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string(50) ‘ accountable for regarding 55 % of the child mortality\. ‘
It is a great established truth from assorted extended researches since old ages that suckling patterns have expanded consequence on immature child , h wellness and mortality especially in developing states. inches Assorted life-long effects such as impaired intellectual development, intellect, strength, developing and creation are connected with Undernutrition due to hapless breastfeeding patterns at the initial stage of kid , s your life. ” Harmonizing to WHO ALSO, major percentage of deceases under 5 old ages of age happen to be associated with malnutrition.
From various researches posted in Lancet in the twelvemonth 2003, it really is revealed that right now there would keep been a decrease of regarding 13 every centum of kid deceases in the event the per centum of only suckling up to six months actually reaches to 90 % and breastfeeding is continued thenceforth for around two aged ages of age.
India includes a really substantial Infant Mortality Rate of 57 % and the main ground for this high mortality rate is malnutrition the common concern here. Uttar Pradesh positions 2nd with Infant fatality rate of 81 per 1000 unrecorded births. Countrywide Family Wellness Survey examine shows that Uttar Pradesh stands at subsequent place to Bihar in determine of weakness instances amidst kids less than 5 outdated ages of age. This substantiates why there are lower costs of kid strength in Uttar Pradesh. The breastfeeding dénombrements for India ( harmonizing to WHO ALSO guidelines ) are far from the optimum draw. Harmonizing to the DLHS-3 in twelvemonth 08, per centum of kids in India having suckling within the hr following birth is usually 40. five and it is farther really low in UP with only 15. 5 %. Likewise, sole breastfeeding rate upto 5 months amongst Indian kids is definitely 46. almost eight % while its lowest in UP with merely 19. some %. A survey executed by Sinha et. ‘s reveals that in Uttar Pradesh and Tamil Nadu breastfeeding patterns and quarante are considerably influenced by the societal, ethnical and traditional patterns and coevals age group difference.
Through this survey, it is aimed to research the socio-cultural and traditional philosophy and habits act uponing the nursing patterns in rural part of Uttar Pradesh ( India ) in order to do recommendation intended for effectual techniques to better suckling index.
Examine capable and method: The technique used for this survey will be ethnographic qualitative research methodological analysis. This kind of survey is definitely proposed being conducted in four small towns of UP, India. The study population consists of female parents of kids with age group of 0 to 23 months and their mother-in-laws. Besides a group of small area wellness percentage members, ASHA workers and traditional beginning attenders might be a portion of this survey. Triangulation of two research explications aggregation approaches i. elizabeth. FGDs and In-depth selection interviews will be desired for infos aggregation. Data analysis will be done by adding it in qualitative exploration packages including NVivo or Atlas using thematic analysis.
This survey will be for merely a short continuance of 6 months with all the attempts to complete the maximal consequences with minimum assets. The budget just for this complete study along with the airing of capital findings relates to US $ 41, 087.
Background:
Introduction to the subject
Child patterns affects well on the wellness associated with an baby and immature youngster as he grows. Connection between the breastfeeding a baby patterns with wellness and mortality rate of baby and premature kid great established through assorted extended researches as old age ranges. It is the ideal alimentary and immune smooth the babe receives in the natural signifier which is best suited for babe , h metamorphosis. Specifically in developing states where hygiene and sanitation is among the major concerns, sole breasts eating assists with minimising the hazard of consumption of disease doing agents ( Anandaiah, Ur. et ‘s., 2000 ).
Adequate percentage of breasts milk complies with about each of the nutritionary require of an baby for atleast the first six months of babe , s your life ( Reddy, S. 95 ). Kids who will be breastfed include better neurodevelopment results, plus the continuance of suckling besides affects a youngster , h intelligence. ( IBFAN ain al. 2006 ). Different researches include proved a positive impact of chest eating on baby and immature kid endurance particularly among the population with elevated baby mortality and deprived socioeconomic status peculiarly among rural kids with hapless homes and deficiency of safe drinking H2O and sanitation installation ( Mentioned by Anandaiah, R. ain al., 2000, Palloni ain al., 1986, Retherford ain Al in 1989 ).
A set of suggestions is recommended by WHO pertaining to infant consuming patterns in developing says on the ground of assorted studies that zone:
” Child should be initiated instantly after childbearing.
