International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 6(11), June, 2014

Pages: 47-51

Date of Publication: 13-Jun-2014


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PERCEPTION OF BENEFICIARIES INVOLVED IN AN INNOVATIVE COMMUNITY HEALTH CARE PROGRAM (CHCP) IN ADOPTED VILLAGE OF WARDHA DISTRICT: A CROSS SECTIONAL STUDY

Author: Abhay Mudey, Meenakshi Khapre, Smrutiranjan Nayak, Shubhangi Baviskar Bhagat, Yogesh Raut, V. K. Deshpande

Category: Healthcare

Abstract:Background of study: CHCP is an innovative, inter-disciplinary and unique approach launched by DMIMS (DU) first time in India in 2011. The main aim of the program was to introduce a comprehensive health care approach in the community along with the development of team spirit in newly entered medical and Para-medical students. This study is designed to evaluate the perception in terms of benefits of this innovative programme from beneficiaries involved in the program Methodology: A community based Cross sectional study, which was conducted from Feb to July. A comprehensive team comprised of 150 medical, 100 dental and 100 nursing students structured at the beginning of academic session and 5 families are allotted to each team of 3 medical +2 dental + 2 nursing students. Faculty members from all the three disciplines were designated for the program to give expert guidance to students. Randomly total 50 villagers i.e. one from each 5 allotted families of health team, who belong to the adopted area of programme, were selected for study. Result: Findings were that 90 % perceived that program was useful for them. Out of them 66.7% had perception that they get free, dental and nursing advice together.59.57% perceived that if students guide them, fear of hospital is minimized. In all community is benefited through Routine Health check-up, early detection, Removes the fear, anxiety, myths of some diseases & doorstep health education Conclusion: Beneficiaries get doorstep services by medical, dental and nursing students free of cost. They are also happy because of the counseling & health education by these students to remove fear and psychological tension regarding their diseases.

Keywords: Comprehensive health, Community health care, primary care, Doorstep service

Full Text:

INTRODUCTION
Community based medical education (CBME) consists of activities that use the community extensively as a learning environment, where students, teachers, community members and representatives of other sectors are actively engaged throughout the educational experience in providing medical education that is relevant to community needs. It may be an urban or a rural community, though at present in developing countries most of the people live in rural areas. Primary care stands at the centre of health care systems. CBME is a broad concept, providing students with opportunities to interact with people from a wide range of social, cultural and ethnic backgrounds. It is directed towards the priority health needs and development of professional competencies. CBME might involve visiting families or taking part in community projects. It provides students with opportunities to become increasingly involved in health issues and, as their competency grows, to plan and provide care.[1] Rural population comprises 60% of total population of India. Nearly 3o% of population even today does not have access to health care facilities even in modern e-health era. In 1942 Bhore committee addressed same problem and assigned one year compulsory internship in rural community and concept of community physician was also introduced way back.[2,3] But if we look deep into the solution of this under serving problem we can make out that inculcation of this concept of serving in rural community can be done in very early stages of medical career. The classroom lectures or the bed-side clinics in the wards do not take into account the total factors, which have bearing on health and disease. The approach should not only be in the area of medical care but also sensitive to the political, economical and environmental factors. Hence there is need for a community based teaching. [4] In India too Reorientation of Medical Education (ROME) was introduce to make the medical students to be responsive to community need. But the above program commences from Internship where students are posted in rural and urban health centre apart from hospital training. CHCP is an innovative, inter-disciplinary and unique approach launched by DMIMS (DU) first time in India in 2011. In this programme students are introduce in community from first year onwards till completion of course. The aim of above study was to assess perception of beneficiaries in community in terms of services made available to them through introduction of this program.

MATERIAL AND METHODS
DMIMS is an experienced community based public charitable trust committed to providing comprehensive and holistic health care to over 3,50,000 poor and marginalized patients hailing from surrounding districts of central India. Nachangaon is adopted for 2012-2013 batches for giving comprehensive health care through health team by this innovative CHCP programme Study design A community based Cross sectional study Study duration 6 months (1st Feb to 31st July) Study participants Beneficiaries from the community of adopted villages. Sampling method One family member from 5 adapted families of each health team was selected for interview so that total members involved were from 50 families. Study tools Form to record data from the family members of adopted villages involved in the programme referred to as Family Form

METHODOLOGY
In DMIMS (DU), a comprehensive team of 150 Medical, 100 Dental and 100 Nursing students was structured at the beginning of academic session and 5 families were allotted to each team of 3 Medical +2 Dental + 2 Nursing students. This team is referred as “Health Team Unit”. All the students were given introductory lectures regarding their role in program. Faculty members from all the three disciplines were designated for the program to give expert guidance to students. Each health team visited their families fortnightly on Saturday morning. They interact with family members regarding their health and health problems; impart health education and the members of families who need medical help are refer to hospital. After an exposure to the program for approximately 6 months we have conducted this study of assessment of perception regarding this innovative approach of CHCP programme.

For this assessment data was collected from family members included in the programme by pre designed and pre tested questionnaire. Interviews in community were conducted at home. The questions were translated and asked and later they were analysed.

OBSERVATIONS AND RESULTS
In case of beneficiaries, findings were that 90 % perceived that program was useful for them. Out of them 66.7% had perception that they get free medical dental and nursing advice together. 75.5% of all the participants stated that they personally were benefited from the initiative. Out of them 70.6% perceived concession was the most beneficial part followed by the facility of regular health check-up (14.7%) 59.57% perceived that if students guide them, fear of hospital is minimized. Just half of the participants were of the perception that the concession services they are getting regarding the laboratory investigations are of satisfactory level. On asking the beneficiaries of the program regarding continuing the program, more than two third (80%) stated that it should be continued.

