Davey Sanjeev, Maheshwari Chaitanya, Raghav Santosh Kumar, Singh Nirankar, Muzammil Khursheed, Pandey Prakhar
Department of Community Medicine, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India.
J Family Med Prim Care. 2018 Jul-Aug;7(4):780-786. doi: 10.4103/jfmpc.jfmpc_115_18.
In National Programme for Prevention and Control of Deafness (NPPCD), the management of ear diseases of rural India is now guided by Revised Indian Public Health Standards (IPHS) for Rural Health Facilities for providing quality ear care. However, despite the IPHS existence, coverage and quality ear care is questionable. Moreover, this issue has not yet been studied till now in the Indian context. The objective of the study was to assess the role of Private Medical College Training Center (Rural Health Training Centre [RHTC]) in augmenting quality of ear care services in NPPCD at district level by adopting IPHS Standards.
A combined retrospective and prospective cohort study was done at RHTC of a Medical College in West Uttar Pradesh from January 1, 2013, to December 31, 2017, by retrospective approach of selecting all ear patients ( = 3840) and prospective way of assessing the impact of IPHS for ear care. The semi-structured Pro forma was used in exploring the coverage and quality of ear care. The data were analyzed by Epi Info version 7.2.
Out of total 4817 ear, nose, and throat (ENT) patients, the majority of ear patients ( = 3840) were initially dissatisfied with coverage and quality of ear services provided by ENT specialists at RHTC. However, when IPHS exposure was given from July 1, 2015 to December 31, 2017, not only majority of patients were satisfied ( = 3110, 81%) but also ear curative treatment was significantly higher ( = 2120, 68.1% vs. = 130, 17.8%, odds ratio = 9.8, RR = 1.5, < 0.00001).
Adherence to IPHS in NPPCD is essential for delivering better ear care by RHTC through primary health-care approach.
在国家防聋治聋计划（NPPCD）中，印度农村地区耳部疾病的管理目前遵循经修订的印度农村卫生设施公共卫生标准（IPHS），以提供优质的耳部护理。然而，尽管有IPHS，但耳部护理的覆盖范围和质量仍存在疑问。此外，在印度背景下，这个问题至今尚未得到研究。本研究的目的是通过采用IPHS标准，评估私立医学院培训中心（农村卫生培训中心[RHTC]）在提高地区级NPPCD中耳部护理服务质量方面的作用。
2013年1月1日至2017年12月31日，在北方邦西部一所医学院的RHTC进行了一项回顾性和前瞻性队列研究的组合研究，采用回顾性方法选择所有耳部患者（n = 3840），并以前瞻性方式评估IPHS对耳部护理的影响。使用半结构化表格来探索耳部护理的覆盖范围和质量。数据采用Epi Info 7.2版本进行分析。
在总共4817名耳鼻喉（ENT）患者中，大多数耳部患者（n = 3840）最初对RHTC的耳鼻喉专科医生提供的耳部服务的覆盖范围和质量不满意。然而，当在2015年7月1日至2017年12月31日期间进行IPHS培训后，不仅大多数患者表示满意（n = 3110，81%），而且耳部治疗效果也显著提高（n = 2120，68.1%对n = 130，17.8%，优势比 = 9.8，相对危险度 = 1.5，P < 0.00001）。
在NPPCD中遵循IPHS对于RHTC通过初级卫生保健方法提供更好的耳部护理至关重要。
