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The 'Cost of Health Services in India (CHSI)' is the first large scale multi-site facility costing study to incorporate evidence from a national sample of both private and public sectors at different levels of the health system in India. This paper provides an overview of the extent of heterogeneity in costs caused by various supply-side factors.A total of 38 public (11 tertiary care and 27 secondary care) and 16 private hospitals were sampled from 11 states of India. From the sampled facilities, a total of 327 specialties were included, with 48, 79 and 200 specialties covered in tertiary, private and district hospitals respectively. A mixed methodology consisting of both bottom-up and top-down costing was used for data collection. Unit costs per service output were calculated at the cost centre level (outpatient, inpatient, operating theatre, and ICU) and compared across provider type and geographical location.The unadjusted cost per admission was highest for tertiary facilities (₹ 5690, 75 USD) followed by private facilities (₹ 4839, 64 USD) and district hospitals (₹ 3447, 45 USD). Differences in unit costs were found across types of providers, resulting from both variations in capacity utilisation, length of stay and the scale of activity. In addition, significant differences in costs were found associated with geographical location (city classification).The reliance on cost information from single sites or small samples ignores the issue of heterogeneity driven by both demand and supply-side factors. The CHSI cost data set provides a unique insight into cost variability across different types of providers in India. The present analysis shows that both geographical location and the scale of activity are important determinants for deriving the cost of a health service and should be accounted for in healthcare decision making from budgeting to economic evaluation and price-setting. [ABSTRACT FROM AUTHOR]

Herbal medicines are in great demand for preliminary health care due to their wide medicinal value, with no side effects. Since many species are used in the system of traditional medicine, scientists have great opportunities to develop appropriate packages of practices for their multiplication and conservation. Abrus precatorius is the native plant of India and used in many ways in the Indian Ayurvedic system of medicine. This seeds of the species is dormant due to hard seed coat. So the aim of the study is to remove seed dormancy and enhance germination capacity within a short period. To overcome the problem of dormancy, seeds were scarified by seed scarifier and sand paper and also treated with acid (H2SO4) and hot water just before sowing. 60-95% germination was achieved under different treatment conditions while the seeds without any treatment fail to germinate. The highest (95%) germination was observed just 12 days after sowing in seeds treated with concentrated H2SO4 for 120 minutes. 70-75% germination was achieved when the seeds were treated with acid for 105 and 135 minutes. Seeds treated with con. H2SO4 for 150, 90 and 60 minutes and also scarified by sand paper showed similar results with 60-65% germination. The seeds scarified by a mechanical scarifier and treated with hot water did not show more than 32.5% germination. [ABSTRACT FROM AUTHOR]

Health management information systems (HMIS) produce large amounts of data about health service provision and population health, and provide opportunities for data-based decision-making in decentralized health systems. Yet the data are little-used locally. A well-defined approach to district-level decision-making using health data would help better meet the needs of the local population. In this second of four papers on district decision-making for health in low-income settings, our aim was to explore ways in which district administrators and health managers in low- and lower-middle-income countries use health data to make decisions, to describe the decision-making tools they used and identify challenges encountered when using these tools. A systematic literature review, following PRISMA guidelines, was undertaken. Experts were consulted about key sources of information. A search strategy was developed for 14 online databases of peer reviewed and grey literature. The resources were screened independently by two reviewers using pre-defined inclusion criteria. The 14 papers included were assessed for the quality of reported evidence and a descriptive evidence synthesis of the review findings was undertaken. We found 12 examples of tools to assist district-level decision-making, all of which included two key stages-identification of priorities, and development of an action plan to address them. Of those tools with more steps, four included steps to review or monitor the action plan agreed, suggesting the use of HMIS data. In eight papers HMIS data were used for prioritization. Challenges to decision-making processes fell into three main categories: the availability and quality of health and health facility data; human dynamics and financial constraints. Our findings suggest that evidence is available about a limited range of processes that include the use of data for decision-making at district level. Standardization and pre-testing in diverse settings would increase the potential that these tools could be used more widely. [ABSTRACT FROM AUTHOR]

More than supply the demand for health care usually determines the design of public health services. This is more so when technological developments, including that of information and communication technologies, pierce through the process of utilization of any service by the public. Although prior research papers have focused on the factors that impact on the adoption of information technology, there are limited empirical research works that simultaneously capture technology factors (TAM, TAM2) and end-user development specifc factors (perceived technology usage and intention to recommend) helping healthcare professionals to adopt Health Management Information System (HMIS) software in the healthcare environment. To fill this gap, the present paper used the Technology Acceptance Model (TAM), the extended TAM model (TAM2) and identified the important determinants of user acceptance perceived risk and trust. This is specifcally undertaken in order to describe ESIChealthcare professionals behavioral intention to adopt HMIS software services. The study was conducted in the Employees' State Insurance Corporation (ESIC) main hospital and dispensaries in the Tirunelveli sub-region. The required data were collected from 171 ESIC healthcare professionals in the Tirunelveli sub-region. A Structural Equation Model (SEM) approach was used. Convergence anddivergence with earlier findings were found, confrming that Perceived Usefulness (PU), Perceived Ease of Use (PEOU), social infuence, facilitating conditions and training hadsignificant infuence on the intention of healthcare professionals to adopt HMIS software. The study provideda basis for further refnement of technology adoption model. Improvingperceived usefulness factor (perceived long-term usefulness) may turn healthcare professionals towards adoption of HMIS. [ABSTRACT FROM AUTHOR]

The novel coronavirus that shook the world population has restructured the world order. While the scientists are grappling hard to find a solution to the imminent problem at hand, the pandemic has thrown the human race into a perplexed stage questioning and mostly changing everything they believed in. The pandemic has replaced human beings as social animal to virtual being. The social distancing mandate required for the survival as propounded by WHO has forced individuals to keep the other humans at bay. The present paper is an attempt to look at the changes the world is facing with respect to the social, cultural, economic, and psychological aspects with a special focus on the internationally acclaimed Kerala model of survival. Kerala, a small state located within the southern peninsula of the country has played an important role in containing the spread of the virus despite its larger population density. The paper focuses on the innovative mechanics followed by the state to curtail the spreading. It also attempts to look at the changes that have been brought in the general human behavior. [ABSTRACT FROM AUTHOR]

Quality health care is the essential need for all the citizens of the country. It forms the basis for equitable and sustainable economic development. India has made significant progress in basic health care over the past few decades. However, still most people do not have access to essential health care services. Health insurance is very important for every citizen, especially in India, where there is a large rural population. As everyone cannot afford private Health insurance coverage, so government must take initiatives to provide health insurance coverage to poor people. Government of India has been taking initiatives to provide financial assistance for health care costs for vulnerable and needy families. Rastriya Swasthya Bima Yojana (RSBY) was launched in the year 2008, but was not very successful. Prime Recently, Ayushman Bharat Jana Arogya Yojana (PMJAY) was launched on 23rd September 2018. It provides health insurance cover of Rs. 5 lakhs per year, per family for secondary and tertiary care hospitalization to more than 10.74 crore poor and vulnerable families. Ayushman Bharat PMJAY card holders can claim cashless services at all the empanelled hospitals or at the private hospitals (approximately 20,000 plus) those have registered to offer PMJAY. The total number of Ayushman Bharat Cards issued till 21st March 2022 are 17,86,97,235 and Hospital admissions under PMJAY as of 21st March 2022 since launch are 3,11,27,750. Ayushman Bharat PMJAY has shown a good progress since its launch. It is a successful health insurance scheme till now. This paper studies about reasons of perceived failure of Rastriya Swasthya Bima Yojana (RSBY), Introduction of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY), its features, coverages and benefits, the factors behind the success of Ayushman Bharat PMJAY scheme, its challenges and about the future of the scheme. [ABSTRACT FROM AUTHOR]

