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Copyright of Irrigation & Drainage is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Les auteurs examinent l'effet des quotas d'emplois sur les performances des entreprises publiques indiennes. Utilisant des données sur les entreprises détenues par l'administration fédérale se rapportant à la période 2014–2017, ils mobilisent des méthodes par variables instrumentales et constatent que les quotas améliorent les performances de l'entreprise lorsqu'ils sont appliqués à tous les niveaux de la hiérarchie. Leurs résultats révèlent aussi que les catégories sociales visées par la discrimination positive sont surreprésentées au bas de la hiérarchie et sous‐représentées au sommet, en raison, principalement, de défaillances au niveau de la publication des vacances de postes et de pratiques discriminatoires au sein des organisations. [ABSTRACT FROM AUTHOR]

Résumé: Des réactions ambiguës et paradoxales, procycliques mais aussi contracycliques, ont été observées sur le marché du travail dans différents pays après un ralentissement économique. En l'absence de dispositifs de protection sociale adaptés, comme une assurance‐chômage, un taux d'emploi contracyclique pourrait être le signe de difficultés plutôt que de possibilités d'emploi productif. Confrontant les données sur l'emploi et le chômage aux recommandations de la 19e Conférence internationale des statisticiens du travail sur la sous‐utilisation de la main‐d'œuvre, l'autrice critique les statistiques du sous‐emploi en Inde et appelle à actualiser les méthodes de collecte de données pour mieux éclairer l'action publique dans le domaine de l'emploi. [ABSTRACT FROM AUTHOR]

Résumé: L'auteur analyse les phénomènes d'exclusion et de hiérarchisation en matière de protection des travailleurs dans quatre pays d'Asie (Chine, Inde, Malaisie et Viet Nam), en reprenant l'approche de la segmentation juridique de Dingeldey et al. (2021), mais dans une perspective qualitative. Plusieurs facteurs distinguent ces pays de ceux du monde du Nord et expliquent les spécificités de leurs marchés du travail: le nombre relativement important des travailleurs exclus du champ d'application de la législation du travail; la terminologie juridique, difficilement transposable, et le contexte historique (le passé colonial contribuant à expliquer l'écart entre le cadre légal et la réalité du travail). [ABSTRACT FROM AUTHOR]

The family is the dominant player in India's current long‐term care (LTC) system. Yet informal family‐based arrangements will be insufficient to accommodate India's growing need for LTC due to increasing longevity and geographic mobility, the prevalence of chronic disease and disability among the elderly, and the decline of extended family living arrangements. Addressing the growing need for LTC will require a robust expansion of the current LTC system, especially its non‐familial components. This overhaul will require investments in infrastructure, human resources and legal and regulatory environments. The objectives of this study are to i) provide a descriptive summary and analysis of the LTC system in India, with attention to cross‐state heterogeneity and to the financial, social and cultural factors that impede the operation of India's LTC system; ii) estimate and assess the current and future need for LTC and its critical financial and human inputs; and iii) critically analyse and discuss the institutions and policies, technologies and behaviours needed to bring capacity comfortably into conformance with the need for LTC. [ABSTRACT FROM AUTHOR]

Copyright of Irrigation & Drainage is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Irrigation & Drainage is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: L'auteur utilise des méthodes de décomposition pour estimer le poids respectif d'une série de facteurs dans les disparités salariales au sein du groupe des salariés réguliers en Inde sur la période 1993‐2012. Il distingue aussi le rôle des caractéristiques elles‐měmes de celui de leur rendement dans l'écart et son évolution. Si la détention d'un diplôme du supérieur joue un rôle prépondérant, certains facteurs institutionnels (affiliation syndicale, emploi dans le secteur public) sont également déterminants. Pour expliquer les inégalités, on ne peut donc pas se contenter d'analyser les facteurs démographiques et techniques. Il faut aussi considérer les caractéristiques institutionnelles de l'économie. [ABSTRACT FROM AUTHOR]

Résumé: Cet article porte sur l'impact des envois de fonds effectués par les migrants internes en Inde sur le taux d'activité des membres du ménage, hommes ou femmes, restés au foyer. Les estimations obtenues par la méthode des variables instrumentales révèlent un effet négatif sur ce taux. Les envois de fonds semblent sans incidence sur l'emploi salarié régulier, mais ils entraînent un recul de l'emploi salarié occasionnel et du travail familial non rémunéré, et une progression de l'activité indépendante, surtout chez les femmes. Ils se traduisent aussi par une forte hausse de la proportion de femmes se consacrant aux tâches domestiques, en dehors du marché du travail. [ABSTRACT FROM AUTHOR]

Résumé: L'auteur recense les arguments avancés dans la littérature sur les liens entre un droit du travail indien prétendument «restrictif» et divers indicateurs économiques et sociaux. Il montre que les indicateurs de la législation utilisés dans le passé pour faire des comparaisons entre États sont entachés d'erreurs et ont été interprétés, à tort, comme des mesures de la flexibilité du marché du travail. Ces analyses présentent aussi des faiblesses sur le plan économétrique et semblent difficiles à répliquer au moyen d'indicateurs corrigés et actualisés. L'auteur fournit également des données témoignant de la dégradation de la situation des travailleurs du secteur manufacturier indien. [ABSTRACT FROM AUTHOR]

Purpose: The need to enhance mental health in primary care settings for infants and toddlers is increasingly becoming apparent. However, the lack of trained healthcare personnel and culturally appropriate measures makes it a challenge in low‐ and middle‐income countries. A needs‐based assessment of the extent of the problems in toddlers will help address the lacunae in providing mental health services. Methods: A needs‐based assessment was carried out of a community sample of 9,287 mothers with toddlers aged between 13 and 25 months in Kerala, India. This assessment was conducted by junior public health nurses using an indigenously developed checklist titled 'Screening checklist for Behavioural, Emotional and Rhythm‐related disturbances in Toddlers' (S‐BERT). Results: According to the mothers surveyed, 30.4% of toddlers had concerning or distress causing behaviours. Three factors, namely behavioural, rhythm‐related and emotional disturbances, were deemed significant when the item response theory was used to examine the factor structure of S‐BERT. Conclusion: This study suggests that behaviours that cause distress to mothers of toddlers are common, if queried specifically. Given the constraints in health resources as the cultural factors in operation, use of indigenous tools and principles of collaborative stepped care may be the way forward. [ABSTRACT FROM AUTHOR]

