learn the intricacies of working in a very different setting I would also like to thank School of health system studies, Mumbai for the valuable support. Also a sincere thanks to Vatsalya, Lucknow and especially Dr.Neelam Singh for giving me this opportunity to be a part of such a respected organisation and give me this opportunity to work in a different setting. In the end I would like to thank my Family, especially my parents for their tireless effort and support in making me capable to reach this stage in my life
Objective 1. To assess the boundaries and landmarks of the village BITHAULI KHURD 2. To determine the socio-economic and demographic profile of BITHAULI KHURD 3. To understand the living conditions, health problems and health facilities available in BITHAULI KHURD 4. To assess the public resources available in the village, how many of these resources are actually functional, how does it affect the availability, accessibility and affordability for certain sections of the village community Research Design A community based study was undertaken to study the socio-economic profile, demographic profile, living conditions, health problems and availability of health facilities in BITHAULI KHURD village of Lucknow. Also a mapping of the boundaries of the village was done and an assessment of the various resources present in the village and also how the accessibility and the availability of these resources varies for the different socio-economic sections of the population Key informant interviews, focussed group discussions and observation methods of qualitative data collection were employed to gather information on the living conditions, practices and beliefs of the people and the facilities available and issues faced by the people and also a semi structured questionnaire was also used. Secondary data was also obtained from the department of Health, AROs office, and B.D.Os offices and also data was gathered from the various frontline worker like ASHA, AWW, and ANM for demographic and socioeconomic profile.
Research Methodology: Universe of study: Bithauli Khurd village in Bithauli Khurd panchayat in Chinhat block of Lucknow district in western Uttar Pradesh Type of Study: It was a cross sectional study Sampling frame: Households in the village of Bithauli Khurd Sampling: Convenience Sampling (Non-Probability) Sample size: 52 house holds Methods of data collection: Face to face interviews were carried out. Tool used: Semi-structured interview schedule which was translated and conducted in hindi Secondary data was also obtained from the health professionals and the other frontline workers Ethical consideration: Verbal consent was taken from the respondents prior to the interview and participation was made voluntary. Respondents were made aware and assured of confidentiality.
Introduction Uttar Pradesh (literally "Northern Province"), abbreviated as UP, is a state located in Northern India. The state is bordered by Rajasthan to the west, Haryana and Delhi to the northwest, Uttarakhand and the country of Nepal to the north, Bihar to the east, and Jharkhand to the southeast, Chhattisgarh to the south and Madhya Pradesh to the southwest. It covers 243,290 square kilometres (93,933 sq mi), equal to 6.88% of the total area of India, and is the fourth largest Indian state by area. With over 200 million inhabitants in 2011, it is the most populous state in the country as well as the most populous country subdivision in the world. Hindi is the official and most widely spoken language in its 75 districts. Uttar Pradesh is the third largest Indian state by economy, with a GDP of 9763 billion (US$150 billion). Agriculture and service industries are the largest parts of the state's economy. Lucknow is the largest and the capital city of Uttar Pradesh.