In the new paradigm of health-centric governance, policymakers are in constant need of appropriate metrics to determine suitable policies in a non-arbitrary fashion. To this end, in this paper, a compartmentalized model for the transmission of COVID-19 is developed, with a socially distanced compartment added to the model. The modification allows for administrators to quantify the extent to which voluntary social distancing norms are followed, and address restrictions accordingly. Modifications are also made to incorporate inter-region migration, and suitable metrics are proposed to quantify the impact of migration on the rise of cases. The healthcare capacity is modeled and a method is developed to study the consequences of the saturation of the healthcare system. The model and related measures are used to study the nature of the transmission and spread of COVID-19 in India, and appropriate insights are drawn. [ABSTRACT FROM AUTHOR]

This study mainly focuses on Indian research output in Lung Cancer, one of the leading causes of carcinogens and tumor promoters ingested via smoking. The data for this study was obtained from Scopus database for the period of 1984-2013. The analysis shows that majority (94 per cent) of the scientists preferred to publish research papers in joint authorship. In depth, this study analysed that USA is the major collaborating partner of India with a share of 24.66 per cent publications. Tata Memorial Hospital, Mumbai is the most productive institution in India on Lung Cancer research. It has contributed 16.90 per cent of the total research output. Indian Journal of Cancer is the most productive journal of Lung Cancer research and it has contributed 8.65 per cent of publications. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to identify the constituents of cause-related marketing (CRM) capabilities in the context of an emerging market healthcare sector, by incorporating the resource-based view alongside the dynamic capability perspective. Moreover, the authors aim to illustrate how the typologies of CRM capabilities help to achieve service innovation whilst taking into consideration the role of service flexibility (SF) and service climate. Design/methodology/approach: The authors develop a research framework through a representative and novel case study in the Indian healthcare market by utilizing and analyzing the subject-specific literature. Furthermore, a quantitative survey of healthcare professionals was conducted to assess the relationships utilizing PLS–SEM. Findings: After identifying the constituents of CRM capabilities, the study confirms the mediating mechanism of SF between CRM capabilities and service innovation. Furthermore, findings from the study suggest that service climate positively moderates the relationship between CRM capability and SF. Research limitations/implications: The study was conducted in the emerging country healthcare market of India. Thus, the generalizability of the framework needs to be tested in a similar or contrasting context. Furthermore, the sample size for the study was limited to healthcare professionals, and the customer's perspective was missing. Originality/value: This paper is a first step to identify the specific dimensions of CRM capability and explain it as a higher-order factor. The study further provides an integrative framework that includes CRM capability, service innovation, SF and service climate. More specifically, it enhances the understanding of the constituents of the CRM capabilities and their influence on service innovation. [ABSTRACT FROM AUTHOR]

Financing is an important aspect of any program for successful transformation. Financial commitment of government is considered to be the highest form of commitment for successful work. Without budgetary provision, no program can achieve the desired target. The role of health financing of central government, international donor agencies, provincial government, and local bodies have been identified. The paper focused on monitoring and evaluation mechanisms for health financing in the context of recent developments. Health financing models have been discussed to gain an understanding about relation of financing and overall healthcare development. The search engines like PubMed, Scopus, Web of Sciences, and jstor (journal storage) were consulted to unearth the mechanism of health finances for development of good health. The paper put forth various themes and sub-themes according to financial implications on health structure of India. All healthcare programs need a continuous stream of resources like medicine, workforce, physical infrastructure, monitoring, and evaluation to achieve good health. Whereas, different stakeholders also need financial support to evolve with great vigour and vivacity. There is a pressing need to infuse financial resources into public health system for achievement of universal health care rather than incremental growth in traditional financial processes spreading over several decades. The specific roles and responsibilities of central, provincial, local governments, and international donors have to be delineated to expedite resource mobilisation. However, while implementing programs, there should be coordination among all the stakeholders. [ABSTRACT FROM AUTHOR]

Healthcare has become one of India's largest sectors with high income generation and employment opportunities. Indian Healthcare includes Public and private hospitals, clinics outsourcing, telemedicine, medical tourism, health insurance and other medical equipment. Public spending on public health and welfare in India are still not at the required level even after introduction of Ayushman Bharath. The gap between the actual spending by common man and the required amount is high in low-income which results in inter-state inequality in healthcare. The aim of this paper is to analyze the public private participatory projects by Narayana Hrudayalaya and its CSR activities to reduce the problems faced by common Indian citizen in receiving good healthcare. [ABSTRACT FROM AUTHOR]

Background: Low- and middle-income countries (LMICs) account for a higher burden of noncommunicable diseases (NCD) and home to a higher number of premature deaths (before age 70) from NCDs. NCDs have become an integral part of the global development agenda; hence, the scope of action on NCDs extends beyond just the health-related sustainable development goal (SDG 3). However, the organization and integration of NCD-related health services have faced several gaps in the LMIC regions such as India. Although the national NCD programme of India has been in operation for a decade, challenges remain in the integration of NCD services at primary care. In this paper, we have analysed existing gaps in the organization and integration of NCD services at primary care and suggested plausible solutions that exist. Method: The identification of gaps is based out of a review of peer-reviewed articles, reports on national and global guidelines/protocols. The gaps are organized and narrated at four levels such as community, facility, health system, health policy and research, as per the WHO Innovative Care for Chronic Conditions framework (WHO ICCC). Result: The review found that challenges in the identification of eligible beneficiaries, shortage and poor capacity of frontline health workers, poor functioning of community groups and poor community knowledge on NCD risk factors were key gaps at the community level. Challenges at facility level such as poor facility infrastructure, lack of provider knowledge on standards of NCD care and below par quality of care led to poor management of NCDs. At the health system level, we found, organization of care, programme management and monitoring systems were not geared up to address NCDs. Multi-sectoral collaboration and coordination were proposed at the policy level to tackle NCDs; however, gaps remained in implementation of such policies. Limited research on the effect of health promotion, prevention and, in particular, non-medical interventions on NCDs was found as a key gap at the research level. Conclusion: This paper reinforces the need for an integrated comprehensive model of NCD care especially at primary health care level to address the growing burden of these diseases. This overarching review is quite relevant and useful in organizing NCD care in Indian and similar LMIC settings. [ABSTRACT FROM AUTHOR]