Community renewable energy (CRE) represents a growing empirical and academic turn towards community‐based sustainability and climate change interventions. This paper brings together postcolonial theory and CRE for the first time to outline fundamental tensions in the conceptualisation and application of the idea of community. The understanding of community within the CRE discourse is largely: (1) location‐based; and/or (2) a community of choice that is consciously opted into. Driven by postcolonial theory, this paper counterpoises both as a form of community as contract against an idea of community as solidarity. Its central thesis is that actually existing community, contrary to how the bulk of CRE literature commonly understands it, is a combination of bonds of solidarity and emergent purposes. The paper conceptualises community as fluid bonds of solidarity that align and realign differently around different purposes. [ABSTRACT FROM AUTHOR]

Objective: To estimate the pooled prevalence of smokeless tobacco consumption (STC) by gender and location in Bangladesh, India and Myanmar and to identify periodic changes in STC prevalence using data extracted from published studies.Methods: We searched for a combination of keywords in electronic databases and used a standard form to extract data from each article. We undertook a meta-analysis to estimate pooled prevalence and confidence intervals within these countries. To compare periodic changes in STC prevalence, we grouped studies into five-year periods (2000-2004, 2005-2009, 2010-2014 and 2015-2019).Results: The pooled estimates of STC prevalence were 25% (95% CI: 22-28%), 22% (95% CI: 15-28%) and 21% (95% CI: 14-28%) for Bangladesh, India and Myanmar, respectively. In pooled estimates across these countries, we found higher STC prevalence for men (30%; 95% CI: 24-35%) than women (16%; 95% CI: 10-23%) and for rural dwellings (24%; 95% CI: 18-31%) than urban dwellings (17%; 95% CI: 10-24%). We found significant decrease in STC in Bangladesh and India in the period 2010-2014 and 2015-2019, respectively. In Myanmar, STC prevalence increased significantly and substantially in 2010-2014, to levels higher than in Bangladesh and India.Conclusions: The prevalence of STC in Bangladesh, India and Myanmar is highest in rural areas and among men. Public health prevention strategies are needed to maintain decrease in STC in Bangladesh and India, and to reverse the increased use in Myanmar. [ABSTRACT FROM AUTHOR]

Objective: To synthesise the evidence for estimating the direct and indirect patient costs of drug-sensitive and drug-resistant tuberculosis care in India.Method: PubMed, Embase, Web of Science, IndMED and Google Scholar were searched for studies conducted in India between 2000 and 2018 and published in English. The search terms were "tuberculosis" AND "costs" (cost Analysis, economics, cost of illness, health care costs, health expenditures, direct service costs, catastrophic cost) AND "India". The cost of TB care was from the patient's perspective. Data regarding costs were extracted, indexed to the year 2018 using cumulative inflation rate and converted to US dollars at the exchange rate of 2018.Results: Thirteen studies were included in this review. The mean (unweighted) total cost incurred by patients being treated for drug-sensitive TB in a public health facility was $ 235.00 (SD- 222.10), and the median of means was $ 170.60 (range - 43.70-718.40). The mean direct cost was 45.5% of the total cost. Only one study, which was conducted in a private facility, reported the mean total cost for drug-resistant TB as $ 7778.04. Catastrophic cost (total cost ≥ 20% of the total annual household income) was experienced by 7% to 32.4% of drug-sensitive TB patients and by 68% of drug-resistant TB patients.Conclusion: Despite free diagnostic and treatment services provided under the Revised National Tuberculosis Control Programme, the patient cost of tuberculosis care is high. Relevant studies vary widely in methodology and cost reporting. [ABSTRACT FROM AUTHOR]

Objective: To discern and quantify the TB diagnostic cascade among patients registered under the Revised National TB Control Programme, Chennai city, Tamil Nadu, South India.Methods: This cross-sectional study was conducted in metropolitan Chennai from February 2017 to March 2018. We interviewed TB patients retrospectively on their diagnostic attempt in different health facilities.Results: Of 455 TB patients, only 4.4% received their diagnosis at their first health facility. Of 1250 visits to health facilities, the vast majority (79.4 vs. 20.6%) was in the public rather than the private sector. 56% of patients went to a public facility as the first point of care, of whom 1.6% shifted to private facilities subsequently. The remaining 54.4% shifted between up to five government health facilities. Male patients and those with a higher family income were more likely to shift from private to public.Conclusion: Most shifts between diagnostic facilities occurred in the public sector. This necessitates interventions at public health facilities for strengthening and extending services to TB patients at their first point of care. [ABSTRACT FROM AUTHOR]

Copyright of Irrigation & Drainage is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Les atteintes aux droits des travailleurs au sein des chaînes d'approvisionnement mondiales de la confection sont bien documentées aujourd'hui. En revanche, on ignore souvent que le problème tend à s'aggraver sous l'effet des politiques d'achat agressives de clients toujours plus puissants. L'exemple de filières indiennes montre que ces pressions se répercutent sur les salaires, qu'elles encouragent les formes de travail atypiques et qu'elles banalisent la violence verbale et physique à l'encontre des travailleurs. Pour l'auteur, la solution passe par l'adoption de mécanismes de fixation des prix qui tiennent compte des coûts du travail décent, un cadre législatif adapté et une plus large implication des travailleurs. [ABSTRACT FROM AUTHOR]

