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Organ donation following circulatory determination of death (DCDD) has contributed significantly to the donor pool in several countries, without compromising the outcomes of transplantation or the number of donations following brain death (BD). In India, majority of deceased donations happen following BD. While existing legislation allows for DCDD, there have been only a few reports of kidney transplantation following DCDD from the country. This document, prepared by a multi-disciplinary group of experts, reviews the international best practices in DCDD and outlines the path for furthering the same in India. The ethical, medical, legal, economic, procedural, and logistic challenges unique to India for all types of DCDD based on the Modified Maastricht Criteria have been addressed. India follows an opt-in system for organ donation that does not allow much scope for uncontrolled DCDD categories I and II. The practice of withdrawal of life-sustaining treatment (WLST) in India is in its infancy. The process of WLST, laid down by the Supreme Court of India, is considered time-consuming, possible only in patients in a permanent vegetative state, and considered too cumbersome for day-to-day practice. In patients where continued medical care is determined to be futile following detailed and repeated assessment, the procedure for WLST, as laid down and published by Vidhi Centre for Legal Policy in conjunction with leading medical experts is described. In controlled DCDD (category-III), the decision for WLST is independent of and delinked from the subsequent possibility of organ donation. Once families are inclined toward organ donation, they are explained the procedure including the timing and location of WLST, consent for antemortem measures, no-touch period, and the possibility of stand down and return to the intensive care unit without donation. While donation following neurologic determination of death (DNDD) is being increasingly practiced in the country, there are instances where the cardiac arrest occurs during the process of declaration of BD, before organ retrieval has been done. Protocol for DCDD category-IV deals with such situations and is described in detail. In DCDD category V, organ donation may be possible following unsuccessful cardiopulmonary resuscitation of cardiac arrest in the intensive care. An outline of organ-specific requisites for kidney, liver, heart, and lung transplantation following DCDD and the use of techniques such as normothermic regional perfusion and ex vivo machine perfusion has been provided. With increasing experience, the outcomes of transplantation following DCDD are comparable to those following DBDD or living donor transplantation. Documents and checklists necessary for the successful execution of DCDD in India are described. [ABSTRACT FROM AUTHOR]

Podcasts are a unique media that have been used in Indigenous and endangered language communities in the form of Indigenous radio podcasts, instructional websites, or tools to aid classroom instruction. A podcast called Rituals of Kanauji speakers was created in Kanauji, a low-resource Indian language variety. Using this case study in Kanauji, I aim to examine the usage of podcasts for outside classroom instruction in low-resource and lesser-studied languages. Thus, this study highlights the uniqueness of podcasting for language revitalization, as podcasts can be created and consumed anytime and anywhere. For low-resource languages, there can be three kinds: podcasts for teaching language, those for cultural expression and general awareness, and those for entertainment purposes. The paper also describes their pros and cons as well as directions for creating a podcast, to help native speakers and linguists in their future documentary projects. Remote data collection of audio recordings was done via WhatsApp for making this podcast. The performance statistics from Kanauji's podcast demonstrate that it has helped promote the language and brought pride and prestige to native speakers. Finally, I conclude that podcasts break the norm and help in language reclamation.

As the discipline of language documentation and description evolves, so do the expectations placed on researchers. Current trends emphasize collaborative efforts that prioritize tangible contributions to the community, such as a pedagogical grammar, dictionary, or collection of texts. Some argue that for unwritten languages orthography development is imperative so that materials prepared by the researcher (perhaps in collaboration with the community) are accessible to speakers. In light of the current discussions of methodology and ethical issues related to endeavors to document and describe the world's languages, this paper explores the challenges faced by a single researcher (the author) working on a single language (Darma) within a multilingual setting (in India). This project emphasizes ethnographic and discourse-centered research methodologies which reveal language ideologies that are discussed here to demonstrate that while orthography development is a reasonable objective in many cases, one must be sensitive to a variety of interconnecting issues including history, social relationships, language ideology, and local politics associated with writing and education. While orthography development has not been a viable option in the "Darma Documentation and Description Project," it is nevertheless a matter that needs to be addressed for the benefit of the community as well as ongoing discussions of methodology and best practices in linguistic and anthropological research.

Diversity, flexibility, easy accessibility, broad continuing acceptance in developing countries and increasing popularity in developed countries, relative low cost, low levels of technological input, relative low side effects, and growing economic importance are some of the positive features of traditional medicine. In rural India, traditional medicine continues to be the only available form of care. Many communities continue to treat patients using their old methods, unaffected by contemporary medical advancements. Due to their accessibility, affordability, and ease of use, tribal tribes prefer to utilize and consult their own traditional healers. These are likewise thought to be highly effective and without any adverse effects. This paper aims to identify various traditional medicines used for treating illness and infirmities, by taking accounts from the residents of Chungtlang village, Mamit District, Mizoram. The objective here lies in discovering traditional knowledge of medicinal plants and their uses for various infirmities. [ABSTRACT FROM AUTHOR]

Background: The Knowledge Network project was launched in 2010 to build evidence on the HIV epidemic by using the data generated by HIV programme implementing organisations in India. This paper describes the implementation of the programme and the strategies adopted to enhance the capacity of individuals to document and publish HIV prevention programme learnings. Further, it discusses the outcomes of the initiative.Methods: A multipronged approach was adopted, where a group of experts were brought together to collaborate with programme implementing organisations, review available data, develop research questions and guide peer-reviewed publications. Further, scientific writing courses were conducted to support individuals from HIV programme implementing organisations as well as educational and government organisations (mentees) to build the documentation capacity of individuals leading programme implementation and current and future researchers. The impact and quality of evidence generated was measured by examining the number of papers published, the number of citations, and the number of papers with at least 10 citations. Additionally, course participants' responses to open-ended questions in the anonymous course evaluation questionnaires are presented as verbatim quotes.Results: Overall, 99 papers on HIV programmatic learnings from India were finalised under the programme, of which 95 have been published. In all, 67 papers were co-authored by mentees. Most papers were published in high-impact factor (1 or more) journals and 72% were cited at least once in the literature. The main themes documented include key populations' HIV risk, HIV risk of general population groups, HIV/STI service delivery models and community mobilisation interventions.Conclusion: The study demonstrates that an integrated approach, involving partnership, capacity-building and mentorship, can maximise the use of available data and build the evidence base on HIV programmatic learnings. The capacity-building model adopted in the programme can be used to build scientific writing and documentation capacity in other public health programmes that are implemented at scale. [ABSTRACT FROM AUTHOR]