The healthcare industry has emerged as one of the most competitive industries in India. With more private hospitals in the country, the healthcare industry is growing at an accelerated rate. The healthcare market is witnessing both private as well as foreign investments as the Indian healthcare market is expected to grow by a rate of 15% in the coming 5 years. However, one of the major challenges faced by both the new and old hospital sectors is healthcare marketing. This paper tries to study the challenges faced by the hospitals in India with regards to healthcare marketing. The study is based on secondary data and literature available and also makes an attempt to identify the opportunities related to healthcare marketing in India. [ABSTRACT FROM AUTHOR]

India’s experience with the National Rural Health Mission (NRHM) is notable on account of nationally formalising – at scale – community action in service delivery,monitoring, and planning of health services. A study was undertaken to document and create a historical record of NRHM’s ‘communitization’ processes. The oral history method of the Witness Seminar was adopted and two virtual seminars with five and nine participants, respectively, were conducted, and supplemented with 4 in depth interviews. Analysis of transcripts was done using ATLAS.ti 22 with the broad themes of emergence, evolution, and evaluation and impact of ‘communitization’ under NRHM. This paper engages with the theme of ‘emergence’ and adopts the Multiple Streams Framework (MSF) conceptualised by John Kingdon for analysis. Key findings include the pioneering role of boundary spanning decision makers and the Jan Swasthya Abhiyan (JSA) in advocacy and design of ‘communitization’ structures, and the legacy of rights based social mobilizations and state-civil society partnerships in health during the 1990s influencing the ethos underlying ‘communitization’. Democracy, leadership from the civil society in policy design and implementation, and state-civil society partnerships are linked to the positive results witnessed as part of ‘communitization’ in NRHM. [ABSTRACT FROM AUTHOR]

Camps are a popular approach to deliver medical care in India. While it is usually a one-off event for physical ailments, it is a long-term affair in Psychiatry. One of the first camps in psychiatry was rolled out as early as in 1967 at Mandar, Ranchi, followed by Raipur Rani (Haryana) in 1976 and at Gunjur, Karnataka in 1977. This camp approach became extremely popular and got expanded across India as they were thought to be synonymous with community-based outreach for mental illnesses. In the past 5 years, however, newer models of community care have emerged, necessitating a relook at this traditional approach. In this paper, the authors trace the origin, utility and future directions of these camps, taking data from community psychiatry camps conducted by the National Institute of Mental Health and Neurosciences, Bengaluru, a premier neuropsychiatric tertiary care institute in India. Data have been collated from the annual reports of the Institute, database from the District Mental health Program, Government of Karnataka, India, and compared with published literature on the same field. While camps remain as one of the important avenues to reach the unreached, there is a need to change the approach of their functioning by incorporating training (primary care providers) aspects and collaborative care. The latter may make the initiative more meaningful and sustainable. [ABSTRACT FROM AUTHOR]

Background: Utilisation of continuum of maternal health care services is crucial for a healthy pregnancy and childbirth and plays an important role in attaining Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs) related to maternal and child health. This paper aims to assess the percentage of dropouts across various stages of utilization of continuum of maternal health services (CMHS) in India and also investigates the factors hindering the utilization of these services. Methods: We used recent data from National Family Health Survey(NFHS) encompassing a total sample of 1,70,937 pregnant women for the period 2015–16. The percentage of women dropping out while seeking maternal health care is measured using descriptive statistics. While, the factors impeding the utilization of maternal health services is estimated using a Multinomial Logistic Regression Model, where dependent variable (CMHS) is defined as complete care, incomplete care and no care. Results: Only17% of pregnant women availed the utilisation of complete care and 83% either did not seek any care or dropped after seeking one or two services. For instance, it is found that 79% of women who registered for antenatal care services (ANC) did not avail the same adequately. An empirical investigation of determinants of inadequate utilization of CMHS revealed that factors like individual characteristics, for instance- access to media (RRR: 2.06) and mother's education play (RRR: 3.61) a vital role in the uptake of CMHS. It is also found that the interaction between wealth index and place of residence plays a pivotal role in seeking complete care. Lastly, the results revealed that male participation (RRR: 2.69) and contacting multi-purpose worker (MPW) (RRR: 2.33) are also at play. Conclusion: The study suggests that the major determinants of utilisation of CMHS are access to media, mother's education, affordability barriers and male participation. Hence, policy recommendations should be oriented towards strengthening these dimensions and the utilisation of adequate ANC has to be considered as the need of the hour. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This paper is one of the first studies that identifies factors that inhibit access to healthcare services and healthcare-seeking behaviour (HCSB) in rural India during the COVID-19 pandemic. METHODS: The data source was the household sample survey of the World Bank on 'COVID -19-Related Shocks in Rural India 2020, Rounds 1-3'. Binomial and multinomial regression analysis was carried out to estimate the determinants of health care avoidance and HCSB. RESULTS: Families belonging to low consumption quartiles not only delayed obtaining health care but also underutilized formal health resources at public and private facilities. The majority of non-agricultural households, as well as those that reduced their consumption during the outbreak, were forced to self-medicate through pharmacies. Family planning, immunization, child growth monitoring, and routine medical check-ups were among the services that were not availed during the pandemic. CONCLUSION: The findings of this study emphasize the need of removing financial obstacles to care during the COVID-19, as well as the importance of child-related care continuity (child development monitoring, antenatal care, and immunization) and routine check-ups. [ABSTRACT FROM AUTHOR]

Introduction: Presently the leprosy program has no defined surveillance protocols for patients who complete the fixed duration multidrug therapy and are released from treatment (RFT). Hence, the information about the post‑RFT events in these patients is sparse and qualitative and quantitative data regarding their health care requirements is missing. During the DermLep survey carried out by the Indian Association of Dermatologists,Venereologists and Leprologists (IADVL), a number of patients presented to dermatologists during the post RFT period for a variety of symptoms. This paper analyses the events in these patients during the post RFT period. Results: Out of a total of 3701 leprosy patients who presented to 201 dermatologists across India during the DermLep survey, 708 (26.2%) were in the post RFT period (488 males; 220 females). Of these, 21% were PB and 79% MB patients as per their treatment records. Majority were in the age group of 31‑59 years (55.5%); however, a significant proportion of them (20.7%) were elderly (>60 years). Majority of the patients (45.5%) presented within the first year of RFT with variable symptoms; 28% were between 1‑5 years, 5.5% between 5‑10 years; and 11.0% presented more than 10 years after RFT. Most common presenting complaint being persistent skin lesions as perceived by patients in 21.2%, followed by neuritis in 14.5%; trophic ulcers in 13.8%; deformities in 67 (11.8%); lepra reactions in 66 (11.6%); and recurrence of original symptoms in 6.7%. Conclusion: The DermLep Survey highlights the importance of ‘post RFT’ patients as an important subset of leprosy patients who visit dermatologists for various health related issues. The most common complaints in this subset were active/persistent skin lesions, lepra reactions and neuritis. In these patients, who are a sub‑group of ‘persons affected with leprosy’ the disease related issues can persist for many years post RFT. Hence, it is important to provide services in the programme to monitor and manage these complications for the prevention of impairments, disability and the related social issues. [ABSTRACT FROM AUTHOR]