BLOCK OF LUCKNOW: There are 8 blocks in Lucknow district LUCKNOW BAKSHI KA TALAB CHINHAT GOSAIGANJ KAKORI MAL MALIHABAAD MOHANLALGANJ SAROJINI NAGAR
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CHINHAT BLOCK: There are 33 panchayats in Chinhat Block, of which the alloted gram pachayat is BITHAULI KHURD BASIC PROFILE OF THE BLOCK: The total population of the block is 1.98000 of which majority of the population consists of Hindus which constitute of around 68% of the total population whereas the rest consists of the Muslims Literacy rate: Males 69% Females 48% Total 57.4% Total Population: 1,98,000 Pregnant mothers 4733 Lactating mothers 4700 O to 1 yr total children 4061 1 to 5 yrs children 28000
SCHOOLS: 1. Chief school : 107 rural 2. Urban :59 Health care facilities: Taking into account the health care facilities of the whole block there are about 258 anganwadi workers, 65 ASHA, 33 ANM. There are 35 sub-centres, 4 primary health care centres but not all of them are upgraded to 24*7 facility. There is one CHC (24*7 upgraded) and the JSY load is 185 Immunisation status: Immunisation status for the whole block for the year 2013-14 was 97.2% and for 2014-15 is has increased to 98 % Family planning services: 1. Tubectomy 42 Intra uterine devices done 152 Oral pills 1286 Condoms 1667
VILLAGE: BITHAULI KHURD Introduction : The total POPULATION of the village is 1738 which consists of 291 (Rural) households. As the village is under the process of urbanisation thus some portion of the village is under urban setting and the majority still comes under rural areas. There are geographical segregations in terms of the pockets where the hindus and the muslims or the people from the general category as well as other categories like OBC, SC,ST are residing There is 100% electrification in the village .there is one PUBLIC DISTRIBUTION SHOp but what was revealed while doing the community survey and the mapping was that the system was very well functioning for the effluent sections of the village but was not working effectively for the poor and some particular caste and classes in the village. Of the total population around 62% of them had a BPL card while the rest did not . BPL card holders 62% No BPL card 38% Literacy rate: Males 58% Females 44% Total 52.4% Total literacy rate for the whole population is around 52.4% , in which the literacy rate for males is 58% and for females it is around 44%.
Caste wise distribution: CASTE MALES FEMALES GENERAL 108 96 OBC 816 124 SC 543 295 Majority of the population belongs to the SC and OBC community where as only as small section of the population belongs to the general population. HEALTH FACILITIES: There is one sub centre present in the village which has one ASHA, present. The SC is not functional 24*7 and lacks many of the basic necessities like proper hygiene and sanitation facilities. Further as there is no other health care facility in the nearby, and the nearest government health care facility is a 10 to 12km away ,people generally prefer to go to the private health care facilities which in most of the instances are not qualified health care professionals thus compromising on the health and the services they get. SUB CENTRES 1 PRIVATE HEALTH CARE PROVIDERS 10 VETERNARY HOSPITAL 1
Family planning services provided by the frontline workers in the last three months Of the total 291 households in the village there are around 70% of the houses which have inbuilt toilets where as 30 % still doesnt have toilet facilities and use the public toilets, many of which are still non-functional and ill constructed. Results: Basic demographic data: Of the total households interviewed about 69% of the households had males as the head of the households whereas the rest have females as the head of the household 0 10 20 30 40 50 60 70 male femals 68.2 31.8 gender of head of hte household 68.2%
Religion: Of the total house holds around 74.2% of them belonged to hindus whereas the rest 24.8% were of the muslim population Caste: Majority of the population belongs to SC and OBC population where as a small percentage belongs to general 0 10 20 30 40 50 60 70 80 hindu muslim 74.2 24.8 religion of the household 0 5 10 15 20 25 30 35 40 45 general obc sc 29.7 27 43.2 caste wise distribution
Housing characteristics: 66.8% of the respondents had pucca house while 16% had a kuccha house PDS Utilisation: 76% of the respondents said they had access to the PDS system while the rest said that they did not Income of the household: income of the house hold ranged from less than 1000 to 10000 and above with majority of the respondents falling in the category of 1000 to 4999 16 66.8% 0% 10% 20% 30% 40% 50% 60% 70% 80% kaccha semi pucca pucca Type of house Percentage 76% 24% 0% 20% 40% 60% 80% Yes No PDS Utilisation PDS Access 0 10 20 30 40 50 60 70 80 less than 1000 1000 to 4999 5000 to 9999 10000 and above income of the household
