Urban Health Unit & Training Centre

The Urban Health unit & Training Centre (UHU&TC), located at Chetla is the urban field practice area of All India Institute of Hygiene & Public Health, Kolkata. It was established in 1955, it caters the primary health care need of slum population of Chetla area as well as field practice area for the different post graduate courses being pursued in AIIH&PH and other institutes from different parts of India. Total field practice area of Urban Health Unit & Training Centre is about 3.9 Sq. Km with population 1,02,045 divided predominantly in KMC Ward No. 74 & 82 and folder is maintained for a population 39136 in three units.

Officers’ Profile:

Other Technical Staff Members

Sl. No.	Name of the post / Designation	Number
	Public Health Nursing Supervisor	1
	Public Health Nurse	4
	HA(F)	8
	HA(M)	2
	Social Worker	2
	Sister	2
	Field Investigator	2
	Pharmacist	1
	DEO	2
	Laboratory technician	5
	Laboratory attendant	2

Clinic Description	No. of Patients
General OPD	24808
MCH Clinics	10233
NCD Clinics	2988
School Health Unit	1670
T.B OPD	6255
Family Planning Clinics	586
Adolescent Friendly Health Clinics	75
Mental Health Clinic	69
Total OPD attendance	46145

1. Maternal & Child Health Unit:

Services to the community:

SERVICE COMPONENTS: The aim of MCH Unit is to provide primary health care to the Mothers & Children below 5 years.

MATERNAL HEALTH CARE: Components of maternal health care are antenatal care, intranatal care, postnatal care, family welfare service and services to the mothers in inter-conceptional period.

M.C.H. O.P.D. clinic attendance & Child Morbidity:

The report of MCH from Dec 18 to November 2019 is based on the service evaluation of the families recorded in Family folders. Whole Chetla area is divided in to 4 areas named as Units A, B, C and D. Two slums having House hold of 1938 located in KMC ward 81 and 82 are currently included under unit B.

Sl.	Description of Activity	No. (%)
ANTE NATAL CARE SERVICES (ANC)
1	Total number of Pregnant Women (PW) Registered for ANC	133
1.1	Of which Number registered within first trimester	129 (96.9%)
2	Number of Pregnant Women received 4th check-ups	187
3	Number of Pregnant Women given T.T 1	133 (100%)
	Number of Pregnant Women given T.T 2/ booster	108 (81.2%)
4	ANC-1 Albendazole tablets >12 Wks	11
5	ANC-180 IFA tablets	203
6	ANC-360 Calcium Tablets	203
7	Pregnant Women with Hypertension (BP > 140/90)	0
8	Pregnant Women with Anaemia
8.1	Number having Hb level <11 (tested cases)	87 (65.4%)
8.2	Number having Hb level <7 (tested cases)	0
POST NATAL CARE SERVICES (PNC)
9.1	PNC-180 IFA tablets	235
9.2	PNC-360 Calcium Tablets	235
FAMILY PLANNING SERVICES
10	Number of PTK Used	501
11	Number of Oral Pill cycles distributed	413
12	Number of Condom pieces distributed	12312
13	Number of Injectable contraceptive	262
14	Number of Centchroman pill distributed	24
CHILD CARE SERVICES
15	Total number of children aged between 12 and 23 months who have been fully immunized	294 (M:157, F:137)
16	Vit. A doses:9moths-5yrs	483
17	Number of immunisation session planned and held	93
18	Number of children who received TT/Td booster doses at 10 and 16 years	439

**Over and above registered pregnant woman at UHU&TC, some pregnant woman are registered in other health facilities. The MCH staffs of UHU&TC provides the 4th Antenatal check-up at UHND (outreach session) and field visit.

Child morbidity pattern

Childhood Morbidities	No. of Cases
ARI including Pneumonia	439
Diarrhoea	196
Measles	5

New Initiative

• DMPA (Antara Programme)- initiated on 25/03/2019

• TT Vaccine in Routine Immunization has been replaced by Td Vaccine since June-2019

• ROTAVIRUS VACCINE introduced in Routine Immunization Since August-2019

Outreach Session/Urban Health & Nutrition Day (UHND)-

• Held: 40 sessions.

• Beneficiaries attended: 999

Reporting of Suspected Measles: 6 cases were reported.

Vaccination in Pulse Polio: 238 numbers of under-five children vaccinated.

