Journal articles on the topic 'Rural hospitals India Quality control'
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Singh, Ajai K., Poonam Chaturvedi, Pradeep K. Maurya, Dinkar Kulshreshtha, Abdul Qavi, and Anup Thacker. "Early PNF exercises functional outcome and quality in patients with stroke of urban and rural area in Uttar Pradesh: a prospective community based study." International Journal of Research in Medical Sciences 6, no. 2 (January 24, 2018): 639. http://dx.doi.org/10.18203/2320-6012.ijrms20180313.
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Background: Early rehabilitation plays a very important role in stroke outcome. In India people from rural areas get primary treatment from district hospitals, where the rehabilitation facilities are not available, and then referred to the tertiary care hospital (after 2-3weeks) hence the rehabilitation process is delayed. It may delay the improvement in functional outcome and quality of life. These factors should be evaluated. To evaluate effects of PNF intervention in urban and rural population in Uttar Pradesh.Methods: Total 90 patients were recruited in this study and divided into rural (coming from rural areas of Uttar Pradesh) and urban (coming from urban areas) groups. Patients were given rehabilitation for 4weeks and improvement in functional activities was assessed by Barthel's-Index (BI), Quality of Life was assessed by Stroke Specific Quality of Life Scale (SSQOL) and sensory motor improvement was assessed by Fugl- Meyer Assessment before and after the intervention. Patients were again assessed at 6months.Results: 41 patients in experimental and 49 patients in control group completed the 6 months follow up and were available for analysis. On analysis urban group showed better (<0.05) improvement in functional activities, sensory motor improvement (FMA) and quality of life (SSQOL) as well. People who directly admitted to our multispecialty and tertiary care hospital and received early rehabilitation showed better improvement than the patients who received late rehabilitation.Conclusions: Early rehabilitation leads to early improvement in functional activities. PNF exercises are very effective in improving motor function and should be given from the first day after stroke.
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Nagaonkar, Bahubali. "Strengthening health system through outsourcing of non-clinical services: inputs for improving management." Bharati Vidyapeeth Medical Journal 1, no. 3 (December 22, 2021): 23–35. http://dx.doi.org/10.56136/bvmj/2021_00037.
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Background: Public-Private Partnership (PPP) as a strategic management policy to improve hospital health services standards to the Indian Public Health Standards level, specially the non-clinical services. The studies on the qualitative as well quantitative aspects of services by identifying components that are suitable for execution Public Private partnerships for improving hospital services specially for non-clinical services are needed. There is also a need to identify probable modalities for the sustainability of the same. Objectives: The aim was to propose management inputs in improving non-clinical services of cleaning, security, diet, driver, and laundry in the hospitals under Public Health Department Maharashtra. The objectives were to assess the scope and feasibility of specific managerial inputs to promote the Public-Private Partnership under the National Rural Health Mission in emphasizing the qualitative aspect of service. To identify components where Public-Private Partnership can be evolved for hospital services, develop probable modalities for sustainability. Material and methods: The study adopted an experimental, epidemiological study design involving a study and control group. The study group of six sub-districts hospitals received an intervention package, and the control group of 14 sub-district hospitals did not receive an intervention package. Which included interventions to improve performance of clinical quality indicators, training, monitoring, and corrections. The author randomly selected the hospitals from betterperforming hospitals. The focus was mainly on “outsourcing'' components such as non-clinical services and their impact on the quality of services. In the evaluation of non-clinical services, the focus was on the quality of performance and cost-saving, compared to expenditure if regularly appointed employees would have delivered the services. Results and impact: Only 25% of patients were satisfied with non-clinical services. The contractors did not pay as per Minimum Wages Act 1948. The department accepted the checklist for monitoring cleaning and security services and disseminated it across the state as a circular.
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Jain, Shuchi, Pramod Kumar, Manish Jain, Megha Bathla, Shiv Joshi, Sushil Srivastava, Mahtab Singh, Ajit Sudke, Vikram Datta, and Poonam Shivkumar. "Increasing adherence to plotting e-partograph: a quality improvement project in a rural maternity hospital in India." BMJ Open Quality 10, Suppl 1 (July 2021): e001404. http://dx.doi.org/10.1136/bmjoq-2021-001404.
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Abnormal prolonged labour and its effects are important contributors to maternal and perinatal mortality and morbidity worldwide. E-partograph is a modern tool for real-time computerised recording of labour data which improves maternal and neonatal outcome. The aim was to improve the rates of e-partograph plotting in all eligible women in the labour room from existing 30% to achieve 90% in 6 months through a quality improvement (QI) process.A team of nurses, obstetricians, postgraduates and a data entry operator did a root cause analysis to identify the possible reasons for the drop in e-partograph plotting to 30%. The team used process flow mapping and fish bone analysis. Various change ideas were tested through sequential Plan-Do-Study-Act (PDSA) cycles to address the issues identified.The interventions included training labour room staff, identification of eligible women and providing an additional computer and internet facility for plotting and assigning responsibility of plotting e-partographs. We implemented these interventions in five PDSA cycles and observed outcomes by using control charts. A set of process, output and outcome indicators were used to track if the changes made were leading to improvement.The rate of e-partograph plotting increased from 30% to 93% over the study period of 6 months from August 2018 to January 2019. The result has been sustained since the last PDSA cycle. The maternal outcome included a decrease in obstructed and prolonged labour with its associated complications from 6.2% to 2.4%. The neonatal outcomes included a decrease in admissions in the neonatal intensive care unit for birth asphyxia from 8% to 3.4%. It can thus be concluded that a QI approach can help in improving adherence to e-partography plotting resulting in improved maternal health services in a rural maternity hospital in India.
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Prajapati, Deoraj, and Gaurav Suman. "Six sigma approach for neonatal jaundice patients in an Indian rural hospital – a case study." International Journal of Health Care Quality Assurance 33, no. 1 (December 17, 2019): 36–51. http://dx.doi.org/10.1108/ijhcqa-07-2019-0135.
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Purpose The purpose of this paper is to implement Six Sigma approach to decrease the length of stay (LOS) of neonatal jaundice patients in an Indian government rural hospital situated in northern hill region. Design/methodology/approach Six Sigma’s Define–Measure–Analyse–Improve–Control procedure is applied in order to decrease the LOS of neonatal jaundice patients. The mean and standard deviation have been computed as 34.53 and 20.01 h, respectively. The cause and effect diagram is used in the “Analyse” phase of the Six Sigma. The regression analysis and GEMBA observation techniques are used to validate the causes identified through cause and effect diagram. Findings The waiting time for registration, waiting time for tests, waiting time for phototherapy and time for discharge implementation are the main factors that are responsible for longer LOS. Based on the identified root causes, some recommendations are suggested to the hospital administration and staff members in order to reduce the LOS. Research limitations/implications The present research is limited to provide recommendations to the hospital administration to reduce LOS and it entirely depends upon the implementation of the administration. However, target of administration is to reduce the LOS up to 24 h. Practical implications Six Sigma model will reduce bottlenecks in LOS and enhance service quality of hospital. The developed regression model will help the doctors and staff members to assess and control the LOS by controlling and minimising the independent variables. Social implications The project will directly provide benefits to society, as LOS will decrease and patients’ satisfaction will automatically increase. Originality/value Six Sigma is a developed methodology, but its application in paediatric department is very limited. This is the first ever study of applying Six Sigma for neonatal jaundice patients in India.
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Syed, Thabish, Rakesh Thakuriya, and J. P. Rishi. "The profile of Autosomal Dominant Polycystic Kidney Disease (ADPKD) patients in rural areas of North India." Journal of Scientific and Innovative Research 5, no. 4 (August 25, 2016): 119–21. http://dx.doi.org/10.31254/jsir.2016.5403.
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Aims & Objectives: To study the profile of Autosomal Dominant Polycystic Kidney Disease (ADPKD) in low lying areas of NorthIndia. This is a 2 year observation study of patients attending Nephrology department in National Institute of Medical Sciences, Shobha Nagar, Jaipur, Rajasthan, India. Material & Methods: This is a 2 year prospective study done in National Institute of Medical Sciences- a tertiary hospital in rural area close to Jaipur. All ADPKD patients attending Nephrology department were studied to know their complete profile. Results: A total of 54 ADPKD patients attended Nephrology department between Jan 2014-Jan 2016, Out of which 34 patients presented with pain abdomen, 22 patients with hypertension, 8 patients with chronic renal failure kept on medical management, 8 with Chronic Kidney Disease CKD-ESRD (End Stage Renal Disease) on maintenance hemodialysis(MHD). Out of these 8 CKD-ESRD, there were 4 incidents of AV fistula thrombosis and 1 died recently whereas 20 patients remained completely asymptomatic. Conclusion: Timely diagnosis, proper understanding of disease by patients will provide good quality of life in these patients. Low salt diet, good control of hypertension (<130/80 mm of hg) delays progression to ESRD in these patients.
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Menezes, Anna Rachel. "Standard operating procedure for the management of hypertensive urgencies in a community health centre in rural Tamil Nadu: a quality improvement project." International Journal Of Community Medicine And Public Health 9, no. 6 (May 27, 2022): 2678. http://dx.doi.org/10.18203/2394-6040.ijcmph20221552.
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Background: Hypertension is one of the heaviest health care burdens in rural India where less than 1/10th of patients has blood pressures under control. This sheds limelight on community healthcare centers to proactively prevent, manage and treat hypertension and its complications. St. Ann’s Hospital is one such CHC located in the Elathigiri subdisrtict of Tamil Nadu. We formulated a standard operating procedure at the CHC for the effective prevention and treatment of hypertensive urgency- one of the easily treatable but highly impactful complications of hypertension. We then strengthened its usage using plan-do-study-act cyclesMethods: An SOP was formulated using international and national guidelines, contoured to the low resources present at the center. Healthcare workers were trained to follow the SOP. Sequential PDSA cycles were then used to evaluate and control the step-ladder of barriers in effective management. The results were analyzed using indicators and compared to baseline values established at the start of the study.Results: A rise of 41.4% was seen in correct SOP execution at the end of PDSA-2. At the end of the study, there was a 22% increase in the percent of patients correctly diagnosed, 19% increase in patients stabilized in the first hour and 14% increase in patients returning for follow up visits (p<0.05).Conclusions: Our SOP could significantly reduce the burden of HU at the CHC. We encourage its usage in similar low resource centers and promote PDSA cycles as a method to ensure its efficient utilization.
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Gupta, Vinod, Akhil Gupta, and Sucheta Gupta. "Risk factors of Helicobacter pylori infection in children: a cross-sectional study in Chenani." International Journal of Advances in Medicine 8, no. 7 (June 23, 2021): 892. http://dx.doi.org/10.18203/2349-3933.ijam20212344.
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Background: H. pylori infections generally occur early in childhood and continue to cause gastric diseases later in life. Epidemiological studies suggest its transmission through fecal to oral and oral to oral routes. Several factors control this transmission including socioeconomic status, quality of drinking water, personal and environmental hygiene, contamination of food, overcrowding and density of population.Methods: A cross-sectional study, involving 100 children aged 1 to 15 years, presenting gastrointestinal complaints was conducted in the department of medicine, district hospital, Udhampur, Jammu, Jammu and Kashmir, India from October 2019 to March 2020. Children with the pathology of central nervous system or with any other known pathology were excluded.Results: Majority of children belonged to the group >6, ≤11 years age (41%), 89% of children were school-going and 78% of participants belonged to the rural areas. Major economic activity of the participants came out to be business and trading (31%), as much as 62% of households were having a size of >4 persons per unit. As many as 24 children were found positive for antigen test upon stool sample examination. The infection rate was significantly higher among children having unsafe source of drinking water (14/24, 58.3%) and poor sanitation facilities (18/24, 66.7%). Overcrowding at home due to bigger household size was found to be a major risk factor among children.Conclusions: The prevalence of H. pylori among children was quite high. Major risk factors included sanitation and drinking water facilities at home and at schools.