BPL card holder: 84% of the respondents had a BPL card while rest didnt Educational status of the head of the household Occupation of the head of the household 84% 16% 0% 20% 40% 60% 80% 100% Yes No BPL card Holder BPL card Holder 40 42 44 46 48 50 52 54 56 literate lilleterate 54.1 45.9 educational status of the head of the household 0 10 20 30 40 50 manual labour farming others 48.6 24.3 27 occupation of the head of the household
Health related findings: Place of delivery of the last child Majority ie 54.3% of the respondents went to a private setting for the delivery Breast feeding initiated within one hour of birth: Only 18.2% of the respondents said they had started breast-feeding within one hour of delivery 0 10 20 30 40 50 60 government private home 28.6 54.3 17.1 place of the last delivery 0 10 20 30 40 50 60 70 80 90 yes no 18.2 81.8 breast feeding initiated within one hour of birth
Type of services availed when ill 36% of the respondemts said that they preffered to go to a private hospital when ever they fell ill and omly 14% of them said that they would prefer going to a government setting. When asked about the reason for non-utilisation of the government health care setting, poor quality of care, long waiting hours, unavailability of the health care facility were cited to be the major reasons Substance abuse was very high among the respondents and the major form of consumption was beetal nut chewing , beedi consumption and gutka consumption 30% 36% 16% 14% 0% 10% 20% 30% 40% private clinic private hospital sub center govt. hospital Type of services availed when ill Type of services availed when ill 2% 4% 26% 12% 40% 10% 6% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% no nearby facility facility timing not convinient health personal often absent waiting time too long poor quality of healthcare servises usually medicine not available in the facility don't trust Reason for non utilisation of Govt. facilities 56% 22% 14% 72% 0% 10% 20% 30% 40% 50% 60% 70% 80% Smokeless tobacco Cigarette/Beedi Alcohol Beetul nut Substance abuse
Using family planning services There was very high unmet needs for the contraception and one of the reasons cited for this was the inability of the frontline workers to provide the services Have a toilet facility 70% of the respondents said that they had a toilet facility. But still around 30% of the respondents said that they practiced open defecation Practicing open defecation 0 10 20 30 40 50 60 70 80 90 yes no 16.2 84.7 using any form of family planning services 0 10 20 30 40 50 60 70 80 yes no 70.2 29.8 having a toilet facility 0 10 20 30 40 50 60 70 yes no 68.2 29.8 practicing open defecation
Water treatment Majority ie 75.8% of the respondents said that they were not treating the water used for drinking to make it safe. When asked about the methods used for making the water safe they said that they used boiling or chlorine tablets to make it safe Methods used 0 10 20 30 40 50 60 70 80 yes no 24.2 75.8 treating dreanking water 0 10 20 30 40 50 60 boiling chlorine other 24.2 16.1 59.4 methods of treating dreanking water
Discussions: The total POPULATION of the village is 1738 which consists of 291 (Rural) households Total literacy rate for the whole population is around 52.4%, in which the literacy rate for males is 58% and for females it is around 44%.. Although majority of the households had a toilet facility still a large no. of people went for open defecation practices. There was very high unmet need for the contraception and the main reason cited for this was the lack of services being provided by the frontline workers FGDs and KI interviews from both the providers and the beneficiarys side revealed many facts about the present situation of the health care system and the prevailing problems in the community. Most of the FGDs revealed that majority of the population felt dissatisfied with the working of the health care functionary like ASHA and AWW Of the total 291 villages in the village there are around 70% of the houses which have inbuilt toilets where as 30 % still doesnt have toilet facilities and use the public toilets , many of which are still non-functional and ill constructed. Total literacy rate for the whole population is around 52.4% , in which the literacy rate for males is 58% and for females it is around 44%. There is one sub centre present in the village which has one ASHA , present. The SC is not functional 24*7 and lacks some of the basic necessities like proper hygiene and sanitation facilities. On respondent stated Adhikari log zyada kuch kaam kar nai paa rahe hain, aur ASHA behanji bhi bas tab hi kaam karti hain jab adhikari kar daura hota hai. Many of the respondents were not aware about the services to be provided to them by ASHA and AWW. sarkari mein jaana pasand nai karte kyuki waha suvidhaayein nai hai aur jaha hain waha doctor theek se baat nai karte jaankari bas tabhi dene aati hai jab badi doctor aati hain , jo samay pe pahuch gaye unko suvidhaayein mil jaati hain baaki reh jaate hain On family planning and unmet needs on respondent said that agar yeh sab jaankaari aur suvidhayein humein mile toh family itni kyu badhegi..agar gareeb logo ko mahilaao ko yeh suvidhayein mil jaae toh itne bacche ho hi nai kuch bhi nai batati ki bacche kam kaise ho Sarkar ne boht si suvidhaayein di hain jo humein pata hi nai..unse bachta hi nai toh janta paayegi kya