Rural healthcare is the biggest challenge faced by developing countries such as India. With more than 70% of its population residing in rural areas (Census of India, Rural Urban Distribution of Population, 2011), the inadequate health facilities have lead to a high mortality rate. One of the key issues that needs to be tackled is the lack of proper health care data collection and management. In this paper, we propose a generic model that can be scaled to any form of data collection and analysis. The model consists of a mobile application for data collection and a centralized cloud server for effective data storage. Furthermore, the paper discusses our case study where we implemented the proposed model in the geographical area of Kuppam in Andhra Pradesh, India. Additionally, geospatial mapping of diseased patients to recognize spatial distribution of diseases was conducted. Our model uses information technology to aid and enhance the quality of health care services and attempts to bridge gaps in health care sector. [ABSTRACT FROM AUTHOR]

Malnutrition, a word which seems to shake our roots and disturb our future. Today the underdeveloped and many developing countries are battling this threat in many ways. The reason behind malnutrition is the determinants which make it prevail in our neighborhood and our country on the whole. Malnutrition possess a very serious threat to the future of our country especially the children between (1 - 3) years of age. This paper attempts to identify the existing prevalence of malnutrition in Uttarakhand, to explore the predisposing factors contributing to it in under five children and compare the prevalence with the selected neighboring states. An in - depth survey of all the related literatures and published articles in the selected area was made. It has been reported in recent times about the hike in India's hunger problems and the number of reported cases of stunting and wasting has also rocketed though underweight has slightly reduced. The only way to curb malnutrition is by; breaking the shackles of the determinants, thorough regular surveys and screenings, improved and adequate health care services, reaching out to the needy and spreading awareness among the masses. [ABSTRACT FROM AUTHOR]

Telemedicine has been a buzzword in India since the 1990s. In 2020, due to the COVID-19 pandemic in India, a national lockdown limited access to in-person healthcare services. The Ministry of Health & Family Welfare issued India's first set of government guidelines for the use of telemedicine. Emphasis was placed on training doctors and gearing up teleconsultations. This effort led to a significant increase in consultations and the recruitment of additional clinicians to practice telemedicine. However, there remain challenges relating to privacy, patient data storage, unevenness in telecom infrastructure and a systematic approach to integrating teleconsultation data with the overall patient record and public health information systems. This paper will provide an overview of telehealth, examine key interventions that have occurred in India during the pandemic and explore potential future approaches that can leverage the benefits of telehealth across the health care spectrum. [ABSTRACT FROM AUTHOR]

This paper aims to determine occupational stress determinants in Indian Banking Industry. All the statements were taken from the previous literature review and then factor analysis applied to it. Survey response were collected from 518 respondents in National Capital Region of lndia.6 Factors were extracted using principle component matrix. These factors may further be used as dependent variable when combining with other variables of organisation. Based on concern raised by some international organisation and Indian government plan towards mental healthcare bill for employees working in different organisation, this paper is an attempt to empirically determine the attributes of occupational stress in Banking Industry. [ABSTRACT FROM AUTHOR]

Purpose Recently, the Indian government launched health insurance schemes for the poor both to protect them from high health spending and to improve access to high-quality health services. This article aims to review the potentials of health insurance interventions in order to improve access to quality care in India based on experiences of community health insurance schemes. Data sources PubMed, Ovid MEDLINE (R), All EBM Reviews, CSA Sociological Abstracts, CSA Social Service Abstracts, EconLit, Science Direct, the ISI Web of Knowledge, Social Science Research Network and databases of research centers were searched up to September 2010. An Internet search was executed. Study selection One thousand hundred and thirty-three papers were assessed for inclusion and exclusion criteria. Twenty-five papers were selected providing information on eight schemes. Data extraction A realist review was performed using Hirschman's exit-voice theory: mechanisms to improve exit strategies (financial assets and infrastructure) and strengthen patient's long voice route (quality management) and short voice route (patient pressure). Results of data synthesis All schemes use a mix of measures to improve exit strategies and the long voice route. Most mechanisms are not effective in reality. Schemes that focus on the patients’ bargaining position at the patient-provider interface seem to improve access to quality care. Conclusion Top-down health insurance interventions with focus on exit strategies will not work out fully in the Indian context. Government must actively facilitate the potential of CHI schemes to emancipate the target group so that they may transform from mere passive beneficiaries into active participants in their health. [ABSTRACT FROM PUBLISHER]

This paper examines the role of local health systems in developing countries in health biotechnology innovation. The heath systems encompass the final users of health biotechnology products and services. In innovation studies in general, users have been identified as playing vital roles as sources for innovation and in shaping the innovation process. It is therefore of interest to cast light upon the role of users in the health biotechnology innovation in developing countries. This paper briefly reviews literature on science and technology based health innovation in both industrialised and developing countries. It then examines to what extent the focus of developing countries is on their local health problems and explores the linkages between the organisations involved in research and development of health biotechnology products and services with the local health system, and thereby identifies the main roles of their own health systems in the innovation process. The paper bases this analysis on research on publication patterns and case studies on leading developing countries in health biotechnology and focuses particularly on health biotechnology development in Brazil, Cuba and India. [ABSTRACT FROM AUTHOR]

Objectives: This paper explores the role of immigrant-serving agencies in facilitating access to dementia services and supports provided by dementia service agencies (particularly the health authority and local chapters of the Alzheimer Society) through their propensity to develop trusting relationships between staff and clients. Design: Our research is a qualitative case study of Punjabi and Korean speakers living in the Lower Mainland of BC, Canada. Data are drawn from interviews with 15 dyads of persons with dementia and their family caregivers (10 Punjabi, 5 Korean), six focus groups (one focus group with each of 8–10 older men, older women, and mixed gender working age adults in each community). We also interviewed 20 managerial and frontline staff of dementia service agencies, i.e. the health authority and the local Alzheimer Society (n = 11) and two immigrant-serving agencies (n = 9), each dedicated to either Punjabi or Korean-speaking clients. We adopted the Candidacy framework for understanding access to dementia services and supports and the concept of trust as guiding precepts in this study. Results: Families of persons with dementia are pivotal to identification of a problem requiring professional help, navigation to appropriate services and acceptance of services offered. However, trust in family members should not be taken for granted, since family dynamics are complex. Alternative sources of trusted support are therefore needed. Immigrant-serving agencies are more often instrumental in establishing trusted relationships between their staff and clients, but they often lack detailed knowledge about heath conditions, their treatment and management, and they lack power to implement statutory care. Conclusions: Partnerships between mainstream mental health/dementia services and the community sector have proven successful in increasing the accessibility of specialized resources, while maximizing their combined trustworthiness, accessibility and effectiveness. Such partnerships should become fundamental components of health service strategy and provision for vulnerable and underserved immigrant older adults. [ABSTRACT FROM AUTHOR]

