Volume 1 | Issue 1

September 2018

Dept. of Health Research Govt. of India (Mentored by

National Institute of Epidemiology, ICMR-NIE,

Chennai)

Dept of Health & FW Govt. of Tamilnadu

(Partnered by Directorate of Public Health,

Chennai)

Linked to

Tirunelveli Medical College, Tirunelveli (Under the Directorate of Medical Education, Chennai )

………nghjpifapy; nghJey nghUie…… the eternal river of health…….

Pothigai e-news letter of

Model Rural Health Research Unit Kallur, Tirunelveli, Tamilnadu

Model Rural Health Research Unit (MRHRU) located at the Government Primary Health Centre campus, Kallur is linked to the Tirunelveli Medical College (TVMC), mentored by the ICMR-National Institute of Epidemiology and established in partnership with the Department of Public Health, Government of Tamilnadu. MRHRU Kallur was inaugurated on 20th June 2016. This MRHRU is a platform for undertaking product development and health research with view to identify important health problems in the region. The MRHRU houses labs for Molecular biology, Biochemistry, Pathology, Microbiology and has facilities for conducting training and consultation. The Unit is supported by a core team of Scientists, Technical Assistants and field staff. The faculty of TVMCH and Scientists from NIE and other ICMR Institutes are encouraged to utilise this unit for conducting health research. Research Projects will be developed and funding will be sought through competitive process from the National and International funding agencies.

MRHRU – the Family

Dr V.M.Katoch & Dr Sanjay M Mehendale

laid Foundation on 27-8-2014

Inaugurated by Dr.Sowmya Swaminathan

on 20-06-2016

The National Institute of Epidemiology- ICMR performs the role of mentor for the MRHRU in the form of guiding in framing of research questions, provision of human and material resources as well as directing the researchers in obtaining the funds necessary for carrying out the research. The faculty from Tirunelveli Medical College performs the role of researchers taking keen interest in the health problems faced by the local community, planning of research projects, their implementation, translating the results into actions as well as providing point of care clinical services to the community. The Tamilnadu State Health Service collaborates in the research activities by providing access to existing health care infrastructure and manpower as well co-funding projects which are of prime importance to the community. Though the community is majorly a beneficiary of the fruits borne by MRHRU, they also contribute to the research activities by active involvement and participation in all community health education activities and extend their cooperation in various projects from time to time.

MRHRU – the Function 11 October 2017

The MRHRU identified 4 important core areas for concentrated sustained research activity under the MRHRU platform to improve long term gains in the project and increase faculty involvement. The 4 core areas were further stratified into specific priorities and placed with one working group which will actively work towards making specific project proposals and involve in translational research in these areas for some more coming years

FACULTY CONSENSUS MEETING ON RESEARCH IDENTIFYING PRIORITIES

WORKING GROUPS Identification and reduction of risk factors to improve

maternal & neonatal mortality indices CREATE

WORKING GROUPS

School & Adolescent Health Non Communicable Diseases – Cancer, DM, HTN

Communicable Diseases – Seasonal Fevers Geriatric Health

PRIORITIES BASED ON

LOCAL HEALTH SYSTEM

REQUIREMENT AND

FEASIBLITY

STRATIFICATION OF THE WORKING GROUP Observation Studies

Community Based Participatory Research Prevention / Preventive Intervention Studies

Health Systems Research

MRHRU – the Preparation August 2017:Basic Course Workshop in Research Methodology for PG. Participants : PG students TVMC, Total number of Participants 100 November 2017: 2nd Proposal Development Workshop Director NIE presided, Participants : 22 June 2018: Basic Course Workshop on Biostatistics Participants : 45, Resource Persons: Dr R.Ramakrishnan & team March 2018 onwards:Integration of Research training in UG curriculum Weekly Saturday 2 hours devoted to Lectures, Hands on Training and small group discussions on research methods and advances in medical science to develop and conduct Short Term Student projects during the course.

MRHRU – the Way

Forward

CREDIBLE KNOWLEDGE

PARTNER IN THE RURAL HEALTH

SYSTEM

CREATION OF RURAL COHORT

BASED ON DIGITAL TECHNOLOGY

COLLOBORATION WITH NATIONAL AND REGIONAL

INSTITUTES

STARTING A CENTRE OF RURAL

DISEASE REPOSITORY

POINT OF CARE DIAGNOSTIC

SUPPORT TO LOCAL HEALTH SYSTEM

MRHRU-TVMC MOU’s

proposed & in various

stages of

implementation:

Department of Statistics, MS

University, Tirunelveli

Department of Sociology,

Govt. Rani Anna Women’s

College, Tirunelveli.

MRHRU – the Activities

Population

based cohort

in an area or

locality serve

as an ideal

platform for

undertaking

sentinel

demographic

surveillance

activities to

collect data

on

longitudinal

basis to set

health

priorities for

the country.

Developed

countries

have long

established

such cohorts

for understanding and describing trends of

various health events across populations with a

view to develop various health policies.

In India, there are two cohorts; one is Vadu (Pune,

Maharashtra) and another in Vallabhgarh (near

Delhi).

