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BMC Health Services Research

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Open Access 01-12-2014 | Research article

Feasibility of sustainable provision of intradermal post exposure prophylaxis against rabies at primary care level –evidence from rural Haryana

Authors: Harshal Salve, Sanjeev Kumar, Rizwan SA, Sanjay K Rai, Shashi Kant, Chandrakant S Pandav

Published in: BMC Health Services Research | Issue 1/2014

Abstract

Background

Rabies is the most severe and neglected public health problem in India. Management of animal bite with post exposure prophylaxis is the only existent strategy to prevent rabies related deaths. Cost-effective and sustainable programme for provision of post exposure prophylaxis (PEP) is needed in India.

Methods

In this study, we have documented the experience of implementation of intra-dermal anti rabies vaccination in Animal Bite Management (ABM) clinic at Primary Health Centre (PHC). This study facility belonged to Comprehensive Rural Health Services Project, Ballabgarh in Faridabad district of Haryana. Hospital service record of ABM clinic was analyzed and various feasibility issues such as costing of services, vaccine wastage and other operational issues in providing PEP services at PHC level were documented.

Results

A total of 619 patients were treated in the ABM clinic. Service utilization of ABM clinic was increased by 38% in the second year of implementation. Mean age of the patients was 23.9 years (SD: 18.8) and majority (70.4%) were males. Majority (86%) of the patients received the first dose of anti-rabies vaccine within the recommended 48 hours. A total 446 vaccine vials (1 ml) were consumed of which 20.8% was contributed in vaccine wastage. User-fee (350 Indian Rupees) collected from the patients. User-fee was re-used to purchase vaccines, intradermal (ID) syringes and other consumables required to ensure regular availability of ARV services at the PHC.

Conclusions

This study demonstrated the cost-effective and sustainable model of provision of PEP against rabies at primary care level. ID PEP provision at primary care level not only address the unmet need of animal bite management in the community also reduces the out of pocket expenditure of the patients.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6963/14/278/prepub

Title: Feasibility of sustainable provision of intradermal post exposure prophylaxis against rabies at primary care level –evidence from rural Haryana
Authors: Harshal Salve
Sanjeev Kumar
Rizwan SA
Sanjay K Rai
Shashi Kant
Chandrakant S Pandav
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/1472-6963-14-278

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Feasibility of sustainable provision of intradermal post exposure prophylaxis against rabies at primary care level –evidence from rural Haryana

Abstract

Background

Methods

Results

Conclusions

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