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Paulraj, Kannan, and Saravanan Rangaswamy. "Patients Perception towards Quality of Health Care & Hospitals in Rural India." Asian Journal of Research in Social Sciences and Humanities 6, no. 7 (2016): 41. http://dx.doi.org/10.5958/2249-7315.2016.00408.1.
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Zakotnova, N. V. "Quality performance of medical service in rural treatment-and-prophylactic institutions in Tomsk region." Bulletin of Siberian Medicine 3, no. 3 (September 30, 2004): 71–75. http://dx.doi.org/10.20538/1682-0363-2004-3-71-75.
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Rural treatment-and-prophylactic institutions (TPI) and mainly central regional hospitals (CRH) – the key rural health protection units – insufficiently control and improve the medical service system quality due to a number of reasons. In rural CRH a number of incomplete examination cases and, consequently, a number of wrong diagnosis cases is higher significantly. Incomplete treatment becomes evident in rural areas more frequently as well. As a result the treatment quality in rural CRH is lower significantly than in Tomsk TPI. It is necessary to draw a special attention to the problem of rural medical service quality increase and to liven up the control of privided medical service quality in regional centers.
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Mohite, VR, AK Pratinidhi, and RV Mohite. "Dietary factors and breast cancer: A case control study from rural India." Asian Journal of Medical Sciences 6, no. 1 (July 25, 2014): 55–60. http://dx.doi.org/10.3126/ajms.v6i1.10285.
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Background: Diet, a modifiable risk factor for breast cancer is estimated approximately one-third of cases could be prevented by dietary modification. Objectives: To identify possible dietary risk factors of breast cancer among newly diagnosed cases of breast cancer and to determine the strength of association of the risk factors and cancer of breast. Methods: A hospital based case- control study was conducted in Satara district, India during year 2009 to 2011 among newly diagnosed cases of breast cancer and matched controls. The total number of 217 breast cancer cases and equal number of controls age, religion and residence matched were enrolled by purposive sampling technique from selected hospitals of the study area. The data was collected individually by employing pre-tested questionnaire utilizing interview method. Descriptive statistics, Odd’s ratio and chi-square test was used to find out the strength of association and statistically significant differences. Results: Maximum, 31.80% breast cancer cases were in age group 40-49 yrs with lowest age at diagnosis of disease was 25 years. Max, 63.59%, 71.42% and 56.68% breast cancer cases were housewives, literate and from upper economic class respectively. The risk of developing breast cancer as indicated by odd’s ratio was 2.38 times higher in overweight women, 2.1 times in women consuming non-vegetarian diet, 3.9 times with women consuming extra fat in diet and 13.5 times in women with having excess salt in their diet. Conclusion: The dietary risk factors such as non-vegetarian diet, excess fat and salt in diet and overweight was strongly associated with breast cancer. DOI: http://dx.doi.org/10.3126/ajms.v6i1.10285 Asian Journal of Medical Sciences Vol.6(1) 2015 55-60
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Mohite, Vaishali R., Asha K. Pratinidhi, and Rajsinh Vishwasrao Mohite. "Reproductive risk factors and breast cancer: a case control study from rural India." Bangladesh Journal of Medical Science 14, no. 3 (June 20, 2015): 258–64. http://dx.doi.org/10.3329/bjms.v14i3.21865.
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Background: Breast cancer is the most common type of cancer in women and is influenced by reproductive factors perceived by women worldwide.Aims: To identify the reproductive risk factors of breast cancer in newly diagnosed cases and to find out the strength of association of the risk factors with the breast cancer. Material and Methods: A hospital based case-control study was conducted in Satara district, India during year 2009 to 2011 among newly diagnosed cases of breast cancer and matched controls. A total of 434 participants including 217 cases and 217 controls were enrolled by purposive sampling technique from selected hospitals of study area. The information was collected by employing pre-tested questionnaire by utilizing interview method. Statistical Analysis used: Descriptive statistics, Odds ratio and Chi-square test was used to find out strength of association and statistical significant difference. Results: Highest proportion [31.80%] breast cancer cases was in age group 40-49 years with lowest age of 25 years at diagnosis of the disease. A very high proportion of both cases [88.02%] and controls [67.28%] were Hindu by religion and were from rural residence. Maximum proportion of breast cancer cases were housewives [63.59%], literate [71.42%] and from upper economic class [56.68%]. The proportions of cases were higher as compared to the controls with respect to risk factors like unmarried status, nulliparity, history of abortion, post menopausal status, absence of breast feeding and the history of exposure to hormonal contraceptives. The risk of getting breast cancer as indicated by Odds ratio was 8 times higher in unmarried women, 2.8 times in nulliparous women, 2.4 times with post menopausal status, 10.4 times with absence of breast feeding, 1.5 times with exposure to hormonal contraceptives and 4.5 times with history of ovarian disease respectively. Conclusion: The reproductive risk factors such as unmarried status of women, nulliparity, menopause, absence of breast feeding, history of ovarian disease and use of contraceptives were strongly associated with breast cancer.Bangladesh Journal of Medical Science Vol.14(3) 2015 p.258-264
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Tao, Ling, Wei Long, and Yan Qing Wang. "Design and Implementation of the Control System for an ARM9-Based Biochemical Analyzer." Advanced Materials Research 268-270 (July 2011): 454–57. http://dx.doi.org/10.4028/www.scientific.net/amr.268-270.454.
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The design and implementation of the control system of an ARM9-based biochemical analyzer was introduced in detail. The S3C2440, an ARM9-based MCU, was the core of the control system. Precision regulator circuit of light of the analyzer was designed to stabilize the voltage supply of the light source. Closed-loop motor positioning control technology and freely programmable CPLD stepper motor sub-circuit technology were used to precisely position the grating. And flexible gain control technology based on digital potentiometers was employed to solve the problem of signal regulation. Such core technical problems was solved in succession, it thereby improves the instrument's performance and function and provides a number of inexpensive high-quality products for domestic small and medium sized hospitals especially rural hospitals and promoted the establishment of those hospitals in consequence.
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Sharma, J. K., and Ritu Narang. "Quality of Healthcare Services in Rural India: The User Perspective." Vikalpa: The Journal for Decision Makers 36, no. 1 (January 2011): 51–60. http://dx.doi.org/10.1177/0256090920110104.
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Developing nations have been focusing on relevant infrastructure, technology, disease control, and health outcomes in terms of deaths and disability-adjusted life years, largely ignoring the service quality aspect from the patient's viewpoint. However, researchers opine that real improvement in quality of care cannot occur if the user perception is not involved. Patients' perception is significant as it impacts their ‘health-seeking behaviour’ including utilization of services, seeks involvement in issues directly related to them, enables the service provider to meet their expectations better, and provides relevant information to the policy makers to improve the quality. Some studies conducted in the recent years have made attempts to develop multi-dimensional scales and measure quality of healthcare services in the developing nations. The current study seeks to assess the perception of patients towards quality of healthcare services in rural areas of seven districts of Uttar Pradesh based on the scale developed by Haddad et al (1988) after making adjustment for Indian culture and language. 500 patients were contacted at the healthcare centres. A response rate of 79.2 per cent was obtained resulting in 396 complete questionnaires. The 23-item scale employed in the study comprised five homogeneous sub-scales and tested well for reliability. The findings illustrated some interesting differences in user perception regarding service quality and how they varied between different healthcare centres and according to the demographic status of patients. It was observed that: ‘Healthcare delivery’ and ‘financial and physical access to care’ significantly impacted the perception among men while among women it was ‘healthcare delivery’ and ‘health personnel conduct and drug availability’. With improved income and education, the expectations of the respondents also increased. It was not merely the financial and physical access that was important but the manner of delivery, the availability of various facilities and the interpersonal and diagnostic aspect of care as well that mattered to the people with enhanced economic earnings. What was most astonishing was the finding that the overall quality of healthcare services is perceived to be higher in Primary Healthcare Centres than in Community Healthcare Centres (CHCs). Inadequate availability of doctors and medical equipments, poor clinical examination and poor quality of drugs were the important drawbacks reported at CHCs. The current study demonstrates that the instrument employed was reliable and possessed the power to discern differences in the opinion of people on the basis of demographic factors and point out the quality differences in different healthcare centres. It could be employed to evaluate healthcare quality perception in other rural and urban regions of the country and to assess the perception of users towards private healthcare centres. Further, research could be conducted on price-quality relationship. The government and policy makers are urged to consider the perceptions of patients as well in order to affect improvement in the quality of services and subsequently increase their utilization.
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Bose, Anjana, and Agniva Ghosh Dastidar. "Do surgical patients of remote areas really need to overburden urban medical colleges: a practical survey analysis." International Surgery Journal 6, no. 2 (January 28, 2019): 564. http://dx.doi.org/10.18203/2349-2902.isj20190404.
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Background: Public health care delivery is inadequate and as a result the demand supply gap is large, this is specially so in rural India. Even with so many hospitals in the peripheries still there is overcrowding in the urban Medical Colleges. Overcrowding is when hospitals operate beyond a safe level of 85% bed occupancy. This leads to delay in treatment and subsequent medical complications. Furthermore, quality of the treatment is jeopardised as its effects physician’s effectiveness, causing frustration among medical staff and may even contribute to violence. The objective was to identify the elective/non-emergency operations that could have been done in rural hospitals but were done in a tertiary Medical College and to find out the cause for avoiding the local government hospitals nearer to their residence. This study suggested some remedies to correct this disparity.Methods: This was an observational and descriptive study where patient’s type of operation, distance travelled and cause for coming to an urban Medical College was noted.Results: Majority of the patients did not have any idea as to why they chose this hospital, other reasons are lack of infrastructure in their rural hospital, bad reputation, lack of cleanliness, malpractice by the hospital staff etc.Conclusions: Health care facilities in different locations should be based on utilization rates and also proper and efficient management of these established facilities should be done.
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Pfaff, Colin, Gift Malamula, Gabriel Kamowatimwa, Jo Theu, Theresa J Allain, Alemayehu Amberbir, Sunganani Kwilasi, et al. "Decentralising diabetes care from hospitals to primary health care centres in Malawi." Malawi Medical Journal 33, no. 3 (September 27, 2021): 159–68. http://dx.doi.org/10.4314/mmj.v33i3.3.
