5. to enhance the patients integration into
the family and community and
6. to evolve a model for the total health care of the rural
(April 1984-July 1984)
The Primary Health Centre at Kallandiri,
17 kms from Madurai was chosen as the base for the study.
Kallandiri PHC with its 17 sub-centres caters to the population
of 97,000 with an estimated population of 4656 aged 60 and
above (1981 census; Area Map attached). The first four months
were utilised towards the Organisation of Geriatric Clinic
at Kallandiri PHC premises with the permission from Directorate
of Primary Health Centre, Govt. of Tamil Nadu, seeking the
co-operation of PHC staff, recruitment of project staff and
in training in administering the specially developed schedules.
A special study proforma (Appendix I), a screening schedule
with 45 symptoms, (modified form from Phase I-Section II,
Appendix I), ICMR scale for measuring Socio-economic Status,
Family and social Integration Assessment Schedules (weighted
and modified from the one used in the Phase I study-Appendices
II, III) and an Intervention Schedule were evolved. Khatri's
Family Jointness Scale was utilised for assessing the degree
of Family Jointness. Besides the services of the consultants
at the Government Rajaji Hospital, Madurai, the services of
the following were utilised for intervention: The District
Tuberculosis Officer, ICMR Tuberculosis Research Centre, Govt.
Rajaji Hospital and the District Leprosy Officer, Madurai.
Training Programme for PHC Medical Officers
The PHC Medical Officers were imparted suitable
training to develop necessary skills in detection, management
and referral of the common medical and psychiatric problems
in the rural aged. The staff from Madurai Medical College,
(specialists in various fields) offered their services towards
this Programme. This included didactic lectures as well as
An evaluation questionnaire (Appendix IV)
was developed to test the skills achieved and knowledge gained
by the PHC Medical Officers at the completion of training.
The data was compared with the finding on PHC Medical Officers
from outside the catchment area of Kallandiri PHC. The multi
choice questionnaire (MCQ) consisted of 80 questions pertaining
to all the fields in which training was imparted (psychiatry,
Central Nervous System, Internal Medicine, Cardiovascular,
Ophthalmology, ENT, Oncology, Respiratory, Urology, Rheumatology,
The training material was pretested on three
medical officers from three different PHCs other than Kallandiri
viz., Muthanendal, Thirupparankundram and Samayanallur PHCs.
One mark was allotted to each of the 80 questions in the evaluation
questionnaire with a maximum of 80 marks. The total marks
obtained by the three medical officers put together in every
field in which training was imparted were recorded separately.
After the training programme for Kallandiri PHC MO's was completed,
the same evaluation questionnaire was administered to the
three medical officers of Kallandiri PHC and their total marks
obtained in every field in which the training was imparted
were recorded separately. The analysis of the performances