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■s A Report
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IM Health
I■h
Information
Needs
Assessment
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<
The Survey Results
From Pilot Sites
Of the
Health InterNetwork (HIN) Project
By
Foundation for Research in Health Systems,
6, Gurukrupa 183 Azad Society,
Ahmedabad,
India
Tel: +91-79-674 0437, 5589, 6279
Fax: +91-79-674 0437
Email: frhsahdadl©sancharnet.in
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HTN India
List of contributors
Expert committee members
Dr Nirmala Murthy, FRHS, Bangalore
Dr D K Srinivas, Rajiv Gandhi University of Health Sciences, Bangalore;
Dr CAK Yesudian, Tata Institute of Social Research, Mumbai;
Dr Shandiadevi Tottikamat, Tuberculosis Research Centre, Chennai
Data collection team
From NTI , Bangalore:
Dr Lalita Suryanarayana,
Mr Hem ant Kumar,
Mr Mallikarjuniah,
Mr B A Eswar,
From NIHARD, Cuttak:
Dr B N Mukhi,
Mr A Bara!
Dr E Venkat Rao,
Mr. S. Mohanty
From FRHS
Ms Akhila Vasan,
r
Mr. Prashanth C.
Mr Dinesh S.,
Ms. Madhaviiata G,
Mr Deepak Dhongde,
(
Dr Vikas Aggarwal
<
f
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HJN Indi*
Abbreviations
DHO
District Health Officer
DOTS
Directly Observed Treatment- Short Course
FRHS
Foundation for Research in Health System
GOI
Government of India
Health InterNetwork
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IT
Information Technology
KVA
Kilovolt Ampere
LAN
Local Area Network
NTI
National Tuberculosis Institute, Bangalore
PHC
Primary Health Centre
RGVHS
Rajiv Gandhi University of Health Sciences
RNTCP
Revised National Tuberculosis Control Program
TRC
Tuberculosis Research Centre, Chennai
UPS
Uninterrupted Power Supply
WHO
World Health Organization
HIN India
Executive summary
This report presents data from tire Health Information Needs Assessment survey carried out in two
districts, Rural Bangalore in Karanataka and Deogarh in Orissa, which have been selected as the pilot
sites for implementing tire Health InterNetwork (HIN) project. The objective of this survey was to
assess information needs of health professionals involved in the TB and Tobacco Control Programs.
They included health researchers, administrators, and healthcare service providers from government
and private sectors.
Since the aim of the HIN-lndia project is to increase health professionals' access and use of research
information by 75 % and 50% respectively, this survey attempted to gather the baseline information
about the access and use of research information. The survey also gathered information on how health
professionals in the pilot areas rated their current access to information in terms of ease, speed, and
usefulness as well as it found out their “real” need for health information. Considering the fact that the
HIN project involves making Web-based information available at selected health institution, this
survey also assessed the E-rcadiness of the existing health facilities in the project districts in terms of
availability of hardw are, space, electricity, connectivity, and human expertise.
A total of 303 interviews were conducted from five categories of health professionals namely
researchers, administrators, government doctors, private doctors and paramedical staff. This sample
was drann from health practitioners at primary7 health centers from the two pilot districts, health
administrators at district, state and national level as also researchers from medical colleges and
research institutions.
A total of eight survey instruments were administered to collect information from different categories
of respondents. This report presents data on access, use and need for health research information
separately for the five beneficiary groups namely. Researcher (30), Administrator (35). Government
Doctor (50). Private Doctor (66) and Paramedical staffs (122).
This survey highlighted the fact that private doctors treated significant proportion of TB patients but
their awareness about the size and nature of TB threat as well as about its treatment regimen were
much lower as compared to those of government doctors. Therefore HIN must try to increase access
to health information among government as well as private doctors.
This survey showed varying degree of awareness among the five respondent groups. For example,
awareness that TB is still a ^killer” disease in India varied from over 80% among administrators to
55% among paramedical. The five most frequently reasons mentioned for 'TB to be a killer disease'
were: patients not regular in taking treatment, patients lack awareness, patients cannot afford the time
to go to doctor, drugs not available in sufficient quantity, and resistant bacteria. But very few
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HIN India
respondents mentioned causes such as social stigma and preference for traditional practitioner, which
often delay the treatment.
Knowledge about RNTCP gmdelmes for diagnosmg and treating TB was near 100 percent among
government doctors but below 50 percent among private doctors and paramedical staff. Yet. 1/3 of
government doctors mentioned that they preferred individualized case management rather than the
RNTCP regimen for their private patients. Tins gap between their knowledge, attitude and practice
suggests that though government doctors received knowledge in the RNTCP training programs,
something more is needed to mfluence then attitudes and practices. Therefore, HIN cannot focus only
on creating knowledge content while ignoring the issues of influencing perceptions and attitudes that
finally change practices.
With respect to the Tobacco threat, almost all respondents said it was a major health problem. Bui
contain tobacco, as well as about various diseases or
their knowledge about different products that
seemed limited to the level of general knowledge.
health conditions that arc attributed to tobacco-use.
All health practitioners sa.d that they could play an important role in reducing tobacco use because
they have credibility in community prov.ded they themselves do not use tobacco. Different categories
of respondents emphasized different measures for reducing tobacco use. Administrators mo^
frequently recommended ban on tobacco advertisement. Government doctors and paramedical stan
recommended health education through mass campa.gn. while private doctors recommended patient
counseling. They did not make these recommendations based on any research studies or technical
information because less than 20 percent administrators / researchers and less than 5 percent in other
practitioners reported access to such information.
However with regard to TB. about l/3rf of Government doctors and ‘A of Private doctors reported
having access to technical information.
Access to medical Journal, mainly Indian Journals, was
higher among private doctors (67%) than among government doctors (17%), while 40 percent of
government doctors and 25 percent private doctors reported ’no access to medical journals.
Government doctors’ mam sources of health information were training programs and meetings
Similarly for paramedical staff, the main information sources were Training/meetmgs and 1EC
Library was the least frequently mentioned source
source (10 %) while Internet was mentioned by about 17
percent of doctors.
' 1 not seem to actively seek information. They received
Health practitioners in government set-up did
during monthly meetings, which they thought was adequate
information during training programs or (
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HIN India
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They paid most attention to program guidelines and government circulars, which they received
usually during district level meetings. Administrators on the other hand, reported receiving a lot of
information for w hich they had no time. Yet 2/3rd of all respondents wanted further information on
TB and practically all wanted information on tobacco-use.
Different categories of respondents however, wanted different types of information. Researchers and
administrators wanted information on new developments in TB treatment (40%).
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Doctors and
paramedical staff wanted information on how to prevent spread of TB (68 %) and how to motivate
patients to continue TB treatment (55%). Sizable number of doctors also wanted information about
etiology of TB in the context of HIV/AID.
In case of Tobacco, the three most frequently mentioned information needs, which were uniform in all
categories of respondents were: (i) health effects of different types of tobacco use (81%). (ii) advise
about cessation (61 %), and (iii) types of tobacco use (60 %).
The survey data also indicated the need to create greater awareness among service providers about
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why patients discontinue TB treatment and their typical characteristics, which would help service
providers, so that they could give special attention on counseling them. The survey also identified the
need for quick transfer of patients' information to doctors in case of referrals or transfer of patient
from one doctor to another.
In addition to TB and Tobacco, respondents listed other important public health topics for their work
Government doctors’ list was the longest, followed by that of paramedical staff and private doctors
Those lists suggest that practitioners' information needs go much beyond TB and Tobacco. Therefore
HIN project, which focuses only on TB and Tobacco, might not receive their attention to the desired
extent.
For gaining knowledge in their areas of expertise, most doctors mentioned using journals and
scientific publications, while paramedical staff mentioned meetings and books, as their sources of
information. But their preferred sources of information were different in the five groups. It was the
Internet among administrators and researchers; scientific journals and Internet among government and
private doctors; and Audio-Visual media and Experts' lectures among paramedical staff. Health
professionals preferred getting technical information in English while paramedical staff wanted that
information in their local languages.
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HIN India
Most respondents reported difficulties in accessing information related to their area of work. The three
most frequently mentioned difficulties were “information difficult to get”, “Expensive
and
"irregular”.
Data on the current pattern of information use and the need for communication showed that all
respondents, except administrators, primarily wanted new information for diagnosing and treating
complicated cases. Their need to communicate with outside experts was much less compared to their
need to communicate with persons within organization. Even among administrators and researchers
less than half reported communicating with experts outside organization.
Access to the Internet varied greatly among the respondent groups. It was 7o percent among
researchers / administrators. 25 percent among doctors and 5 percent among paramedical staff. The
common and most frequently mentioned barriers in using the Internet were, lack of time, lack of skills
and slow access
Notwithstanding these barriers, most respondents (89%) said that access to internet
would help them in their work.
However none of the 26 district-level health institutions, 21 in Rural Bangalore and 5 m Orissa, had
any signs of e-readincss. None of these institutions had computer or Internet facility. In 13 of them
had one or two persons each, who had some computer skills. But the remaining 13 institution had no
staff that could use computer though they all showed willingness to learn. All 26 sites were also
deficient on several parameters of the e-readiness such as availability of regular electricity supply.
telephone lines, Internet access, training facility etc.
that HIN needs to focus
This survey was particularly useful in identify ing specific knowledge areas
came out of this
on. in order to improve quality of TB care. Some of the major recommendations that
survcv were:
•
Since the survey had showed that doctors preferred individualized case-management to am
particular regimen. HIN should provide doctors authentic information about various drugs used m
TB treatment. That might reduce their dependence on drug salesmen for information HIN could
also provide doctors opportunity to discuss their objections to the RNTCP drug regimen, with
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experts, to increase their conviction in the treatment.
Since awareness about the link between tobacco-use and health problems other than ororespiratory problems, was found to be not high, by providing that information HIN might help
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increase health practitioners ability to dissuade many more patients from using tobacco
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HEN India
Since different categories of respondents need different types of information, and they also prefer
.
different types of media -from the Internet to AV media, HIN needs to take those preferences
into considerations while designing the content and deciding the inodes of communication.
Since respondents from all categories reported low use of information for policx and program
•
related decision. HIN project might have to develop / adopt a training module for guiding and
promoting information use among HIN beneficiaries for program planning and implementation
decisions.
.
Since government doctors and paramedical staff deal with many health programs other than TB
and tobacco, their information needs go far beyond the TB and Tobacco programs. The surrey
identified many other health topics about which they would need information. Restricting HIN
website only to TB and Tobacco might not motivate them enough to want to invest time and
effort in this project.
.
Since government doctors and paramedical staff might not have the time and mclination to seek
web-based information, the HIN should consider providing health information also in media such
as Newsletters, meetings, and Audio-Visual media and addition to helping them to use the
Internet.
.
Since all categories of respondents mentioned “insufficient computer skills ' as a barrier to
accessing the Internet, HIN should not only provide training but also ensure that they have online
help available for trouble shooting as well as continuing support and encouragement for using the
computer system.
Since the survey data suggests that beneficiaries of HIN would find facilities like e-mail. Chat
rooms, discussion-board etc. very useful. HIN should promote use of those facilities, which would
also help increase their interactions with outside experts, especially with research institutions
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That would mean ensuring that there would be someone responding to queries sent by users as
well as encouraging users to reach out to experts for information.
E- readiness assessment indicated that only 50% Institutions have potential users with some skills
in using computers but none have the required physical facilities such as computers. Internet
connectivity, telephone lines etc. The first step in HIN implementation therefore is to provide
those facilities and then undertake intensive training. That would help them in receiving the
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content being prepared based on the Needs Assessment Survey.
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HIN India
Background
In September 2000, the UN Secretary7 General launched a public-private initiative to bridge the digital
divide in health Information. Health InterNetwork (HIN) Project is a part of that initiative, led by the
WHO. This initiative brings together international agencies, the private sector, foundations, non
governmental organizations and country partners to ensure equitable access to health information.
The project aims at establishing a network among health service providers, researchers and policy
makers to ensure that they get equitable, reliable and rapid access to health information, using Internet
technologies.
India has been selected as the first HIN pilot country from 6 to 8 HIN pilots planned worldwide,
because India has several priority public health programs as well as valuable skills and resources,
w hich could contribute to the development of the global Health InterNetwork. The aim of this project
is to improve Internet-based communication and networking among health professionals. It plans to
achieve 75 % increase in access and 50% increase in use of health research information bv its
primary beneficiaries. The primary beneficiaries of the HIN-India pilot project are researchers, policy
makers and health service providers.
HIN-lndia plans to focus on Tuberculosis (TB) and Tobacco Control Programs because significant
research on Tuberculosis control w as first carried out in India but India w as one of the last countries
to use this research into its health program. Similarly, studies from Eastern India were the first in the
world to link palate cancer to chewing of tobacco but India's program to reduce tobacco use is still in
a nascent stage. HIN aims to correct such anomalies by increasing use of Indian health research into
the country ?s health policy and program planning.
The pilot phase of the HIN-India is being implemented in Deogarh district in Orissa and Bangalore
Rural district in Karnataka. The core elements of this phase are creating content, establishing
connectivity and capacity building.
I. Content
During the pilot phase, an Internet portal will be developed to provide a shortcut to high-quality.
relevant and current information related to TB and Tobacco-use. Through this portal, users will be
able to access statistical data, scientific publications and information related to health policy anc
practices. In addition, the portal will make available information related to technology.
epidemiological tools, distance learning modules and a host of local and regional public health
information that is currently not available, electronically.
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HIN India
IL Connectivity
In this phase, 10-12 pilot sites will be equipped with the essential hardware, software, Internet
connectivity and the necessary training to potential beneficiaries of the HIN Internet portal.
7/7. Capacity building
This phase will focus on building skills among beneficiaries that will include: 1) information use
in dailv work, 2) basic computer and Internet skills, and 3) hands-on training in using specialized
public health tools.
Through these activities, the project aims to address ‘information gaps" that exist between
researchers, policy-makers and practitioners because research information is either not easily available
or is not available in the form that can be easily understood and used by different types of
beneficiaries. Since very few people other than researchers read through and understand research
papers and protocols, appropriate formatting of this infonnation is crucial for increasing use of
research by policy-makers and practitioners. This project will also attempt to present research
information in an easy-to-use format by using various Information and Communication Technology
solutions.
In addition, the HIN Internet portal will improve access to Indian research on TB and Tobacco
through E-publishing. Though India’s contribution to the published research on TB is only 5-6 percent
and that on Tobacco even less, a huge amount of valuable unpublished information lies in her research
institutions as raw or partially analyzed data. HIN plans to make this infonnation available through epublishing. Also it will address the issue of Indian researchers finding access to international
databases expensive and difficult.
Major project activities included in this pilot are.
•
Networking of key research institutions in Tuberculosis and Tobacco, and selected medical
college libraries in Karanataka and Orissa with the National Medical Library, New Delhi
•
Supporting electronic publishing of key medical journals, health research reports and policy
documents related to Tuberculosis and Tobacco Control programs
•
Developing interfaces to allow integrated access to various health data sources
•
Establishing Internet connectivity7 at selected sites and conducting training for participants at those
sites
•
Providing need-based health research information in forms that are useful to different
stakeholders
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HIN India
•
Testing technologies such as Simputer, solar power, health kiosks. Wireless in Local Loop, radio
based connectivity etc. for their appropriateness and affordability at the community level
•
Establishing benchmarks to measure the impact of the pilot
Since the HIN plans to develop need-based content, the Project Advisory' Committee commissioned a
survey of potential main beneficiaries in the pilot states of Karnataka and Orissa, to understand their
information needs. Findings from this survey, which was carried out in January 2002, are presented in
this report.
Information Needs Assessment Survey
Foundation for Research in Health Systems (FRHS). a non-governmental research organization
located in Bangalore, carried out the Health Information Needs Assessment Survey in the two project
states, Karnataka and Orissa, under the guidance of the Expert Advisory' Committee of the project.
The objective of the survey was to assess the information needs of health professionals namely:
researchers, administrators, and service providers involved in the TB and Tobacco Control Programs.
Types of Information gathered
As the overall aim of the HIN-India project is to achieve 75 % increase in access to health research
information and 50% increase in the use of research information in designing health policies and
programs, the survey gathered information on the current levels of access and use of health research
information. Specifically, the survey gathered information on.
•
Existing levels of health information among beneficiary groups with respect to TB and
Tobacco-use
•
Beneficiaries* ratings of access to health research information, in terms of ease and speed,
and usefulness
•
Beneficiaries’ perception about types of information they needed
•
E-readiness of health facility in terms of availability of hardware, space, electricity.
connectivity, and human expertise
Survey Area.
The survey was carried out in three blocks of Rural Bangalore district - Doddaballapur, Kanakapura,
and Ramanagar and in three blocks of Deogarh district - Barkote, Riyamal and Tileibani.
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HIN India
Display Number 1: Survey Area
Deogarh district of Orissa • Barkote,
Rural Bangalore district • Doddaballapur,
•
Kanakapura,
•
Riyamal,
•
Ramanaga
•
Tileibani
lieneficiaries surveyed
The survey was carried out at three levels- District, State and National. District level respondents
included government and private doctors: health administrators and supervisors: laboratory
technicians and paramedical staff at Primary Health Centres. State level respondents included state
health officers, faculty of medical colleges and hospital administrators from public and private
hospitals. National level respondents were policy makers and program administrators of TB and
International agencies, and
Tobacco control programs, representatives of selected NGOs.
Practitioner’s Association.
Sampling procedure and Sample Size:
At the outset, the expert committee decided on a sample size of around 300, of which 20 interx ieu s to
be conducted at the national level and the remaining in the two project-states, in 2:1 proponion since
Bangalore Rural is much larger a district than Dcogarh district of Orissa.
In the final tally, a total of 303 interviews were conducted from among different categories of
respondents as shown in Table I.
Table I: Sample Size of the Different Categories of Respondents
Bangalore
Orissa
National
| Total
Medical
73
40
3
| 116
Paramedical
82
40
0
| 122
Researchers / Teachers
13
10
7
^(T
Policy makers / Administrators
10
15
10
35
Total No. of Respondents
178
105
20
303
Category
Service
providers:
This sample size was adequate to conclude that 5 percentage-point difference between any n-so
categories of respondents, on any indicator would be statistically significant with 95 percent
probability7
For example, we could conclude that administrators were significantly older than
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HIN India
government doctors, because 74 % among administrators and 48 % among government doctors were
over age 40. But age distribution of private and government doctors was statistically not different
because percentage of over age 40 in these two groups, were 48 % and 44% respectively.
Selection of respondents was done using the following procedure. In each district we randomly
selected three blocks. In these blocks, interviewers visited the Block Hospital, Community Health
Center and all Primary' Health Centers, which were 4-5 per block. Ln each of these health institutions
they interviewed all available doctors. 2 paramedical persons, and laboratory technician or
pharmacists, if available. They then contacted equal number of private doctors practicing nearby the
government institutions.
Figure 1: Sampling Procedure
Random Selection of Block
Visit to Block Hospital. CHC and PHC
II
Contacted Doctors. Paramedical Stall. Pharmacist and
Laboratory Technicians
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Contacted equal numbers of private practitioners
Data Collection technique:
A total of eight survey instruments were developed to collect information from different categories of
respondents - seven schedules for seven categories of respondents and one for assessing the ereadincss.
Display Number 2: Eight Data Collection Tools
Seven for Different Categories of respondents1. Administrators,
2. Researchers and Faculty Members,
3 .Government Medical Officers.
4. Private Practitioners,
5. Multipurpose Health workers.
6. Pharmacists.
7. Laboratory' Technicians
8. E-rcadiness schedule
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HIN India
The expert committee had debated various options of data collection such as focus group discussion,
structure instrument, and in-depth interview and finally decided to carry out individual interviews
using structured instruments that would have as many open-ended questions as possible. Some experts
wanted to limit the open-ended questions to facilitate data analysis but finally it was agreed that open-
ended questions would be very useful for capturing respondents real information needs. Each
interview schedule took about 30-40 minutes to complete (Appendix A). Doctor s schedule was tire
longest and took the longest time to complete. Paramedical schedule was short but it also took long
time because most of the questions in section VI (dealing with other public health topics and current
Internet use) needed to be translated and explained to them before they could respond.
In spite of the length of the schedule, respondents at the district level, including private doctors
willingly gave time for the interview. They liked this survey, they said, because this topic was new
The fact that this was a WHO sponsored project also helped to evoke positive response from them.
However, interviewing respondents at state and national levels was problematic because most
respondents were too busy. “‘In the time you take for this interview, 1 rather process 20 files one
administrator told. One officer said, '‘Lack of information was not my problem: lack of time is
Some officers preferred schedules to be left with them, so that they can fill of their own rather than
giving interxdcw. Interviewers had to make repeat visits to collect those schedules. Officers dealing
w ith TB program did not want to answer questions related to Tobacco, and visa versa.
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The entire survey was completed in 2 weeks, using nine interviewers in Bangalore, four in Onssa and
one in Delhi. AU interviewers were highly skilled in interview techniques. Four were from National
Tuberculosis Institute (NT1) and the remaining were NGO staff, from FRHS in Bangalore and from
National Institute of Applied Human Research and Development (NIAHRD) in Cuttuck, Orissa. They
underwent a three-dav training that included a field visit and pilot-testing of survey instruments. This
pilot testing helped to rephrase and change sequence of certain questions to ensure smooth flow of
interview’.
Data Analysis
The survey data was computerized and analyzed using SPSS package. To retain the richness of
information gathered in the open-ended questions, extensive code lists were prepared so that all
distinct answers could be entered in the computer. Data was analyzed separately for five beneficiary
groups namely. Researcher (30), Administrator (35), Government Doctor (50), Private Doctor (66)
and Paramedical staff (122).
Findings from this analysis are presented in this report, in 5 sections. Section 1 describes
characteristics of respondents. Section 2 presents data on awareness among respondents about TB and
Tobacco Control program. Section 3 presents data on respondents* access to and use of information.
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HIN India
Section 4 deals with respondents’ information needs and preferred media for information. And section
5 presents findings on e-readiness of the project sites.
Section 1: Characteristics of Respondents
In this survey, about half of the respondents (56%) were over 40 years of age. Among administrators
and researchers, this proportion was much higher (over 80 percent). Most of our respondents were
males (80%) except in the paramedical category where half of them were females. Most
administrators and researchers were specialists in their areas while most of private and government
doctors were non-spccialists (Table 2 A & B).
Over 75 percent of our respondents were working at the district level and below. They were mainly
government and private doctors and paramedical staff. Remaining 25 percent reported working at
international, national or state levels. Though respondents were asked to select only one option for
“level at which they worked”, at least 30 percent administrators and researchers reported working at
more than one level. For example, those working at the national level with an international agency
reported working at both levels. Similarly, researchers from national institutions located at state
capital reported working at both national and state levels.
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Table 2 A: Demographic Characteristics of the Respondents (in %)
Characteristics
Researchers
Administrators
Over age 40
Male_____
Specialist
87
73
87
74
91
74
Govt.
Doctors
48____
80
48
Private
Doctors
' 44
J79___
41
Paramedical
Staff
54________
51________
0
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Table 2 B: Demographic Characteristics of the Respondents (in %)
Level at yvhich
they work______
International
National_______
State__________
District________
Total
Sample
Size (N)
Researchers
Administrators
13
11
70
53
20
30
34
37
37
35
Govt.
Doctors
2____
4____
8
88____
50
Private
Doctors
_0_____
15____
15
73____
66
Paramedical
Staff
0_________
0_________
0
100_______
122
j
In terms of actual workload, government doctors were treating about 60 patients per day while private
doctors were treating 30 patients per day. Majority of patients treated by government doctors
reportedly belonged to the “poor” socio-economic class (64%) while private doctors also reported that
half of their patients were poor. However, these data were based on perceptions and not derived from
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HIN India
actual data either on patient load or about economic status of patients. All most all doctors, both
government and private, reported treating TB patients (90%); government doctors treating 3 times
more TB patients than private doctors (Figure 2). That was because government doctors reported the
number TB patients treated in their institutions while private doctors reported cases being treated in
their single doctor clinic.
1
Figure 2: Patient Statistics Comparison of the Government and Private Doctors
1
Average
number of
patients
per day per
doctor
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130
Average
number of
TB patients
under care /
doctor
17
[□Gov. Doc BPri. Doc |
This data however confirmed that in TB treatment, private doctors had a significant role. Therefore
their knowledge and practices related to TB treatment need as much attention as those of government
doctors.
Section 2: Awareness and Perceptions about TB and Tobacco related diseases
In this section we present data on awareness of TB and Tobacco related diseases in each category of
respondents. Respondents' awareness was assessed in terms of how well they understood the TB
threat (disease burden and people dying due to TB in India) and Tobacco problem (Tobacco related
diseases and mortality due to them).
Awareness about the Harden
The survey data showed that over 80 percent of all respondents except paramedical staff viewed TB as
a serious public health problem. But less than 25 percent of them could correctly answer the question
on India’s share in global TB burden or on number of deaths due to TB. Awareness about deaths due
to TB” was relatively high among government doctors (38%) because they had recently attended a
RNTCP training program. Administrators came next (27%), followed by researchers (20%). Hardly 5
percent private doctors and paramedical staff knew' these statistics.
In fact, among paramedical staff only' 43 % viewed TB to be a serious problem while remaining
(57%) viewed it as a “problem under control or a minor health problem” (Table 4).
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HIN India
Table 4; Awareness about the TB burden Among Respondent Groups (in %)
35
Govt.
Doctors
50
Private
Doctors
66
Paramedical
staff_______
122
90
83
92
80
43
27
46
20
17
63
80
' 84
77
20
29
Characteristics
Researchers
Administrators
Sample Size (N)________
% Perceived TB a major
public health problem
% Knew India's share in
global TB burden_______
% Thought TB to be a
"killer disease'"_________
% Knew number of
people dying due to TB in
India
30
t
j 7
i 55
[ 38
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Reasons for the Rarden
To the question. Is TB still a killer disease and why?” over 80% of administrators and doctors said
"yes”. Fewer researchers thought it was a killer disease (63%) and even fewer paramedical staff
believed it to be a “killer” disease (55%). In response to an open ended question. "Why is it a "killer
disease?" respondents came with a long list of reasons (Box 1).
Box 1: Why is TB
Still a killer disease?
Irregular treatment
Lack of awareness /
Health education
Poverty' / Illiteracy
Spread of resistant bacteria
Non-availability of drugs
Patients go to quacks
It is not being properly
Controlled
RNTCP is not yet covering
the whole country
Health workers not
properly trained
Patients have no rest
High infectivity
#Said
02
U Said
80
31
24
22
15
02
01
03
02
01
02
Superiors, doctors mistake
Patients when visiting doctors,
hide details
Lack of personal hy giene
Treatment long duration
Social stigma
Superstitious beliefs
In India TB is the king of the
diseases
Because of combinations with
other diseases like HIV/
diabetes
Because it affects all systems
of the body
Lack of detection /
not diagnosed early
01
02
02
03
02
01
Sis
04
03
04
The five most frequently mentioned reasons were.
•
Patients not regular in taking treatment
•
Patients lack awareness
•
Patients are too poor, cannot afford the time to go to doctor
17
BIN India
•
Drugs not available in sufficient quantity, and
•
Resistant bacteria
Table 5: Top Five Reasons why TB is a “Killer Disease” (expressed in %)
Researchers
Administrators
Govt.
Doctors
Private
Doctors
Paramedical
staff
Number perceiving TB as
a killer disease
19
28
42
51
67
Irregular treatment
26
29
53
48
18
29
2
13
32
12
12
3
11
5
18
£
7
15
6
7
Lack of awareness among
TB patients_____________ 21
Patients
arc
poor
/
Illiterate, cannot afford the
11
time__________________
Drugs not available in
5
sufficient quantity
Resistant bacteria
26
14
Researchers often mentioned "irregular treatment" and "resistant bacteria" as the reasons for making
TB a "killer” disease while administrators gave prominence to patients being illiterate and poor and
that do not have time to continue treatment. Government doctors blamed lack of awareness among
patients and irregular treatment while both private doctors and paramedical staff mainly blamed
irregular treatment. By irregular treatment they meant, patients stopping treatment when they feel
slightly better or they change doctors for convenience. The new doctors also change the drug regimen
cither because they do not know the TB regime or prefer their own regime, they said.
We then classified these reasons in to four groups (Figure 3). "Social" reason, which included
illiteracy, poverty , poor nutrition, social stigma, superstition, constituted 17 percent of all reasons.
"Patient” related reasons were 29% (poor compliance, lack of hygiene, patients going to quacks,
I
association with HJV/AJDS). “Service provider” related reasons were 36% (irregular treatment.
mistake in diagnosis, improper counseling); while 18 % were "health system
I
reasons (non-
availability of drugs, resistant bacteria, expense, long-duration treatment, poor follow-up, workers not
trained).
I
i
I
There were significant differences in the types of reasons suggested by different respondent groups.
I
both patient and system related reasons. Government and private doctors infrequently mentioned
I
"system related” reasons while paramedical staff practically made no mention of "social” reasons.
I
I
For example, administrators emphasized the “system related” reasons while researchers emphasized
18
HIN India
Figure 3: Reasons why TB is a killer disease?
In fact, paramedical group seemed to be least knowledgeable about why patients do not continue TB
treatment. About half of them gave no answer to this question and most did not mention any "social
Param edic
«
.5
o
pp
o
GMO
Re sea rc h ers
Adm in.
{□Social ■ Patient related
T3
G>
<.<D•>
*0
hurimltimXm
aService provider related OSystem related
I
reasons, which they must be encountering in the field. This data provided useful clues as to what kind
of knowledge strengthening is needed among different respondent groups.
Knowledge of RNTCP Guidelines
Next we tried to find out how well respondents knew the revised guidelines of the Revised National
Tuberculosis Control Program (RNTCP) and whether they subscribed to them Their knowledge was
assessed using a series of questions. First we asked the service providers an open ended question -
"When do you suspect TB?” (This question was not asked to researchers and administrators). If their
answers contained the criteria mentioned in the RNTCP guidelines, we assumed that they were using
RNTCP criteria for suspecting TB. Answers to this question showed that more than 3/4th ot
government and private doctors were using RNTCP criteria for suspecting TB (fever, cough for more
than 2 weeks and loss of weight).
Then we asked them a series of questions related to salient features of RNTCP such as method oi
diagnosis, mode of treatment, follow-up of patients and when to stop treatment. In each case, we hac
listed options from which they could choose any or all options. Only one among those options was the
"correct” answer and those who selected that option were assumed to have the knowledge of RNTCP
guidelines.
About half the private doctors had not heard about RNTCP or DOTS (Table 6). Therefore, on all
RNTCP knowledge questions private doctors scored low compared to government doctors. Even half
of paramedical staff did not mention that under RNTCP, each dose is to be given under direct
observation. This might be because some of them had not received training as yet.
19
HIN India
Table 6: Knowledge about the RNTCP Guidelines (DOTS)
Govt.
Doctors
Kumber of Respondents_____________________ 50____
% Used RNTCP guidelines for suspecting TB_____________ 84____
94____
% Had heard of DOTS_____________________
% Mentioned Sputum microscopy for diagnosis____________ 94____
88____
% Mentioned each dose to be given under direct observation
96
% Mentioned sputum microscopy as the follow-up procedure
% Mentioned sputum conversion at the end of treatment as 70
criteria for stopping treatment________________ _________
96
% Approved of DOTS________ ______________
% Willing to adopt DOTS for private practice ___________ 66
Private
Doctors
66____
77____
58____
56____
40____
77____
48
Paramedical
staff______
122_______
87________
76________
76________
57________
89________
NA*
53
NA*
NA*
47
Wliile the data presented in Table 6 gives baseline status of RNTCP knowledge, the not-so-correct
answers give us pointers for deciding information content for the HIN. For example, to the openended question “when do vou suspect TB?” they mentioned several non-specific symptoms (Box _).
