For an appropriate health intervention to be implemented in a community, it is required to define the health needs of the community.
Communities vary by way of their geographic location, occupation, ethnicity, housing conditions, beliefs, festivals, oracle or religious beliefs, topography, etc. that in one way or another influences their health. These communal traits may also in turn influence their attitude towards traditional or modern health care. Meaning, every community provides its own unique/ special health challenges to the health authority and one cannot be used completely for the other. To obtain this important data, a community diagnosis is done to comprehensively assess the health state of the community in relation to the social, physical and biological environment. This qualitative and quantitative description of the health of the citizens of the community is important to ascertain the characteristics that put members at higher risk or lower risk or may actually be protective.
Ankyease community was coined from the local name of the Guava tree. That is “Atia” = guava tree and “ase” = under (Twi language). Put together, we have under the Guava tree.
Community diagnosis of Ankyease was done and the observation summarized in this presentation. A descriptive/ cross-sectional study was done within the period of July and August 2017. A structured questionnaire was used but a visit to each of the 50 household (sample size), involved an informal focus-group/ qualitative interview to buttress some of the responses given by the respondents. A visual observation of the community was also done to obtain the housing profile and other structures of interest.
Most of the inhabitants of the community were of Ewe background and mostly below the age of 18 years. On the average, most of the members of each household or occupants were below the 5 in number.
The usual high prevalence of malaria was observed with an increase in the incidence of teenage pregnancy. There were no toilet facilities, schools, health centres as well as any established local or traditional industries within the community. They however produce most of their staple foods themselves since most of them are farmers. Others were also involved in the trading of firewood with the nearby communities for money, fish or any other good that may be mutually acceptable to both parties.
A presentation given to delegates at the Health Systems Research Symposium, Vancouver, 2016 describing our work to promote rational use of antibiotics in children under 5 and improve consultation behaviour among community health care providers in Bangladesh.
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For an appropriate health intervention to be implemented in a community, it is required to define the health needs of the community.
Communities vary by way of their geographic location, occupation, ethnicity, housing conditions, beliefs, festivals, oracle or religious beliefs, topography, etc. that in one way or another influences their health. These communal traits may also in turn influence their attitude towards traditional or modern health care. Meaning, every community provides its own unique/ special health challenges to the health authority and one cannot be used completely for the other. To obtain this important data, a community diagnosis is done to comprehensively assess the health state of the community in relation to the social, physical and biological environment. This qualitative and quantitative description of the health of the citizens of the community is important to ascertain the characteristics that put members at higher risk or lower risk or may actually be protective.
Ankyease community was coined from the local name of the Guava tree. That is “Atia” = guava tree and “ase” = under (Twi language). Put together, we have under the Guava tree.
Community diagnosis of Ankyease was done and the observation summarized in this presentation. A descriptive/ cross-sectional study was done within the period of July and August 2017. A structured questionnaire was used but a visit to each of the 50 household (sample size), involved an informal focus-group/ qualitative interview to buttress some of the responses given by the respondents. A visual observation of the community was also done to obtain the housing profile and other structures of interest.
Most of the inhabitants of the community were of Ewe background and mostly below the age of 18 years. On the average, most of the members of each household or occupants were below the 5 in number.
The usual high prevalence of malaria was observed with an increase in the incidence of teenage pregnancy. There were no toilet facilities, schools, health centres as well as any established local or traditional industries within the community. They however produce most of their staple foods themselves since most of them are farmers. Others were also involved in the trading of firewood with the nearby communities for money, fish or any other good that may be mutually acceptable to both parties.
A presentation given to delegates at the Health Systems Research Symposium, Vancouver, 2016 describing our work to promote rational use of antibiotics in children under 5 and improve consultation behaviour among community health care providers in Bangladesh.
What policy can help alleviate the burden of undernutrition?
Recent research from UNICEF Innocenti unpacks new evidence from impact evaluations in Ghana.
