shubh verma

Community Profile of Bithauli Khurd village

Chinhat Block

Lucknow

Uttar Pradesh

TATA INSTITUTE OF SOCIAL SCIENCES

MUMBAI

SCHOOL OF HEALTH SYSTEM STUDIES

MASTER OF PUBLIC HEALTH IN SOCIAL EPIDEMIOLOGY

2014-16

RURAL INTERNSHIP REPORT INTERNSHIP ORGANISTION – VATSALYA

LUCKNOW DISTRICT, UTTAR PRADESH

SUBMITTED TO:

PROF. ANIL KUMAR

SUBMITTED BY

AKANKSHA VERMA- M2014PHSE002

HARINDER KUMAR- M2014PHSE010

Acknowledgement

At this juncture of the completion of my internship presentation and

report writing I would like to take this opportunity to express my heartfelt

gratitude to thank each and everyone who helped me during this

internship

First of all I would like to thank the Almighty for always showering his

blessings on me and giving me this life and all the other blessings.

I would also like to thank all the internship coordinators for giving us

this opportunity in the form of this rural internship to explore the new

facts and get new experiences in a rural setting.

I would also take this opportunity to sincerely thank Prof.Anil Kumar

sir for providing his valuable guidance and support throughout the period

of internship and helping me shape my vision and improve my skills and

also learn the intricacies of working in a very different setting

I would also like to thank School of health system studies, Mumbai for

the valuable support.

Also a sincere thanks to Vatsalya, Lucknow and especially Dr.Neelam

Singh for giving me this opportunity to be a part of such a respected

organisation and give me this opportunity to work in a different setting.

In the end I would like to thank my Family, especially my parents for

their tireless effort and support in making me capable to reach this stage

in my life

Objective

1. To assess the boundaries and landmarks of the village BITHAULI KHURD

2. To determine the socio-economic and demographic profile of BITHAULI KHURD

3. To understand the living conditions, health problems and health facilities available in

BITHAULI KHURD

4. To assess the public resources available in the village, how many of these resources

are actually functional, how does it affect the availability, accessibility and

affordability for certain sections of the village community

Research Design

A community based study was undertaken to study the socio-economic profile, demographic

profile, living conditions, health problems and availability of health facilities in BITHAULI

KHURD village of Lucknow. Also a mapping of the boundaries of the village was done and

an assessment of the various resources present in the village and also how the accessibility

and the availability of these resources varies for the different socio-economic sections of the

population

Key informant interviews, focussed group discussions and observation methods of qualitative

data collection were employed to gather information on the living conditions, practices and

beliefs of the people and the facilities available and issues faced by the people and also a

semi structured questionnaire was also used.

Secondary data was also obtained from the department of Health, ARO’s office, and B.D.O’s

offices and also data was gathered from the various frontline worker like ASHA, AWW, and

ANM for demographic and socioeconomic profile.

Research Methodology:

Universe of study:

Bithauli Khurd village in Bithauli Khurd panchayat in Chinhat block of Lucknow district in

western Uttar Pradesh

Type of Study: It was a cross sectional study

Sampling frame:

Households in the village of Bithauli Khurd

Sampling:

Convenience Sampling (Non-Probability)

Sample size:

52 house holds

Methods of data collection:

Face to face interviews were carried out.

Tool used:

Semi-structured interview schedule which was translated and conducted in hindi

Secondary data was also obtained from the health professionals and the other frontline

workers

Ethical consideration: Verbal consent was taken from the respondents prior to the interview

and participation was made voluntary. Respondents were made aware and assured of

confidentiality.

Introduction Uttar Pradesh (literally "Northern Province"), abbreviated as UP, is a state located in Northern

India.

The state is bordered by Rajasthan to the west, Haryana and Delhi to the northwest,

Uttarakhand and the country of Nepal to the north, Bihar to the east, and Jharkhand to the

southeast, Chhattisgarh to the south and Madhya Pradesh to the southwest.