Practitioners may have to be educated on importance of diagnosing patient following guidelines, as it
will reduce the chances of misdiagnosis by them.
Box 2: When did respondents suspect TB?
Fever
Cough for more than 2 weeks / Cough with expectoration
Loss of weight
Weakness
Loss of appetite. Anorexia / not feeling hunger
Sweating
Blood in sputum
Chest pain
Recurrent respiratory tract infections
Non-specific enlargement of Lymph nodes
2 sputum positive
Raised ESR
Antibiotics fail
Based on X-ray findings
Clinical features
Dry lips
Sunken eyes
Restless
Loose motion
Headache
Indigestion
Exposure to KOCH’S
’7
...................... -
•
#Said
167
199
139
33
83
05
87
31
04
05
01
02
03
02
02
01
01
01
01
01
02
02
20
HIN India
For example, they may have to be informed why the diagnosis, based on the reading of X-rays, could
be incorrect. Patients might still have TB symptoms in spite of their negative tests.
But the most interesting finding in this section was that though practically all government doctors said
that they approved of DOTS. 34% of them did not want to use the DOTS in private practice. In
private practice, they preferred individualized case management. Among private doctors 53 percent
said thev would not use DOTS: they preferred individualized case management. When asked what
drugs they normally prescribe, they listed seven different drugs, as shown below:
Display Number 3: Drugs Private Doctors Normally Prescribe
54
55
wo
on
wk
-■
to
□ Rifampicin
E] Streptomycin
□ Pyrazin amide
SINH
s Ofloxacin
□ Combipack
E3
□ Ethambutol
□ B-complex, haemotonic j
Though we did not ask administrators and researchers if they knew about the RNTCP guidelines, we
had asked them whether they knew the basis for developing those guidelines. While l/3rd of them did
not answer this question. l/3rd attributed them to the results of pilot studies conducted by NTL
Bangalore and Tuberculosis Research Centre (TRC), Chennai in the 1960s. The remaining l/3rG said
that failure of the earlier National Tuberculosis Control Program prompted the government to revise
the guidelines.
Awareness about Tobacco Related Diseases
To the question. “How serious is the tobacco-use problem?"' the overwhelming response from ail
categories of respondents was, “it is a ma jor public health problem".
Table 7: Respondents’ perception about seriousness of the tobacco-use problem in India
Sample Size (N)________
% Perceived Tobacco
use to be a major public
health problem
35
Govt.
Doctors
50
Private
Doctors
66
Paramedical
staff_______
122
91
9K
100
S5
Researchers
Administrators
30
93
21
HIN India
We then asked them questions about types of tobacco use, health consequences of tobacco use, and
what can health professional do to prevent tobacco use in the community.
Most respondents knew about tobacco use in the form of cigarettes and Beedi, also tobacco yvith betel
leaves (83%), Guthka (80%), and pan masala (78%).
Box 3: Awareness of Tobacco
Products
Gutkha
Pan masala
Snuff
Khaini
Betel leaf with tobacco
Cigarette
Beedi
Total.
N=303
243
234
165
155
253
275
274
Others (chutta, ganja, hukka)
Mava
Areca nut with tobacco
73
57
75
But many did not know' several other products that also contain tobacco (Box 3). The top five diseases
attributed to tobacco use by all four respondent groups were Oral cancer (49%), Cancer of lungs
(43%). Pulmonary TB (43 %), Respiratory tract infection (41%) and Diseases related to heart and
circulatory system (35%). Very few mentioned diseases such as gum problems, liver problem and
birth defects to smoking (Box 4).
Box 4: Diseases attributed to tobacco use by number of
respondents
Respiratory tract infections
Pulmonary TB / Pleural effusion
Cancer of lungs /Lung disorders
Oral cancer
Diseases related to heart and Circulatory sy stem
Ulcers (mouth, gastric)
Sub-muco fibrosis
Teeth / gum problems
Birth deficiencies
Liver problems
Nerves weakness
Total
N=303
124
130
131
148
106
72
05
09
03
03
04
We had expected higher frequency of cancer being mentioned in relation to tobacco-use than what ^c
found. We suspect that this indicates respondents' lack of seriousness in answering these questions
than their lack of knoyvledge. Firstly, tobacco related questions came after ansyyering too many
questions about TB. Compared to questions on TB, Tobacco related questions w'ere of non-technical
nature. Also, there is no Tobacco-Control Program as yet; therefore respondents were not sure why
22
HIN India
we were asking those questions. Some administrators dealing with the TB program were reluctant to
answer Tobacco-related questions.
Notwithstanding these constraints, all health practitioners said that they could play important role in
reducing Tobacco use. Nearly 70 percent of doctors and paramedical staff reported that when they
come across patients who smoke, they7 regularly' advise them about ill effects of smoking on health.
Remaining 30 percent said that they did so, occasionally. When asked what actions could health
professions take for reducing Tobacco use, they mentioned mainly two - (i) Advising patients about
consequence of smoking and motivating them to give-up, (ii) Organizing health education through
mass campaign (Table 8). Some also suggested other actions that government must take such as
banning Tobacco advertisement, no smoking in public places and stronger warning on Tobacco
products.
Table 8: Top Five Actions recommended for Tobacco control (figures in %)
Respondents (N)
Researchers
Administrators
Govt.
Doctors
Private
Doctors
30
35
50
66
Paramedic
Staff
122
j-------------
Health
Education
through mass campaign 47
Counseling
and
53
motivating patients
Ban on smoking in
53
public places_____
Ban
on
Tobacco
23
Advertisement
Stronger warning on
37
tobacco products
60
80
55
87
31
72
71
66
57
56
67
43
66
52
55
34
37
40
42
27
There were some interesting differences in the recommended actions by the four respondent groups
Researchers most frequently recommended ban on smoking in public places. Administrators
recommended ban on tobacco advertisement. Government doctors and paramedical staff frequently
recommended health education while private doctors recommended patient counseling
Tltes<
diffcrences perhaps reflect the actions they could take themselves or knew how to do Most
respondents have quite a few suggestions on what actions health professional could take to reduce
tobacco use (Box 5).
We then tried to find out respondents' perception about the age at which people start using tobacco
Nearly 2/3rd reported that people normally start smoking before the age of 15. When asked, to whai
extent parents can help prevent children from using Tobacco, over 80 percent across all categories
23
HIN India
said that parents could help to a large extent while the remaining 20 percent said that parents could
help to some extent or not at all.
#Said
Box 5: Role health professional could play in reducing tobacco use
217
Health education through mass campaigns
190
Counsel patients about consequences and motivate them to give up
04
Scare people by show ing pictures of terminal stage cancers
06
Be a role model by not using tobacco
01
Explain patients about environmental pollution
Organize Cancer detection camps
HiiOiM 02
02
Celebrate Anti tobacco day
01
Sensitize policy makers
01
Write articles
01
Give Lectures in selective groups
Next we asked thevh. what they could do to prevent children from using tobacco. This question was
asked only to service providers and administrators, and not to researchers. The action they most
frequently mentioned was giving health education in schools. A distant second runner action was
counseling parents to be a role model by not smoking or using tobacco in front of children and not
asking children to buy tobacco for them (Table 9).
Table 9: Perceptions about how tobacco use could be prevented (figures in %)
Administrators
Doctors
Private
Doctors
Paramedical
Staff*
Govt.
N (Number ofRespondents)
35
50
66
j 122
Give health education in schools about
bad-effects of tobacco
94
100
53
I 87
Ensure schooling for children
6
6
15
Counsel parents or family members to
become role models
5
30
14
I 9
1----| 20
Divert their attention from Tobacco
5
2
3
I 1
Use interesting media like films,
exhibitions to communicate with children
11
2
6
6
Control pocket money
00
00
00
5
These data suggested that perception among respondents about tobacco related health problems and
what could health professionals do to reduce tobacco-use, was rather uniform among all respondent
categories. Except researchers, all four respondent groups favored government policy of restricting
24
HIN India
tobacco advertisement (over 67%) and thought that it would have the desired impact on tobacco use.
Only 20 percent researchers favored this policy or thought that it would have the desired effect. It was
not the policy but government’s ability to enforce that policy, was a suspect.
To an open-ended question, “What in your opinion would have impact on tobacco use in this
country ?” we received 15-16 different suggestions from all respondents (Box 6).
Box 6: What would have impact on Tobacco use in this country?
Vigorously implement No smoking in public places
Increase taxes on tobacco products
Issue stronger warnings on tobacco products
Ban on sale near schools
Put total ban on production and sale of Tobacco
Make people conscious about health hazards
Provide information about alternative crops that farmers could grow
Fix minimum age for smoking
Make Tobacco companies pay for die tobacco related diseases
Counsel patients at individual level
Give health education through different communication media
Don’t allow Tobacco companies to sponsor sports events
Develop Ferocious ads to scare people away from tobacco
Do not show film actors in tobacco ads or smoking in films
Give prizes, or incentives to those who give up tobacco use
Advise people to handle mental worries
#Said
160
76
107
107
53
02
04
01
02
02
09
01
03
02
01
02
These suggestions reflected a fair amount of interest and concern about tobacco problem. But they did
not know whether these suggestions would work and or did not know about any stud) that had shown
how to reduce tobacco use in a community.
Section 3: Access and Use of information
Having collected information on current levels of knowledge and awareness of TB and Tobacco
program, we proceeded to find out respondents' health information needs. With respect to TB
program we asked doctors and paramedical staff' "Do you have access to research / clinical
information related to TB treatment?” About i/3rd of government doctors and /i of private doctors
reported that they had access to such information. We did not ask this question to administrators and
researchers because we assumed (perhaps wrongly on hindsight) that they would have access or
would know where to get information if they needed one.
However in case of Tobacco, we asked ail respondents "Do you know any study on how to reduce
tobacco-use in a community?” To that question, less than 20 percent administrators and researchers
25
HIN India
responded “yes” while less than 5 percent responded “yes” in the other three categories of respondents
(Table 10A).
Table 10 (A) Access to Research Information by Respondent categories
Researchers
N
(Number
30
Respondents)
% Reported access to Not Asked
research
and
clinical
information related to TB
% Reported knowing any' 17
study related to reducing
tobacco-use
in
the
community.
35
Govt.
Doctors
50
Private
Doctors
66
Paramedical
staff______
122
Not Asked
36
48
34
20
4
5
2
Administrators
To those who reported having access to TB related research/clinical information, we further asked to
specify-' the sources of information. Medical Journal was the source of information for 67 % private
doctors (67%); it was so only for 17% government doctors. Over 40 percent government doctors and
25 percent private doctors reported having no access to medical journals.
Government doctors mentioned training and meetings as their main sources of information. Similarly
information sources for paramedical staff were training/mcetings and IEC (Table 10B). Library was
the least frequently mentioned source (10%) while Internet was mentioned by about 17 percent ot
doctors but not at all by paramedical staff.
Table 10 (B): Sources of Technical information for those reported having access to Technical j
information in TB (figures in percent)j
N (Number ofRespondents)_________
Medical Journal___________________
Training, meetings, seminar, conferences
I EC, Mass media__________________
Libraries, Books etc.________________
Internet, Websites, etc.
Government Doctor
18______________
17_______________
33_______________
_0_______________
11_______________
17
Paramedical staff
Private Doctor
32__________
63__________
28
42____________
0_____________
9
19
_7_________
0
52
60
The journals they mentioned, which were not too many, consisted mainly of Indian Journals (Box 7)
The most frequently mentioned medical journals were Journal of Indian Medical Association (J IM A).
Indian Medical Journal and British Medical Journal, in that order.
Next we explored the pattern of information use by respondents by asking them the question "How do
you use new informationWe had listed 15 options of "use" including one that said "other, specify
26
HIN India
and read out to them those options to chose from. These options could be grouped into four broad
categories (Table 11). Researchers reported that they most frequently used information for diagnosis
and treatment (37%), followed by for lectures and writing articles (33%). Administrators most
frequently used information for policy and program decisions (36%) followed by for diagnosing and
treatment (27%), since most administrators were also practitioners. The other three groups of
practitioners mainly used information for treatment of patients (about 50 %).
Box 7: Which Medical Journals Doctors
have access to:
Journal of IMA (JIMA)
Indian Medical Journal
British Medical Journal
Pediatric Journal /Indian Pediatrics
IAP
Lancet
NEJM
Indian Journal of TB & Chest Diseases
CHEST
Homeopathy
JAPI
Annual of Intern medicine
JAMA
AIDS Journal
Lung India
International Journal ofTB & Lung diseases
Physician's digest
Applied medicine
Karnataka Medical Journal
Indian Chest Society Journal
American Medical Journal
Journal of American Dental Association
N=116
# Said
31
15
22
04
02
09
09
11
06
04
01
01
01
01
01
01
01
01
01
01
01
01
About 20 percent of doctors reported using information for developing educational material but verfew reported using it for program decisions. This is one area where HIN needs to contribute.
27
HIN India
| Table 11: Use Pattern of New Information by Respondent Type (in %)
I
Researchers
N
(Number
30
respondents)
For diagnosis, treatment, 37
dealing with medical
emergencies___________
For policy and program 18
decisions______________
For use in lectures, 33
articles, press release
use,
for 12
For
local
developing
educational
material
35
Govt.
Doctors
50
Private
Doctors
66
Paramedical
Staff
122
27
44
53
51
36
16
11
7
20
20
20
13
17
20
16
29
Administrators
But in in-depth interviews, some of the respondents except researchers said that they usually did not
seek information, actively. Administrators mentioned that a lot of information was thrust upon them
Some reported suffering from information overload.
Government doctors and paramedical staff received program related information during training
programs or during monthly meetings.
Training modules, they thought, provided adequate
information. "Usually we ge/ these modules towards the end of the program, ffe keep them as
reference material hut rarely feel the need to look at them', some doctors said. They paid most
attention to govemment circulars, which they received usually during district level meeting. Those
circulars were also the main source of information for paramedical staff. Govemment doctors usually
read out circulars in health workers' meetings but each worker did not get a copy for herself or
himself. Some workers said that they would like to have copies of all circulars, which they could cany,
with them during village visits and share information with patients and community members. "At
present we are sending more information than we arc receiving’’ they said. They were referring to the
monthly reports they sent to districts but received no feedback in return.
Though most doctors said that the)' used information for diagnosis and treatment, only one private
doctor in Rural Bangalore actually described a case, which he had treated after receiving information
from a doctor in Australia via the Internet (Box 8).
28
HIN India
Box 8:
“This young boy ofabout age 14 was brought to my clinic in a semi- conscious state. I examined
the boy and referred him to NIMHANS. But the parents brought the boy back a couple of days
later saying the hospital asked them to take the boy home. The parents were desperate. They
begged me to do whatever is possible. I just thought of taking a chance to see if some expert
would be available online. 1 went to Aptech in Kanakapura to use one of the chat rooms and to
see if any doctor was available. There was one Dr. ______ from Australia. He was a
neurosurgeon. After 1 described to him the symptoms, he thought the boy most probably needed a
surgery’. He asked me to get a Mill done and then consult a local specialist. I took the boy to
Ragav's in Jayanagar and arranged for a MR1 in lieu of my commission. I then consulted the
neurosurgeon attached to this lab. He did the surgery and now the boy is well .
Section 4: Information needs and preferred Mode of Communication
After assessing the current information access and pattern of information use by respondents, vve
explored their need for information with respect to TB, Tobacco use and other public health areas.
Information Needs
To assess respondents' Information need we asked two direct questions. (l)“Do you require further
information on TB?' and (2) “Would you like to get information on how to reduce tobacco use in a
community ?" In case of Tobacco, tiie response was overwhelmingly “yes in all the categories of
respondents. In case of TB. the need for “further TB information’ was relatively low among
government doctors, administrators and researchers probably because of RNTCP training programs,
but it was reportedly high among private doctors and paramedical staff (Table 12).
|~TabJe 12: Respondents5 reporting need for TB and Tobacco Information
Researchers
30
N (Number of Respondents)
°/o Reported need for TB
43
information
for
%
Reported
need
to 90
related
information
Tobacco use
35
Govt.
Doctors
50
Private
Doctors
66
Paramedical
staff________ I
122
74
68
98
97
83
98
100
84
Administrators
In response to an open-ended question. “What further TB information you need? many researchers
and administrators needed information on new development in TB treatment (40%).
Doctors and
paramedical staff needed information on how to prevent TB spread (68 %) and how to motivate
patients to continue TB treatment (55%). Surprisingly 35 % private doctors and 18 % government
doctors also wanted information on etiology of TB, which we thought, medical students learn in
29
HIN India
medical colleges. Some doctors then explained that they expected to see different manifestations of
TB because of HIV/A1D and hence the need for information (Table 13, section A).
To the question “what information you would like to have about effects of Tobacco use? we had
provided seven options (Table 13, section B) and asked respondents to rank them in order of their
preference. Most respondents found that task very' difficult. They instead, answered it as a multiple
choice question, ticking as many options as they liked.
Table 13: Types of Information Needed in TB and Tobacco by Respondent Type (in %)
I
Researchers
Administrators
13A: Type of TB Information Needed (%)
0
How to prevent spread 0
ofTB_______________
0
How to motivate patients 0
6
10
Etiology of TB____
40
New developments in 43
TB (success stories)
13B: Type of Tobacco Information needed (%)
83
Health effects of tobacco 56
Use______________ __
41
56
Advice about cessation
66
30
Types of tobacco use
45
44
Effects of Passive
Smoking_____________
38
48
Effect on women and
Children_____________
41
41
Effect of advertisement
31
Effect on agriculture and 44
employment
Govt.
Doctors
Private
Doctors
Paramedical
Staff
42
68
44
54
18
61
50
| 44
6
35
11
84
85
83
57
59
67
71
58
I 65
! 58
! 51
53
59
61
41
45
48
39
’ 41
63
(T
47
Tlie three most frequently mentioned Tobacco information needs overall were (i) health effects ot
different ty'pes of tobacco use (81%), (ii) advice about cessation (61 %). and (iii) types of tobacco use
(60 %). We observe no significant differences in information needs by type of respondents because
this was a multiple-choice question, which they could answer without much thought. Therefore we
also suspect that these answers do not reflect their “real information needs, as in the case of TB.
In addition to TB and Tobacco, we asked respondents to indicate important public health topics for
their work by giving them a list of all possible topics to choose from Since this list was in English,
investigators had to translate it for paramedical personnel, which demanded a long time and a lot of
patience of both, interviewer’s and of respondent s. Respondents were asked to select as many topics
I
as they liked. We then selected topics that were selected by more than 50 percent of respondents and
30
HIN India
presented in Table 14 separately for each group, by ranking them based on how frequently the topic
was mentioned.
Table 14: Public Health Problems that Respondents selected as Important for their work, by
Respondent Type
_
_
Researchers
Administrators
Emergency
response in health
Tuberculosis
Tuberculosis
Government
Doctors
Tuberculosis
Primary
and Maternal and infant
community health health __________
Diarrheal diseases
Acute respiratory' HIV/AIDS
infections
Tobacco use
Private
Doctors
Tuberculosis
Paramedical staff
HIV/A1DS
Malaria
Tuberculosis
HIV/AIDS
Acute
respiratory
infections
Maternal and Maternal and Infant
Tobacco use
Malaria
infant health
health__________
Child and adolescent
Malaria
respiratory
and Acute
Maternal
health
infections
infant health
respiratory
Acute
Tobacco use
Prevention
and Malaria
infections
control of disease
Dairrheal diseases
Infectious
HIV/AIDS
diseases
Reproductive health
Diarrheal
Reproductive health
diseases
Tobacco use
Child and adolescent Reproductive
health
health_____________
Infectious diseases !
Infectious diseases
Eye diseases and j
Eye diseases and
blindness_________ _i
blindness
Vector
borne ]
Nutrition and food
tropical
diseases
i
safety
Nutrition and food
Water and sanitation
safety____________ ]
Tuberculosis and Tobacco came very high on all lists perhaps because the interview was being
I
conducted in the context of TB and Tobacco. Interestingly, government doctors list was the longest,
followed by that of paramedical staff. This was because government doctors and paramedical staff
were involved in many health programs compared to other three categories of respondents. Private
Doctors' list was relatively short, containing 9 topics while Administrators’ and Researchers lists
i
were the shortest because of focused nature of their work. We also suspect that since this exercise
came towards the end of a long interview, administrators who were too pressed for time perhaps did
not spend much time on this list.
We then asked respondents to select one most useful source of information from a list of 9 items, to
got.
31
i
HJN India
(0
General information outside area of expertise;
(ii)
General information in the area of expertise;
(i«)
In-depth information in the areas of expertise and
(iv)
In-depth information outside the areas of expertise.
For all four categories of respondents. TV & Radio were the useful sources for general information.
For general as well as in-depth information in the areas of expertise, they all mentioned journals and
scientific publications as being useful sources, except paramedical staff who mentioned meetings and
books, instead. HowcA^er, most respondents could not understand why they would need in-depth
information outside their areas of expertise. Therefore we deleted that data in the final analysis.
Table 15: Useful Sources of Information and preferred Languages, for different types of
Information
Type
of Researchers
Information
TV & Radio
General
knowledge
General
Journals and
/>?
knowledge
scientific
publications
the area
expertise
Journals and
In-depth
m scientific
knowledge
the area of publications
expertise
English
Preferred
language
Administrators
TV & Radio
Journals
scientific
publications
and
Journals
scientific
publications
and
English
Govt.
Doctors
TV & Radio
Private
Doctors
TV & Radio
Paramedical
staff______
TV & Radio
Journals and
scientific
publications
Journals
scientific
publications
| Meeting
journals and
scientific
publications
Journals and •
; Books
scientific
publications
English
English
J________
i Local
i languages
AH health professionals except paramedical staff, preferred English language for technical
information while paramedical staff wanted information in their respective local languages.
We then tried to find out difficulties they encountered in accessing information related to their area of
work.
About 30 percent reported "no difficulty”. Among those who reported difficulties, the three
most frequently mentioned difficulties were "information difficult to get . "expensive and "irregular
(Table 16).
32
HIN India
Table 16: Difficulties reported by Respondents in accessing information in their areas of
expertise (multiple responses)
Paramedical
Private
Govt.
staff________
Doctors
Doctors
' 36%
' 26%________
50%_________ 37%__________ 42%
"No difficult”
Difficult to Difficult to get
Three frequently Difficult to get Difficult to get Irregular
(74%),
get (23%),
(24%),
(13%f
(25%),
mentioned
Expensive
Not up-to-date, Not
up-to-date Difficult to Expensive
difficulties
(10%)
(25%)
(8%),
get (22%),
(18%),
Irregular (8%)
Irregular (25%)
Irregular
Expensive
Expensive
(10%)
(18%)
(15%)
Researchers
Administrators
Interestingly, these difficulties were identical for all respondent groups, though their severity varied
While only 13 percent researchers mentioned "information difficult to get'’, this difficulty was
mentioned by 74% paramedical staff. When we tried to find out what they meant by. "Information
was difficult to get” most respondents said that they were too busy and had no time to go to library.
They preferred getting information on their desk, may be as a newsletter
Modes of Communication
In this section, we present data on respondents' preferred modes of communication, based on their
answers to the following five questions:
(1) With whom you need to communicate in course of your w ork?
(2) What is your preferred mode of communication for information9
(3) Do you have access to Internet and web-sites'?
(4) What type of barners you face in accessing Internet9
(5) Do you think access to Internet will benefit you and how ?
Data on need to communicate in course yvork showed that all categories of respondents needed to
communicate more with persons within organization as well as with patients and less with expert
outside organizations (Table 17).
33
HIN India
Table 17: With whom they need to communicate in the course of their work (in %)
N (Number of respondents)
Superior in the organization
Experts withm organization
Experts outside organization
With patients_____________
With general public________
Funding / donor agencies
Mass media /advocacy groups
Researchers
Administrators
30
57
77
53
53
33
43
30
35
57
83
49
46
43
37
46
Private
Govt.
Doctors Doctors
50____ 66
' 30
46
' 52
66
_35_____
10
72____ _65____
56____ _38_____
6_____ I 11
26
; 17
Paramedical
Staff
122_______
74________
70________
25________
47________
44________
0_________
7
The most preferred mode of communication for administrators and researchers was the Intemct/c-
mail (82%). For government and private doctors it was scientific journals (82%) and the Internet
(78%). For paramedical staff it was AV media (80%) (Table 18). Verbal presentation by experts was
the least preferred mode, except for paramedical staff.
Table 18: Preferred mode of communication by category of respondents (in %)
N (Number of respondents)
Internet and email_________
Newsletters or fact sheets
Verbally from experts___
Scientific journals_________
AV media such as CD. DVD
Magazines and newspapers
Researchers
Administrators
30
87
77
3_7
77
47
50
35
77
60
46
74
74
83
Govt.
Doctors
50____
78____
68____
62____
82
74____
78
Paramedical
Private
Staff
Doctors
66____ I 122
82_____ j 52________
77____ I 69________
i 75________
67
94_____ I 53
76____ I 80_______
88
f 77
Respondents' preference for Internet however, did not reflect their current access to the Internet but
perhaps reflected their awareness that this project was about providing Internet connectivity to health
institutions.
Present access to Internet ranged from 75 percent among researchers ! administrators to 25 percent
among government doctors and to 5 percent among paramedical staff (Table 19).
34
HIN India
Table 19: Access to Internet and Web Sites as Reported by Respondents (in %)
Access to Internet
Researchers
Admini
strators
Govt.
Doctors
Private
Doctors
Paramedical
Staff
N (Number of Respondents)
30
35
50
66
122
73
% Reported Access to Internet
T?
% Having Internet access at home
% Reported access to web-sites____ 53
%Reported
accessing
website 43
related to work
74
24
60
60
W
53
23
38
23
54
II
10
I
T
0
Most of those reporting access to Internet also reported accessing Web-sites, mainly related to their
work. Some of them mentioned visiting web-sites like Jama.com, IMA, WHO, TBINDIA. BMJ.com.
and Google Search Engines, but infrequently.
We then asked ail respondents to list up to three barriers they faced in using the Internet. This
question was asked to all respondents, irrespective of their access to Internet. Therefore, some of these
barriers were “perceived'’ and not “actual’’ barriers. For example. 17 paramedical staff reported slow
Internet connection'’ as a barrier though only 7 had access to the Internet. Other had heard that this
was a barrier.
Table 20: Top 4 Barriers to Internet Use mentioned by Type of Respondents
Researchers
N=30
Administrators
N=35
Private Doctors
N=66
Govt.
Doctors
N=50_____________
Insufficient skills in
computer use
Don't have the time
Telephone line
problems
Don't have the time
Don’t have the
time
Uneven quality of Insufficient skills for Insufficient skills in
computer use
Internet use
information
Slow
Internet
Insufficient
skills
for connection
computer use
Insufficient
skills
Ven costly
for computer use
Don't have the time
Not
in
language
preferred
Slow
Internet
connection
Ven costly
Paramedical
Staff
N=122_______
Insufficient
skills
in
computer use
Insufficient
skills
for
Internet use
Slow Internet
connection
No access
computer
to
The common and most frequently mentioned barriers across all respondent groups were lack of time,
lack of skills and slow access. Notwithstanding these barriers, most respondents (89?4>) said that
access to Internet would help them in their work. Even paramedical staff, who had not heard about the
Internet and did not know how it worked, also listed its benefits after hearing about it from
investigators.
35
r
"I
HIN India
Table 19: Top three Internet Benefits mentioned by respondents (in %)
N (Number of Respondents)
Can get new information
about drugs/ diagnosis/
management/ technology/
statistics/ rare diseases_____
Can get more information on
any topic________
with
Can
interact
col 1 cagu es/patients/
superiors about treatment
I
35
Govt.
Doctors
50
Private
Doctors
66
Paramedical
Staff
122
70
71
94
88
64
50
34
56
41
37
3
15
Researchers
Administrators
30
I
18
31
13
The three most frequently mentioned Internet benefits were (i) getting new infotmation about drugs
and diagnosis (ii) getting more information on any topic and (iii) interacting with colleagues and
patients. These expectations of respondents from the Internet are consistent with their current use ot
new information, which was primarily for diagnosing and treating of complicated cases. Also it is
I
consistent with their current pattern of communication, which is high with colleagues / patients and
low with outside experts.
Section 5: Assessment of E-readiness
In this section we present data on e-readiness of the 29 health institutions. 22 in Rural Bangalore and
7 in Orissa, which wc visited as potential sites for the HIN. Of these. 26 were district level institutions
(PHCs and Taluk hospitals) and 3 state level institutions.
None of the 26 district-level health-centers that we visited had computer or Internet facility . In 13
institutions. 1-2 persons had some computer skills. Of them. 65 % had basic skills in operating a
computer, 30 percent had experience of using MS-Office applications, while 9 percent had experience
of using the Internet (Table 22). in the remaining 13 institutions there was nobody with computer
skills though they showed willingness to learn.
Table 22: Computer Skills among the Potential users of the HIN facility (in numbers)
I
Doctors
12____
Potential users
9
Basic skills
Experienced user of
3
MS-Office
Experienced user of 2
Internet
Advanced computer 0
skills
0
T~
j Total
! 23
i 15
3
1
0
7
0
0
|0
2
0
0
1
1
Admin. Staff
8
Paramedical staff
Others
J_________ _ 2
36
HIN India
At all 26 sites we also assessed physical conditions such as availability of physical space, electricity,
telephone, Internet access etc. This assessment showed that except for physical space, all sites were
deficient on all other conditions (Table 23).
Table 23: Assessment of HIN Potential sites in terms of E-readiness parameters
Physical Conditions________________________
Adequate physical space for hardware___________
Appropriate site temperature (Moderatc-211 Low-5)
Dust-free Environment______________________
Frequent electricity fluctuations________________
Frequent electricity outages___________________
Generator available________________________ _
Earthing for electricity connection available______
Fixed telephone lines available______
Internet Access available_____________________
Computer training facility in the vicinity_________
★Scheduled load shedding for 6 hours a day
Yes
23
17
17
7__
13*
J_
26
2_
J
No
3
9
9
19
13
25
0
19
25
23
I
1
At the state level, e-readincss was assessed at three places - National Tuberculosis Institute (NT1).
Bangalore, and two medical colleges in Orissa
At the NTl there were 14 users from
Statistics/monitoring section. The institute had acquired Office Software. It had the Internet
connection, available only at the Library on 2 machines. Staff was given limited access to Internet by
maintaining a log in the register.
The budget for the procurement and maintenance of the hardware came from the government of India
It had not entered into maintenance contract because the equipment was still in the warranty period.
The other two state level institutions that we assessed were Cuttack Medical College and Sambhalpur
Medical College. Cuttack Medical College had access to Personal Computers and peripherals such as
Scanner 7400C, HP Ext CD writer, 56 KPPC. Win 98. HIG XP. Norton anti virus etc. The physical
facility was ample. The present source of funding involved 6 lakh from the Government of India for
one year and Rs. 10 lakh per year from OHSD Project, up to 2002.
Sambhalpur Medical College had computer facility only to be used by library staff. In terms of
peripherals, it had CD ROM. modem and DPS but no scanners, digital cameras or DVD. It reported
load shedding of 3-4 hours per day. Also it had no fixed telephone lines but had applied for one.
37
HIN India
Summary and Recommendations
The Health Information Needs Assessment Survey carried out in the two HIN-India Pilot areas.