The purpose of this article was to explore the pattern of publications, using bibliometric analysis, of Journal of Documentation for the period of 2005 to 2018. The results of the study shows that a total of 687 articles were published in the 14 years period from 2005 to 2018, with 71 (10.3%) articles being published the highest total in the year 2018. The study confirmed that the maximum number of articles i.e. 304 (43.9%), were published by single authors, out of which, a large number were on research articles. Out of total number of articles published 228 (33.1%) were 16-20 pages in length. Volume number 74 in 2018 had the highest number of citations with a total of 91 (13.6%). In addition, the study confirmed that the highest number of articles were research articles with a total of 493 (71.7), while others were case studies, conceptual studies, literature reviews, viewpoints and technical papers and short communications, etc. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a research study in Thane District, Maharashtra, India, on access to sexual and reproductive health and rights (SRHR) for women and girls of Nomadic and Denotified Tribes (NT-DNT). NT-DNT communities face stigma and violence due to their historically criminalised status and nomadic lifestyle. Their precarious legal, social, and economic status has a negative impact on women's SRHR. Existing literature on this subject is sparse, and studies by researchers from within the community, which could bring about organic and community-led change, are almost non-existent. This study, carried out by a woman from a Nomadic Tribe, presents an insider's perspective on the experiences of and factors underlying the violation of the SRHR of girls and women of NT-DNT communities. The study used a human rights-based participatory methodology with qualitative methods including three focus group discussions with 21 women and 10 in-depth interviews with women and key informants from NT-DNT communities. The findings describe the gender, community, and health system barriers which hinder women's and girls' access to SRHR. Issues such as language barriers between the women and medical fraternity, criminalisation by the police, and extreme deprivation – more intense than faced by the general poor – are unique to women of these communities. The NT-DNT communities face extreme deprivation of basic resources such as identity documents, shelter, sanitation, education support, workplace safety, and transportation, which further deny women their sexual and reproductive rights. The paper aims to amplify these women's voices to advocate for better SRHR services for women and girls of NT-DNT communities. [ABSTRACT FROM AUTHOR]

Located in the Northern State of Punjab, the historic city of Patiala has always been a centre of culture in north India, and has seen the evolution of its own distinct style of architecture with Rajput and Mughal influences. The city is renowned for its rich architectural heritage, Music, Craft, Sports and Cuisine. The fourth Maharaja Narinder Singh was a great patron of art, architecture and music and it was during his time that several palaces like the Moti Bagh Palace, Sheesh Mahal and Banasur Bagh were designed followed by Baradari Palace. Later it was Maharaja Bhupinder Singh (1900-1938) who made Patiala State famous with his lavish lifestyle.This paper describes the process followed for Documentation and condition assessment of the historic Sheesh Mahal & Char Bagh Complex in order to restore and revitalise the palace building and the Mughal garden. The exercise included Archival research, Field surveys, Condition Mapping, inventories using traditional methods as well as GIS and preparation of restoration & conservation solutions along with post conservation management manual. The Major challenges encountered were identifying the correct documentation methodology for mapping as well as managing the large database generated on site. The Documentation and Mapping was used as a significant tool to guide towards the conservation and Management strategy of the complex. [ABSTRACT FROM AUTHOR]

Audiovisual (AV) recording of the informed consent process in a clinical or vaccine trial to document the consent process of participants (especially from vulnerable populations), ensures preservation of their rights and well-being. This paper describes the AV consent process during a phase III rotavirus vaccine trial among healthy infants in Chandigarh and examines its effects. Out of 155 parents/guardians of participating infants who were contacted to be a part of the study, 50 were reluctant to participate in the study trial (not necessarily in the AV consenting process). Among 105 parents/guardians of participating infants who expressed initial willingness to participate in the trial, all agreed to undergo the AV consenting process; and 100 finally consented to participate and were enrolled in the study. So, the participation rate was 64.5% (100/155) among those who were contacted, and 95.2% (100/105) among those who underwent AV consenting process. AV recordings of these 100 patient representatives were transcribed and later translated into English for a thematic analysis of the text. A total of 105 queries were raised by 55 participants. All queries were patiently listened to and addressed, allaying most fears, especially those related to adverse events following intervention. The AV process ensured transparency and accountability of the investigators, responsive referral mechanism in case of adverse events, building an initial rapport with the participant, complete vaccination of the trial subjects, and provision for free private care consultation depending upon the willingness of the parents. These benefits of the AV consent process might have led to a higher participation rate.

Background: Medical record keeping is a systematic method of documentation of a single patient's medical history and treatment record over time). It is crucial from multiple perspectives: patients, health care providers, medical research, etc. Conventinally, these records have been made with pen and paper. However, recent advances have led to the development of e-health record systems (EHRS). Objective: The primary objective is to describe our experiences at NeuroGen, where we have used all methods of patient documentation including traditional paper-pen method, video documentation, and EHRS. The secondary objective is to present the advantages and limitations of the different record keeping methods. Study Design: This is an interview-based descriptive study. Methods: We designed and conducted a questionnaire to compare traditional methods versus EHRS that was administered to 40 of our health care providers to obtain their feedback. We hereby present the advantages and disadvantages of traditional and EHRS based on the questionnaire. Results: The poster highlights that the EHRS when combined with video recording, whcich we are currently using at NeuroGen, vary in benefits and limitations, benefits outweighing the limitations. Conclusion: We conclude that despite the limitations of EHRS, traditional methods will soon have to be replaced and therefore recommend adaptation to the electronic health record system. [ABSTRACT FROM AUTHOR]

Background: In March 2018, the Government of India launched a direct benefit transfer (DBT) scheme to provide nutritional support for all tuberculosis (TB) patients in line with END TB strategy. Here, the money (@INR 500 [~8 USD] per month) is deposited electronically into the bank accounts of beneficiaries. To avail the benefit, patients are to be notified in NIKSHAY (web-based notification portal of India's national TB programme) and provide bank account details. Once these details are entered into NIKSHAY, checked and approved by the TB programme officials, it is sent to the public financial management system (PFMS) portal for further processing and payment. Objectives: To assess the coverage and implementation barriers of DBT among TB patients notified during April–June 2018 and residing in Dakshina Kannada, a district in South India. Methods: This was a convergent mixed-methods study involving cohort analysis of patient data from NIKSHAY and thematic analysis of in-depth interviews of providers and patients. Results: Of 417 patients, 208 (49.9%) received approvals for payment by PFMS and 119 (28.7%) got paid by 1 December 2018 (censor date). Reasons for not receiving DBT included (i) not having a bank account especially among migrant labourers in urban areas, (ii) refusal to avail DBT by rich patients and those with confidentiality concerns, (iii) lack of knowledge and (iv) perception that money was too little to meet the needs. The median (IQR) delay from diagnosis to payment was 101 (67–173) days. Delays were related to the complexity of processes requiring multiple layers of approval and paper-based documentation which overburdened the staff, bulk processing once-a-month and technological challenges (poor connectivity and issues related to NIKSHAY and PFMS portals). Conclusion: DBT coverage was low and there were substantial delays. Implementation barriers need to be addressed urgently to improve uptake and efficiency. The TB programme has begun to take action. [ABSTRACT FROM AUTHOR]