Infants should have simply chest milk up to 4-6 months old. At this kind of immature age ranges, no various other nutrients or liquids will be recommended.
Obtain downing at of six months, equal and appropriate auxiliary nutrients should be added to the baby , s diet in order to supply sufficient foods for optimum developing.
It is recommended that suckling continues, in combination with auxiliary nutrients, up to the next birthday or beyond ( World Overall health Organization. 1991, P. 5 ). inch
Situation/ Problem Analysis.
Weakness during the first stage of kid , s life causes life-long serious growing and developmental results and its effect becomes regarding irreversible if occurs through the first two old age groups of significant stage of kid , s growing. The steep within malnutrition amongst kids during first two old age ranges of lifestyle reflects after hapless newborn eating patterns. Adequate and proper ingesting in the primary stage of child , h life can be useful for forestalling weakness and guarantees proper growing and progress kids. As per WHO examine, malnutrition reputations for more than 50 % of all below five deceases. Improper eating had cause two-third of deceases under five old ages of age. As mentioned above studies published in Lancet in 2003 implies that 13-16 % child deceases can be avoided by increasing the coverage of only breastfeeding intended for first 6 months to 85 % and thus continued nourishing for about two old age range ( BPNI, 2006 ).
Malnutrition staying widespread in India, it really is accountable for regarding 55 % of the child mortality.
A number of the Key suckling Indexs of India according to DLHS-3 as well as its comparing with UP province is as listed below:
Child feeding patterns as per DLHS-3 ( Year 2008 )
India ( % )
Uttar Pradesh ( % )
Rate of suckling within just one hr in children upto 3 old age range
40. a few
15. 4
Rate of sole child for 0-5 months children
46. eight
19. some
Rate of sole breastfeeding for six months time for kids of 6-35 several weeks
25. a few
8. 2
Rate of 6-9 weeks kids having solid/semi-solid nutritional and breasts milk
57. 1
54. 5
Indian cultural and traditional beliefs have good influence in wellness related patterns of its inhabitants. A study conducted by simply BPNI showed that as a result of traditional and cultural perception , t influence, sole breastfeeding price is low and the use of supplying pre-lacteal provender is widespread. The above mentioned given characters reflects that infant eating patterns in India are far from array of recognized prices. ( Gupta, A. ain al., 2005 )
A survey was conducted by simply R. E. Sinha and A. Pradhan on cultural impact of suckling patterns and abstention in Uttar Pradesh and Tamilnadu, India. They identified that in Uttar Pradesh and Tamil Nadu breastfeeding patterns and abstention are greatly inspired by social, cultural and traditional patterns and coevals age big difference ( Sinha, R. et al., 2k ). I would like to further research the socio-cultural and classic beliefs and patterns work uponing the breastfeeding patterns in countryside Uttar Pradesh ( India ) to do recommendation for effectual techniques to better suckling status/indicator.
Analysis inquiry or perhaps hypothesis:
Exactly what are the socio-cultural and classic beliefs and patterns act uponing the breastfeeding habits in non-urban portion of Uttar Pradesh ( India )?
Already Noted:
India has a really substantial Infant Fatality Rate of 57 %. ( NFHS-III, Jan 08 ). Uttar Pradesh offers 2nd highest Infant Mortality Rate of 81 every 1000 unrecorded births. This besides features highest lower than five fatality rate. ( Indicus Deductive, 2008 )
Malnutrition is considered the most common reason for immature child mortality in India accounting for approximately fifty-five % of entire child deceases. Countrywide Family Well being Survey research shows that Uttar Pradesh stands at second place to Bihar in physique of weakness instances amongst kids less than 5 old ages old. This substantiates why there are lower rates of kid strength in Uttar Pradesh. ( NRHM, 2010 )
As per District Level Household and Facility Survey indexs for the kid feeding patterns in Uttar Pradesh is highly hapless and undesirable ( informations shown in table above )
My own Study Can Add:
This kind of survey should look into various single, experiential, socio-cultural and traditional values and habits , affect on child patterns
By the results in the survey advice can be designed for effectual plans to better the positioning of chest eating in rural Uttar Pradesh, India
Aim and aims:
Purpose: This study intends to analyze the socio-cultural and classic beliefs and patterns act uponing the breastfeeding patterns in non-urban portion of Uttar Pradesh ( India ) in order to do advice for effectual schemes to higher breastfeeding index
Aims:
To look into sole, experiential, socio-cultural and traditional beliefs and patterns , influence on breastfeeding habits
To desire effectual plans sing the findings of the survey to higher the position of chest eating in Uttar Pradesh, India
Proposed study methodological examination:
The research solution to be used to reply this kind of research query is qualitative research method.