Bangalore Rural and Deogarh, showed that majority of respondents considered TB and tobacco-use as
serious public health problems in India. Nearly three-fourths of them (72%) perceived TB to be a
killer disease. However, very few respondents knew the size of the diseases burden or knew about
studies that were carried out on various clinical and behavioral aspects of TB treatment. They
however knew that in spite of treatment being available, TB is a killer disease, because patients arc
irregular in taking treatment. They ascribed irregularity of treatment mainly to patients not being
educated or too poor to complete the treatment. Patients stop treatment when they feel slightly better
or instead of completing the full course at government centers they go to private doctors nearby, tor
convenience. Private Doctors often start them on new regimen either because patients do not bring
their treatment records or doctors have their preferred regimen that they like to follow
This survey helped identify- areas such as why patients discontinue senices, characteristics of patients
likely to discontinue services, social causes affecting TB treatment etc. about which service providers
must know more. Only then would they be expected to provide special attention to counseling such
patients. Also there must be a system to transfer patient information to wherever they go so that they
I
get continue to get the same treatment.
Though practically all government doctors knew about RNTCP and also approved of those guidelines.
l/3rd of them were not willing to use those guidelines in their private practice. Among private doctors
I
nearly half of them had not even heard about RNTCP. though all of them reported treating TB
patients.
I
I
I
I
This is one information gap that the HIN could help address. In the survey, many respondents
reported that they preferred individualized case-management and not any particular regimen. They
also listed variety of drugs they prescribed for TB patients. HIN should provide doctors authentic
information about various drugs used in TB treatment. It could also provide opportunity for doctors to
discuss their objections to the RNTCP drug regimen with experts. That may reduce their resistance to
I
the recommended drug regimen as well as dependence on drug salesmen for information.
Awareness about the link between tobacco use and diseases such as oral cancer, lung cancer and
pulmonary TB was high, as one would have expected. In addition, the survey produced a list of 21
other health conditions attributed to tobacco-use, about which awareness was not as high Providing
information on those diseases and their link with Tobacco use might also help increase health
practitioners ability to dissuade many more patients from using tobacco.
38
HIN India
The survey data also revealed that respondents across categories held similar views about the effect of
tobacco use, how to prevent its use and what role health professionals could play in reducing tobacco.
While practically all respondents adniitted not having access to technical information regarding
tobacco-use, they reported need for scientific information on how to stop tobacco use in community.
Most of them were also keen on getting information on how to bring about behavioral changes with
respect to tobacco use and finding effective educational material especially for use with children. HIN
can help in meeting both those needs.
In case of TB. practitioners wanted information on etiology of TB in the context of HIV/AIDS, as
well as on how to prevent its spread of TB and how to motivate patients to continue treatment
Researchers and administrators wanted information on new developments in TB research and success
stories from the field. Information items thus identified by respondents should be used in designing
the HIN content.
A majority of service providers reported using new information for diagnosis, treatment, and for
dealing with emergency medical cases. Among researchers l/3rd of information use was for patient
treatment and l/3rd was for preparing articles and lectures for researchers. Also among administrators
only J/3rd of use was for policy and program decision- making, which seemed rather low. In other
respondent groups, the use of information for program decision-making was also found to be very-
low. Therefore, in the HIN. this area might needs special attention. Project beneficiaries need to be
trained and guided on how to use information for program planning and implementation. This could
be achieved through special!} designed modules or through distance learning program, on use of
research information in program planning and management.
Though HIN is mainly focused on TB and Tobacco, the survey made it amply clear that health
practitioners' information needs go much beyond those two areas. When asked to select public health
topics important to their work, government doctors and paramedical staff selected a long list of topics
because the} deal with a large number of health programs on a day-to-day basis. Therefore, their
mfonnation need on manr of those topics might even be greater than their need for TB and Tobacco
information. This is because TB is a well-structured program, which provides a lot of information to
them in the form of guidelines and teaching material and Tobacco program is still on drawing board.
At the same time, health topics such as HIV/AIDS, malaria, non-communicable / chronic diseases,
mental health are of current interest to them. They might also need information about consumer
protection law. medical ethics, patient rights etc., which were not even explored in this survey.
Therefore for a doctor, restricting HIN website only to TB and Tobacco might mean too much
investment of their time and effort for too little gain. HIN must facilitate doctors’ access to
information in other areas of their interest, if they wished to do so.
39
HIN India
Though this survey indicated overwhelming need for information among respondents, one could ask,
was this really their felt need? Or people reported “need” because this was a WHO sponsored survey
dealing with health information need. If they really need information why do they especially
government doctors, not read medical journals to any significant extent? One answer to that question
was. doctors do not have time to seek or even read journals. They expected most of relevant
information to come them as government circulars and guidelines, or provided to them through
training. Therefore, very7 few7 government doctors actively sought information through journals or
through the Internet. Significantly more Private Doctors reported reading journals and accessing
Internet for information than government doctors, because they had no other recourse like the
government.
This survey seemed to suggest that ail doctors need information but government doctors feel no need
to actively seek information. For them time is also a constraint as they are responsible for many health
programs as well as for administration of health centers having 30-40 Functionaries. Besides, many of
them undertake private practice after office hours. Given this busy schedule of theirs how is it
possible to motivate government doctors and paramedical staff to seek web-based information9 This
is a challenge for the HIN.
One option that the HIN should consider is providing health information to them through their
preferred mode such as Newsletters, training and Audio-Visual media Creating their interests in the
Internet, making information easily accessible and in a form that is appealing to them are other
challenges that the HIN needs to carefully address.
Access to Internet was highest among administrators and researchers (75%) followed by private
doctors (53%). government doctors (24%) and paramedical staff (5%) All categories of respondents
mentioned "insufficient computer skills” as a barrier to accessing the Internet. That information
indicated the need for training and for online help in troubleshooting. Some of the problems like files
getting corrupted. Virus attacks, hardware problems, which they arc likely to face in the initial stages
would discourage them from using computers. In addition respondents would face other problems like
“no time”, “poor connectivity”, “information being of quality7” etc. which would be their other reasons
for not accessing the Internet.
The HIN would be able to address the issue of connectivity and content quality. But how will rt
address the issue of doctors being able allocate some time to seek information? For government
doctors, accessing information might have to be built into their regular duties, like attending meetings
and sending reports, if it has to get any attention in their busy schedule.
40
HIN India
To the question “whether the Internet will benefit in tlieir work'; the response was overwhelmingly
positive (89%). Benefits listed were common across all categories of respondents, which were getting
new information, more information and being able to interact with colleagues and experts mainly m
the context of diagnosis and treatment. This data suggests that beneficiaries of HIN might find
facilities like e-mail, Chat rooms, and discussion-boards, very useful. Currently most of their
interaction is within their organization - with supervisors, patients and colleagues. Their interaction
w ith outside experts is rather low, expect in case of administrators. With HIN they should expect to
increase interaction with outside experts, especially with research institutions. Initially, HIN might
have to make special efforts to structure such interactions. These could include visits to research
institutions, visits by researchers, researchers answering questions posed by practitioners, as well as
promoting interaction between researchers, administrators and practitioners through email and bulletin
board. The last suggestion of course assumes beneficiaries' e-readiness and comfort in accessing
information, sending queries and participating in e-discussion.
Our e-rcadincss assessment however, indicated that only 50% Institutions have potential users with
some skills in using computers but almost no skill in using internet. The other 50 percent have no staff
with any computer skill at all. This finding implies that the project must have an intensive training
component as well as capacity to provide on-line help to users to solve problems as and when they
arise.
Considering various site conditions and interest shown by staff at various sites, we selected six health
institutions in Bangalore rural district and five in Dcogarh district as potential HIN Pilot sites. Their
current status in terms of physical infrastructure, skills and availability of equipment as shown belov%
would help HIN managers to identify physical input that the project needs to provide to initiate the
Pilot phase.
41
t
HIN India
Table B: E-readiness parameters by category of proposed sites
*-
8 c
G
c:
□cz
Kanakapura
taluk
hospital
Doddamaral
awar -HC
Sathnur
PHC
Bidadi CHC
Tubagerc
PHC
Doddahcjjaj
i PHC
District
health
office,
Deogarh__
Barkotc
CHC
Bamparda
PHC
Tileibani
PHC
Chttabar
PHC
s
<L>
CX
E
H
I
5 I** 8
Q 5
E
o
p
o
C
“O
<z>
>> §
2
•r
y co
.a 'L*
O
O
Vj
b to
O GJ
2
« - s I
O ct
U h
Z
No
respons
c______
x
o
o c
o
C
o
C
o
C5
Q-.S .ti
E .5 o
o
Q
LU o
-o
o
Ln
%
ex
Ct
H
Y
Frequent
Frequent
Y
Y
2
x
M
N
Occasional
Frequent
N
Y
0
x
H
Y
Rare
Frequent
N
Y
0
X
Z
M
N
Never
Frequent
N
Y
0
x
No
respons
e______
Z
H
Y
Never
Frequent
N
Y
0
x
X
Z
M
N
Frequent
Occasional
N
Y
0
x
x
L
Y
Rare
Rare
N
L
Y
Occasional
Occasional
N
Y
0
X
L
Y
Rare
Rare
N
Y
0
x
Z
L
Y
Occasional
Occasional
N
Y
1
x
T*
Z
L
Y
Occasional
Occasional
N
Y
0
x
! x
Z
X
2
I*
T
X
1
Though 5 out of 12 sites have no “dust free” environment and all sites reported moderate to high
temperature, none of the sites need physical alterations to control dust and reduce heat. Instead hand
held vacuum cleaner should be provided at each site to keep computers clean. Air conditioners are
also not necessary since currently available do not need air conditioners except for keeping the
equipment dust free. That role could be played by dust covers, equally well and cheaply.
Our e-readiness assessment also showed that all sites were having electricity problem. Especially in
Bangalore rural, electricity outage is a common occurrence.
That would affect the access time for
Internet and would frequently corrupt drivers. That problem could be solved by installing UPS
I
(Uninterrupted Power Supply) system at each site with a 2-3 hours backup supply of power using
42
HIN India
truck batteries. This whole equipment may cost around Rs.10000/- and would be much cheaper to
operate than having generators.
At most sites, telephone lines needs to be installed since only 3 out of 12 sites presently have
telephones. Getting telephone connections in Bangalore rural might not be difficult and could be done
quickly with the help of state government. However, at the five sites in Orissa, we understand that
telephone lines might not be possible and therefore would need VS AT links.
VSAT (Very Small Aperture Terminal) refers to receive/transmit terminals installed at dispersed sites
connected to a central hub via satellite using ^raail diameter antenna dishes (0.6 to 3.8 meter). VS AT
teclinology' represents a cost-effective solution for users seeking an independent communications J
i
* «T'
_ -XS?.
.1-.
_ «
I network connecting a large number of geographically dispersed sites. VSAT networks offer value_______
r__ of
___supporting
vr _ the Internet,_ data, LAN.. voice/fax
'fax ,
i added satellite-based services
capable
provide
powerful,
dependable
private
and
public
network
communications
[
communications, and can j
**
’
_________ ___________:|
All sites in Bangalore rural should be provided with l()()-hour TCP/IP connection for a penod of 1
year. So that unnecessary' usage of Internet connection will be restricted. All these sites can dial
Internet provider's number locally. But in case of Dcogarh district there is no Internet service provider
company at the moment, except in Sambhalpur. which is around 100 Km away from Dcogarh.
Therefore one would have to dial a STD code to connect to Internet. For this reason also, health
institutions in Dcogarh district need to be provided with VSAT links.
Oniv 2 sites (Kanakapura taluk hospital and District Tuberculosis Office) situated in Bangalore city,
have training facility’ in the vicinity. One is a small private training institute and the other is a branch
of Aptcch Computer Education. They charge about Rs. 1000 per person for basic trainmg in computer
I
but would provide no support afterwards. Therefore, training contract might be given to NIC, which
is a GOl department and has presence in all districts. NIC could provide support sendees after the
training.
Basic training course should include Windows OS, Use of MS-Word and Internet, Email. This
training would require about 40 hours or one wzeek. Since PHC staff cannot afford to give one full
week for this training, the training period may have to spread over 2-3 weeks.
Of the 12 sites selected for HIN implementation, only two (District Tuberculosis Office in Karnataka
and Deogarh) have computers. The remaining ten need to be provided with new computers as a first
step in developing their e-readiness. Computer Training should ideally take place after installing these
computes so that the staffs get hand-on training on their own systems and there would not long gaps
between training and actual use of the system.
43
i
APPENDIX A: Interview Schedules
(1) Program Administrators
Health Information Needs assessment for Health Inter-Network
Interview schedule for Program Administrators
WHO is initiating a survey to assess information needs related to TB, tobaccorelated diseases and other public health problems among government health care
providers, policy makers as well as private health care providers. Findings from this
survey will be used to develop an interactive website (portal) on a pilot- basis in an
attempt to address information needs of health care providers.
We would be grateful if you can kindly give your consent to be interviewed as part of
the survey. Information you give will be kept confidential and used only for research
purpose.
I. General Information
Name (in capitals):
Age (in years):
Sex (Male=M; Female=F):
(Ref. Appendix B - Table 2)
(Ref. Appendix B - Table 2.1)
Office address:
Phone:
Pager/Mobile:
Fax:
Email:
Residence address:
(Optional)
Phone:
Pager/Mobile:
Fax:
Email:
II. Employment
1. a. Qualification:
b. Designation:
(Ref. Appendix B - Table 2.2)
2. Which of the following categories best describes your main area of work? (Mention as many)
Health service provision (patient care & services)
Research (including academics)
Policy-making (including administration and management)
Others (specify)
1
2
3
4
(Ref. Appendix B - Table 3)
F:\ALKA\DOC\hm\APP A7.DOC
1
3. What is the level at which you mainly work? (Mention as many)
International
National
Regional
State
District/community
1
2
3
4
5
(Ref. Appendix B - Table 2.3)
4. How many years have you been in Government service?
(Ref. Appendix B - Table 4)
5. How many years have you been working in the present capacity?
(Ref. Appendix B - Table 5)
III. About Tuberculosis
6. How do you perceive tuberculosis as a problem? (Multiple response)
1
2
3
4
9
A problem under control
A major public health problem
A minor health problem
A resurgent problem
Don’t know
(Ref. Appendix B - Table 7)
7. How much do you think India contributes to the total global tuberculosis burden?
(Ref. Appendix B - Table 7.1, 7.2)
8. Is TB still a killer disease and why? (Yes=Y; No=N; Don’t know-D)
(Ref. Appendix B - Table 7.1, 8, 8.1, 8.2)
9. About how many patients die in a year of TB in India?
(Ref. Appendix B - Table 7.3)
10. How many TB patients are on treatment in your institution / jurisdiction?
(Ref. Appendix B - Table 6.3)
11. What guidelines are being followed to manage T. B. cases?
NTCP
RNTCP
Text-book guidelines
Others (specify)
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 10)
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2
12. Have you heard of Directly Observed Treatment Short-course (DOTS)? (Yes-Y; No-N)
(Ref. Appendix B - Table 11)
13. If yes, from where did you hear about it? (You may select more than one source listed
below).
A
B
C
D
E
F
G
Medical text books
Medical journals
Colleagues
Training/ orientation programme
Mass media
Internet
Any others (specify)
(Ref. Appendix B - Table 11)
14. What are the salient features of DOTS? (Multiple response)
a. Diagnosis by
X-ray
Sputum microscopy
Clinical
Mantoux test
Others (specify)
Don’t know
1
2
3
4
5
9
(Ref. Appendix B - Table 11.1)
b. Mode of treatment
Drugs are supplied once a month
Drugs are supplied once a week
Each dose given under direct observation
Don’t know
(Ref. Appendix B - Table 11.2)
c. Follow up T. B. patient’s progress by
Clinical progress
X ray progress
Sputum microscopy
Don’t know
(Ref. Appendix B - Table 11.4)
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1
2
3
9
1
2
3
9
15. Does this program face any problems? (Yes-Y; No-N)
a. If yes, mention them.
Drugs
Reagents for sputum examination
X-ray plates
Staff availability
Patient cooperation
Others (specify)
Can’t say
1
2
3
4
5
6
9
(Ref. Appendix B - Table 12)
16. Do you know on what basis the guidelines for T. B. control program have been developed?
(Ref. Appendix B - Table 37, 37.1)
17. How is the progress of T. B. control program monitored?
No. of new sputum positive patients on treatment 1
No. of patients on treatment
2
Sputum negative at the end of intensive phase (IP) 3
4
Smear positive : smear negative ratio
5
Cure at the end of treatment
6
Number of defaulters
7
Others (specify) ______________
9
Don’t know
(Ref. Appendix B - Table 13)
18. Do you feel the current Government policy for TB management (DOTS) will be effective in
controlling TB? (Yes=Y; No=N; Don’t know=D)---------------------(Ref. Appendix B - Table 11.6)
a. If no, why? Give your opinion.
(Ref. Appendix B - Table 15, 15.1)
19. What would be your suggestion to improve the policy of TB management?
Use x-ray for all patients
Use daily treatment
Individualized case management
Others (specify)
Can’t say
1
2
3
4
9
(Ref. Appendix B - Table 15, 15.1)
20. Would you like to have more information on TB? (Yes=Y; No=N)
(Ref. Appendix B - Table 16.1)
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4
a. If yes, what information do you need? Specify.
(Ref. Appendix B - Table 18, 18.1)
21. Do you use tobacco in any form? Yes
No
(Ref. Appendix B - Table 20)
22. If no, have you ever used in the past? Yes
No
(Ref. Appendix B - Table 20)
23. Have you or anyone in your close family ever suffered from TB? Yes No
(Ref. Appendix B - Table 20)
IV. About Tobacco Related Diseases
24. Do you think Tobacco use is a major public health problem in India? (Yes-Y; No-N)
(Ref. Appendix B - Table 21)
25. Do you know how many people die globally due to Tobacco related illnesses? (Yes=Y;
No=N) __________
a. If yes, how many?
(Ref. Appendix B - Table 21.1)
26. Are you aware of different forms of Tobacco use in India? (Yes-Y; No-N)
a. If yes, what are they?
Gutkha
Pan Masala
Mava
Snuff
Khaini
Betal leaf with Tobacco
Areca nut
Cigarette
Beedi
Others (specify)
1
2
3
4
5
6
7
8
9
10
(Ref. Appendix B - Table 22)
27. What are the diseases attributed to Tobacco use? Mention 5 most important diseases.
(Ref. Appendix B - Table 23, 23.1)
28. Do you feel doctors could play an important role in reducing Tobacco use? (Yes=Y; No=N)
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5
29. What role do you think they are playing or could play?
(Ref. Appendix B - Table 26, 26.1)
30. What information you would like to have about tobacco-use?
Types of tobacco use
Health effects of different types of tobacco use
Advice about cessation
Passive smoking
Effect on women and children
Effect of advertisement
Problem of agriculture and employment
(Ref. Appendix B - Table 18.2)
31. What can government do to combat the Tobacco-use problem?
Ban on advertisements
No smoking in public places
Increased taxes on tobacco products
Stronger warnings on tobacco products
Ban on sale near schools
Others (Specify)
32. Do you think government policy of restricting Tobacco advertisement would have impact on
use of Tobacco in the country? (Yes=Y; No=N)
a. What do you think will have impact on tobacco use in this country?
(Ref. Appendix B - Table 26.2, 26.3)
33. Have you received / issued any Government letter regarding use of tobacco? (Yes-Y;
No=N)
(Ref. Appendix B - Table 27.5)
34. Do you think providing people more information regarding ill effects of Tobacco-use will help
reduce Tobacco-use in community? (Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
35. In your opinion, at what age people start using Tobacco?
a. Male
b. Female
(Ref. Appendix B - Table 27, 27.1)
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6
36. To what extent parents can help in preventing children using Tobacco?
To a large extent
To some extent
Not at all
Don’t know / Can’t say
1
2
3
9
(Ref. Appendix B - Table 27.2)
37. What can you do to prevent children from using Tobacco?
(Ref. Appendix B - Table 27.3, 27.4)
38. Do you know of any study on how to reduce tobacco use in a community? (Yes=Y; No-N)
(Ref. Appendix B - Table 16.2)
a. If yes, please give details.
(Ref. Appendix B - Table 27.7)
39. Would you like to get such information? (Yes=Y; No=N)
(Ref. Appendix B - Table 16.3)
V. Other Public health Problems
40. What are the most important public health topics for your work?
Maternal & infant health
Child & adolescent health
Reproductive health
Adult health
Gender & health
Health & the elderly
Migrant & refugee health
Acute respiratory infections/
Pneumonia
• Diarrhoeal diseases
• HIV/AIDS
• Malaria
• Mental health
• Tobacco use
• Tuberculosis
• Infectious disease
• Vector-borne, parasitic & tropical
disease
• Non-communicable / chronic
disease
• Disabilities
• Eye diseases & blindness
• Oral health
•
•
•
•
•
•
•
•
F\ALKA\Da?\hin\APP A7.DOC
Substance abuse
Blood safety
Violence & injuries
Health information systems & tools
Medical & laboratory technology
Pharmaceuticals, vaccines, &
biologicals
• Intersectoral public health topics
• Development & health
• Environment & health
• Ethics & health
• Globalization & health
• Health economics & financing
• Human rights & health
• Information sciences and health
• Nutrition & food safety
• Occupational health
• Public / media relations & health
• Travel & health
• Water resources & sanitation
• Zoonoses & veterinary health
• Primary & community health
• Prevention & control of disease
•
•
•
-•
•
•
7
•
•
•
•
•
•
•
•
•
•
•
Surveillance & reporting
Epidemiology & statistics
Treatment & healthcare
Diagnostics
Drug information
Surgery & anesthesia
Rehabilitation
Emergency response in health
Traditional / alternative medicine
Research methods
Evidence-based policy & practice
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•
•
•
•
•
•
•
•
•
•
Health policy & legislation
Health systems
Capacity building & sustainability
Management and administration
Program planning & evaluation
Medical sciences
Nursing and midwifery
Allied health disciplines
Professional/continuing education
Others (specify)
8
41. What do you find to be the most useful source of information in the following categories?
Source of
information
Books (manuals,
text & reference)
Databases &
indexes
Awareness
in general
Awareness in
your area of
expertise
In depth
information in
your area of
expertise
In depth
information outside
your area of
expertise
n
□
□
n
Journals & scientific
publications_______
Meetings and
meeting
proceedings______
Print news services
(papers, magazines)
Regular reporting
and briefings______
Technical guidelines
& fact sheets______
Television & radio
n
□
□
□
Librarians and
reference services
Colleagues/ experts
in your organization
Colleagues/ experts
outside your
organization______
If any other, specify.
□
□
□
□
□
□
(Ref. Appendix B - Table 29, 29.1, 29.2, 29.3)
42. What is your preferred language for the following categories of information?
Awareness in general
Awareness in your area of expertise
In depth information in your area of expertise
In depth information outside your area of expertise
(Ref. Appendix B - Table 29.4, 29.5, 29.6, 29.7)
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9
i i
43. What are the main difficulties you experience related to information in the following
categories? (Check as many)
Awareness
information in
general
In depth
information in
your area of
expertise
Awareness
information in
your area of
expertise
In depth
information
outside your
area of
expertise
No difficulty
Difficult to get
Don't know where
to find_________
Difficult to use
Expensive
Poor quality
Irregular
Not up to date
Not relevant to
local situation
Not in prefered
langueage
If any other,
specify:
(Ref. Appendix B - Table 30, 30.1, 30.2, 30.3)
44. With whom is communication important for your work? (Mention as many)
Superior
1
Colleagues or experts within your organization
2
Experts outside your organization
3
Directly with patients
4
Directly with general public
5
Funding / donor agencies
6
Press / mass media / advocacy groups
7
Others (specify)
,
8
(Ref. Appendix B-Table 31)
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10
45. Do you need new information related to your work? (Yes-Y; No-N)
a. If yes, in what form would you like to have such information?
Electronic media such as Internet, email
Newsletters or fact sheets
Verbally from colleagues and experts
Scientific journals
AV media such as CD, DVD
Magazines and newspapers
Others (specify)
(Ref. Appendix B - Table 32)
46. Are you aware of any website giving health information? (Yes-Y; No N)
a. If yes, please mention.
(Ref. Appendix B - Table 34.2, 34.3)
47. How do you most commonly use new information?
Support diagnosis and treatment
1
Include in articles / books
9
Make policy / program decisions
2
Adapt and distribute for local use
10
Advise decision / policy makers
3
Develop health education material
11
Modify treatment protocol
4
Circulate to colleagues
12
Respond to emergencies
5
Find more information on the topic
13
Prepare grant / funding proposals
6
File for later reference
14
Issue press releases
7
Others (specify)
15
Use in lectures / presentations
8
(Ref. Appendix B - Table 33)
VI. Access to Internet
48. Do you have access to the Internet?
No
Yes - at home
Yes - at an Internet cafe
Yes - at work
Yes - at home and work
Yes - others (specify)
1
2
3
4
5
6
(Ref. Appendix B - Table 34)
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11
49. a. During the last one-month, how many times did you access the Internet?
1
2
3
4
5
6
7
0
1-2
3-4
5-6
7-8
9-10
11 +
(Ref. Appendix B - Table 34.1)
b. What kinds of sites / information do you access on the Internet?
None
1
Information related to the present work
2
Non-work related information
3
General knowledge
4
New information
5
Entertainment matters
6
Others (specify)
7
(Ref. Appendix B - Table 34.4)
50. What barriers do you face in using the Internet? (Mention up to 3 in total from the following
lists)
Physical barriers
Resource / skill barriers
10
Don’t have the time
1
Electricity outages / interruptions
Insufficient skills for computer use
2
Internet connection in inconvenient
Insufficient skills for Internet use
3
location
11
Very costly
4
Slow Internet connection
12
Telephone line problems
13
No barriers at all
14
Others (specify)
15
Barriers related to Internet content
Local censorship issues
5
Not in preferred language
6
Too much information
7
Uneven quality of information
8
(Ref. Appendix B - Table 35)
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12
51. a. Do you think having access to the Internet will help you in your work?
Yes
No
Not sure
1
0
9
b. If yes, list up to 3 key ways in which you think access to the Internet would help your
work.
(>)
(ii)
(iii)
(Ref. Appendix B - Table 36, 36.1)
Name of investigator
Date
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Signature of investigator
13
(2) Researchers - Faculty members
Health Information Needs assessment for Health Inter-Network
Interview schedule for Researchers - Faculty members
WHO is initiating a survey to assess information needs related to TB, tobaccorelated diseases and other public health problems among government health care
providers, policy makers as well as private health care providers. Findings from this
survey will be used to develop an interactive website (portal) on a pilot- basis in an
attempt to address information needs of health care providers.
We would be grateful if you can kindly give your consent to be interviewed as part of
the survey. Information you give will be kept confidential and used only for research
purpose.
I. General Information
Name (in capitals):
Age (in years):
Sex (Male=M; Female=F):
(Ref. Appendix B - Table 2)
(Ref. Appendix B - Table 2.1)
Office address:
Phone:
Pager/Mobile:
Fax:
Email:
Residence address:
(Optional)
Phone:
Pager/Mobile:
Fax:
Email:
II. Employment
1. a. Qualification:
b. Designation:
(Ref. Appendix B - Table 2.2)
2. Which of the following categories best describes your main area of work? (Mention as many)
Health service provision (patient care & services)
Research (including academics)
Policy-making (including administration and management)
Others (specify)
1
2
3
4
(Ref. Appendix B - Table 3)
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14
3. What is the level at which you mainly work? (Mention as many)
International
National
Regional
State
District/community
1
2
3
4
5
(Ref. Appendix B - Table 2.3)
4. How many years have you been in service?
(Ref. Appendix B - Table 4)
5. How many years have you been working in the present capacity?
(Ref. Appendix B - Table 5)
III. About Tuberculosis
6. How do you perceive tuberculosis as a problem? (Multiple response)
1
2
3
4
9
A problem under control
A major public health problem
A minor health problem
A Resurgent problem
Don’t know
(Ref. Appendix B - Table 7)
7. How much do you think India contributes to the total global tuberculosis burden?
(Ref. Appendix B - Table 7.1, 7.2)
8. Is TB still a killer disease and why? (Yes=Y; No=N; Don’t know=D)
(Ref. Appendix B -Table 7.1, 8, 8.1, 8.2)
9. About how many patients die in a year of TB in India?
(Ref. Appendix B - Table 7.1, 7.3)
10. How many TB patients are on treatment in your institution?
(Ref. Appendix B - Table 6.3)
11. What guidelines do you think your hospital is following to manage T. B. cases?
NTCP
RNTCP
Text-book guidelines
Others (specify)
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 10)
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15
12. Have you heard of Directly Observed Treatment Short-course (DOTS)? (Yes-Y; No-N)
(Ref. Appendix B - Table 11)
13. If yes, from where did you hear about it? (You may select more than one source listed
below).
A
B
C
D
E
F
G
Medical text books
Medical journals
Colleagues
Training/ orientation program
Mass media
Internet
Any others (specify)
(Ref. Appendix B - Table 11)
14. What are the salient features of DOTS? (Multiple response)
a. Diagnosis by
X-ray
Sputum microscopy
Clinical
Mantoux test
Others (specify)
Don’t know
1
2
3
4
5
9
(Ref. Appendix B - Table 11.1)
b. Mode of treatment is that
Drugs are supplied once a month
Drugs are supplied once a week
Each dose given under direct observation
Don’t know
1
2
3
9
(Ref. Appendix B - Table 11.2)
c. Follow-up of patient’s progress
Clinical progress
X ray progress
Sputum microscopy
1
2
3
(Ref. Appendix B - Table 11.4)
15. What is the basis on which guidelines forT. B. control program have been developed?
(Ref. Appendix B - Table 37, 37.1)
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16
16. HowT. B. control program is being monitored?
No. of new sputum positive patients on treatment 1
No. of patients on treatment
2
Sputum negative at the end of intensive phase (IP)3
4
Smear positive : smear negative ratio
5
Cure at the end of treatment
6
Number of defaulters
7
Others (specify)
9
Don’t know
(Ref. Appendix B - Table 13)
17. Do you feel the current Government policy for TB management (DOTS) would be
effective in controlling TB? (Yes=Y; No=N)
(Ref. Appendix B - Table 11.6)
a. What is your suggestion to improve that policy?
1
2
3
4
9
Use x-ray for all patients
Use daily treatment
Individualized case management
Others (specify)
Can’t say
(Ref. Appendix B - Table 15, 15.1)
b. On what basis are you making these suggestions?
(Ref. Appendix B - Table 15.2)
18. Would you like to have more information on TB? (Yes=Y; No=N)
(Ref. Appendix B - Table 16.1)
a. If yes, what information do you need?
(Ref. Appendix B - Table 18, 18.1)
19. Which medical journal do you have access to?
(Ref. Appendix B - Table 19, 19.1)
20. Do you use tobacco in any form? Yes
No
(Ref. Appendix B - Table 20)
21. If no, have you ever used in the past? Yes
No
(Ref. Appendix B - Table 20)
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17
22. Have you or anyone in your close family ever suffered from TB? Yes No
(Ref. Appendix B - Table 20)
IV. About Tobacco Related Diseases
23. Do you think Tobacco use is a major public health problem in India? (Yes=Y; No-N)
(Ref. Appendix B - Table 21)
24. Do you know how many people die globally due to Tobacco related illnesses? (Yes=Y;
No=N)
a. If yes, how many?
(Ref. Appendix B - Table 21.1)
25. Are you aware of different forms of Tobacco use in India? (Yes=Y; No=N)
a. If yes, what are they?