Résumé: Des études montrent que les indices des prix à la consommation (IPC) de type Laspeyres, plutôt calqués sur la structure des dépenses des ménages aisés, souffrent d'un biais ploutocratique. Les auteurs recherchent ce biais en Inde de 2012 à 2015, en construisant un indice démocratique qui met tous les ménages sur un pied d'égalité. Ils analysent la situation pour plusieurs sous‐indices (rural, urbain, régionaux), différentes fonctions de consommation et trois tranches de dépenses. Ils soulignent que le biais mis en évidence, qui pénalise les ménages et régions les plus pauvres, a des répercussions potentielles sur la politique monétaire et l'indexation des paiements de transfert. [ABSTRACT FROM AUTHOR]

Copyright of Irrigation & Drainage is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To assess the proportion and sales of unapproved Fixed Dose Combinations (FDCs) of anti-tubercular, antimalarial and antiretroviral medicines available on the Indian market.Methods: Available FDCs of anti-tubercular, antimalarial and antiretrovirals were screened against the Central Drugs Standard Control Organization (CDSCO) database of approved FDCs. The FDC sales information in the given categories was obtained from AIOCD AWACS PharmaTrac, a market database. FDCs available in India were also screened against the National List of Essential Medicines India 2015 and the Orange Book Database of products approved by USFDA.Results: Of 110 available first- to fourth-line anti-tubercular FDCs, only 32 were approved. Of 20 antimalarial FDCs available, eight were approved. However, almost 95% of available antiretroviral FDCs and branded products were approved. The sales volume of all anti-tubercular drugs was 730 million units of which 71% were unapproved, amounting to 14.30 billion rupees in sales value (58%). Almost half of the sales value and volume of antimalarials was generated by unapproved products. About 1% of sales volume of antiretroviral FDCs came from unapproved formulations, accounting for 5% of sales value.Conclusion: A large proportion of FDC formulations available in India has never been approved by CDSCO, hence raising the doubts about their safety and efficacy. An opaque regulatory framework and ambiguity over licensing powers have contributed to the problem. The rationality of unapproved FDCs should be reviewed and irrational formulations should be banned. [ABSTRACT FROM AUTHOR]

Objectives: Lymphatic filariasis (LF) elimination through mass drug administration (MDA) of DEC and albendazole have resulted in very low levels of infection in most endemic districts in India. But small pockets with residual microfilaraemia in the community and antigeneamia in children ('hotspots') are a cause of concern. We aimed to identify the determinants of such transmission hotspots and filarial infection in households using data from 33 communities.Methods: The filariasis vector Culex quinquefasciatus was collected from 627 randomly selected households using gravid traps. Parallel data on environmental, entomological, demographical, socio-economical and behavioural factors were analysed to identify the determinants of hotspots and household-level infection.Results: Hotspots and non-hotspots did not differ significantly in terms of socio-economical and behavioural aspects, but did differ in terms of demographical and environmental factors. Logistic regression revealed that tiled and concrete houses increased the risk of an area being a hotspot by 2.0 and 2.9 times respectively. Presence of Culex breeding habitats was significantly associated with elevated risk of being a hotspot. Proximity of U-drains to a house increased the risk of filarial infection 5.8 times.Conclusions: An environment suitable to Culex breeding influences continued transmission despite eight rounds of MDA, particularly in hotspots. Proximity to U-drains increases the risk of infection in households. Implementing localised vector control measures may help interrupt low-level transmission, thereby reducing the risk of resurgence in the absence of MDA. [ABSTRACT FROM AUTHOR]

Résumé: Les auteurs examinent l'effet des chocs de demande sur les ajustements d'effectifs dans les États indiens et le rôle en la matière de la législation protectrice de l'emploi (LPE). L'analyse repose sur des données de panel relatives au secteur manufacturier (2000–2012), les ajustements étant représentés par le taux de rotation du personnel. Elle montre que la LPE n'empêche pas les compressions d'effectifs: les taux de sortie, liés par une relation inverse à la rigueur de la LPE, réagissent plus fortement aux chocs de demande négatifs dans les États protecteurs. Les auteurs en concluent que la LPE sert l'intérêt des entreprises comme celui des travailleurs. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of diabetes mellitus (DM), assess its influence on health-related quality of life (HRQoL) among patients with TB.Methods: In this prospective study, eligible patients at three primary healthcare centres in urban slum region of south Delhi, India, underwent blood glucose screening at treatment initiation. HRQoL scores were determined by conducting face-to-face interviews using Dhingra and Rajpal (DR-12) scale at pre-treatment, end of intensive phase and end of the treatment.Results: In 316 patients, the overall DM prevalence was 15.8%, of whom 9.5% were known to have diabetes, and 6.3% were diagnosed at TB treatment initiation. DM was more common among patients of older age (P < 0.001), with higher BMI (P < 0.001), with PTB (P = 0.02) and with poor psychological status. HRQoL was significantly poor in the socio-psychological & exercise adaptation domain in patients with DM ˃50 years of age at each visit. Older age, poor literacy, loss in workdays, alcohol use and socio-economic status significantly predict poor HRQoL scores in patients with DM. Uncontrolled DM patients demonstrated poor HRQoL at the end of the intensive phase (P = 0.04) of treatment and at its completion (P = 0.03) compared to those with controlled DM.Conclusion: Addressing screening measures and glycaemic control along with social determinants such as literacy level and alcohol consumption could be an important means of improving the HRQoL of TB with DM patients. [ABSTRACT FROM AUTHOR]

Objective: This study examined associations between household sanitation and enteric infection - including diarrhoeal-specific outcomes - in children 0-2 years of age in a low-income, dense urban neighbourhood.Methods: As part of the MAL-ED study, 230 children in a low-income, urban, Indian neighbourhood provided stool specimens at 14-17 scheduled time points and during diarrhoeal episodes in the first 2 years of life that were analysed for bacterial, parasitic (protozoa and helminths) and viral pathogens. From interviews with caregivers in 100 households, the relationship between the presence (and discharge) of household sanitation facilities and any, pathogen-specific, and diarrhoea-specific enteric infection was tested through mixed-effects Poisson regression models.Results: Few study households (33%) reported having toilets, most of which (82%) discharged into open drains. Controlling for season and household socio-economic status, the presence of a household toilet was associated with lower risks of enteric infection (RR: 0.91, 95% CI: 0.79-1.06), bacterial infection (RR: 0.87, 95% CI: 0.75-1.02) and protozoal infection (RR: 0.64, 95% CI: 0.39-1.04), although not statistically significant, but had no association with diarrhoea (RR: 1.00, 95% CI: 0.68-1.45) or viral infections (RR: 1.12, 95% CI: 0.79-1.60). Models also suggested that the relationship between household toilets discharging to drains and enteric infection risk may vary by season.Conclusions: The presence of a household toilet was associated with lower risk of bacterial and protozoal enteric infections, but not diarrhoea or viral infections, suggesting the health effects of sanitation may be more accurately estimated using outcome measures that account for aetiologic agents. [ABSTRACT FROM AUTHOR]