For the working of the Pradhan the respondents said that Pradhan apna kaam theek se nai karte sirf paisa kha rahe hain , naa saaf safai hoti hai naa vikas hota hai For the ICDS they said ki khana khan eke liye hum apne baccho ko bhejte hi nai, kyunki usme boht baar keede mile hain , bas dikhane ko 4 5 baccho ko bula ke baant deti hain baaki sab acha acha apne ghar ko le jaati hain There have been differentiation on the services to be provided to the general and the minority community especially the Muslim community and the scheduled community. The main problem which was identified was lack of hygiene and sanitation facilities, which is considered to be the main reason for the spread of diseases and majority of the diseases. From the providers perspective the most important which was highlighted was the lack of effective funding and the deficiency of Human resource to help and cater to the needs of the community. Conclusion: Although the village is in the process of urbanisation, still it lacks some of the very basic facilities and amenities which have a heavy toll on the health of the population in terms of non-functional government health care facility, high unmet needs for contraception etc. Further due to lack of availability and accessibility of these services there occurs a very heavy burden of economic cost on the poorer sections of the society in terms of the private treatment. Proper monitoring, evaluation and better functioning of these facilities along with better availability, accessability, affordability and quality care is the most important step in order to cater to the needs of the people in a rural setting.

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  • 1. shubh verma Community Profile of Bithauli Khurd village Chinhat Block Lucknow Uttar Pradesh
  • 2. TATA INSTITUTE OF SOCIAL SCIENCES MUMBAI SCHOOL OF HEALTH SYSTEM STUDIES MASTER OF PUBLIC HEALTH IN SOCIAL EPIDEMIOLOGY 2014-16 RURAL INTERNSHIP REPORT INTERNSHIP ORGANISTION VATSALYA LUCKNOW DISTRICT, UTTAR PRADESH SUBMITTED TO: PROF. ANIL KUMAR SUBMITTED BY AKANKSHA VERMA- M2014PHSE002 HARINDER KUMAR- M2014PHSE010
  • 3. Acknowledgement At this juncture of the completion of my internship presentation and report writing I would like to take this opportunity to express my heartfelt gratitude to thank each and everyone who helped me during this internship First of all I would like to thank the Almighty for always showering his blessings on me and giving me this life and all the other blessings. I would also like to thank all the internship coordinators for giving us this opportunity in the form of this rural internship to explore the new facts and get new experiences in a rural setting. I would also take this opportunity to sincerely thank Prof.Anil Kumar sir for providing his valuable guidance and support throughout the period of internship and helping me shape my vision and improve my skills and also learn the intricacies of working in a very different setting I would also like to thank School of health system studies, Mumbai for the valuable support. Also a sincere thanks to Vatsalya, Lucknow and especially Dr.Neelam Singh for giving me this opportunity to be a part of such a respected organisation and give me this opportunity to work in a different setting. In the end I would like to thank my Family, especially my parents for their tireless effort and support in making me capable to reach this stage in my life
  • 4. Objective 1. To assess the boundaries and landmarks of the village BITHAULI KHURD 2. To determine the socio-economic and demographic profile of BITHAULI KHURD 3. To understand the living conditions, health problems and health facilities available in BITHAULI KHURD 4. To assess the public resources available in the village, how many of these resources are actually functional, how does it affect the availability, accessibility and affordability for certain sections of the village community Research Design A community based study was undertaken to study the socio-economic profile, demographic profile, living conditions, health problems and availability of health facilities in BITHAULI KHURD village of Lucknow. Also a mapping of the boundaries of the village was done and an assessment of the various resources present in the village and also how the accessibility and the availability of these resources varies for the different socio-economic sections of the population Key informant interviews, focussed group discussions and observation methods of qualitative data collection were employed to gather information on the living conditions, practices and beliefs of the people and the facilities available and issues faced by the people and also a semi structured questionnaire was also used. Secondary data was also obtained from the department of Health, AROs office, and B.D.Os offices and also data was gathered from the various frontline worker like ASHA, AWW, and ANM for demographic and socioeconomic profile.