Gutkha
Pan Masala
Mava
Snuff
Khaini
Betal leaf with Tobacco
Areca nut
Cigarette
Beedi
Others (specify)
1
2
3
4
5
6
7
8
9
10
(Ref. Appendix B - Table 22)
26. What are the diseases attributed to Tobacco use? Mention 5 most important diseases.
(Ref. Appendix B - Table 23, 23.1)
27. Do you feel doctors could play an important role in reducing Tobacco use? (Yes=Y; No=N)
28. What role do you think they are playing or could play?
(Ref. Appendix B - Table 26, 26.1)
29. What information you would like to have about tobacco-use?
Types of tobacco use
Health effects of different types of tobacco use
Advice about cessation
Passive smoking
Effect on women and children
Effect of advertisement
Problem of agriculture and employment
(Ref. Appendix B - Table 18.2)
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18
30. What can government do to combat the Tobacco-use problem?
Ban on advertisements
No smoking in public places
Increased taxes on tobacco products
Stronger warnings on tobacco products
Ban on sale near schools
Others (Specify)
31. Do you think government policy of restricting Tobacco advertisement would have impact on
use of Tobacco in the country? (Yes=Y; No=N)
a. What in your opinion will have impact on tobacco use in this country?
(Ref. Appendix B - Table 26.2, 26.3)
32. Do you think providing people more information regarding ill effects of Tobacco-use will help
reduce Tobacco-use in community? (Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
33. In your opinion, at what age people start using Tobacco?
a. Male
b. Female
(Ref. Appendix B - Table 27, 27.1)
34. To what extent parents can help in preventing children using Tobacco?
To a large extent
To some extent
Not at all
Don’t know / Can’t say
1
2
3
9
(Ref. Appendix B - Table 27.2)
35. Do you know about any study on how to reduce tobacco use in a community? (Yes=Y;
No=N)
(Ref. Appendix B - Table 16.2)
a. If yes, please give details.
(Ref. Appendix B - Table 27.7)
36. Would you like to get such information? (Yes=Y; No-N)
(Ref. Appendix B - Table 16.3)
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19
i
V. Other Public health Problems
37. What are the most important public health topics for your work?
Maternal & infant health
Child & adolescent health
Reproductive health
Adult health
Gender & health
Health & the elderly
Migrant & refugee health
Acute respiratory infections/
Pneumonia
Diarrhoeal diseases
HIV/AIDS
Malaria
Mental health
Tobacco use
Tuberculosis
Infectious disease
Vector-borne, parasitic & tropical
disease
Non-communicable / chronic
disease
Disabilities
Eye diseases & blindness
Oral health
Substance abuse
Blood safety
Violence & injuries
Health information systems & tools
Medical & laboratory technology
Pharmaceuticals, vaccines, &
biologicals
Intersectoral public health topics
Development & health Environment & health
Ethics & health
Globalization & health
Health economics & financing
Human rights & health
Information sciences and health
Nutrition & food safety
Occupational health
Public / media relations & health
Travel & health
Water resources & sanitation
Zoonoses & veterinary health
Primary & community health
Prevention & control of disease
Surveillance & reporting
Epidemiology & statistics
Treatment & healthcare
Diagnostics
Drug information
Surgery & anesthesia
Rehabilitation
Emergency response in health
Traditional / alternative medicine
Research methods
Evidence-based policy & practice
Health policy & legislation
Health systems
Capacity building & sustainability
Management and administration
Program planning & evaluation
Medical sciences
Nursing and midwifery
Allied health disciplines
Professional/continuing education
Others (specify)_____________
(Ref. Appendix B - Table 28)
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20
38. What do you find to be the most useful source of information in the following categories?
Source of
information
Books (manuals,
text & reference)
Databases &
indexes
Journals & scientific
publications_______
Meetings and
meeting
proceedings______
Print news services
(papers, magazines)
Regular reporting
and briefings______
Technical guidelines
& fact sheets______
Television & radio
Librarians and
reference services
Colleagues/ experts
in your organization
Colleagues/ experts
outside your
organization______
If any other, specify:
Awareness
in general
Awareness in
your area of
expertise
n
In depth
information in
your area of
expertise
In depth
informatibn outside
your area of
expertise
□
□
□
n
n
n
□
□
□
□
□
□
□
n
□
□
n
□
□
□
n
□
n
n
□
n
(Ref. Appendix B - Table 29, 29.1, 29.2, 29.3)
39. What is your preferred language for the following categories of information?
Awareness in general
Awareness in your area of expertise
In depth information in your area of expertise
In depth information outside your area of expertise
(Ref. Appendix B - Table 29.4, 29.5, 29.6, 29.7)
F:\ALKA\DOC\hin\APP A7.DOC
21
40. What are the main difficulties you experience related to information in the following
categories? (Check as many)
Awareness
information in
general
Awareness
information in
your area of
expertise
In depth
information in
your area of
expertise
In depth
information
outside your
area of
expertise
No difficulty
Difficult to get
Don't know where
to find_________
Difficult to use
Expensive
Poor quality
Irregular
Not up to date
Not relevant to
local situation
Not in prefered
langueage
If any other,
specify:
(Ref. Appendix B - Table 30, 30.1, 30.2, 30.3)
41. With whom is communication important for your work? (Mention as many)
Superior
1
Colleagues or experts within your organization
2
Experts outside your organization
3
Directly with patients
4
Directly with general public
5
Funding / donor agencies
6
Press / mass media / advocacy groups
7
Others (specify)
8
(Ref. Appendix B - Table 31)
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22
42. Do you need new information related to your work? (Yes-Y; No-N)
a. If yes, in what form would you like to have such information?
Electronic media such as Internet, email
Newsletters or fact sheets
Verbally from colleagues and experts
Scientific journals
AV media such as CD, DVD
Magazines and newspapers
__
Others (specify)
(Ref. Appendix B - Table 32)
43. Are you aware of any website giving health information? (Yes=Y; No=N)
a. If yes, please mention.
(Ref. Appendix B - Table 34.2, 34.3)
44. How do you most commonly use new information?
Support diagnosis and treatment
1
Include in articles / books
9
Make policy / program decisions
2
Adapt and distribute for local use
10
Advise decision / policy makers
3
Develop health education material
11
Modify treatment protocol
4
Circulate to colleagues
12
Respond to emergencies
5
Find more information on the topic
13
Prepare grant / funding proposals
6
File for later reference
14
Issue press releases
7
Others (specify)
15
Use in lectures / presentations
8
(Ref. Appendix B - Table 33)
VI. Access to Internet
45. Do you have access to the Internet?
No
Yes - at home
Yes - at an Internet cafe
Yes - at work
Yes - at home and work
Yes - others (specify)
1
2
3
4
5
6
(Ref. Appendix B - Table 34)
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23
46. a. During the last one-month, how many times did you access the Internet?
0
1-2
3-4
5-6
7-8
9-10
11 +
1
2
3
4
5
6
7
(Ref. Appendix B-Table 34.1)
b. What kinds of sites / information do you access on the Internet?
None
1
Information related to the present work
2
Non-work related information
3
General knowledge
4
New information
5
Entertainment matters
6
Others (specify)
7
(Ref. Appendix B - Table 34.4)
47. What barriers do you face in using the Internet? (Mention up to 3 in total from the following
lists)
Resource / skill barriers
Physical barriers
Don’t have the time
1
Electricity outages / interruptions
Insufficient skills for computer use
2
Internet connection in inconvenient
Insufficient skills for Internet use
3
location
11
Very costly
4
Slow Internet connection
12
Barriers related to Internet content
Telephone line problems
13
No barriers at all
14
Others (specify)
15
Local censorship issues
5
Not in preferred language
6
Too much information
7
Uneven quality of information
8
10
(Ref. Appendix B - Table 35)
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24
48. a. Do you think having access to the Internet will help you in your work?
Yes
No
Not sure
1
0
9
b. If yes, list up to 3 key ways in which you think access to the Internet would help your
work.
(')
(ii)
(iii)
(Ref. Appendix B - Table 36, 36.1)
Name of investigator
Date
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Signature of investigator
25
(3) Government Medical Officers
Health Information Needs assessment for Health Inter-Network
Interview schedule for Government Medical Officers
WHO is initiating a survey to assess information needs related to TB, tobaccorelated diseases and other public health problems among government health care
providers, policy makers as well as private health care providers. Findings from this
survey will be used to develop an interactive website (portal) on a pilot- basis in an
attempt to address information needs of health care providers.
We would be grateful if you can kindly give your consent to be interviewed as part of
the survey. Information you give will be kept confidential and used only for research
purpose.
I. General Information
Name (in capitals):
Age (in years):
Sex (Male=M; Female=F):
(Ref. Appendix B - Table 2)
(Ref. Appendix B - Table 2.1)
Office address:
Phone:
Pager/Mobile:
Fax:
Email:
Residence address:
(Optional)
Phone:
Pager/Mobile:
Fax:
Email:
II. Employment
1. a. Qualification:
b. Designation:
(Ref. Appendix B - Table 2.2)
2. Which of the following categories best describes your main area of work? (Mention as many)
Health service provision (patient care & services)
Research (including academics)
1
2
Policy-making (including administration and management)
3
4
Others (specify)
(Ref. Appendix B - Table 3)
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26
3. What is the level at which you mainly work? (Mention as many)
International
National
Regional
State
District/community
1
2
3
4
5
(Ref. Appendix B - Table 2.3)
4. How many years have you been in Government service?
(Ref. Appendix B - Table 4)
5. Do you practice outside the working hours? (Yes=Y; No=N)
(Ref. Appendix B - Table 38)
6. If so, since how many years?
(Ref. Appendix B - Table 38)
7. How many patients do you see on an average, per day?
(Ref. Appendix B - Table 6)
8. What percent of your patients belong to
Lower SE class
Middle class
Upper class
(Ref. Appendix B - Table 6.1)
III. About Tuberculosis
9. How do you perceive tuberculosis as a problem? (Multiple response)
A problem under control
A major public health problem
A minor health problem
A Resurgent problem
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 7)
10. How much do you think India contributes to the total global tuberculosis burden?.
(Ref. Appendix B - Table 7.1, 7.2)
11. Is TB still a killer disease and why? (Yes=Y; No=N; Don’t know=D)
(Ref. Appendix B - Table 7.1, 8, 8.1, 8.2)
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27
12. About how many patients die in a year of TB in India?
(Ref. Appendix B-Table 7.1, 7.3)
13. Do you treat any Tuberculosis patients? (Yes=Y; No=N)
(Ref. Appendix B - Table 6.2)
14. How many TB patients are under your care now?
(Ref. Appendix B - Table 6.3)
15. When do you suspect TB?
(Ref. Appendix B - Table 9, 9.1)
16. What guidelines are you following to treat these patients?
1
2
National (NTCP /RNTCP) guidelines
Text-book guidelines
Own regimen
3
(Ref. Appendix B-Table 10)
17. Have you heard of Directly Observed Treatment Short-course (DOTS)? (Yes-Y; No-N)
(Ref. Appendix B - Table 11)
18. If yes, from where did you hear about it? (You may select more than one source listed
below).
Medical text books
Medical journals
Medical representative
Colleagues
CME programmes
RNTCP training/ orientation programme
Mass media
Internet
Any others (specify)
A
B
C
D
E
F
G
H
I
(Ref. Appendix B - Table 11)
19. What are the salient features of DOTS? (Multiple response)
a. Diagnosis by
X-ray
Sputum microscopy
Clinical
Mantoux test
Others (specify)
Don’t know
1
2
3
4
5
9
(Ref. Appendix B - Table 11.1)
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28
b. Mode of treatment
Drugs are supplied once a month
Drugs are supplied once a week
Each dose given under direct observation
Don’t know
1
2
3
9
(Ref. Appendix B - Table 11.2)
20. How do you follow up T. B. patient’s progress? (Multiple response)
Clinical progress
X ray progress
Sputum microscopy
1
2
3
(Ref. Appendix B - Table 11.4)
21. Do you face any problems with
a. Availability of drugs? (Yes=Y; No=N)
b. Availability of reagents for sputum examination? (Yes=Y; No=N)
c. X-ray referral? (Yes=Y; No=N)
(Ref. Appendix B - Table 12)
22. When do you stop treatment for the patient?
2 months after sputum conversion
3 months after sputum conversion
4 months after sputum conversion
5 months after sputum conversion
Sputum conversion at the end of the treatment
Clearance on chest X-ray
Don’t know
1
2
3
4
5
6
9
(Ref. Appendix B - Table 11.5)
23. How do you monitor T. B. program in your PHO? Select indicators that you use (Multiple
response)
No. of new sputum positive patients on treatment 1
No. of patients on treatment
2
Sputum negative at the end of intensive phase (IP)3
Smear positive : smear negative ratio
4
Cure at the end of treatment
5
Number of defaulters
6
Others (specify)
7
(Ref. Appendix B - Table 13)
24. How do you think, regular reporting by you helps in program management?
(Ref. Appendix B - Table 38.1)
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29
25. How frequently you are required to send your report?
Every month
Every quarter
Half yearly
Annually
1
2
3
4
(Ref. Appendix B - Table 14)
26. Do you feel the current Government policy for TB management (DOTS) will be effective in
controlling TB? (Yes=Y; No=N; Don’t know=D)
(Ref. Appendix B - Table 11.6)
a. If yes, would you be happy to use the same in your private practice? (Yes=Y; No-N)
(Ref. Appendix B - Table 11.6)
b. What is your suggestion to improve the policy?
1
2
3
4
9
Use x-ray for all patients
Use daily treatment
Individualized case management
Others (specify)
Can’t say
(Ref. Appendix B - Table 15, 15.1)
27. Do you have access to research / clinical information related to T. B. treatment? (Yes-Y;
No=N)
(Ref. Appendix B - Table 16)
28. If yes, specify the sources.
(Ref. Appendix B - Table 17, 17.1)
29. Do you require further information on TB? (Yes=Y; No-N)
(Ref. Appendix B - Table 16.1)
a. If yes, what information do you need?
Etiology of T. B.
How to prevent spread of T. B.?
How to motivate patients?
Others (specify)
1
2
3
4
(Ref. Appendix B - Table 18, 18.1)
30. Which medical journal do you have access to?
(Ref. Appendix B - Table 19, 19.1)
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30
31. Do you use tobacco in any form? (Yes=Y; No=N)
(Ref. Appendix B - Table 20)
32. If no, have you ever used in the past? (Yes=Y; No=N)
(Ref. Appendix B - Table 20)
33. Have you or anyone in your close family ever suffered from TB? (Yes=Y; No=N)
(Ref. Appendix B - Table 20)
IV. About Tobacco Related Diseases
34. Do you think Tobacco use is a major public health problem in India? (Yes=Y; No=N)
(Ref. Appendix B - Table 21)
35. Do you know how many people die globally due to Tobacco related illnesses? (Yes=Y;
No=N)
a. If yes, how many?
(Ref. Appendix B - Table 21.1)
36. Are you aware of different forms of Tobacco use in India? (Yes=Y; No=N)
a. If yes, what are they?
Gutkha
Pan Masala
Mava
Snuff
Khaini
Betal leaf with Tobacco
Areca nut
Cigarette
Beedi
Others (specify)
1
2
3
4
5
6
7
8
9
10
(Ref. Appendix B - Table 22)
37. What are the diseases attributed to Tobacco use? Mention 5 most important diseases.
(Ref. Appendix B - Table 23, 23.1)
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31
38. What is the component in Tobacco that is responsible for ill effects on health? (Multiple
response)
1
2
3
4
9
Nicotine
Tar
Smoke
Others (specify)
Don’t know / Can’t remember
(Ref. Appendix B - Table 24)
39. When you come across a patient smoking, do you tell him about ill-effects of
smoking?
Sometimes
Regularly
Rarely
Never
1
2
3
4
(Ref. Appendix B - Table 25)
40. Do you feel doctors could play an important role in reducing Tobacco use? (Yes-Y; No-N)
41. What role do you think they are playing or could play?
(Ref. Appendix B - Table 26, 26.1)
42. What information you would like to have about effects of tobacco-use on health?
Types of tobacco use
Health effects of different types of tobacco use
Advice about cessation
Passive smoking
Effect on women and children
Effect of advertisement
Problem of agriculture and employment
(Ref. Appendix B - Table 18.2)
43. How would you like the government to support you to deal with Tobacco abuse?
Ban on advertisements
No smoking in public places
Increased taxes on tobacco products
Stronger warnings on tobacco products
Ban on sale near schools
Others (Specify)
44. Do you think government policy of restricting Tobacco advertisement would have impact on
use of Tobacco in the country? (Yes=Y; No=N)
a. What in your opinion will have impact on tobacco use in this country?
(Ref. Appendix B - Table 26.2, 26.3)
32
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Imo
1 ‘
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p rx
45. Have you received any Government letter regarding use of tobacco? (Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
46. Do you have health education material related to anti-Tobacco use? (Yes=Y; No-N)
(Ref. Appendix B - Table 27.5)
If yes,
a. List the materials.
(Ref. Appendix B - Table 27.6)
b. Have you ever used these health education materials in the community?
(Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
47. Do you think giving information about bad effects of Tobacco will help community to reduce
use of Tobacco? (Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
48. At what age, do you think, people start using Tobacco?
a. Male
b. Female
(Ref. Appendix B - Table 27, 27.1)
49. To what extent parents can help in preventing children using Tobacco?
To a large extent
To some extent
Not at all
Don’t know / Can’t say
1
2
3
9
(Ref. Appendix B - Table 27.2)
50. What can you do to prevent children from using Tobacco?
(Ref. Appendix B - Table 27.3, 27.4)
51. Do you know any study on how to reduce tobacco use in a community? (Yes=Y; No=N)
(Ref. Appendix B - Table 16.2)
a. If yes, please give details.
(Ref. Appendix B - Table 27.7)
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33
52. Would you like to get such information? (Yes-Y; No-N)
(Ref. Appendix B - Table 16.3)
V. Other Public health Problems
53. What are the most important public health topics for your work?
Maternal & infant health
Child & adolescent health
Reproductive health
Adult health
Gender & health
Health & the elderly
Migrant & refugee health
Acute respiratory infections/
Pneumonia
Diarrhoeal diseases
HIV/AIDS
Malaria
Mental health
Tobacco use
Tuberculosis
Infectious disease
Vector-borne, parasitic & tropical
disease
Non-communicable / chronic
disease
Disabilities
Eye diseases & blindness
Oral health
Substance abuse
Blood safety
Violence & injuries
Health information systems & tools
Medical & laboratory technology
Pharmaceuticals, vaccines, &
biologicals
Intersectoral public health topics
Development & health
Environment & health
Ethics & health
Globalization & health
Health economics & financing
Human rights & health
Information sciences and health
Nutrition & food safety
Occupational health
Public / media relations & health
Travel & health
Water resources & sanitation
Zoonoses & veterinary health
Primary & community health
Prevention & control of disease
Surveillance & reporting
Epidemiology & statistics
Treatment & healthcare
Diagnostics
Drug information
Surgery & anesthesia
Rehabilitation
Emergency response in health
Traditional / alternative medicine
Research methods
Evidence-based policy & practice
Health policy & legislation
Health systems
Capacity building & sustainability
Management and administration
Program planning & evaluation
Medical sciences
Nursing and midwifery
Allied health disciplines
Professional/continuing education
Others (specify)__ ___________
(Ref. Appendix B - Table 28)
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34
54. What do you find to be the most useful source of information in the following categories?
Source of
information
Books (manuals,
text & reference)
Databases &
indexes
Journals & scientific
publications_______
Meetings and
meeting
proceedings______
Print news services
(papers, magazines)
Regular reporting
and briefings______
Technical guidelines
& fact sheets______
Television & radio
Awareness in
your area of
expertise
In depth
information in
your area of
expertise
In depth
information outside
your area of
expertise
□
□
□
□
□
n
o
□
□
Awareness
in general
□
□
Librarians and
□
reference services
Colleagues/ experts □
in your organization
Colleagues/ experts
outside your
organization______
If any other, specify.
n
□
□
□
□
□
□
□
n
□
n
□
□
□
□
□
□
□
□
□
n
□
□
(Ref. Appendix B - Table 29, 29.1, 29.2, 29.3)
55. What is your preferred language for the following categories of information?
Awareness in general
Awareness in your area of expertise
In depth information in your area of expertise
In depth information outside your area of expertise
(Ref. Appendix B - Table 29.4, 29.5, 29.6, 29.7)
F:\ALKA\DOC\hin'APP A7. DOC
35
56. What are the main difficulties you experience related to information in the following
categories? (Check as many)
Awareness
information in
general
Awareness
information in
your area of
expertise
In depth
information in
your area of
expertise
In depth
information
outside your
area of
expertise
No difficulty
Difficult to get
Don't know where
to find_________
Difficult to use
Expensive
Poor quality
Irregular
Not up to date
Not relevant to
local situation
Not in prefered
langueage
If any other,
specify:
(Ref. Appendix B - Table 30, 30.1, 30.2, 30.3)
57. With whom is communication important for your work? (Mention as many)
Superior
1
Colleagues or experts within your organization
2
Experts outside your organization
3
Directly with patients
4
Directly with general public
5
Funding / donor agencies
6
Press / mass media / advocacy groups
7
Others (specify)
________
8
(Ref. Appendix B - Table 31)
F:\AI.KA\DOC\hin\APP A7.DOC
36
58. Do you need new information related to your work? (Yes=Y; No=N)
a. If yes, in what form would you like to have such information?
Electronic media such as Internet, email
Newsletters or fact sheets
Verbally from colleagues and experts
Scientific journals
AV media such as CD, DVD
Magazines and newspapers
Others (specify)
(Ref. Appendix B - Table 32)
59. Are you aware of any website giving health information? (Yes=Y; No=N)
a. If yes, please mention.
(Ref. Appendix B - Table 34.2, 34.3)
60. How do you most commonly use new information?
Support diagnosis and treatment
1
Include in articles / books
9
Make policy / program decisions
2
Adapt and distribute for local use
10
Advise decision / policy makers
3
Develop health education material
11
Modify treatment protocol
4
Circulate to colleagues
12
Respond to emergencies
5
Find more information on the topic
13
Prepare grant / funding proposals
6
File for later reference
14
Issue press releases
7
Others (specify)
Use in lectures / presentations
8
15
(Ref. Appendix B - Table 33)
VI. Access to Internet
61. Do you have access to the Internet?
No
Yes - at home
Yes - at an Internet cafe
Yes - at work
Yes - at home and work
Yes - others (specify)
1
2
3
4
5
6
(Ref. Appendix B - Table 34)
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37
62. a. During the last one-month, how many times did you access the Internet?
1
2
3
4
5
6
7
0
1-2
3-4
5-6
7-8
9-10
11 +
(Ref. Appendix B - Table 34.1)
b. What kinds of sites / information do you access on the Internet?
None
1
Information related to the present work
2
Non-work related information
3
General knowledge
4
New information
5
Entertainment matters
6
Others (specify)
7
(Ref. Appendix B - Table 34.4)
63. What barriers do you face in using the Internet? (Mention up to 3 in total from the following
lists)
Physical barriers
Resource / skill barriers
10
Don’t have the time
1
Electricity outages / interruptions
Insufficient skills for computer use
2
Internet connection in inconvenient
Insufficient skills for Internet use
3
location
11
Very costly
4
Slow Internet connection
12
Telephone line problems
13
No barriers at all
14
Others (specify)
15
Barriers related to Internet content
Local censorship issues
5
Not in preferred language
6
Too much information
7
Uneven quality of information
8
(Ref. Appendix B - Table 35)
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38
64. a. Do you think having access to the Internet will help you in your work?
Yes
No
Not sure
1
0
9
b. If yes, list up to 3 key ways in which you think access to the Internet would help your
work.
(•)
(•')
(iii)
(Ref. Appendix B - Table 36, 36.1)
Name of investigator
Date
F:\ALKA\DOC\hin\APP A7.DOC
Signature of investigator
39
(4) Private Practitioners
Health Information Needs assessment for Health Inter-Network
Interview schedule for Private Practitioners
WHO is initiating a survey to assess information needs related to TB, tobaccorelated diseases and other public health problems among government health care
providers, policy makers as well as private health care providers. Findings from this
survey will be used to develop an interactive website (portal) on a pilot- basis in an
attempt to address information needs of health care providers.
We would be grateful if you can kindly give your consent to be interviewed as part of
the survey. Information you give will be kept confidential and used only for research
purpose.
I. General Information
Name (in capitals):
Age (in years):
Sex (Male=M; Female=F):
(Ref. Appendix B - Table 2)
(Ref. Appendix B - Table 2.1)
Office address:
Phone:
Pager/Mobile:
Fax:
Email:
Residence address:
(Optional)
Phone:
Pager/Mobile:
Fax:
Email:
II. Employment
1. a. Qualification:
b. Specialty:
(Ref. Appendix B - Table 2.2)
2. Which of the following categories best describes your main area of work? (Mention as many)
Health service provision (patient care & services)
Research (including academics)
Policy-making (including administration and management)
Others (specify)
1
2
3
4
(Ref. Appendix B - Table 3)
F:\ALKA\TX3C\hin\APP A7.DOC
40
3. What is the level at which you mainly work? (Mention as many)
International
National
Regional
State
District/community
1
2
3
4
5
(Ref. Appendix B - Table 2.3)
4. How many years have you been practicing?
(Ref. Appendix B - Table 4)
5. How many patients do you see on an average, per day?
(Ref. Appendix B - Table 6)
6. What percent of your patients belong to
Lower SE class
Middle class
Upper class
(Ref. Appendix B - Table 6.1)
III. About Tuberculosis
7. How do you perceive tuberculosis as a problem? (Multiple response)
A problem under control
A major public health problem
A minor health problem
A Resurgent problem
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 7)
8. How much do you think India contributes to the total global tuberculosis burden?
(Ref. Appendix B - Table 7.1, 7.2)
9. Is TB still a killer disease and why? (Yes=Y; No=N; Don’t know=D)
(Ref. Appendix B - Table 7.1, 8, 8.1, 8.2)
10. About how many patients die in a year of TB in India?
(Ref. Appendix B - Table 7.1,7.3)
11. Do you treat any Tuberculosis patients? (Yes=Y; No=N)
(Ref. Appendix B - Table 6.2)
F:\ALKA\DOCAhm\APP A7.DOC
41
12. How many TB patients are under your care now?
(Ref. Appendix B - Table 6.3)
13. When do you suspect TB?
(Ref. Appendix B - Table 9, 9.1)
14. If you clinically suspect TB, what investigations do you order?
1
2
3
4
5
6
9
X-ray
Mantoux test
Sputum examination
Blood test
IgGJgM, PGR etc.
Others (specify)
Don’t know
(Ref. Appendix B - Table 39)
15. Where do you send the patients for X-ray?
Own X-ray
Government X-ray
Other private X-ray
1
2
3
(Ref. Appendix B - Table 40)
16. Where do you send the patients for lab investigation?
Own lab
Government lab
Other private lab
1
2
3
(Ref. Appendix B - Table 40)
17. What drugs do you normally prescribe?
Rifampicin
INH
Pyrazinamide
Ethambutol
Streptomycin
Ofloxacin
Combipack
Others (specify)
Don’t know
1
2
3
4
5
6
7
8
9
(Ref. Appendix B - Table 41)
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42
18. What duration you give each prescription?
One week
One month
Two months
Entire duration
Others (specify)
Don’t know
1
2
3
4
5
9
(Ref. Appendix B - Table 42)
19. Is your treatment regimen individually tailored for the patient? (Yes=Y; No-N)
(Ref. Appendix B - Table 43)
20. If yes, on what parameters do you decide treatment?
Clinical
Radiological extent
Associated other illness
Organ involved
Body weight
Others (specify) __________
(Ref. Appendix B - Table 43)
1
2
3
4
5
6
21. Have you heard of Directly Observed Treatment Short-course (DOTS)? (Yes=Y; No=N)
(Ref. Appendix B - Table 11)
22. If yes, from where did you hear about it? (You may select more than one source listed
below).
A
B
C
D
E
F
G
H
I
Medical text books
Medical journals
Medical representative
Colleagues
CME programmes
Training / orientation programme
Mass media
Internet
Any others (specify)
(Ref. Appendix B - Table 11)
23. What are the salient features of DOTS? (Multiple response)
a. Diagnosis by
X-ray
Sputum microscopy
Clinical
Mantoux test
Others (specify)
Don’t know
(Ref. Appendix B - Table 11.1)
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1
2
3
4
5
9
43
b. Mode of treatment
(i) Rifampicin
Once a month
Once a week
1
2
(ii) INH
Once a month
Once a week
1
2
Each dose given under direct observation
Don’t know
3
9
(Ref. Appendix B - Table 11.2,11.3)
24. How do you follow up T. B. patient’s progress? (Multiple response)
Clinical progress
X ray progress
Sputum microscopy
1
2
3
(Ref. Appendix B - Table 11.4)
25. When do you stop treatment for the patient?
2 months after sputum conversion
3 months after sputum conversion
4 months after sputum conversion
5 months after sputum conversion
Sputum conversion at the end of the treatment
Clearance on chest X-ray
Don’t know
1
2
3
4
5
6
9
(Ref. Appendix B - Table 11.5)
26. Do you feel that private practitioners play an important role in TB control?
(Yes=Y; No=N)
(Ref. Appendix B - Table 44)
27. What would be your role in government T. B. control program?
Referral of chest symptomatics
Referral for sputum examination
Contribute to surveillance
As DOTS center
Others (specify)
Can’t say
1
2
3
4
5
9
(Ref. Appendix B - Table 44)
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28. How would you like the government to support you?
1
2
Training
Providing diagnostic facilities
Providing drugs
Updating on government policy
Others (specify)--------------------------Can’t say
3
4
5
9
(Ref. Appendix B - Table 45)
29. Do you feel the current Government policy for TB
controlling TB? (Yes=Y; No=N; Don t know-D) —
management (DOTS) will be effective in
(Ref. Appendix B - Table 11.6)
a. If yes, would you be happy to use the same in your practice? (Yes=Y; No=N)
(Ref. Appendix B - Table 11.6)
b. What is your suggestion to improve the policy?
1
2
Use x-ray for all patients
Use daily treatment
Individualized case management
Others (specify)
Can’t say
3
4
9
(Ref. Appendix B - Table 15, 15.1)
30. Do you have access to research / clinical information related to T
No=N)
. B. treatment? (Yes-Y;
(Ref. Appendix B - Table 16)
31. If yes, specify the sources.
(Ref. Appendix B - Table 17, 17.1)
32. Do you require further information on TB? (Yes=Y; No=N)
(Ref. Appendix B - Table 16.1)
a |f yes, what information do you need?
Etiology of T. B.
How to prevent spread of T. B.?
How to motivate patients?
Others (specify)
1
2
3
4
(Ref. Appendix B - Table 18, 18.1)
33. Which medical journal do you have access to?
(Ref. Appendix B - Table 19, 19.1)
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45
34. Do you use tobacco in any form? (Yes=Y; No=N)
(Ref. Appendix B - Table 20)
35. If no, have you ever used in the past? (Yes=Y; No=N)
(Ref. Appendix B - Table 20)
36. Have you or anyone in your close family ever suffered from TB? (Yes=Y; No=N)
(Ref. Appendix B - Table 20)
IV. About Tobacco Related Diseases
37. Do you think Tobacco use is a major public health problem in India? (Yes=Y; No=N)
(Ref. Appendix B - Table 21)
38. Do you know how many people die globally due to Tobacco related illnesses? (Yes=Y;
No=N)
a. If yes, how many?
(Ref. Appendix B - Table 21.1)
39. Are you aware of different forms of Tobacco use in India? (Yes=Y; No=N)
a. If yes, what are they?
Gutkha
Pan Masala
Mava
Snuff
Khaini
Betal leaf with Tobacco
Areca nut
Cigarette
Beedi
Others (specify)
1
2
3
4
5
6
7
8
9
10
(Ref. Appendix B - Table 22)
40. What are the diseases attributed to Tobacco use? Mention 5 most important diseases.
(Ref. Appendix B - Table 23, 23.1)
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46
41. What is the component in Tobacco that is responsible for ill effects on health? (Multiple
response)
Nicotine
Tar
Smoke
Others (specify)
Don’t know / Can’t remember
1
2
3
4
9
(Ref. Appendix B -- Table 24)
42. When you come across a patient smoking, do you tell him about ill-effects of
smoking?