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BackgroundNon-communicable diseases (NCDs) such as diabetes and hypertension have become a prominent public health concern in Malawi, where health care services for NCDs are generally restricted to urban centres and district hospitals, while the vast majority of Malawians live in rural settings. Whether similar quality of diabetes care can be delivered at health centres compared to hospitals is not known. MethodsWe implemented a pilot project of decentralized diabetes care at eight health centres in four districts in Malawi. We described differences between district hospitals and rural health centres in terms of patient characteristics, diabetes complications, cardiovascular risk factors, and aspects of the quality of care and used multivariate logistic regression to explore factors associated with adequate diabetes and blood pressure control. ResultsBy March 2019, 1339 patients with diabetes were registered of whom 286 (21%) received care at peripheral health centres. The median duration of care of patients in the diabetes clinics during the study period was 8.8 months. Overall, HIV testing coverage was 93.6%, blood pressure was recorded in 92.4%; 68.5% underwent foot examination of whom 35.0% had diabetic complications; 30.1% underwent fundoscopy of whom 15.6% had signs of diabetic retinopathy. No significant differences in coverage of testing for diabetes complications were observed between health facility types. Neither did we find significant differences in retention in care (72.1 vs. 77.6%; p=0.06), adequate diabetes control (35.0% vs. 37.8%; p=0.41) and adequate blood pressure control (51.3% vs. 49.8%; p=0.66) between hospitals and health centres. In multivariate analysis, male sex was associated with adequate diabetes control, while lower age and normal body mass index were associated with adequate blood pressure control; health facility type was not associated with either. ConclusionQuality of care did not appear to differ between hospitals and health centres, but was insufficient at both levels.
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Gulia, Seema, Manju Sengar, Rajendra Badwe, and Sudeep Gupta. "National Cancer Control Programme in India: Proposal for Organization of Chemotherapy and Systemic Therapy Services." Journal of Global Oncology 3, no. 3 (June 2017): 271–74. http://dx.doi.org/10.1200/jgo.2015.001818.
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Cancer is a major health problem in India, with an estimated incidence of 1 million cases in 2012 that is likely to double in 2035 to approximately 1.7 million. The majority of cases are diagnosed in advanced stages, and approximately two thirds of patients die as a result of their disease. The mortality-to-incidence ratio is 0.68 in India, which is far higher than that in developed countries (approximately 0.38). One of the important reasons for this discrepancy is inequitable distribution and inaccessibility of health care resources in India. One component of scarce health care resources is the low ratio of oncologists to patients with cancer (1:2,000), which leads to delivery of systemic anticancer therapy in many hospitals by health care professionals who do not have required training. Given these facts, there is a need to focus on organization of medical oncology services in terms of manpower and infrastructure to standardize the delivery of systemic anticancer therapy. Redistribution of resources can streamline the delivery of cancer care, preferably close to the patient’s home. This article describes the blueprint for organization of medical oncology services and delivery of chemotherapy and other systemic therapies to Indian patients. The model uses existing health care services in the country and is a four-tiered system of increasing sophistication: District Hospitals, Medical College Hospitals, Regional Cancer Centres, and Apex Cancer Centres. Delivery of quality care to patients with cancer through standardized protocols is crucial in improving cancer outcomes in India.
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Varghese, Bindi. "Management Practices in Hospital Administration: a study of the Challenges Faced by the Healthcare Organisation in South India." Atna Journal of Tourism Studies 6, no. 1 (August 14, 2021): 1–15. http://dx.doi.org/10.12727/ajts.6.1.
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This paper accentuates the need for quality assurance and standardization norms for hospital administration which is the need of the hour. Lack of effective administration practices in the hospital and hospitality sector necessitate the need for a total quality management approach in the Healthcare Sector. Application of quality control systems is a vital aspect that hospitals in South India cannot disregard. It would lead the South in a new direction by ensuring quality and enhancing customer satisfaction. Hence, this paper makes an attempt to understand the hospital management practices in South India effectively. The research addresses Medical Tourism as a ‘cost effective’ private medical care initiative in collaboration with the tourism industry for patients needing surgical and other forms of specialised treatment. This process is being facilitated by the corporate sector involved in medical care as well as the tourism industry – both private and public. There is also a constant effort taken by corporate hospitals to support medical tourism to its fullest potential. India today has copious opportunities to compete with other developed nations and building a quality health care system of its own.
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Bhattacharya, Sumanta. "A NEED FOR INDIA TO INVEST MORE IN THE HEALTH CARE SECTOR TO PROVIDE BETTER HEALTH SERVICES TO ITS PEOPLE AFTER LOOKING AT THE COVID-19 CASUALTY." International journal of multidisciplinary advanced scientific research and innovation 1, no. 9 (November 29, 2021): 190–94. http://dx.doi.org/10.53633/ijmasri.2021.1.9.03.
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With 75% of the health are expenditure comes from the people of India , the rest is by the government , the government spends only 1.6% of the GDP on health care sector , there is major problems in our health care sector starting from shortage of beds , to lack of doctors and nurses , the difference in the quality of treatment in the urban and rural areas as well as in private and public hospitals . The doctors even limit themselves to the private hospital because of maximum facilities , the cost of treatment is so high that half of the people die out of loan , The government during this catastrophic has provided and increased its budget for the treatment and for public health care facilities but that is not enough during at one time . around 1.8 million people have died in the pandemic situation , in India only 2 % of the people have been vaccinated . India has entered the second wave of corona virus , when it comes to rural India , there is hardly any facility available , especially for the pregnant women and its child during this COVID-19 pandemic . There is lack of medical facilities in India both rural and urban , infrastructural and human resources to cure the people . India is being dependent on other countries for import of oxygen cylinders , India is the global hotspot of COVID at present . Keywords: health care, expenditure, covid-19, budget, GDP, vaccinated, catastrophic
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Sudhakar, Sreejith, Justin Jose, and Shanuga Cherayi. "A Cross Sectional Survey of Factors Influencing Healthcare Access in Older Women of South India." Innovation in Aging 5, Supplement_1 (December 1, 2021): 829–30. http://dx.doi.org/10.1093/geroni/igab046.3041.
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Abstract We examined the determinants of healthcare access barriers, treatment-seeking, and self-medication in older women aged 60 years and more, using a cross-sectional survey design. Using a structured interview format, we interviewed 1005 older women from 7 out of 14 districts in the state through a stratified random sampling procedure. Multiple linear regression analysis results reveal that older women's healthcare access barriers significantly increased when they experienced a long duration of multimorbidity alongside poor recognition of autonomy and basic amenities available at health facilities. However, confidentiality, the ability to pay for healthcare expenditure, and the type of health care significantly improved healthcare access. In factors influencing older women's delay in treatment-seeking, optimal instrumental functionality in daily living, optimal quality of life and access to healthcare services significantly reduced delay in treatment initiation. Whereas poor health-seeking behaviors, long duration of multimorbidity, and the quality of basic amenities at hospitals significantly increased treatment initiation delay and explained 13.6% of the variance. In factors influencing older women's use of self-medication, advancing age, living in rural areas, optimal functionality, perception of providers' respect for confidentiality were associated with increased self-medication frequency. Whereas, better wealth status, prompt attention to older women's health needs, and basic amenities at hospitals significantly reduced their self-medication practice. Therefore, the optimal functional abilities, fewer morbidities, and optimal health system responsiveness significantly reduce healthcare access barriers and self-medication while improving older women's treatment-seeking behaviors.
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Cadilhac, Dominique A., Tara Purvis, Monique F. Kilkenny, Mark Longworth, Katherine Mohr, Michael Pollack, and Christopher R. Levi. "Evaluation of Rural Stroke Services." Stroke 44, no. 10 (October 2013): 2848–53. http://dx.doi.org/10.1161/strokeaha.113.001258.
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Background and Purpose— The quality of hospital care for stroke varies, particularly in rural areas. In 2007, funding to improve stroke care became available as part of the Rural Stroke Project (RSP) in New South Wales (Australia). The RSP included the employment of clinical coordinators to establish stroke units or pathways and protocols, and more clinical staff. We aimed to describe the effectiveness of RSP in improving stroke care and patient outcomes. Methods— A historical control cohort design was used. Clinical practice and outcomes at 8 hospitals were compared using 2 medical record reviews of 100 consecutive ischemic or intracerebral hemorrhage patients ≥12 months before RSP and 3 to 6 months after RSP was implemented. Descriptive statistics and multivariable analyses of patient outcomes are presented. Results— Sample: pre-RSP n=750; mean age 74 (SD, 13) years; women 50% and post-RSP n=730; mean age 74 (SD, 13) years; women 46%. Many improvements in stroke care were found after RSP: access to stroke units (pre 0%; post 58%, P <0.001); use of aspirin within 24 hours of ischemic stroke (pre 59%; post 71%, P <0.001); use of care plans (pre 15%; post 63%, P <0.001); and allied health assessments within 48 hours (pre 65%; post 82% P <0.001). After implementation of the RSP, patients directly admitted to an RSP hospital were 89% more likely to be discharged home (adjusted odds ratio, 1.89; 95% confidence interval, 1.34–2.66). Conclusions— Investment in clinical coordinators who implemented organizational change, together with increased clinician resources, effectively improved stroke care in rural hospitals, resulting in more patients being discharged home.
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Sharma, Manoj Kumar, Sonali Pandey, and Suryakant Nagtilak. "METABOLIC SYNDROME IN URBAN AND RURAL POPULATION OF GREATER NOIDA NATIONAL CAPITAL REGION OF INDIA." Asian Journal of Pharmaceutical and Clinical Research 11, no. 9 (September 7, 2018): 110. http://dx.doi.org/10.22159/ajpcr.2018.v11i9.26487.
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Objective: The objective of this study was to evaluate the prevalence of metabolic syndrome (MetS) and to define its predictors in urban and rural patients presenting to tertiary care hospitals located in Greater Noida district Gautam Budh Nagar, India.Methods: A total of 367 participants recruited in the study, aged 20–55 years, comprising, 290 patients (149 rural and 141 urban) and 77 healthy age, sex-matched controls from the study area. Anthropometric, clinical and laboratory examination information was obtained. MetS was defined as per the National Cholesterol Education Program, Adult Treatment Panel III (NCEP, ATP III) report.Results: There were significant differences in biochemical and anthropometric measurements between control and patient population (p<0.05). There was a substantial difference in the prevalence of MetS among male and female patient population of urban as well as rural areas. As per NCEP, ATP III criteria, the prevalence of MetS in urban patient population was 21.7% in male and 27.8% in female whereas rural male and female exhibited 13.8% and 18.8% of MetS, respectively. Waist circumference was found as the strongest predictor of MetS among the patient population.Conclusion: Rapid urbanization of the cities is affecting the village life and indicating toward a major burden of diseases associated with MetS. A higher prevalence of MetS in female irrespective of the area of residence needs major health-care policy change. There is an urgent need to address this issue by adopting healthy eating, physical exercise, and weight reduction.
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Prasad, Indulata. "Caste-ing Space: Mapping the Dynamics of Untouchability in Rural Bihar, India." CASTE / A Global Journal on Social Exclusion 2, no. 1 (May 16, 2021): 132–52. http://dx.doi.org/10.26812/caste.v2i1.232.
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B. R. Ambedkar, the scholar, activist, and chief architect of the Indian constitution, in his early twentieth century works, referred to the untouchable quarters in India as ghettos. He recognized that untouchability was manifested through combining social separation with spatial segregation. Ambedkar’s theorization of untouchability can be applied along with feminist and Dalit scholars’ theories of the relationship between dynamic spatial experiences and the reworking of caste hierarchies to understand how securing control over productive assets, such as land, has altered social and spatial segregation in rural Bihar. Combined with narratives of the past and present, maps drawn by Bhuiyan Dalit women depicting the physical spaces they occupy in their village (i.e. housing, community center), the locations of sources of water and electricity, and the quality of the resources to which they have access demonstrate that gaining control over land following the Bodhgaya Land Movement (BGLM) of the late 1970s helped end the most overt and readily discernible forms of caste-based discrimination. Nevertheless, resource discrimination and spatial and social segregation continue, albeit more covertly. The logic of untouchability still undergirds social interactions in rural Bihar, preventing Dalits from fully realizing their rights as guaranteed by law.