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1. Findings from Mumbai and Thane
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assessment survey
Presented by: Dr. Anuja Jayaraman, Director, Research
7th August 2020
2. The objective of the survey was to assess community’s understanding of the COVID-19 pandemic
with respect to their:
• knowledge
• sources of information
• preventive behaviours
• trust in institutions
• information needs
• attitudes towards pandemic response initiatives and,
• services available to them (food, sanitation, medical facilities, helplines)
in order to better inform outbreak response measures
OBJECTIVE
3. ➢ Study type: Cross-sectional survey
➢ Study period: May to June 2020
➢ Sampling method: Simple random
➢ Sample size: 300 per area
➢ Study participants: Beneficiaries (aged 18 and older) in the programme intervention areas in
Malvani, Mankhurd-Govandi, Wadala and Kurla in Mumbai and Kalwa in Thane
➢ Questionnaire: adapted from WHO’s ‘SURVEY TOOL AND GUIDANCE: Rapid, simple, flexible
behavioural insights on COVID-19’*, 26 questions
➢ Data analysis: Stata v.14
• Telephonic interviews were conducted after taking informed, verbal consent
• Each interview lasted for about 20 to 25 minutes
METHODOLOGY
*https://www.euro.who.int/__data/assets/pdf_file/0007/436705/COVID-19-survey-tool-and-guidance.pdf
4. • Response rate:
• Socio-demography:
➢ Mean age of the respondents was 33 years
➢ Majority of the respondents were female (76%)
➢ Mean family size was 5
RESULTS
N(%)
Interviews completed 1567 (34)
Refusal 144 (3)
Migrated to native place 410 (9)
Phone unavailable 2439 (53)
Total beneficiaries contacted 4560
5. Information received about COVID-19
95%
92%
87%
73%
69%
0%
20%
40%
60%
80%
100%
Preventive measures Symptoms Ways of
transmission
Action to be taken if
symptoms present
Risk groups
N=1567
6. Source of information, residence in containment zone (N=1567)
VARIABLES N (%)
1. Source of information
• Television 1450 (93)
• Family/friends/neighbours 865 (55)
• Social media (Facebook/Instagram) 621 (40)
• SNEHA 271(17)
2. Residence in hotspot/containment
zone
No 1296 (83)
Yes 260 (16)
Don’t know 11 (1)
7. Knowledge about COVID-19 symptoms
96% 95%
92%
60%
22%
15%
0%
20%
40%
60%
80%
100%
Fever Dry cough Cold Difficulty in
breathing
Headache Aches and pains
N=1567
8. Reported infected status of family and quarantine (N=1567)
VARIABLES N (%)
1. Has anyone in the family been infected with the novel coronavirus?
• Suspected, not confirmed with a test 32 (2)
• Suspected, tested negative 72 (5)
• Yes, tested positive 4 (<1 )
• No 1459 (93)
2. Self or family admitted in hospital (N=108)
• Yes 6 (6)
3. Mean number of days of hospitalisation 10
4. Self or family kept in quarantine (N=108)
• Yes 12 (11)
5. Mean number of days of quarantine 13
9. Preventive measures followed in the family
96% 95%
86%
73%
31%
13%
0%
20%
40%
60%
80%
100%
Washing hands
regularly with soap
& water
Wearing masks
when going out
Maintaining social
distancing
Using home
remedies like
kaadha, eating
turmeric/ginger etc
Disinfecting
surfaces/items
bought from market
Taking homeopathic
medicines
N=1567
10. Information needs (N=1567)
Topics on which further information
was needed by the community
N (%)
Protecting family’s health 676 (43)
Economic impact of pandemic on family 240 (15)
Children’s education
191 (12)
Procuring ration 159 (10)
Care of high risk group 75 (5)
Accessing health services if infected 55 (4)
Mental health of self if kept away from
family for quarantine
17 (1)
Travel to native place 18 (1)
Others* 97 (6)
No information needed 573 (37)
*Others included information on new symptoms of COVID-19, vaccine for COVID-19 and duration of the pandemic
11. Attitudes towards pandemic response initiatives (N=1567)
“It is appropriate to discriminate
against certain people based on
their occupation or religion”
N (%)
Agree 113 (7)
Disagree 1454 (93)
“If someone tests positive for
COVID-19, the government should
be permitted to admit them in
hospitals”
N(%)
Agree 1534 (98)
Disagree 33 (2)
“If someone comes in contact with a
COVID positive individual, the government
should be permitted to keep them in
quarantine”
N (%)
Agree 1298 (83)
Disagree 269 (17)
“I think the restrictions being implemented
now are very tough”
N (%)
Agree 713 (45)
Disagree 854 (55)
“One should be allowed to go out of
the house only for professional,
health or emergency reasons”
N (%)
Agree 1466 (94)
Disagree 101 (6)
12. Awareness of service provisions in area of residence (N=1567)
Awareness about services provided in area of
residence by Government/NGO
N (%)
Disinfection of public toilets
954 (61)
Patrolling of perimeter by police 950 (61)