Objective: To assess the rate of default from treatment in the visceral leishmaniasis (VL) elimination programme and to identify risk factors and its underlying causes.Methods: Case-control study conducted between December 2009 and June 2012 in three primary health centres (PHCs) of Muzaffarpur district, India. Patients who defaulted from treatment from the PHCs were considered as 'cases' and those who completed their treatment as 'controls'. Two controls were included in the study for each case. Respondents' opinion and satisfaction with the services provided at the PHCs were also elicited. Logistic regression was performed to assess the contribution of sociodemographic variables on patient status, and a discriminant analysis was used (after decomposing the original data) to identify factors that can predict the patient status as defaulter or not, based on factor scores of the components as predictor variables.Results: During the study period, 16.3% (89/544) of patients defaulted; 87 cases and 188 controls were interviewed through a semistructured questionnaire. Women tended to be more at risk for default (OR, 1.6, 95% CI (0.9 -2.9). Treatment received was miltefosine in 55.6% and sodium stibogluconate (SSG) in 44.4%. Most (86%) defaulters completed their treatment at other healthcare facilities; 70% of them preferred non-governmental institutions. Most cited reasons for default were seeking a second opinion for VL treatment and preferring to be treated in specialised VL centres. Discriminant analysis showed only one significant predictor: dissatisfaction with the medical care received in PHCs.Conclusion: Efforts are needed to enhance the quality of VL care at PHC level, which will be beneficial in increasing treatment completion rates. [ABSTRACT FROM AUTHOR]

Objective: In 2015, New Delhi witnessed a massive outbreak of Dengue virus (DENV) resulting in high morbidity and mortality. We report the molecular characterisation of the dominant circulating DENV strain to understand its evolution and dispersal.Materials and Methods: DENV infections were diagnosed by detection of IgM/NS1 antigen, and serotyping was performed by C-PrM PCR. Envelope gene was amplified, and variation(s) in envelope gene were analysed. Phylogenetic tree construction, time-based phylogeny and origin of DENV were analysed. Site-specific selection pressure of envelope gene variants was analysed.Results: Confirmed DENV infection was observed in 11.34% (32 of 282) cases, while PCR positivity for C-PrM region was observed in 54.16% (13 of 24) of NS1 antigen-positive cases. All samples belonged to serotype 2 and cosmopolitan genotype. Phylogenetic analysis using envelope gene revealed segregation of cosmopolitan genotype strains into specific lineages. The Indian strains clustered separately forming a distinct monophyletic lineage (lineage III) with a signature amino acid substitution viz., I162V and R288K. Selection pressure analysis revealed that 215D, 288R and 304K were positively selected sites. The rate of nucleotide substitution was 6.93 × 10-4 substitutions site-1 year-1 with time to most common ancestor was around 10 years with JX475906 (Hyderabad strain) and JN030345 (Singapore strain) as its most probable ancestor.Conclusion: We observed evolution of a distinct lineage of DENV-2 strains on the Indian subcontinent with possible changes in endemic circulating dengue strains that might give rise to more pathogenic strains. [ABSTRACT FROM AUTHOR]

Objective: Spoligotyping is a valuable genotyping tool to study the genetic diversity and molecular epidemiology of Mycobacterium tuberculosis (M. tb). The aim of this study was to analyse different spoligotype patterns of M. tb strains isolated from patients with tuberculosis from different parts of India.Materials and Methods: A total of 163 M. tb isolates were spoligotyped between January 2014 and January 2015. About 47% (n = 77) were from patients with extrapulmonary tuberculosis; of these, 10 were MDR, and seven were Pre-XDR. Of the 86 M. tb isolates from patients with pulmonary tuberculosis, 25 were MDR, and 25 were Pre-XDR.Results: We found 61 spoligo patterns, 128 clusters in the spoligotype data base (spoldb4 data base) with spoligo international type (SIT) number and 35 true unique isolates. The most pre-dominant spoligotype was EAI lineage (56), followed by Beijing (28), CAS (20), T(9), U(7), X(3), H(3), BOVIS_1 BCG(1) and LAM(1).Conclusion: Although our study identified EAI, CAS and Beijing strain lineages as pre-dominant, we also found a large number of orphan strains (20%) in our study. Beijing strains were more significantly associated with MDR TB than CAS and EAI lineages. Further studies on large sample sizes would help to clearly describe the epidemiology of M. tb in India. [ABSTRACT FROM AUTHOR]

Objective: To estimate the national costs relating to diarrhoea and acute respiratory infections from not handwashing with soap after contact with excreta and the costs and benefits of handwashing behaviour change programmes in India and China.Methods: Data on the reduction in risk of diarrhoea and acute respiratory infection attributable to handwashing with soap were used, together with World Health Organization (WHO) estimates of disability-adjusted life years (DALYs) due to diarrhoea and acute respiratory infection, to estimate DALYs due to not handwashing in India and China. Costs and benefits of behaviour change handwashing programmes and the potential returns to investment are estimated valuing DALYs at per capita GDP for each country.Results: Annual net costs to India from not handwashing are estimated at US$ 23 billion (16-35) and to China at US$ 12 billion (7-23). Expected net returns to national behaviour change handwashing programmes would be US$ 5.6 billion (3.4-8.6) for India at US$ 23 (16-35) per DALY avoided, which represents a 92-fold return to investment, and US$ 2.64 billion (2.08-5.57) for China at US$ 22 (14-31) per DALY avoided - a 35-fold return on investment.Conclusion: Our results suggest large economic gains relating to decreases in diarrhoea and acute respiratory infection for both India and China from behaviour change programmes to increase handwashing with soap in households. [ABSTRACT FROM AUTHOR]