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Van Heng, Yang, Chan Davoung, and Hans Husum. "Non-Doctors as Trauma Surgeons? A Controlled Study of Trauma Training for Non-Graduate Surgeons in Rural Cambodia." Prehospital and Disaster Medicine 23, no. 6 (December 2008): 483–89. http://dx.doi.org/10.1017/s1049023x00006282.
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AbstractIntroduction:Due to the accelerating global epidemic of trauma, efficient and sustainable models of trauma care that fit low-resource settings must be developed. In most low-income countries, the burden of surgical trauma is managed by non-doctors at local district hospitals.Objective:This study examined whether it is possible to establish primary trauma surgical services of acceptable quality at rural district hospitals by systematically training local, non-graduate, care providers.Methods:Seven district hospitals in the most landmine-infested provinces of Northwestern Cambodia were selected for the study. The hospitals were referral points in an established prehospital trauma system. During a four-year training period, 21 surgical care providers underwent five courses (150 hours total) focusing on surgical skills training. In-hospital trauma deaths and postoperative infections were used as quality-of care indicators. Outcome indicators during the training period were compared against pre-intervention data.Results:Both the control and treatment populations had long prehospital transport times (three hours) and were severely injured (median Injury Severity Scale Score = 9). The in-hospital trauma fatality rate was low in both populations and not significantly affected by the intervention. The level of post-operative infections was reduced from 22% to 10.3% during the intervention (95% confidence interval for difference 2.8–20.2%). The trainees' selfrating of skills (Visual Analogue Scale) before and after the training indicated a significantly better coping capacity.Conclusions:Where the rural hospital is an integral part of a prehospital trauma system, systematic training of non-doctors improves the quality of trauma surgery. Initial efforts to improve trauma management in low-income countries should focus on the district hospital.
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Kumar, Hemant, Sachidananda Kapinakadu, and Manjula Anil. "Health seeking behaviour and its determinants among rural population- a cross sectional study in South India." International Journal Of Community Medicine And Public Health 6, no. 11 (October 24, 2019): 4944. http://dx.doi.org/10.18203/2394-6040.ijcmph20195085.
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Background: Remedial action that a person takes to treat his or her perceived illnesses, is called health-seeking behaviour. Understanding health seeking behaviour (HSB) in a community and the factors which influence their decision, are crucial for planning a “need based” comprehensive health care programmes for the people, especially for underprovided and rural population. The objective of present study was to determine HSB and its determinants in a defined rural population.Methods: A community based cross -sectional study was conducted in rural field practice area of A. J. Institute of Medical Sciences and Research Centre, Mangalore (Karnataka) from 1st October 2017 to 31st July 2018. A total of 866 heads of households were included in the study, using universal sampling method. A pre-tested, validated questionnaire was used to collect the data. p values of <0.05 were considered significant.Results: Among 866 participants, almost all (98.03%) heads of families were males, while majority of them (35.68 %) were farmers. Further, majority (48.15%) of the households preferred to visit government hospitals for their ailments, while among those visiting private practitioners, majority of them (55.54%) preferred Allopath system of medicine. Health insurance subscription rates were found to be low (18.93%). Main determinants of HSB were observed to be cost of treatment, convenience of approach, quality of services and life threatening emergencies.Conclusions:Present study brings out higher utilization of government health care facilities among the study subjects, while cost of treatment and life threatening emergencies were the main predictors of HSB.
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Chaudhuri, Atanu, Venkatramanaiah Saddikutti, and Thim Prætorius. "iKure Techsoft: Providing Technology Enabled Affordable Health Care in Rural India." Asian Case Research Journal 22, no. 02 (December 2018): 385–411. http://dx.doi.org/10.1142/s0218927518500165.
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iKure Techsoft was established in 2010 with the main objective to provide affordable and high quality primary health care to the rural population in India and to build a sustainable for-profit business model. To that end, iKure’s cloud based, and patent pending, Wireless Health Incident Monitoring System (WHIMS) technology along with their hub-and-spoke operating model are central, but also essential to exploit and explore further if iKure is to scale-up. iKure provides primary health care services through three hub clinics and 28 rural health centres (RHCs). Each hub clinic employs between one and up to six medical teams (each consisting of 1 doctor, 1 nurse, 1 paramedic and 2 health workers stationed at the hub) & 1 mobile medical team (1 doctor, 1 paramedic, 2 health workers) for catering to the RHCs). Each medical team manages six RHCs. Paramount in iKure’s health care delivery model is their self-developed software called WHIMS, which is a cloud-based award-winning application that runs on low internet bandwidths. WHIMS allow for (a) centralized monitoring of key metrics such as doctor’s attendance, treatment prescribed, patient record management, pharmacy stock management, and (b) supports effective communication, integration and contact that connects RHCs with hub clinics, but also city-based multi-specialty hospitals with whom iKure has formal tie-ups. iKure, moreover, also works extensively with Non-Governmental Organizations (NGOs). Collaboration with local NGOs in the target areas helps to build trust with the rural villagers and their local knowledge and access helps to assess service demand. NGOs also provide the necessary local logistical support and basic infrastructure in the rural areas where iKure works. Moreover, collaboration, for example, with corporate organizations are central as they contribute with part of their corporate social responsibility (CSR) funds to support iKure initiatives. At present, iKure is planning to add diagnostic services to its six hub clinics as well as expand its presence in other parts of West Bengal and other states across India. Expanding rural health care services even with the technology support of WHIMS is challenging because, for example, health is a very local issue (due to, among other things, local customs and languages) and it requires investing significant amount of time and resources to build relationship with the rural people as well as collaborators such as NGOs and corporates. The accompanying case describes iKure’s journey so far in terms of understanding: (a) the state of health care and government health care services provided in rural India, (b) the establishment and evolution of the iKure business and health care model, (c) iKure’s operations and health care delivery model including the WHIMS technology solution and hub-and-spoke set-up of operations, (d) the collaborative model which relies on NGOs and private corporates, and (e) finally iKure’s challenges related to scaling-up.
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Kurian, Elizabeth, Pankaj Vishwakarma, Jaikumar Deenadayalan, Amit Mondal, Dhanaji Ranpise, Shobhana Chavan, and Prem Kumar S. G. "Determinants of vision function related quality of life of patients undergoing unilateral cataract surgical services in charitable hospitals in India: a multicentre prospective cohort study." International Journal Of Community Medicine And Public Health 5, no. 3 (February 24, 2018): 1138. http://dx.doi.org/10.18203/2394-6040.ijcmph20180774.
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Background: Cataract is the leading cause of avoidable blindness in developing world, including India. The objective of this study is to measure the changes in quality of life (VRQoL) after cataract surgery and identify the predictors of an improvement in these outcomes.Methods: A multi-center prospective, longitudinal cohort study was conducted. At baseline patients aged ≥18 years with first-eye cataract were interviewed about VRQoL. Six months’ later participants were re-interviewed at their residences. Multiple classification analysis (MCA) was performed to assess the variation in the intensities of mean change scores for general function, psychosocial impact and visual function with select factors.Results: The six-month follow-up rate was 87.3%. There was a significant improvement in visual acuity and VRQoL post-surgery. The mean general function, psychosocial impact and visual function scores were 34.6 (SD 10.9), 10.5 (SD 3.7) and 8.4 (SD 2.2) in the baseline and 15 (SD 5.5), 5 (SD 2.2) and 4.4 (SD 1.6) in the follow-up assessments, respectively. In MCA, patients prescribed spectacles post-surgery (β 0.137) and those from rural backgrounds (β 0.137) had the most impact on general function. Patients with complete follow-up visits had a relatively higher effect on the psychosocial impact (β 0.084) whereas patients from rural background and men had the most impact on the visual function scores (β 0.102 and 0.076) respectively.Conclusions:Cataract surgery is associated with meaningful improvements in VRQoL in general. The determinants of better VFQoL include regular and complete patient follow-up visits and prescription and provision of spectacles post-surgery.
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Das, Arghya, Rahul Garg, E. Sampath Kumar, Dharanidhar Singh, Bisweswar Ojha, H. Larikyrpang Kharchandy, Bhairav Kumar Pathak, et al. "Implementation of infection prevention and control practices in an upcoming COVID-19 hospital in India: An opportunity not missed." PLOS ONE 17, no. 5 (May 23, 2022): e0268071. http://dx.doi.org/10.1371/journal.pone.0268071.
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Infection prevention and control (IPC) program is obligatory for delivering quality services in any healthcare setup. Lack of administrative support and resource-constraints (under-staffing, inadequate funds) were primary barriers to successful implementation of IPC practices in majority of the hospitals in the developing countries. The Coronavirus Disease 2019 (COVID-19) brought a unique opportunity to improve the IPC program in these hospitals. A PDSA (Plan—Do—Study- Act) model was adopted for this study in a tertiary care hospital which was converted into a dedicated COVID-19 treatment facility in Varanasi, India. The initial focus was to identify the deficiencies in existing IPC practices and perceive the opportunities for improvement. Repeated IPC training (induction and reinforce) was conducted for the healthcare personnel (HCP) and practices were monitored by direct observation and closed-circuit television. Cleaning audits were performed by visual inspection, review of the checklists and qualitative assessment of the viewpoints of the HCP was carried out by the feedbacks received at the end of the training sessions. A total of 2552 HCP and 548 medical students were trained in IPC through multiple offline/onsite sessions over a period of 15 months during the ongoing pandemic. Although the overall compliance to surface disinfection and cleaning increased from 50% to >80% with repeated training, compliance decreased whenever newly recruited HCP were posted. Fear psychosis in the pandemic was the greatest facilitator for adopting the IPC practices. Continuous wearing of personal protective equipment for long duration, dissatisfaction with the duty rosters as well as continuous posting in high-risk areas were the major obstacles to the implementation of IPC norms. Recognising the role of an infection control team, repeated training, monitoring and improvisation of the existing resources are keys for successful implementation of IPC practices in hospitals during the COVID-19 pandemic.
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Behera, Manas Ranjan, Deepanjali Behera, and Chardsumon Prutipinyo. "Examining the relationship between living conditions, work environment and intent to stay among nurses in current posts in rural areas of Odisha state, India." Bangladesh Journal of Medical Science 19, no. 3 (March 10, 2020): 527–36. http://dx.doi.org/10.3329/bjms.v19i3.45871.
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Objectives : The scarcity of nursing workforce in rural and underserved areas are key challenges for healthcare systems across the countries. Such inequities have not only impede quality care but also an impact to population health outcomes especially in developing countries. An understanding about nurses’ retention and attrition are crucial to inform policy and decision makers for improved rural retention among nursing workforce. The aim of the study was to examine the relationship between living conditions, work environment and intent to stay in current posts of work; and the associated factors influencing intent to stay in current posts of work among nurses in rural areas of Odisha state, India.