2. School Health Unit:

School Health Unit of Urban Health Centre Chetla is working in an organized way with a goal for healthy children to build a healthy nation. Beside health appraisal and school health clinics, the unit conducts health related programmes in schools and health centres. Total 41 schools of KMC Ward 74, 82 & 81 and 4 Schools from adjacent area are under care of School Health unit of UHU&TC. Total Children enrolled in School health unit are more than 15000in 45 schools. Facility based and outreach comprehensive health care services are provided to the students. The services include health promotion through counselling and repeated behavioural change communication in schools. Specific protection to the children done by immunization with T.T, supplementation of IFA tabs, Vit. A, as per National Programme for control of anaemia & prevention of blindness. Worm infestation is prevented by mass deworming and BCC for personal hygiene including Hand washing. Health check-up of the children done at schools during School Health visit in view of early diagnosis treatment and specific protection.

Goal: Health promotion of school children.

Objectives:

• Early diagnosis, treatment, follow-up services and referral when needed.

• Prevention of diseases.

• Awakening of health consciousness in children.

• Training of health staff.

Activities/Achievements:

• Total health appraisal for school children-242 (Male-98, Female-144).

• Total number of sick school children, attended in School Health Clinic-1451. (Male-793, Female-658).

• Total number of teachers examined-22 & non-teachers examined-11.

• Health education session- In Schools – 22 sessions. In clinic – 61 sessions.

• Roll play on personal hygiene, dental health, seminar on non-communicable, disease awareness, & nutrition week observation etc.

• Incidence of dental caries and skin disease has been decreased remarkably in reporting year.

• Anaemia improved after distribution of iron-folic acid tabs.

• Worms infestation controlled by deworming at specific intervals.

• Reduction in episodes of diarrhoea by following hand washing and other sanitary measures.

School Health Visit

School children were examined during school health visits in different schools of Chetla. A total of 11 schools were visited. Morbidity pattern found during school visit is as follows:

Disease	Boys	Girls	Total
Worm infestation	16	13	29
Skin disease	12	14	26
GI disease	11	11	22
Dental caries	26	31	57
Gynaecological problem	—	37	37
Genito urinary disease	05	07	12
Pallor/ Anaemia	06	11	17
Eye	06	03	09
ENT	05	07	12
Malnutrition	09	12	21
Total	96	146	242

School Health Clinic:

Comprehensive health care services are provided to students attending School Health clinic. This clinic provides services like Immunization, Health check-up treatment in sickness, Pathological tests and counselling. In reporting period 64 clinical sessions were conducted on which 1926 students were examined (Male -1034, Female-892).

Morbidity pattern among children attended School Health clinic

Disease	Boys	Girls	Total		Disease	Boys	Girls	Total
Cough & Cold	199	145	344		Skin infection	124	91	215
Fever	295	224	519		ENT	16	13	29
GI Disorder	75	55	130		Dental caries	27	24	51
Worm infestation	56	22	78		Gynaecological	—	146	146
Eye problem	11	12	23		Genito-Urinary/UTI	12	7	19
Animal/ Insect bite	9	2	11		Over weight	2	5	7
Head lice/ Pediculosis	16	17	33		Accidents	4	1	5
Injury	112	56	168		Burn injury	5	3	8
Headache & Musculoskeletal	18	9	27		Blood Grouping Lab test	27	892	1926
Nutritional deficiency/ Pallor	26	24	50

Immunization status of the Children:

The Health examination reveals that majority of students were getting Primary vaccination at their childhood. BCG scar were present on most of the students (78% boys, 80% girls) The T.T 10-year Vaccination is 89.20% and T.T 16 years is 86.50 %.

Adolescent Friendly Health Clinic:

A total of 296 adolescents attended Adolescent Health Clinic of which males were 141 and females were 155. Total number of adolescent clinic done during the year was 21.

Training Programme SH Unit:

School Health unit provides the opportunity to learn school health setup for the medical, nursing and paramedical students. In the reporting period Core course student (MD, DPH), Sanitary Engineering’s students of AIIH&PH, DHP&E students of AIIH&PH, M.Sc. & B.Sc. (Nursing) from various institutes of India, BHMS students from National Institute of Homeopathy attended training curriculum in School Health Unit.

Glimpses of work done by School Health Unit:

3. Nutrition unit: (December 2018- November 2019)

Brief functions of Nutrition Unit, UHC Chetla

The Nutrition Unit of UHC Chetla is engaged in nutritional surveillance of the population of the service area of the Centre. The nutritional status of the vulnerable population of the slum community is periodically monitored through regular home visits with particular emphasis on under-five children. The growth of under-five children in the community is followed up with the help of periodic growth monitoring and anthropometry. The feeding practices of children including breast feeding practices as well as the dietary habits of the families including consumption of iodized salt are monitored through home visits. The presence of malnutrition, specific nutritional deficiencies, defective infant and child feeding practices are identified in home visits. Specific nutrition and health education to mothers and other caregivers in the community is given with a view to improve the nutritional status of the community and to prevent non communicable diseases. Inter-personal communication is imparted to improve knowledge of exclusive breast feeding, feeding practices of children, family-diet etc. Also nutrition education sessions and awareness programs are organized for mothers, elderly persons and other members in the community. Nutritional assessment of school children is done through nutrition and health appraisal at schools by means of anthropometric measurements, identification of nutritional problems of school children and interventions are given in collaboration with School Health Unit of UHC Chetla.