Objective: To identify gaps in the use of HIV prevention and care services and commodities for female sex workers, we conducted a baseline cross-sectional survey in four cities, in the context of an implementation research project aiming to improve use of sexual and reproductive health services.Methods: Using respondent-driven sampling, 400 sex workers were recruited in Durban, 308 in Tete, 400 in Mombasa and 458 in Mysore and interviewed face-to-face. RDS-adjusted proportions were estimated by nonparametric bootstrapping and compared across cities using post hoc pairwise comparison.Results: Condom use with last client ranged from 88.3% to 96.8%, ever female condom use from 1.6% to 37.9%, HIV testing within the past 6 months from 40.5% to 70.9%, receiving HIV treatment and care from 35.5% to 92.7%, care seeking for last STI from 74.4% to 87.6% and having had at least 10 contacts with a peer educator in the past year from 5.7% to 98.1%. Many of the differences between cities remained statistically significant (P < 0.05) after adjusting for differences in FSWs' socio-demographic characteristics.Conclusion: The use of HIV prevention and care by FSWs is often insufficient and differed greatly between cities. Differences could not be explained by variations in socio-demographic sex worker characteristics. Models to improve use of condoms and HIV prevention and care services should be tailored to the specific context of each site. Programmes at each site must focus on improving availability and uptake of those services that are currently least used. [ABSTRACT FROM AUTHOR]

Enteric fever is a major cause of morbidity and mortality in tropical areas worldwide. The Indian subcontinent bears the brunt of the disease, both in terms of absolute case numbers and drug-resistant strains. Recent phylogenetic studies suggest that the multidrug-resistant clade H58 originated in India and subsequently expanded through Asia and Africa. In Africa, it caused unrecognised outbreaks in areas previously considered free of the disease. In this study, we discuss the current status of enteric fever in India, the factors preventing its control and its future directions in this rapidly developing nation. [ABSTRACT FROM AUTHOR]

The extension of social protection to all has become a central policy objective, both nationally and internationally. A considerable number of middle- and low-income countries have undertaken substantial efforts to extend social protection, while the international community reaffirmed its commitment to the extension of social protection through the adoption of the ILO Recommendation concerning National Floors of Social Protection, No. 202 (2012). This article reviews the legal provisions and the implementation of the Indian Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), legislated in 2005, and does so in the light of the more recent provisions of ILO Recommendation No. 202. Since its introduction ten years ago, MGNREGA has provided a source of income to rural workers, increased wage rates, achieved high female participation rates and created durable assets. India's local governance bodies, Panchayati Raj Institutions (PRI), have been empowered and involved in the processes of planning and monitoring. However, despite successes, there have been considerable shortcomings in implementation. This article highlights two central themes: first, the innovative policy framework of the Act, which brings together rights-based entitlements, demand-driven employment, and citizen-centred monitoring. Second, it assesses the accessibility and adequacy of benefits in the implementation of MGNREGA. We conclude that MGNREGA offers potential for South-South learning, both in terms of policy-design and implementation. [ABSTRACT FROM AUTHOR]

Résumé T. S. Papola est l'un des membres fondateurs du Comité de rédaction de la Revue internationale du Travail, constitué en 2007. Il est aussi et surtout une figure de l'économie du travail en Inde, et ses travaux novateurs lui ont valu une large reconnaissance internationale. Au lendemain de sa disparition, en novembre 2015, l'auteur revient dans cet hommage sur certains aspects saillants de son œuvre, en s'appuyant sur les connaissances qu'il a pu rassembler à son contact. [ABSTRACT FROM AUTHOR]

Résumé En Inde, l'activité féminine recule depuis le milieu des années 2000, et l'évolution du Kerala, Etat autrefois exemplaire en la matière, est particulièrement défavorable. L'auteure examine la variation des taux d'activité et d'emploi des femmes au Kerala entre 2004 et 2012 en tenant compte du revenu du ménage, de l'âge, du niveau d'instruction et de la profession. Le désengagement de femmes plutôt jeunes, instruites, pouvant viser des postes au plus haut niveau, suggère un effet du travailleur découragé, encore renforcé par l'écart salarial croissant entre les sexes dans les professions les plus prestigieuses, aux dépens des particularités historiques du marché du travail du Kerala. [ABSTRACT FROM AUTHOR]

Objective Combination antiretroviral therapy ( ART) has improved in efficacy, durability and tolerability. Virological efficacy studies in India are limited. We determined incidence and predictors of virological failure among patients initiating first-line ART and described virological resuppression after confirmed failure, with the goal of informing national policy. Methods Therapy-naïve patients initiated on first-line ART as per national guidelines were monitored every 3 months for adherence and virological response over 2 years. Genotyping on baseline samples was performed to assess primary drug resistance. Multivariate Cox regression analysis was used to assess predictors of virological failure. Results Virological failure rate among 599 eligible patients was 10.7 failures per 100 person-years. Cumulative failure incidence was 13.2% in the first year and 16.5% over 2 years. Patients initiated on tenofovir had a significantly lower rate of virological failure than those on stavudine or zidovudine (6.7 vs. 11.9 failures per 100 person-years, P = 0.013). Virological failure was independently associated with age <40 years, mean adherence <95%, non-tenofovir-containing regimens and presence of primary drug resistance. In a subset of 311 patients who were reassessed after treatment failure, 19% (11/58) patients resuppressed their viral load to <400 copies/ml after confirmed virological failure. Conclusions Our results support the inclusion of tenofovir as first-line ART in resource-limited settings and a role for regular adherence counselling and virological monitoring for enhanced treatment success. Detection of early virological failure should provide an opportunity to augment adherence counselling and repeat viral load testing before therapy switch is considered. [ABSTRACT FROM AUTHOR]