Distribution of essentials like ration/medicines 941 (60)
Disinfection of area/building after positive case is
found
894 (57)
Door to door survey for screening of COVID-19
suspects
691 (44)
Communication about symptoms/preventive
measures (speakers/posters/FLWs)
350 (22)
Testing of suspect cases & their contacts 299 (19)
Testing of high risk group 285 (18)
Quarantine of infected persons & their contacts
269 (17)
Note: About 65% of the surveyed families used public toilets
13. Trust in institutions (to efficiently handle the pandemic, N=1567)
INSTITUTIONS N (%)
Police
1463 (93)
Hospitals 1374 (88)
Local public health bodies
(health posts/anganwadi/CHV)
1360 (87)
Government 1351 (86)
Religious institutions 1193 (76)
Any other* 413 (26)
*Others include SNEHA and local political committees
14. Major worries during the present crisis (N=1567)
FEARS & WORRIES DURING THE
PANDEMIC
N (%)
Unemployment/loss of wages 1124 (72)
Inability to pay bills 770 (49)
Health of family members 802 (51)
Restricted access to food supplies 553 (35)
Restricted freedom of movement 448 (29)
Physical health of self 253 (16)
Others* 180 (11)
Losing loved ones 58 (4)
Mental health of self 43 (3)
Inability to meet people dependant on you 31 (2)
Overburdening of health system 31 (2)
*Others include schooling of children, accessing ANC services and the duration of the pandemic
15. Source of ration in past two months (N=1567)
Source of household ration in the
past two months
N (%)
Ration shop, paid 1137 (73)
Ration shop, free 907 (58)
Received cooked food 550 (35)
Received ration from SNEHA 538 (34)
Received ration from other NGOs/local
political and religious leaders
425 (27)
Had ration reserves for emergency 174 (11)
Others* 189 (12)
*Others include ICDS, private donors in the community and employers
16. Food security, income loss and intention to migrate (N=1567)
VARIABLES N (%)
1. Has the family ever gone without a meal in the last two months because of lack of resources to
get food?
• Yes 212 (14)
2. If yes, how often? N=212
Rarely (once or twice) 102 (48)
Sometimes (three to ten times) 92 (43)
Often (more than ten times) 18 (9)
3. Loss or great reduction in source of income
of primary earning member
1337 (85)
4. Plan of going to native place after relaxation
of travel restrictions
306 (20)
17. High risk group (N=1567)
N (%)
Presence of high risk group in family 929 (59)
• ANC 70 (4)
• Child (0-6 years) 698 (45)
• Older adults (>60 years) 261 (17)
• Diseased
(any ailment including chronic conditions like DM/HTN and
immunocompromised like on CA Rx etc.)
212 (14)
18. Awareness and use of Helplines
VARIABLES N (%)
1. Aware of helplines for medical/non-medical relief during this pandemic (N=1567)
• No 1023 (65)
• Yes 544 (35)
2. Used any helpline 7% (N=544)
3. Satisfied with response 42% (N=38)
19. • Information received is high for symptoms of COVID-19, ways of transmission and
preventive measures but moderate for actions to be taken if symptoms arise and high risk
groups
• Fever and dry cough emerged as the most known symptoms but awareness of new
symptoms like headache, aches and pains is low
• Television was reported to be the major source of information on COVID-19
• Majority of the respondents reported practice of preventive guidelines like handwashing,
social distancing and the use of masks when going in public
• Very few families reported infection or occurrence of COVID-19 symptoms
CONCLUSION
20. • ‘How to best take care of family’s health and children’s education, ration procurement and
economic impact on family’ are the major information needs that emerged from the survey
• Most families worried about loss of employment/reduced wages, health of family members
and limited access to food supplies
• The community appeared to place high level of trust on police and hospitals for efficient
handling of this pandemic
• About 14% of the families reported to have gone without a meal due to inability to buy food
in the past two months
• Awareness and use of COVID-19 relief helplines was very low
CONCLUSION contd.
21. • Communication on new symptoms of COVID-19, high risk groups and action plan if
symptoms arise could be shared with the community
• Information about helplines could be given and the community to be encouraged to
use them
• Interventions to allay food insecurity could be undertaken: ration distribution,
communication about rights under PDS, referrals to PDS and ICDS etc
• Need of the hour is to work on unemployment and wage loss
RECOMMENDATIONS
22. “What the world needs now is solidarity.
With solidarity we can defeat the virus and
build a better world.”
~ UN Secretary-General Antonio Guterres
Thank you
Image of CME investigator conducting telephonic
interview during WFH