Archives of
Yr. 2016-17
Serving Since 2016
omen n eed et upport
W
I
N
G
S
I'm a paragraph. Click here to add your own text and edit me. It's easy.
Concept: An inter-professional approach through cumulative expertise of various doctors, dentists, physiotherapists, nutritionists and medical and paramedical students in the club helps us deliver a holistic comprehensive integrative healthcare program to women from under-served, marginalized groups.
Context: In a patriarchal society such as ours, women are not only neglected but groomed to put the needs of the men in the family ahead of their own. This attitude is ingrained deeper in less privileged sections in our community. Neglect coupled with ignorance puts health of women at greater risk. From adolescence, through motherhood and silver years, our target has been to cater to woman's health issues in all phases of life.
Aim: To deliver healthcare & health-education to under-served women belonging to marginalized groups & vulnerable population through a sustainable comprehensive program.
Program Components ( At - A - Glance ) :
Salient Features:
> An 'Evidence-Based' approach to healthcare
# The W.I.N.G.S. healthcare program at a site spans 6 months. It includes a baseline camp & 2 follow-up camps at intervals of 3 months. Qualitative research at baseline camp helps us analyze knowledge & awareness levels of target population, to help us construct tailored health education seminars. The longitudinal design of program helps consolidate vital concepts of health education dispensed. It also allows us to measure progress through health records maintained by us & verify the impact of our intervention.
# Each healthcare service included has been pilot-tested on a large scale individually & proven to be successful before integration with the comprehensive care protocol.
# We have successfully integrated our past projects to our comprehensive care protocol, to deliver one comprehensive healthcare pack; leading to increased efficiency, big savings on resources expended & exponentiation of our outreach.
> In keeping with the spirit of 'Preventive Medicine'
# The protocol lays special emphasis on health education. Through this we strive to empower the people to look after their own health, considering they have poor access to basic healthcare services. We also educate village health workers & the people on various govt health schemes that they can rightfully avail of, for subsidized healthcare services.
# Program includes screening for cancerous as well as pre-cancerous lesions which are like a ticking time-bomb. Treating them can help prevent cancer. For cancer screening, we have partnered with Cancer Patients Aid Association.
> 'Sustainability' - a key component of responsible public health practice
# The village health workers are trained to promote & implement recommended healthcare practices in their village. They are trained to dispense basic health education on issues covered in our camps & periodically revise the same with the villagers. They are trained to train the women in their village to conduct breast & oral self-examination for cancer screening (Training the Trainers). They are trained to identify high risk cases, monitor them & to refer people to appropriate healthcare provider in case of observable warning signs. This serves a dual purpose-
(i) Vocational training for healthcare workers to expand their skill set & services offered by them.
(ii) Empowering remote/rural community with sustainable basic healthcare.
Focus areas:
# Menstrual health & hygiene (awareness & safe practice)
> Problem: Persisting taboos pertaining to menstruation have a profound impact on emotional state, lifestyle, and importantly, female health (Garg S., Anand T. 2015). A research study found that in rural India, only 37.52% girls were aware of menstrual physiology; satisfactory cleaning of external genitalia was practiced by only 37.96% (Paria B. et al, 2014).
.
> Solution: We conduct interactive group sessions where information is disseminated by trained volunteers using educational aids, demonstrations of recommended exercises, and counselling sessions dispelling myths & promoting healthy practice.
# WHO recommended exclusive breastfeeding practice
> Problem: Exclusive breastfeeding (EBF) for first 6 months of life is a prime strategy for reducing infant morbidity and mortality, particularly in resource-limited settings (Mogre V et al, 2016). Yet, only 36.4% of Indian neonates receive breastfeeds within one hour of birth (Patel A et al, 2013).
.
> Solution: We conduct informative seminars as well as one-on-one counseling to spread awareness about EBF, its lasting physiological & psychological benefits for mother and child, proper technique & about kangaroo mother care.
# Nutrition (Mothers & under-5 children)
> Problem: Malnutrition is rampant in rural India, causing several complications among mothers & children. Nutritional deficiencies during pregnancy can result in congenital anomalies. Malnutrition contributes to half of the under-5 child deaths in rural India (read more). .
> Solution: For under-5 kids- we give a multi-micronutrient home fortification powder - Sprinkles - validated by the WHO, to fulfill the requirement of 15 Vitamins and minerals for kids between 6 months – 5 yrs of age. We provide a 6month supply at a time. .
> Solution: For Mothers- We educate women about the importance of registration of pregnancy at hospital/clinic, immunization, pre-natal vitamins (ANC pack provided free of cost at govt. hospitals/clinics). We counsel them on nutrition, healthy diet, and educate them about "backyard farming". We also distribute seeds of indigenous nutritious fruit bearing perennial plants including banana, papaya, guava as means to meet nutritional requirements.