Care at Doorstep (CAD) is a home care service that includes medical and social care by skilled professionals. The purpose of this paper is to explore the need for CAD among users of the district mental health programme (DMHP) in Ramanagaram, Karnataka, India who have severe mental illness. The design of this study was descriptive where a qualitative inductive methodology was adopted. Data was collected from interviews of 20 caregivers and 7 mental health service providers linked to the DMHP. Socio demographic information was collected from participants and a semi-structured interview guides were used to explore needs and challenges in delivering care at home by the professionals. The themes that emerged from the manually transcribed and coded data were categorized as needs and challenges and used for developing a CAD model. [ABSTRACT FROM AUTHOR]

The unexpected lockdown announced by the Government of India in March 2020 in response to the pandemic left the coastal community in Kerala deprived of not only essential amenities but also healthcare. Some poverty-ridden, over-crowded coastal regions had been declared as critical containment zones with severe restriction of movement, adding to their vulnerability. People with serious health-related suffering (SHS) in this community required urgent relief. A group of educated youth in the community joined hands with a non-governmental organisation specialised in palliative care (PC) services and strived to find the best possible solutions to address the healthcare needs in their community. This paper reports the collaborative activities done during the pandemic in the coastal region and compares the activities with steps proposed by the WHO to develop community-based PC (CBPC). By engaging, empowering, educating, and coordinating a volunteer network and providing the required medical and nursing support, the programme was able to provide needed services to improve the quality of life of 209 patients and their families who would have been left with next-to-no healthcare during the pandemic. We conclude that even in the context of much poverty, delivery of CBPC with the engagement of compassionate people in the community can successfully reduce SHS. [ABSTRACT FROM AUTHOR]

Since Covid-19 or Corona Virus was first discovered, it exploded into a Pandemic -resulting in devastating effects on human lives and livelihood worldwide. The high costs of non-cooperation in responding to the virus and ultimately significant loss of lives have been seen. In spite of favourable demographic structures, climatic conditions and youngpopulations, South Asian countries like India are badly affected in both epidemiological andeconomic terms. South Asian Countries are trying their best to address the health concerns. Regional self- governments are also trying to manage the crisis by implementing day- to-day containment measures and ensuring health care and social services. In this situation, many Non-Governmental Initiatives and multilevel co-ordination mechanisms in regional levels have been developed tocombat the Pandemic. From detecting the disease, contact tracing, measurement of oxygenlevel, Doctors' advice, Medicine supply, oxygen cylinder supply, food supply, and evencremate the dead bodies of Covid patients, local cooperation is doing a commendable job. Iwant to focus in my paper on how regional collaborations take an important role toaddress COVID- 19 Pandemic. [ABSTRACT FROM AUTHOR]

Over the years, healthcare system in India has been largely centralized, expensive and impersonal. In a country where expenditure on healthcare is low, most healthcare expenditure is out‑of‑pocket and where most of the population continue to live in rural areas or in urban fringes, such a care is inaccessible, unresponsive and unaffordable. COVID pandemic exposed these realities further. Based on experiences of directly managing health services during COVID‑19 pandemic in different settings and across different levels, authors of this paper argue for a decentralized, distributed and responsive health systems for India, that is likely to be more effective and sustainable in normal times, and in times of crisis. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic has long-lasting impact in social, personal, and economic area globally. When we think of the economic recovery of India in the future, we face the challenge of moving forward more sustainably. An international NGO ARUP had published a worldwide report named 'Health.Care.Without.Harm'; mentioning that only healthcare sector itself is accountable for about 4.4 percent of universal net emissions. The present study, therefore, highlights the vulnerabilities in the linear economy and how the pandemic crisis challenges the linear economy and provide opportunity to uptake circular practices and sustainable development within India's healthcare economy. The paper outlines the recommendations on the circular economy by suggesting policy and market-driven solutions for the healthcare sector's sustainability. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to present a historical overview of the health service sector in India. The development in the healthcare sector from the late eighteenth century into current times is examined from the prism of the role played by British and US healthcare systems in influencing change in the Indian setup.Design/methodology/approach Online databases searched were PubMed and JSTOR, using the search terms, “Indian health service system in transition”, “British influence on the Indian healthcare setup” and “American neo-liberal influence on Indian healthcare sector”. The authors then examined titles and abstracts of selected articles for short-listing relevant articles. Reference lists of selected articles were examined for further locating related studies. While this constituted the secondary literature for the current paper, reports by governmental and non-governmental organisation reports on the Indian health service system too were utilised as primary data sources.Findings Influenced by the British and later by the American healthcare system, the Indian healthcare network has undergone numerous changes. In the present era, the Indian healthcare system is increasingly veering towards the American model of healthcare delivery. Health is increasingly being conceived of as a commodity to be traded in the market, with the state’s role curtailed towards provisioning for and facilitating access of the weakest sections of the society through a means-tested insurance system. This has happened without adequate checks and balances on the private sector to ensure that the needs of the people accessing the system are adequately met.Social implications By tracing the development of the health service sector in India and the motives that guide such change, the paper depicts how the thrust of the system has altered from one providing universal healthcare services to the people, irrespective of their ability to pay, at the time of independence to commercialisation in present times. With the marketisation of healthcare, the focus has shifted from serving people to profiting from the provisioning of healthcare.Originality/value The paper throws light on the underlying inadequacies of the Indian healthcare setup and the need for more active participation by the government in this sector in the future if it aims to make healthcare more equitably accessible to its vast population. [ABSTRACT FROM AUTHOR]

The Coronavirus disease 2019 (COVID-19) pandemic has necessitated medical centers across the world to deliver healthcare through telemedicine. We discuss the adoption, delivery of telemedicine services at a tertiary care center and patient satisfaction involving 456 patients in south India. Most respondents had sought telemedicine care at the department of Medicine (16.23%). The maximum satisfaction was reported by patients in OBG (100%). The responses were generally positive across all the age groups. The paper offers insights on best practices adopted at the center, lessons learnt, and provides recommendations for health care systems offering telemedicine during COVID-19 times. [ABSTRACT FROM AUTHOR]

In India, marginalised people with serious or chronic illness face particular challenges to finding sustainable treatment, and often experience financial devastation. One state welfare scheme (the EWS hospital bed quotas) holds the promise of treatment for those in Delhi's margins, through partnerships with corporate hospitals. Yet, the process of gaining access to treatment via the scheme is very frustrating. This ethnography illustrates the ways in which low-income patients' attempts to lay claim to state services often bring them into play with a mode of the state that is, in anthropologists' conceptions, opaque, arbitrary and erratic. In response to the 'illegible' modes of access to the scheme, patients and their families are compelled to construct and reproduce their eligibility to access treatment, through a repertoire of intricate and entwined practices, namely: the attainment of credible low-income documentation, the use of big men to leverage resources, and different kinds of performance. The burden of enacting these practices is further compounded and troubled by the state scheme's blurry entanglement with the private sector, in which roles and responsibilities for a 'duty of care' to citizens with illness are elusive. This paper therefore aims to be an original contribution to the social sciences, in interpreting health-seekers' experiences of state-private schemes in Delhi within anthropological understandings of the state and marginalised people's meaning-making of illegible state processes. [ABSTRACT FROM AUTHOR]

