Background:Delivery of maternal health care services is a major challenge to the health system in developing countries. Provision of antenatal care (ANC) services is the major function of public health delivery system in India to improve maternal health outcomes and its impact on maternal morbidity and mortality. Studies are lack in documenting variation in utilization of ANC services between geographical regions of Andhra Pradesh (AP).Objective:The objective of this study is to assess variation in utilization of ANC services stratified by geographical region, type of delivery and determinants of utilization of ANC services in AP.Methodology:It is a cross-sectional study of District Level Household and Facility Survey-4 of the state of AP. Multistage, stratified and probability proportional to size sample with replacement was used. Around 3982 women who delivered after the year 2007 were considered for analysis. Binomial logistic regression was carried out to determine association of demographic, system level variables with adequate ANC.Results:Study reveals wide variation across four regions of AP in utilization of ANC services. Reception of adequate ANC was low in Rayalaseema region (27.9%) and high in North-coastal region (42.4%). The utilization of private health facilities for ANC services were highest in South-coastal region (73.2%) and lowest in North-coastal region (43.2%).Conclusion:Policy measures are to be adopted and implemented by government to address the demand-supply imbalance such as public health infrastructure and quality of services in underperforming districts of AP and to increase outreach of current programs by engaging communities.

Background: Anaemia is very prevalent in adolescent girls, especially in developing countries like India. Treatment of anaemia based on the cause during adolescence decreases morbidity and mortality during early pregnancy. Despite weekly iron and folic acid supplementation programmes, the prevalence of anaemia among women and adolescent girls is still high. The objective of the study was to assess the proportion of anaemia and its determinants among adolescent school girls.Methods: An observational study was conducted in adolescent school girls of Chandragiri from January to March, 2018. Demographic data, knowledge and practices of personal hygiene were collected. Nutritional status was assessed by collecting anthropometric, body composition measurements, dietary habits and haemoglobin was estimated.Results: Of the 111 girls studied, 55.9% were found to be anaemic. Knowledge and practices of personal hygiene was lower in anaemic girls compared to non-anaemic girls. The extent of deficit of iron rich food consumption was low in both anaemic and non-anaemic girls.Conclusions: Prevalence of mild anaemia was high and iron rich foods intake was low in our study subjects. Assessment of burden of anaemia among adolescent girls is essential to address gaps in implementation of public health programs and effective intervention programs can be designed to reduce the burden of anaemia.

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Background: The undernutrition status among the vulnerable groups in rural areas still persists, despite provision of Anganwadi services in villages. Assessment knowledge and practices about maternal and child health services of frontline workers, will identify knowledge and implementation gaps. Objective was to assess the knowledge, attitude and practices of community health workers of maternal and child health services for identifying gaps for designing and implementing intervention.Methods: In this community based prospective, pre and post intervention-based study, Knowledge, Attitude and Practices (KAP) of the community health workers, in 16 villages and 13 Anganwadi centres of Chandragiri Mandal, Chittoor district, Andhra Pradesh about maternal and child health services were collected. The basic infrastructure of the anganwadis and health centres of Auxiliary nurse midwifes were assessed using a prevalidated survey instrument. Descriptive analysis was used.Results: The knowledge of antenatal and postnatal care was least among Anganwadi workers. Awareness regarding need of colostrum feeding was high in AWW compared to ASHA. ANM and AWW had lesser knowledge about duration of the exclusive breast feeding to the infant. Only 57.1% of ANM had sufficient knowledge about protein energy malnutrition consequences. AWW, ASHA did not have knowledge of vitamin A deficiency signs and symptoms although providing massive dose of vitamin A to children. ASHAs did not have awareness about anaemia and the knowledge was below 50% in ANMs.Conclusions: The study emphasizes the need for proper training with interactive sessions to these frontline workers, which will enhance their knowledge and skills for provision of quality services.