Impact of the COVID-19 pandemic on the utilisation of health services at public hospitals in Yemen: a retrospective comparative study

BackgroundThe COVID-19 pandemic has led to a global crisis, creating an unprecedented situation, which has taken the world by storm, overshadowing on all life’ aspects and having a significant impact on the health systems of most countries. In this study, the delivery of health services is investigated both before and during the outbreak of the COVID-19 pandemic at public hospitals in Yemen to assess the impact of COVID-19 on the utilisation of health services.MethodData collected from 127 hospitals in Yemen were reviewed using the DHIS2 system. The data represented 3 months before the outbreak of COVID-19 between January and March 2020 and during the outbreak of COVID-19 outbreak between April and June 2020. The results were then compared with the same period in 2019. The utilisation pattern of healthcare services during the period of investigation was compiled and analysed by applying a generalised estimating equation (GEE) to examine the effects of the COVID-19 outbreak in Yemen. The data collected from the targeted hospitals included information related to consultations, surgeries, deliveries, C-sections and penta-3rd dose immunisation.ResultsThe trendline of health services used during the pandemic showed a gradual decline beginning from April 2020 for consultations, surgeries and penta-3rd dose utilisation. The GEE model revealed a significant effect (p<0.05) during the outbreak compared with preoutbreak in the consultation services (B=−1,343.9; 95% CI −1,767.2 to −920.6; χ2=38.718), surgeries (B=−54.98; 95% CI −79.13 to −30.83, χ2=19.911) and penta-3rd dose (B=−24.47; 95% CI −30.56 to −18.38 and χ2=62.010). As for deliveries and C-sections, the results were shown to be statistically non-significant.ConclusionThe impact of COVID-19 on continuity of health services delivery in Yemen has been distinct and profound, where the study revealed that the number of the consultations, surgeries and number of vaccinated children have been declined during the COVID-19 pandemic, likely due to the partially lockdown measures taken and fear of being infected. However, the deliveries and C-section services remained nearly in the same level and did not affect by the COVID-19 pandemic.

Farmers’ Utilisation Pattern of Soil Health Card’s Recommendation on Sali Rice Cultivation in Assam

Aims: The present study was undertaken to examine the utilisation pattern of Soil Health Card’s (SHC) recommendation by the farmers on sali rice cultivation in Assam. Study Design: The numbers of respondents were selected by proportional allocation to size to make it 150 and the relevant data were cross-sectional. Place and Duration of Study: The study was undertaken at Assam Agricultural University, Jorhat. Respondents were selected from the Darrang district of Assam during the period 2017-18. Methodology: Descriptive as well as inferential statistical tools were employed in order to attain the objective of the study. The data was analysed by using frequency, percentage, mean, standard deviation and Chi-square test. Results: The result revealed that 56.67 per cent of the respondents were unable to read the content of SHC, and 82.00 per cent of the respondents did not understand the content of SHC. Moreover, 74.66 per cent of farmers did not apply fertilisers and other nutrients as per the SHC recommendation. The chi-square test showed that application of urea, Diammonium Phosphate, Singe Super Phosphate and Muriate of Potash had a higher association with increased age, education, landholding, and gross annual income of respondents. Conclusion: The SHC scheme could not bring any positive changes to sali rice in the initial year at Darrang district. Thus, the study has suggested initiating the mass awareness campaign regularly using the concept of social marketing for judicious application of fertilisers and nutrients based on the SHC report. It is also necessary to provide technical backstopping to farmers on SHC recommendation and application to make agriculture productive, profitable, and sustainable.

Drug Utilisation Pattern in Ear, Nose and Throat Inpatient Department using WHO Prescribing Indicators

Introduction: Assessment of drug utilisation pattern (DUP) based on World Health Organisation (WHO) drug prescribing indicators would enhance the standards of patient care at all levels of the healthcare. It helps to improve the quality of life in developing countries like Nepal. Objective: To assess DUP in patients admitted in ear, nose and throat inpatient department at a tertiary hospital in Eastern Nepal using the WHO prescribing indicators. Methods: A hospital based cross-sectional descriptive study was carried out in 96 patients in ENT department of a tertiary care teaching hospital from February-April 2019. Pre-designed proforma was used to collect the relevant data from the medical case sheets and drug charts. Descriptive statistics were calculated using Microsoft Excel 2010. Results: Out of 96 patients, 52 (54.17%) were female. Most of the patients (46, 47.18%) were pre­scribed four drugs. Combination of Ibuprofen and Paracetamol (77, 19.74%) was the commonest prescribed drug. Ceftriaxone (62, 63.92%) was the most frequently prescribed systemic antibiotic. The average number of drugs per prescription was 4.06. None of the drugs were prescribed by generic name. Out of 360 drugs, only 118 (30.26%) were prescribed from National List of Essential Medicines (NLEM) and 117 (30.00%) drugs were fixed drug combinations. Ninety two (95.83%) patients had been prescribed at least one antibiotic. Conclusions: The prescribing practices of essential medicines, generic drugs, antibiotics and inject­able drugs showed deviation from the standard recommended by the WHO. The prescribers should be motivated to enhance prescription of drugs by generic names and from NLEM.