Nutrition Clinic is conducted at UHC Chetla where anthropometric measurement of under-five children, adolescents, women of reproductive age group and other family members is carried out. Specific health and nutrition education and advice on prevention and management of Non communicable diseases is carried out and treatment is given for health problems identified.

Students of Diploma in Dietetics and M.Sc. Applied Nutrition conducted Nutritional assessment of Antenatal,Postnatal,Under-5 children, Women of Reproductive age group and Geriatrics in field practice area of UHU&TC,Chetla and dietary advice was given accordingly

With a view to achieving completeness of nutritional surveillance activities, the Unit also maintains liaison with the ICDS Centers and NGOs engaged in child welfare work in the community.

Nutrition Unit of UHC Chetla also observes the National Nutrition Week every year with a view to creating awareness on nutritional issues in the community.

The performance of the Nutrition Unit during the year:

4. D Occupational Health Unit:

Occupational health unit, UHU&TC Chetla provides public health services to the beneficiaries of unorganised sector in its field practice area. Benefits include promotive, preventive, and curative service through clinic and field visit.

Workplace visits are provided by health personnel, illness is identified and cured accordingly. and counselling are done on identified problem related to different occupation.

Distribution Health education of Occupational Health Beneficiaries in Urban Field Practice Area (n=2220)

5. Health Education Unit: (December 2018- November 2019)

Health education unit of UHU&TC is conducting the IEC and BCC in the community. This unit gives learning opportunity to all categories of Medical, Nursing & paramedical students of different institutes. Apart from facilitation of teaching activities this unit also conduct various awareness programmes in the community. In the reporting year this unit conducted 42 community awareness programmes as listed in the community awareness programme above.

6. Family Welfare Clinic: (December 2018- November 2019)

Runs once in a week on Tuesdays. Gynecologist from department of MCH, AIIH&PH attended this clinic. During the reporting period the achievements of FW clinic is as below:

No. of Clinic	Total Pt. attended	Cu-T insert	Cu-T Removal	Amenorrhoea	Dysmenorrhoea	Olygomenorhoea	Menorrhagia& irregular menstruation	RTI & UTI	Leucorrhoea	DU B	Others	Total VIA	VIA Positive
36	570	1	9	137	16	25	74	68	57	13	161	10	0

7. TB UNIT:

1. Total Number of TB Cases :	42
Pulmonary:	35
Extra Pulmonary :	7
2. New Smear Positive :	19
Smear Negative	3
Extra Pulmonary :	4
3. Re-Treatment Cases :	15
Smear Positive :	12
Smear Negative :	1
Extra Pulmonary :	2
4. Category – I :	27
Category -II :	15
8. Total No. of HIV Positive Case :	0
9. Total No. of MDR Case :	0
10. Total No. of Male Case :	29
11. Total No. of Female Case :	13
12. Total No. of Child Case :	3
13. Total No. of XDR Case :	0

8. Epidemiology Unit:

Epidemiology Unit undertakes regular need based field investigations & surveys. It also undertakes active (field based) and passive (facility based) surveillance of diseases and Risk factors. Collection of Vital statistics is currently limited to collection of adult death data from the local crematoria. The Unit undertakes compilation of above information to provide the trend, outbreak warning signs and useful evidence for allocation of UHU &TC resources.

Passive Surveillance:

Given below is the pattern of cases who attended at UHC &TC during December 2017 to November 2018:

Reason for UHU & TC visit(s)	December 2018 – November 2019
Respiratory diseases	8025
NCDs	2988
Test and Other reasons	876
ANC, PNC & Adult Immunization (from OPD register)	4976
Fever	4055
Skin Diseases	3380
GIT Diseases	2772
Injuries	2858
Other infections	2743
Deficiency Diseases	507
Others (includes school health, TB and other diseases not mentioned in the list provided to OPD and other departments)	12,965
Total attended at UHU & TC	46145

Maximum cases were of Respiratory diseases. Total number of NCD clinics done during December 2018 to November 2019 was 47. Here a total of 2988 patients were attended, of these 2704 were old cases and 284 were new cases.

