Disposable delivery kit

Disposable Delivery Kit: 

Basic Delivery Kit/ Disposable Delivery Kit (DDK) increases awareness and use of clean delivery practices. The kits are designed for use in the home by untrained and trained birth attendants (TBAs) and women delivering alone. Basic delivery kits contain supplies that are essential for supporting clean delivery practices and providing clean cord care immediately after birth. While DDKs are designed for use in the home, they can also be used in resource-poor medical facilities such as health posts or health centers.

Features:

• Portable in nature

• Compact design

• Easily Disposable

Contents of DDK:

• 1pcs disposable non Woven gown

• 1pair shoe cover non Woven

• 1 pcs disposable cap

• 1 pcs face mask

• 1 pair latex surgical gloves

• 1 pcs underpad (Under sheet)

• 1 pcs drape sheet (perineal sheet)

• 1 pcs mops

• 2 pcs cord clamp

• 1 pcs baby receiving sheet

• 1 pcs feeding tube

• 1 pcs sterile surgical blade

Principles of Clean Delivery:

According to WHO’s Six Principles of Cleanliness at Birth, 

• “The hands of the birth, the attendant must be washed with water and soap, as well as the perineum of the woman. 
• The surface on which the infant is delivered must be clean. Instruments for cutting the cord and cord care (razor blade, cutting surface, cord ties) should be clean. 
• Nothing should be applied either to the cutting surface or to the stump. The stump should be left uncovered to dry and to mummify.” 

The six principles of cleanliness include: 

1. Clean hands 
2. Clean perineum 
3. Nothing unclean introduced into the vagina 
4. Clean delivery surface
5. Clean cord-cutting instrument 
6. Clean cord care (including cord ties and cutting surface).

Why Are Delivery Kits Important?

• Promotion of clean delivery practices
• Reduction of maternal sepsis
• Reduction of neonatal tetanus, sepsis, and cord infection
• Reinforcement of maternal and newborn health programs and 
• Provision of a convenient source of clean supplies.

References:

1. https://path.azureedge.net/media/documents/MCHN_BDKG.pdf
2. https://www.indiamart.com/proddetail/disposable-delivery-kit-4461948112.html
3. https://www.indiamart.com/proddetail/disposable-delivery-kit-12878976588.html photo credit

Safe injection Practices

Safe injection practices prevent transmission of infectious diseases from one patient to another, or between a patient and health care personnel(HCP) during preparation and injection of medications. A safe injection 

• Does not harm the recipient (e.g. no abscess formation.)
• Does not expose HCP to any avoidable risks (e.g. needle stick injury)
• Does not harm the community (e.g. unsafe disposal of waste)

What are unsafe injection practices?

Unsafe injection practices are caused by avoidable risky situations and practices including: 

• Lack of awareness of the risks of unsafe injections. 
• Overuse of injections for illnesses for which effective oral medications exist. 
• Needle-stick injuries to health care workers from recapping needles. 
• Lack of clean workspaces. 
• Re-use of syringes because of shortages of syringes. 
• Unsafe sharps collection and waste management.

What are safe injection practices recommendations?

1. Prepare injections using an aseptic technique in a clean area.
2. Disinfect the rubber septum on a medication vial with alcohol before piercing.
3. Do not use needles or syringes for more than one patient (this includes manufactured prefilled syringes and other devices such as insulin pens).
4. Medication containers (single and multidose vials, ampules, and bags) are entered with a new needle and new syringe, even when withdrawing additional doses for the same patient.
5. Use single-dose vials for parenteral medications when possible.
6. Do not use single-dose (single-use) medication vials, ampules, and bags or bottles of intravenous solution for more than one patient.
7. Do not combine the leftover contents of single-use vials for later use.

The following apply if multidose vials are used:

• Dedicate multidose vials to a single patient whenever possible.
• If multidose vials will be used for more than one patient, they should be restricted to a centralized medication area and should not enter the immediate patient treatment area to prevent inadvertent contamination.
• If a multidose vial enters the immediate patient treatment area, it should be dedicated for single-patient use and discarded immediately after use.
• Date multidose vials when first opened and discard within 28 days, unless the manufacturer specifies a different date.
• Do not use a fluid infusion or administration sets (e.g., IV bags, tubings, connections) for more than one patient.

Injections should only be used:

• For serious and life-threatening illness where they are recommended by treatment guidelines. 
• When patients are unable to swallow. 
• When patients vomit profusely. 
• When there is no effective oral medication or the absorption process is significantly altered. 

References:

1. https://www.cdc.gov/oralhealth/infectioncontrol/faqs/safe-injection-practices.html
2. https://www.who.int/occupational_health/activities/1bestprac.pdf
3. https://www.who.int/infection-prevention/tools/injections/IS_HealthCareProviders_Leaflet.pdf
4. https://www.ncdc.gov.in/WriteReadData/l892s/Handbook%20on%20Safe%20Injection%20Practices.pdf
5. https://www.cdc.gov/injectionsafety/ip07_standardprecaution.html
6. https://vikaspedia.in/health/sanitation-and-hygiene/handbook-on-safe-injection-practices/techniques-of-safe-injections
7. https://www.cdc.gov/injectionsafety/PDF/Injection-Safety-Guidelines-P.pdf

Identifying the Research Problem

Non-Communicable Diseases: An Introduction

 When diseases are called chronic?

According to the Commission on Chronic Illness in the USA   "chronic diseases" have one or more of the following characteristics :

• They are permanent. 
• They leave residual disability.
• They are caused by nonreversible pathological alteration.
• They require special training of the patient for rehabilitation.
• They may be expected to require a long period of supervision, observation or care."

