Health status of the community is not only dependent upon the availability of the health institutions and medical professionals but also upon the socio-economic profile, utilization, and awareness level. Infectious disease like diarrhea, respiratory diseases, and vaccine preventable diseases are responsible for 16.7%, 13% and 25% of deaths among infants in India(1).

The present study is representative of the population of 66,186, living in 27 villages of Chandigarh. The study was conducted over a period of one year in ] 995-96 by multi-stage sampling technique by visiting the randomly selected J] 59 households, thus, covering a population of 5567. Five villages were selected randomly in the first stage and subsequently every tenth house was visited in the selected villages. The information was collected by interviewing the ante-natal mothers, eligible couples and women in the households. In order to know the level of morbidity in the total population in the rural areas, an illness upto one month duration was considered acute and those beyond one month was taken as chronic disease.

The study revealed that safe drinking water was available to all the households whereas 73.9% had access to sanitary latrines. A crude birth rate of 27. I and crude death rate of 4.3 per 1000 live births was recorded in these rural areas. This cross-sectional study also ob- served that 20.5% of the rural population was suffering from acute (16.0%) and chronic (4.5%) diseases. Disability was observed among 0.3%. Malnutrition (weight for age, lAP classification) was recorded among 44.8% of the under-five children.

Routine immunization coverage under the National Universal Immunization Program was quite high (92.8% for BCG, 97.1 % for three doses of DPT and OPV and 91.3% for measles; 90.1 % were fully immunized for all these vaccines). Pulse Polio immunization coverage evaluated by 30 cluster technique for the year 1996-97 was higher in rural areas (\93%) in comparison to urban areas (86%). Vitamin A coverage among children in the age group of 9 months to 3 years was 57.9%. Out of 95 pregnant women registered in the study, 91 (95.8%) were utilizing antenatal services from different categories of health workers. Among 73 pregnant women in the second and third trimesters, 66 (90.4%) had received tetanus toxoid and 59 (80.8%) were consuming iron and folic tablets. Among 1025 eligible couples, the family planning method was being adapted by 523 (51.0%); little over half (50.4%) were using spacing methods while remaining were using permanent methods.

On assessing the knowledge of women in the family, it was observed that only 63.8%, 64.4% and 72.9% were aware about vaccine preventable diseases, tetanus during pregnancy and iron folic and tablets, respectively. Seventy one per cent women were aware about ORS and 73% knew about continuation of breastfeeding during diarrhea. Awareness about home available fluids was only 28%. Majority (54.5%) of women mentioned health workers as source of procuring ORS packets, followed by private doctors (11.0%) and chemists (6.0%). The knowledge about recognizing pneumonia through its clinical presentation was known to only 8.9%, seventy four per cent of the women utilized health facility for various reasons.

Interestingly, the coverage of VIP vaccines, tetanus toxid and iron folic acid tablets was higher than level of knowledge observed

among the women in the study. Factors contributing towards better performance in rural Chandigarh include close proximity of the city, availability of good transport system, access to the health services and presence of a strong health infrastructure. The average rural area covered by a subcenter in Chandigarh is 3 square km in comparison to 22.89 at national level. The average population covered by male multipurpose workers, female multipurpose workers and trained dais in Chandigarh is 5516, 4728 and 148 in comparison to the national level figures of 8746,4687 and 1046, respectively(2).

In conclusion the study has revealed that some of the targets under the Health for all by 2000 have already been achieved in rural areas of Chandigarh whereas components like vitamin A, iron and folic acid tablets to pregnant women and the knowledge of women regarding various components of mother and child health need to be strengthened.
 

H.M. Swami,
Vikas Bhatia,
S.P.S. Bhatia,
Department of Community Medicine,
Government Medical College,
Sector 32, Chandigarh 160047,
India.
 

1. National Child Survival and Safe Motherhood Programmes. Programmes intervention, child survival. MCH Division, Ministry of Health and Family Welfare, Government of India, New Delhi 1996.

2. Bulletin on Rural Health Statistics in India. Director General Health Services, Ministry of Health and Family Welfare, Government of India, New Delhi, 1997.