Background and Aim: Intensive-care practices and settings may differ for India in comparison to other countries. While international guidelines are available to direct the use of enteral nutrition (EN), there are no recommendations specific to Indian settings. Advisory board meetings were arranged to develop the practice guidelines specific to Indian context, for the use of EN in critically ill patients and to overcome challenges in this field. Methods: Various existing guidelines, meta-analyses, randomized controlled trials, controlled trials, and review articles were reviewed for their contextual relevance and strength. A systematic grading of practice guidelines by advisory board was done based on strength of the supporting evidence. Wherever Indian studies were not available, references were taken from the international guidelines. Results: Based on the literature review, the recommendations for developing the practice guidelines were made as per the grading criteria agreed upon by the advisory board. The recommendations were to address challenges regarding EN versus parenteral nutrition; nutrition screening and assessment; nutrition in hemodynamically unstable; route of nutrition; tube feeding and challenges; tolerance; optimum calorie-protein requirements; selection of appropriate enteral feeding formula; micronutrients and immune-nutrients; standard nutrition in hepatic, renal, and respiratory diseases and documentation of nutrition practices. Conclusion: This paper summarizes the optimum nutrition practices for critically ill patients. The possible solutions to overcome the challenges in this field are presented as practice guidelines at the end of each section. These guidelines are expected to provide guidance in critical care settings regarding appropriate critical-care nutrition practices and to set up Intensive Care Unit nutrition protocols. [ABSTRACT FROM AUTHOR]

There have been worldwide reports of chromatic aberrations in bats, most striking among which is albinism. Albinism is an inherited, hypo-pigmentary state characterised by a complete lack of melanin. Albinistic individuals have pale skin, white fur, and pinkish-red eyes. Here we report the first record of albinism in Lesser Woolly Horseshoe Bat Rhinolophus beddomei. During a bat survey in Goa, India; a single individual of albino Lesser Woolly Horseshoe Bat was recorded along with a normally coloured conspecific individual from a small shelter with tiled roof. We confirm the species identity of this bat based on its morphology, and acoustic characteristics of its echolocation call. We further update the list of colour aberrations in bats reported from India. [ABSTRACT FROM AUTHOR]

Landraces are important genetic resources that have a significant role in maintaining the long-term sustainability of traditional agro-ecosystems, food, nutrition, and livelihood security. In an effort to document landraces in the on-farm conservation context, Central Western Ghat region in India was surveyed. A total of 671 landraces belonging to 60 crops were recorded from 24 sites. The custodian farmers were found to conserve a variety of crops including vegetables, cereals and pulses, perennial fruits, spices, tuber and plantation crops. The survey indicated a difference in the prevalence of landraces across the sites. A significant difference with respect to the Shannon-diversity index, Gini-Simpson index, evenness, species richness, and abundance was observed among the different survey sites. Computation of a prevalence index indicated the need for immediate intervention in the form of collecting and ex situ conservation of landraces of some crops as a back-up to on-farm conservation. The study also identified the critical determinants of on-farm conservation, including (i) suitability to regional conditions, (ii) relevance in regional cuisine and local medicinal practices, (iii) cultural and traditional significance, and (iv) economic advantage. The information documented in this study is expected to promote the collection and conservation of landraces ex situ. The National Genebank housed at ICAR-NBPGR, New Delhi conserves around 550 accessions of landraces collected from the Central Western Ghats region surveyed in this report. Information collected from custodian farmers on specific uses will be helpful to enhance the utilization of these accessions. [ABSTRACT FROM AUTHOR]

The geometrid moths of Kalakad-Mundanthurai Tiger reserve were studied during the years 2012 to 2016. Since collection of specimens was not permitted, only field notes, accompanied by photo documentation was undertaken. Two-hundred-and-sixty geometrid moths identified to various hierarchical levels of taxa and one new genus for southern India, are reported. [ABSTRACT FROM AUTHOR]

The present study analyses the growth, contribution, and impact of research carried out by the researchers at the Orissa University of Agricultural Technology (OUAT), Bhubaneswar, India, based on the publications indexed in Scopus during 2008 to 2012. It is identified that the average annual publications range from 33 to 34 papers, with 0.96 degree of collaboration. The maximum number of papers are published within the 1-5 page range. OUAT, S. K. Mishra, Agricultural and Biological Sciences, and India are the most prolific institution/organization, author, subject area, and country respectively. Bradford's Law is used to determine the scattering of literature in the publication pattern of the university during the period under study, which shows that the Indian Journal of Animal Research is the most preferred research journal among the university research community. [ABSTRACT FROM AUTHOR]

Objective: To undertake process documentation (PD) of two health education interventions for tribal school children (6-14 years) and adolescent girls (12-19 years) in rural central India., Methods: The present participatory process documentation exercise was undertaken at Kasturba Rural Health Training Center, (KRHTC), Anji, which is a field practice area of the Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram. The various steps identified for process documentation were decided after reviewing the monthly and annual reports of KRHTC, training reports, published research papers, flipbooks and daily diaries of health educators. In order to get the health educators' perceptions, a free listing and pile sort exercise on the domain of 'perceived advantages of the present approach' was undertaken, followed by a semi-structured Focus Group Discussion (FGD) with the educators. A two-dimensional scaling and hierarchical cluster analysis was completed with the pile sort data to get the collective picture of perceived advantages., Results: The health education interventions were need-based, focusing on a target audience. The approach was community-based and has the potential to stimulate an action-experience-learning cycle of health educators and community members by stimulating their creative potential. The health educators found locally-developed handmade flipbooks with relevant messages and culturally sensitive pictures to be facilitating factors., Conclusions: The present study provided process documentation of two health education interventions which could be useful to both governmental and non-governmental organizations working in resource poor rural settings of developing countries.

There are printed artistic documents where text lines of a single page may not be parallel to each other. These text lines may have different orientations or the text lines may be curved shapes. For the optical character recognition (OCR) of these documents, we need to extract such lines properly. In this paper, we propose a novel scheme, mainly based on the concept of water reservoir analogy, to extract individual text lines from printed Indian documents containing multioriented and/or curve text lines. A reservoir is a metaphor to illustrate the cavity region of a character where water can be stored. In the proposed scheme, at first, connected components are labeled and identified either as isolated or touching. Next, each touching component is classified either straight type (S-type) or curve type (C-type), depending on the reservoir base-area and envelope points of the component. Based on the type (S-type or C-type) of a component two candidate points are computed from each touching component. Finally, candidate regions (neighborhoods of the candidate points) of the candidate points of each component are detected and after analyzing these candidate regions, components are grouped to get individual text lines.

