Department of Community Medicine, AIIMS Nagpur, Nagpur, Maharashtra, India.
Model UPHC Project, Tata Trusts, Nagpur, Maharashtra, India.
J Mother Child. 2021 Oct 11;25(1):51-60. doi: 10.34763/jmotherandchild.20212501.d-21-00006.
This study was carried out to evaluate the implementation status of Urban Health and Nutrition Day (UHND) and to explore barriers and bottlenecks as perceived by community-level service providers in the selected city of Nagpur, Maharashtra.
This mixed-method study was conducted using a triangulation design. An initial gap assessment was carried out quantitatively using an observation checklist. Focus group discussion among ASHAs and interviews among frontline health workers involved in community mobilisation were carried out to understand the bottlenecks and barriers.
Supplies of drugs and logistics, like paediatric iron and folic acid tablets, calcium tablets, and weighing machines, were inadequate. Services like distribution of conventional contraceptives, testing for malaria, urine albumin/sugar, haemoglobin estimation, screening for diabetes and hypertension, sputum collection, and qualitative iodine test kits are not available in any of the UHND sessions. Major challenges in the implementation of UHND were found to be as follows: unserved areas and left-out urban slum pockets; the distribution paradox of UHND location with an ill-defined geographic boundary; restriction of range of services to antenatal registration and immunisation with gross neglect of other components; suboptimal training of staff; insufficient availability of space, logistics, and health manpower; non-involvement of community members and Urban Local Bodies; and poor monitoring and supervision.
The conduct, use, and list of services offered in UHND are far from the desired goal. For optimal use, reallocation of the UHND sessions, preferably in unserved and underserved slums, need to be carried out after suitable vulnerability assessment. Integration of the Health, Women, and Child Department and Urban Local Bodies is required for convergent planning, monitoring, and supervision.
本研究旨在评估城市健康与营养日（UHND）的实施现状，并探索马哈拉施特拉邦那格浦尔市选定社区中，社区服务提供者所感知的障碍和瓶颈。
本混合方法研究采用三角测量设计。初步差距评估采用观察检查表进行定量评估。通过对 ASHAs 进行焦点小组讨论以及对参与社区动员的一线卫生工作者进行访谈，以了解障碍和瓶颈。
药品和后勤供应不足，例如儿科铁和叶酸片、钙片和体重秤。常规避孕药具的分发、疟疾检测、尿液白蛋白/糖、血红蛋白估计、糖尿病和高血压筛查、痰液采集和定性碘试剂盒检测等服务在任何 UHND 会议中都无法提供。在 UHND 的实施中，发现主要挑战如下：未服务的地区和被忽视的城市贫民窟；与定义不清的地理边界相关的 UHND 位置分布悖论；将服务范围限制在产前登记和免疫接种，严重忽视其他组成部分；工作人员的培训不足；空间、后勤和卫生人力的供应不足；社区成员和城市地方机构的不参与；以及监测和监督不力。
UHND 的进行、使用和提供的服务与预期目标相去甚远。为了实现最佳利用，需要在进行适当的脆弱性评估后，对 UHND 会议进行重新分配，最好在未服务和服务不足的贫民窟进行。需要整合卫生、妇女和儿童部门以及城市地方机构，进行集中规划、监测和监督。
