Seva Mandir’s Balwadi Programme
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- Agencies responsible for immunization services at village level
Iron DeficiencyNo monitoring of Hemoglobin (Hb) level in children attending the Balwadis has been done so far. It was found difficult because of the need for skilled manpower to conduct the test and the need to prick the child in order to take a blood sample, for which cooperation from children is difficult. One of the six-monthly reports also mentioned some difficulty encountered in operating the instrument procured for measuring Hb. Given the seriousness of iron deficiency in the area, other forms of monitoring can be intensified. Children suffering from acute deficiency are often seen craving to eat mud. Symptoms can also be seen in the coloration of nails etc. Inferences and suggestions: Nutritional status data should be carried out for the entire population especially at entry and exit points and at periodic intervals in between. The entire population of children attending the Balwadi should be monitored for nutrition and individual cards should show the performance over time. Only in this way can attention be focused on improving performance through monitoring data. The frequency of measurement could be increased once local people are trained to carry out this activity. At the aggregate level, monitoring should be done Balwadi wise and block wise, showing figures for both average and range. The extremely poor performing balwadis should be identified for special support and training. The information should be presented graphically so that both sanchalikas and parents can easily understand it and feel the need to take urgent steps for the under-nourished. Sanchalikas should be provided training on the extra ration and attention to be provided to the mal-nourished children. In the absence of blood sampling for iron deficiency, sanchalikas may be trained to carry out clinical examination to spot cases of anemia and monitor their progress. Immunisation Although immunization is not part of the services being offered under Balwadi, since it is closely related to child health care, the review team felt the need to explore the status of immunization of children attending the balwadis. The sample study revealed that the status left much to be desired. Under the Universal Immunisation Programme (UIP) implemented by the Government of Rajasthan it is desirable that every child should get 1 BCG, 3 DPT, 1 Measels and 5 OPV (Oral Polio Vaccine ) vaccinations before the age of one year. If for some reason this vaccination was not done in the due period, it can still be given even at a later date. The maximum period upto which vaccination can be given without loosing potency for different vaccines is shown in Table 10. Annexure 1. Two booster doses of DPT and OPV drops are scheduled at the age of 16-18 months and 5 years under UIP. This coincides with the age group of the Balwadi. During the field visit, it was observed that many of the children attending the Balwadi had not undergone immunization. Four to five children of 12 months to 23 months age were examined at random for BCG mark at every center visited. Since immunization cards are not maintained by the Balwadis, it was possible to check for only BCG which is the only one to leave a tell tale scar on the arm. Out of 32 children examined, the BCG mark was not found in 15 cases. Village wise data showed that in Rawla fala where Seva Mandir is running an incentive scheme for immunization on a trail basis, all the four children examined had got the BCG mark and at Madla fala three out of four children have the BCG mark. On Discussion with parents, community, sanchalikas, GVC members, no of reasons were identified for low immunization coverage: Ignorance among parents Failure of ANM to conduct immunization sessions regularly Parents have a fear of fever and other side effects caused by vaccination. ANM prefers not to open a BCG vial for less no of children, because of fear of wastage of vaccine - as it must be used within four hours after opening a vial. A number of parents pointed out that the child was vaccinated on the lower limb (DPTand Measels) although no vaccination was given on the arm (BCG). Inferences and suggestions: The review team is of the opinion that Sanchalikas can take a pro-active role to ensure that at least the children coming to the balwadi are properly immunized. This can be done if she is trained to create awareness among parents on one hand and link up with the existing government facilities on the other. Such a convergence is desirable both for immunization as well as child health care in general. Boxes 1 and 2 show the agencies responsible for immunization services and for motivating parents and children respectively. Box 1 Agencies responsible for immunization services at village levelHealth Sub-center operating under Medical and Health Department, Government of Rajasthan - One ANM has been provided per 5000 population, who is responsible for immunization activity. AWCs under ICDS of the Government of Rajasthan are to serve as the immunization center in the village on the day, which is assigned as MCHN day – If the number of children at AWC is 40 or more the ANM visits once in a month on assigned Thursday. If the number of children is < 40, she visits once in every two months on the assigned Thursday. In addition to the above, Seva Mandir- GNM in incentive villages provides this service on a monthly basis. Box 2 Health worker responsible for motivating parents ASHA (Accredited Social Health Activist): The health worker responsible for motivating parents and children for vaccination at AWCs on MCHN days gets Rs 150/- day as incentive. TBA of Seva Mandir – TBA is responsible for motivating children for vaccination at sub-center/ AWCs and gets an incentive of RS 10/- for each vaccination. A coupon system has been instituted to ensure that parents are involved and incentive is given only for genuine cases of vaccination. Health Directory: wp-content -> uploads -> 2013 2013 -> International post doctoral research fellowship programme final report title of the research 2013 -> Seals Family History 1565 to 2004 2013 -> Rao bulletin 15 July 2013 html edition this bulletin contains the following articles 2013 -> R institute of technology school of foreign languages 2013 -> Provisional Programme – subject to change thursday 10th april 2013 -> June, 2013 National hiv testing Day Month Men’s Health Week Hurricane Safety Month 2013 -> In memory of the residents of the Parish Chesham Bois that served their country during wwii 2013 -> Federal contract awards in georgia april 2013 Download 2.04 Mb. Share with your friends:
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