Objectives To examine the uses, cost and quality of care of traditional healing for short-term morbidities and major morbidities in India and to compare them with the non-traditional healing. Methods We used data from a nationally representative survey, the India Human Development Survey (2004-2005) and descriptive as well as bivariate analyses for the examination. Results Use of traditional healing is much less common than use of non-traditional healing in both rural and urban areas and across all socio-economic and demographic characteristics; it is slightly more common in rural than urban areas for short-term morbidities. Use of traditional healing is relatively more frequent for cataract (especially in rural areas), leprosy, asthma, polio, paralysis, epilepsy and mental illnesses; its total cost of care and mean waiting time (in the health facility) are substantially lower than for non-traditional healing. Among patients who use both traditional and non-traditional healing, a relatively higher proportion use traditional healing complemented by non-traditional healing for short-term illnesses, but vice versa for major morbidities. Conclusion This is the first study which has investigated at the national level the uses, complementarities, cost and quality aspects of traditional and non-traditional healing in India. Traditional healing is more affordable and pro-poor. Relatively higher use of traditional healing in patients from poorly educated as well as poor households and suffering from diseases, such as, epilepsy and mental illnesses; and higher demand for traditional healing for the above diseases highlight the need for research/policy reorientation in India. [ABSTRACT FROM AUTHOR]

Résumé S'il est notoire que le non-respect du droit du travail est monnaie courante dans les pays en développement, on n'a guère d'éléments précis sur son ampleur. Les auteurs ont quantifé les violations de la loi indienne sur les établissements industriels: les entreprises contrevenantes sont le double de celles qui respectent la législation, mais aussi bien plus nombreuses que celles qui l'évitent. Ainsi ce non-respect est-il une caractéristique du «segment intermédiaire manquant» en Inde. Les auteurs explorent les grandes tendances et les modalités de ces violations et montrent les pistes à suivre par la recherche et pour l'action. [ABSTRACT FROM AUTHOR]

OBJECTIVE To evaluate an insurance awareness campaign carried out before the launch of three community-based health insurance (CBHI) schemes in rural India, answering the questions: Has the awareness campaign been successful in enhancing participants' understanding of health insurance? What awareness tools were most useful from the participants' point of view? Has enhanced awareness resulted in higher enrolment? METHODS Data for this analysis originates from a baseline survey (2010) and a follow-up survey (2011) of more than 800 households in the pre- and post-campaign periods. We used the differencein- differences method to evaluate the impact of awareness activities on insurance understanding. Assessment of usefulness of various tools was carried out based on respondents' replies regarding the tool(s) they enjoyed and found most useful. An ordinary least square regression analysis was conducted to understand whether insurance knowledge and CBHI understanding are related with enrolment in CBHI. RESULTS The intervention cohort demonstrated substantially higher understanding of insurance concepts than the control group, and CBHI understanding was a positive determinant for enrolment. Respondents considered the 'Treasure-Pot' tool (an interactive game) as most useful in enhancing awareness to the effects of insurance. CONCLUSIONS We conclude that awareness-raising is an important prerequisite for voluntary uptake of CBHI schemes and that interactive, contextualised awareness tools are useful in enhancing insurance understanding. [ABSTRACT FROM AUTHOR]

OBJECTIVES India is the most malaria-endemic country in South-East Asia, resulting in a high socioeconomic burden. Insecticide-treated or untreated nets are effective interventions to prevent malaria. As part of an Indian first-aid guideline project, we aimed to investigate the magnitude of this effect in India. METHODS We searched MEDLINE, Embase and Central to systematically review Indian studies on the effectiveness of treated or untreated vs. no nets. Parasite prevalence and annual parasite incidence served as malaria outcomes. The overall effect was investigated by performing meta-analyses and calculating the pooled risk ratios (RR) and incidence rate ratios. RESULTS Of 479 articles, we finally retained 16 Indian studies. Untreated nets decreased the risk of parasite prevalence compared to no nets [RR 0.69 (95% CI; 0.55, 0.87) in high-endemic areas, RR 0.49 (95% CI; 0.28, 0.84) in low-endemic areas], as was the case but more pronounced for treated nets [RR 0.35 (95% CI; 0.26, 0.47) in high-endemic areas, risk ratio 0.16 (95% CI; 0.06, 0.44) in low-endemic areas]. Incidence rate ratios showed a similar observation: a significantly reduced rate of parasites in the blood for untreated nets vs. no nets, which was more pronounced in low-endemic areas and for those who used treated nets. The average effect of treated nets (vs. no nets) on parasite prevalence was higher in Indian studies (RR 0.16-0.35) than in non-Indian studies (data derived from a Cochrane systematic review; RR 0.58-0.87). CONCLUSIONS Both treated and untreated nets have a clear protective effect against malaria in the Indian context. This effect is more pronounced there than in other countries. [ABSTRACT FROM AUTHOR]

Objective To investigate associations between background characteristics (psychosocial adversity, risk behaviours/perception of risk and HIV-related knowledge, perceptions and beliefs) and psychological and cognitive morbidity among people coming for testing for HIV/ AIDS in Goa, India. Methods Analysis of cross-sectional baseline data (plus HIV status) from a prospective cohort study. Participants were recruited at the time of coming for HIV testing. Results Consistent with associations found among general population samples, among our sample of 1934 participants, we found that indicators of psychosocial adversity were associated with CMD (common mental disorder - major depression, generalised anxiety and panic disorder) among people coming for testing for HIV. Similarly, perpetration of intimate partner violence was associated with AUD (alcohol use disorder). Two STI symptoms were associated with CMD, and sex with a non-primary partner was associated with AUD. Suboptimal knowledge about HIV transmission and prevention was associated with low cognitive test scores. In contrast with other studies, we found no evidence of any association between stigma and CMD. There was no evidence of modification of associations by HIV status. Conclusions Among people coming for testing for HIV/ AIDS in Goa, India, we found that CMD occurred in the context of social and economic stressors (violence, symptoms of STI, poor education and food insecurity) and AUD was associated with violence and risky sexual behaviour. Further research is necessary to understand the role of gender, stigma and social norms in determining the relationship between sexual and mental health. Understanding associations between these background characteristics and psychological morbidity may help inform the design of appropriate early interventions for depression among people newly diagnosed HIV/ AIDS. [ABSTRACT FROM AUTHOR]