Mortality Statistics:

Death records were collected for the population residing in service area. Mortality data are collected from KMC electrical crematorium, Saha Nagar Burning Ghat, Kevratala. As depicted maximum (41 %) of the reported deaths occur on account of Cardio- Vascular diseases, followed by respiratory diseases (15 %).

Pattern of Adult deaths during December 2018 to November 2019 as collected from local KMC electrical crematorium

Cause of Death	Male	Female	Total	Proportionate Mortality Rate
CVA	113	118	231	41%
Br. Pneumonia	45	42	87	15%
Diabetes+ Kidney Diseases	37	36	73	13%
Carcinomas & tumour	16	18	34	6%
Septicaemia	14	29	43	7%
Hepatitis+ Anaemia	8	8	16	3%
Unnatural deaths	28	11	39	7%
Others	14	14	28	5%
Liver Diseases	13	4	17	3%
TOTAL	288	280	568	100%

9. Vector Borne Disease Control Programme

Malaria: Blood Slide collected from the fever patients attended the General OPD. Slides are examined at Public Health Laboratory. The Confirmed Malaria cases are treated as per NVBDCP Guideline.

Dengue: The Suspected Dengue cases are referred to nearest UPHC, KMC for confirmation.

10. Special Clinics:

Mental Health Clinic: Functioning fortnightly on alternate Mondays. A psychiatrist is attending this clinic.

11. Other special activities:

1. Vigilance week:

2. World Population Control Fortnight (11.7.2019 to 24.7.2019)

3. Intensified pulse polio programme (IPPI)—Three rounds in 2019.

Field Activities / Programme Undertaken

UHU&TC is a population laboratory of AIIH&PH, Kolkata. Field visit is an integral part of practical teaching of Public Health. Routine field visit is an ongoing process undertaken by different academic units for community services as well as to fulfil the learning objectives of different Medical, Nursing & Paramedical Courses. Apart from the routine field visit throughout the year, the students of DHPE course are exposed to field for practical learning of Communication skills and interventional programme to improve the health status of the community. Core course students of AIIH&PH undertake Family Care Programme for family diagnosis and intervention through a teaching learning process which ultimately lead to community diagnosis for need based action. The students of Sanitary Engineering Department were taken to school for Midday meal hygiene and sanitation exposure.

Research Activities

• Dr. Partha Sarathi Naskar, student of MPH is under taking a research on “an epidemiological study on hypertension among adolescent students of urban school under the service area of UHU&TC under supervision of Dr.Papiya Das, Public Health Specialist and Mrs. Maitree Purkait, PHN, School health.

• Dr. Sreejith H Das, a student of DPH is undertaking a research titled, “The prevelance of perceived stress among school teachers in a slum area of Kolkata,West Bengal- a community based cross sectional study” under supervision of of Dr.Papiya Das, Public Health Specialist and Mrs. Maitree Purkait, PHN, School health.

Conference / Seminar/ Workshop Attended and training received

• Dr.Deepa Shaw, CMO, attended Sensitization on AFP/MR Surveillance &Recent updates on Routine Immunization during month of March’19.

• Dr.Deepa Shaw, CMO, attended training on MAA during month of May’19 at AIIHPH, Kolkata.

• Dr.Deepa Shaw, CMO, attended a training on “WASH” at UHU&TC, Chetla during month of September’19.

• Dr.Papiya Das, Public Health Specialist, attended Sensitization on AFP/MR Surveillance &Recent updates on Routine Immunization during month of March’19.

• Dr.Papiya Das, Public Health Specialist, participated as resource person CME on RNTCP & its recent Updates during the month of june’19.

• Dr.Papiya Das, Public Health Specialist, participated as resource person for training on “WASH” at UHU&TC, Chetla during month of September’19.

• Dr. Rajarshi Chakraborty, Medical Officer, attended Sensitization on AFP/MR Surveillance &Recent updates on Routine Immunization during month of March’19.

• Dr. Rajarshi Chakraborty, Medical Officer, attended a training on injectable contraceptive during month of February’19.

• Dr. Rajarshi Chakraborty, Medical Officer, attended a training on “WASH” at UHU&TC, Chetla during month of September’19.

Swachhata Initiatives

1. Swachhta pledge taken by all participants.

2. Cleaning and mopping of the entire building done.

3. All Officers and staffs did cleaning and sweeping of the office premises.

4. Plantation done.

5. Beautification of campus done by placing potted plants in the corridors.

6. Patients and school children were counselled and motivated for keeping their surrounding clean and hygienic.

7. Hand washing demonstration to the school children done.

8. Talk on menstrual hygiene with inter personal communication done in the UHU&TC in all OPDs and MCH clinics.

9. Awareness programs were done in schools, communities and in the UHU&TC, Chetla. A total of 15 such awareness programs were done.