Agnita Mohanty | Team TrickyScribe: Family planning in the past often lacked a structured approach, disregarding reproductive health and rights. Cultural, religious, and ideological factors prevented discussions on contraception. Birth spacing, however, is crucial for maternal and child health. A woman’s body requires at least two years to recover from childbirth before conceiving again. Poor birth spacing can increase the risk of infant and maternal mortality, emphasizing the importance of informed family planning.

Changing Times: Rise of Single-Child Families

In recent decades, especially in urban areas, the preference for a single child has gained traction. While this shift invites debate, it highlights a significant societal change. Stereotypes about single children being spoiled or self-centered persist, yet modern parents are challenging these views. Educated and economically stable couples, even in traditionally male-biased societies, are opting for a single child regardless of gender. This signals a gradual shift in societal norms.

A Futuristic Lens

The single-child trend in India represents both an opportunity and a challenge. While it may alleviate overpopulation concerns, it could also lead to a demographic imbalance, economic strain, and psychological pressures for families. By learning from China’s experience and proactively addressing these issues, India can balance individual family choices with the broader socio-economic needs of the nation.

Key Factors Driving the Change

1. Economic Stability: Parents see single-child families as a way to provide better opportunities for their offspring.

2. Lifestyle Changes: Modern aspirations and urban lifestyles often make larger families impractical.

3. Gender Neutrality: The preference for male children is diminishing among educated couples.

Challenges of Single-Child Families

The rise of single-child households brings societal and economic implications. While it may stabilize population growth, it could also lead to long-term challenges akin to those seen in China during its one-child policy era.

Lessons from China’s One-Child Policy

1. Gender Imbalance: A preference for male children led to skewed sex ratios and female infanticide.
2. Aging Population: The elderly population grew significantly due to reduced birth rates.
3. Economic Strain: Fewer taxpayers and a shrinking workforce increased dependency on the state.
4. Family Pressure: Single children bore the responsibility of caring for aging parents on both sides.

Implications for India: Growing trend of single-child families could lead to similar challenges:

1. Declining Youth Population: The percentage of children under 15 decreased from 28.6% (2015-16) to 26.5% (2019-21) according to NFHS-5 data.

2. Skewed Sex Ratios: Despite improvements, the birth sex ratio remains unbalanced, reflecting deep-rooted societal biases.

3. Aging Population: A rising proportion of individuals aged 60 and above signals an aging demographic.

4. Economic Concerns: A smaller workforce and fewer taxpayers may lead to economic challenges.

Psychological and Social Impacts: Single children might face heightened emotional and social pressure as they grow up. Parents may struggle to balance the desire for financial independence with the need to support their only child. With no siblings to share responsibilities, single children could experience increased stress during their parents’ old age.

The Way Forward

India’s demographic and economic future hinges on addressing these challenges effectively:

1. Promoting Gender Equality: Initiatives like Beti Bachao, Beti Padhao must continue advocating for the girl child to reduce gender imbalances.

2. Strengthening Social Security: The government must develop policies to support an aging population and reduce dependency on family-based caregiving.

3. Encouraging Balanced Family Planning: Awareness campaigns on the benefits of two-child families can mitigate the risks of population decline and economic strain.

4. Investing in Youth: Ensuring access to quality education and healthcare for all children, regardless of family size, is essential.

Total Views: 2,36,960

Agnita Mohanty | Team TrickyScribe: Growing up in all-girls convent school, the competition to be in shape was intense. We girls were affected with even a slight gain of weight. I remember one of my friends coming back to school after the summer vacations chubbier. Most girls made fun of her because she was not able to control her weight gain. She informed us that she has been diagnosed with PCOD. The reactions of the girls were like,” okay, so you need to exercise more and go on a diet”, the poor thing actually did that but the result was fruitless. Our nescience back then was due to lack of knowledge and proper information. Depending on our environment/background we all must have heard about PCOD at some point. The misinformation and myths surrounding common health issues are clamorous to the point that women suffering from PCOD actually don’t even feel the need to take it seriously.

Polycystic Ovarian Disease or PCOD is a medical condition which causes the ovaries to produce eggs in large numbers which form cysts on its outer edges; this leads to hormonal imbalance. According to UNICEF, PCOD (Polycystic Ovarian Disease) is caused by a combination of hormonal imbalance and genetic tendencies.  Women have two ovaries and in a normal menstrual cycle, they will consecutively release mature, ready-to-be-fertilized eggs each month. At this point, if the egg is fertilized it forms a foetus or else women menstruate.