Objective To describe spatial and temporal profiles of Road Traffic Injuries (RTIs) on different road networks in Vellore district of southern India. Methods Using the information in the police maintained First Information Reports ( FIRs), daily time series of RTI counts were created and temporal characteristics were analysed with respect to the vehicle, road types and time of the day for the period January 2005 to May 2007. Daily incidence and trend of RTIs were estimated using a Poisson regression analysis. Results Of the reported 3262 RTIs, 52% had occurred on the National Highway ( NH). The overall RTI rate on the NH was 8.8/100 000 vehicles per day with significantly higher pedestrian involvement. The mean numbers of RTIs were significantly higher on weekends. Thirteen percentage of all RTIs were associated with fatalities. Hotspots are major town junctions, and RTI rates differ over different stretches of the NH. Conclusion In India, FIRs form a valuable source of RTI information. Information on different vehicle profile, RTI patterns, and their spatial and temporal trends can be used by administrators to devise effective strategies for RTI prevention by concentrating on the high-risk areas, thereby optimising the use of available personnel and resources. [ABSTRACT FROM AUTHOR]

Résumé Dans un contexte de déclin des institutions traditionnelles des relations professionnelles dans les économies postfordistes, les auteurs examinent les mouvements qui apparaissent face à la mondialisation pour défendre les travailleurs des pays en développement, notamment en Asie. Depuis les luttes identifiées comme marxiennes en Chine jusqu'aux formes les plus variées de représentation et de protestation observées en Inde, ces mouvements appellent une approche plus inclusive des relations professionnelles, dans la pratique comme dans la recherche. L'avenir sera façonné par la rencontre des réformes venant du sommet et des mouvements sociaux spontanés qui comblent le vide existant en matière de représentation. [ABSTRACT FROM AUTHOR]

Objectives This paper reports the first trial of Lot Quality Assurance Sampling ( LQAS) assessing associations between access to LQAS data and subsequent improvements in district programming. This trial concerns India's approach to addressing an increase in malaria-attributable deaths by training community health workers to diagnose, treat and prevent malaria, while using LQAS to monitor sub-district performance and make programme improvements. Methods The Ministry of Health introduced LQAS into four matched high malaria burden districts (Annual Parasite Incidence >5) ( N > 5 million). In each sub-district, we sampled four populations in three 6-monthly surveys: households, children <5 years, people with fever in the last 2 weeks and community health workers. In three districts, trained local staff collected, analysed and used data for programme management; in one control district, non-local staff collected data and did not disseminate results. For eight indicators, we calculated the change in proportion from survey one to three and used a Difference-in-Differences test to compare the relative change between intervention and control districts. Results Coverage increased from survey one to three for 24 of 32 comparisons. Difference-in-Differences tests revealed that intervention districts exhibited significantly greater change in four of six vertical strategies (insecticide treated bed-nets and indoor residual spraying), one of six treatment-seeking behaviours and four of 12 health worker capacity indicators. The control district displayed greater improvement than two intervention districts for one health worker capacity indicator. One district with poor management did not improve. Conclusions In this study, LQAS results appeared to support district managers to increase coverage in underperforming areas, especially for vertical strategies in the presence of diligent managers. [ABSTRACT FROM AUTHOR]

Résumé Le débat sur la flexibilisation du marché du travail indien porte notamment sur l'autorisation administrative de licenciement pour les entreprises de plus de 100 salariés. Le plaidoyer en faveur de sa suppression (ou de l'élévation du seuil) est étayé par Basu, Fields et Debgupta (2009). L'auteur conteste leur argumentation théorique en faveur de l'embauche et du licenciement au gré de l'employeur, avec libre signature d'un contrat, et démontre que leur conclusion politique est logiquement insoutenable, même dans le cadre de leur modèle. Le plaidoyer pour la flexibilisation du marché du travail et la liberté contractuelle s'en trouve infondé. [ABSTRACT FROM AUTHOR]

Objective To assess reproductive risk factors for anaemia among pregnant women in urban and rural areas of India. Method The International Institute of Population Sciences, India, carried out third National Family Health Survey in 2005-2006 to estimate a key indicator from a sample of ever-married women in the reproductive age group 15-49 years. Data on various dimensions were collected using a structured questionnaire, and anaemia was measured using a portable HemoCue instrument. Anaemia prevalence among pregnant women was compared between rural and urban areas using chi-square test and odds ratio. Multinomial logistic regression analysis was used to determine risk factors. Results Anaemia prevalence was assessed among 3355 pregnant women from rural areas and 1962 pregnant women from urban areas. Moderate-to-severe anaemia in rural areas (32.4%) is significantly more common than in urban areas (27.3%) with an excess risk of 30%. Gestational age specific prevalence of anaemia significantly increases in rural areas after 6 months. Pregnancy duration is a significant risk factor in both urban and rural areas. In rural areas, increasing age at marriage and mass media exposure are significant protective factors of anaemia. However, more births in the last five years, alcohol consumption and smoking habits are significant risk factors. Conclusion In rural areas, various reproductive factors and lifestyle characteristics constitute significant risk factors for moderate-to-severe anaemia. Therefore, intensive health education on reproductive practices and the impact of lifestyle characteristics are warranted to reduce anaemia prevalence. [ABSTRACT FROM AUTHOR]

