Fidelity of Snakebite Envenomation Management in Ajmer district, Rajasthan, India: An Implementation Study

Siddharth Khurana, dr. Yodi Mahendradhata MSc., PhD., FRSPH; Prof. dr. Ari Probandari MPH., PhD

2023 | Tesis | S2 Ilmu Kesehatan Masyarakat

Introduction: Snakebite envenomation (SBE) causes high morbidity, and mortality globally. In India about 58,000 deaths/1,000,000 snakebite occur annually. And 140,000 gets disabled. SBE can only be managed with Anti-snake Venom (ASV) with other lifesaving procedures. Despite having SBE management guidelines, there is risk due to lack of availability of diagnostic resources, skilled healthcare professionals (HCPs), missing of golden hour, ineffective antivenom, Under-reporting, community health behavior. SBE data of 33 districts of Rajasthan from the year 2017-2022, Ajmer reports the highest number of cases (1112, from 2021-22). 

Method: A descriptive qualitative research design was conducted. Total 28 in-depth interviews (IDI) of HCPs (19), snakebite patients (9) were done through open ended questionnaire. Respondents were chosen based on purposive sampling. Observation of facilities of healthcare system was done as per acess permitted. Triangulation of quality data sources to cross check the perspective of different stakeholders to assess potential moderators that influence adherence. 

Result: Our study showed majority of Government schemes free medicine, free treatment facilities and investigations, awareness program, emergency transport service were operational. Lack of specialized training program for HCPs. Under reporting of cases, due to offline mode of record keeping system and shortage of data operators. There is limited operating time for labs at primary and secondary health care level. 

Conclusion: There is significant improvement in health care system with implemented government schemes and general community awareness. These factors played as enablers of fidelity of SBE management.

Introduction: Snakebite envenomation (SBE) causes high morbidity, and mortality globally. In India about 58,000 deaths/1,000,000 snakebite occur annually. And 140,000 gets disabled. SBE can only be managed with Anti-snake Venom (ASV) with other lifesaving procedures. Despite having SBE management guidelines, there is risk due to lack of availability of diagnostic resources, skilled healthcare professionals (HCPs), missing of golden hour, ineffective antivenom, Under-reporting, community health behavior. SBE data of 33 districts of Rajasthan from the year 2017-2022, Ajmer reports the highest number of cases (1112, from 2021-22). 

Method: A descriptive qualitative research design was conducted. Total 28 in-depth interviews (IDI) of HCPs (19), snakebite patients (9) were done through open ended questionnaire. Respondents were chosen based on purposive sampling. Observation of facilities of healthcare system was done as per access permitted. Triangulation of quality data sources to cross check the perspective of different stakeholders to assess potential moderators that influence adherence. 

Result: Our study showed majority of Government schemes free medicine, free treatment facilities and investigations, awareness program, emergency transport service were operational. Lack of specialized training program for HCPs. Under reporting of cases, due to offline mode of record keeping system and shortage of data operators. There is limited operating time for labs at primary and secondary health care level. 

Conclusion: There is significant improvement in health care system with implemented government schemes and general community awareness. These factors played as enablers of fidelity of SBE management.

Kata Kunci : Snakebites, Envenomation, Anti-venin, Anti-venom, Fidelity, Health-behavior