National Health Mission

(By Sehmeet singh (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons)

National Health Mission

National Health Mission (NHM 2012-2017) is an initiative undertaken by the Government of India for the development of under reserved areas. It mainly focuses on universal access to quality oriented and affordable health care services. It consists two sub missions- National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM). The main components include  Health System Strengthening,Reproductive Maternal Neonatal Child and Adolescent Health (RMNCH & A) , communicable and non communicable diseases in rural and urban areas.

Goals

• Reduce MMR to 1/1000 live-births
• Reduce IMR to 25/1000 live-births
• Reduce TFR to 2.1
• Prevention of anemia in women
• Prevent mortality and morbidity from communicable and non communicable diseases
• Reduce annual incidence and mortality of TB by half
• Reduce incidence of leprosy to zero
• Kala Azar elimination by 2015

National Rural Health Mission (NRHM) 

It is launched in 2005 and envisages to provide equitable, affordable and quality health care services to rural population. Under NRHM, a special focus gives to Empowered Action Group States as well as North Eastern States, Jammu and Kashmir and Himachal Pradesh. A wide range of determinants of health such as water, sanitiation, education, nutrition, social and gender equality are covered. The community health workers are appointed under the NRHM, named as Accredited Social Health activists (ASHA).

National Urban Health Mission (NUHM) 

NUHM is approved by Government of India on 2013. It envisages to meet the health care needs of urban population, especially slum dwellers and other marginalized groups like rickshaw pullers, street vendors, coolies, street children and construction site workers.

Fight the Fear: Using Prevention of Child Sexual Abuse Model (PCSA Model),2015

Fight the Fear: Using Prevention of Child Sexual Abuse Model (PCSA Model),2015

(Published in International Journal of Comprehensive Nursing)

Abstract

As the child sexual abuse is wide spread public threat, it is high time to take action to stop the sexual predators. Here, the author attempts to develop and utilize a Prevention of Child Sexual Abuse Model (PCSA Model), 2015 to address the issue focusing on levels of prevention. The Prevention of Child Sexual Abuse Model (PCSA Model) is a conceptual model, focuses on problem solving domain by using a cross sectional flow chart. The PCSA model divides into three swim lanes named 3As- Assess, Action and Awareness. It helps the health care providers in identifying the victim, refer them for care, protect them, follow up and giving awareness with the multidisciplinary approach through the levels of

primary, secondary and tertiary prevention, to fight the fear of children.

Key words: child neglect, child sexual abuse, conceptual framework, conceptual model, fear of children, prevention model. 

Full PDF

HEALTH BEHAVIOUR AND LEVEL OF STRESS AMONG ADOLESCENT BOYS

HEALTH BEHAVIOR AND LEVEL OF STRESS AMONG ADOLESCENT BOYS

(Published in journal.sochni 2014)

ABSTRACT

Introduction: The concept of adolescent health is getting importance ahead globally, thus far there is a paucity of national studies to assess the health behaviour and stress level among adolescent boys.

Objectives: This study was aimed to assess the health behaviour and stress level among adolescent boys in Vellore city, Tamil Nadu.

Methodology: Descriptive design was used. Using proportionate and purposive sampling technique, 380 subjects studying in 8th, 9th, 10th 11th and 12th grades were selected from the 10 selected schools in Vellore city. The investigator utilized the WHO questionnaire for assessing Health Behaviour and the adolescent stress questionnaire which is developed by the researcher. The content validity of the Adolescent Stress Questionnaire tool was 0.93, reliability was 0.97 and Factor analysis KMO and Bartlett's Test 0.82 (P<0.01) which is highly reliable for using the instrument in Indian context (Adolescent Stress Questionnaire 2014).

Results: The adolescent boys were categorized into 10-13, 14-16 and 17-19 years with the distribution of 29.73%, 42.63% and 27.64% respectively. The mean age of the subjects was 14.49±1.46. It was uncovered that 4.7% of the subjects had smoked in their life time and 0.3% of them were currently smokers. Those who have consumed alcohol, majority 17.1% were from upper socio economic families (P=0.05).  Among those who had higher level of stress in regard to family relations, majority of them (54.5%) consumed alcohol (P=0.04). Regarding the safety behaviour, the subjects from upper socioeconomic status (76.3%) were not practising safety behaviour on the roads as compared to the subjects from lower socio economic status (P=0.002). 

Conclusion: The findings suggest an urgent call for implementing the life skill education programme in schools to develop and nurture the adaptive health behaviour among adolescent boys and to cope with stress, which paves the way for moulding a healthier workforce in coming days.

Key words: Health behaviour, stress, smoking, alcoholism, physical activity and adolescent boys.

Adolescent Health Behavior and Stress Level (Full PDF)

Adolescent Stress Questionnaire 2014

Abdominal Palpation in Pregnancy

Image by Øyvind Holmstad (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons

Abdominal Palpation in Pregnancy

Abdominal examination in pregnancy comprises of four steps such as

• Inspection
• Palpation 
• Percussion
• Auscultation

Preparation of the patient

• Ask the mother to empty the bladder
• Check height, weight and blood pressure of the mother
• Position the patient in supine position at an angle of 30 degree
• Provide privacy
• Expose the abdomen from below chest to symphysis pubis and keep a drape sheet to cover the abdomen when you are not examining her
• Stand on the right side of the mother and warm up your hands

Inspection

Remember 'SSSFU' during inspection of the abdomen which means size, scars, skin changes, fetal movements and umbilicus.

Size and shape of the uterus should be appropriate to the gestational age and symmetrical. It might be in round or ovoid in shape.

Transverse scars, laparoscopic or laparotomy scars indicates previous surgeries including LSCS.

Skin changes includes striae gravidarum, striae albicantes and linea nigra.  Striae gravidarum is caused by hormonal changes and appears early in prenancy.  Striae albicantes are stretch marks from previous pregnancies. Linea nigra is a dark coloured straight line from below chest to symphysis pubis.

Fetal movements are visible from 24 weeks which indicates viability.

Umbilicus  may become flattened.

Palpation

Before proceeding into palpation, measure abdominal girth in inches or centimeters by keeping a inch tape around the abdomen. Then, palpate the fundus by ulnar border of the left hand and measure the gestational weeks using fingerbreadth method. Up to umbilicus, it is to be considered as 24 weeks. Keep four fingers of right palm above the umbilicus and measure it by considering one finger width is one week.

To measure the fundal height, keep the inch tape from symphysis pubis to fundus. The fundal height in centimeters is equal to gestation weeks with a difference up to +/-3 cm.

1. Fundal grip- Palpate the superior border of the fundus by using palms of two hands determine the pole of the fetus.
2. Lateral grip- Palpate the lateral sides of the abdomen to determine the spine and limbs of the fetus. If the fetus lies at a right angle to the axis of the uterus, it is in a transverse lie. If the head and buttocks are palpable on lateral sides, it indicates the fetus is in a oblique lie.
3. Pelvic grip-Turns into foot end of the patient and move both of your hands from lateral sides to pubis. If the hands are converged, it indicates head is not engaged. If the hands are not converged, it indicates engaged head.
4. Pawlick grip-  Grasp the lower portion of the abdomen using the fingers and thumb of the right hand to feel the ballotment of the head, which indicates the floating head and the progress of the labour.

Percussion

This technique can be used in mothers with polyhydramnios.

Auscultation

Fetal Heart Sounds (FHS) can be heard by fetoscope/ stethescope/ hand held doppler monitor. The fetal heart rate is normally between 110 and 160 b.p.m.