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Objective Non-communicable diseases (NCD) are on the increase in low-income countries, where healthcare costs are paid mostly out-of-pocket. We investigate the financial burden of NCD vs. communicable diseases (CD) among rural poor in India and assess whether they can afford to treat NCD. Methods We used data from two household surveys undertaken in 2009-2010 among 7389 rural poor households (39 205 individuals) in Odisha and Bihar. All persons from the sampled households, irrespective of age and gender, were included in the analysis. We classify self-reported illnesses as NCD, CD or 'other morbidities' following the WHO classification. Results Non-communicable diseases accounted for around 20% of the diseases in the month preceding the survey in Odisha and 30% in Bihar. The most prevalent NCD, representing the highest share in outpatient costs, were musculoskeletal, digestive and cardiovascular diseases. Cardiovascular and digestive problems also generated the highest inpatient costs. Women, older persons and less-poor households reported higher prevalence of NCD. Outpatient costs (consultations, medicines, laboratory tests and imaging) represented a bigger share of income for NCD than for CD. Patients with NCD were more likely to report a hospitalisation. Conclusion Patients with NCD in rural poor settings in India pay considerably more than patients with CD. For NCD cases that are chronic, with recurring costs, this would be aggravated. The cost of NCD care consumes a big part of the per person share of household income, obliging patients with NCD to rely on informal intra-family cross-subsidisation. An alternative solution to finance NCD care for rural poor patients is needed. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the performance of a single determination of HIV viral load (VL) 6-12 months after starting antiretroviral therapy (ART) for identifying patients who will subsequently develop virological failure. Methods We selected HIV-infected patients with at least two VL determinations after 6 months of ART from an HIV cohort study in India. Patients were divided in two groups depending on whether the first VL was below (Group 1) or above (Group 2) 1000 copies/ml. Cut-off for virological failure was defined according to World Health Organization recommendation (>5000 copies/ml). Results The study included 584 patients and 560.1 person-years of follow-up. Of all virological failures, 83% were diagnosed at the first VL determination. The cumulative incidence of virological failure after 1 and 2 years since the first VL was 0.9% [95% confidence interval (CI), 0.3-2.7] and 1.7% (95% CI, 0.6-5), respectively, for Group 1, and 58.2% (95% CI, 47-69.7) and 63.1% (95% CI, 49.8-76.4), respectively, for Group 2. Compared with Group 1, patients from Group 2 had a hazard ratio for virological failure of 78.3 (95% CI, 27.8-220.2). Conclusions A single VL determination after 6 months of ART was able to identify patients with high risk of virological failure. [ABSTRACT FROM AUTHOR]

Objective To compare two commercially available kits, Japanese Encephalitis-Dengue IgM Combo ELISA (Panbio Diagnostics) and JEV-CheX IgM capture ELISA (XCyton Diagnostics Limited), to a reference standard (Universiti Malaysia Sarawak – Venture Technologies VT ELISA). Methods Samples were obtained from 172/192 children presenting to a site in rural India with acute encephalitis syndrome. Results Using the reference VT ELISA, infection with Japanese encephalitis virus (JEV) was confirmed in 44 (26%) patients, with central nervous system infection confirmed in 27 of these; seven patients were dengue seropositive. Of the 121 remaining patients, 37 (31%) were JEV negative and 84 (69%) were JEV unknown because timing of the last sample tested was <10 day of illness or unknown. For patient classification with XCyton, using cerebrospinal fluid alone (the recommended sample), sensitivity was 77.8% (59.2–89.4) with specificity of 97.3% (90.6–99.2). For Panbio ELISA, using serum alone (the recommended sample), sensitivity was 72.5% (57.2–83.9) with specificity of 97.5% (92.8–99.1). Using all available samples for patient classification, sensitivity and specificity were 63.6% (95% CI: 48.9–76.2) and 98.4% (94.5–99.6), respectively, for XCyton ELISA and 75.0% (59.3–85.4) and 97.7% (93.3–99.2) for Panbio ELISA. Conclusion The two commercially available ELISAs had reasonable sensitivities and excellent specificities for diagnosing JEV. [ABSTRACT FROM AUTHOR]

Accurate diagnosis is the key to effective treatment and control of malaria. We screened 180 microscopically diagnosed Indian malaria-positive blood samples for pure and mixed infections by Plasmodium falciparum and Plasmodium vivax. An unusually high proportion of mixed infections was detected, signifying the sensitivity of PCR assay over traditional microscopic diagnosis. [ABSTRACT FROM AUTHOR]

Vu le vieillissement rapide de la population indienne, la migration des régions rurales et la concentration continue de la population active dans le secteur informel, il est nécessaire de prendre des mesures concrètes afin d'assurer la sécuritééconomique des personnes âgées. Ces dernières courent, d'ailleurs, un risque accru d'être pauvres ou de tomber dans la pauvreté en raison de l'effritement des liens familiaux traditionnels qui sont essentiels pour leur garantir un minimum de sécurité ainsi que de l'augmentation de la longévité qui entraîne une hausse des dépenses pour leurs soins. Parallèlement aux efforts déployés pour s'attaquer à ce problème, le gouvernement indien et certains Etats de l'Inde ont lancé une série de programmes visant à fournir à la grande majorité des Indiens des services de soins de santé et d'assurance maladie auxquels ils n'ont pas suffisamment accès. Bien que les travailleurs du secteur structuré jouissent d'une plus grande sécurité sociale que ceux du secteur informel, ils ne représentent qu'une faible part de la population active. Les femmes sont, quant à elles, extrêmement vulnérables à l'insécuritééconomique. L'expérience indienne sert de leçon à d'autres pays. Quoiqu'il y ait de la place pour des initiatives privées dans le domaine de la sécurité sociale, force est de constater que la plupart d'entre elles devront être financées par l'impôt. Même si la plus grande partie du financement provient de sources publiques, les prestataires privés jouent un rôle considérable, mais ils seront confrontés à des défis plus importants à mesure qu'un plus grand nombre de personnes demanderont des prestations. L'Inde a également montré que les Etats peuvent souvent mener à bien la mise en œuvre de mesures financées par le gouvernement central, avec bien sûr des avantages et des inconvénients propres à une telle décentralisation. Enfin, la pratique indienne peut éclairer des questions comme le ciblage, l'utilisation des technologies de l'information dans les systèmes de sécurité sociale et la gestion des ressources humaines. [ABSTRACT FROM AUTHOR]