Methods : A cross sectional survey was conducted among 232 nurses from October 2016 to February 2017. Multistage sampling technique was used to select the study subjects from rural hospitals. Data were collected using structured self-administered questionnaires. Descriptive statistics were computed to summarize the basic characteristics of study sample. Logistic regression model was fitted and odds ratio with 95% of confidence interval was calculated to identify associated factors
Results: The proportion of a nurse’s intent to stay and continue working in rural areas for next 3 years was 73.7%. There was a positive correlation between intention to stay with the living conditions and work environment. Logistic regression shown that age (OR=0.95, 95% CI = 0.89 - 0.98, P = 0.047), living conditions (OR = 1.13, 95% CI = 1.04 - 1.22, P=0.009) and work environment (OR = 1.07, 95% CI = 1.01 – 1.14, P = 0.015) were the significant predictors that are associated with intent to stay in rural areas among the nursing profession.
Conclusion - Improving living conditions and creating a culture of supportive work environment among the nursing community in rural areas can create increased retention in the workforce.
Bangladesh Journal of Medical Science Vol.19(3) 2020 p.527-536
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Gaidhani, Abhilasha Valmik, and Rupali Vishal Chaugule. "The effectiveness of pre-operative care bundle on post-operative outcome among adult patients undergoing cardiac surgeries in selected hospitals." Malahayati International Journal of Nursing and Health Science 5, no. 1 (March 17, 2022): 60–68. http://dx.doi.org/10.33024/minh.v5i1.6354.
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Background: Cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated 17.9 million lives each year. CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other conditions. More than four out of five CVD deaths are due to heart attacks and strokes, and one-third of these deaths occur prematurely in people under 70 years of age. India has one of the highest burdens of cardiovascular disease (CVD) worldwide. The annual number of deaths from CVD in India is projected to rise from 2.26 million (1990) to 4.77 million (2020). Coronary heart disease prevalence rates in India have been estimated over the past several decades and have ranged from 1.6% to 7.4% in rural populations and from 1% to 13.2% in urban populations.Purpose: To determine the effectiveness of preoperative care packages on postoperative outcomes of CABG patients and the relationship of postoperative outcomes with clinical and demographic variables.Method: In this study, the design used was a quasi-experimental design. In this study, a simple random sampling technique was used. sample size was 40 (experimental group 20 and control group 20) Study Findings 95% of patients were diagnosed with TVD, the remaining 5% were DVD patients.Results: This shows that there is moderate with 30% and good with 70% recovery in the experimental group, while in the control group 85% is moderate, 10% is good and 5% is bad. This indicates that there is a significant difference between the postoperative outcome scores between the experimental and control groups as p<0.05Conclusion: there is a significant effect of a pre-operative care bundle in patients undergoing CABG on preventing CABG complications and increasing life expectancy.
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Kumar Rastogi, Naveen, Kapil Goel, Tanu Jain, Samir V Sodha, Rajesh Yadav, Chandra Shekhar Aggarwal, and Akshay Dhariwal. "Evaluation of National Injury Surveillance Centre, India, 2015-16." Indian Journal of Community Health 32, no. 1 (March 31, 2020): 51–56. http://dx.doi.org/10.47203/ijch.2020.v32i01.011.
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Background: Globally, injuries accounts for 9% of all deaths, but India account for 11%. Due to limited data on injury characteristics, National Injury Surveillance Centre (NISC) was established in 2014 in New Delhi. Aim & Objectives: To evaluate attributes of NISC and make evidence-based recommendations. Methods and Material: We conducted cross-sectional study and used US Centers for Disease Control and Prevention guidelines to assess simplicity, flexibility, acceptability, stability, timeliness, representativeness, usefulness, and data quality. We reviewed 2015 records and interviewed 20 key-informants. We used Epi-Info7 for analysis. Results: NISC captured 4043 injuries in 2015 from one hospital. Among five data entry operators, four reported lengthy format, but all reported it easy. Among ten relevant key-informants, all reported data-management software easy. System demonstrated flexibility in three variables. All 20 staff reported willingness to participate, and 90% felt quarterly reporting acceptable. Regarding stability, data was collected for 361/365 days. Quarterly reports were available but only submitted annually. Regarding usefulness, all WHO-recommended variables included. Regarding data quality, 17% data-fields were missing. Conclusion: NISC is simple, flexible, stable, acceptable and potentially useful based on data captured. Timeliness based on annual reporting is high, can be improved to quarterly. We recommend training to improve data quality and integration of additional hospitals to improve representativeness.
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Peters, Michael A., Olakunle Alonge, Anbrasi Edward, Yvonne Commodore-Mensah, Japneet Kaur, Navneet Kumar, and Krishna D. Rao. "Barriers to effective hypertension management in rural Bihar, India: A cross-sectional, linked supply- and demand-side study." PLOS Global Public Health 2, no. 10 (October 12, 2022): e0000513. http://dx.doi.org/10.1371/journal.pgph.0000513.
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Effective management of hypertension in low- and middle-income settings is a persistent public health challenge. This study examined supply- and demand-side barriers to receiving quality care and achieving effective hypertension management in rural Bihar, India. A state-representative household survey collected information from adults over 30 years of age on characteristics of the hypertension screening, diagnosis, and management services they received. A linked provider assessment determined the percent of providers who provided quality hypertension care (i.e., had a functioning BP measurement device, measured a patient’s BP, could correctly diagnose hypertension, had at least one first-line antihypertension medication, and could prescribe correctly based on standard guidelines). Patients were linked with their provider to determine the quality-adjusted coverage of hypertension management and logistic regression analysis was conducted to determine characteristics associated with receiving quality care. A total of 14,386 patients and 390 providers were studied. Nearly a quarter (22.5%) of adults had never had their BP measured before and 8.1% of adults reported a previous hypertension diagnosis. Less than one third (31.0%) of all interviewed providers demonstrated ability to provide quality hypertension care, and quality varied between provider types (14.8% of private homeopathic, 25.2% of informal, 40.0% of private modern medicine, and 60.0% of public providers gave quality care). While 95.8% of diagnosed individuals received some treatment, only 10.9% of patients received care from quality local providers. Nearly 45% of individuals with hypertension received care from non-local providers. Individuals from the general caste with comorbidities living in villages with more high-quality providers were most likely to receive quality care from a local provider. Whereas the coverage of services for individuals diagnosed with hypertension is high, the quality of these services is suboptimal for economically and socially vulnerable populations, which limits effective management and control of hypertension in rural Bihar. Efforts should be targeted towards providers to initiate quality treatment upon diagnosis, including correct prescription of antihypertensives.
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Sharma, Parag, Chitra Singh, Ram K. Solanki, and Wasim. "A descriptive analysis of patients admitted in short stay ward at psychiatric centre, Jaipur, Rajasthan, India." International Journal of Research in Medical Sciences 5, no. 4 (March 28, 2017): 1667. http://dx.doi.org/10.18203/2320-6012.ijrms20171284.
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Background: The average length of stay (LOS) at psychiatric centre and the factors determining longer LOS in Psychiatry disorders remains largely unexplored. Longer LOS is associated with social isolation and maladaptive behaviours in patients thus warrants a shorter stay. The observed LOS and predicted LOS among different psychiatry hospitals in future may serve as an index of quality care and efficient management of meagre but available resources in our country. The aim was (1) To study the socio demographic and clinical factors of patients admitted at our hospital and (2) To ascertain the relationship between the socio demographic, clinical factors and LOS.Methods: A retrospective analysis of psychiatry inpatients admitted at Psychiatric Centre, Jaipur during July 2014 and June 2015. The data was analysed studying the 489 case records. The socio demographic characteristics and clinical factors were correlated with LOS in hospital.Results: Our study has shown the correlation of socio-demographic factors and clinical factors with LOS. Rural population, marital status, employment status, number of episodes and diagnosis itself has positive correlation with longer LOS.Conclusions: From present study it was shown the correlation of socio-demographic factors and clinical profile with LOS. Rural population, marital status, premorbid employment status, number of episodes and diagnosis itself has positive correlation with longer LOS. However, gender and substance abuse had no correlation with LOS. Short term and planned admissions along with individualized treatment plans fitting patient’s social background may be more beneficial as compared to long term admissions.
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Adler, Alma J., Todd Ruderman, Francis Valeta, Laura Drown, Celina Trujillo, Gina Ferrari, Amos Msekandiana, et al. "Protocol for a feasibility randomised control trial for continuous glucose monitoring in patients with type 1 diabetes at first-level hospitals in rural Malawi." BMJ Open 12, no. 2 (February 2022): e052134. http://dx.doi.org/10.1136/bmjopen-2021-052134.
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IntroductionThe majority of people living with type 1 diabetes (PLWT1D) struggle to access high-quality care in low-income countries (LICs), and lack access to technologies, including continuous glucose monitoring (CGM), that are considered standard of care in high resource settings. To our knowledge, there are no studies in the literature describing the feasibility or effectiveness of CGM at rural first-level hospitals in LICs.Methods and analysisThis is a 3-month, 2:1 open-randomised trial to assess the feasibility and clinical outcomes of introducing CGM to the entire population of 50 PLWT1D in two hospitals in rural Neno, Malawi. Participants in both arms will receive 2 days of training on diabetes management. One day of training will be the same for both arms, and one will be specific to the diabetes technology. Participants in the intervention arm will receive Dexcom G6 CGM devices with sensors and solar chargers, and patients in the control arm will receive Safe-Accu home glucose metres and logbooks. All patients will have their haemoglobin A1c (HbA1c) measured and take WHO Quality of Life assessments at study baseline and endline. We will conduct qualitative interviews with a selection of participants from both arms at the beginning and end of study and will interview providers at the end of the study. Our primary outcomes of interest are fidelity to protocols, appropriateness of technology, HbA1c and severe adverse events.Ethics and disseminationThis study is approved by National Health Sciences Research Committee of Malawi (IRB Number IR800003905) and the Mass General Brigham (IRB number 2019P003554). Findings will be disseminated to PLWT1D through health education sessions. We will disseminate any relevant findings to clinicians and leadership within our study catchment area and networks. We will publish our findings in an open-access peer-reviewed journal.Trial registration numberPACTR202102832069874.
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Bashar, M. D. Abu. "Assessment of infrastructure facilities, manpower and services at health sub-centres from a rural block of Haryana, North India." International Journal Of Community Medicine And Public Health 9, no. 7 (June 28, 2022): 2965. http://dx.doi.org/10.18203/2394-6040.ijcmph20221767.
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Background: A sub-centre is the most peripheral and first point of contact between the health care system and the Community. The success of any nationwide programme largely depends on well-functioning sub-centres providing services of acceptable standard to people. Indian Public Health Standards (IPHS) were programmed with an objective to standardize the health care infrastructure and services. Current study was undertaken with the aim to assess the infrastructure facilities, manpower and services of a sample of sub-centers from North India against the IPHS standards.Methods: A cross sectional study was carried out from February 2014 to October 2014 in 30 of the 32 sub-centres in a rural block of district Ambala in the state of Haryana, North India using a specially designed semi structured questionnaire to compare the existing physical infrastructure, manpower, quality control and service delivery in these sub-centres against the IPHS standards.Results: Significant gaps existed in available physical infrastructure and availability of manpower (especially male worker). The parameters designed for quality control like citizen’s charter, internal and external monitoring were also found to be deficient. Record keeping and reporting was also unsatisfactory. However, availability of the requisite services and service delivery was found to be satisfactory.Conclusions: There is urgent need to equip the sub-centres with the necessary infrastructure and logistics along with need of regular monitoring and supervision of the sub-centers by internal and external agencies so as to improve the quality of facilities and services provided by them.