Introduction: It is well acknowledged that India's community health workers known as Accredited Social Health Activists (ASHA) are the bedrock of its health system. Many ASHAs are currently working in fragile and conflict-affected settings. No efforts have yet been made to understand the challenges and vulnerabilities of these female workers. This paper seeks to address this gap by bringing attention to the situation of ASHAs working in the fragile and conflict settings and how conflict impacts them and their work.Methods: Qualitative fieldwork was undertaken in four conflict-affected villages in two conflict-affected districts -Kokrajhar and Karbi Anglong of Assam state situated in the North-East region of India. Detailed account of four ASHAs serving roughly 4000 people is presented. Data transliterated into English were analysed by authors by developing a codebook using grounded theory and thematic organisation of codes.Results: ASHAs reported facing challenges in ensuring access to health services during and immediately after outbreaks of conflict. They experienced difficulty in arranging transport and breakdown of services at remote health facilities. Their physical safety and security were at risk during episodes of conflict. ASHAs reported hostile attitudes of the communities they served due to the breakdown of social relations, trauma due to displacement, and loss of family members, particularly their husbands.Conclusions: Conflict must be recognised as an important context within which community health workers operate, with greater policy focus and research devoted to understanding and addressing the barriers they face as workers and as persons affected by conflict. [ABSTRACT FROM AUTHOR]

In the era of patient centered healthcare, patients are educated, more aware and demanding than ever. However, there is a significant misalignment between patients and doctors due to improper communication resulting in broken patient-doctor therapeutic relationships and degraded quality of healthcare. This suggests that patients have a greater and mature role to play in their healthcare. The paper aims to fill this gap by studying the contribution of patients in their healthcare through patientdoctor communication in selected Indian multispeciality hospitals. Qualitative multi-case study was steered and in-depth interviews of thirteen patients, twelve doctors were conducted along with the secondary data analysis of more than 600 pages of the documents from the official websites of the sample hospitals. Grounded theory three level coding revealed the themes of contribution of patients in through effective communication. The results indicate that patients contribute to their healthcare through effective communication by demonstrating association with doctors, reflecting reciprocally, resolving communication challenges and supporting their overall treatment process. The paper extends the literature on patient's contribution in their healthcare. It presents clear and succinct implementable implications and distinctive ways in which patients cooperate with the doctors, work mutually, improves communication and strengthen their overall healthcare process. [ABSTRACT FROM AUTHOR]

Technology has played a role in the quality and assurance of life. Application of technology in the healthcare field has increased manifolds in past decade with the development of new devices and IT. Telemedicine - a technology for remote diagnosis of diseases provides health care facilities to the remote area. In the context of India, telemedicine can be an option to provide healthcare facilities to last mile, the interior villages with the help of technology. Although it is a conceptual paper, the paper investigates the enabler of telemedicine technology adoption and implementation and ends up with the proposed model with the constructs and constructs definitions with the proposed items which are useful for telemedicine implementation. Through the systematic literature review followed by one to one interaction with the physicians, patients and telemedicine experts who all are currently using the technology the propositions are made which are likely to affect the implementation and adoption of telemedicine technology. telemedicine is a useful technology, when it comes to the affordability, quality and reach of healthcare services in India. Private hospitals as well as government both have to work together to provide the better healthcare for better India. [ABSTRACT FROM AUTHOR]

Big India has achieved high rates of economic growth post after economic liberalization in 1991. A sustained level of high growth was achieved resulting in a large GDP for the country. India is today the 6th largest economy (in terms of nominal GDP) of the world with a GDP of 2.597 trillion USD (Ranking of countries on gross domestic product as on 2017 by World Bank). However this GDP growth has not led to much improvement in social development indicators. One of the key social development indicators pertaining to health is infant mortality rate (IMR). Although, the initiatives of Government of India to bring down the infant mortality rate (IMR) have earned its kudos, they are not enough. Moreover, this improvement in IMR is not uniform across the country. In India, BIMARU (acronym of four Indian states Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh) states are economically poor and having serious deficit in health awareness. Therefore, any improvement in the overall IMR of the country cannot happen without improving the indicator significantly in these BIMARU states. This paper attempts to identify the determinants of IMR for the BIMARU states. A basic regression model (pooled OLS) of IMR has been developed on the basis of data collected from the Annual Health Survey (AHS) for 184 districts of BIMARU states for 3 consecutive years (2011, 2012 and 2013). The analysis presented in this paper lays out the determinants of IMR in BIMARU states in India and argues in favor of developing targeted initiatives to improve IMR. [ABSTRACT FROM AUTHOR]

Purpose Medical tourism encourages the traveling of patients, expert healthcare professionals and promotes cross-border trade in healthcare services. The Indian medical tourism sector is facing new challenges as well as certain ethical and legal issues because of continuous market changes and patient’s requirements while at the same time advancements in current health services have also been observed. It is therefore very important to understand and address the issues of the medical tourists. The purpose of this paper is to evaluate the important factors which can make India an affordable medical tourism destination.Design/methodology/approach In this paper, the factors influencing Indian medical tourism sector have been explored by conducting literature review, they are ranked according to the results of a questionnaire-based survey and further analyzed by using the interpretive structural modeling (ISM) approach. The mutual relationships between these factors were identified to develop an ISM model so as to find out the important factors which can make India an affordable place for medical tourism.Findings The results of the survey and the model show that cost of medical procedures, facilitation, and care, the infrastructure of Indian hospitals, clinical excellence and the competence of doctors and staff are the top level factors.Practical implications It is very important to address the concerns of the patients coming to a developing country like India for availing medical services. This research has evaluated the important factors which can make India an affordable medical tourism destination.Originality/value This research assesses the effects of globalization on delivery of healthcare services in India by conducting critical analysis of the medical tourism industry by collecting original data from the international patients coming to India for different types of medical procedures so that a comprehensive model can be prepared which will help the hospitals and policymakers to improve the processes related to medical tourism. [ABSTRACT FROM AUTHOR]

