Thursday, January 24, 2008

Health Expenditure at House Level in DelhiPresenting

Authors: Surbhi Batra, J Kishore, GK Ingle,
Introduction: In the present era to allocate resources judiciously in the health sector the policy making bodies need to have a deeper understanding of the health seeking behavior of the common man, which has two components: 1) utilization of the available resources 2) expenses on treatment. Information on these issues is not extensively studied. Objectives: To study the health expenditure and utilization of resources by the people in Delhi Methods: 200 families chosen by stratified random sampling from 4 out of 9 districts according to socioeconomic status. After obtaining voluntary informed consent information on family size, loans, savings (total), insurance, expenditure per month on food, clothing, education, luxuries, housing, recreation and health including self-medication, indigenous medicine, treatment of chronic illness, was obtained using pre-tested questionnaire. The data was analyzed by using computer software package Epi-Info and ANOVA test and Mann-Whitney were used for statistical significance at 5% level. Results: A higher mean age of head of household and per capita income in posh and middle class colony was observed. There were significant differences in savings, insurance cover, per capita and total incomes, and expenditure on food, clothing, housing, transport, recreation in different areas of Delhi. Expenditure on smoking was more in middle class and posh colonies in spite of lower smoking rates. Both areas had more health seeking behavior and expenditure on health particularly over the counter medicine, on alternative system of medicine, private health care compared to slum and resettlement areas. It was also observed that upper strata of Delhi spent more for their chronic diseases whereas people from slum and resettlement prefer more government hospitals for tuberculosis, and other lung diseases. Conclusion: Residents of posh and middle class colonies spends more on their health which could be due to their higher per capita income, suffering from chronic diseases and preference to private health care set up. This study concluded that more expenditure does not ensure freedom from illnesses and special emphasis is required on preventive health services.

Beliefs and perceptions about cancers among patients attending

Authors: J Kishore, Irfan Ahmad, PK Mohanta, GK Ingle

Introduction: The prevalence of beliefs and myths amongst cancer patients is a reflection of the level of knowledge available in the community regarding cancer. Since a cancer patient has the capability of influencing opinions amongst others more forcefully. This information could be utilized in preparation of cancer awareness program. However, not much information is available particularly about Indian cancer patients.
Objectives: To study the belief system and perceptions of the cancer patient about the disease.
Method: A face-to-face interview was conducted among 95 patients of cancer attending the out-patient-department of Oncology & Radiotherapy, Maulana Azad Medical College, New Delhi, regarding their beliefs and perception about cancer and their outlook towards its treatment. The questionnaire was designed and pre-tested. It contained 42 items on various aspects such as patient’s own idea of his disease, about its causation, its early diagnosis and its prevention, the impact of treatment whether successful or futile beside demographic information. The data was analysed using Epi-Info software package.
Results: Majority of patients were misinformed about the cancer. 27.3% believed that cancer is contagious and can be transmitted by contact. People get cancer due to ill wishes (58%), spirit (48%), God curse (59%), evil eye (60%), past/present sin (38%), and immoral behaviour (34%). Only 15% of patients believed that cancer can be prevented. 48% believed that death is certain in cancer. Wrong views were significantly more in illiterate than literate patients.
Conclusion: Beliefs in myths are common which is associated with illiteracy. Such wrong views are hindrance in accepting proper health services and need to be removed through mass awareness program.

Lifestyle Diseases in School Children In Delhi (Aged 8-12 years): Prevalence, Risk Factors and Awareness

Research Question: What is the Prevalence and Awareness Levels with regard to Lifestyle Diseases amongst school going children (Aged 8 -12 years)?What are the associated risk factors? Objective: To assess the Awareness levels and Prevalence with regard to Lifestyle Diseases amongst the children and to study the associated risk factors.Type of Study: Cross sectional study. Participants: A sample of 293 children studying in Government and Public Schools (6th – 8th Std) in Delhi. Tool: Questionnaires inquiring about eating habits, physical activity, sleep habits, opinions on right living were used to gather the data. Result: 10% of the population was obese and 39% were underweight. 90% of the population opines that physical activity is needed for good health but as much as 45% rarely on never indulges in physical activity. The most preferred pastime activity of more than 70% falls under the sedentary category. Although the awareness levels with regard to right eating habits are high (90%), however 50% consume soft drinks, chips and chocolates as frequently as 3 times a week. 8% experience problems with sleep very frequently and 45% experience sometimes. Conclusion: The high prevalence of both obesity and underweight reminds of the predicament that a developing country like India faces. With the huge lag between awareness levels and actual practice amongst the children, the onus is on the family, education and the media to mould productive and healthy lifestyle patterns for the children.

Authors: Phalguna, J Kishore, N Bhagat