Quantitative documentation of the research papers of Nayana Nanda Borthakur published in peer-reviewed journals during 1963-2005 reveals a total of 106 papers to his credit. Collaborative authorship pattern is found to be in the team size of 2-5. Twenty five are single authored papers, 33 two authored, 27 three authored, 17 four authored and four papers are five authored. Two and three authored papers constitute nearly 57% of the total authorship of his papers while single author papers are nearly 10% of the total authorship. Most active researchers in the research group of NN Bortahkur were Arnold NP, Al-Kanani T, Bhartendu S, Donnelly DJ, and Sarjaz-Raeini, M. Collaborative coefficient is 0.76 and productivity coefficient is 0.65 and 54 channels of communication were used to publish his research results of which International Journal of Biometeorology (15) tops the list followed by the Journal of Nuclear Agriculture and Biology (8) and Communications in Soil Science and Plant Analysis (7). His fifty percentile age is found to be 28 years. Publication concentration is 18.5 and publication density is 2. As depicted in the title tomography, the core area of research was related to evaporation, air ions, electrohydrodynamics (EHD), microwave irradiation, beta-ray gauge technique among others. [ABSTRACT FROM AUTHOR]

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Documentation is the chief approach for conserving indigenous traditional knowledge. Traditional foods form an integral part of the diets of indigenous people all over the world. The indigenous techniques for rice-based foods in the North-eastern region of India have not been documented systematically. The North-eastern region is made up of eight states: Meghalaya, Assam, Tripura, Mizoram, Nagaland, Arunachal Pradesh, Sikkim and Manipur, each with its own food habits and social distinctiveness. Rice cakes are well-known in the North-east region and are mainly consumed during tea time, ceremonies, festivals, and other occasions. This study was performed through direct interview and observation, which signifies the distinct features in the preparation of rice cakes and the limitation of knowledge merely to domestic level. It also describes the techniques of rice cake production, which have few similarities among different states. This study recommends the need to upgrade, preserve, and document indigenous knowledge to promote rice cakes for better marketing and, more importantly, to attempt to conserve these products through general awareness. In addition, several health benefits of rice cake products have been discussed. [ABSTRACT FROM AUTHOR]

One thousand people die every day in India as a result of TB, a preventable and treatable disease, even though the Constitution of India, government schemes, and international law guarantee available, accessible, acceptable, quality health care. Failure to address the spread of TB and to provide quality treatment to all affected populations constitutes a public health and human rights emergency that demands action and accountability. As part of a broader strategy, health activists in India employ Public Interest Litigation (PIL) to hold the state accountable for rights violations and to demand new legislation, standards for patient care, accountability for under-spending, improvements in services at individual facilities, and access to government entitlements in marginalized communities. Taking inspiration from right to health PIL cases (PILs), lawyers in a New Delhi-based rights organization used desk research, fact-findings, and the Right To Information Act to build a TB PIL for the Delhi High Court, Sanjai Sharma v. NCT of Delhi and Others (2015). The case argues that inadequate implementation of government TB schemes violates the Constitutional rights to life, health, food, and equality. Although PILs face substantial challenges, this paper concludes that litigation can be a crucial advocacy and accountability tool for people living with TB and their allies. [ABSTRACT FROM AUTHOR]

Early childhood development (ECD) provides building blocks for future educational achievement, emotional and moral development; the early years of life provide a critical window of opportunity for intervention. Experts across the world are emphasizing on promotion of ECD through the 5-pronged Nurturing Care Framework (NCF). The Sustainable Development Goals have focussed on optimum development for all children by 2030. For India, with 164.5 million population of children between 0–6 years, the magnitude of the problem is huge. We have been focusing on ECD since the launching of the Integrated Child Development Scheme (ICDS) in 1976. Many national policies and programs have evolved since then to promote ECD. Inspite of all efforts, the overall picture of early childhood development in India is still not optimal, due to multiple factors. All five components of nurturing care framework have not been included comprehensively in the services offered. If India focuses on these areas and comes up with a convergent ECD delivery system through a single portal that can be provided with equity at the grassroot level, coupled with proper documentation, we may proceed towards our goals at a better pace. Multiple stakeholders (the government, public and private health care providers, non-government organizations, professional bodies) need to work in synergy to enable us to reach the 2030 goals [ABSTRACT FROM AUTHOR]

Background: The ethnic communities in Nagaland have kept a close relationship with nature since time immemorial and have traditionally used different kinds of insects and their products as folk medicine to treat a variety of human ills and diseases. The present study was conducted to record the entomotherapeutic practices of seven different ethnic groups of Nagaland. Method: Documentation is based on semi-structured questionnaires and group discussions with a total of 370 informants. The data collected were analysed using fidelity level (FL) and informant consensus factor (ICF). Results: Fifty species of medicinal insects belonging to 28 families and 11 orders were identified in connection with treatments of at least 50 human ailments, of which the most frequently cited were coughs, gastritis, rheumatoid arthritis, stomach ache and wound healing. Mylabris sp. showed the highest fidelity level (FL) of 100% for its therapeutic property as a dermatologic agent, while the informant consensus factor (ICF) ranged from 0.66 to 1.00. The use of medicinal insects varies amongst the seven ethnic groups, suggesting that differences in cultures and geographic location can lead to the selection of specific insect species for specific medicinal purposes. The largest number of insect species appear to be used for treating gastrointestinal, dermatological and respiratory diseases. Conclusion: The list of medicinal insect species, many of which are reported for the first time in the present study, suggests the presence of a considerable diversity of therapeutically important insect species in the region and elaborate folk medicinal knowledge of the local ethnic groups. This knowledge of insects not just as a food, but also as therapy is passed down verbally from generation to generation, but is in danger of being lost if not documented in a systematic way. Having stood the test of time, traditional folk medicinal knowledge and its contribution through entomotherapy should not be regarded as useless as it has the potential to lead to the development of novel drugs and treatment methods. [ABSTRACT FROM AUTHOR]