What are Non-Communicable diseases(NCDs)?

Non-communicable diseases include:

• Cardiovascular, renal, nervous, and mental diseases,
• Musculoskeletal conditions such as arthritis, and allied diseases 
• Chronic non-specific respiratory diseases (e.g., chroni~bronchitis, emphysema, asthma) 
• Permanent results of accidents 
• Senility, blindness, cancer, diabetes, obesity
• Various other metabolic and degenerative diseases (Disorders of unknown cause and progressive course are often labeled "degenerative".) and
• Chronic results of communicable diseases. 

What is the problem statement?

• The prevalence of chronic diseases is increasing in most countries due to several reasons.
• A total of 57 million deaths occurred worldwide during 2016. Of these, 41 million were due to NCDs, principally cardiovascular diseases, cancer, and chronic respiratory diseases. 
• NCDs are estimated to account for about 63 percent of all deaths in India.
• The impact of chronic diseases on the lives of people is serious when measured in terms of loss of life, disablement, family hardship, and poverty, and economic loss to the country. 
• Developing countries are now warned to take appropriate steps to avoid the "epidemics" of non-communicable diseases likely to come with socio-economic and health developments.

What are the risk factors for NCDs?

1. Tobacco: Around 7 million people die from tobacco use every year, both from direct tobacco use and second-hand smoke.
2. Insufficient physical activity: Around 1.6 million people die each year due to physical inactivity & people having insufficient physical activity have a 20% to 30% increased risk of all-cause mortality. 
3. Harmful use of alcohol: Around 3.3 million people die each year from the harmful use of alcohol, accounting for about 5. 9% of all deaths in the world. 
4. Unhealthy diet: Adequate consumption of fruit and vegetables reduce the risk for cardiovascular diseases, stomach cancer, and colorectal cancer.
5. Raised blood pressure: It is estimated to cause 9.4 million deaths, about 12.8% of all deaths. It is a major risk factor for cardiovascular diseases.
6. Overweight and obesity: At least 2.8 million people die each year as a result of being overweight or obese. Risks of heart disease, stroke, and diabetes increase steadily with increasing body mass index (BMI).
7. Raised cholesterol: Raised cholesterol is estimated to cause 2 .6 million deaths annually. It also increases the risk of heart disease and stroke.
8. Cancer-associated infections: The principal infectious agents are human papillomavirus, Hepatitis B virus, Hepatitis C virus, and Helicobacter pylori. These infections are largely preventable through vaccinations and measures to avoid transmission, or treatable.
9. Environmental risk factors: occupational hazards, air, and water pollution. and possession of destructive weapons in case of injuries.

What are the preventive measures?

NCDs are multifactorial in causation, so prevention demands a complex mix of interventions. But, now with the identification of risk factors, health promotion activities aimed at primary prevention:

1. Protecting people from tobacco smoke and banning smoking in public places, warning about the dangers of tobacco use, enforcing bans on tobacco advertising, promotion and sponsorships, and raising taxes on tobacco.
2. Restricting access to retailed alcohol, enforcing bans on alcohol advertising, and raising taxes on alcohol.
3. Reduce salt intake and salt content of the food.
4. Replacing trans-fat in food with polyunsaturated fat.
5. Promoting public awareness about diet and physical activity including through mass media.

There are many other cost-effective and low-cost population-wide interventions that can reduce risk factors for NCDs. These include :

1. Nicotine dependence treatment.
2. Enforcing drink-driving laws.
3. Restrictions on the marketing of foods and beverages high in salt, fats, and sugar.
4.  Food taxes and subsidies to promote healthy diets.
5. Healthy nutrition environments in schools.
6. Nutrition information and counseling in health care; and
7. National physical activity guidelines (school-based physical activity programs for children and workplace programs for physical activity and healthy diets).
8. Integrated approach: Simultaneously attacking several risk factors known to be implicated in the development of non-communicable diseases. Such concerted preventive action should reduce not only cardiovascular diseases but also other major NCDs, with an overall improvement in health and length of life. 

References:

1. Park, K., 2019. Park's Textbook Of Preventive And Social Medicine. 25th ed. Jabalpur: M/s Banarsidas Bhanot Publishers, p.1000.
2. Kadri, A., 2019. IAPSM's Textbook Of Community Medicine. 1st ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd, p.1221.
3. https://www.cdc.gov/globalhealth/healthprotection/fetp/training_modules/new-8/overview-of-ncds_ppt_qa-revcom_09112013.pdf
4. http://www.bmrat.org/index.php/BMRAT/article/view/411
5. https://extranet.who.int/ncdccs/documents/
6. https://www.nhp.gov.in/healthlyliving/ncd2019
7. https://www.change4health.gov.hk/en/saptowards2025/ photo credit

Steps for the Earthquake Safety

Step 1: Secure your space by identifying hazards and securing moveable items. 

Step 2: Plan to be safe by creating a disaster plan and deciding how you will communicate in an emergency. 

Step 3: Organize disaster supplies in convenient locations. 

Step 4: Minimize financial hardship by organizing important documents, strengthening your property, and considering insurance.

Step 5: Drop, Cover and Hold On when the earth shakes. 

Step 6: Improve safety after earthquakes by evacuating if necessary, helping the injured, and preventing further injuries or damage. 

Step 7: Reconnect and Restore daily life by reconnecting with others, repairing damage, and rebuilding community

References:

1. https://www.earthquakecountry.org/library/Seven_Steps_Flyers_English.pdf
2. https://www.cdc.gov/cpr/documents/BeReady_Earthquakes.pdf

Introduction to Research Methodology & Biostatistics