  • 5. Research Methodology: Universe of study: Bithauli Khurd village in Bithauli Khurd panchayat in Chinhat block of Lucknow district in western Uttar Pradesh Type of Study: It was a cross sectional study Sampling frame: Households in the village of Bithauli Khurd Sampling: Convenience Sampling (Non-Probability) Sample size: 52 house holds Methods of data collection: Face to face interviews were carried out. Tool used: Semi-structured interview schedule which was translated and conducted in hindi Secondary data was also obtained from the health professionals and the other frontline workers Ethical consideration: Verbal consent was taken from the respondents prior to the interview and participation was made voluntary. Respondents were made aware and assured of confidentiality.
  • 6. Introduction Uttar Pradesh (literally "Northern Province"), abbreviated as UP, is a state located in Northern India. The state is bordered by Rajasthan to the west, Haryana and Delhi to the northwest, Uttarakhand and the country of Nepal to the north, Bihar to the east, and Jharkhand to the southeast, Chhattisgarh to the south and Madhya Pradesh to the southwest. It covers 243,290 square kilometres (93,933 sq mi), equal to 6.88% of the total area of India, and is the fourth largest Indian state by area. With over 200 million inhabitants in 2011, it is the most populous state in the country as well as the most populous country subdivision in the world. Hindi is the official and most widely spoken language in its 75 districts. Uttar Pradesh is the third largest Indian state by economy, with a GDP of 9763 billion (US$150 billion). Agriculture and service industries are the largest parts of the state's economy. Lucknow is the largest and the capital city of Uttar Pradesh.
  • 7. BLOCK OF LUCKNOW: There are 8 blocks in Lucknow district LUCKNOW BAKSHI KA TALAB CHINHAT GOSAIGANJ KAKORI MAL MALIHABAAD MOHANLALGANJ SAROJINI NAGAR
  • 9. CHINHAT BLOCK: There are 33 panchayats in Chinhat Block, of which the alloted gram pachayat is BITHAULI KHURD BASIC PROFILE OF THE BLOCK: The total population of the block is 1.98000 of which majority of the population consists of Hindus which constitute of around 68% of the total population whereas the rest consists of the Muslims Literacy rate: Males 69% Females 48% Total 57.4% Total Population: 1,98,000 Pregnant mothers 4733 Lactating mothers 4700 O to 1 yr total children 4061 1 to 5 yrs children 28000
  • 10. SCHOOLS: 1. Chief school : 107 rural 2. Urban :59 Health care facilities: Taking into account the health care facilities of the whole block there are about 258 anganwadi workers, 65 ASHA, 33 ANM. There are 35 sub-centres, 4 primary health care centres but not all of them are upgraded to 24*7 facility. There is one CHC (24*7 upgraded) and the JSY load is 185 Immunisation status: Immunisation status for the whole block for the year 2013-14 was 97.2% and for 2014-15 is has increased to 98 % Family planning services: 1. Tubectomy 42 Intra uterine devices done 152 Oral pills 1286 Condoms 1667
  • 11. VILLAGE: BITHAULI KHURD Introduction : The total POPULATION of the village is 1738 which consists of 291 (Rural) households. As the village is under the process of urbanisation thus some portion of the village is under urban setting and the majority still comes under rural areas. There are geographical segregations in terms of the pockets where the hindus and the muslims or the people from the general category as well as other categories like OBC, SC,ST are residing There is 100% electrification in the village .there is one PUBLIC DISTRIBUTION SHOp but what was revealed while doing the community survey and the mapping was that the system was very well functioning for the effluent sections of the village but was not working effectively for the poor and some particular caste and classes in the village. Of the total population around 62% of them had a BPL card while the rest did not . BPL card holders 62% No BPL card 38% Literacy rate: Males 58% Females 44% Total 52.4% Total literacy rate for the whole population is around 52.4% , in which the literacy rate for males is 58% and for females it is around 44%.