Introduction: India contributes to about 18% of global maternal deaths and 22.6% of still births. Efforts to improve the quality of care are challenged by the lack of reliable documentation of data. Hence, a concise, structured maternity case sheet (PrasavRecord) was designed with the aim to bring about an improvement in documentation of treatment and events related to woman in labour from the time of admission till her discharge from the hospital. Aim: To study the improvement in quality of documentation from the time of admission till discharge of a woman in labour with the help of structured format i.e., PrasavRecord. Materials and Methods: The study was conducted in February 2017. A quasi experimental study design was used, and the completeness of data recorded by the resident doctors in the existing hospital case sheet (control group) with those recorded in PrasavRecord (intervention group) were assessed in a total of 65 deliveries in each arm. Details of the patient from admission to the labour room followed by the entire sequence of events during labour as well as hospital stay in postpartum period were recorded over 130 parameters under different sections in PrasavRecord. Statistical analysis was done by using SPSS version 21.0. Results: Completeness of the documentation in terms of history, investigations and findings at examination including those at labour, nearly, 92% of the doctors rated PrasavRecord as "good and very good" for appearance, recommended its routine use, and 75% agreed that the format will be useful for conversion to electronic medical record. There was highly significant difference between the average percentage of completeness in PrasavRecord 75.8 {95% CI (74.2-77.4)} and hospital case sheets 42.2 {95% CI (40.9-43.6)} i.e., z=5.38 p-value <0.001. Conclusion: PrasavRecord is a simple, acceptable and user-friendly data entry format which improves the quality of documentation of the processes and practices during childbirth. Larger trials are required to finetune it to facilitate its widespread use thereby, ensuring a uniform documentation process of labour and postpartum. [ABSTRACT FROM AUTHOR]

Purpose: National Accreditation Board for Hospitals and Healthcare Providers operates the health-care accreditation program in India. Research on impact of accreditation on eye-care centers is scarce. This article was conceptualized to scientifically evaluate the changes in documentation brought about by accreditation and its effects on staff in the Ophthalmology Department of an Indian Medical College.Methods: This was conducted as a quasi-experimental study in four steps. First, a point-based evaluation of case sheets in both pre-accreditation and postaccreditation phase, along with statistical analysis of the results, was done. Step two involved analysis of quality indicators and patient safety indices in successive years from inception of data to post-accreditation phase. Step three comprised a survey of staff employing a validated tool, and finally, face-to-face semistructured interviews with designated authorities, including finance departmental head, completed the study.Results: A statistically significant difference was seen in scores achieved by the pre and postaccreditation case sheets, with the postphase case sheets achieving 15% increased scores over the prephase case sheets. Quality indicator indices displayed improvements post-accreditation. There was an accompanying increase in quantity of documentation. Financial data analysis showed increased expenditure for accreditation under multiple heads. Staff believed that accreditation led to increased workload but did not express decreased satisfaction and felt that accreditation was eventually beneficial. However, staff believed rewards for improving quality can be enhanced.Conclusion: Accreditation increases quality and quantity of documentation, and staff workload. Increased financial costs also ensue.Staff believe that accreditation improves quality, is beneficial, but desire enhanced rewards. [ABSTRACT FROM AUTHOR]

Objectives: In Karnataka state, perinatal mortality rate is almost equal to infant mortality rate. This preliminary study was conducted in two districts of Karnataka to study potential problems to start of perinatal death audit. Methods: Hospitals providing maternal and child health care services, which met study inclusion criteria, in Dakshina Kannada and Koppal Districts were included. Following variables were studied: (i) Documentation and reporting systems in these hospitals; (ii) Role of health care personnel in documentation and reporting (iii) Existing system of audit, if any. Results: Totally 94 hospitals met our criteria with Dakshina Kannda District having 63 (67.02%) and the rest in Koppal District. Documentation and reporting was poor in Koppal District and inadequate in Dakshina Kannada district. Health care personnel were apprehensive about perinatal death audit. Conclusion: Problems identified need to be addressed before starting perinatal death audit. [ABSTRACT FROM AUTHOR]

This is the first complete documentation of the early stages of Acytolepis lilacea lilacea, the subspecies from southern India, with the first record of the larval host plant Cycas circinalis, and a comparison with the early stages of Acytolepis puspa felderi Toxopeus, 1927, a sympatric and similar species, highlighting the notable differences. The significant differences noted in the early stages of Acytolepis lilacea lilacea with that of A. puspa are the difference in ornamentation of eggs, more fluffy, blue shaded and less hairy larvae and more elongated pupae. No previous record of the early stages of any of the subspecies of Acytolepis lilacea Hampson, 1889 is available. Preliminary observations regarding the flight period and seasonal varriations of Acytolepis lilacea lilacea, from Parambikulam Tiger Reserve, Kerala, India, are also presented. [ABSTRACT FROM AUTHOR]

Background: Poor documentation practices in labour rooms have been a challenge especially in resource limited countries. This hinders the efforts towards improving quality of maternal healthcare services. Little effort has been made on this regard in many countries including India. SWOT analysis on labour room documentation would be the first step in understanding the situation, barriers and to formulate strategies for improvement. Materials and Methods: Facility based cross-sectional study was carried out in five secondary health facilities of Cuttack district, Odisha, India. A qualitative method using in-depth interviews among 26 healthcare providers was adopted for data collection and inductive content analysis approach for analysis. Strategies like pioneering, positive, conservative and resistive were formulated under each of the three major components identified. Results: Three major components emerged were i) Adherence and completeness of labour room records and reports, ii) Status of the monitoring and supervision and iii) Utilization of labour room data. Improving knowledge and skill through training and supportive supervision, adopting computer-based application for data management, better coordination among supervisors and labour room staff, infrastructural strengthening for documentation and its security, making documentation a priority, more accountability would improve the documentation. Ensuring data analysis and interpretation, discussion in review meetings and regular monitoring and supervision will improve performance. Conclusion: Ensuring documentation of labour room records, regular quality monitoring and supervision, and analysis and interpretation of data are critical to improve labour room performance. Making it a priority and adopting the strategies will achieve the same, thereby better labour outcome. [ABSTRACT FROM AUTHOR]

Context: COVID-19 pandemic and nationwide lockdown has affected the health system. Many health-care facilities are prioritizing their services, and hence, those suffering from life-limiting conditions will have difficulty in accessing health services. Aims: The aim of the study was to perform a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis of the palliative care (PC) services provided by the Institute of Palliative Medicine (IPM), Kozhikode, amid COVID-19 pandemic. Settings and Design: A SWOT analysis of PC services provided by IPM. Subjects and Methods: The data for SWOT analysis was collected by brainstorming and review of records and registers. Results: Good prioritization and documentation system and routinely adhering to infection control practices are notable strengths. Lack of funding and interrupted supply of personal protective equipment are notable weaknesses. Availability of established communication channels with active community participation are a few opportunities available to improve the services. Working with high-risk groups, return of Non-residential Indians (NRI), lack of transparency and stigma among the general public are the threats that can affect the service delivery. Conclusions: Having good prioritization and documentation system, reinforcing infection control practices, already established emergency homecare system, presence of a well-developed network of community-based PC services, and a vast network of community volunteers and awareness and cooperation of families had helped IPM to quickly reorganize its services and transition smoothly to continue to provide PC for those suffering from life-limiting illnesses in this pandemic situation. [ABSTRACT FROM AUTHOR]