It covers 243,290 square kilometres (93,933 sq mi), equal to 6.88% of the total area of India,

and is the fourth largest Indian state by area.

With over 200 million inhabitants in 2011, it is the most populous state in the country as well

as the most populous country subdivision in the world. Hindi is the official and most widely

spoken language in its 75 districts.

Uttar Pradesh is the third largest Indian state by economy, with a GDP of ₹9763 billion

(US$150 billion). Agriculture and service industries are the largest parts of the state's economy.

Lucknow is the largest and the capital city of Uttar Pradesh.

BLOCK OF LUCKNOW:

There are 8 blocks in Lucknow district

LUCKNOW

BAKSHI KA TALAB

CHINHAT

GOSAIGANJ

KAKORI

MAL

MALIHABAAD

MOHANLALGANJ

SAROJINI NAGAR

CHINHAT BLOCK:

There are 33 panchayats in Chinhat Block, of which the alloted gram pachayat is BITHAULI

KHURD

BASIC PROFILE OF THE BLOCK:

The total population of the block is 1.98000 of which majority of the population consists of

Hindus which constitute of around 68% of the total population whereas the rest consists of

the Muslims

Literacy rate:

Males

69%

Females

48%

Total

57.4%

Total Population: 1,98,000

Pregnant mothers 4733

Lactating mothers 4700

O to 1 yr total children 4061

1 to 5 yrs children 28000

SCHOOLS:

1. Chief school : 107 –rural

2. Urban :59

Health care facilities:

Taking into account the health care facilities of the whole block there are about 258

anganwadi workers, 65 ASHA, 33 ANM.

There are 35 sub-centres, 4 primary health care centres but not all of them are upgraded to

24*7 facility.

There is one CHC (24*7 upgraded) and the JSY load is 185

Immunisation status:

Immunisation status for the whole block for the year 2013-14

was 97.2% and for 2014-15 is has increased to 98 %

Family planning services:

1. Tubectomy

42

Intra uterine devices done 152

Oral pills 1286

Condoms 1667

VILLAGE: BITHAULI KHURD

Introduction :

The total POPULATION of the village is 1738 which consists of 291 (Rural) households.

As the village is under the process of urbanisation thus some portion of the village is under

urban setting and the majority still comes under rural areas.

There are geographical segregations in terms of the pockets where the hindus and the

muslims or the people from the general category as well as other categories like OBC, SC,ST

are residing

There is 100% electrification in the village .there is one PUBLIC DISTRIBUTION SHOp

but what was revealed while doing the community survey and the mapping was that the

system was very well functioning for the effluent sections of the village but was not working

effectively for the poor and some particular caste and classes in the village.

Of the total population around 62% of them had a BPL card while the rest did not .

BPL card holders 62%

No BPL card 38%

Literacy rate:

Males

58%

Females

44%

Total

52.4%

Total literacy rate for the whole population is around 52.4% , in which the literacy rate for

males is 58% and for females it is around 44%.

Caste wise distribution:

CASTE MALES FEMALES

GENERAL 108 96

OBC 816 124

SC 543 295

Majority of the population belongs to the SC and OBC community where as only as small

section of the population belongs to the general population.

HEALTH FACILITIES:

There is one sub centre present in the village which has one ASHA, present. The SC is not

functional 24*7 and lacks many of the basic necessities like proper hygiene and sanitation

facilities. Further as there is no other health care facility in the nearby, and the nearest

government health care facility is a 10 to 12km away ,people generally prefer to go to the

private health care facilities which in most of the instances are not qualified health care

professionals thus compromising on the health and the services they get.

SUB CENTRES 1

PRIVATE HEALTH CARE PROVIDERS 10

VETERNARY HOSPITAL 1

Family planning services provided by the frontline workers in the last three months

Of the total 291 households in the village there are around 70% of the houses which have

inbuilt toilets where as 30 % still doesn’t have toilet facilities and use the public toilets, many

of which are still non-functional and ill constructed.