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Sarma, Dr Jyotirmoy. "Need for Upgradation of Technologies in Water Supply Projects in India." International Journal for Research in Applied Science and Engineering Technology 10, no. 2 (February 28, 2022): 644–47. http://dx.doi.org/10.22214/ijraset.2022.40338.
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Abstract: India, water supply services in urban and rural areas in India are provided mainly by public authorities. These authorities are mostly involved in operation and maintenance of the water supply schemes. When any additional fund becomes available, expansion of pipe network, additional house connections and repair works are taken up. But, there is an urgent need for upgradation of technologies in the water supply schemes. At present, there is not much effort for upgradation of technologies for treatment of water, measurement and control of system, increase in efficiency of pumping stations and water distribution network, etc. The author highlights some of the feasible technologies, which may be evaluated and adopted by water authorities. For technology upgradation, enormous works are needed in India, which in turn will necessitate research and generate employment and business opportunities to Industries. Keywords: Upgradation of Technology, Water Treatment, Water Quality Assessment, Smart Water Meters, Water Quality Sensor, Smart Water Grid.
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Rajagopal, Shanmuga Sundaram, Krishnaveni Kandasamy, Agilan Natarajan, Joyal Sebastian, Manikanta Konakalla, Rohit Sam, and Sambathkumar Ramanathan. "IMPACT OF PHARMACIST INTERVENTION IN SCREENING AND EDUCATION ON BLOOD PRESSURE IN A RURAL AREA IN SOUTHERN INDIA." Asian Journal of Pharmaceutical and Clinical Research 9, no. 9 (December 1, 2016): 339. http://dx.doi.org/10.22159/ajpcr.2016.v9s3.14782.
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ABSTRACTObjective: Hypertension (HTN) expends a consequential public health concern on cardiovascular health status and health-care systems in India. Theeffectuation of the pharmaceutical care program in the health care is an extremely important need to achieve the optimum therapeutic effect. Theobjective of the study was to assess the impact of pharmacist intervention on patient’s blood pressure (BP) level, quality of life (QOL), and knowledge,attitude, and practice (KAP) of hypertensive patients.Methods: A randomized controlled pilot study was carried out for 6 months. The hypertensive patients were randomized into control and interventiongroup based on age, and both the groups were interviewed using KAP and WHO QOL-BREF questionnaires, screened BP, respectively, at baseline andeach follow-up after post counseling section to the intervention group. The effect of pharmacist intervention on QOL and KAP among control andintervention was statistically analyzed by paired t-test using SPSS version 16.Results: The total sample studied was 60, of which 20 (33.33%) were males and 40 (66.67%) were females. In our study, the QOL score for eachdomain of both intervention and control groups were almost poor (p˃0.05) at baseline and for the intervention group, a highly significant improvement(p<0.001) was observed for all domains in final follow-up. KAP score of intervention group also showed a significant improvement (p<0.001) frombaseline to final follow-up. In this study, intervention group showed a significant mean reduction of systolic BP from baseline 150.13±25.670 to finalfollow-up 145.33±12.914.Conclusion: The results of the study showed a significant improvement in the patient’s KAP toward different aspects of HTN and QOL followingpharmacist mediated counseling. Involvement of pharmacy practitioners in the management of HTN significantly improves QOL and KAPs.Keywords: Hypertension, Quality of life, Knowledge, Attitude and practice, Pharmacist intervention, Patient counseling.
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MATTHEWS, ZOË, JAYASHREE RAMAKRISHNA, SHANTI MAHENDRA, ASHA KILARU, and SARASWATHY GANAPATHY. "BIRTH RIGHTS AND RITUALS IN RURAL SOUTH INDIA: CARE SEEKING IN THE INTRAPARTUM PERIOD." Journal of Biosocial Science 37, no. 4 (January 17, 2005): 385–411. http://dx.doi.org/10.1017/s0021932004006911.
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Maternal morbidity and mortality are high in the Indian context, but the majority of maternal deaths could be avoided by prompt and effective access to intrapartum care (WHO, 1999). Understanding the care seeking responses to intrapartum morbidities is crucial if maternal health is to be effectively improved, and maternal mortality reduced. This paper presents the results of a prospective study of 388 women followed through delivery and traditional postpartum in rural Karnataka in southern India. In this setting, few women use the existing health facilities and most deliveries occur at home. The analysis uses quantitative data, collected via questionnaires administered to women both during pregnancy and immediately after delivery. By virtue of its prospective design, the study gives a unique insight into intentions for intrapartum care during pregnancy as well as events following morbidities during labour. Routine care in the intrapartum period, both within institutions and at home, and impediments to appropriate care are also examined. The study was designed to collect information about health seeking decisions made by women and their families as pregnancies unfolded, rather than trying to capture women’s experience from a retrospective instrument. The data set is therefore a rich source of quantitative information, which incorporates details of event sequences and health service utilization not previously collected in a Safe Motherhood study. Additional qualitative information was also available from concurrent in-depth interviews with pregnant women, their families, health care providers and other key informants in the area. The level of unplanned institutional care seeking during the intrapartum period within the study area was very high, increasing from 11% planning deliveries at a facility to an eventual 35% actually delivering in hospitals. In addition there was a significant move away from planned deliveries with the auxiliary nurse midwive (ANM), to births with a lay attendant or dai. The proportion of women who planned for an ANM to assist was 49%, as compared with the actual occurrence, which was less than half of this proportion. Perceived quality of care was found to be an important factor in health seeking behaviour, as was wealth, caste, education and experience of previous problems in pregnancy. Actual care given by a range of practitioners was found to contain both beneficial and undesirable elements. As a response to serious morbidities experienced within the study period, many women were able to seek care although sometimes after a long delay. Those women who experienced inadequate progression of labour pains were most likely to proceed unexpectedly to a hospital delivery.
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Agrawal, G. D. "Diffuse agricultural water pollution in India." Water Science and Technology 39, no. 3 (February 1, 1999): 33–47. http://dx.doi.org/10.2166/wst.1999.0131.
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Concern over agricultural diffuse pollution sources in integrated water quality management has been growing recently. Such sources are likely to be even more critical in developing countries, including India, where agriculture and rural habitats are still dominant, unlike the G7 or other affluent industrialised nations. A number of special features of the Indian scene need to be considered. These include: (i) extremely varying rainfall and stream-flow patterns; (ii) still largely traditional agricultural practices with average application of fertilizers and pesticides and significant areas under dry farming or only marginal irrigation; (iii) a very large cattle population, with agriculture almost always linked with animal husbandry; (iv) a culture of living close to the river (if not in the river) with dominating instream uses of bathing, washing, cattle wading, waste disposal, etc. and large-scale floodplain farming; and (v) scant respect for rules, regulations and laws alongside an extremely weak law-enforcement machinery. The paper shows that in the non-monsoon (non-flood) periods, which may account for all but 2 months of a year, agricultural diffuse pollution sources seem to have no impact on stream water quality. During these periods flows are low to minimal and pollution is dominated by the in-stream uses, sullage waters of rural communities and point discharges from urban/industrial sources, if any. Pollution due to agricultural return waters, either as wash-off or as seepage, appears to be rare during the 8-10 fair weather months. However, surface wash-off of pollutants from agricultural sources becomes the dominant factor during flood flows, and seepage/drainage from agricultural fields/soils continues to pollute streams for a month or two after the monsoons are over. Application of chemical fertilizers and pesticides (or any other agricultural chemicals) in India is still low compared to developed countries, and while eutrophication due to high levels of washed-off nutrients is observed in rural ponds and other stagnant bodies of water receiving agricultural drainage, and excessive pesticide residuals are often reported for vegetables, fodder, milk, etc., monitoring of streams and rivers does not show any significant pollution due to nutrients or pesticides from agricultural diffuse pollution during fair weather months. High nitrate concentrations have been reported in groundwater and in many areas, such as Punjab and Haryana, these can often be linked directly to diffuse agricultural sources. The major problem of agricultural diffuse pollution appears to be the heavy silt loads, along with large quantities of dissolved salts, nutrients, organics and even heavy metals and bacterial contaminants washed off during floods. The silt tends to clog up the flow channel to further encourage seasonal floodplain agriculture. This results in a vicious circle, which degrades the channel, increases flood-damage and is undesirable from ecological and sustainability points of view. High concentrations of salts and nutrients encourage growth of weeds and macrophytes after the floods have passed. The presence of organics, heavy metals and bacterial contamination renders the streamwater unfit for in-stream use or abstraction. With the introduction of intensive agriculture and adoption of modern farming techniques involving the application of much irrigation water and agricultural chemicals, the problems caused by diffuse agricultural pollution are bound to grow. Routine pollution control methods of discharge permits (or consent letters), EIAs or environmental audits, and normal enforcement measures by regulatory agencies are not likely to work for control of such pollution. Using the example of a small river in central India, Paisuni (Mandakini), the paper brings out the nature of the problems, and suggests a possible management approach.
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Alqwaifly, Mohammed. "A cross-sectional study of awareness regarding dog bite and its management in rural community of Maharashtra, India." International Journal of Advances in Medicine 7, no. 9 (August 25, 2020): 1307. http://dx.doi.org/10.18203/2349-3933.ijam20203593.
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Background: Stroke is a major cause of morbidity and disability worldwide. However, its outcomes have improved in the last few years with advancement in acute stroke treatment, including the use of tissue plasminogen activator (t-PA) within 4.5 hours of onset, which led several international guidelines to adopt it as the standard of care. In this study, authors sought to assess the knowledge, practices, and attitudes of emergency and medicine staff in Qassim, Saudi Arabia toward acute ischemic stroke care.Methods: A quantitative observational cross-sectional study involving 148 physicians from emergency and medicine departments (only three neurologists) was conducted in three main hospitals of the Qassim region, Saudi Arabia. Information was obtained from a self-administered questionnaire. A logistic regression model was used to control for potential confounding factors.Results: Ninety-two percent of participants were aware of t-PA. Eighty-seven percent of participants thought that t-PA was an effective treatment for acute ischemic stroke. Only 20% of participants had given t-PA or participated in the use of t-PA in acute ischemic stroke. Moreover, 64% of participants believed that allowing blood pressure to remain high was the most appropriate action in the first 24 hours in acute ischemic stroke patients who presented outside the t-PA window.Conclusion: Most of the emergency and medicine staff are well informed about t-PA, but the majority of these physicians have never given t-PA or participated in the administration of t-PA to a stroke patient. The main finding here is the positive outlook among emergency and medicine physicians in Qassim toward training in acute stroke care and administering t-PA for stroke, which will positively impact patient outcomes.
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Parikh, Sonal Shah, Juzar Ali, Sanjay Bhatt, and DV Bala. "A Snapshot of Grassroots Primary Care and Tuberculosis Control in India—a US Fulbright–Nehru Scholar Program Experience." US Respiratory & Pulmonary Diseases 12, no. 02 (2017): 26. http://dx.doi.org/10.17925/usrpd.2017.12.02.26.