  • 12. Caste wise distribution: CASTE MALES FEMALES GENERAL 108 96 OBC 816 124 SC 543 295 Majority of the population belongs to the SC and OBC community where as only as small section of the population belongs to the general population. HEALTH FACILITIES: There is one sub centre present in the village which has one ASHA, present. The SC is not functional 24*7 and lacks many of the basic necessities like proper hygiene and sanitation facilities. Further as there is no other health care facility in the nearby, and the nearest government health care facility is a 10 to 12km away ,people generally prefer to go to the private health care facilities which in most of the instances are not qualified health care professionals thus compromising on the health and the services they get. SUB CENTRES 1 PRIVATE HEALTH CARE PROVIDERS 10 VETERNARY HOSPITAL 1
  • 13. Family planning services provided by the frontline workers in the last three months Of the total 291 households in the village there are around 70% of the houses which have inbuilt toilets where as 30 % still doesnt have toilet facilities and use the public toilets, many of which are still non-functional and ill constructed. Results: Basic demographic data: Of the total households interviewed about 69% of the households had males as the head of the households whereas the rest have females as the head of the household 0 10 20 30 40 50 60 70 male femals 68.2 31.8 gender of head of hte household 68.2%
  • 14. Religion: Of the total house holds around 74.2% of them belonged to hindus whereas the rest 24.8% were of the muslim population Caste: Majority of the population belongs to SC and OBC population where as a small percentage belongs to general 0 10 20 30 40 50 60 70 80 hindu muslim 74.2 24.8 religion of the household 0 5 10 15 20 25 30 35 40 45 general obc sc 29.7 27 43.2 caste wise distribution
  • 15. Housing characteristics: 66.8% of the respondents had pucca house while 16% had a kuccha house PDS Utilisation: 76% of the respondents said they had access to the PDS system while the rest said that they did not Income of the household: income of the house hold ranged from less than 1000 to 10000 and above with majority of the respondents falling in the category of 1000 to 4999 16 66.8% 0% 10% 20% 30% 40% 50% 60% 70% 80% kaccha semi pucca pucca Type of house Percentage 76% 24% 0% 20% 40% 60% 80% Yes No PDS Utilisation PDS Access 0 10 20 30 40 50 60 70 80 less than 1000 1000 to 4999 5000 to 9999 10000 and above income of the household
  • 16. BPL card holder: 84% of the respondents had a BPL card while rest didnt Educational status of the head of the household Occupation of the head of the household 84% 16% 0% 20% 40% 60% 80% 100% Yes No BPL card Holder BPL card Holder 40 42 44 46 48 50 52 54 56 literate lilleterate 54.1 45.9 educational status of the head of the household 0 10 20 30 40 50 manual labour farming others 48.6 24.3 27 occupation of the head of the household
  • 17. Health related findings: Place of delivery of the last child Majority ie 54.3% of the respondents went to a private setting for the delivery Breast feeding initiated within one hour of birth: Only 18.2% of the respondents said they had started breast-feeding within one hour of delivery 0 10 20 30 40 50 60 government private home 28.6 54.3 17.1 place of the last delivery 0 10 20 30 40 50 60 70 80 90 yes no 18.2 81.8 breast feeding initiated within one hour of birth
  • 18. Type of services availed when ill 36% of the respondemts said that they preffered to go to a private hospital when ever they fell ill and omly 14% of them said that they would prefer going to a government setting. When asked about the reason for non-utilisation of the government health care setting, poor quality of care, long waiting hours, unavailability of the health care facility were cited to be the major reasons Substance abuse was very high among the respondents and the major form of consumption was beetal nut chewing , beedi consumption and gutka consumption 30% 36% 16% 14% 0% 10% 20% 30% 40% private clinic private hospital sub center govt. hospital Type of services availed when ill Type of services availed when ill 2% 4% 26% 12% 40% 10% 6% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% no nearby facility facility timing not convinient health personal often absent waiting time too long poor quality of healthcare servises usually medicine not available in the facility don't trust Reason for non utilisation of Govt. facilities 56% 22% 14% 72% 0% 10% 20% 30% 40% 50% 60% 70% 80% Smokeless tobacco Cigarette/Beedi Alcohol Beetul nut Substance abuse