Results:

Basic demographic data:

Of the total households interviewed about 69% of the households had males as the head of

the households whereas the rest have females as the head of the household

0 10 20 30 40 50 60 70

male

femals

68.2

31.8

gender of head of hte household

68.2%

Religion:

Of the total house holds around 74.2% of them belonged to hindus whereas the rest 24.8%

were of the muslim population

Caste:

Majority of the population belongs to SC and OBC population where as a small percentage

belongs to general

0 10 20 30 40 50 60 70 80

hindu

muslim

74.2

24.8

religion of the household

0 5 10 15 20 25 30 35 40 45

general

obc

sc

29.7

27

43.2

caste wise distribution

Housing characteristics:

66.8% of the respondents had pucca house while 16% had a kuccha house

PDS Utilisation:

76% of the respondents said they had access to the PDS system while the rest

said that they did not

Income of the household: income of the house hold ranged from less than 1000 to

10000 and above with majority of the respondents falling in the category of 1000 to 4999

16

66.8%

0% 10% 20% 30% 40% 50% 60% 70% 80%

kaccha

semi pucca

pucca

Type of house

Percentage

76%

24%

0% 20% 40% 60% 80%

Yes

No

PDS Utilisation

PDS Access

0 10 20 30 40 50 60 70 80

less than 1000

1000 to 4999

5000 to 9999

10000 and above

income of the household

BPL card holder:

84% of the respondents had a BPL card while rest didn’t

Educational status of the head of the household

Occupation of the head of the household

84%

16%

0% 20% 40% 60% 80% 100%

Yes

No

BPL card Holder

BPL card Holder

40 42 44 46 48 50 52 54 56

literate

lilleterate

54.1

45.9

educational status of the head of the household

0 10 20 30 40 50

manual labour

farming

others

48.6

24.3

27

occupation of the head of the household

Health related findings:

Place of delivery of the last child

Majority ie 54.3% of the respondents went to a private setting for the delivery

Breast feeding initiated within one hour of birth:

Only 18.2% of the respondents said they had started breast-feeding within one hour of

delivery

0 10 20 30 40 50 60

government

private

home

28.6

54.3

17.1

place of the last delivery

0 10 20 30 40 50 60 70 80 90

yes

no

18.2

81.8

breast feeding initiated within one hour of birth

Type of services availed when ill

36% of the respondemts said that they preffered to go to a private hospital when ever they fell

ill and omly 14% of them said that they would prefer going to a government setting. When

asked about the reason for non-utilisation of the government health care setting, poor quality

of care, long waiting hours, unavailability of the health care facility were cited to be the

major reasons

Substance abuse was very high among the respondents and the major form of

consumption was beetal nut chewing , beedi consumption and gutka

consumption

30%

36%

16%

14%

0% 10% 20% 30% 40%

private clinic

private hospital

sub center

govt. hospital

Type of services availed when ill

Type of services availed whenill

2%

4%

26%

12%

40%

10%

6%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

no nearby facility

facility timing not convinient

health personal often absent

waiting time too long

poor quality of healthcare servises

usually medicine not available in the facility

don't trust

Reason for non utilisation of Govt. facilities

56%

22%

14%

72%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Smokeless tobacco

Cigarette/Beedi

Alcohol

Beetul nut

Substance abuse

Using family planning services

There was very high unmet needs for the contraception and one of the reasons cited for this

was the inability of the frontline workers to provide the services

Have a toilet facility

70% of the respondents said that they had a toilet facility. But still around 30% of the

respondents said that they practiced open defecation

Practicing open defecation

0 10 20 30 40 50 60 70 80 90

yes

no

16.2

84.7

using any form of family planning services

0 10 20 30 40 50 60 70 80

yes

no

70.2

29.8

having a toilet facility

0 10 20 30 40 50 60 70

yes

no

68.2

29.8

practicing open defecation

Water treatment

Majority ie 75.8% of the respondents said that they were not treating the water used for

drinking to make it safe.