Background: Government of India is introducing new and relatively costly vaccines under immunization program. Monitoring of vaccine wastage is needed to guide the program implementation and forecasting. Under pilot introduction of rotavirus vaccine in two districts both 5- and 10-doses vials were used, which was considered as an opportunity for documenting the wastage. The wastage rates for other routine vaccines were also documented.Methods: A survey conducted in two districts (Kangra, Himachal Pradesh and Pune, Maharashtra) covered 49 vaccine stores, 34 sub-centres and 34 outreach sessions collected vaccine receipt, distribution and usage data for two complete years 2016 and 2017.Results: The overall wastage rates for almost all vaccines were higher in Kangra district (BCG 37.1%, DPT 32.1%, Measles 32.2%, OPV 50.8%, TT 34.1% and pentavalent 18.4%) than Pune district (BCG 35.1%, DPT 25.4%, Measles 21.7%, OPV 14.3%, TT 23.1% and pentavalent 13.2%). Wastage for pneumococcal conjugate and measles-rubella vaccines in Kangra district were 27 and 40.5%, respectively. With transition from 5- to 10-doses vials for rotavirus vaccine, wastage at stores levels increased in both Kangra (29 to 33.2%) and Pune (17.8 to 25.7%) districts. With transition from intramuscular to intradermal fractional inactivated polio vaccine, the wastage increased from 36.1 to 54.8% in Kangra and 18.4 to 26.9% in Pune district.Conclusions: The observed vaccine wastage rates for several vaccines were relatively higher than program assumption for forecasting. The observed variations in the vaccine wastage indicates need for state or region based documentation and monitoring in India for appropriate programmatic action. [ABSTRACT FROM AUTHOR]

Background and Aims: Besides providing a surgical roadmap, rectal MRI plays a major role in treatment planning. We recently started using a structured template for reporting rectal cancer via MRI. We study the impact of using this template at our hospital in terms of number of essential imaging parameters described in the reports as compared to the pre-template free-text reports. Methods: A structured rectal MRI reporting template was created in consensus with members of the colorectal tumour board and was introduced in the department, which included 14 essential parameters to be mentioned in the reports. We conducted a retrospective analysis of rectal MRI reports of 100 cases with histologically proven rectal cancer, comprising 50 consecutive free-text reports before the template was introduced and 50 consecutive structured reports after its introduction, checking for the presence or absence of inclusion of the 14 parameters. An anonymous online feedback survey was conducted as well after the introduction of the template for the members of the colorectal tumour board. Results: Overall, the total number of parameters reported increased from a median value of 10 (range 6-13) to 14 (range 12-14). The common unreported parameters prior to template introduction included T staging, presence or absence of restricted diffusion, anterior peritoneal reflection (APR) involvement, and presence or absence of extramural vascular invasion; these were reported in 16%, 22%, 30% and 50% respectively. These improved to 98-100% reporting after template introduction. Maximum improvement was in T staging (16% to 98%) (P < 0.0001), restricted diffusion on DWI (from 22% to 100%) (P < 0.0001) and APR involvement (from 30% to 100%) (P < 0.0001). The most common unreported parameter after template introduction was the "tumoral T2 signal intensity" (unreported in 4% cases). The results of the survey were as follows: 100% felt a decreased need to talk to the radiologist to clarify the report, 81.8% felt an improvement in the quality of reporting as compared to free style reports, and 91% felt that the new template is easier to interpret. Conclusion: The introduction of a structured template for rectal cancer significantly improved the quality of rectal MRI reports, along with the satisfaction of referring providers. [ABSTRACT FROM AUTHOR]

The fundamental approach for the confirmation of any terrestrial meteorite impact structure is the identification of diagnostic shock metamorphic features, together with the physical and chemical characterization of impactites and target lithologies. However, for many of the approximately 200 confirmed impact structures known on Earth to date, multiple scale‐independent tell‐tale impact signatures have not been recorded. Especially some of the pre‐Paleozoic impact structures reported so far have yielded limited shock diagnostic evidence. The rocks of the Dhala structure in India, a deeply eroded Paleoproterozoic impact structure, exhibit a range of diagnostic shock features, and there is even evidence for traces of the impactor. This study provides a detailed look at shocked samples from the Dhala structure, and the shock metamorphic evidence recorded within them. It also includes a first report of shatter cones that form in the shock pressure range from ~2 to 30 GPa, data on feather features (FFs), crystallographic indexing of planar deformation features, first‐ever electron backscatter diffraction data for ballen quartz, and further analysis of shocked zircon. The discovery of FFs in quartz from a sample of the MCB‐10 drill core (497.50 m depth) provides a comparatively lower estimate of shock pressure (~7–10 GPa), whereas melting of a basement granitoid infers at least 50–60 GPa shock pressure. Thus, the Dhala impactites register a strongly heterogeneous shock pressure distribution between <2 and >60 GPa. The present comprehensive review of impact effects should lay to rest the nonimpact genesis of the Dhala structure proposed by some earlier workers from India. [ABSTRACT FROM AUTHOR]

Introduction: Medical audit in the current scenario of increasing medical demands and the increasing trend of medical multispecialty has been a crucial tool to analyse and regulate the service provided to the service receiver or the patient. Medical Records can be defined as the set of documents that provide the clinical, para-clinical, and financial data about the patient. Materials and Methods: The study was conducted for a period of one year in our own teaching hospital (Teerthanker Mahaveer Medical College, Hospital & Research Centre, Moradabad, Uttar Pradesh, India) which is tertiary care Centre with 900 functional beds, in the urban area of the state to analyse the documentation of medical audit. The data so collected was through brainstorming, observation, interview, and review of workflow during the lean sessions was conducted. Results: The intensity of difference among the standard of record keeping in various departments was actually surprising. First of all the department of Paediatrics and gynaecology was found to be most satisfactory while general medicine department was not at all in order. Conclusion: This study showed that in order to achieve patient's satisfaction, the correct measurement of the quality of the services being offered to the patients is the basic quality of the medical service provider. [ABSTRACT FROM AUTHOR]

Introduction: Newborn vaccination is an integral part of routine immunization program in India, but program implementation gaps exist. The focus of this article is to identify and describe an implementation strategy which could improve the newborn vaccination at the facility level. Materials and Methods: A situation analysis was conducted through a mixed-methods approach to identify the lacunae in the health system and the same was used to develop an implementation strategy to improve newborn vaccination coverage across the six priority states. Results: Issues in stewardship and human resource, vaccine-related stock-outs, and poor service delivery were some of the reasons for low facility-level vaccination coverage. After implementation of a health system–based strategy, the new born vaccination improved from 55% to 88% across 10 quarters of program implementation. Factors such as sensitization of stakeholders, vaccination on holidays, rigorous documentation, and supportive supervision of health staff were primary reasons for improvement in service delivery. Conclusion: Importance of newborn immunization at birth is well established. The results from six states prove that "health systems approach" as an implementation strategy is a viable tool to improve newborn immunization at birth. [ABSTRACT FROM AUTHOR]