However, in case of someone with PCOD, the ovaries will often release either immature or only partially-mature eggs. Overtime, this leads to the development of cysts which are like small sacs filled with liquid. This in turn leads to inflammation of the ovaries. Generally, the ovaries release a limited number of androgens which are male hormones during the menstrual cycle but in case of PCOD the ovaries will start producing excessive androgens. This is symptomatic cause of hair loss, weight gain, irregular periods, and in some extreme cases, even infertility among women.

What should we do?

UNICEF states, that there is no set ‘cure’ as such for PCOD. Furthermore, one can ideally manage it by bringing about changes in one’s lifestyle. The first step would be to consult with your gynaecologist and an endocrinologist. The next thing one can do is go for regular exercise and maintain a healthy and balanced diet; keep at bay excessive consumption of sugary foods and get into a low carb high  protein and fibrous food this way you can keep your PCOD under control. This way you can get rid of some weight, which is beneficial, as even a 5% reduction in weight eases treatment significantly.

How treatment works?

Depending on the seriousness of the disorder, your gynaecologist may prescribe hormonal medication to help balance your hormones. In severe cases usually a second line treatment/surgery is required such as Laparoscopic ovarian drilling-  it is a surgical procedure that uses a laser to treat PCOD. An alternate to medications in severe conditions LOD can improve the ovaries’ response to hormones, increasing the chance of ovulation. LOD can be effective for couples wanting to go for pregnancy but has probable chances of infection, bleeding, and adhesion. Another line of treatment are Aromatase inhibitors- these are medications given to patients to decrease the estrogen levels to increase secretion of FSH (Follicle-stimulating hormone) from the pitutary gland. This stimulates follicular development and induce ovulation. However, its effectiveness is unclear. Furthermore, other symptoms of PCOD maybe:

Irregular periods which may be heavy, long, irregular or absent.

Excess hair growth around the face, chest, stomach, back or other areas of the body.

Appearance of acne on the face, chest, and upper back, that may be difficult to treat.

Abdominal weight gain

Hair thinning or falling out

Dark patches or skin darkening

Infertility among women

Cysts

Notably, PCOD symptoms are different for different women. However, symptoms may change over time and can develop without a clear trigger showing symptoms around the time of the first menstrual cycle during puberty or at a later stage.

Are PCOD and PCOS same?

Although both sound alike but in fact Polycystic Ovarian Syndrome (PCOS) is slightly different from PCOD. As stated earlier if a person suffers from PCOD; her ovaries start releasing eggs which are immature, become swollen and form cysts at the edge of the ovaries. This causes hormonal imbalances. On the other hand, PCOS is a condition where the endocrine issues cause the ovaries to produce excess androgens and these immature eggs become cysts while inside the ovaries themselves.

Both PCOS and PCOD cause symptoms such as excessive weight gain, infertility, acne, irregular periods, etc.  However, PCOS also induces metabolic syndrome, which increases risk of heart disease, strokes, and diabetes alongwith, sleep apnea, where the person is unable to breathe while asleep, which leads to a highly disturbed sleep cycle. As no ovulation is taking place, the uterine lining builds up every month increasing chances of endometrial cancer.

Patients with PCOS are prescribed oral contraceptives (birth control pills) containing estrogen (female hormone) and progestin (which mimics progesterone, another female hormone) to stabilize the menstrual cycle and medicines to deal with the symptoms such as acne and other skin problems. Weight loss and living a healthier lifestyle is also recommended to reduce chances of endometrial cancer and diabetes.

Major distinguishing differences

PCOS is a disorder of the endocrine system which has more dangerous complications than PCOD which can be managed by making informed lifestyle changes and its treatment most times may not involve any medical treatment while in case of PCOS, external hormone medications are required.

Currently, PCOD is more common among women around the world. UNICEF estimates about one-third of all menstruating women around the globe have PCOD. According to a study conducted in Southern India and Maharashtra, about 9.13% of menstruating women suffer from PCOS, while 22.5% have PCOD.

PCOS has too many hormonal complications making pregnancy difficult with chances of conceptions grim. In case of PCOD, pregnancy is possible with minimal medical intervention and lifestyle changes.

It is incontestable that both PCOS or PCOD, have a sense of social stigma and misinformation in our society. These common disorders are never covered in our school syllabus and is treated as something to be kept under wraps since they are related to “the girls’ problem”. Furthermore, women diagnosed with PCOD or PCOS need to monitor there health rather than ignore it.  Family members should be supportive enough to help patients get medical care and access to treatments aiding relief from the symptoms as far as possible.

Total Views: 1,39,745

Agnita Mohanty | Team TrickyScribe: Nursing is a profession which concerned with the health of the people combining scientific knowledge and technical skill to provide quality care. Quality education plays a significant role in improving eminent nursing practices, for improvement of sound public health practice. The goal of the nursing profession is to prepare professionals in the field of nursing equipped with quality care and dedicated skills.

