RIHFW Kashmir

Orientation Training for Family Health Awareness Campaigns

STI/ RTI (sexually transmitted and reproductive tract infections) are a hidden scourge killing and disabling unsuspecting people silently. Estimatedly some 333 million new cases occur each year globally, mainly in the poor countries of Africa, Asia and Latin America. Prevalence is very high in the Southeast Asian countries. Incidence of acute STI is quite high in India (40 million new cases occur each year). Because of the stigma, most of the victims hide their condition and failure to diagnose and treat the infection at an early stage leads to severe complications and sequelae which may include infertility, foetal wastage, ectopic pregnancy, cancers, disability, and death.

In addition to causing serious health problems, STI's also entail massive expenditure to the society and the family, as cost of providing care and workdays lost from sickness. Inherent problems of under-treatment because of stigma and inadequate treatment facilities lead to rapidly developing antibiotic resistance, which further increases the cost of the 2nd-line therapy. Further increase in cost of the therapy, in turn, results in further inadequate therapy, attritions and thus further failures.

Hitherto, diagnosis of STI's/ RTI's. has been largely laboratory-backed and institution-based which reduces the access considerably. Syndromic approach, on the other hand, envisages diagnosing STI/ RTI on the basis of symptoms as experienced by the patient, and this requires that the patient should be aware of the warning signs and symptoms of STI/ RTI. This is especially true in case of females in whom STI/ RTI may give rise to little or no discomfort despite silently causing a lot of damage.

In order to generate awareness among the rural populations and urban slum dwellers who are classically the silent and unsuspecting sufferers of STI/ RTI, the Department of Health and Family Welfare Government of Jammu and Kashmir, through the State Aids Control Organization, conducts one round of family health awareness campaign each year. The aim of the campaign is to generate demand for services for prevention and cure of STI/ RTI, and the objectives are:

• To raise the level of awareness of RTI/ STI and HIV/ AIDS in rural areas and among other vulnerable groups of populations.
• To encourage health-seeking behaviour in general population for RTI/ STI.
• To make people aware about the services available in the public health systems for the management of RTI/ STI, and
• To facilitate the early detection and prompt treatment of RTI/ STI by mainstreaming the programme with the infra-structure available under the primary health care system.

The first FHAC in the State was conducted during June 2001. Our Institute organized orientation training of district trainers in April 2000 in which 92 CMO's, DHO's and BMO's participated. Again, in anticipation of the 2nd round (1-15 April 2002), our Institute was asked to arrange reorientation training for district health managers and trainers so as to enable them to function as trainers of medical officers and paramedics in the field. About 70 senior level officers participated in the programme held on February 16, 2002 in the RIHFW, Dhobiwan. The orientation programme was attended, among others, by the Director Health Services Kashmir, the Project Director State Aids Prevention and Control Society, and the local MLA. On the eve of the launch of 3rd round in 2003 another such workshop was held.

Table XII: Orientation training of senior district medical officers during Family Health Awareness Campaign:

(Areas of discussion)

• STI/ RTI: Epidemiology, global burden and country scenario; results of NFHS-II
• Syndromic approach in diagnosis and management of STI/ RTI
• HIV/ AIDS epidemic; relation of HIV/AIDS with STI/ RTI; prevention of HIV/ AIDS
• Family Health Awareness Campaign: Concept, objectives, strategy and approach.