# Unwanted pregnancy & unsafe abortion
.
> Problem: A WHO report states, in India the law for abortion 'was liberalized already in 1971, however, many women are unaware of the legal provisions, services are not easily accessible and it is officially acknowledged that an estimated “two thirds of all abortions take place outside the authorized health services by unauthorized, often unskilled providers.” (Ministry of Health & Family Welfare, India) in effect contributing a large number of unsafe abortions. These numbers are unlikely to decrease until women become informed of their right to legal and safe abortion.'
.
> Solution: We educate the women & health workers about planned pregnancy, safe abortion, their rights as per the law of the nation and govt funded services they can avail of, in our interactive training sessions.
# Breast cancer awareness & breast self-examination
.
> Problem: As per Indian Council of Medical Research (ICMR) report, breast cancer is the most common cancer in Indian women. A study on breast cancer awareness among Indian women, by Gupta A. et al, 2015,warns about alarmingly low level of cancer literacy in said demographic. As per American Cancer Society (link), 'the 5-year relative survival rate for stage III breast cancers is about 72%. Often, women with these breast cancers (upto stage III) can be successfully treated. Breast cancers that have spread to other parts of the body (Metastasis- stage IV) are more difficult to treat and tend to have a poorer outlook.'
.
> Solution: ICMR sub-committee on breast cancer recommends (guidelines link) opportunistic screening in high risk women. Through our partnership with Cancer Patients Aid Association, clinical breast examination is carried out at our camps. Suspicious cases are provided with fully sponsored management by CPAA. We create awareness about breast cancer in our interactive seminar. We train women and village health workers to identify high risk individuals, & educate them about clinical presentation of the disease & breast self examination. For tests & treatment at subsidized costs, we connect them with our partner NGOs, and help them avail of government schemes available in our teaching hospitals.
# Oral cancer awareness & self-examination
.
> Problem: Oral cancer is another common cancer in India (ICMR report). Chewing tobacco (a common practice in India, especially in lower socio-economic strata) puts people at a greater risk of developing oral cancer. .
> Solution: Our dental volunteers and the otorhinolaryngologists (E.N.T. docs) on the CPAA team conduct visual screening for oral cancer & precancerous lesions along with routine dental check-up. We also create awareness about oral cancer in our interactive seminar & complement it with an anti-tobacco didactic. We teach people to conduct oral self-examination & train health workers to revise it periodically with them.
# Cervical cancer awareness & screening
> Problem: In India, cervical cancer is the second most common cancer in women. As per data from National Institute of Cancer Prevention and Research, and National Cancer Registry Program:
-
One woman dies of cervical cancer every 8 minutes in India. Annual deaths due to Cervical Cancer ~67500 women
-
Rural women are at higher risk of developing cervical cancer as compared to their urban counterparts.
-
The survival chance of a person becomes better if the cervical cancer is diagnosed and treated at earlier stages.
Therefore it is important to avail of cervical cancer (Ca Cx) screening. A simple proven method is screening by visual inspection with acetic acid (VIA). This method can also help detect pre-cancerous lesions. .
> Solution: We create awareness about cervical cancer in our interactive seminar. We have partnered up with Cancer Patients Aid Association (CPAA) to conduct cervical cancer screening. Further management of suspicious/confirmed cases is fully sponsored by CPAA. We also counsel on risk factors that predispose a person to cervical cancer & on warning signs and pre-cancerous lesions in our health education seminar.
# Physiotherapy for musculo-skeletal problems
> Problem: Musculo-skeletal problems are common during pregnancy (Ramchandra P et al, 2015) and advanced age, especially in postmenopausal women due to hormonal changes. There are numerous scientific studies validating the efficacy of Physiotherapy for a variety of issues in women including common ones like back pain & knee pain. A meta-analysis of several research studies suggests that impact exercise reduces postmenopausal bone loss (Martyn St James, Caroll S. 2009). .
> Solution: Our physiotherapy volunteers analyze the problem & counsel the patient on its management. Wherever applicable, we construct personalized home based exercise regimen for the patient.
.
# Past projects in healthcare
Our program also includes other healthcare initiatives from our previously launched projects, including hypertension screening, eye check-up (in collab with Rotaract Club of Lotus College of Optometry), anaemia screening, general health check-up & complaint specific medical check-up. We also maintain health records & evaluate progress made over the span of the program.
FAIMER (Phil,USA) Student Project For Health 2017 winner felicitated at
World Summit on Social Accountability, Tunisia.
Going Forward: A lot more can be done, should be done and will be done, one step at a time. Follow us on social media for regular updates. Happy Rotaracting!:)
Women's Health Task Force, Rotaract Club of The Caduceus.