Study Design and style:
” Ethnography is a qualitative research methodological analysis utilized for descriptive surveies of cultures and people. inch Hence, Ethnographic survey design and style will be used below to go into the socio-cultural and traditional philosophy and patterns act uponing the breastfeeding a baby patterns since there is a demand inductive qualitative research to comprehend the socio-cultural and classic beliefs related to suckling and research that identifies morals and habits that may be hinderance for early on induction of chest ingesting, foremilk consuming and care of sole weanling harmonizing to WHO rules for expanding states.
Study Area:
Uttar Pradesh province of India has a human population of 80, 415. Volume of kids era 12-23 months are eleven, 990 away of which 12, 181 of the kids lives in rural portion of Uttar Pradesh. There are sixty two. 5 % of hitched adult females who happen to be nonliterate ( non able to read and compose ) and sixty five. 4 % of them stay in rural countries. Actually key proportion of Indian human population resides in rural parts in smaller sized units named small neighborhoods where literacy rate is usually low specifically amongst females as compared to men. This review is proposed to be done in two small towns of Barabanki and two small cities of Sultanpur territory of Uttar Pradesh ( Maps of Uttar Pradesh, 2010 ).
Research Population:
India has capital authorities by national degree and further province and local authorities. Within just Local Government you will find two bifurcations: , Panchayats , ( rural ) and , Municipalities , ( metropolitan ). The Panchayats happen to be formed by locally offered resources which is divided into ” small community panchayets “, ” panchayet samities inches, and inches territory panchayets “.
A great enterprise referred to as National Non-urban Health Mission ( NRHM ) is definitely started by simply wellness ministry to guarantee effective health care for single, relatives, community, and wellness system degrees. Nationwide Rural Overall health Mission makes proviso of ” ASHA or Licensed Social Wellness Activist for each 1000 people “. ASHA worker is definitely chosen by small community and taught to work as a nexus among community and wellness program. ( NRHM, 2010 ) At little town degree there is a small town wellbeing commission.
The survey populace for this survey comprises of woman parents of kids with age bracket of 0 to 3 months and the mother-in-laws. Besides a group of small town health and fitness commission associates and classic birth attenders will be a portion of this survey.
Sampling Technique and Sample Size:
Two qualitative study techniques will be used for this analysis survey.
Target Group Dialogue: Focus Group Discussions will be done to become cognizant in the socio-cultural and traditional philosophy and habits most current among this kind of population that is certainly act uponing the breastfeeding patterns. Complete 12 FGD , t are suggested to be executed with each dwelling of any little selection of 6-8 members.
In-depth interviews: Purposive and convenience striving method to be used for complex semi-structured interview. It is recommended that about 32 selection interviews will be executed in four small villages ( 8 interviews in each tiny town ) selected indiscriminately within Uttar Pradesh province. But further alteration in Numberss can be applicable based upon the impregnation point to get the informations aggregation.
Data Collection Method:
A , question matrix , will probably be developed with the really starting of planing the information assimilation tool. ” A query matrix can be described as tabular array that allows you to released the subjects ( frequently coordinating to the aspires of your study ), more item on the information needed, the annonces aggregation method, the beginning ( i. e. the player / documents ) and, eventually, some bill of exchange requests. ” ( Designing informations aggregation equipment by Doctor Rebecca King )
Info will be gathered by triangulation of two informations crowd techniques we. e. FGDs and Specific interviews. In the beginning FGDs will probably be conducted followed by In-depth selection interviews as the subjects and primary findings come about from FGD , t will be used pertaining to farther geographic expedition within the in-depth selection interviews. Field showing or routing of the informations aggregation tools will be done to look into it is pertinence and relevancy single time before beginning the full-fledge survey.