Mental health information systems are increasingly being used to measure the effectiveness of mental health interventions. Little or no data is available for mental health service availability and service uptake in lowand middle-income countries. Through a narrative review, this paper illustrates the importance of routine monitoring data and suggests methods for developing, implementing and evaluating mental health indicators in low- and middle-income countries with a primary focus on India. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to understand and compare the level of patient’s expectations of healthcare services and their perceived performance. The paper also provides insights into the specific service factors and quality of hospital services which are required to meet the needs of Indian patients.Design/methodology/approach A total of 210 exit interviews were conducted using a structured questionnaire addressing the probable factors of quality related to healthcare services in a five-point Likert scale. The survey was conducted among the patients recently discharged and about to be discharged from private hospitals of Delhi and NC. A set of questionnaires is administered to collect responses on expected and perceived service qualities.Findings The paper reviews and discusses the importance of service quality for Indian patients using the SERVQUAL gap model as the measure of service quality. The results gave an overview of the perspectives of Indian patients on the quality of service in private hospitals. Patients indicated best satisfaction in some dimensions of services, namely, the tangible dimension of “hospitals provide ample parking spaces,” empathy dimension of “Doctors are never too busy to respond to my request”, assurance dimension of “I can depend on Doctor/Nurse,” and in the responsiveness dimension of “employees always communicate truly” on hospital matters.Research limitations/implications The first limitation is in the scope of sample, that is research findings are limited to Delhi. The second limitation is that the research should have been done in two parts, that is by contacting the patient before they take the services and after the service encounter. Third limitation – for a better understanding, the analysis should have been performed on the gap between the patient’s perception and the perception of the medical service provider about the customer’s perception.Practical implications This research would be beneficial to healthcare organizations to do their best to achieve greater patient satisfaction. The findings of the paper that, for all dimensions, the patient’s perception is always higher than the expectation suggests that in the Indian healthcare segment, there is a need of dissemination of information regarding the most modern medical facilities.Originality/value This current research is concluded with the suitability of a model that can be used to find the levels of patient satisfaction for healthcare services. The present study is based on primary data and offers a systematic procedure that could form the cornerstone for providing further insights into the conceptual and empirical comprehension of patients perceived service quality and its constituents. The current emergency medicine patient’s service dilemmas are a complex interaction of patients and physician factors specifically targeting efficiency and patient satisfaction. The awareness of these issues particular to the emergency patient can help to maximize efficiency, minimize subsequent medico-legal risk and improve patient care if a tailored management plan is formulated. [ABSTRACT FROM AUTHOR]

Purpose: This joint position statement, by the Indian Association of Palliative Care (IAPC) and Academy of Family Physicians of India (AFPI), proposes to address gaps in palliative care provision in the country by developing a community-based palliative care model that will empower primary care physicians to provide basic palliative care. Evidence: India ranks very poorly, 67th of 80 countries in the quality of death index. Two-thirds of patients who die need palliative care and many such patients spend the last hours of life in the Intensive care unit. The Indian National Health Policy (NHP) 2017 and other international bodies endorse palliative care as an essential health-care service component. NHP 2017 also recommends development of distance and continuing education options for general practitioners to upgrade their skills to provide timely interventions and avoid unnecessary referrals. Methods: A taskforce was formed with Indian and International expertise in palliative care and family medicine to develop this paper including an open conference at the IAPC conference 2017, agreement of a formal liaison between IAPC and AFPI and wide consultation leading to the development of this position paper aimed at supporting integration, networking, and joint working between palliative care specialists and generalists. The WHO model of taking a public health approach to palliative care was used as a framework for potential developments; policy support, education and training, service development, and availability of appropriate medicines. Recommendations: This taskforce recommends the following (1) Palliative care should be integrated into all levels of care including primary care with clear referral pathways, networking between palliative care specialist centers and family medicine physicians and generalists in community settings, to support education and clinical services. (2) Implement the recommendations of NHP 2017 to develop services and training programs for upskilling of primary care doctors in public and private sector. (3) Include palliative care as a mandatory component in the undergraduate (MBBS) and postgraduate curriculum of family physicians. (4) Improve access to necessary medications in urban and rural areas. (5) Provide relevant in-service training and support for palliative care to all levels of service providers including primary care and community staff. (6) Generate public awareness about palliative care and empower the community to identify those with chronic disease and provide support for those choosing to die at home. [ABSTRACT FROM AUTHOR]

This research paper presents a historical analysis of the unprecedented growth of dengue fever cases in Delhi (the capital city of India) during 2015 with an objective to identify factors responsible for its spread and suggest corrective measures to control the disease. The study was conducted based on secondary data with respect to dengue spread in Delhi from various sources, such as newspapers, published scientific research papers, internet, and news bulletins of the health organizations at the central and state governments in India. Data with respect to Ayurvedic treatment of dengue fever was from the selected employees of a private hospital in Faridabad (State of Haryana, India). As a result, two factors were identified to be responsible for the fast spread of dengue: climatic conditions and the delayed reaction of health organizations to control mosquitoes. Another unique finding in this study was that most patients go for Ayurvedic treatment at hospitals equipped with facilities for allopathy only. This study recommends that health organizations should invest in research about dengue, develop innovative methods for forecasting and reduce the treatment cost. In addition, health organizations must be proactive in educating citizens and controlling the disease. [ABSTRACT FROM AUTHOR]

This study analyse the research activities of dental sciences in India during 1997-2016 as reflected in Web of Science database, by search string like Dentistry, Oral Surgery & Medicine was used. A total 3098 records are retrieved from the web of science database and exported to the MS-Excel. Based on the total publications, the study investigate the India's publications' relative growth rate and doubling time, impact of top 20 journals and India's top 20 research organizations. The study reveals that, there is an increase in the number of publications during this period i.e.0.78% in 1997 and 20.32% in 2016. Journal of clinical paediatric dentistry is occupying the 1st place with 191 publications in top 20 journals and Oral Oncology is the highest 22.7% of citations. 26.12% of the publications published in International collaboration with USA. The mean value of doubling time is 2.3. [ABSTRACT FROM AUTHOR]

Background: Health policy interventions were expected to improve access to health care delivery, provide financial risk protection, besides reducing inequities that underlie geographic and socio-economic variation in population access to health care. This article examines whether health policy interventions and accelerated health investments in India during 2004–2018 could close the gap in inequity in health care utilization and access to public subsidy by different population groups. Did the poor and socio-economically vulnerable population gain from such government initiatives, compared to the rich and affluent sections of society? And whether the intended objective of improving equity between different regions of the country been achieved during the policy initiatives? This article attempts to assess and provide robust evidence in the Indian context. Methods: Employing Benefit-Incidence Analysis (BIA) framework, this paper advances earlier evidence by highlighting estimates of health care utilization, concentration and government subsidy by broader provider categories (public versus private) and across service levels (outpatient, inpatient, maternal, pre-and post-natal services). We used 2 waves of household surveys conducted by the National Sample Survey Organisation (NSSO) on health and morbidity. The period of analysis was chosen to represent policy interventions spanning 2004 (pre-policy) and 2018 (post-policy era). We present this evidence across three categories of Indian states, namely, high-focus states, high-focus north eastern states and non-focus states. Such categorization facilitates quantification of reform impact of policy level interventions across the three groups. Results: Utilisation of healthcare services, except outpatient care visits, accelerated significantly in 2018 from 2004. The difference in utilisation rates between poor and rich (between poorest 20% and richest 20%) had significantly declined during the same period. As far as concentration of healthcare is concerned, the Concentrate Index (CI) underlying inpatient care in public sector fell from 0.07 in 2004 to 0.05 in 2018, implying less pro-rich distribution. The CI in relation to pre-natal, institutional delivery and postnatal services in government facilities were pro-poor both in 2004 and 2018 in all 3 groups of states. The distribution of public subsidy underscoring curative services (inpatient and outpatient) remained pro-rich in 2004 but turned less pro-rich in 2018, measured by CIs which declined sharply across all groups of states for both outpatient (from 0.21 in 2004 to 0.16 in 2018) and inpatient (from 0.24 in 2004 to 0.14 in 2018) respectively. The CI for subsidy on prenatal services declined from approximately 0.01 in 2004 to 0.12 in 2018. In respect to post-natal care, similar results were observed, implying the subsidy on prenatal and post-natal services was overwhelmingly received by poor. The CI underscoring subsidy for institutional delivery although remained positive both in 2018 and 2004, but slightly increased from 0.17 in 2004 to 0.28 in 2018. Conclusions: Improvement in infrastructure and service provisioning through NHM route in the public facilities appears to have relatively benefited the poor. Yet they received a relatively smaller health subsidy than the rich when utilising inpatient and outpatient health services. Inequality continues to persist across all healthcare services in private health sector. Although the NHM remained committed to broader expansion of health care services, a singular focus on maternal and child health conditions especially in backward regions of the country has yielded desired results. [ABSTRACT FROM AUTHOR]