Sometimes
Regularly
Rarely
Never
1
2
3
4
(Ref. Appendix B - Table 25)
43. Do you think doctors could play an important role in reducing Tobacco use? (Yes-Y; No-N)
44. What role do you think they are playing or could play?
(Ref. Appendix B - Table 26, 26.1)
45. Which of the following types of information you would like to have about tobacco-use?
Types of tobacco use
Health effects of different types of tobacco use
Advice about cessation
Passive smoking
Effect on women and children
Effect of advertisement
Problem of agriculture and employment
(Ref. Appendix B - Table 18.2)
46. How would you like the government to support you to deal with Tobacco abuse?
Ban on advertisements
No smoking in public places
Increased taxes on tobacco products
Stronger warnings on tobacco products
Ban on sale near schools
Others (Specify)
47. Do you think government policy of restricting Tobacco advertisement would have impact on
use of Tobacco in the country? (Yes=Y; No=N)
a. What in your opinion will have impact on tobacco use?
(Ref. Appendix B - Table 26.2, 26.3)
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48. Have you received any Government letter regarding use of tobacco? (Yes-Y; No-N)
(Ref. Appendix B - Table 27.5)
49. Do you have health education material related to anti-Tobacco use? (Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
If yes,
a. List the materials.
(Ref. Appendix B - Table 27.6)
b. Have you ever used these health education materials in the community?
(Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
50. Do you think giving information about bad effects of Tobacco will help community to reduce
Tobacco-use? (Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
51. At what age, do you think, people start using Tobacco?
a. Male
b. Female
(Ref. Appendix B - Table 27, 27.1)
52. To what extent parents can help in preventing children using Tobacco?
To a large extent
To some extent
Not at all
Don’t know / Can’t say
1
2
3
9
(Ref. Appendix B - Table 27.2)
53. What can you do to prevent children from using Tobacco?
(Ref. Appendix B - Table 27.3, 27.4)
54. Do you know about any study on how to reduce tobacco use in a community? (Yes=Y;
No=N)
(Ref. Appendix B - Table 16.2)
a. If yes, please give details.
(Ref. Appendix B - Table 27.7)
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55. Would you like to get such information? (Yes=Y; No=N)
(Ref. Appendix B - Table 16.3)
V. Other Public health Problems
56. What are the most important public health topics for your work?
Maternal & infant health
Child & adolescent health
Reproductive health
Adult health
Gender & health
Health & the elderly
Migrant & refugee health
Acute respiratory infections/
Pneumonia
Diarrhoeal diseases
HIV/AIDS
Malaria
Mental health
Tobacco use
Tuberculosis
Infectious disease
Vector-borne, parasitic & tropical
disease
Non-communicable / chronic
disease
Disabilities
Eye diseases & blindness
Oral health
Substance abuse
Blood safety
Violence & injuries
Health information systems & tools
Medical & laboratory technology
Pharmaceuticals, vaccines, &
biologicals
Intersectoral public health topics
Development & health
Environment & health
Ethics & health
Globalization & health
Health economics & financing
Human rights & health
Information sciences and health
Nutrition & food safety
Occupational health
Public / media relations & health
Travel & health
Water resources & sanitation
Zoonoses & veterinary health
Primary & community health
Prevention & control of disease
Surveillance & reporting
Epidemiology & statistics
Treatment & healthcare
Diagnostics
Drug information
Surgery & anesthesia
Rehabilitation
Emergency response in health
Traditional / alternative medicine
Research methods
Evidence-based policy & practice
Health policy & legislation
Health systems
Capacity building & sustainability
Management and administration
Program planning & evaluation
Medical sciences
Nursing and midwifery
Allied health disciplines
Professional/continuing education
Others (specify)__ ___________
(Ref. Appendix B - Table 28)
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57. What do you find to be the most useful source of information in the following categories?
Source of
information
Awareness
in general
Awareness in
your area of
expertise
In depth
information in
your area of
expertise
Books (manuals,
text & reference)
Databases &
indexes
Journals & scientific
publications_______
Meetings and
meeting
proceedings______
Print news services
(papers, magazines)
Regular reporting
and briefings______
Technical guidelines
& fact sheets______
Television & radio
In depth
information outside
your area of
expertise
□
n
□
n
□
□
□
□
Librarians and
reference services
Colleagues/ experts
in your organization
Colleagues/ experts
outside your
organization______
If any other, specify.
(Ref. Appendix B - Table 29, 29.1, 29.2, 29.3)
58. What is your preferred language for the following categories of information?
Awareness in general
.Awareness in your area of expertise
In depth information in your area of expertise
In depth information outside your area of expertise
(Ref. Appendix B - Table 29.4, 29.5, 29.6, 29.7)
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50
59. What are the main difficulties you experience related to information in the following
categories? (Check as many)
Awareness
information in
general
Awareness
information in
your area of
expertise
In depth
information in
your area of
expertise
In depth
information
outside your
area of
expertise
No difficulty
Difficult to get
Don't know where
to find_________
Difficult to use
Expensive
Poor quality
Irregular
□
Not up to date
Not relevant to
local situation
Not in prefered
langueage
If any other,
specify:
(Ref. Appendix B-Table 30, 30.1, 30.2, 30.3)
60. With whom is communication important for your work? (Mention as many)
Superior
1
Colleagues or experts within your organization
2
Experts outside your organization
3
Directly with patients
4
Directly with general public
5
Funding / donor agencies
6
Press / mass media / advocacy groups
7
Others (specify)
8
__________________
(Ref. Appendix B - Table 31)
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61. Do you need new information related to your work? (Yes=Y; No=N)
a. If yes, in what form would you like to have such information?
Electronic media such as Internet, email
Newsletters or fact sheets
Verbally from colleagues and experts
Scientific journals
AV media such as CD, DVD
Magazines and newspapers
Others (specify)
(Ref. Appendix B - Table 32)
62. Are you aware of any website giving health information? (Yes=Y; No=N)
a. If yes, please mention.
(Ref. Appendix B - Table 34.2, 34.3)
63. How do you most commonly use new information?
Support diagnosis and treatment
1
Include in articles / books
9
Make policy / program decisions
2
Adapt and distribute for local use
10
Advise decision / policy makers
3
Develop health education material
11
Modify treatment protocol
4
Circulate to colleagues
12
Respond to emergencies
5
Find more information on the topic
13
Prepare grant / funding proposals
6
File for later reference
14
Issue press releases
7
Others (specify)
15
Use in lectures / presentations
8
(Ref. Appendix B - Table 33)
VI. Access to Internet
64. Do you have access to the Internet?
No
Yes - at home
Yes - at an Internet cafe
Yes - at work
Yes - at home and work
Yes - others (specify)
•4
2
3
4
5
6
(Ref. Appendix B - Table 34)
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52
65. a. During the last one-month, how many times did you access the Internet?
1
2
3
4
5
6
7
0
1-2
3-4
5-6
7-8
9-10
11 +
(Ref. Appendix B - Table 34.1)
b. What kinds of sites / information do you access on the Internet?
None
1
Information related to the present work
2
Non-work related information
3
General knowledge
4
New information
5
Entertainment matters
6
Others (specify)
7
(Ref. Appendix B - Table 34.4)
66. What barriers do you face in using the Internet? (Mention up to 3 in total from the following
lists)
Physical barriers
Resource / skill barriers
10
Don’t have the time
1
Electricity outages / interruptions
Insufficient skills for computer use
2
Internet connection in inconvenient
Insufficient skills for internet use
3
location
11
Very costly
4
Slow Internet connection
12
Telephone line problems
13
No barriers at all
14
Others (specify)
15
Barriers related to Internet content
Local censorship issues
5
Not in preferred language
6
Too much information
7
Uneven quality of information
8
(Ref. Appendix B - Table 35)
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67. a. Do you think having access to the Internet will help you in your work?
Yes
No
Not sure
1
0
9
b. If yes, list up to 3 key ways in which you think access to the Internet would help your
work.
(')
(ii)
(iii)
(Ref. Appendix B - Table 36, 36.1)
Name of investigator
Date
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54
(5) Multipurpose Health Workers
Health Information Needs assessment for Health Inter-Network
Interview schedule for Paramedical staff (Multipurpose health workers)
WHO is initiating a survey to assess information needs related to TB, tobaccorelated diseases and other public health problems among government health care
providers, policy makers as well as private health care providers. Findings from this
survey will be used to develop an interactive website (portal) on a pilot- basis in an
attempt to address information needs of health care providers.
We would be grateful if you can kindly give your consent to be interviewed as part of
the survey. Information you give will be kept confidential and used only for research
purpose.
I. General Information
Name (in capitals):
Age (in years):
Sex (Male=M; Female=F):
(Ref. Appendix B - Table 2)
(Ref. Appendix B - Table 2.1)
Office address:
Phone:
Pager/Mobile:
Fax.
Email:
Residence address:.
(optional)
Phone:
Pager/Mobile.
Fax:
Email:
II. Employment
1. a. Qualification:
b. Designation:
(Ref. Appendix B - Table 54)
2. Which of the following categories best describes your main area of work? (Mention as many)
Health service provision (patient care & services)
Research (including academics)
Policy-making (including administration and management)
Others (specify)
1
2
3
4
(Ref. Appendix B - Table 3)
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55
3. What is the level at which you mainly work? (Mention as many)
International
National
Regional
State
District/community
1
2
3
4
5
(Ref. Appendix B - Table 2.3)
4. How many years have you been in government service?
(Ref. Appendix B - Table 4)
5. How many years have you been working in the present position?
(Ref. Appendix B - Table 5)
III. About Tuberculosis
6. How do you perceive tuberculosis as a problem? (Multiple response)
A problem under control
A major public health problem
A minor health problem
A Resurgent problem
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 7)
7. How much do you think India contributes to the total global tuberculosis burden?
(Ref. Appendix B - Table 7.1, 7.2)
8. Is TB still a killer disease and why? (Yes=Y; No=N; Don’t know=D)
(Ref. Appendix B - Table 7.1, 8, 8.1, 8.2)
9. About how many patients die in a year of TB in India?
(Ref. Appendix B - Table 7.1, 7.3)
10. Have you undergone any TB training? (Yes=Y; No =N)
(Ref. Appendix B - Table 47)
a. If yes, please specify, when and what?
11. When do you suspect TB?
(Ref. Appendix B - Table 9, 9.1)
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56
12. Have you heard of Directly Observed Treatment Short-course (DOTS)? (Yes-Y;
No=N)
(Ref. Appendix B - Table 11)
13. If yes, from where did you hear about it? (You may select more than one source
listed below).
A
B
C
D
E
F
G
Medical text books
Medical journals
Colleagues
Training/ orientation program
Mass media
Internet
Any others (specify)
(Ref. Appendix B-Table 11)
14. What are the salient features of DOTS? (Multiple response)
a. Diagnosis by
X-ray
Sputum microscopy
Clinical
Mantoux test
Others (specify)
Don’t know
1
2
3
4
5
9
(Ref. Appendix B-Table 11.1)
b. Mode of treatment
Drugs are supplied once a month
Drugs are supplied once a week
Each dose given under direct observation
Don’t know
1
2
3
9
(Ref. Appendix B - Table 11.2)
15. How do you follow up T. B. patient’s progress? (Multiple response)
Clinical progress
X ray progress
Sputum microscopy
1
2
3
(Ref. Appendix B - Table 11.4)
16. Why should the treatment be directly observed?
Correct treatment ensured
Take more care
Observe the improvement
Others (specify)
Don’t know
(Ref. Appendix B - Table 48)
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1
2
3
4
9
57
17. Why is it important to educate patient before starting treatment?
To ensure need for regular treatment
Need for DOT
Preventive aspects of TB
Know patient & family
Others (specify)
Don’t know
1
2
3
4
5
9
(Ref. Appendix B - Table 49)
18. What is the importance of home visiting in case of patient default?
To cure patient
To build rapport with patient
To prevent disease from spreading
To prevent drug resistant TB
To prevent disease from recurring
Others (specify)
Don’t know
1
2
3
4
5
6
9
(Ref. Appendix B - Table 50)
19. What is the importance of sputum examination?
Definite diagnosis
Easy to monitor progress
Easy to motivate patient
Others (specify)
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 51)
20. What will happen if patient does not take treatment?
Patient will not get cured
Spread of disease to others
Drug resistant disease
Others (specify)
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 52)
21. Do you maintain treatment card for each patient? (Yes=Y; No-N)
(Ref. Appendix B - Table 53)
22. What is the objective of maintaining the treatment card regularly?
To check on regularity for treatment
Quick defaulter retrieval action
Easy for supervision
Others (specify)
Don’t know
(Ref. Appendix B - Table 53)
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1
2
3
4
9
58
23. Do you have access to research / clinical information related to T. B. treatment?
(Yes=Y; No=N)
(Ref. Appendix B - Table 16)
24. If yes, specify the sources.
(Ref. Appendix B - Table 17, 17.1)
25. Do you require further information on TB? (Yes=Y; No=N)
(Ref. Appendix B - Table 16.1)
a. If yes, what information do you need?
1
2
Etiology of T. B.
How to prevent spread of T. B.?
How to motivate patients?
Others (specify)
3
4
(Ref. Appendix B - Table 18, 18.1)
b. Here are a few methods of delivering information to you. Mention the useful methods.
Personal communication
Internet
AV media, CD, DVD
Government circulars
Orientation programs
Others (specify)
(Ref. Appendix B - Table 46)
26. Do you use tobacco in any form? Yes
No
(Ref. Appendix B - Table 20)
27. If no, have you ever used in the past? Yes
No
(Ref. Appendix B - Table 20)
28. Have you or anyone in your close family ever suffered from TB? Yes No
(Ref. Appendix B - Table 20)
IV. About Tobacco Related Diseases
29. Do you think Tobacco use is a major public health problem in India? (Yes=Y; No=N)
(Ref. Appendix B - Table 21)
30. Do you know how many people die globally due to Tobacco related illnesses?
(Yes=Y; No=N)
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59
a. If yes, how many?
(Ref. Appendix B - Table 21.1)
31. Are you aware of different forms of Tobacco use in India? (Yes-Y; No-N)
a. If yes, what are they?
Gutkha
Pan Masala
Mava
Snuff
Khaini
Betal leaf with Tobacco
Areca nut
Cigarette
Beedi
Others (specify)
1
2
3
4
5
6
7
8
9
10
(Ref. Appendix B - Table 22)
32. What are the diseases attributed to Tobacco use? Mention 5 most important diseases.
(Ref. Appendix B - Table 23, 23.1)
33. What is the component in Tobacco that is responsible for ill effects on health?
(Multiple response)
Nicotine
Tar
Smoke
Others (specify)
Don’t know / Can’t remember
1
2
3
4
9
(Ref. Appendix B - Table 24)
34. When you come across a patient smoking, do you tell him about ill-effects of
smoking?
Regularly
Sometimes
Rarely
Never
1
2
3
4
(Ref. Appendix B - Table 25)
35. Do you feel health workers could play an important role in reducing Tobacco use?
(Yes=Y; No=N)
(Ref. Appendix B - Table 55)
36. Do you think health workers are well equipped to play this role?
(Ref. Appendix B - Table 55)
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60
37. What information you would like to have about tobacco-use?
Types of tobacco use
Health effects of different types of tobacco use
Advice about cessation
Passive smoking
Effect on women and children
Effect of advertisement
Problem of agriculture and employment
(Ref. Appendix B - Table 18.2)
38. Here are a few methods of delivering information to you. Mention the useful methods.
Personal communication
Journals
Internet
AV media, CD, DVD
Government circulars
Orientation programs
Others (specify)
(Ref. Appendix B - Table 46)
39. How would you like the government to support you to deal with Tobacco abuse?
Ban on advertisements
No smoking in public places
Increased taxes on tobacco products
Stronger warnings on tobacco products
Ban on sale near schools
Others (Specify)
40. Do you think government policy of restricting Tobacco advertisement would have
impact on use of Tobacco in the country? (Yes=Y; No=N)
a. What in your opinion will have impact on tobacco use in this country?
(Ref. Appendix B - Table 26.2, 26.3)
41. Have you received any Government letter regarding use of tobacco? (Yes-Y; No-N)
(Ref. Appendix B - Table 27.5)
42. Do you have health education material related to anti-Tobacco use? (Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
If yes,
a. List the materials.
(Ref. Appendix B - Table 27.6)
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61
b. Have you ever used these health education materials in the community?
(Yes=Y; No=N) ____________
(Ref. Appendix B - Table 27.5)
43. Do you think giving information about bad effects of Tobacco will help community to
reduce use of Tobacco? (Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
44. In your opinion, at what age people start using Tobacco?
a. Male
b. Female
(Ref. Appendix B - Table 27, 27.1)
45. To what extent parents can help in preventing children using Tobacco?
To a large extent
To some extent
Not at all
Don’t know / Can’t say
1
2
3
9
(Ref. Appendix B - Table 27.2)
46. What can you do to prevent children from using Tobacco?
(Ref. Appendix B - Table 27.3, 27.4)
47. Do you know about any study on how to reduce tobacco use in a community? (Yes-Y,
No=N)
(Ref. Appendix B - Table 16.2)
a. If yes, please give details.
(Ref. Appendix B - Table 27.7)
48. Would you like to get such information? (Yes=Y; No=N)
(Ref. Appendix B - Table 16.3)
a. If yes, here are a few methods of delivering information to you. Mention the useful
methods.
Personal communication
Journals
Internet
AV media, CD, DVD
Government circulars
Orientation programs
Others (specify)
(Ref. Appendix B - Table 46)
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V. Other Public health Problems
49. What are the most important public health topics for your work?
Maternal & infant health
Child & adolescent health
Reproductive health
Adult health
Gender & health
Health & the elderly
Migrant & refugee health
Acute respiratory infections/
Pneumonia
Diarrhoeal diseases
HIV/AIDS
Malaria
Mental health
Tobacco use
Tuberculosis
Infectious disease
Vector-borne, parasitic & tropical
disease
Non-communicable / chronic
disease
Disabilities
Eye diseases & blindness
Oral health
Substance abuse
Blood safety
Violence & injuries
Health information systems & tools
Medical & laboratory technology
Pharmaceuticals, vaccines, &
biologicals
Intersectoral public health topics
Development & health
Environment & health
Ethics & health
Globalization & health
Health economics & financing
Human rights & health
Information sciences and health
Nutrition & food safety
Occupational health
Public / media relations & health
Travel & health
Water resources & sanitation
Zoonoses & veterinary health
Primary & community health
Prevention & control of disease
Surveillance & reporting
Epidemiology & statistics
Treatment & healthcare
Diagnostics
Drug information
Surgery & anesthesia
Rehabilitation
Emergency response in health
Traditional / alternative medicine
Research methods
Evidence-based policy & practice
Health policy & legislation
Health systems
Capacity building & sustainability
Management and administration
Program planning & evaluation
Medical sciences
Nursing and midwifery
Allied health disciplines
Professional/continuing education
Others (specify)___________ __
(Ref. Appendix B - Table 28)
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63
50. What do you find to be the most useful source of information in the following categories?
Source of
information
Awareness
in general
Awareness in
your area of
expertise
In depth
information in
your area of
expertise
n
n
u
□
n
□
In depth
information outside
your area of
expertise
I
Books (manuals,
text & reference)
Databases &
indexes
Journals & scientific
publications_______
Meetings and
meeting
proceedings______
Print news services
(papers, magazines)
Regular reporting
and briefings______
Technical guidelines
& fact sheets______
Television & radio
□
n
□
□
□
Librarians and
□
reference services
Colleagues/ experts □
in your organization
Colleagues/ experts
outside your
organization______
If any other, specify.
□
□
□
□
□
□
□
□
(Ref. Appendix B - Table 29, 29.1, 29.2, 29.3)
51. What is your preferred language for the following categories of information?
Awareness in general
Awareness in your area of expertise
In depth information in your area of expertise
In depth information outside your area of expertise
(Ref. Appendix B - Table 29.4, 29.5, 29.6, 29.7)
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64
52. What are the main difficulties you experience related to information in the following
categories? (Check as many)
Awareness
information in
general
Awareness
information in
your area of
expertise
In depth
information in
your area of
expertise
In depth
information
outside your
area of
expertise
No difficulty
Difficult to get
Don’t know where
to find_________
Difficult to use
Expensive
Poor quality
Irregular
Not up to date
Not relevant to
local situation
Not in prefered
langueage __
If any other,
specify:
(Ref. Appendix B - Table 30, 30.1, 30.2, 30.3)
53. With whom is communication important for your work? (Mention as many)
Superior
1
Colleagues or experts within your organization
2
Experts outside your organization
3
Directly with patients
4
Directly with general public
5
Funding / donor agencies
6
Press / mass media / advocacy groups
7
Others (specify)
8
(Ref. Appendix B - Table 31)
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65
54. Do you need new information related to your work? (Yes-Y; No-N)
a. If yes, in what form would you like to have such information?
Electronic media such as Internet, email
Newsletters or fact sheets
Verbally from colleagues and experts
Scientific journals
AV media such as CD, DVD
Magazines and newspapers
_
Others (specify)
(Ref. Appendix B - Table 32)
55. Are you aware of any website giving health information? (Yes=Y; No-N)
a. If yes, please mention.
(Ref. Appendix B - Table 34.2, 34.3)
56. How do you most commonly use new information?
Support diagnosis and treatment
1
Include in articles / books
9
Make policy / program decisions
2
Adapt and distribute for local use
10
Advise decision / policy makers
3
Develop health education material
11
Modify treatment protocol
4
Circulate to colleagues
12
Respond to emergencies
5
Find more information on the topic
13
Prepare grant! funding proposals
6
File for later reference
14
Issue press releases
7
Others (specify)
15
Use in lectures / presentations
8
(Ref. Appendix B - Table 33)
VI. Access to Internet
57. Do you have access to the Internet?
No
Yes - at home
Yes - at an Internet cafe
Yes - at work
Yes - at home and work
Yes - others (specify)
1
2
3
4
5
6
(Ref. Appendix B - Table 34)
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66
58. a. During the last one-month, how many times did you access the Internet?
0
1-2
3-4
5-6
7-8
9-10
11 +
1
2
3
4
5
6
7
(Ref. Appendix B - Table 34.1)
b. What kinds of sites / information do you access on the Internet?
None
1
Information related to the present work
2
Non-work related information
3
General knowledge
4
New information
5
Entertainment matters
6
Others (specify)
7
(Ref. Appendix B - Table 34.4)
59. What barriers do you face in using the Internet? (Mention up to 3 in total from the following
lists)
Physical barriers
Resource / skill barriers
Don’t have the time
1
Electricity outages / interruptions
Insufficient skills for computer use
2
Internet connection in inconvenient
Insufficient skills for Internet use
3
location
11
Very costly
4
Slow Internet connection
12
Telephone line problems
13
No barriers at all
14
Others (specify)
15
Barriers related to Internet content
Local censorship issues
5
Not in preferred language
6
Too much information
7
Uneven quality of information
8
10
(Ref. Appendix B - Table 35)
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67
60. a. Do you think having access to the Internet will help you in your work?
Yes
No
Not sure
1
0
9
b. If yes, list up to 3 key ways in which you think access to the Internet would help your
work.
(')
(•')
(iii)
(Ref. Appendix B - Table 36, 36.1)
Name of investigator
Date
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Signature of investigator
68
(6) Pharmacists
Health Information Needs assessment for Health Inter-Network
Interview schedule for Pharmacists
WHO is initiating a survey to assess information needs related to TB, tobaccorelated diseases and other public health problems among government health care
providers, policy makers as well as private health care providers. Findings from this
survey will be used to develop an interactive website (portal) on a pilot- basis in an
attempt to address information needs of health care providers.
We would be grateful if you can kindly give your consent to be interviewed as part of
the survey. Information you give will be kept confidential and used only for research
purpose.
I. General Information
Name (in capitals):
Age (in years):
Sex (Male=M; Female=F):
(Ref. Appendix B - Table 2)
(Ref. Appendix B - Table 2.1)
Office address:
Phone:
Pager/Mobile:
Fax:
Email:
Residence address:
(optional)
Phone:
Pager/Mobile:
Fax:
Email:
II. Employment
1. Which of the following categories best describes your main area of work? (Mention
as many)
Health service provision (patient care & services)
Research (including academics)
Policy-making (including administration and management)
Others (specify)
1
2
3
4
(Ref. Appendix B - Table 3)
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69
2. What is the level at which you mainly work? (Mention as many)
International
National
Regional
State
District/community
1
2
3
4
5
(Ref. Appendix B - Table 2.3)
3. How many years of experience you have as a pharmacist?
(Ref. Appendix B - Table 4)
III. About Tuberculosis
4. How do you perceive tuberculosis as a problem? (Multiple response)
A problem under control
A major public health problem
A minor health problem
A Resurgent problem
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 7)
5. How much do you think India contributes to the total global tuberculosis burden?
(Ref. Appendix B - Table 7.1, 7.2)
6. Is TB still a killer disease and why? (Yes=Y; No=N; Don’t know=D)
(Ref. Appendix B - Table 7.1, 8, 8.1, 8.2)
7. About how many patients die in a year of TB in India?
(Ref. Appendix B - Table 7.1, 7.3)
8. Have you undergone any TB training? (Yes=Y; No -N)
(Ref. Appendix B - Table 47)
a. If yes, please specify, when and what?
9. When do you suspect TB?
(Ref. Appendix B - Table 9, 9.1)
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70
10. What are the drugs you give to T. B. patients?
Rifampicin
INH
Pyrazinamide
Ethambutol
Streptomycin
Ofloxacin
Combipack
Others (specify)
Don’t know
(Ref. Appendix B - Table 56)
1
2
3
4
5
6
7
8
9
11. What do you tell the patients while giving them the drugs?
(Ref. Appendix B - Table 57)
12. Have you heard of Directly Observed Treatment Short-course (DOTS)? (Yes-Y;
No=N)
(Ref. Appendix B - Table 11)
13. If yes, from where did you hear about it? (You may select more than one source
listed below).
A
B
C
D
E
F
G
Medical text books
Medical journals
Colleagues
Training/ orientation program
Mass media
Internet
Any others (specify)
(Ref. Appendix B - Table 11)
14. What are the salient features of DOTS? (Multiple response)
a. Diagnosis by
X-ray
Sputum microscopy
Clinical
Mantoux test
Others (specify)
Don’t know
(Ref. Appendix B - Table 11.1)
1
2
3
4
5
9
b. Mode of treatment
Drugs are supplied once a month
Drugs are supplied once a week
Each dose given under direct observation
Don’t know
1
2
3
9
(Ref. Appendix B - Table 11.2)
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71
15. How do you follow up T. B. patient’s progress? (Multiple response)
Clinical progress
X ray progress
Sputum microscopy
1
2
3
(Ref. Appendix B - Table 11.4)
16. Why should the treatment be directly observed?
Correct treatment ensured
Take more care
Observe the improvement
Others (specify)
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 48)
17. Why is it important to educate patient before starting treatment?
To ensure need for regular treatment
Need for DOT
Preventive aspects of TB
Know patient & family
Others (specify)
_
Don’t know
1
2
3
4
5
9
(Ref. Appendix B - Table 49)
18. What is the importance of home visiting in case of patient default?
To cure patient
To build rapport with patient
To prevent disease from spreading
To prevent drug resistant TB
To prevent disease from recurring
Others (specify)
Don’t know
1
2
3
4
5
6
9
(Ref. Appendix B - Table 50)
19. What is the importance of sputum examination?
Definite diagnosis
Easy to monitor progress
Easy to motivate patient
Others (specify)
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 51)
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72
20. What will happen if patient does not take treatment?
Patient will not get cured
Spread of disease to others
Drug resistant disease
Others (specify)
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 52)
21. Do you maintain treatment card for each patient? (Yes=Y; No =N)
(Ref. Appendix B - Table 53)
22. What is the objective of maintaining the treatment card regularly?
To check on regularity for treatment
Quick defaulter retrieval action
Easy for supervision
Others (specify)
Don’t know
1
2
3
4
9
(Ref. Appendix B - Table 53)
23. Do you have access to research / clinical information related to T. B. treatment?
(Yes=Y; No=N)
(Ref. Appendix B - Table 16)
24. If yes, specify the sources.
(Ref. Appendix B - Table 17, 17.1)
25. Do you require further information on TB? (Yes=Y; No=N)
(Ref. Appendix B - Table 16.1)
a. If yes, what information do you need?
Etiology of T. B.
How to prevent spread of T. B.?
How to motivate patients?
Others (specify)
1
2
3
4
(Ref. Appendix B - Table 18, 18.1)
b. Here are a few methods of delivering information to you. Mention the useful methods.
Personal communication
Journals
CME
Internet
AV media, CD, DVD
Government circulars
Orientation programs
Others (specify)
(Ref. Appendix B - Table 46)
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73
26. Do you use tobacco in any form? Yes
No
(Ref. Appendix B - Table 20)
27. If no, have you ever used in the past? Yes
No
(Ref. Appendix B - Table 20)
28. Have you or anyone in your close family ever suffered from TB? Yes No
(Ref. Appendix B - Table 20)
IV. About Tobacco Related Diseases
29. Do you think Tobacco use is a major public health problem in India? (Yes-Y; No-N)
(Ref. Appendix B - Table 21)
30. Do you know how many people die globally due to Tobacco related illnesses?
(Yes=Y; No=N)______________
a. If yes, how many?
(Ref. Appendix B - Table 21.1)
31. Are you aware of different forms of Tobacco use in India? (Yes-Y; No-N)
a. If yes, what are they?
Gutkha
Pan Masala
Mava
Snuff
Khaini
Betal leaf with Tobacco
Areca nut
Cigarette
Beedi
Others (specify)
1
2
3
4
5
6
7
8
9
10
(Ref. Appendix B - Table 22)
32. What are the diseases attributed to Tobacco use? Mention 5 most important diseases.
(Ref. Appendix B - Table 23, 23.1)
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74
33. What is the component in Tobacco that is responsible for ill effects on health?
(Multiple response)
Nicotine
Tar
Smoke
Others (specify)
Don’t know / Can’t remember
1
2
3
4
9
(Ref. Appendix B - Table 24)
34. When you come across a patient smoking, do you tell him about ill-effects of
smoking?
Regularly
Sometimes
Rarely
Never
1
2
3
4
(Ref. Appendix B - Table 25)
35. Which of the following types of information you would like to have about tobacco-use?
Types of tobacco use
Health effects of different types of tobacco use
Advice about cessation
Passive smoking
Effect on women and children
Effect of advertisement
Problem of agriculture and employment
(Ref. Appendix B - Table 18.2)
36. Here are a few methods of delivering information to you. Mention the useful methods.
Personal communication
Journals
CME
Internet
AV media, CD, DVD
Government circulars
Orientation programs
Others (specify)
(Ref. Appendix B - Table 46)
37. How would you like the government to support you to deal with Tobacco abuse?
Ban on advertisements
No smoking in public places
Increased taxes on tobacco products
Stronger warnings on tobacco products
Ban on sale near schools
Others (Specify)
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75
38. Do you think government policy of restricting Tobacco advertisement would have
impact on use of Tobacco in the country? (Yes=Y; No=N)
a. What in your opinion will have impact on tobacco use in this country?
(Ref. Appendix B - Table 26.2, 26.3)
39. Have you received any Government circular regarding use of tobacco? (Yes-Y; No-N)
(Ref. Appendix B - Table 27.5)
40. Do you have health education material related to anti-Tobacco use? (Yes-Y; No-N)
(Ref. Appendix B - Table 27.5)
If yes,
a. List the materials.
(Ref. Appendix B - Table 27.6)
b. Have you ever used these health education materials in the community?
(Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
41. Do you think giving information about bad effects of Tobacco will help community to
reduce use of Tobacco? (Yes=Y; No=N)
(Ref. Appendix B - Table 27.5)
42. In your opinion, at what age people start using Tobacco?
a. Male
b. Female
(Ref. Appendix B - Table 27, 27.1)
43. To what extent parents can help in preventing children using Tobacco?
To a large extent
To some extent
Not at all
Don’t know / Can’t say
1
2
3
9
(Ref. Appendix B - Table 27.2)
44. What can you do to prevent children from using Tobacco?
(Ref. Appendix B - Table 27.3, 27.4)
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76
45. Do you know about any study on how to reduce tobacco use in a community? (Yes-Y;
No=N)______________
(Ref. Appendix B - Table 16.2)
a. If yes, please give details.
(Ref. Appendix B - Table 27.7)
46. Would you like to get such information? (Yes=Y; No=N)
(Ref. Appendix B - Table 16.3)
a. If yes, here are a few methods of delivering information to you. Mention the useful
methods.
Personal communication
Journals
CME
Internet
AV media, CD, DVD
Government circulars
Orientation programs
Others (specify)
(Ref. Appendix B - Table 46)
V. Other Public health Problems
47. What are the most important public health topics for your work?
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Maternal & infant health
Child & adolescent health
Reproductive health
Adult health
Gender & health
Health & the elderly
Migrant & refugee health
Acute respiratory infections/
Pneumonia
Diarrhoeal diseases
HIV/AIDS
Malaria
Mental health
Tobacco use
Tuberculosis
Infectious disease
Vector-borne, parasitic & tropical
disease
Non-communicable / chronic
disease
Disabilities
Eye diseases & blindness
F:\ALKA\DOC\hin\APP A7.DOC
Globalization & health
Health economics & financing
Human rights & health
Information sciences and health
Nutrition & food safety
Occupational health
Public / media relations & health
Travel & health
Oral health
Substance abuse
Blood safety
Violence & injuries
Health information systems & tools
Medical & laboratory technology
Pharmaceuticals, vaccines, &
biologicals
Intersectoral public health topics
Development & health
Environment & health
Ethics & health
(Ref. Appendix B - Table 28)
77
Water resources & sanitation
Zoonoses & veterinary health
Primary & community health
Prevention & control of disease
Surveillance & reporting
Epidemiology & statistics
Treatment & healthcare
Diagnostics
Drug information
Surgery & anesthesia
Rehabilitation
Emergency response in health
Traditional / alternative medicine
Research methods
Evidence-based policy & practice
Health policy & legislation
Health systems
Capacity building & sustainability
Management and administration
Program planning & evaluation
Medical sciences
Nursing and midwifery
Allied health disciplines
Professional/continuing education
Others (specify)
F:\ALKA\DOC\hin\APP A7.DOC
78
48. What do you find to be the most useful source of information in the following categories?
Source of
information
Books (manuals,
text & reference)
Databases &
indexes
Journals & scientific
publications_______
Meetings and
meeting
proceedings______
Print news services
(papers, magazines)
Regular reporting
and briefings______
Technical guidelines
& fact sheets______
Television & radio
Awareness
in general
Awareness in
your area of
expertise
In depth
information in
your area of
expertise
□
□
□
□
n
In depth
information outside
your area of
expertise
□
n
Librarians and
reference services
Colleagues/ experts
in your organization
Colleagues/ experts
outside your
organization______
If any other, specify.
□
□
□
□
□
□
□
□
□
□
□
□
(Ref. Appendix B - Table 29, 29.1, 29.2, 29.3)
49. What is your preferred language for the following categories of information?
Awareness in general
Awareness in your area of expertise
In depth information in your area of expertise
In depth information outside your area of expertise
(Ref. Appendix B-Table 29.4, 29.5, 29.6, 29.7)
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79
50. What are the main difficulties you experience related to information in the following
categories? (Check as many)
Awareness
information in
general
Awareness
information in
your area of
expertise
In depth
information in
your area of
expertise
In depth
information
outside your
area of
expertise
No difficulty
Difficult to get
Don’t know where
to find_________
Difficult to use
Expensive
Poor quality
Irregular
Not up to date
Not relevant to
local situation
Not in prefered
langueage
If any other,
specify:
(Ref. Appendix B - Table 30, 30.1, 30.2, 30.3)
51. With whom is communication important for your work? (Mention as many)
Superior
1
Colleagues or experts within your organization
2
Experts outside your organization
3
Directly with patients
4
Directly with general public
5
Funding / donor agencies
6
Press / mass media / advocacy groups
7
Others (specify)
8
(Ref. Appendix B - Table 31)
F:\ALKA\D(X"'hin APP A7.DOC
80
52. Do you need new information related to your work? (Yes-Y; No-N)
a. If yes, in what form would you like to have such information?
Electronic media such as Internet, email
Newsletters or fact sheets
Verbally from colleagues and experts
Scientific journals
AV media such as CD, DVD
Magazines and newspapers
Others (specify)
(Ref. Appendix B - Table 32)
53. Are you aware of any website giving health information? (Yes-Y; No-N)
a. If yes, please mention.
(Ref. Appendix B - Table 34.2, 34.3)
54. How do you most commonly use new information?
Support diagnosis and treatment
1
Include in articles / books
9
Make policy / program decisions
2
Adapt and distribute for local use
10
Advise decision / policy makers
3
Develop health education material
11
Modify treatment protocol
4
Circulate to colleagues
12
Respond to emergencies
5
Find more information on the topic
13
Prepare grant / funding proposals
6
File for later reference
14
Issue press releases
7
Others (specify)
15
Use in lectures / presentations
8
(Ref. Appendix B - Table 33)
VI. Access to Internet
55. Do you have access to the Internet?
No
Yes - at home
Yes - at an Internet cafe
Yes - at work
Yes - at home and work
Yes - others (specify)
1
2
3
4
5
6
(Ref. Appendix B - Table 34)
x
81
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f/4’ (
\H\o
y C? -
56. a. During the last one-month, how many times did you access the Internet?
1
2
3
4
5
6
7
0
1-2
3-4
5-6
7-8
9-10
11 +
(Ref. Appendix B - Table 34.1)
b. What kinds of sites / information do you access on the Internet?
None
1
Information related to the present work
2
Non-work related information
3
General knowledge
4
New information
5
Entertainment matters
6
Others (specify)
7
(Ref. Appendix B - Table 34.4)
57. What barriers do you face in using the Internet? (Mention up to 3 in total from the following
lists)
Physical barriers
Resource / skill barriers
10
Don’t have the time
1
Electricity outages / interruptions
Insufficient skills for computer use
2
Internet connection in inconvenient
Insufficient skills for Internet use
3
location
11
Very costly
4
Slow Internet connection
12
Telephone line problems
13
No barriers at all
14
Others (specify)
15
Barriers related to Internet content
5
Local censorship issues
Not in preferred language
6
Too much information
7
Uneven quality of information
8
(Ref. Appendix B - Table 35)
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82
58. a. Do you think having access to the Internet will help you in your work?
Yes
No
Not sure
1
0
9
b. If yes, list up to 3 key ways in which you think access to the Internet would help your
work.
(i)
(ii)
(iii)
(Ref. Appendix B - Table 36, 36.1)
Name of investigator
Date
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Signature of investigator
83
(7) Lab Technicians
Health Information Needs assessment for Health Inter-Network
Interview schedule for Lab Technicians
WHO is initiating a survey to assess information needs related to TB, tobaccorelated diseases and other public health problems among government health care
providers, policy makers as well as private health care providers. Findings from this
survey will be used to develop an interactive website (portal) on a pilot- basis in an
attempt to address information needs of health care providers.
We would be grateful if you can kindly give your consent to be interviewed as part of
the survey. Information you give will be kept confidential and used only for research
purpose.
I. General Information
Name (in capitals):
Age (in years):
Sex (Male=M; Female=F):
(Ref. Appendix B - Table 2)
(Ref. Appendix B - Table 2.1)
Office address:
Phone:
Pager/Mobile:
Fax:
Email:
Residence address:
(Optional)
Phone:
Pager/Mobile:
Fax:
Email:
II. Employment
1. Which of the following categories best describes your main area of work? (Mention
as many)
Health service provision (patient care & services)
Research (including academics)
Policy-making (including administration and management)
Others (specify)
_______ _____
1
2
3
4
(Ref. Appendix B - Table 3)
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84
2. What is the level at which you mainly work? (Mention as many)
International
National
Regional
State
District/community
1
2
3
4
5
(Ref. Appendix B - Table 2.3)
3. How many years of experience you have as a lab technician?
(Ref. Appendix B - Table 4)
4. What is your nature of work?
Sputum examination
Blood examination
Others (specify)
1
2
3
(Ref. Appendix B - Table 58)
5. How many OPD patients attend this health facility per day on an average?
III. About Tuberculosis
6. What are the tests carried out at your center routinely?
X-ray
Sputum microscopy
Blood
Urine
Mantoux test
Others (specify)
1
2
3
4
5
6
(Ref. Appendix B - Table 59)
7. Do you do sputum microscopy for TB diagnosis? (Yes=Y; No=N)
(Ref. Appendix B - Table 60)
8. If yes, how many sputa do you examine in a month?
(Ref. Appendix B - Table 61)
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85
9. Before declaring a negative result, how many fields do you see under the
microscope?
10
40
80
100
(Ref. Appendix B - Table 62)
10. What are the precautions one needs to take while examining a slide?
1
2
3
9
Wear a mask
Wear gloves
Any other (specify)
Don’t Know
(Ref. Appendix B - Table 63)
11. Are you able to take those precautions? (Yes=Y; No=N)
(Ref. Appendix B - Table 64)
a. If no, why?
(Ref. Appendix B - Table 65)
12. Have you heard of DOTS? (Yes=Y; No=N)
(Ref. Appendix B - Table 11)
13. What are the salient features of DOTS?
a. Diagnosis by
X-ray
Sputum microscopy
Clinical
Mantoux test
Others (specify)
1
2
3
4
5
(Ref. Appendix B - Table 11.1)
b. Mode of treatment
1
Drugs are supplied once a week
2
Drugs are supplied once in 15 days
3
Drugs are supplied once a month
Each dose given under direct observation 4
5
Drugs are supplied thrice a week
6
Others (specify)
9
Don’t know
(Ref. Appendix B - Table 11.2)
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86
14. How do you follow up the patient’s progress?
Clinical progress
X ray progress
Sputum microscopy
1
2
3
(Ref. Appendix B - Table 11.4)
15. Have you been trained in RNTCP for sputum microscopy? (Yes=Y; No=N)
(Ref. Appendix B - Table 66)
16. Do you have difficulty
a. In preparing the smear? (Yes=Y; No=N)
If yes, what kind of difficulties?
b. In staining the slide? (Yes=Y; No=N)
If yes, what kind of difficulties?
c. In supply of lab consumables? (Yes=Y; No=N)
If yes, what kind of difficulties?
(Ref. Appendix B - Table 67)
17. At what time intervals do you do sputum examination for a patient under treatment?
Every month
Once in two months
Once in three months
Once in six months
Others (Specify)
Don’t know
1
2
3
4
5
9
(Ref. Appendix B - Table 68)
18. Do you have access to research / clinical information related to TB treatment? (Yes-Y;
No=N)
(Ref. Appendix B - Table 16)
19. If yes, specify the sources.
(Ref. Appendix B - Table 17, 17.1)
20. Do you require further information on TB? (Yes=Y; No=N)
(Ref. Appendix B - Table 16.1)
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87
a. If yes, what information do you need?
1
2
Etiology of T. B.
How to prevent spread of T. B.?
How to motivate patients?
Others (specify)
3
4
(Ref. Appendix B - Table 18, 18.1)
b. Here are a few methods of delivering information to you. Mention the useful methods.
Personal communication
Journals
Internet
AV media, CD, DVD
Government circulars
Orientation programs
Others (specify)
(Ref. Appendix B - Table 46)
21. Do you use tobacco in any form? Yes
No
(Ref. Appendix B - Table 20)
22. If no, have you ever used in the past? Yes
No
(Ref. Appendix B - Table 20)
23. Have you or anyone in your close family ever suffered from TB? Yes No
(Ref. Appendix B - Table 20)
IV. Other Public health Problems
24. What are the most important public health topics for your work?
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Maternal & infant health
Child & adolescent health
Reproductive health
Adult health
Gender & health
Health & the elderly
Migrant & refugee health
Acute respiratory infections/
Pneumonia
Diarrhoeal diseases
HIV/AIDS
Malaria
Mental health
Tobacco use
Tuberculosis
Infectious disease
Vector-borne, parasitic & tropical
disease
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•
•
•
•
•
•
•
•
•
•
•
•
•
•
Non-communicable / chronic
disease
Disabilities
Eye diseases & blindness
Oral health
Substance abuse
Blood safety
Violence & injuries
Health information systems & tools
Medical & laboratory technology
Pharmaceuticals, vaccines, &
biologicals
Intersectoral public health topics
Development & health
Environment & health
Ethics & health
(Ref. Appendix B - Table 28)
88
27. What are the main difficulties you experience related to information in the following
categories? (Check as many)
Awareness
information in
general
Awareness
information in
your area of
expertise
In depth
information in
your area of
expertise
In depth
information
outside your
area of
expertise
No difficulty
Difficult to get
Don't know where
to find_________
Difficult to use
Expensive
Poor quality
□
Irregular
Not up to date
Not relevant to
local situation
Not in prefered
langueage
If any other,
specify:
(Ref. Appendix B - Table 30, 30.1, 30.2, 30.3)
28. With whom is communication important for your work? (Mention as many)
Superior
1
Colleagues or experts within your organization
2
Experts outside your organization
3
Directly with patients
4
Directly with general public
5
Funding / donor agencies
6
Press / mass media / advocacy groups
7
Others (specify)
8
(Ref. Appendix B - Table 31)
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91
29. Do you need new information related to your work? (Yes-Y; No-N)
a. If yes, in what form would you like to have such information?
Electronic media such as Internet, email
Newsletters or fact sheets
Verbally from colleagues and experts
Scientific journals
AV media such as CD, DVD
Magazines and newspapers
Others (specify)
(Ref. Appendix B - Table 32)
30. Are you aware of any website giving health information? (Yes-Y; No-N)
a. If yes, please mention.
(Ref. Appendix B - Table 34.2, 34.3)
31. How do you most commonly use new information?
Support diagnosis and treatment
1
Include in articles / books
9
Make policy / program decisions
2
Adapt and distribute for local use
10
Advise decision / policy makers
3
Develop health education material
11
Modify treatment protocol
4
Circulate to colleagues
12
Respond to emergencies
5
Find more information on the topic
13
Prepare grant / funding proposals
6
File for later reference
14
Issue press releases
7
Others (specify)
15
Use in lectures / presentations
8
(Ref. Appendix B - Table 33)
VI. Access to Internet
32. Do you have access to the Internet?
No
Yes - at home
Yes - at an Internet cafe
Yes - at work
Yes - at home and work
Yes - others (specify)
1
2
3
4
5
6
(Ref. Appendix B - Table 34)
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92
33. a. During the last one-month, how many times did you access the Internet?
1
2
3
4
5
6
7
0
1-2
3-4
5-6
7-8
9-10
11 +
(Ref. Appendix B - Table 34.1)
b. What kinds of sites / information do you access on the Internet?
None
1
Information related to the present work
2
Non-work related information
3
General knowledge
4
New information
5
Entertainment matters
6
Others (specify)
7
(Ref. Appendix B - Table 34.4)
34. What barriers do you face in using the Internet? (Mention up to 3 in total from the following
lists)
Physical barriers
Resource / skill barriers
10
Don’t have the time
1
Electricity outages / interruptions
Insufficient skills for computer use
2
Internet connection in inconvenient
Insufficient skills for Internet use
3
location
11
Very costly
4
Slow Internet connection
12
Telephone line problems
13
No barriers at all
14
Others (specify)
15
Barriers related to Internet content
Local censorship issues
5
Not in preferred language
6
Too much information
7
Uneven quality of information
8
(Ref. Appendix B - Table 35)
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93
35. a. Do you think having access to the Internet will help you in your work?
Yes
No
Not sure
1
0
9
b. If yes, list up to 3 key ways in which you think access to the Internet would help
your work.
(i)
(ii)
(iii)
(Ref. Appendix B - Table 36, 36.1)
Name of investigator
Date
Signature of investigator
(8) E-Readiness Assessment
E-readiness Assessment
Objectives of this assessment are to:
1. Identify the required level of IT hardware and eonnectivity needs af each pilot site.
2 Assess the actions and resources required for establishing the required IT hardware
and connectivity for each pilot site.
Checklist
1 How many users will there be of the system?----(Ref. Appendix B - Table 69)
2. Who are these users and what is their level of skills in using IT?
No
skills
Users
Doctors
Basic
^Experienced
computer user of
common office
skills
applications
Experienced
user of
Internet
1
2
3
Administrators 1
2
3
Paramedical 1
2
staff
3
4
5
Others (specify)
(Ref. Appendix B - Table 69)
3. Is adequate physical space available for the hardware? (Yes=Y; No-N)
(Ref. Appendix B - Table 70)
Advance
computer
skills
4. Evaluate the site conditions in terms of:
a. Temperature
High
Low
Moderate
1
2
3
b. Is environment generally dust free? (Yes=Y; No=N)
c. Are air-conditioners available? (Yes=Y; No=N)
(Ref. Appendix B - Table 70.1)
5. Assess availability of Electricity at the site in terms of
a. Number of supply hours per day
b. Fluctuations experienced
Frequently
Occasionally
Rarely
Never
1
2
3
4
c. Frequency of outages
Frequently
Occasionally
Rarely
Never
1
2
3
4
d. Is generator available? (Yes=Y; No=N)
e. Is earthing / grounding available for electrical connections? (Yes-Y; No-N)
(Ref. Appendix B - Table 70.2)
6. Assess availability of telephone lines
a. Number of fixed phone lines
b. Availability of dedicated telephone line for Internet access
c. Number and type of connection
1
Dial-up
2
Leased lines
3
VSAT
d. Quality of transmission
Bandwidth/speed
Frequency of outages
(Ref. Appendix B - Table 70.3)
7. Installation fees, monthly fees and calling tariffs for the following types of
connectivity:
■
■
■
■
Dial-up telephone lines
Lease-lines (specify cost for each transmission rate)
Wireless-modem (if applicable)
VSAT (specify bandwidth)
8. Assess availability of PCs and peripherals in terms of
•
•
•
•
•
Number of computers
Type of processors
Speed
RAM
Hard disk memory space
9. Assess the area where the computers are located in terms of.
Size
•
Dust-free environment? (Yes=Y; No=N)
•
Are air-conditioners available? (Yes=Y; No-N)
10. What is the average number of users per terminal (existing)?
(Ref. Appendix B - Table 71)
11. How many hours of access they have?
(Ref. Appendix B - Table 71)
12. Are computers connected to a l_AN? (Yes=Y; No-N)
(Ref. Appendix B - Table 72)
13. How many of them are connected to a modem?
(Ref. Appendix B - Table 72)
14. How many and what types of printers are available?
(Ref. Appendix B - Table 73)
15. Does the site have the following IT equipment/peripherals? (Yes=Y; No=N)
Scanners
Digital cameras
CD-ROM
DVD
(Ref. Appendix B - Table 73)
16. If LAN is available, then specify
a. Is NAT (anti-virus) in use? (Yes=Y; No=N)
b. Is firewall installed? (Yes=Y; No=N)
c. What is the availability of legal IP-addresses?
d. Is there any network management? (Yes=Y; No=N)
e. Load characteristics of the LAN.
f. Are there any problems with reliability of the U\N? (Yes=Y; No=N)
g. Is the LAN switched? (Yes=Y; No=N)
If yes, specify models.
h. What sorts of routers are used, if any?
(Ref. Appendix B - Table 72)
17. List the available software / computer applications and indicate for each
•
•
•
Status of licensing
Is user using the current versions
What is the software update strategy
• software distributed
• central server
• remote update
• any other
18. What are the rules and procedures for accessing Internet, in terms of time and
payment?
19. Present source of funding and amount of annual IT budget. Including:
• Capital expenditure
• Human resources (staffing and training)
• Repair, maintenance and support
20. Assess availability of hardware / software support services in terms of
•
•
•
•
•
•
Number of maintenance staff if any?
Is there a support contract with a supplier?
Are spare parts available?
Quality of support services
Distance from support service
Cost of support services
(Ref. Appendix B - Table 74)
21. Is training facility available in the vicinity? (Yes-Y; No-N)
(Ref. Appendix B - Table 70.4)
Name of investigator
Date
Signature of investigator
APPENDIX B: Findings of the Survey
Data analyses by category of respondents
Tabic 1: Number of respondents by location and category of respondents
National
Karnataka
Orissa
Total
10
07
02
01
00
00
00
20
10
13
33
40
62
09
11
178
J5_
35
30
50
Administrators_____________________
Researchers-Faculty members_________
Government Medical Officers (GMO)
Private Practitioners (PP)____________
Multipurpose Health Workers (MPHW)
Pharmacists_____________________
Lab Technicians_______________
Total
10
15
25
30
05
05
105
16
303
66
92
14
Table 1.1: Number of respondents by category of respondents
National
Karnataka
Orissa
Total
Administrators_________________________
Researchers-Faculty members_____________
Government Medical Officers
Private Practitioners_____________________
Paramedical Staff (MPHW. Pharmacists. Lab
Technicians)___________________________
10
07
02
01
00
10
15
13
33
40
82
10
j_5
25
40
35
30
50
122
Total
20
17«
105
303
66
Table 2: Age-wise distribution by category of respondents
Administrators
<=40
! >40
Total
Researchers
GMO
26
24
50
04
26
30
09
26
35
Total
PP
Paramedical
37
29
Staff
56
66
66
122
132
171
303
PP
Paramedical
Total
Table 2.1: Sex-wise distribution by category of respondents
Researchers
Administrators
GMO
Staff
| Male
Female
Total
40
10
50
22
08
30
32
03
35
52
62
14
66
60
122
Table 2.2: Qualification by category of respondents
MBBS
Specialists
Non-MBBS
Administrators
Researchers
N=35
N=30
02
26
07
01
26
03
Paramedical
Staff
NM22
N=66
N=50
NA
26 ___ 30
NA
24 __ 27
NA
09
0
GMO
PP
208
95
303
Table 2.3: Level at which respondents work by category of respondents
Administrators
Researchers
N=35
N=30
04
12
09
16
06
04
11
01
13
13
International_____
National_________
Regional________
State____________
District/community
Paramedical
Staff
N=66
N=122
N=50
____ 01 _____ 0_ _______ 00_
00
____ 01 ____ 04
___ 0£ ____06 _______ 00
04 _____ 10 _______ 01
121
44
48
GMO
PP
Table 3: Respondents’ main area of work by category of respondents
Administrators
Researchers
N=35
N=30
20
15
13
12
05
22
Health service provision
Rcsearch/Tcaching
Policy-making________
Paramedical
Staff
N=122
N=66
N=50
120
____ 49 ____ 66
____ 02 ____ 03 _______ 02
00
03
03
GMO
PP
Table 4: Number of years in service by category of respondents
Administrators
Researchers
N=35
N=30
02
27
01
02
29
04
<=10 years
>10 years
Not mentioned
Paramedical
Staff
N=122
N=66
N=50
_24
___ 26 ____ 32
____ 24 ____ 34 _______ 62
36
00
00
GMO
PP
Table 5: Number of years in the present position by category of respondents
Administrators
N=35
______ 23
<=5 years
____ n
> 5 years
01
Not mentioned
*Data corresponds only to healtli workers
Researchers
N=30
18
11
01
Paramedical
Staff*
N=122
N=66
N=50
16
NA
NA
46
NA
NA
NA1
60
NA
GMO
PP
Table 6: Average number of patients per day in the OPD by category of respondents
<=50
>50 &
100
>100
No response
PP
Administrators
Researchers
GMO
N=35
N=30
N=66
N=50
_____29 _____ 61
_____ 13 ___ 04
_____08 _____ 00
00
01
NA
NA
NA
NA
NA
NA
NA
NA
Paramedical
Staff
N=122
NA
NA
NA
NA
Total
N=303
_____ 9_
____ 28
____ 17
____ 44
232
Table 6.1: Proportion of patients belonging to lower socio-economic class by category of respondents
Administrators
Researchers
GMO
PP
N=35
N=30
N=50
____ 00
_____12
____ 29
09
N—66
___ 13
___ 18
___ 27
08
NA
NA
NA
NA
NA
NA
NA
NA
<=25%________
>25% & <=50%
>50%_________
No response
Paramedical
Staff
N=122
NA
NA
NA
NA
Table 6.2: Number of respondents treating Tuberculosis patients by category of respondents
Administrators
Researchers
N=35
N=30
NA
NA
# of respondents treating
Tuberculosis patients
Paramedical
Staff
N=122
N=66
N=50
NA
59
45
PP
GMO
Table 6.3: Number of TB patients currently under care by category of respondents
Administrators
Researchers
N=35
N=30
00
03
03
01
00
04
19
02
02
02
01
02
06
20
0____________
>0 & <=50
>50 & <=100
>100 & <=150
>150 & <-200
>200________
No response
GMO
PP
N=50
N=66
___ ooj ___ 14
____ 35_* ___ 38
___ 02_ ___ 00
____ 00_' ___ 01
___ 0£ ___ 00
01 ’
_____08_
_01
12
Paramedical
Staff
N=122
NA
NA
NA
NA
NA
NA
NA
Table 7: Perception about TB by category of respondents
Administrators
N=35
Researchers
N=30
09
A problem under control_____
29
A major public health problem
00
A minor health problem______
04
A resurgent problem________
00
Don’t know / No response________
*Data corresponds only to health workers & pharmacists
02
27
19
09
00
Paramedical Staff*
PP
GMO
N=122
N=66
N=50
59
18
08
52
46 ___ 53
13
___ 00 ___ 03
00
___ 04 ___ 08
01
00
01
Table 7.1: Perception about TB burden by category of respondents
# who said India contributes one-third
to global TB burden_______________
# who think TB is a killer disease
# who knew how many people die in
Administrators
Researchers
GMO
N=35
N=30
N=66
N=50
11
10
Paramedical
Staff*
N=122
09
51
02
67
07
16
08
28
10
19
06
a year due to TB in India___________
*Data corresponds only to health workers & phannacists
42
19
PP
Table 7.2: Responses to the question “How much do you think India contributes to the total global
tuberculosis burden?”
One-third (30-40 %)__________________
<=25 %_____________________________
One per minute_______________________
350 millions_________________________
2 millions _________________________
>= 50 %____________________________
Majority / considerably / very significantly
Don't know
# Said
____ 54
____ 59
01
____ 01
____ 01
____ 35_
_J6
50
Table 7.3: Responses to the question “About how many patients die in a year of TB in India?”
5 lacs / one per minute / one in ten deaths due to TB
1 lacs_____
1000 per day_______________________________
10 lacs________
1 per day
______________________________
<= I %_______ ___________
25 lacs________
4 lacs________ ______________________________
' About 5 lacs _______________________________
I 250 lacs
50 lacs_______
About 365 patients___________________________
Nil
j < 100 ____________________________________
10 per minute___________________________ _
100 s of thousands______________________ _
<= 30 %________________________________
Quite a number______________________
Don’t know / no idea
_______
# Said
44
03
02
07
01
02_
04
03
02
01
02
01
01
03
01
01
28
07
92
>
Table 8: Main reasons why TB is a killer disease by category of respondents
PP
Administrators
Researchers
GMO
N=28
N=19
N_=42_ N=51
12 ___ 27
___ 12 ' ___ 0j_
___ 02_'
09
05 ' ___ 06
__ 05_ ___ 03
09
11
04
Irregular treatment________________
05
Lack of awareness / Health education
03
Non-availability of drugs__________
09
Poverty7 / Illiteracy________________
02
Spread of resistant bacteria________
08
Not mentioned__________________
*Data corresponds only to health workers & pharmacists
05
04
01
02
05
07
Paramedical
Staff*
N=67
32
09
00
02
05
26
Table 8.1: Responses to the question “Why is TB still a killer disease?”
Irregular treatment_____________________________________
Lack of awareness / Health education___________
Poverty / Illiteracy
_________________________ _______
Spread of resistant bacteria
Non-availability of drugs__________________________ _
Patients go to quacks_________________________
It is not being properly controlled________________________
I RNTCP is not yet covering the whole country
i Health workers not properly trained
• Patients have no rest_____________________
; High infectivity_____________________________
! Superiors', doctors', officers' mistake_____________________ _
Patients when visiting doctors, hide details
Lack of personal hygiene_______________________________
Treatment long duration________________________________
l Social stigma______________________________
! Superstitious beliefs_____________________
! In Jndia TB is the king of the diseases
Because of combinations with other diseases like HIV/diabctcs
; Because it affects all systems of the body__________________
Lack of detect ion/not diagnosed early
# Said
80
___ 31
___ 24
___ 22
15
___ 02
___ 01
__ 03_
02
01
___ 02_
02
___ 01
___ 02
___ 02
03
___ 02
01
04
03
04
Table 8.2: Distribution of reasons “Why is TB still a killer disease?” in broad categories by
respondent type
Administrators
10
08
09
12
GMO
N=55
N=33
N=39
Social_______________
Patient related
Sen ice provider related
System related
Researchers
04
13
06
10
13
18
15
09
PP
Paramedical
N----86
Stair
N= 49
17
26
31
12
01
10
33
05
Total
N=262
45
75
94
48
Table 9: Symptoms of TB by category of respondents
Administrators
Researchers
N=30
N=35
NA
Fever________________________
NA
Cough for more than 2 weeks / Coi
with expectoration
________
NA
Loss of weight________________
NA
Weakness____________________
NA
i Loss of appetite I Anorexia
NA
i Sweating __________________
NA
i Blood in sputum______________
NA
Chest pain___________________
NA
jocurrentjespiraton tract infectioi
NA
Non-specific enlargement of
i Lymph nodes_________________
I 2 sputum positive
NA
NA
l_Raised ESR
I Antibiotics fail________________
NA
*Data corresponds only to health workers & pharmacists
__
NA
NA
Paramedical
Stair
N=122
N=66
N=50
____ 34 ____ 46 _______ 87
106
51
42
PP
GMO
NA
NA
NA
NA
NA
NA
NA
NA
31
05
17
04
21
12
02
05
42
05
28
01
21
05
02
00
66
23
38
00
45
14
00
00
NA
NA
NA
01
00
00
00
00
01
00
02
02
Tabic 9.1: Responses to the question “When do you suspect TB?”
