title: Availability of Village Health and Nutrition Day services in Uttarakhand, India.
abstract: BACKGROUND
  Village Health and Nutrition Day (VHND) was identified to provide primary care services (health, nutrition and sanitation) at village level under National Rural Health Mission.
  
  
  OBJECTIVE
  The study aimed to assess availability of health, nutrition and sanitation services, required instruments/equipment and medicines at VHND with client satisfaction from the VHND services.
  
  
  METHODS
  A cross-sectional study was conducted in three districts of Uttarakhand at Nainital, Tehri-Garhwal and Chamoli involving 24 villages in six blocks using multistage stratified sampling using predesigned pretested observation checklists (quantitative data). All the concerned functionaries of health, Integrated Child Development Services and Panchayati Raj Institution were interviewed (qualitative data) to understand the gap in services and remediation.
  
  
  RESULTS
  Of the 24 VHNDs observed, blood pressure measurement was done at 11 (45.83%) and weight at 13 (54.17%) sites in ante-natal care services; non-availability of blood pressure instrument and adult weighing machine were 45.83% and 41.66% sites, respectively. Immunization for children was provided at 22 sites; however, availability of other services were poor-vitamin A (three), growth monitoring of children (seven); supplementary nutrition (five); identification of households for construction of toilet (eight). Yet, one-third of clients provided three and four for satisfaction from VHND services on the scale score of 1-5.
  
  
  CONCLUSIONS
  It was noted that none of the VHND site was providing all the stipulated services, though immunization was provided mostly. Anganwadi centers were lacking availability of various essential instruments and equipment. So regular orientation of village functionaries for ensuring all the VHND services with the availability of required logistic is recommended.
authors.affiliation: Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
authors.forename: Vartika
authors.initials: V
authors.lastname: Saxena
authors.affiliation: Department of Community Medicine, Integral University, Lucknow, Uttar Pradesh, India.
authors.forename: Praveer
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
authors.forename: Ranjeeta
authors.initials: R
authors.lastname: Kumari
authors.affiliation: VCSGGMS and RI Srinagar, Garhwal, Uttarakhand, India.
authors.forename: Bhola
authors.initials: B
authors.lastname: Nath
authors.affiliation: All India Institute of Medical Sciences, Jodhpur, Rajashthan, India.
authors.forename: Ranabir
authors.initials: R
authors.lastname: Pal
keywords: Availability of health services; client satisfaction; supplies and equipment; village health and nutrition day