Garhwal Community Development and Welfare Society

Research

We seek to improve the health status of rural and indigenous populations through research, training and service delivery programmes.

— Dr. Rajesh Singh, Director

Past Research Programs

Rural Health Providers’ quality of care

Research

(Supported by the Population Council of India through a European Commission grant, 2002-04)

127 RHPs were mapped in district Tehri Garhwal (Uttarakhand) and 620 in Agra (Uttar Pradesh). These RHPs were the first port of call for common illnesses, especially among women and children. In-depth quality of care assessments (for reproductive tract infections)for 160 RHPs revealed that RHPs interpersonal quality was better than their technical skills. They were easily accessible and available, non-judgmental, familiar with local customs and dialects. Technical quality (as measured by adherence to treatment guidelines) was deficient due to incomplete knowledge levels, and RHPs performed a median of 2 steps out of 6 recommended steps under the syndromic management guidelines for reproductive tract infections. Technical quality was associated with moderate but not very high knowledge levels, building a strong case for training of RHPs on the guidelines. (link to pdf of published paper)

Community level multi micronutrient fortification for school children aged 6-10 years

(Supported by Uttarakhand government, The Micronutrient Initiative and World Food Program, 2008-09)

200 school children were assessed for levels of haemoglobin, folate, Vit A and B-12. Around 60% were anemic and the basic underlying cause was iron, folate and zinc deficiency. State government initiated fortification of school mid-day meals based on the findings.

Identification of Alzheimer’s disease patients in the sub-Himalayan region and identify and train their care givers.

(Supported by Helpage India, Jan-Dec 2009)

6061 rural households were surveyed in 3 blocks of Tehri; 10% of the population surveyed had Alzheimer’s symptoms. More women were symptomatic as compared to men (women 63 % and men 37%) and 72 % women with Alzheimer’s were widows. 52 care givers were identified and trained to take care of Alzheimer’s patients; care givers included family members as well as local RHPs.

Facility and infrastructure assessment of selected government health facilities in Uttarakhand

(Supported by Constella Futures Group, through USAID funding, 2009)

33 District hospitals and 23 Community Health Centres (sub-divisional level) were assessed against the government’s Indian Public Health Standards. Findings revealed that only 37% of human resources were available against the required standards; pharmacists comprised the largest group of available human resources and they managed public health centres in place of medical doctors; around 70%-80% of medical equipment was available (e.g. incubators) but much of it was unused as staff was not adequately oriented.

New Research Programs

Interactive, Structured, Multi-modal Clinical Guidelines to Improve Quality of Care by Rural Healthcare Providers in India

(Supported by ISIF Asia)

ISIFGCDWS is currently collaborating with First Care (www.firstcarehealth.in) to develop and implement a mobile phone based health application which seeks to improve and standardize the quality of health care at first contact delivered by village based health workers. First Care is a project founded by IIT-Madras’s Rural Technology and Business Incubator (www.rtbi.in) to strengthen and support frontline community and village based health workers using enabling and appropriate technologies.

The step by step guidelines developed through this collaborative m-health project are adapted from WHO’s Integrated Management of Childhood Illnesses, and Integrated Management of Adolescent and Adult Illnesses. These guidelines have been used in many countries for training community health workers and paramedics in management of common illnesses like fevers and diarrheas, at the first level of care.

GuideView

The guidelines, executable on mobile phones and also on computers, will be field tested using a randomized- controlled study design with around 20 village based healthcare providers.

Currently we are developing the applications.

For project updates, please visit this webpage every 2-3 months.

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