“
# Said
167
j Fever
____ _________________
199
I Cough for more than 2 weeks / Cough with expectoration
139
; Loss of weight_________________________________
33
_Weakncss_______________________________ _____
83
Loss of appetite / Anorexia / not feeling hunger
05
Sweating
_________________________
87
i Blood in sputum___________________________ _____
31
j Chest pain
__________________________ __
04
; Recurrent respiratory tract infections
i Non-specific enlargement of lymph nodes
01
| 2 sputum positive
________________
02
I Raised ESR
03
! Antibiotics fail________________________
02
I Based on X-ray findings
_______
02
| Clinical features__________________ _______________
01
| Dry lips_____ _________________________ _ _______
01
i Sunken eyes
_____
01
; Restlessness _________________________
01
Loose motion___________________________ _______
01
Headache
_______________________
_______
02
[ Indigestion
02
I Exposure to KOCH’S
Table 10: Guidelines for TB treatment by category of respondents
Administrators
Researchers
N=35
N=30
28
07
02
35
03
02
NTCP / RNTCP guidelines
Text-book guidelines_____
Own regimen
Paramedical
Staff
N=122
N=66
N=50
NA
NA
___ 48
NA
NA
___ 04
NA
NA
01
GMO
PP
Table 11: Knowledge about DOTS and source of information on DOTS by category of respondents
Researchers
Administrators
GMO
Paramedical
Staff*
N=122
93
PP
N=50
N=66
N=30
N=35 __
38
47
30 __
32
Heard of DOTS
Source of information on DOTS
01
19
09
10
; Medical text books___________ 07
01
18
11
18
11
! Medical journals_____________
00
04
00
00
I Medical representative________
00
08
07
06
04
11
j Colleagues_________________
00
15
06
00
00
| CME program______________
74
12
19
35
23
RNTCP training
program___________________
07
04
05
09
Mass media_________________ 07
04
00
01
02
04
Internet____________________
04
00
00
00
___
_______________
________
-_______________
! No
response
______ _________
__ 00______ _ ____________
*Data corresponds only to health workers & phannacists for source of information on DOTS
Table 11.1: Diagnosis under DOTS by category of respondents
X-ray____________
Sputum microscopy
Clinical__________
Mantoux test_____
Don't know
Administrators
Researchers
GMO
PP
N=35
N=30
N=50
22
47
15
05
00
N=66
23
37
17
11
31
09
05
02
11
____ 28
06
02
00
10
04
Paramedical
Staff
N=122
55
93
12
07
22
Table 11.2: Mode of treatment under DOTS by category of respondents
Administrators
Drugs supplied once a month
Drugs supplied once a week
Each dose given under direct
observation______________
Don't know
N=35
______ 04
______ 04
27
02
Researchers
GMO
PP
N=30
04
26
N=50
06
__ 05_
44
N=66
NA
NA
26
Paramedical
Staff
N=122
15
04
69
01
00
23
34
___ 12
Table 11.3: Mode of treatment under DOTS
PP
N=66
07
__ 19
05
20
26
23
Rifampicin - once a month____________
Rifampicin - once a week_____________
INH - once a month_________________
INH - once a week__________________
; Each dose given under direct observation
I Don't know
Table 11.4: TB patient’s follow-up by category of respondents
; Clinical progress__
i X-ray progress
Sputum microscopy
Administrators
Researchers
N=35
N=30
____ 09
___ 05
26
10
______ 07
32
Paramedical
Staff
N=50 N=66 N=122
55 ~
32
18
12
43
11
108
51
48
PP
GMO
Table 11.5: Stopping treatment for the TB patient by category of respondents
2 months after sputum conversion
; 3 months after sputum conversion
4 monthsafter sputum conversion
5 months alter sputum conversion
Sputum conversion at the end of the
treatment
__________________
i Clearance on chest X-ray
Don't know
Administrators
Researchers
GMO
N=35
NA
NA
NA
_ NA
NA
N=30
NA
NA
NA
NA
NA
N=50
02
02
09
05
35
NA
NA
NA
NA
Paramedical
Staff
N=66 N=122
NA
04
NA
07
NA__
08
NA
04
NA
32
PP
01
01
NA
NA
32
03
Table 11.6: Response to government policy (DOTS) by category of respondents
Administrators
Researchers
N=35
N=30
______ 25
NA
32
NA
# who approve of DOTS______________
# willing to use DOTS in private practice
Paramedical
Staff
N=122
N=66
N=50
NA
48 ____ 35
NA
31
33
GMO
PP
Table 12: Problems reported in TB control program by category of respondents
Problems in drug availability
Problems in availability of
Reagents for sputum
Examination
Problems vwth X-ray referral
Staff availability__________
! Patient co-operation_______
Administrators
N=35
05
01
Researchers
N=30
NA
NA
01
11
16
NA
NA
NA
Paramedical Staff
PP
GMO
N=122
N=66
N=50
NA
NA
___ 09
NA
NA
07
11
00
00
NA.
NA
NA
NA
NA
NA
J
Table 13: Monitoring indicators of TB program by category of respondents
Administrators
Researchers
GMO
PP
N=35
N=30
23
19
N=50
32
N=66
NA
Paramedical
Staff
N=122
NA
23
10
17
17
29
NA
NA~
NA
NA
11
18
10
01
03
15
34
13
01
00
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
ft of new sputum positive patients on
treatment________________________
# of p atients on treatment___________
Sputum negative at the end of intensive
phase (IP) ______________________
Smear positive: smear negative ratio
Cure althc_end of treatment
i ft of defaulters_____________________
I ft of health education sessions________
Don't know
14
24
JJ
07
03
Table 14: Frequency of reporting under TB control program by category of respondents
Administrators
Researchers
GMO
T PP
N=35
N=3()
NA
NA
NA
NA
N=50
34
16
02
02
N=66
NA
NA
NA
NA
i
I Ever> month
j Every quarter
I Half yearly
: Annually
NA
NA
NA
NA
Paramedical
Staff
N=122
NA
NA
NA
NA
Table 15: Suggestions to improve government policy (DOTS) by category of respondents
Use x-ray for all patients_________
Use daily treaunent
| Individualized case management
Proper implementation of DOTS
j Involve private practitioners/ NGO
Increase public awareness______
DOTS to co\ er whole country
; Community participation________
I Can’t say_____________________
Administrators
Researchers
GMO
PP
N=35
N=30
N=50
01
____ 03
06
____ 01
00
____ 00
____ 00
00
23
N=66
03
08
06
15
06
02
01
00
01
00
00
02
05
03
01
02
02
00
00
_ PA
16
___ 02
____ 02
02
____ 00
____ 02
00
Paramedical
Staff
N=122
NA
NA
NA
NA
NA
NA
NA
NA
NA
Table 15.1: Responses to the question “What is your suggestion to improve the current government
policy for TB management (DOTS)?”
# Said
| Use x-ray for all patients
____ 12
i Use daily treatment
_________________________________________________ ____ 17
' Individualized case management____________________________________________ ____ 42
I Proper implementation of DOTS____________________________________________ ____ 12
I Involve private practitioners / NGO_________________________________________ ____ 05
; Increase public awareness_________________________________________________ ____ 05
DQTSjo coveryviiolecountrv
_____
02
03
i Community participation__________________________________________________
01
Give attention to implementation details (like making water available for the patients l
; swallow the tablet)_______________________________________________________
01
i A lot of training to DOTS providers_________________________________________
01
j The program should move away from technical aspects to ensure compliance________
01
i Personal involvement_____________________________________________________
01
! Political and administrative commitment at a]l levels
01
Job assignment for each level of worker has to be spelt out clearly_________________
01
Vertical program for TB control____________________________________________
01
Motivated and dedicated health care staff_____________________________________
23
CanT say
Table 15.2: Responses to the question “On what basis are you making these suggestions?”*
| # Said
03
Program docs not have the infrastructure to deliver sendee to the doors of the patient to
: ensure DOTS_____________________________________________________________
01
Program docs not have die infrastructure for retrieval of dropouts___________________
01
Patients are discharged before they complete treatment and arc charged for medicines
01
A study/survey conducted in Kumool ! Anantapur districts_________________________
01
; Practical experience in field_______________________________________
01
I Case identification and follow-up in die field is not proper___________________
01
I A study in Vanivilas hospital on childhood TB__________________________
01
; A study on HIV and TB_________________________________
_______________
02
Though NTCP was good there was administration and managerial problem; should not
i repeat the same mistake__________________________________________
01
| All segments / districts are not covered by DOTS program in India
01
! Based on KHOJ project, encounters with villagers of cyclone affected Orissa. VHAI is
i going to train one girl in each village
01
Talking to TB workers in implementing the program______________________________
01
| Unless the jobs arc assigned clearly difficult to issue show cause notice ifjob is not done
I properly; unless there is fear of penalty, difficult to extract work
01
■ Proved success of leprosy control program in India____________________
01
i Results achieved by implementing RNTCP since 1993_________
01
I Bulk of die patients go to private practitioners_________________________
*This question was asked only to researchers - faculty members
Table 16: Access to clinical information about TB by category’ of respondents
I________________
# of respondents having access to
clinical information about TB
Administrators
Researchers
N=35
N=30
NA
NA
Paramedical
Staff
N=122
N=66
N=50
42
32
18
GMO
PP
Table 16.1: Need for more information on TB by category of respondents
I
Administrators
Researchers
N=35
N=30
13
26
# of respondents who need more
information on TB
Paramedical
Staff
N=122
N=66
N=50
118
65
34
PP
GMO
Total
N=303
256
..
Table 16.2: Access to research information related to tobacco use by category oi respondents
Paramedical
Administrators
Researchers
GMO
PP
N=35
N=30
N=50
02
N=66
Total
Staff
05
07
# of respondents having access to
research information about
tobacco use__________________
*Data corresponds only to health workers & pharmacists
N=3(I3
N=I22
03
20
03
Table 16.3: Need for more information related to tobacco use by category of respondents
Administrators
Researchers
N=35
N=30
27
29
# of respondents who need more
information related to tobacco use
*Data corresponds only to health workers & pharmacists
Paramedical
Staff'
N=66
N=122
N=50
103
66
49
PP
GMO
Table 17: Sources of information among those who reported access to TB information by category of
respondents
Medical journals__________________
RNTCP training__________________
Internet, websites_________________
Libraries / text-books, clinical material
Monthly meetings_________________
CME
Seminars / conferences_____________
Mass media______________ __ _____
IEC material___________________ _
Colleagues, supervisors
GMO
PP
N=18
___ 03
____ 05
03
____ 02
01
____ 00
00
00
____ 00
00
N-32
20
00
06
03
00
II
06
___ 03
01
___ 00
00
Paramedical
Staff
N=42
00
14
00
03
05
02
01
06
19
05
Total
N=303
274
Table 17.1: Responses to the question “If you have access to information about TB treatment, specify
the sources.”
# Said
23
______ 19
______ 09
08
06
08
04
07
19
05
04
08
Medical journals____________________________________________
RNTCP training____________________________________________
Internet, websites___________________________________________
Libraries / text-books, clinical material__________________________
Monthly meetings___________________________________________
CME_____________________________________________________
Seminars / conferences_______
Mass media______________________ ___ _____________________
IEC material_______________________________________________
Colleagues, supervisors____
Through hospitals
______________________________________
Through NTI, District TB office, TB sanitarium. Central TB division.
Bangalore Medical college. TB Association of India______________
WHO
03
Table 18: Type of TB information needed by category of respondents
Etiology of TB__________________
How to prevent spread of TB?_____
How to motivate patients?________
New developments I research on
TB treatment (success stories)_____
Treatment of drug resistant cases
Guidelines for program
Management / RNTCP training mate
IEC material / health education
TB drugs
Administrators
Researchers
N=26
N=13
Paramedical
StaiT
N=34
N=118
N=65
54
23
09
81
45
21
61
40
27
01
07
03
GMO
PP
Total
N=256
91
147
128
38
02
00
00
14
03
__ 00
______ 00
13
00
OS
00
00
01
01
03
02
00
02
04
13
03
00
02
00
01
00
01
00
01
07
08
07
Tabic 18.1: Responses to the question “What information do you need?”
# Said
Etiology of TB_______________________
-__________________
How to prevent spread of TB?_________________ ______ :________________
How to motivate patients?________________________ ________________________________
New developments / research on TB treatment (success stories)
Treatment of drug resistant cases____________________________
_____________ ___
Guidelines for program management / RNTCP training material
___________
IEC material / health education
_
_____
TB drugs_____________________
_______________________
Complication due to HIV and diabetes
___________________________________
WHO guidelines
_ ___________________________________________
I Administration management aspects (defaulter management, intervention of PP s and NGO s)
91
147
128
38
04
____ I3_
(8
____ C7_
11
___ (3_
02
j Epidemiological data
______________ _____________________________
I Funding agencies for research
(Statistics_____________________ _________ _ __________ ____________________________
' Pediatric TB_______________________
____________________________________
| Recent WHO programs in South-East Asia countries__________________________________
j Other countries where TB is more epidemic
______________________________
; Treatment of MDR TB
__
_ _________________________________
Adequate literature
____ _________________
Special people who had TB and were cured
. Sources of information on TB in district
Operational areas
I Experiment from other countries
i Operation research, studies
____________________________
Recent information on success stories of DOTS strategy
Status of RNTCP and NTCP___________________________________
02
01
~()2
01
"(H
1)2
1)2
01
i)l_
")2
'LL
)i
'H
’.)!
Table 18.2: Type of tobacco information needed by category of respondents
Administrators
Researchers
N=29
19
I Types of tobacco use___________
24
Health effects of different types of
I Tobacco use__________________
12
Advice about cessation_________
13
Passive smoking______________
11
i Effect on women and children
12
| Effect of advertisement_________
09
Problem of agriculture and
employment__________________
*Dala corresponds only to health workers & pharmacists
N=27
___ 08
15
15
12
13
11
12
Paramedical
Staff*
N=103
N=66
N=49
__ 60
__ 31^ __ 47
86
56
41
GMO
28
29
26
20
22
PP
44
38
39
32
26
67
53
63
48
42
Total
N=274
165
222
166
145
152
123
111
Table 19: Access to journals by categoly of respondents
______ 04
______ 02
_____ 01^
00
20
09
_____ H_
02
_____ 01
00
Paramedical
StalT
N=122
NA
NA
NA
NA
NA
NA
05
00
04
NA
Indian Journal of TB & Chest Diseases
05
00
06
NA
CHEST
06
00
00
NA
Homeopathy
00
00
04
NA
No access to any journals
03
22
16
NA
Researchers
GMO
N=27
N=50
Journal of IMA (JIM A)_____________
Indian Medical Journal_____________
British Medical Journal_____________
Pediatric Journal / Indian Pediatrics
IAP __________________________
Lancet
00
00
07
00
00
09
NEJM
PP
N=66
11
06
Table 19.1: Responses to the question ‘’Which medical journal do you have access to?”
# Said
Journal of IMA (JI MA)__________
Indian Medical Journal___________
British Medical Journal__________
Pediatric Journal / Indian Pediatrics
IAP__________________________
Lancet
NEJM
Indian Journal of TB & Chest Diseases
CHEST
Homeopathy
JAPI - -----______________
Annual of Intern medicine_______________
JAMA_______________________________
AIDS Journal ________________________
Lung India
________________________
International Journal of TB & Lung diseases
Physician’s digest
Applied medicine______________________
Karnataka Medical Journal______________
Indian Chest Society Journal_____________
American Medical Journal_______________
Journal of American Dental Association
31
15
______ 22
04
___ 02
09
09
1 1
06
04
01
01
01
01
01
01
01
01
01
01
01
01
Table 20: Use of tobacco by category of respondents*
Administrators
N=35
Current use_______________________________
Ever used_________________________________
Ever suffered from TB (self or
close family member)_______________________
*No response to all the above questions in Orissa
PP
Researchers
GMO
N=30
N=66
N=50
___ 02 ___ 06
04
___ 05
09
06
00
02
03
02
04
02
Paramedical
SlafT
N=122
08
07
"12
Table 21: Perception about tobacco use
Administrators
Researchers
N=35
N=30
28
32
i Tobacco use is a major public
health problem___________
* Data corresponds only to health workers & pharmacists
Total
Paramedical
Stair
N=66 N=122
N=50
66:
104
49
PP
GMO
r4=3O3
279
Table 21.1: Responses to the question “Do you know how many people die globally due to tobacco
related illness?”
# Said
31
06
0j_
09
01
01
01
01
01
02
07
148
<= 40 %______________________
| >50%
1 patient even minute
< 4 millions___________________
Thousands____________________
11000 per day_________________
E\ eiy 10 seconds_______________
300 per year___________________
; 50 lacs
____________________
About 20 million
_____
I Huge number__________________
; Pon t know / no idea / no response
Table 22: Awareness about types of tobacco use by category of respondents
Administrators
Researchers
GMO
PP
Paramedical
StafT
Total
N=35
N=30
N=50
___ 49
47
23
37
36
__ 50
___ 24
___ 50
___ 50
16
N=66 N=122
76
_ __ 60
77
56
10
___ 10
32
42
36
38
85
___ 58
02
21
99
___ 66
97
66
38
12
N=.303
29
28
09
27
27
31
16
32
33
03
Gutkha________________
Pan masala_____________
; Mava_________________
i Snuff
__ __________
Khaini_________________
Betel leaf with tobacco
Areca nut with tobacco
Cigarette_______________
Beedi_________________
Others (chutta. ganja, hans
I hukka. chewing)__________
*Data corresponds only to health workers & pharmacists
29
26
05
27
18
29
12
28
28
04
243
234
57
165
155
253
75
275
274
73
Table 23: Awareness about diseases attributed to tobacco use by category of respondents
Paramedical
PP
GMO
Researchers
Administrators
Staff*
N=66 N=122 __
N=50
N=30
N=35
28
___
34
34
07
21
Respiratory tract infections
56
___
37
26
02
09
Pulmonary TB / pleural e/Tbsion
36
30
____ 37
06
22
Cancer of lungs / lung disorders
45
41
___ 36
05
Oral cancer / mouth cancer
2J
22
3S
16
11
19
Diseases related to heart and
Circulatory system__________
29
22
13
03
05
Ulcers (mouth, gastric)_______
00
05
00
00
00
Sub-muco fibrosis__________
03
02
03
00
0}
Teeth / gum problems_______
00
03
00
00
00
Birth deficiencies___________
03
00
00
00
00
Liver problems____________
04
00
00
00
Nerves weakness______________ |________ 00
*Data corresponds only to health workers &. pharmacists
.9”
Table 23.1: Responses to the question “What are the diseases attributed to tobacco use?
I
Respiratory tract infections_______________
Pulmonaiy TB / pleural effusi on
! Cancer of lungs / lung disorders____________
i Oral cancer / mouth cancer_______________
Diseases related to heart and Circulatory system
Ulcers (mouth, gastric)__________________
Sub-muco fibrosis______________________
Teeth / gum problems___________________
Birth deficiencies
Liver problems ______________________
I Nerves weakness______________________
Anemia___________________________ _
Industrial hazards______________________
RTI / white discharge___________________
Mental problems______________________
Addiction____________________________
Burger’s disease ____________________
Blindness___________________________
Stroke ____________________________
Gastro intestinal diseases
# Said
124
130
131
148
106
____ 72
____ 05_
09
03
____ 03_
04
____ 02
____ 01
____ 02
01
___ 02
01
01
____ 02
01
Total
N=303
124
130
UT
148
106
72
05
09
03
03
04
Table 24: Tobacco component responsible for ill-effects by category of respondents
Administrators
Researchers
GMO
N=35
N=30
N=50 N=66
___ 47 ___ 64
___ 22 ___ 35
___ 24 ___ 32
06
01
Paramedical
Staff*
N=122
_____ 80
_______ 12
______ 07_
01
00
06
NA
NA
NA
NA
NA
Nicotine_____________________
NA
Tar_________________________
NA
Smoke______________________
NA
Others (599 toxic agents, tannin,
hydrocarbons, benzpyrine, carbon
Oxide, smell)_________________
,________
____
bA
Don't know / can
’t remember
*Data corresponds only to health workers & pharmacists
PP
00
NA
Table 25: Frequency of advice about ill effects of smoking by category of respondents
Administrators
Researchers
Paramedical
Stall*
N=122
80
23
02
01
PP
GMO
N=66
N=50
N=30
____
36
NA
NA
Regularly
14
NA
NA
Sometimes
00
~
NA
NA
Rarely
00
NA
NA
Never
__________
*Data corresponds only to health workers & phannacists
N=35
47
17
01
01
Table 26: Role in reducing tobacco use by category of respondents
Administrators
Researchers
N=35
N=30
21
Health education through mass
campaigns__________________
11
Counsel patients about
; consequences and motivate them
I to give up________ ___________ ________________
*Data corresponds only to health workers & phannacists
14
16
Paramedical
Stall*
N=122
N=66
N=50
106
36
40
PP
GMO
36
47
80
Table 26.1: Responses to the question “What role do you think you could play in reducing tobacco
use?”
Health education through mass campaigns____________________
Counsel patients about consequences and motivate them to give up
Scare people by showing pictures of terminal stage cancers
Be a role model by not using tobacco________________________
Explain patients about environmental pollution________________
Governments role is more significant than ours
Cancer detection camps___________________
_____________
Celebrating Anti tobacco day_______________________________
Sensitizing die policy makers_______________________________
Take stringent measures
Writing articles____________________________ ____________
Lectures in selective groups
# Said
217
190
04
06
_____ 01
_____ 01
_____ 02
_____ 02_
01
°1
01
01
Total
N=303
217
190
Table 26.2: Suggestions for dealing with tobacco use by category of respondents
Administrators
Researchers
N=35
N=30
Restrict tobacco ads
_______
23
_______ 07
Ban advertisements________
16
______ n
No smoking in public places /
20
16
having smokers’ zone_____
Increased taxes on tobacco product
00
00
Stronger warnings on tobacco
13
11
Products
Ban on sale near schools
11____
12
Total ban on production and
04
05
sale of Tobacco
*Data corresponds only to health workers & pharmacists
GMO
PP
| Total
Paramedical
Stair
N=50
N=66
N=122
___ 33 ___ 51 _______ 73
___ 26 ___ 36 _______ 42
28
44
52
N=303
187
137
160
18
20
26
28
32
35
76
107
19
11
32
11
33
22
107
53
Jomitry?”: ReSpOnSeS t0 thc fluesti()n “What in your opinion will have impact on tobacco use in this
p )unr>’
--------------Restrict tobacco ads-----------------------Ban advertisements
~
~
- ---No smoking in public places / having a smokers’ zone
Increased taxes on tobacco products
Stronger warnings on tobacco products
~
Ban on sale near schools
Total ban on production and sale of tobacco
-Individuals becoming conscious about health hazards
’
Provide information about alternative crops that farmers can grow_____
Fixing minimum age for smoking
Tobacco companies have to pay for the tobacco related diseases
Counseling patients on individual level
Health education to people through different communication mcdia
Tobacco companies should not sponsor sports events
Ferocious ads_____________
——————————
Not showing film actors in tobacco ads
"
~~
-Encourage, give prizes, provide government facilities to Fhosc u ho give up tobacco use
Advise people to handle mental worries
Table 27: Age at tobacco use for males by category of respondents
Administrators
Researchers
GMO
N=35
N=30
<=15 years _____
18
20
> 15 years_________ _
16
10
Don’t know / can’t say
01
00
*Data corresponds only to health workers <fc pharmacists
PP
Paramedical
# Said
187
137
160
____ 76
107
107
53
02
04
01
___
02
09
01
03
02
01
02
Total
Stair
Nj=50^
_ ___ 35
_____ 15
00
N=66
N=122___
42
84
___ 20 _______ 22
04
16
N=303
199
___ 83_
21
Tabic 27.1: Age at tobacco use for females by category' of respondents
Researchers
GMO
PP
Administrators
N=30
10
11
<= 15 years_________
15
09
> 15 years__________
10
10
DonT know/ can't say'
*Data corresponds only to health workers & pharmacists
N=35
Table 27.2: Role of parents by category of respondents
Administrators
Researchers
____________________
N=35
N=30
To a large extent_____
______ 25
21
______ 04
i To some extent
11
I Not at aO
00
00
’ 61
Don't know / can’t say
03
*Data corresponds only to health workers & pharmacists
N=50
_____ 13
_____ 37
00
Paramedical
StafT
N=122
N=66
N=50
____ 37 _____56 _______ 95
09 _______ 09_
____ 13
02—
01
00
' 00
00
66
GMO
Total
Paramedical
Stair
N=66
N=122
_____ 16 _______ 49
____ 38 _______ 44
12
29
PP
N=303
99
143
61
Total
N=303
____ 234
___ 4£
(14
Table 27.3: Suggestions to prevent children from using tobacco by category of respondents
Administrators
Researchers
GMO
Paramedical
PP
Total
StafT
1___________________________
I Giving health education about
i bad-effects in schools /
motivating________________
Give them education /
I Schooling_________________
Parents should be role models /
j counsel parents or family
i members
Divert their attention from
i Tobacco___________________
; Use interesting methods like
1 films, exhibitions to
| communicate them__________
i Control pocket money
106
N=303
224
10
11
26
15
09
25
52
NA
01
02
02
08
04
NA
01
04
07
16
00
NA
00
00
06
06
N=35
33
NA
N=50
50
N=66
35
02
NA
03
03
NA
03
N=30
*Data corresponds only to health workers & pharmacists
N=122
Table 27.4: Responses to the question “What can you do to prevent children from using tobacco?”
# Said
224
26
52
08
16
06
03
01
03
04
03
01
02
03
01
01
02
Giving health education about bad-elTccts in schools / motivating
Give them education / schooling______________________________
Parents should be role models / counsel parents or family members
Divert their attention from tobacco
_
_
Use interesting methods like films, exhibitions to communicate them
Control pocket money______________________________________
Ban tobacco sale near schools________________________________
Reduce social acceptance of tobacco use_______________________
Not showing the actors smoking in TV serials / films
Advise them in a friendly way_______________________________
Threaten them____________________________________________
Advise them about moral values____________________________ _
Punishment
_________________________________ _ ____
Ban on tobacco products____________________________________
Tobacco products should not reach the hands of children_________
Children should not be out free after 6.00 pm___________________
Peer pressure works on them
Table 27.5: Access and use of information related to tobacco use by category of respondents
NA
12
Paramedical
Staff1'
N^122_
17
01
NA
NA
18
16
06
32
28
2S
47
59
96
Administrators
Researchers
GMO
N=35
N=30
N=50
17
# of respondents who issued / received
government letter about tobacco use_______
NA
# of respondents with health education mater
NA
# of respondents who used health
education material in the community_______
2X
# of respondents who think that giving
information about bad effects of tobacco
will help community to reduce tobacco
use________________ ________
*Data corresponds only to health workers & pharmacists
PP
(28
Table 27.6: Responses to the question “List the health education materials related to anti tobacco use
you have.”
Poster / chart / photo / wall poster / pamphlet / sticker
Books_______________________________________
Flash cards
Smoke-quit
# Said
____ [8
02
05
01
Table 27.7: Responses to the question “Details of any study you know on how to reduce tobacco use in
the community.”
Health education campaigns____________________________
About how ads increase tobacco use (article in BMJ)________
Survey by KIDWAI on tobacco use______________________
On a visit to a cancer hospital___________________________
Studies given to public regarding the attack of TB__________
World bank publication - curbing the epidemic 1999_______
Recent introduction of anti abuse therapy to prevent sinoking
__________
Through CME^S
j WHO publications
I National study - economics of tobacco use
i Parliamentary committee recommendation_________________
I ICMR and AllMS studies
j HRIDAY
~
j Canadian Lung Association study 1990
# Said
06
__ 01
02
01
01
01
01
oT
02
0]
01
01
01
01
Table 28: Information needs on other public health problems by category of respondents
Maternal & infant health______________
Child & adolescent health_____________
| Reproductive health__________________
j Adult health
■ Gender & health_____________________
l_Health & the elderly
_ _ _ _
__
Migrant & refugee health______________
Acute respirator} infections / pneumonia
Diarrheal diseases___________________
HIV / AIDS________________________
Malaria____________________________
Mental health_______________________
Tobacco use________________________
Tuberculosis________________________
Infectious disease____________________
Vcctor-boruc. parasitic & tropical disease
Non-conununicable / clvonic disease
Disabilities_________________________
Eye diseases & blindness______________
Oral health
Substance abuse_____________________
Blood safety________________________
Violence & injuries__________________
Health information systems & tools_____
Medical & laboratoiy technology_______
Pharmaceuticals, vaccines & biologicals
Intersectoral public health topics_______
Development & health________________
| Environment & health
PP
Administrators
Researchers
GMO
N=35
N=30
N=66
N=50
47
43
___ 31 ___ 29
_ 34
___ 35
___ 14 ___ 25
09 ___ 09
05
17
03
04
40 ___ 47
40
42
__ 38 ___ 48
___ 39 ___ 46
22
23
___ 42 ___ 42
___ 46 ___ 59
___ 28 ___ 41
24 ___ 17_
16
____ 12_
16 ___ 10
___ 26 ___ 22
_22
23
06
11
____14 ____19
___ 14
__16
____ 12 ____ 13
09 ___ 10
____ 17 ____ 14
___ 07 ___ 05
____ 15 ___ 08
23
16
18
10
14
09
07
14
03
14
15
23
20
10
16
25
14
11
08
10
10
04
08
11
06
15
08
08
09
09
12
08
07
07
06
06
09
11
16
09
11
09
05
15
21
11
08
09
03
05
04
05
05
03
04
03
03
04
04
03
Paramedical
StifT
N: 122
86
82
80
59
03
25
’ 31
81
___ 81
95
103
43
___ 74
114
74
64
36
40
74
47
20
____ 40
____ 23
37
____ 29
____ 38_
26
31
52
i_____________________________
| Administrators
Researchers
N=35
N=30
07
04
06
04
01
04
09
02
02
02
02
03
05
05
10
07
_05.
07
03
07
27
03
08
05
02
05
08
05
09
04
02
02
11
10
10
06
10
06
13
H
09
01
10
03
24
18
14
11
10
08
08
04
05
09
02
06
07
15
10
07
Ethics & health________________
Globalization &. health__________
Health economics & financing
Human rights & health__________
Information sciences and health
Nutrition & food safety
Occupational health____________
Public / media relations & healtli
Travel & health
Water resources & sanitation
Zoonoses & veterinary' health
Primary' & community health_____
Prevention & control of disease
Surveillance & reporting________
Epidemiology & statistics_______
Treatment & healthcare_________
Diagnostics___________________
Drug information______________
Surgery & anesthesia___________
Rehabilitation_________________
Emergency response in health
Traditional / alternative medicine
Research methods
Evidence-based policy & practice
Healtli policy & legislation______
Health systems________________
Capacity building & sustainability
Management and administration
Program planning & evaluation
Medical sciences__________
Nursing and midwifery_________
Allied health disciplines________
Professional/continuing education
16
13
09
06
03
09
Paramedical
Staff
N=122
N=66
N=50
10 ~
17
18
___ 05_'____ 12
07
06 ~____ 10
09
09 '
15 ______ 22
13 “
12
15
63
31
22 '
21
19
21
11 ~
24
10
09 ’
06
11
47
29 ____ 25
10 ~ __ 08^
_____09
29
18 ______ 54
34 ~ _28
______ 52
21 '____ 08 ______ 46
11 ______ 35
____ 19_
42
____ 24_
25
____27_'
____ 26
31
24 '____ 29
____ 34
12 '
15 _____ 01
_____ H_’ ____ 15 ______ 12
17 '
25 ______ 22
07 '
____ 05
11
08 ’
18
05
05 ____ 12_
02
____ 09_’____ B ____ 06
____ 14 ______ 18
____ 02_'
07 ______ 03
08 ______ 09
___ 14j
____ 09_’
10 ______ 10
12 ‘
08
13
~ 38
07
____
08 '
04 _____ 08_
26
21
18
I GMO
pp
_
__ 0£
Table 29: Most useful source of information for general awareness by category of respondents
Books______________________
Databases and indexes______________
Journals & scicnlific publications_____
Meetings_________________________
Print news services (papers, magazines)
Regular reporting__________________
Technical guidelines________________
TV & radio_______________________
Librarians & reference services_______
Colleagues 7 experts
Administrators
Researchers
GMO
PP
N=35
N=30
06
____ 03
______06
______07
04
04
____ 05
____ 03
____ 07
03
____ 02
____ 08
____ 03
01
N=50
16
00
___ 04
__ 11
N=66
20
04
____ B
_____ 01
_____ 03
______22
_____ 02
03
06
__L)1
01
19
01
01
__ 06
__ 11
__ 19
06
__ 03
26
05
04
Paramedical
Staff
N^122____
17
00
00
10
35
00
01
56
00
01
Tabic 29.1: Most useful source of information for awareness in area of expertise by category of
respondents
Administrators
Researchers
GMO
PP
N=35
N=30
03
____ 05
... 09
____ 02
____ 00
____ (H_
01
____ 00
04
' 00
00
N-50
09
__ 05
13
__ 10
02
__ 03
04
05
N=66
16
03_
24
08
08
08
05
05
04
09
00
09
06_
14
06
04
05
05
08
03
05
00
Books___________________________
Databases and indexes______________
Journals & scientific publications_____
Meetings_________________________
Print news sendees (papers, magazines)
Regular reporting__________________
Technical guidelines________________
TV & radio_______________________
Librarians & reference services
Colleagues / experts________________
Training
05
00
Paramedical
StafT
N=122
14
D3
08
'45
10
r7
|J7
| JO
12
32
Table 29.2: Most useful source of information for in-depth information in area of expertise by
category of respondents
Books___________________________
Databases and indexes______________
Journals & scientific publications_____
Meetings_________________________
Print news senices (papers, magazines)
Regular reporting__________________
Technical guidelines
TV & radio_____________ __
Librarians & reference services_______
Colleagues / experts________________
Training
Administrators
Researchers
GMO
PP
N=35
____ 09
_____ 09
_____ 15
04
_____ 04
____ 07
jl
04
04
_____ 04
00
N=30
06
____ 06
____ 10
____ 01
____ 00
02
02
00
____ 05
____ 00
00
N=50
__ 10
03
13
03
03
03
06
04
05
05
00
N=66
13
05
33
04
07
01
08
04
02
05
00
Paramedical
Staff
N=122 __
41
00
____
19
0<j
05
07_
____ 13
01__
____ 08__
33
Table 29.3: Most useful source of information for in-depth information outside the area of expertise
by category’ of respondents
Administrators
N=30
TV & radio______
____
Librarians & reference services
Colleagues / experts
GMO
PP
09
03
05
04
05
____ 03
06
03
01
02
N=50
06
04
07
02
08
N=66
10
_04
08
05
04
00
03
01
01
03
03
00
00
02
07
03
04
02
07
N=35
Books______________________
Databases and indexes
Journals & scientific publications
Meetings____________________
Print news services (papers,
magazines)__________________
Regular reporting_____________
Technical guidelines___________
Researchers
(2?
