|PREVALENCE OF SYMPTOMS IN A SOUTH INDIAN RURAL COMMUNITY
AND UTILIZATION OF AREA HEALTH CENTRE
|DR Nagpaul, GVJ Baily, M Prakash & GE Rupert Samuel:
Indian J Med Res 1977, 66, 635-47.
The broad relationship between the extent and pattern
of sickness in a south Indian rural community, attendance at the
Area Health Centre (AHC) and service rendered to the sick at the
centre were studied by National Tuberculosis Institute (NTI), Bangalore.
The objectives were to study (i) point prevalence of symptoms of
all kinds and their pattern (ii) attendance at the AHC and the pattern
of symptoms among them: and (iii) number of visits for each spell
of sickness, by nature of symptom, laboratory tests offered, and
referral to better equipped health institutions. A 30,000 population
served by the Bettahalasur Primary Health Centre (PHC) which is
20 km. away from Bangalore city was chosen. The selection of villages
was done by random sample so that about 1000 persons from each of
5 field health workers' area was available for symptoms questioning.
The out patients at the PHC were questioned for symptoms by the
PHC medical officer in a manner exactly similar to that for the
community by the trained NTI para medical staff. The answers given
by patients were recorded by NTI staff both at the centre and at
the community. On revisits made for the same spell of sickness,
the interval in days from the first visit, any laboratory tests
done and reference to better equipped institutions were also recorded.
The point prevalence of sickness in the area
was 9.5%; cough, pain and fever, in that order were the three
cardinal symptoms that accounted for 68% of the total sickness in
the community. Only 1.3% of the sick, at any point of time, had
attended the AHC but the attendance by the sick persons residing
in the village where the health centre is located was 9.2%. The
composition of the out patients attendance was significantly different
from that of the sick in the community in respect of age, sex and
symptoms. Thus, women and the elderly persons who also constitute
a major reservoir of tuberculosis, tended to disregard their symptoms
while younger persons in the productive age group had availed the
health centre facilities more freely. Among symptoms, cough was
the most ignored. Of the total out patients, 71% had attended only
once, 18% twice and 11% three times or more for any particular episode
of sickness. Only 7 9% were offered laboratory examination and an
insignificant number were referred to better equipped health institutions.
|KEY WORDS: SYMPTOM PREVALENCE, RURAL COMMUNITY,
RURAL HEALTH SERVICES.