DISCUSSION
94 % of respondents had positive attitude towards the utility of program. It had mainly motivated them for regular health check-up. Easy to access health care as the students themselves go to their allotted family and escort them to hospital for regular health check-up or during emergency. They are also benefited by health education given by students. Seven families were motivated for using FP methods and two for vasectomy. Three cases of hypertension and one of diabetes were detected while one with frequent history of epileptic fits was put on medication. Also the team approach was highly appreciated by the community. There is paucity of research on community’s attitude towards the community centric medical education. A study conducted at the University of Natal, Durban in 1998 notes that the active participation of community in the educational process is very uncommon. [5]The study indicates the shortcomings of medical schools as lack of “fulfilling their social contract at the level of the community. When it was implemented in a manner to “facilitate development of a health programme desired by the community a good compliance was received from community. Same approached was used in our program too. Before the implementation the political leader, influential person in village, Youth group and Mahila Mandal were contacted. The program was tailored according to their needs and expectations and implemented only after the final acceptance of the blue print from community. Therefore a good response was seen in his study. Next was the practical question of how many were benefited and how? 75.5 % were benefited by different means given in result section. It had also helped many of them to remove the fear of hospital as the students guide the patient. Only half of them felt the concession on lab test to be satisfactory. Most of them were advised for the test other than routine for which they have to do out of pocket expenditure. About four in five families share their health information with students and want the program to continue further with some modifications like availability of drugs, renewal in concession etc. Thirty-five years after Alma Ata declared primary health care as the tool to achieving Health for all, growing health inequities still persist. Therefore it is important that the community leaders and members play a crucial role in the identification of the health need which need to be addressed by health professionals by such type of community oriented educational programme. In the CHCP, the health is viewed through the eyes of community. Thus the CHCP approach in training of the under graduates gives better understanding of the subject and benefit to community.

CONCLUSION
Community people get doorstep services by medical, dental and nursing students free of cost. They are also happy because of the counseling & health education by these students to remove fear and psychological tension regarding the different diseases. However there is a scope for strengthening this innovative CHCP programme by making meaningful changes in the planning and reorganizing the complete programme to be implemented from next academic year based on study findings.

References:

1. Critchley J, DeWitt DE, Khan MA, Liaw ST: A required rural health module increase students' interest in rural health careers. Rural Remote Health 2007, 7:688.

2. Government of India, Census. The Registrar General and Census Commissioner, India. New Delhi, Ministry Of Home Affairs. Government of India; Census, 2011

3. Govt. of India (1946). Report of the Health Survey and Development Committee, Govt. of India Press, Shimla.

4. Baumslag N. (1973) Family Care: A Guide. Baltimore USA: The Williams and Williams Co, Bennett M, Wachford. Selection Student for Training in Health Care: WHO. Geneva: WHO Offs Pub; 74, 1983

5. Williams, R. L., Reid, S. J., Myeni, C., Pitt, L., & Solarsh, G. (1999). Practical skills and valued community outcomes: The next step in community-based education. Medical Education, 33(10), 730-737.)

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Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

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‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


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A study by Dorothy Ebere Adimora et al. entitled \"Remediation for Effects of Domestic Violence on Psychological well-being, Depression and Suicide among Women During COVID-19 Pandemic: A Cross-cultural Study of Nigeria and Spain\" is awarded Best Article of Vol 14 issue 23
A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22
A study by Saurabh Suvidha entitled \"A Case of Mucoid Degeneration of Uterine Fibroid with Hydrosalphinx and Ovarian Cyst\" is awarded Best article of Vol 14 issue 21
A study by Alice Alice entitled \"Strengthening of Human Milk Banking across South Asian Countries: A Next Step Forward\" is awarded Best article of Vol 14 issue 20
A study by Sathyanarayanan AR et al. entitled \"The on-task Attention of Individuals with Autism Spectrum Disorder-An Eye Tracker Study Using Auticare\" is awarded Best article of Vol 14 issue 19
A study by Gupta P. et al. entitled \"A Short Review on \"A Novel Approach in Fast Dissolving Film & their Evaluation Studies\" is awarded Best Article of Vol 14 issue 18.
A study by Shafaque M. et al. entitled \"A Case-Control Study Performed in Karachi on Inflammatory Markers by Ciprofloxacin and CoAmoxicillin in Patients with Chronic Suppurative Otitis Media\" is awarded Best Article of Vol 14 issue 17
A study by Ali Nawaz et al. entitled \"A Comparative Study of Tubeless versus Standard Percutaneous Nephrolithotomy (PCNL) \? A Randomized Controlled Study\" is awarded Best Article for Vol 14 issue 16.
A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
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A Study by Shanthan KR et al. entitled "Comparison of Ultrasound Guided Versus Nerve Stimulator Guided Technique of Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Surgeries" is awarded Best Article for Vol 14 issue 01
A Study by Amol Sanap et al. entitled "The Outcome of Coxofemoral Bypass Using Cemented Bipolar Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fracture of Femur in a Rural Setup" is awarded Best Article Award of Vol 13 issue 24
A Study by Manoj KP et al. entitled "A Randomized Comparative Clinical Trial to Know the Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block Against Multimodal Analgesia for Postoperative Analgesia Following Caesarean Section" is awarded Best Article Award of Vol 13 issue 23
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A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17
A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16
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A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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