A comparative study: Dr. APJ Abdul Kalam amrut ahar yojana and take home ration scheme, Armori block, Gadchiroli, Maharashtra

Background: Even after forty-five years of ICDS, nutrition, still, continues to be a major public health challenge in India. The impact of ICDS on child growth and development has been rather slow. The present study is a comparison of Dr. A. P. J. Abdul Kalam amruta ahar yojana and take home ration scheme.Methods: The study adapts a combination approach, i.e. qualitative and quantitative method. Qualitative method is used to study the perception of beneficiaries as well as the providers while quantitative method is conducted among 80 beneficiaries with an aim to identify the utilisation pattern of food and level of satisfaction with both the schemes.Results: A total of 80 pregnant women and lactating mothers participated in this study. This study used a questionnaire containing socio-demographic data and utilisation pattern of one-time square meal and dry ration; socio-demographic questions including concerned age group, their education, religion, employment status and income.Conclusions: The findings depict that the provision of amruta ahar is in demand compared to the dry ration of Take-Home Ration Scheme. According to the beneficiaries, amruta ahar yojana is more advantageous as it leads healthy eating practices which are essential during pregnancy and lactation.

Ecosystem Services of Chariganga and Arpara Beel in Nadia District, West Bengal: A Geographical Enquiry

The ecological set up of the deltaic Bengal has immensely been benefitted by the ecosystem services extended by the freshwater wetlands. Along with the diverse ecological benefits, those floodplain wetlands serve the adjacent agrarian community through the provision of free goods and services. The present study has attempted to identify the ecological resources provided by the Chariganga and Arpara Beel and its impact on the livelihood patterns of the rural inhabitants. Both qualitative and quantitative techniques have been used for the study. Ecosystem Service Index (ESI) has been computed to quantify the values of ecosystem services in each category for the dry and wet periods. Nearly 33 ecosystem services are identified which have significantly influenced the socio-economic lifestyle of the inhabitants of three adjacent villages like Arpara, Gotpara, and Sultanpur but not homogeneously in terms of space, time, and status of stakeholders. The computed ESI values reveal that the maximum index value in each category of ecosystem services has been recorded at Chariganga Wetland in both dry and wet seasons. Moreover, the fluctuation of ESI between the two seasons is least at Chariganga Wetland (0.03) compared to Arpara Wetland (0.28). Spatio-temporal variation in availability of resources has conspicuously altered the yearlong utilisation pattern of wetlands’ resources and put a noticeable imprint upon the diverse economic activities and cultural practices of the beneficiaries. The seasonal transformation of a large segment of the studied wetlands in wet and dry months has noticeably influenced the livelihood strategies of the natives. As a consequence, dynamism in utilisation pattern and contrasted societal views concerning the wetland-people interdependency has come into existence.

Growth of Rural Indebtedness in Punjab

The problem of indebtedness among the rural households of Punjab was become more serious in the last two decades. A large number of studies were carried out in India and abroad to look into the problem of rural indebtedness and its consequences but most of these studies are either based upon a very small sample of a few districts or cover the farmers only. The present study would be wider in scope as it was also included artisans, agricultural labourers (non- cultivators) along with the farmers (cultivators). This study analysed the situation of Punjab as a whole and district wise analysis was done. Therefore, in the present study, an attempt was made to analyse the growth of indebtedness among the rural households in Punjab and attempt was made to explain the utilisation pattern of loan used by rural households and tried to trace out how the situation of household indebtedness in the Punjab evolved and changed over the course of about ten years. The study will be helpful to planners, academicians, researchers as well as policymakers for solving the problem of indebtedness among rural households for the betterment of the society as a whole. It is suggested that encouragement should be given to subsidiary occupations, improvement in access to health at subsidised rate in rural areas to curb the indebtedness and to monitor the informal mechanism of credit by Government and financial institutions along with availability of the appropriate delivery of credit into the agricultural as well as non-agricultural sector of rural areas by eliminating costly sources of money lenders for the accurate functioning of the economy.