Emphasis Group Debate: Three FGDs will be completed for each little town picked indiscriminately with three several groups , female father and mother , group, mother-in-laws , group as well as the 3rd group consisting of handful of small city wellness commission members and traditional labor and birth attenders. It will probably be arranged in topographic point where tiny town wellbeing commission meetings are organised with their preliminar permission. Completely 12 FGDs will be completed, each house of 6-8 members. FGD , s will be conducted by skilled qualitative research workers sooner in the same part as being very good versed with local linguistic communication. Every FGD will certainly prosecute two individuals, facilitator and note taker. With informed consent voice recording tools will be put to use to enter the FGDs together with the notes through the note taker who will focus on the of import subject matter, issues to follow-up through an in-depth interview, organic composition linguistic connection and looks of participants. The estimated standing; permanence stability for one FGD would be around two hours including the ice-breaker activity at the beginning of FGD. These types of FGDs is going to research the socio-cultural and traditional morals and patterns most existing among this kind of population that may be act uponing the breastfeeding patterns and it is responsible for the low chest nourishing index inside the province. Single FGD will probably be held in a 24 hours, then written textual content and interlingual rendition of informations accumulated on the same 24 hours. Accuracy and reliability of the quality of annonces translated will probably be ensured by back cheque of the interlingual rendition.
Specific interviews: A semi organized questionnaire with unfastened concluded inquiries will be developed to carry on the complex interviews using the recognized subjects and cardinal details from the FGD , s i9000 conducted and besides from the findings of vital old researches/literature. An interview inquiry usher will be developed residing of basic clear concluded inquiries within the chief subject matter followed by a scope of examining requests based on that peculiar controlled by be looked into. Interviews will be done by sing the interviewees in their ain house clasp puting nevertheless taking interest that a complete interview may be held with no external disturbance/interference. A strapping recording equipment ( verbatim ) and field records will be accumulated. It is intended that whole 32 selection interviews will be conducted, spliting that every bit in to 8 selection interviews for each in the four little towns underneath survey. Additional bifurcation of these eight interviews for each little town is made between female parents, mother-in-laws, village wellbeing commission members, ASHA worker, traditional beginning attenders, etc . It should be extensively considered that is approximately figure this means you will alter depending on the impregnation point from the informations retrieved. Interviews can last for one to two hours and it would be made sure that only 2 selection interviews will be made by each annonces aggregation official on a individual twenty-four hours so that accumulated informations can be transcribed sooner on the same 24 hours to increase the retrieval of annonces collected.
During the procedure in the interview, ab initio the surveys takers will be made comfy, discussed the reasons and aims of this survey, provided the data sheet and informed consent and eventually up to date that they can cease at any show if they will wish and have if they have any further inquiry inside their head. [ Green and Thorogood 2004: 97 ]
Datas Examination Plan:
When possible informations will probably be transcribed upon same 24 hours of informations crowd in order to get a written , script , of the FGD and selection interviews to analyze. Transcribed informations will be farther converted from neighborhood linguistic interaction to English language. This information will always be incorporated into qualitative research informations deal such as NVivo along with the all-natural information inside the signifier of voice recording and farther examined by a professional research member of staff. The information of the transcript will certainly farther always be organised, indexed and chief subjects will be identified via it. A cryptography framework will be designed and the annonces will be rearranged harmonizing for this cryptography body. Further with some expertness, examining of infos will be done and taking place will be reported. Analytic strategy to be used in this article will be thematic analysis utilizing thematic chain.
Potential risks:
Inappropriate cut for infos aggregation: Data will be accumulated from females due to its relevance to the exploration survey. Females in countryside countries fantastic much filled by their family jobs and work. It is definitely hard to allow them to be available in a unusual clip. Consequently anterior project will be built and interviews and FGDs will be executed at all their convenience.
Unacceptable topographic level for informations aggregation: Due to sensitiveness in the subject and avoid virtually any intervention or biased replies, FGDs will probably be conducted removed from their place at a peculiar appropriate topographic level where the number of female members can speak up/open up. For selection interviews it is hard so they can name up at a peculiar topographic point, consequently it will be conducted by place visit yet attention will probably be taken about avoiding virtually any intervention keeping privateness.
Trouble in inserting right age of kids and remembering the complete continuance: Due to take down literacy rate it is difficult to remember or perhaps right place age their kids. Therefore local diary, festivals, as well as months, pouring or enjoying seasons to be used to assist girl parents bear in mind right cut.