  • 19. Using family planning services There was very high unmet needs for the contraception and one of the reasons cited for this was the inability of the frontline workers to provide the services Have a toilet facility 70% of the respondents said that they had a toilet facility. But still around 30% of the respondents said that they practiced open defecation Practicing open defecation 0 10 20 30 40 50 60 70 80 90 yes no 16.2 84.7 using any form of family planning services 0 10 20 30 40 50 60 70 80 yes no 70.2 29.8 having a toilet facility 0 10 20 30 40 50 60 70 yes no 68.2 29.8 practicing open defecation
  • 20. Water treatment Majority ie 75.8% of the respondents said that they were not treating the water used for drinking to make it safe. When asked about the methods used for making the water safe they said that they used boiling or chlorine tablets to make it safe Methods used 0 10 20 30 40 50 60 70 80 yes no 24.2 75.8 treating dreanking water 0 10 20 30 40 50 60 boiling chlorine other 24.2 16.1 59.4 methods of treating dreanking water
  • 21. Discussions: The total POPULATION of the village is 1738 which consists of 291 (Rural) households Total literacy rate for the whole population is around 52.4%, in which the literacy rate for males is 58% and for females it is around 44%.. Although majority of the households had a toilet facility still a large no. of people went for open defecation practices. There was very high unmet need for the contraception and the main reason cited for this was the lack of services being provided by the frontline workers FGDs and KI interviews from both the providers and the beneficiarys side revealed many facts about the present situation of the health care system and the prevailing problems in the community. Most of the FGDs revealed that majority of the population felt dissatisfied with the working of the health care functionary like ASHA and AWW Of the total 291 villages in the village there are around 70% of the houses which have inbuilt toilets where as 30 % still doesnt have toilet facilities and use the public toilets , many of which are still non-functional and ill constructed. Total literacy rate for the whole population is around 52.4% , in which the literacy rate for males is 58% and for females it is around 44%. There is one sub centre present in the village which has one ASHA , present. The SC is not functional 24*7 and lacks some of the basic necessities like proper hygiene and sanitation facilities. On respondent stated Adhikari log zyada kuch kaam kar nai paa rahe hain, aur ASHA behanji bhi bas tab hi kaam karti hain jab adhikari kar daura hota hai. Many of the respondents were not aware about the services to be provided to them by ASHA and AWW. sarkari mein jaana pasand nai karte kyuki waha suvidhaayein nai hai aur jaha hain waha doctor theek se baat nai karte jaankari bas tabhi dene aati hai jab badi doctor aati hain , jo samay pe pahuch gaye unko suvidhaayein mil jaati hain baaki reh jaate hain On family planning and unmet needs on respondent said that agar yeh sab jaankaari aur suvidhayein humein mile toh family itni kyu badhegi..agar gareeb logo ko mahilaao ko yeh suvidhayein mil jaae toh itne bacche ho hi nai kuch bhi nai batati ki bacche kam kaise ho Sarkar ne boht si suvidhaayein di hain jo humein pata hi nai..unse bachta hi nai toh janta paayegi kya
  • 22. For the working of the Pradhan the respondents said that Pradhan apna kaam theek se nai karte sirf paisa kha rahe hain , naa saaf safai hoti hai naa vikas hota hai For the ICDS they said ki khana khan eke liye hum apne baccho ko bhejte hi nai, kyunki usme boht baar keede mile hain , bas dikhane ko 4 5 baccho ko bula ke baant deti hain baaki sab acha acha apne ghar ko le jaati hain There have been differentiation on the services to be provided to the general and the minority community especially the Muslim community and the scheduled community. The main problem which was identified was lack of hygiene and sanitation facilities, which is considered to be the main reason for the spread of diseases and majority of the diseases. From the providers perspective the most important which was highlighted was the lack of effective funding and the deficiency of Human resource to help and cater to the needs of the community. Conclusion: Although the village is in the process of urbanisation, still it lacks some of the very basic facilities and amenities which have a heavy toll on the health of the population in terms of non-functional government health care facility, high unmet needs for contraception etc. Further due to lack of availability and accessibility of these services there occurs a very heavy burden of economic cost on the poorer sections of the society in terms of the private treatment. Proper monitoring, evaluation and better functioning of these facilities along with better availability, accessability, affordability and quality care is the most important step in order to cater to the needs of the people in a rural setting.