When asked about the methods used for making the water safe they said that they used

boiling or chlorine tablets to make it safe

Methods used

0 10 20 30 40 50 60 70 80

yes

no

24.2

75.8

treating dreanking water

0 10 20 30 40 50 60

boiling

chlorine

other

24.2

16.1

59.4

methods of treating dreanking water

Discussions:

The total POPULATION of the village is 1738 which consists of 291 (Rural) households

Total literacy rate for the whole population is around 52.4%, in which the literacy rate for

males is 58% and for females it is around 44%.. Although majority of the households had a

toilet facility still a large no. of people went for open defecation practices. There was very

high unmet need for the contraception and the main reason cited for this was the lack of

services being provided by the frontline workers

FGDs and KI interviews from both the provider’s and the beneficiary’s side revealed many

facts about the present situation of the health care system and the prevailing problems in the

community.

Most of the FGDs revealed that majority of the population felt dissatisfied with the working

of the health care functionary like ASHA and AWW

Of the total 291 villages in the village there are around 70% of the houses which have inbuilt

toilets where as 30 % still doesn’t have toilet facilities and use the public toilets , many of

which are still non-functional and ill constructed.

Total literacy rate for the whole population is around 52.4% , in which the literacy rate for

males is 58% and for females it is around 44%.

There is one sub centre present in the village which has one ASHA , present. The SC is not

functional 24*7 and lacks some of the basic necessities like proper hygiene and sanitation

facilities.

On respondent stated “ Adhikari log zyada kuch kaam kar nai paa rahe hain, aur ASHA

behanji bhi bas tab hi kaam karti hain jab adhikari kar daura hota hai.”

Many of the respondents were not aware about the services to be provided to them by ASHA

and AWW.

“ sarkari mein jaana pasand nai karte kyuki waha suvidhaayein nai hai aur jaha hain waha

doctor theek se baat nai karte”

“jaankari bas tabhi dene aati hai jab badi doctor aati hain , jo samay pe pahuch gaye unko

suvidhaayein mil jaati hain baaki reh jaate hain”

On family planning and unmet needs on respondent said that “ agar yeh sab jaankaari aur

suvidhayein humein mile toh family itni kyu badhegi..agar gareeb logo ko mahilaao ko yeh

suvidhayein mil jaae toh itne bacche ho hi nai”

“ kuch bhi nai batati ki bacche kam kaise ho”

“Sarkar ne boht si suvidhaayein di hain jo humein pata hi nai..unse bachta hi nai toh janta

paayegi kya”

For the working of the Pradhan the respondents said that “ Pradhan apna kaam theek se nai

karte sirf paisa kha rahe hain , naa saaf safai hoti hai naa vikas hota hai”

For the ICDS they said ki “khana khan eke liye hum apne baccho ko bhejte hi nai, kyunki

usme boht baar keede mile hain , bas dikhane ko 4 – 5 baccho ko bula ke baant deti hain

baaki sab acha acha apne ghar ko le jaati hain”

There have been differentiation on the services to be provided to the general and the minority

community especially the Muslim community and the scheduled community.

The main problem which was identified was lack of hygiene and sanitation facilities, which is

considered to be the main reason for the spread of diseases and majority of the diseases.

From the provider’s perspective the most important which was highlighted was the lack of

effective funding and the deficiency of Human resource to help and cater to the needs of the

community.

Conclusion:

Although the village is in the process of urbanisation, still it lacks some of the very basic

facilities and amenities which have a heavy toll on the health of the population in terms of

non-functional government health care facility, high unmet needs for contraception etc.

Further due to lack of availability and accessibility of these services there occurs a very

heavy burden of economic cost on the poorer sections of the society in terms of the private

treatment.

Proper monitoring, evaluation and better functioning of these facilities along with better

availability, accessability, affordability and quality care is the most important step in order to

cater to the needs of the people in a rural setting.