03
02
-?3
07
06
Paramed ical
Staff
N=122
___ 23
J)1
____03
____ 00
18
01
06
33
03
07
Table 29.4: Preferred language for general awareness by category of respondents
Administrators
Researchers
GMO
PP
N=35
N=30
_____ 00
N=50
06
20
10
00
__ 00
__ 15
00
N=66
06
40
10
01
00
__ 09
00
00
13
01
00
00
06
00
Kannada / English
English_________
Kannada________
Hindi__________
Telugu_________
Oriya__________
Bengali
_____06
_____ 00
00
____ 00
04
00
Paramedical
Staff
N=122
09
04
66
01
00
37
01
Table 29.5: Preferred language for awareness in area of expertise by category of respondents
Administrators
Researchers
GMO
N=35
N=30
N=50
06
10
07
00
__ 00
00
Kannada / English
English_________
Kannada________
Hindi__________
Telugu_________
Oriya__________
Bengali
1£
00
00
00
01
00
00
10
00
00
_____ 00
_____ 01
00
__ 06
00
N=66
Paramedical
Staff
N=122
__ 06
12
15
~ 03
__ 01
00
_08___
61
01
00
34
01
PP
__ 06
00
Table 29.6: Preferred language for in-depth information in area of expertise by category of
respondents
Administrators
Researchers
GMO
PP
N=35
N=30
00
N=50
06
36
06
01
' 00
02
00
N=66
04
53
03
(10
00
06
00
Kannada / English
English_________
Kannada________
Hindi
Telugu_________
Oriya__________
Bengali
00
10
00
00
00
_____10
____ 00
00
00~
01
00
01
00
Paramedical
Staff
N=122
14
13
59
01
00
30
01
Table 29.7: Preferred language for in-depth information outside area of expertise by category of
respondents
Kannada / English
English_________
Kannada________
Hindi
Telugu_________
Oriya______
Bengali
Administrators
Researchers
GMO
PP
N=35
N=30
00
09
____ 00
00
____ 00
N=50
08
34
06
00
01
02
00
N=66
03
58
02
01
00
04
00
00
10
00
00
00
01
00
01
00
Paramedical
Staff
N=122
15
11
58
02
00
31
01
Table 30: Main difficulties related to information access in general awareness by category of
respondents
No difficulty______________
Difficult to get____________
Don't know where to find
Difficult to use____________
Expensive_______________
Poor quality______________
Irregular_________________
Not up to date_____________
Not relevant to local situation
Not in prefcred language
Administrators
Researchers
GMO
pp
N=35
______ 17
___ 04
______ 01
______ 00
______ 05
N=30
___ 12
_04
___ 01
___ 2]_
02
___ 01
___ 02
03
02
00
N=50
31
09
~ 03
03
_ 10
_ 02
10
06
N=66
33
13
08
02
04
06
07
_ 07
05
05
______ 03
______ 06
07
J13
02
21
03
Paramedical
Staff
N=122
96
11
04
02
02
09
08
02
01
05
Table 30.1: Main difficulties related to accessing general information within area of expertise by
category of respondents
No difficulty______________
Difficult to get____________
Don't know where to find
Difficult to use____ _______
Expensive________________
Poor quality______________
irregular_________________
Not up to date_____________
Not relevant to local situation
Not in prefered language
Administrators
Researchers
GMO
PP
N=35
N=30
N=50
__ 21
N=66
24
15
09
03
12
04
10
08
08
02
_13
______ 09
__ 01_
01
05
03
______ 09
__ 09
05
02
_ J2
04
___ 01
00
03
___ 01
_ 01
__ 03
___ 01
01
1 1
03
04
09
03
__ 12
07
01
03
Paramedical
Staff
N=122
32
90
04
_ 03__
16
03
10
05
08
05
Table 30.2: Main difficulties related to accessing in-depth information within area of expertise by
category of respondents
No difficulty______________
Difficult to get____________
Don't know where to find
Difficult to use____________
Expensive________________
Poor quality______________
Irregular_________________
Not up to date_____________
Not relevant to local situation
Not in prefered language
Administrators
Researchers
GMO
PP
N=35
N=30
N=50
15
20
06
02
18
03
11
06
03
03
N=66
18
15
07
__ 06
20
04
11
06
06
02
11
10
01
01
07
02
10
06
03
01
06
____ 06
____01
__ 01
____03
01
____ 02
03
____ 00
00
----- J—
Paramedical
Staff
N=122 I
36 |
27
09
05 |
11
03
07
14
___ ILL
io_
Table 30.3: Main difficulties related to accessing in- depth information outside area of expertise by
category of respondents
Administrators
Researchers
GMO
PP
N=35
N=30
09
__ 02
03
__ 01
02
___ 01
___ 02
00
00
N=50
17
16
08
04
16
03
09
05
_05
08
N=66
No difficulty______________
___ (m
Difficult to get_______
__ __ 08
_____04
_____ 02
_____ 08
03
__ 08
04
04
03
Don't know where to find
Difficult to use____________
Expensive________________
Poor quality______________
Irregular_________________
Not up to date_____________
Not relevant to local situation
Not in prefered language
” 00
21
_14
10
06
09
04
11
05
07
04
Paramedical
Staff
N=122
70
21
07
03
09
02
08
02
06
~ 02
Table 31: With whom it is most important to communicate by category of respondents
Superior_________________
Colleagues or experts within
your organization__________
Colleagues or experts outside
your organization__________
Directly with patients_______
Directly with general public
Funding / donor agencies
Press / mass media / advocacy
groups___________________
Total
N=66
20
Paramedical
Staff
N=122
90
Administrators
Researchers
GMO
PP
N=35
N=30
N=303
170
20
17
N=50
23
29
23
33
34
85
204
17
16
05
23
30
91
16
16
36
15
10
28
13
03
57
54
01
168
132
13
43
25
07
16
09
13
11
08
57
37
Table 32: Need for new information related to the work & preferred form to have such information
by category' of respondents
ft of respondents who need more infonnatio
Preferred form to have such information
Electronic media such as Internet.
Email
_________________________
Newsletters or fact sheets_______________
Verbally from colleagues and experts_____
Scientific journals____________________
AV media such as CD. DVD____________
Magazines and newspapers
CME / conference
________ _
Administrators
Researchers
GMO
PP
N=35
N=30
N=66
34
29
N=50
45
27
26
21
16
26
26
29
01
Paramedical
Staff
N=122
66
1 16
39
54
64
23
34
11
31
23
14
15
00
41
37
51
44
62
50
58
00
84
92
65
98
94
00
39
01
Tabic 33: Use of new information by category of respondents
PP
Administrators
Researchers
GMO
N=35
N=30
N=66
N=50
__ 39_ ___ 47
13 ___ 09
___ H_ ___ 08
___ 19 ___ 28
16 ___ 19
02
03
02
___ 00
25 __ n_
ii
09
___ 08 ___ 08
26 ___ 20
__ 2fy ___ 23
20
15
17
18
08
05
14
18
15
10
09
Support diagnosis and treatment
Make policy / program decisions
Advise decision / policy makers
Modify treatment protocol_______
Respond to emergencies_________
Prepare grant / funding proposals
Issue press releases_____________
Use in lectures / presentations_____
Include in articles / books________
Adapt and distribute for local use
Develop health education material
Circulate to colleagues
Find more information on the topic
File for later reference
£1
14
07
06
05
17
03
04
17
18
12
07
01
19
14
04
08
07
11
12
Paramedical
Stall
N=122
56
04
04
1 07
10
_______ 02
_______ 01
09
08
_______ 15
_______ 26
69
3fy
07
Table 34: Access to Internet by category^ of respondents
Administrators
N=35
x=
N=30
09
No_
Yes - al home__________________
Yes - at an Internet cafe__________
Yes - at work___________________
Yes - al home and work__________
Yes - others (at relatives’ or friends'
house)
I Researchers
02
00
05
14
00
08
08
02
03
09
00
PP
GMO
N=66
N=50
3[
38
05
11
___ 05 ___ 14
04
___ 02
_
04
___ 00
02
00
Table 34.1: Access to Internet in the last one month by category of respondents
0_
1-2
3-4______
5-6______
7-8_____
9-10
11+_____
No response
PP
Administrators
Researchers
GMO
N=26
N=22
N=35
N=12
__05
__ 05
06
___ 01
01
09
02
____ 01
___ 01 ___ 04
01 ___ 03
___ 02 ___ 01
05
00
Ofy
03
03
02
00
02
09
06
02
03
01
00
01
00
00
II
Paramedical
Staff
N=07
02
03
00
00
00
00
02
00
Paramedical
Staff
N=122
1 15
01
02
______ 00
______ 00
04
Table 34.2: Awareness about web sites giving health information and those accessed by category of
respondents
Administrators
Researchers
N=35
N=30
# of respondents aware about web sites givi
health information_____________________
Web sites accessed____________________
Jama.com____________________________
IMA________________________________
WHO____
Tbindia.org__________________________
Bmj.com____________________________
Search engines like googly etc.
21
16
02
02
04
03
00
02
00
00
01
00
00
01
PP
Paramedical
Staff
N=50
N=66
N=122
08
25
02
GMO
01
00
00
00
00
00
03
04
o<2
00
02
00
Table 34.3: Responses to the question “Websites you know that are giving health information.”
# Said
Jama.com
1MA/1MA KSB (Karnataka State Branch)WHO________
Tbindia.org__________________________
Bmj.com____________________________
Search engines like googly etc.__________
Academy of General Practitioners________
Www.docasia.com____________________
Gynecology site______________________
Johns Hopkins_______________________
Cdc.gov_____________________________
www. doc torsk in g, com_________________
Doctorsanywhcre.com_________________
Fogsi.org____________________________
Mcdiline.com
Livizi.com___________________________
www.harrisononline.com_______________
Doctors, com_________________________
Mcdscape.com_______________________
Diabetes & AIDS related_______________
Substance abuse related________________
yvww.stoptb.org______________________
Amedeo.net__________________________
NT1________________________________
TRC___________
www, hea It h scva. com__________________
www.indcgcne.com
06
06
____ 05
__ 03
____ 02
____ 03
____ 01
____ 01
____ 01
01
01
____ 01
____ 01
____ 01
01
01
____ 01
____ 01
____ 01
____ 01
____ 01
____ 01
____ 01
01
01
_____ (H
01
00
00
00
00
00
00
Table 34.4: Kinds of sites / information accessed by category of respondents
Administrators
Researchers
GMO
PP
N=26
N=22
N=12
___ 03
___ 05
___ 04
__ 05
05
01
N=35
___ 09
___ |5
___ 03
___ 10
___ 06
04
09
13
05
07
06
03
08
19
02
06
10
02
None____________________________
Information related to the present work
Non-work related information_______
General knowledge________________
New information__________________
Entertainment matters
Paramedical
Staff
N=07
02
00
00
04
01
03
Table 35: Types of barriers in using Internet by category of respondents
Don’t have the time_____________
Insufficient skills for computer use
Insufficient skills for Internet use
Very costly____________________
Local censorship issues__________
Not in preferred language
Too much information__________
Uneven quality of information
Electricity outages_/ interruptions
Internet connection in inconvenient
Location______________________
Slow Internet connection ______
Telephone line problems
No access to computer__________
No interest____________________
No barriers at all
Administrators
Researchers
GMO
N=35
N=30
N=50
___ 09
___ 23
___ 15
05
02
_ 06
02
01
05
15
09
06
02
07
05
04
05
00
00
03
05
10
02
02
00
00
02
04
03
10
04
()()
00
02
02
08
00
00
02
do
02
03
00
00
03
Paramedical
Staff
N=66
N=122
08
___ 21_
17 _______ 37
___ 08 _______ 22
07
12
02
____ 00
06
01
00
05
11 _______ 00_
09
07
05
10
PP
17
05
00
00
02
16
03
13
02
00
Table 36: Number of respondents who think access to the internet will help them in their work and
benefits mentioned by category of respondents
# of respondents who think that ace
to the Internet will help
them in their work____________
Benefits mentioned_____________
Can get more information________
Can get new information about dru<
diagnosis / management
/ technology / statistics / rare disease
Can interact with colleagues / patici
superiors, networking___________
Get expert opinion for
complicated cases / to modify progr
Easy and quick access___________
For research___________________
For teaching
Administrators
Researchers
GMO
N=35
N=30
I N=50
Paramedical
StafT
N=66
N=122
102
58
PP
34
29
47
12
25
15
21
28 !,
47 !
27 ,
11
04
09
04
00
08
00
00
06
01
02
00 |
00 '
Total
N=303
270
58 I
45
78
127
229
02|
18
44
03~|
08
20
08 |
12
00
00
42
04
02
03 I
00]
Table 36.1: Responses to the question “List up to three key ways in which you think access to the
Internet would help your work.”
# Said
_______
[27
Can get more information___________________________________ _
229
Can get new information about drugs / diagnosis / management / technology
statistics / rare diseases________________________________________ ___
44
Can interact with colleagues / patients /
Superiors, networking____________________________________________
20
Get expert opinion for complicated cases / to modify program____________
42
Easy and quick access_____________________________________________
04
For research___________________________________________________ _
02
For teaching___________________________________________________ _
01
To get the reports__________________________________________
01
To continue medical education_____________________________________
01
Better private management_________________________________________
01
Online treatment facilities_________________________________________
01
Less cost_______________________________________________________
01
Society will be benefited indirectly__________________________________
01
Better quality of information_____________________________________ _
01
Capacity building_________________________________________ __
01
Increases work capacity_________________________________________ _
01
User friendly____________________________________________________
01
To write scientific articles / presentations_____________________________
01
File for later references______________________________________ _
01
Information about other interests like Astrophysics
Table 37: Basis for developing guidelines of TB control program
RNTCP program_________________________________
Failure in NTCP _______________________________
NTFS and TRC’S pilot study in 1960s
To control sputum positive cases thereby prevent spread
Based on the principle that TB patients can be treated in
their homes
_________________________________
Resistance cases have been noticed in the society because
| of the insufficient drugging_________________________
! Adequate maintenance, supply of drugs_______________
I No response
Administrators
N-35________
06
03
13
03
01
Researchers
N=30
02
06
07
03
04
01
01
01
13
01
08
Table 37.1: Responses to the question “Do you know on what basis the guidelines for TB control
program have been developed?”
# Said
__ 08
09
20
06
05
02
_ 02
__ 01
01
01
__ 01
__ 01
01
01
01
RNTCP program________________________________________________
Failure in NTCP__________________________________________________
; NTTs and TRC'S pilot study in 1960s______________________________________
1 To control sputum positive cases thercbi prevent spread
Based on the principle that TB patients can be treated in their homes
Resistance cases have been noticed in die society because of the insufficient drugging
Adequate mainlenancc. supply of drugs
! Due to emergency of MDR-TB_____________________________________________
| Chest symptomatic
________________________
! Sputum microscopy for diagnosis__________________________________________
; Category of disease_____________________________ __ ______________________
| Compliance was poor - result of a research
j Epidemiology of TB________________________________
Small scale field based studies in South India
_____________________________
Findings of controlled clinical trials using DOTS ____________________________
Table 38: Details of private practice
N umber of government medical officers with private practice
Number of government medical officers practicing since 5 years or less
N=50
12
08
Table 38.1: Responses to the question “How do you think regular reporting by you helps in program
management?”
Assessing the program at PHC level_______________________
To get adequate drugs / reagents__________________________
To implement and improve RNTCP_______________________
Follow up of patients___________________________________
Regularity of treatment__________________________________
Correct diagnosis of sputum positive cases__________________
To know the effectiveness of the program and further planning
Continuous supervision_________________________________
To monitor the program_________________________________
Helps in eradicating the disease____________
To maintain vital statistics of RNTCP
# Said
03
03
06
__ 10
03
03
02
03
03
(12
01
Table 39: Investigations ordered on clinically suspecting TB
X-ray_____________________________________________
Mantoux test_______________________________________
Sputum examination_________________________________
Blood test ______________________________________
IgG, IgM, PCR etc._________________________________
ESR_________________
Csf, pleural / peritoneal fluid analysis in appropriate settings
Table 40: Sending the patients for X-ray and lab investigation
Own X-ray_______
Government X-ray
Other Private X-ray
Own lab________
Government lab
Other private lab
N=66
13
20
44
17
18
44
Table 41: Drugs normally prescribed
Rifampicin__________
INH________________
Pyrazinamide________
Ethambutol_______
Streptomycin_________
Ofloxacin___________
Com bi pack__________
B-complcx, haemotonic
N=66
57
55
49
54
30
09
20
01
N=66
61
36
64
40
10
_02_
01
Table 42: Duration given for each prescription
One week
Fifteen days
One month
Two months
Six months
Entire duration
N=66
05
02
27
13
06
14
Table 43: Number of private practitioners using individually tailored treatment regimen for the
patient and parameters on which they decide treatment
ft of private practitioners who use treatment
regimen individually tailored for the patient
Parameters on which they decide treatment
Clinical__________
Radiological extent
Associated other illness________________
Organ involved _____________________
Body weight
__________________
Previous treatment status_______________
Socio-economic condition______________
Sputum examination__________________
ESR
I Severity of the disease
N=66
58
38
33^
20
20
36
01
03
01
04
02
Tabic 44: Number of private practitioners who feel that they play an important role in TB control and
their role in government TB control programme
# of private practitioners who feel that they play an important role
in TB control___________________________
The roles they play_____________________________
Referral of chest symptomatics______________________
Referral for sputum examination__________________
Contribute to surveillance
As DOTS center__________________________________ _
Tell patients about government medicines___________________
Giving statistics____________________________
Referral of poor to sanitarium______________________
Follow-up
N=66
64
29
26
35
13
01
01
01
01
Tabic 45: Government’s support
N=66
Training_____________________________________________________ ___________
Providing diagnostic facilities______
Providing drugs / decrease prices of anti TB drugs___________________ ___________
Updating on government policy, update private practitioners on recent der^elopments in
government programs___________________________________________
Government should show interest________________________________ ____________
Help in follow-up__________________________________________ _______________
i Increase coordination between private and government______________________
j Register / regularize all private practitioners________________________________ _
I Get the statistics from private practitioners
Table 46: Methods of delivering information
Personal communication
| Journals_____________
j CME________________
, Internet______________
i AV media. CD. DVD
i Government circulars
Orientation programs
; Pamphlets, news letters
Books_______________
Doctors
N=122
96
21
05
63
99
88
1 10
03
01
02
Table 47: TB training
! Number undergone TB training / RNTCP training
N=106
87
Table 48: Importance of directly obsen ing the treatment
I
Correct treatment ensured
Take more care
, Observe improvement
1 Prevent spread of TB
I Prevent default________
i To cure disease________
i Observe side-effects
i To prevent over-dose
N=106
92
24
29
03
03
01
01
01
30
34
25
02
01
01
01
01
Table 49: Importance of educating patients before starting treatment
N=106
84
14
50
04
04
05
01
01
01
Ensure need for regular treatment
Need for DOT______________
Preventive aspects of TB______
Know patient and family
__
Remove fear about disease_____
Self-confidence_____________
Side-effects________________
| Assure it is curable__________
Diet and hygiene
Table 50: Importance of home visits in case of patient default
N=106
76
I To cure patient____________
I To buiId rapport with paticnt
■ Prevent disease from spreading
: Prevent drug resistant TB
I Prevent disease from recurring
! To ensure correct treatment
j To avoid default___________
i To find out reason for default
To restart treatment
J8_
61
08
08
07
02
01
01
Table 51: Importance of sputum exam
N=106
103
22
11
1 Definite diagnosis
! Easy to monitor progress
j Easy to motivate patient
Table 52: Results if patient does not take treatment
N=106
88
88
10
13
01
01
Will not get cured______
Spread of disease to others
Drug resistant disease
Death________________
I Loss of weight
i Will turn to AIDS
3?
Table 53: Number of paramedical workers w ho maintain treatment card & objective of maintaining
treatment card regularly
# of paramedical workers maintaining treatment card
Objective of maintaining treatment card regularly
Check on regularity of treatment_________________
Quick defaulter retrieval action__________________
Easy for supervision__________________________
; F0110W-Up_______________________________________
i Know dmg reaction
i Know histoiy of patient________________________
■ Need for drugs
N=106
84
93
35
45
04
01
01
02
Table 54: Qualification*
i
i_________________________________________________________________________________________________
| SSLC or below
PUC______________________________________________________________
| Graduation (B.Sc.. B. Sc .-Nursing. B.A..)_________________________________
Multipurpose -workers training / junior health assistant training / LH V training /
RCH training / basic health worker (BHW) training / pharmacist training,7 health
inspector training / continue education training
Condensed general nursing____________________________________________
Diploma in public health______________________________________________
I Indian population project 9 (IPP 9)
■ TCH
I No response________________________________________________________
*No response to the above question in Orissa
N=92
45
14
04
31
02
03
01
01
30
Table 55: Role of paramedical workers in reducing tobacco use
I # of health workers who feel they can play an important role______
i # of health w orkers who feel they arc well-equipped to play this role
Table 56: Drugs given to TB patients
i Rifampicin
INH_______
Pyrazinamide
I Ethambutol
Streptomycin
Ofloxacin
| Combipack
N=14
14
13
14
14
08
01
01
N-92
90
31
Table 57: Advices given to the patients while giving them the drugs
Advise about treatment______________________
Advise them to take medicines properly_______________
As per doctors’ prescription_________________________
In case of side effects advise them to contact the physician^
Advise them to have sufficient / healthy food___________
Advise them to give up smoking / drinking
N=14
04
14
02
01
01
02
Table 58: Nature of work
N=16
15
14
09
09_
04
01
Sputum Examination
Blood Examination
Stool_____________
Urine
Smear check-up
X-ray_____________
Semen
01
Table 59: Tests carried out at the center routinely
N=16
06
15
X-Ray___________
Sputum Microscopy
Blood____________
Urine____________
Mantoux test______
Stool
11 ~
06
05
01
Table 60: Sputum microscopy for TB diagnosis
j # of lab technicians doing sputum microscopy for TB diagnosis
Table 61: Number of sputa examined in a month
<=25_______
>25________
No response
Not applicable
N=16
07
07
01
01
X-ray
technician
N=16
15
Table 62: Number of fields the technicians sees under the microscope before declaring a negative
result
10______
40______
80______
100_____
Don't knou
N=16
01
09
00
05
01
Table 63: Precautions one needs to take while examining a slide
' Wear a mask_______
' Wear gloves
; Apron____________
; Wash hands and face
j Wax cap__________
i Clean bottle
N=16
09
10
01
02
01
01
Table 64: Number of technicians able to take those precautions
! # of lab technicians who arc able to take those precautions
! # of lab technicians who arc not able to take those precautions
i No response
N=16
08
06
02
Table 65: Problems facing in taking those precautions
Wearing and removing mask during busy times
i No supply of gloves and masks / not available
i Not told in training_______________________
| No practice
| No specific reason
N=06
01
02
01
01
01
Table 66: Training
I # of lab technicians have been trained in RNTCP for sputum microscopy
N=16
10
Table 67: Difficulties faced by lab technicians
_______ N=16_______
I # of lab technicians facing difficulty in preparing the smear_____
# of lab technicians facing difficulty in staining the slide
# of lab technicians facing difficulty in supply of lab consumables
01 (patients won't cooperate)
__ _________ 00___________
01 (improper supply)
Table 68: Time intervals at which the lab technicians do sputum examination for a patient under
treatment
Every month
Once m 2 months
Once in 3 months
Once in 6 months
12-14 months
Don’t know
N=16
01
07
04
01
01
02
3°\
E-readiness assessment for Health Inter-Network
Data analyses by category of levels
Table 69: Number of potential computer users & their skills by category of levels
# of potential computer users_____
Doctors with basic computer skills
Doctors with experience of
common Office applications______
Doctors with experience of Internet
Doctors with advance computer
, skills
__________________
Administrative staff with basic
computer skills________________
Administrative staff with
i experience of common Office
applications__________________
Administrative staff with
i experience of internet___________
Administrative staff with advance
computer skills________________
Paramedical Staff with basic
computer skills
Paramedical Staff with experience
of common Office applications
Paramedical Staff with experience
oflnternct
Paramedical Staff with advance
computer skills _____________
Others with basic computer skills
i Others with experience of common
Office applications____________
! Others with experience of Internet
Others with advance computer
skills
District
Bangalore Rural Deogarh
N=05
N=21
_____ 07
16
04
05
00
03
02
00
00
00
04
01
02
01
00
00
00
00
00
00
01
00
00
00
oo
00
01
Treatment
organizer^
00
00
00
00
0G
01
System
administrator
State
N=03
3514
00
Table 70: Availability of physical space by category of levels
' Availability of adequate physical
i space for hardware
District
Bangalore Rural Deogarh
N=05
N=21
05
18
State
Total
N=03
N=29
03
26
Table 68: Time intervals at which the lab technicians do sputum examination for a patient under
treatment
Eveiy month
Once in 2 months
Once in 3 months
Once in 6 months
12-14 months
Don't know
N=16
01
07
04
01
01
02
3°\
E-readiness assessment for Health Inter-Network
Data analyses by category of levels
Table 69: Number of potential computer users & their skills by category of levels
I_______________________
I # of potential computer users
i Doctors with basic computer skills
Doctors with experience of
common Office applications______
Doctors with experience of Internet
Doctors with advance computer
: skills_________________________
Administrative staff with basic
! computer skills________________
Administrative staff with
I experience of common Office
applications____ ___________ __
Administrative staff w ith
i experience of Internet___________
i Administrative staff with advance
computer skills
Paramedical Staff w ith basic
computer skills
Paramedical Staff with experience
of common Office applications
Paramedical Staff with experience
! of Internet
Paramedical Staff with advance
computer skills ______________
Others w ith basic computer skills
Others with experience of common
Office applications_____________
I Others with experience of Internet
Others w ith advance computer
skills
District
Bangalore Rural Deogarh
N=05
N=21
07
16
04
05
00
03
02
00
00
00
04
01
02
01
00
00
00
00
00
00
01
00
00
00
00
00
01
Treatment
organizer
00
00
00
00
00
01
System
administrator
Stale
N=03
3514
00
Table 70: Availability of physical space by category of levels
I
: Availability of adequate physical
I space for hardware
District
Bangalore Rural Deogarh
N=05
N=21
05
18
Stale
Total
N=03
N=29
26
03
Tabic 70.1: Site conditions by category of levels
Temperature_____
Low________
Moderate
Not mentioned
Environment
Dust free
Air-conditioners
Available
District
Bangalore Rural Deo garb
N=05
N=21
State
Total
N=03
N=29
00
21
00
05
00
00
01
00
02
06
21
02
12
05
03
20
00
01
02
03
State
Total
Deogarh
N=05
N=03
N=29
05
00
00
03
25
04
00
03
02
00
00
02
01
00
07
09
10
03
00
03
02
00
00
01
02
00
13
07
09
00
00
03
04
05
03
29
District
Bangalore Rural Deogarh
N=05
N=21
____ 02
05
01
00
State
Total
N^03
02 ~
02
N=29
09
03
01
02
03
I
Table 70.2: Availability of electricity by category of levels
District
Bangalore Rural
N=21
! # of supply hours per day
20
<=8 hours__________
01
24 hours___________
; Fluctuations experienced
07
Frequently__________
04
Occasionally________
07
Rarely_____________
03
■
Never______________
Frequency of outages
13
Frequently________
03
Occasionally
05
Rarely_____________
00
Never______________
I Generator
Available
HEarthing / grounding for electrical connections
Available
I
21
i i n
I
Table 70.3: Availability of telephone lines by category of levels
Fixed telephone lines available
Dedicated telephone line for
Internet access available_____
Dial-up connection
00
Table 70.4: Availability of training facility in the vicinity by category of levels
District
Bangalore Rural Deogarh
N=05
N=21
00
03
Availability of training facility in
the vicinity ________________
No response
00
06
State
Total
N=03
03
N=29
06
00
06
Table 71: Average number of users per terminal (existing) & hours of access they have by category of
levels
__________________________
Total
State
District
Deogarh
Bangalore Rural
N=29
N=()3
N=05
_______________________________
N=21
■ Average number of users per terminal (existing)_____
02
01
01
02
01
00
01_____
2
01
01
00
00
Hours of access the users have
03
01
01
01
j 8 hours___________________
01
01
00
00
12 hours__________________
01
01
00
00
I 14 hours
,
J____________
■
()()
Table 72: LAN facility and number of computers connected to a modem by category of levels
I Computers connected to a LAN
| NAT (anti-virus) is in use__________
; Firewall is installed_______________
I VSNL-1SP______________________
i Network management
I Load characteristics of the LAN I 1 server & 5 nodes_______________
I Problems with reliability of the
LAN_______________
LAN is switched
Hub based LAN_________________
# of computers connected to a modem
j 1
District
Bangalore Rural Deogarh
State
Total
N=03
01
00
00
00
00
N=05
00
00
_ 00
00
00
00
01
N=29
01
01
00
01
01
01
00
00
00
00
00
00
00
00
00
01
00
01
00
00
00
00
01
01
01
01
N=21
00
00
QI
00
01
01
Table 73: Availability of the IT equipments / peripherals by category of levels
District
Bangalore Rural Deogarh
N=21
Printers______
Scanners_____
Digital cameras
CD-ROM
DVD
01
00
00
_____ 01
00
N=05
01
____ 00
____ 00
00
00
State
Total
N=03
N=29
05
02
00
04
01
03
02
00
03
01
Table 74: Availability of hardware / software support services by category of levels
Maintenance staff available
Support contract with a supplier
Spare parts available________
District
Bangalore Rural Deogarh
N=05
N=21
_____
00
00
_____
01
01
01
01
^3
State
Total
N=03
00
N=29
00
03
04
01
02
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Position: 4700 (1 views)