Recent era has witnessed an inordinate rise in the demand for radiopharmaceuticals due to their multifarious biomedical and clinical application. Scientific fraternity worldwide is continuously working in developing different innovative radiopharmaceuticals of immense clinical importance both from specialized theranostics and personalized medicine point of view. However, this increased production and use of radiopharmaceuticals in various nuclear medicine procedures have been accompanied by an inevitable problem concerning their storage after use and final disposal. Keeping in view the inherently hazardous nature of radiopharmaceuticals due to the presence of radionuclide in them, it is imperative to have an adequate regulatory backup which if followed meticulously can assure their safe storage and disposal so that threat to men and environment is prevented. The present work has been aimed to draft comprehensive regulatory guidelines for the storage and disposal of radiopharmaceuticals which is in resonance with the global standards. For this, the methodology consisting of a thorough research of existing guidelines from Atomic Energy Regulatory Board (AERB) exclusively on storage and disposal of radiopharmaceuticals in India has been done with the objective to identify and select various parameters not yet explicitly covered as is their scope. The guideline has been made to suitably address all sorts of necessary documentation, allocation of responsibility, ways of waste prevention, various mechanisms to deal with radiopharmaceuticals waste in all forms of matter and suggestive recommendations. [ABSTRACT FROM AUTHOR]

Background: Neonatal death remains a global challenge contributing to 45% of underfive deaths. With rising institutional delivery, to accelerate decline in neonatal mortality rate (NMR) improvement in the quality of perinatal care requires attention. Objectives: This implementation research targeted improving service delivery readiness for quality of newborn care at public health facilities in three districts of Uttar Pradesh, India, with high NMR. Materials and Methods: This before-after study assessed the facility readiness and quality of newborn services at 42 health facilities. The changes in 26 signal functions for routine and emergency obstetric and newborn care were tracked. Results: There was marked improvement in newborn service availability: skilled birth attendants (51%), resuscitation (30%), and kangaroo mother care (27%) at these facilities. A multifold rise in newborn resuscitation efforts and documentation (n = 4431 vs. n = 144 in preintervention period) with high success rate (98.6%) was observed. There was also improvement in obstetric care services including partograph use (31%) and active management of third stage of labor (46%). However, several infrastructural indicators (electricity, water supply, toilets, and sanitation) remained unchanged. Conclusion: Overall improvements were observed in the majority of the signal functions for perinatal care and newborn resuscitation efforts. There was a limited impact on the infrastructural and supervision components. [ABSTRACT FROM AUTHOR]

In this article, the author reflects on articles published in July–September 2016 issue of the periodical related to emergence of age in class intervals or groups and not as mean (standard deviation) value.

Keywords: settlement; archaeological open-air museum; documentation; digitalisation; Country; India; border EN settlement archaeological open-air museum documentation digitalisation Country India border Twah Longwar is an abandoned settlement located in the State of Meghalaya in North-East India. UAV remote sensing survey for the archaeological site at Twah Lognwar Unmanned Aerial Vehicles or UAVs were used for documenting and understanding the archaeological site. Digital Reconstruction After the site investigation, collection of data, geographical survey, excavation, scientific dating, and conservation methods have been carried out, the data processed will be used for reconstructing the abandoned settlement. UAV Orthomosaic Map The UAV orthomosaic map depicts the entire representation of the hamlet of the Twah Longwar site. [Extracted from the article]

Background: Achieving development outcomes requires the inclusion of marginalised populations that have the least opportunity to participate in and benefit from development. Slum dwellers often see little of the 'urban advantage', suffering more from infectious diseases, increasing food costs, poor access to education and health care, inadequate water and sanitation, and informal employment. A recent Cochrane Review of the impact of slum upgrading strategies found a dearth of unbiased studies, making it difficult to draw firm conclusions. The Review calls for greater use of process data, and qualitative alongside quantitative methods of evaluation. India is a lower middle income nation with large gender disparities and around 65 million slum inhabitants. The Asha Community Health and Development Society, a non-governmental organisation based in Delhi, has delivered a multi-sectoral program across 71 slums since 1988. This article reports on a mixed-method study to document measureable health and social impacts, along with Asha'se t h o s and processes. Methods: Several observational visits were made to 12 Asha slums where informal discussions were had with staff and residents (n=50). Asha data records were analysed for change over time (and differences with greater Delhi) in selected indicators (maternal-child health, education, child sex ratio) using descriptive statistics. 34 semi-structured individual/small group interviews and 14 focus group discussions were held with staff, residents, volunteers, elected officials, civil servants, bankers, diplomats, school principals, slumlords and loan recipients (n= 147). Results: Key indicators of health and social equity improved over time and compared favourably with those for greater Delhi. The Asha model emphasises rights, responsibilities, equity and non-violence. It employs strategies characterised by long-term involvement, systematic protocols and monitoring, development of civil society (especially women'sa n d children's groups) to advocate for rights under the law, and links with foreign volunteers and fund-raisers. Stakeholders agreed that changes in community norms and living conditions were at least partly attributable to the Asha model. Conclusions: While lacking a control group or complete baseline data, evidence suggested substantial improvements in slum conditions and social equity. The Asha model offers some lessons for slum (and broader) development. [ABSTRACT FROM AUTHOR]

Background. The world’s global cancer burden disproportionally affects lower income countries, where 80% of patients present with late-stage disease and have limited access to palliative care and effective pain-relieving medications, such as morphine. Consequently, millions die each year with unrelieved pain. Objective. The objective of this study was to examine barriers to opioid availability and cancer pain management in India, with an emphasis on the experiences of nurses, who are often the front-line providers of palliative care. Methods. Fifty-nine participants were recruited using a purposive, snowball sampling strategy. Ethnographic data collection included in-depth, semistructured interviews (n = 54), 400+ hours of participant observation, and review of documents over 9 months at a government cancer hospital in South India. Systematic qualitative analysis led to identification of key barriers that are exemplified by representative quotes. Results. Morphine is more available at this study site than in most of India, but access is limited to patients seen by the palliative care service, and significant gaps in supply still occur. Systems to measure and improve pain outcomes are largely absent. Key barriers related to pain management include the role of nursing, opioid misperceptions, bureaucratic hurdles, and sociocultural/infrastructure challenges. Implications. Interventions must streamline process details of morphine procurement, work within the existing sociocultural infrastructure to ensure opioids reach patients most in need, target unexpected audiences for symptom management education, and account for role expectations of health care providers. Conclusion. Macro- and micro-level policy and practice changes are needed to improve opioid availability and cancer pain management in India. [ABSTRACT FROM AUTHOR]