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The Department of Community Medicine, Smt. Nathiba Hargovandas Lakhmichand (NHL) Medical College, Ahmedabad, India, under the aegis of the US Fulbright–Nehru Scholar Program, reviewed the rural and urban primary and district health delivery system, with focus on primary care, child and maternal health and tuberculosis control. The National Health Mission program in India utilizes public and private resources and partnerships to optimally increase access, referrals and improve quality of care. As a collateral, the Revised National Tuberculosis Program, within its broader umbrella, incorporates digital-based locally applicable innovative approaches to tuberculosis (TB) control, to implement the World Health Organization strategy of the Directly Observed Treatment Short-course (DOTS) program. With this approach the program has consistently maintained a high treatment success rate. However, the deficiencies in the program include the loss to follow-up of missing persons with TB, incomplete data in some cases, and erratic coordination between private, academic, public health primary and tertiary care centers.
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Escobar, María Fernanda, María Paula Echavarria, Juan Carlos Gallego, Natalia Riascos, Hilda Vasquez, Daniela Nasner, Stephanie Pabon, et al. "Effect of a model based on education and teleassistance for the management of obstetric emergencies in 10 rural populations from Colombia." DIGITAL HEALTH 8 (January 2022): 205520762211290. http://dx.doi.org/10.1177/20552076221129077.
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Introduction Pregnant women and health providers in rural areas of low-income and middle-income countries face multiple problems concerning high-quality obstetric care. This study was performed to identify changes in maternal and perinatal indicators after implementing a model based on education and telecare between a high-complexity hospital in 10 low-complexity hospitals in a southwestern region of Colombia. Methods A quasiexperimental study with a historic control group and without a pretest was conducted between 2017 and 2019 to make comparisons before and after obstetric emergency care through the use of teleassistance from 10 primary care centers to the referral center (Fundación Valle del Lili, FVL). Results A total of 470 patients were treated before teleassistance implementation and 154 patients were treated after teleassistance implementation. After program implementation, the maternal clinical indicators showed a 65% reduction in the number of obstetric patients who were referred with obstetric emergencies. The severity of maternal disease that was measured at the time of admission to level IV through the Modified Early Obstetric Warning System score was observed to decrease. Conclusion The implementation of a model based on education and teleassistance between low-complexity hospitals and tertiary care centers generated changes in indicators that reflect greater access to rural areas, lower morbidity at the time of admission, and a decrease in the total number of emergency events.
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Hazarey, V., and A. Deshmukh. "Cancer-Free Drive in Rural India: Constituency Wise Initiatives by Member of Legislative Assembly." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 136s. http://dx.doi.org/10.1200/jgo.18.42500.
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Background and context: Reducing the rate of cancer through awareness and prevention programs as well improvements in screening and treatment techniques is paramount. Citizen especially in rural India tend to neglect health due to routine chores of family life. The nonavailability of facilities worsen the issue. Tobacco habits leads to potentially malignant disorders and oral cancers. There is increasing trend of breast cancer, uterine and cervical cancers and also oral cancers. In India oral cancers are main cancers in males. Member of legislative assembly is public representative to represent state of Maharashtra. Cancer Free Constituency Drive was for creating awareness and screening for villagers. Katol is a rural constituency. There are 288 constituencies in Maharashtra state. Aim: 1) To create public awareness of all types of cancers. 2) To provide diagnosis and investigations and treatment to affected population. 3) Capacity building of young medical and dental professionals in cancer diagnosis and paramedical workers in screening all types of cancers. Strategy/Tactics: 72,056 house visits by 220 Asha workers and 129 nursing students and 30 dental interns to sensitize about 3,00,000 people through well designed brochure for all cancers. Self-Mouth mirror examination was designed for oral cancers and awareness against tobacco. The persons with complaints were told to visit camps on scheduled dates at 10 primary health centers. Program/Policy process: The mammography facilities and Papanicolaou test examination, dental examination in mobile vans and self-mouth mirror examination for oral cancers with trained professional carried out diagnosis in 10 primary health centers with the help of experts in medical and dental professionals. Suspeced cases were referred to tertiary referral medical hospitals. Outcomes: 5100 (males 2216 and females 2954) with complaints visited. Total 813 patients suspected to have cancers were examined by specialists from gynecology(84) general surgery (374) otorhinolaryngology (77) pediatrics (37) dermatology (19) and dentistry (131). 38 abnormal on mammography in 132 females, 55 abnormal reports from Pap smears in 472 females were evaluated, however no cancer detected in three months span. Twelve cases of oral cancers were detected and treated. Six breast cancers were detected and treated. Seven other cancers were reported by medicine and pediatric specialists. 150 cases of potentially malignant disorders were also identified. 90 had the oral submucous fibrosis (inability to open the mouth) caused due to areca quid chewing. The self-mouth mirror examination helped to create awareness against tobacco. What was learned: Awareness of cancer leading to early detection and treatment is possible in rural areas through “Cancer-Free Constituency”. The concept will help to pave the way for improved strategies and policies to better control occurrence and treatment of cancer and to address tobacco related health disparities across cancer care continuum.
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Savitha, N. "Factors Determining the Choice of Health Care of Textile and Engineering Industrial Workers in Coimbatore." International Journal Of Innovation And Economic Development 1, no. 6 (2015): 7–19. http://dx.doi.org/10.18775/ijied.1849-7551-7020.2015.16.2001.
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Industrial workers constitute only a segment of general population and the factors that influence the health of the population also apply equally to industrial workers. The present study would bring out the availability and adequacy of health facilities in the urban Coimbatore. Therefore, the study of the people’s perception of health care services would indicate the line of improvement to be made in the health care services in future. Coimbatore is one of the most industrially developed Districts in Tamil Nadu and has the pride of being called the “Manchester of South India”. The data collected from both the textile and engineering industries in Coimbatore city was 1447 employees. It is found that workers who have been born and brought up in urban areas have shown higher tendency to avail private health care services (81%) than those workers whose nativity status is rural areas. Obviously, the reverse pattern is noticed among the sample workers in the case of government health services. The chi-square results between the nativity status and workers’ choice of health care services is found to be highly significant (p<0.001). It is interesting to note that when it comes to health, patients are psychologically ready to pay any amount. They never tend to be treated in low cost hospitals but prefer hospitals where good treatment and quality services are available. The findings show that the quality of health care services playing a vital role in choosing the type of health facilities by the workers.
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Thomas, Owen, Noel Aruparayil, Jesudian Gnanaraj, George Mathew, Kavikumar Nagarajan, Beth Shinkins, and David Jayne. "Point-Of-Care Ultra-Sound (POCUS) for suspected surgical abdominal conditions in rural India–a mixed-method health needs assessment." PLOS Global Public Health 3, no. 1 (January 6, 2023): e0001233. http://dx.doi.org/10.1371/journal.pgph.0001233.
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Introduction Evidence has shown a trend towards rising mortality from surgical abdominal conditions with increasing distance from hospitals in Eastern India. It has been claimed that imaging modalities such as portable ultrasound are ideal for use in rural areas of developing countries for diagnosis and management of a variety of acute abdominal conditions. This mixed-methods study aimed to explore the need for increased access to POCUS in rural, hard-to-reach populations within India, and to identify barriers that may exist to increasing this access. Methods This mixed-methods study utilized a health needs assessment framework. Quantitative data was extracted from medical records within two outreach camp organisations supporting hard-to-reach populations in Uttarakhand and Jharkhand to provide contextual background statistics. Qualitative data was collected using semi-structured interviews taken from employees of each outreach camp. A framework analysis was employed to analyse the qualitative data. Both datasets were analysed in parallel. Results Twelve semi-structured interviews were undertaken, and 3 months of medical records were reviewed. Themes that presented themselves from the data included the use of camps for case-finding of conditions amenable to routine surgery, a need for POCUS to help with this diagnostic process, a perceived high disease burden from renal calculi, and complex cultural and legislative barriers to POCUS specific to this setting. Discussion POCUS was considered a useful tool in expanding access to surgery for these settings and finding ways of overcoming cultural and legislative barriers to its use should be of high priority. POCUS should be highly portable, robust, easily repairable, and battery operated. For telemedicine to be fully utilised, signal quality will have to be proven to be reliable.
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Dey, Sagnik, Bhavesh Purohit, Palak Balyan, Kuldeep Dixit, Kunal Bali, Alok Kumar, Fahad Imam, et al. "A Satellite-Based High-Resolution (1-km) Ambient PM2.5 Database for India over Two Decades (2000–2019): Applications for Air Quality Management." Remote Sensing 12, no. 23 (November 26, 2020): 3872. http://dx.doi.org/10.3390/rs12233872.
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Fine particulate matter (PM2.5) is a major criteria pollutant affecting the environment, health and climate. In India where ground-based measurements of PM2.5 is scarce, it is important to have a long-term database at a high spatial resolution for an efficient air quality management plan. Here we develop and present a high-resolution (1-km) ambient PM2.5 database spanning two decades (2000–2019) for India. We convert aerosol optical depth from Moderate Resolution Imaging Spectroradiometer (MODIS) retrieved by Multiangle Implementation of Atmospheric Correction (MAIAC) algorithm to surface PM2.5 using a dynamic scaling factor from Modern-Era Retrospective analysis for Research and Applications Version 2 (MERRA-2) data. The satellite-derived daily (24-h average) and annual PM2.5 show a R2 of 0.8 and 0.97 and root mean square error of 25.7 and 7.2 μg/m3, respectively against surface measurements from the Central Pollution Control Board India network. Population-weighted 20-year averaged PM2.5 over India is 57.3 μg/m3 (5–95 percentile ranges: 16.8–86.9) with a larger increase observed in the present decade (2010–2019) than in the previous decade (2000 to 2009). Poor air quality across the urban–rural transact suggests that this is a regional scale problem, a fact that is often neglected. The database is freely disseminated through a web portal ‘satellite-based application for air quality monitoring and management at a national scale’ (SAANS) for air quality management, epidemiological research and mass awareness.
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Kathirvel, C., K. Porkumaran, and S. Jaganathan. "Design and Implementation of Improved Electronic Load Controller for Self-Excited Induction Generator for Rural Electrification." Scientific World Journal 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/340619.
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This paper offers an alternative technique, namely, Improved Electronic Load Controller (IELC), which is proposal to improve power quality, maintaining voltage at frequency desired level for rural electrification. The design and development of IELC are considered as microhydroenergy system. The proposed work aims to concentrate on the new schemes for rural electrification with the help of different kinds of hybrid energy systems. The objective of the proposed scheme is to maintain the speed of generation against fluctuating rural demand. The Electronic Load Controller (ELC) is used to connect and disconnect the dump load during the operation of the system, and which absorbs the load when consumer are not in active will enhance the lifestyle of the rural population and improve the living standards. Hydroelectricity is a promising option for electrification of remote villages in India. The conventional methods are not suitable to act as standalone system. Hence, the designing of a proper ELC is essential. The improved electronic load control performance tested with simulation at validated through hardware setup.
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Das, Ujjwal, Barkha Chaplot, and Hazi Mohammad Azamathulla. "The Role of Place of Delivery in Preventing Neonatal and Infant Mortality Rate in India." Geographies 1, no. 1 (April 20, 2021): 47–62. http://dx.doi.org/10.3390/geographies1010004.