Background: The occurrence of workplace hazards, occupational diseases, and deaths contribute significantly to the increase in the global burden of diseases. The Municipal Solid Waste (MSW) workers experience occupational stressors throughout the process of waste management that affects their well-being and results in high rates of occupational health problems. It is vital to understand the workplace practices and occupational morbidities of the MSW workers to ensure their safety and well-being. In this context, the study aimed to explore the occupational health and safety practices at the place of work among the MSW workers in Karimnagar and Hyderabad in Telangana, India. Methodology: A cross-sectional study was conducted in two cities of Telangana. A total of 394 MSW workers were surveyed. The number of MSW workers in Karimnagar and Hyderabad were 152 and 194, respectively. A pre-tested questionnaire was administered to the MSW workers to study the occupational morbidities and workplace safety practices. Focused group discussions were conducted among the MSW workers in both cities. In-depth interviews of sanitary supervisors in Karimnagar were conducted. Semi-structured questionnaires and interview guides were used with questions on sociodemographic characteristics, health status, work environment, protection strategy, and healthcare utilization. MS Excel and NVivo-12 were used for data analysis. Results: Musculoskeletal problem was the major reported morbidity among the MSW workers (76.6%). Injuries were reported more among the MSW workers in Hyderabad (39.7%) along with a fear of being hit by vehicles while working on the main roads. About 88.7% of the MSW workers had less than secondary education. There was a wage difference between the contract and permanent MSW workers. There was a lack of provision of personal protective equipment and poor working conditions, overall. Lack of basic amenities such as the provision of drinking water and toilets apart from inadequate social security and healthcare facilities was reported. Conclusion: This paper highlights the unsatisfactory working environment and high-occupational morbidities among the MSW workers in Telangana. There was a lack of basic amenities at the workplace making it difficult for the MSW workers. A comprehensive approach which focuses on the health and safety with social security for the MSW workers is required. [ABSTRACT FROM AUTHOR]

With the vital role of patients' involvement and empowerment in selecting the most suitable service provider, this study provides an insight into the patient choice factors that affect them when choosing a hospital for treatment. The patient choice concept is essential to understand in a developing country like India, which struggles to provide public-funded health services to its citizens. This paper uses empirical analysis to evaluate data collected from a diverse patient pool of 258 patients from both public and private sector hospitals in two Indian states (New Delhi and Chandigarh). The study reveals quality of treatment, cleanliness, hospital reputation and amenities like payment and food facilities as important patient choice factors considered while choosing a health service provider in the Indian context. It was also found that service provider's response to majority of patient choice factors was indicated unsatisfactory by the patients, and hence a need for improved service delivery is emphasised for hospitals through this study. [ABSTRACT FROM AUTHOR]

Objective: Despite several government initiatives aimed at improving public healthcare services, private-sector has been a dominant player in most of the Indian states. Limited evidence is available on the factors that influence the choice of using public or private health services, which assume significance in the present context, when the government is willing to purchase care from the private providers. This subject is further explored in the paper by using the 71st round of National Sample Survey, 'Key Indicators of Social consumption in India Health', 2014. Data sources/study setting: The analysis included 15 major states of India, dividing them into three groups: low-, middle- and high-income, using average GSDP per capita. We further used multi-variate regression to examine the factors explaining the utilization of either public or private facility. Findings and conclusion: The utilization of public facilities for outpatient and inpatient services was found to be very low, except Assam and Odisha, which attributed to the poor quality of care and long waiting hours. Caste, education and wealth quintiles were the main factors explaining the choice of either public or private facility and strength of association between socio-economic variables and their utilization that varied across 3-categories of states. [ABSTRACT FROM AUTHOR]

Purpose Organizations have to evaluate their internal and external environments in this highly competitive world. Strengths, weaknesses, opportunities and threats (SWOT) analysis is a very useful technique which analyzes the strengths, weaknesses, opportunities and threats of an organization for taking strategic decisions and it also provides a foundation for the formulation of strategies. But the drawback of SWOT analysis is that it does not quantify the importance of individual factors affecting the organization and the individual factors are described in brief without weighing them. Because of this reason, SWOT analysis can be integrated with any multiple attribute decision-making (MADM) technique like the technique for order preference by similarity to ideal solution (TOPSIS), analytical hierarchy process, etc., to evaluate the best alternative among the available strategic alternatives. The paper aims to discuss these issues. Design/methodology/approach In this study, SWOT analysis is integrated with a multicriteria decision-making technique called TOPSIS to rank different strategies for Indian medical tourism in order of priority. Findings SO strategy (providing best facilitation and care to the medical tourists at par to developed countries) is the best strategy which matches with the four elements of S, W, O and T of SWOT matrix and 35 strategic indicators. Practical implications This paper proposes a solution based on a combined SWOT analysis and TOPSIS approach to help the organizations to evaluate and select strategies. Originality/value Creating a new technology or administering a new strategy always has some degree of resistance by employees. To minimize resistance, the author has used TOPSIS as it involves group thinking, requiring every manager of the organization to analyze and evaluate different alternatives and average measure of each parameter in final decision matrix. [ABSTRACT FROM AUTHOR]

Global health research partnerships are increasingly taking the form of consortia. Recent scholarship has proposed what features of governance may be necessary for these consortia to advance justice in global health. That guidance purports three elements of global health research consortia are essential — their research priorities, research capacity development strategies, research translation strategies — and should be structured to promote the health of the worst-off globally. This paper adopted a reflective equilibrium approach, testing the proposed ethical guidance against the experience of a global health research consortium with equity objectives. Case study research was performed with Future Health Systems (FHS), a health systems research consortium funded over two phases. Data on FHS Phase-2 were gathered through in-depth interviews with steering committee members and junior researchers and collection of consortium-related documents. Thematic analysis of the data for consistency with the proposed guidance generated recommendations for how the guidance might be better articulated and identified areas where it could usefully be expanded. Factors facilitating FHS alignment with the ethical guidance were also identified, including early engagement and partnership with low and middle-income country stakeholders, the learning developed during FHS Phase-1, and aspects of the grant program funding it. [ABSTRACT FROM AUTHOR]