Garbage to or cease the interview: Look at the sensitiveness of the subject, it will take a lot of clip to allow them to open up. In Indian society many countryside adult females are still genuinely submissive and would a lot of clip waste to talk over a peculiar very sensitive point or would likely non like to further go on the interview or perhaps treatment. In this instance the interview will be discontinued as per the involuntariness.
Social stigma: In the Indian civilization adult females would no discourse in subject such as chest eating patterns having a male thus lone woman informations move uping causes will be used.
Info aggregation misjudgment, misunderstanding and incorrect paraphrasing: Interviewers great versed together with the local linguistic communication and civilization will be appointed to stop such errors.
Missing or uncomplete annonces: The questionnaires will be evaluated by director before proceed forthing little town or block in order to maintain a cheque in any misplaced or ill-defined informations.
Refusal for going into the interview or FGD: It is anticipated that a few respondents especially adult females can decline to enter the FGD or perhaps interview harmonizing to American indian traditions. For the reason that state of affairs note-taker will observe the treatment with the aid of another individual who facilitates the treatment easy and low hotfooting, repeating the answers to do certain that the note-taker note every thing and the transcripts will be examined by both equally to finish any kind of lost informations.
Early feedback by regular informations examination will assist reducing the options of repeating the same errors in annonces aggregation.
Honest and Sexuality Equity concerns:
At condition degree: Ethical blessing will be sought coming from MoHFW, MCH and secretariat general. Besides a detailed missive will be provided to local authorities and small area panchayet to obtain their authorization for transporting out your survey.
Inside the Interview on family level: At the beginning, the participant/respondent ( female father or mother, mother-in-law, ASHA worker, traditional birth attender, small city wellness commission payment member ) will be discussed rationale in back of the survey and agreement will be sought from the caput of the household and the mature females take parting. They shall be ensured regarding the namelessness and comfort of their reactions. If decided, further all their informed written and mental consent will probably be taken. They will besides be informed that they can stop at any clip if they wish and enquire if they may have any farther inquiry within their head.
The participant will so end up being interviewed in her home with no 1 else around to maintain the responses confidential. During the be aware pickings, every single respondent will probably be given a figure and respondent , s status will be known down in separate sheet along with the codification to acknowledge them pertaining to finishing burning off informations. By looking into making this all their namelessness will be maintained.
Following the completion of the interview, if the respondent asks for any information or aid, interviewer can help with that and suggest referral when needed.
In the Focus Group Discussion: Consent will be obtained from all the participants for digital voice recording of the FGD, after explicating them the intent with the survey. On understanding the treatment will be noted but in illustration of refusal, which is anticipated, the note-taker will take remarks on the treatment.
Gender Collateral:
As this kind of survey relates to female and child wellbeing, the major engagement of will probably be of feminine respondents. Although it will be taken attention of this gender equality is maintained by equal engagement of both organizations in review design, explications aggregation and supervising, details analysis, drumhead readying and airing.
Diffusion Plan:
To do certain that the effect of this review will be utilised to better the chest ingesting patterns and highly low index in the Uttar Pradesh, following stairss will be considered
In order to keep better acceptableness and developing of the findings in the bing national enterprise for elevating the chest eating patterns, MOH and authorities government authorities will be mixed up in research organizing and digesting. It will ease the procedure of acquiring their very own averment to program and implement plans and put the recommendations in to pattern.
Aga Khan Health Service India is at present implementing a ” Maitreya Project inch funded by World Traditional bank on , Social Capital: A slingshot for improving infant feeding , in Gujarat part. Findingss out of this survey can help in growing effectual techniques and can be integrated in the ask undertaking and farther replicated in Uttar Pradesh and other similar provinces with low index
We have a Breastfeeding Advertising Network of India and besides several NGO , s that happen to be working for the baby and child wellness which is indulged in be aftering for better committedness to work on bettering this.
On completion of this research, the consequence will probably be disseminated by:
Summary from the cardinal conclusions will be distributed to UNICEF, WHO, MoHFW, BPNI, AKF, AKHSI, and assorted various other administrations working for the baby and kid wellness in order to guarantee they are made aware about the consequence of this survey.
Transcripts with the survey benefits will be circulated in assorted institutes to get community medical specialty and pediatric areas to section the conclusions with the academic staff.