The mandate of this Unit is to undertake research

on disease identified as priority in the

district/region and establishing this cohort will

serve as a platform to undertake various studies

that provides understanding of demography,

socio-economic and health issues and set health

priorities and policies for the area in particular

and for the district or state or nation in general,

based on longitudinal evidence in this platform.

Therefore MRHRU field practice area is an ideal

setting for developing household cohort and is

currently being implemented since 2014.

RURAL COHORT

DIGITAL DATA & GPS MAPPING

ROAD MAP: Diseases wise registers – will be utilized for longitudinal follow-up of different types of

diseases over years as well as help in planning of research projects and health policies.

61%

39%

HOUSEHOLD

ENUMERATION

STATUS (N=10951)

Households

enumerated

Households

pending to be

enumerated

54% 46%

POPULATION

ENUMERATION

STATUS (N=40368)

Population

enumerated

Population

pending to be

enumerated

HEALTH EDUCATION ACTIVITIES

SCHOOL CAMPAIGNS Health education program focusing on hygiene practices, balanced diet and menstrual hygiene for adolescent girls are conducted routinely

MASS CAMPAIGNS Mass Health campaigns for young women, new mothers and general public regarding dangers of anemia and methods to prevent nutritional anemia

FAST FACTS

38.8% Of the adolescent girls in the MRHRU field area were found to be anemic and 40% never took de-worming tablets

30.4% Of the Under Five children were found to be Underweight

38% Of the antenatal women were found to have Hemoglobin less than 10gm%

The ICMR Task force Nutritional Anemia project is a multi-centric study implemented across nine centers with MRHRU, Kallur as one of the centers. The study is being implemented as three phase; phase 1 involves collection of baseline data among adolescent girls, pregnant women and under-five children. Phase 2 is about intervention to improve the health status of the community and phase 3 involves the assessment of impact of the health intervention. At MRHRU, Kallur, phase 1 has

been successfully completed and

baseline data collected. Phase 2

is currently being carried out in

the form of various activities

such as:

1. Targeted Door to Door Health Education: 22 volunteers from 10 villages were trained to do house to house Health Education on nutrition.

2. School Health Campaign: Adolescent children were given Health Education & Training on nutrition, personal

hygiene and environmental sanitation by experts from NIE

3. Mass Village Health Education

& Training campaign

4. Healthy Cooking: 8 cooking competitions to enhance public participation and awareness of healthy, low cost, locally available hygienic food preparation practices.

5. Identification of malnourished children under each HSC and provision of expert advice on improving nourishment and preventing diseases.

PRELIMINARY OBSERVATION

Adolescent Girls: Girls with Anemia 38.8%

Mild Anemia (11.9-10gms) 63.8%

Underweight for age (BMI<20) 31.5%

Low Ferritin levels 35.5% 31.5%<15mg/ml

26.6%<12ng/ml

Low Selenium 24.9%

Low B12 Level 33.6%

No Health insurance 35%

Hand wash after defecation 77.5%

Not in Mid-day Meal Program 63.6%

Not availing ICDS services 94.6%

Never received de-worming tabs 40%

Not received IFA tablets 27%

Not aware of Govt. Programs 92%

Age-

Group

Total

Pregnant

Women

Anemic

Women

12-20

Years 27 17 (62.9%)

20.01-25

Years 116 48 (41.4%)

25.01-30

Years 76 31 (40.8%)

Above 30

Years 21 10 (47.6%)

MULTI COMPONENT HEALTH INTERVENTION

FIELD PHOTOS

Healthy cooking competition in progress at a village

anganwadi center. Around 100 women have

participated in the cooking competition so far from 6

villages and the program is ongoing. The women were

motivated to cook healthy dishes from locally available

healthy and less expensive raw materials in a hygiene

kitchen.

Drawing competition and elocution competition

was conducted on the theme Swachh Bharath

among school children. Initial screening was

done in each school and for the final round,

around 150 students participated

enthusiastically. Drawing kits were provided

free of cost for the children and health

education was given at the end of the

competition

Health education on personal hygiene and

balanced diet being given to school students

by Faculty from Tirunelveli Medical College.

8

In 2014, a base line survey was conducted on the Toilet Use and Defecation practices amongst

adolescent girls in the study area under Kallur Government Primary Health Centre in Tirunelveli District,

Tamilnadu. Nearly 39.4 % (92/ 233) girls reported the practice of open air defecation due to various social,

economic and personal reasons. 135 of the 233 Households had toilets. While majority (88/98) of the

households did not have toilets, and practiced OAD, 4 households having toilets practiced OAD.

A follow-up survey was conducted among the same adolescent population in early 2018 and

prevalence of OAD has reduced to 24.1% from 39.4% and it is found to be a statistically significant

reduction in the prevalence. 100% of all households in Tirunelveli district now have IHHL now. This district

has achieved the 2019 target of Swachh Bharat Gramin programme of the Government of India as on date.

Though there has been an increase individual household having their own latrine, people have other social

factors which have prevented them from stopping from open air defecation. A detailed study will provide

with data regarding these factors and help to formulate plans to alleviate the identified social factors.

100% of all households in Tirunelveli district have IHHL

OAD has dropped to 24.1% from 39.4%

Art from Drawing competition

conducted at Kallur in the theme

“Swachh Bharat”