Quality assurance is the one of the main mechanisms to ensure that nurses attain adequate standards of education needed for patient care. Some aspects of quality assurance are objective curriculum, qualification of teachers, teaching learning process, educational resources, assessment techniques etc.

Quality assurance is a dynamic process that provides the nursing education institute/campus with tools that measure existing performance levels and enable continuous improvement. Quality assurance includes both internal and external mechanisms which need to be carried out by the institutes itself.

Building “Brand Bihar” for world-class nursing

The Government of Bihar and the Bihar Nurses Registration Council (BNRC) sought to build a high-quality nursing professional nationally and globally. For this end a program was launched by the Deputy Chief Minister Samrat Choudhary on International Women’s Day 2024. Furthermore, a tripartite memorandum of understanding (MoU) was signed between the BNRC, Astrika Foundation, and Piramal Foundation to support the program. The partners will use the E-Kshamata learning management system to develop the competencies of nursing students and faculty improve the quality of nursing education in Bihar.

Mission

Mission Unnayan aims to empower Bihar’s women through exceptional nursing education fostering excellence an creating high – paying job opportunities nationally and globally.
The program aims to enable nursing professionals to be compassionate, professionally excellent and ethically sound individuals ready for domestic and international health system needs. Its goals include:
•Empowering young women in Bihar to compete for high-quality healthcare jobs
•Certifying at least 5,000 high-quality nurses
•Placing 1,000 nurses overseas

Why Competency Certification?
The healthcare system in recent times has changed drastically; in view of the current scenario quality nursing for an effective patient care and safety is necessary. For this end, the first competency certification centres in Bihar were set up by signing a MoU with Nalanda Medical College and Hospital (NMCH) and MGM Institute. The competency certification recognises specialized nurses thereby amplifying better healthcare system. Its key features are:
•It aligns the quality of nurses in Bihar with national and international standards.
•Enables the market to identify a high -quality nurse.
•Allows nurses to identify gaps in their competencies for self- improvement.
•Creates opportunities for both domestic and international employment.

Mission Unnayan : An Objective to Reform

1. Quality Rating of Institutes: This initiative aids in continuous improvement in institutes by providing visibility on gaps through periodic on- ground assessments including geo-tagging. Bihar Nurses Registration Council (BNRC) has partnered with the Quality Council of India (QCI) to rate these institutes, with QCI to rate these institutes to ensure transparency. Ratings of institutes also enable students to make informed choices during admission.

2. Mentor- Mentee Program: The mentor-mentee program pairs top-tier mentor institutions with mentees for a continuous improvement in nursing education. This is a peer learning approach to create a sustainable model that strengthens nursing education and health care system. Mentor institutions are pivotal in elevating overall educational standards by sharing their expertise and knowledge.

3. Competency Certifications: Competency certification centres provide reliable assessments of nursing skills with a digital platform for employers to finds qualified and competent nurses easily. This system ensures employers to find skilled candidates reducing the need for additional training. As more employers who use this platform offer competent compensation; more nurses are motivated to increase their skills creating a continuous cycle of skill enhancement and job readiness.

4. PRERNA – Continuing Nursing Professional Development: The CNDP ensures nurses continually  to deliver safe and effective care through workshops, conferences, online courses and clinical supervision. This program aims to enhance clinical practice and raise nursing standards.

5. E-Gyanodaya – Bihar Nursing Registration Council (BNRC) aims to bridge educational gaps by introducing a comprehensive E-library. These E- libraries will offer students instant access to latest materials, supporting continuous learning and improving opportunities and educational outcomes.

Its advantages are:
•Vast collection of resources
•Cost effectiveness
•Availability of Multimedia Resources
•Search efficiency
•Personalization

The content of E- Library is available both in English and Hindi language which makes it easier to understand and access INC approved nursing content it anywhere and anytime.

6. E- Kshamata Learning Management System: E- Kshamata is an e- learning platform by Aastrika Foundation which offers competency – based modules, self assesments and personalised learning pathways.  E- Kshamata empowers, enhances and improves nursing skills by providing access to high quality, free content and standardized assessments.

7. Digital Platform: In order to support the ongoing reforms; BNRC is adopting a digital first approach to enhance transaction ease, transparency and efficiency. The updated BNRC website will ensure that all nursing institutes are well- informed about reforms, promoting greater engagement and compliance. By digitalising workflows of all key reforms all nursing students, professionals, institutes and employers can engage on a one to one integrated platform.

Total Views: 2,63,591