Supply of the transcript of the study result will be made available to various libraries in MOH, UNICEF, modules of medical specialized and wellbeing institutes and besides to free directories to do certain that it can be examined by pupils and health and fitness professionals.
Seminars and Workshops will be done aiming assorted stakeholders such as NGOs, MOH, international organisations, and faculty users to show the investigation outcomes and also to discourse the recommendations designed for possible intercessions.
Findingss will probably be shared in the regional workshop ” Advertising Child Endurance, Nutrition and Health by accomplishing the best IYCF patterns ” saved in India every twelvemonth.
Wellness Promotion team will be urged to concentrate on an incorrect socio-cultural and traditional morals and habits act uponing the child patterns through wellness training massages simply by mass-media and wellness awareness runs.
The airing software besides requires peculiar spending budget and video reflected in the budget and activities plan given below.
Makes and stuffs:
Particulars
Quantity required
Older Researcher or perhaps Senior Exploration Manager
you
Research Manager
1
Discipline Supervisor pertaining to Research
two
Research Helper
8
Exploration Trainer
one particular
Data entry/typing clerk
some
Administrator
you
Room and projector
1
Training Materials
16
Drinks
16 five 6 yearss
Flip Graphs
8
Immobile sets ( Pens, pencils, sharpener, eraser, highlighter, container holders, etc )
almost eight
Transcripts in the usher for carry oning FGDs
18
Transcripts of the usher pertaining to carry oning Interviews
35
Transcripts of written permission signifiers
45
Tape recording equipments
12
Field take note books to take notes
60
Bags to get field personnel
10
Envelops
50
Journal Books
8
Computers
5
Printer
one particular
Printing documents
6
Ink Cartilage
2
Rental vehicle and gas
2
Recruiting
Training Solutions
Materials
Touring
Timetable for the research:
Companies
W1
W2
W3
W4
W1
W2
W3
W4
W1
W2
W3
W4
W1
W2
W3
W4
W1
W2
W3
W4
W1
W2
W3
W4
Literature reappraisal
Search for Research squad
Develop research protocol
Data-collection tools development
Pretesting data-collection equipment
Recruitment of Research team
Develop preparation Faculty
Prepare developing System
Traning contracts
Train Field squad
Reserving for travell
Pilot-testing field vist
Buy field needs
Reaching the community governments
Data aggregation
Growth studies
Assessment the collected informations
Opinions to the team
Datas Entry
Translation
Datas Analysis
Record composing
Drumhead authorship
Drumhead distribution in cardinal
stakeholders , A, libraries
Behavior Workshops/Seminars
to flow the conclusions
Research Time-table
September
August
November
December
January
Feb
Budget
Spending budget Class
Every Unit Cost in US $
Number of Unit of measurements
Budget Needed
HUMAN RESOURCES
Older Researcher
3000
1
3 thousands
Research Coordinator
2500
you
2500
Discipline Supervisor intended for Research
sixty X 1 = 70
60 By 60
3600
Research Associate
40X8 = 320
320 X 62
19200
Exploration Trainer
500
1
five-hundred
Data entry/typing clerks
a hundred and fifty X some = six hundred
600 X 3
toll free
Administrator
1500
150 Back button 4
600
Sub Total
31200
ELEMENTS , A, EQUIPMENTS
Immobile sets ( Pens, pencils, sharpener, eraser, highlighter, container holders, and many others )
two
8
16
Transcripts with the usher to get carry oning FGDs
0. 5
of sixteen
8
Transcripts of the jason derulo for Selection interviews
0. your five
35
18
Transcripts of written agreement signifiers
zero. 5
45
20
Tape recording tools
20
15
200
Field note literature for taking paperwork
1
60
50
Hand bags for discipline staff
your five
10
40
Envelops ( for coup and notice book )
A
55
5
Sign Book , day-to-day research to manager
A
almost 8
8
Computers
300
4
1200
Printing device
160
you
160
Inkjet printer documents package
10
6
60
Printer Cartilage
60
2
95
Sub Total
1895
Teaching COSTS
Training Room as well as projector
60
1X6X50
three hundred
Training Materials
5
of sixteen
80
Drinks
6
sixteen ten six yearss
ninety six
Training summersault charts
A
8
of sixteen
Sub Total
492
Travel and leisure COSTS
Car lease and fuel
25
25 Back button 60
1500