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Skilled birth attendance and institutional delivery have been advocated for reducing maternal, neonatal mortality and infant mortality (NMR and IMR). This paper examines the role of place of delivery with respect to neo-natal and infant mortality in India using four rounds of the Indian National Family Health Survey conducted in 2015–2016. The place of birth has been categorized as “at home” or “public and private institution.” The role of place of delivery on neo-natal and infant mortality was examined by using multivariate hazard regression models adjusted for clus-tering and relevant maternal, socio-economic, pregnancy and new-born characteristics. There were 141,028 deliveries recorded in public institutions and 54,338 in private institutions. The esti-mated neonatal mortality rate in public and private institutions during this period was 27 and 26 per 1000 live births respectively. The study shows that when the mother delivers child at home, the chances of neonatal mortality risks are higher than the mortality among children born at the health facility centers. Regression analysis also indicates that a professionally qualified provider′s antenatal treatment and assistance greatly decreases the risks of neonatal mortality. The results of the study illustrate the importance of the provision of institutional facilities and proper pregnancy in the prevention of neonatal and infant deaths. To improve the quality of care during and imme-diately after delivery in health facilities, particularly in public hospitals and in rural areas, accel-erated strengthening is required.
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Sharma, Bindu, Raj K. Machandra, Pritha Mehra, Parveen Oberai, Varanasi Roja, Deepti Singh, G. Ravi Chandra Reddy, et al. "Homoeopathic treatment for lower urinary tract symptoms in men with benign prostatic hyperplasia: an open randomized multicentric placebo controlled clinical trial." International Journal of High Dilution Research - ISSN 1982-6206 15, no. 4 (August 18, 2021): 12–13. http://dx.doi.org/10.51910/ijhdr.v15i4.842.
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Background: Benign Prostatic Hyperplasia (BPH) associated with Lower Urinary Tract Symptoms (LUTS) is the most common condition in ageing men. The epidemiological studies estimate that 90% of men between 45 and 80 years of age suffer some type of LUTS.1 There is paucity of such epidemiological data from India but one study reports the prevalence of BPH among rural elderly of India as 11.8%2.
Although LUTS secondary to BPH (LUTS/BPH) is not often a life-threatening condition, the impact of LUTS/BPH and its complications on Quality of Life (QoL) can be significant and should not be underestimated.3 When the effect of BPH-associated LUTS on QoL was studied in a number of community-based populations, for many, the most important motivations for seeking treatment were the severity and the degree of bother associated with the symptoms.4LUTS include storage and/or voiding disturbances common in ageing men. Although voiding symptoms are most common, storage symptoms responsible for daytime frequency, urgency and nocturia interfere the most with life activities. Homoeopathic constitutional treatment is useful in the treatment of a constellation of symptoms due to BPH and LUTS. Along with constitutional medicine homoeopathic practitioners are using organ medicines having special affinity for prostate and urinary bladder with good results. Traditionally the primary goal of treatment is to alleviate bothersome LUTS that result from prostatic enlargement. The literature review indicates that both homoeopathic constitutional medicines as well as organ specific remedies show positive results in relieving the symptoms of BPH but the study was not randomized and there was no control group to show its efficacy. In this backdrop the present study was undertaken to evaluate the storage and voiding symptoms of men having BPH through an internationally validated scale IPSS and the role of homoeopathic intervention, both constitutional and organ remedies on LUTS due to BPH and QoL of the patient.
Objectives: The primary objective was to compare the changes in IPSS (International Prostate Symptom Score) within the three groups enrolled for the study (Constitutional remedy/Constitutional + Organ remedy/Placebo). The secondary objectives were to compare the changes in Prostate volume, Post Void Residual Urine (PVRU), Uroflowmetry and in WHOQOL-BREF.5
Material and Methods: The study was done in an open randomized placebo controlled setting at five research centers under Central Council for Research in Homoeopathy. The patients in the age group of 50-80 years presenting with the symptoms of incomplete emptying, frequency, intermittency, urgency, weak stream, straining and nocturia were screened from the general OPD as per ICD-10 Classification Code N40.0 following the predefined inclusion and exclusion criteria. A consultant Urologist was appointed at each center to screen and follow up the enrolled cases. The participants who qualified the inclusion criteria were enrolled in the study after obtaining the ‘Informed Written Consent’. It was a three armed randomized clinical trial where Intervention was administered as per the randomization chart for three groups i.e. homoeopathic constitutional medicine in LM potency (Group 1), homoeopathic constitutional medicine in LM potency with organ remedy in mother tincture and 3X (Group 2) and placebo (Group 3) in 2:2:1 ratio. The patients were followed for six months and the outcome of intervention was assessed monthly for IPSS (Primary objective) and at third and sixth month for prostate volume, post void residual urine, Qmax and Qavg, PSA and WHOQOL-BREF, (Secondary objectives). Internationally validated scales (IPSS &WHOQOL-BREF) were used to assess the outcome. Primary safety endpoint was any adverse event which may be life threatening, requires prolonged hospital stay, results in significant disability, an injury, accident or any other important medical event.
474 patients were screened and 252 patients were enrolled in the study. The analysis of these patients as per protocol and as per intention to treat was carried out using repeated measures ANOVA and paired T test.
Results: Out of 254 patients enrolled in the study (HC=103, HC + O = 102 and Placebo = 49), 152 were analyzed as per protocol (HC=71, HC + O = 53 and Placebo = 28) as they completed a follow up period of 6 months whereas, 241 patients were analyzed as per ITT (HC=101, HC + O = 92 and Placebo = 48). 13 patients were excluded from analysis for reasons such as protocol violation and incomplete baseline information. There was statistically significant improvement in all the seven components of IPSS, WHOQOL- BREF and Q max values of uroflowmetry in both per protocol as well as ITT analysis.
Discussion: Results from this trial will help in constructing treatment strategy for BPH patients with lower urinary tract symptoms to enable them to make an informed decision about available alternatives for the management of LUTS in BPH. The limitation of the study was that it was not blinded. The inhibition for not making it blinded was the use of mother tinctures of organ specific medicines in liquids of different colors and odours which could not be blinded. Pragmatic trial with longer follow up and a parallel arm comprising of conventional treatment may be undertaken in future to compare their role on LUTS due to BPH on pathological and pathophysiological parameters such as prostatic volume and post void residual urine.
Trial Registration: Clinical Trial Registry - India: CTRI/2012/05/002649.
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Mathur, Purva, Paul Malpiedi, Kamini Walia, Rajesh Malhotra, Padmini Srikantiah, Omika Katoch, Sonal Katyal, et al. "Surveillance of Healthcare-Associated Bloodstream and Urinary Tract Infections in a National Level Network of Indian Hospitals." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s398—s399. http://dx.doi.org/10.1017/ice.2020.1043.
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Background: Healthcare-associated infections (HAIs) are a major global threat to patient safety. Systematic surveillance is crucial for understanding HAI rates and antimicrobial resistance trends and to guide infection prevention and control (IPC) activities based on local epidemiology. In India, no standardized national HAI surveillance system was in place before 2017. Methods: Public and private hospitals from across 21 states in India were recruited to participate in an HAI surveillance network. Baseline assessments followed by trainings ensured that basic microbiology and IPC implementation capacity existed at all sites. Standardized surveillance protocols for central-line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) were modified from the NHSN for the Indian context. IPC nurses were trained to implement surveillance protocols. Data were reported through a locally developed web portal. Standardized external data quality checks were performed to assure data quality. Results: Between May 2017 and April 2019, 109 ICUs from 37 hospitals (29 public and 8 private) enrolled in the network, of which 33 were teaching hospitals with >500 beds. The network recorded 679,109 patient days, 212,081 central-line days, and 387,092 urinary catheter days. Overall, 4,301 bloodstream infection (BSI) events and 1,402 urinary tract infection (UTI) events were reported. The network CLABSI rate was 9.4 per 1,000 central-line days and the CAUTI rate was 3.4 per 1,000 catheter days. The central-line utilization ratio was 0.31 and the urinary catheter utilization ratio was 0.57. Moreover, 3,542 (73%) of 4,742 pathogens reported from BSIs and 868 (53%) of 1,644 pathogens reported from UTIs were gram negative. Also, 1,680 (26.3%) of all 6,386 pathogens reported were Enterobacteriaceae. Of 1,486 Enterobacteriaceae with complete antibiotic susceptibility testing data reported, 832 (57%) were carbapenem resistant. Of 951 Enterobacteriaceae subjected to colistin broth microdilution testing, 62 (7%) were colistin resistant. The surveillance platform identified 2 separate hospital-level HAI outbreaks; one caused by colistin-resistant K. pneumoniae and another due to Burkholderia cepacia. Phased expansion of surveillance to additional hospitals continues. Conclusions: HAI surveillance was successfully implemented across a national network of diverse hospitals using modified NHSN protocols. Surveillance data are being used to understand HAI burden and trends at the facility and national levels, to inform public policy, and to direct efforts to implement effective hospital IPC activities. This network approach to HAI surveillance may provide lessons to other countries or contexts with limited surveillance capacity.Funding: NoneDisclosures: None
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Dangwal, Ritu, Krati Sharma, and Santonu Hazarika. "Hole-in-the-Wall learning stations and academic performance among rural children in India." Journal for Multicultural Education 8, no. 1 (April 8, 2014): 31–53. http://dx.doi.org/10.1108/jme-03-2013-0006.
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Purpose – Earlier research on “Hole-in-the-Wall (HiWEL)” conclusively indicated groups of children pick up computer literacy on their own and are adept at performing basic functions such as cut, copy, paste, surf the internet to answer high-end questions. Research also indicates that children self-organize themselves to figure out things which they find difficult and thus learning is a continuous process for them. The studies have also indicated that HiWEL pedagogy is child centric and is at the discretion of the child. Children organize themselves and become self-regulated learners. However, so far no study has been undertaken to determine whether children accessing Hole-in-the-Wall learning stations (HiWEL LSs) can improve in mathematics and English. The intent of the present study is to examine whether groups of children are able to pick up mathematics and English on their own using the learning station. The paper aims to discuss these issues. Design/methodology/approach – In order to study the impact of HiWEL LS on mathematics and English, the authors took two groups; experimental group and control group from six states. Experimental group – 31 children from each site (except for two sites, where experimental group consisted of 30 children) were randomly selected to be a part of the study. 16 children from class 6th and 15 children from class 7th were identified. For this study, the experimental group consisted of a total of 277 children from nine locations. Mathematics and English tests were administered at two time points, pre and post within a gap of six months of installing the learning station. Control group – children that formed the control group were selected from nearby villages with similar socioeconomic background as the experimental group. A total of 135 children (15 children per location) were selected for this study. This group did not have access to HiWEL LS or to any other computers. These children were also tested on the same two tests at two time points, pre and post within a gap of six months. Findings – Children exposed and using HiWEL LSs pick up academic English and mathematics on their own for grade 6th and 7th. These are government school going children. Qualitatively, the teachers and parents feel that they too have seen the benefits in the academic achievement of these children. Research limitations/implications – The study was done for a six-month period across seven sites. This study should be replicated over across entire India and a bigger sample should be taken for results to be conclusive. Practical implications – The actual quantity of schooling that underprivileged children experience and the quality of teaching they receive are extremely insufficient. This seems to be true of both the educationally more advanced states and the educationally backward states. These findings suggest a new pedagogy for enabling children to improve their academic performance which in turn leads to improvement in school performance. Thus, for the current educational system, it is important to have alternatives. Originality/value – So far, no study has been undertaken to determine whether children accessing HiWEL LSs can improve in mathematics and English. The intent of the present study is to examine whether groups of children are able to pick up mathematics and English on their own using the learning station. And, the findings have been positive.