Background: The wild plants not only form an integral part of the culture and traditions of the Himalayan tribal communities but also contribute largely to the sustenance of these communities. The tribal people use large varieties of wild fruits, vegetables, fodder, medicinal plants, etc. for meeting their day-to-day requirements. The present study was conducted in Churah subdivision of district Chamba where large populations of Muslim Gujjars inhabit various remote villages. These tribal people are semi-pastoralists, and they seasonally (early summers) migrate to the upper altitudes (Adhwari's) along with their cattle and return to permanent settlements before the onset of winters. A major source of subsistence of these tribal people is on natural resources to a wide extent, and thus, they have wide ethnobotanical knowledge. Therefore, the current study was aimed to report the ethnobotanical knowledge of plants among the Gujjar tribe in Churah subdivision of district Chamba, Himachal Pradesh. Methods: Extensive field surveys were conducted in 15 remote villages dominant in Gujjar population from June 2016 to September 2017. The Gujjars of the area having ethnobotanical knowledge of the plants were interrogated especially during their stay at the higher altitudes (Adhwari's) through well-structured questionnaires, interviews, and group meetings. The data generated was examined using quantitative tools such as use value, fidelity, and informant consensus factor (Fic). Results: This study reveals 83 plants belonging to 75 genera and 49 families that were observed to have ethnobotanical uses. Plants were listed in five categories as per their use by the Gujjars, i.e. food plants, fruit plants, fodder plants, household, and ethnomedicinal plants. The leaves, fruits, and roots were the most commonly used plant parts in the various preparations. The highest number of plants was recorded from the family Rosaceae followed by Polygonaceae and Betulaceae. On the basis of use value (UV), the most important plants in the study area were Pteridium aquilinum, Juglans regia, Corylus jacquemontii, Urtica dioica, Diplazium maximum, and Angelica glauca. Maximum plant species (32) were reported for ethnomedicinal uses followed by food plants (22 species), household purposes (16 species), edible fruits (15 species), and as fodder plants (14 species). The agreement of the informants conceded the most from the use of various plants used as food plants and fruit plants (Fic = 0.99), followed by fodder plants and household uses (Fic = 0.98) while it was least for the use of plants in ethnomedicine (Fic = 0.97). The fidelity value varied from 8 to 100% in all the use categories. Phytolacca acinosa (100%), Stellaria media (100%), and Urtica dioica (100%) were among the species with high fidelity level used as food plants, while the important species used as fruit plants in the study area were Berberis lycium (100%), Prunus armeniaca (100%), and Rubus ellipticus (100%). Some important fodder plants with high fidelity values (100%) were Acer caesium, Aesculus indica, Ailanthus altissima, and Quercus semecarpifolia. The comparison of age interval with the number of plant use revealed the obvious transfer of traditional knowledge among the younger generation, but it was mostly concentrated in the informants within the age group of 60–79 years. Conclusions: Value addition and product development of wild fruit plants can provide an alternate source of livelihood for the rural people. The identification of the active components of the plants used by the people may provide some useful leads for the development of new drugs which can help in the well-being of mankind. Thus, bioprospection, phytochemical profiling, and evaluation of economically viable products can lead to the optimum harnessing of Himalayan bioresources in this region. [ABSTRACT FROM AUTHOR]

Background: India has recently renewed emphasis on non-allopathic systems of medicine as a means to address the health needs of its populace. Earlier in 2002, its national health policy had sought to 'revitalize' community-based health knowledge and practices – jointly christened 'local health traditions'. Yet policy texts remain silent on the actual means by which 'revitalization of local health traditions' should take place. Our research sought to understand the policy lessons of and for revitalization of local health traditions in the three Southern Indian states through an ethnographic inquiry in 2014–2016. Methods: Our inquiry included a narrative synthesis of policy texts tracing the history of governance processes and mechanisms pertaining to traditional medicine, including local health traditions, linking this to the activities of non-governmental organizations (NGOs) and networks involved in "revitalization". Through in-depth interviews, observations and case studies, we sought to understand the life worlds of local health tradition practitioners and what revitalization meant to them. Our method revealed that beyond a purely academic inquiry, we needed an (inter)action that would give greater voice to these perspectives and views leading to hosting an interactive dialogue among practitioners, NGO representatives, academics, and government officials. Results: Our ethnographic inquiry unraveled the problematic of a litotic approach to local health traditions as those which are non- institutionalized, non-certified, non-documented; assuming the state to be the only source of power and legitimacy. Revitalization discussions were restricted (and often misled) by such an approach. Local health practitioners and others directed us to interesting possibilities of revitalization either through participatory modes of documentation of traditional health knowledge, strengthening existing collective forums for formal social recognition, and building pedagogical institutions that promote experiential learning. Conclusion: Were we not enabled by ethnography as a method that changes its shape apace with emerging findings, we would have not been able to comprehensively answer our questions. This is critical because not only was this already a marginalized area of inquiry, but with any other method we risked reinforcing inequities by imposing epistemological and other hierarchies on our participants– whom we would argue were partners - in arriving at our conclusions. [ABSTRACT FROM AUTHOR]

Background: Although the need for multi-faceted and multi-sectoral approaches to address the multidimensional issue of child marriage is well-acknowledged, there is a dearth of documented experience on the process of implementing and managing such programmes. Methods: WHO evaluated a district-level, government-led multi-sectoral intervention to address child marriage in Jamui, Bihar and Sawai Madhopur, Rajasthan, implemented by MAMTA Health Institute for Mother and Child (MAMTA). We evaluated the intervention's design, implementation, monitoring, and outputs and identified key challenges and successes. Results: Through actions at the state and district levels, the intervention succeeded in creating a cascade effect to stimulate more concerted action at block and village levels, with tangible intersectoral convergence occurring at the village level. The success factors we identified included an experienced partner NGO that was committed to supporting this effort, context-specific design and implementation, and a flexible and responsive approach. However, despite contributing to informal coordination between various stakeholders, the intervention did not succeed in developing a sustained joint-working mechanism at the district level. Shared ownership for prioritization of child marriage across national- and state-level sectors was not established, due in part to lack of directives transcending ministerial/departmental boundaries. Nevertheless, due to its efforts at the district-level, the intervention was able to enlist leadership from the District Magistrates and Child Marriage Prohibition Officers, in line with their duties outlined in the 2006 Prohibition of Child Marriage Act. The challenges we identified included lack of clear directives and institutional support for collaboration, obstacles to monitoring, administrative challenges, differing perspectives on strategy among district leaders, community resistance, and intervention over-commitment. Conclusions: The findings of this evaluation reveal the potential of multi-sectoral approaches to prevent and respond to child marriage and provide insight into obstacles that affect multi-sectoral coordination. We point to actions that MAMTA could take to strengthen collaboration on this and other initiatives. We also recommend further documentation and evaluation of projects and programmes in this area. [ABSTRACT FROM AUTHOR]