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Background: The World Health Organization Astana Declaration of 2018 sees primary healthcare as key to universal health coverage and gives further support to the goal of building sustainable models of community palliative care. Yet evaluating the benefits of such models continues to pose methodological and conceptual challenges. Objective: To explore evaluation issues associated with a community-based palliative care approach in Kerala, India. Design: An illuminative case study using a rapid evaluation methodology. Methodology: Qualitative interviews, documentary analysis and observations of home care and community organising. Results: We appraise a community palliative care programme in Kerala, India, using three linked 'canvases' of enquiry: (1) 'complex' multi-factorial community-based interventions and implications for evaluation; (2) 'axiological' orientations that foreground values in any evaluation process and (3) the status of evaluative evidence in postcolonial contexts. Three values underpinning the care process were significant: heterogeneity, voice and decentralisation. We identify 'objects of interest' related to first-, second- and third-order outcomes: (1) individuals and organisations; (2) unintended targets outside the core domain and (3) indirect, distal effects within and outside the domain. Conclusion: We show how evaluation of palliative care in complex community circumstances can be successfully accomplished when attending to the significance of community care values. Plain language summary: Where are the values in evaluating palliative care? Learning from community-based palliative care provision The evaluation of any intervention or service will inevitably involve a series of decisions on what we measure, what criteria we use to judge whether the intervention has been successful (or not), what type of data we actually collect and what methods we use to do this. When evaluating a range of palliative care interventions, we suggest that these decisions have often been taken in a concealed way and tend to favour relatively narrow quantitative measures linked to end outcomes. Our paper reports on the evaluation of a community-based palliative care intervention on Kerala, India. In it, we suggest that such complex work requires a broader approach to evaluation that: makes the values being used to assess success explicit; draws on a range of data types; is interested in delivery processes; and places the voices of participants at the heart of the assessment. The paper concludes with some broader observations on how these principles might be applied more widely within palliative care. [ABSTRACT FROM AUTHOR]

Background: Teenage pregnancy is a concerning public health problem in India. Misperception and misunderstanding about pregnancy and its preventive methods lead to pregnancy when adolescents are involved in unsafe sexual intercourse. This scoping review aims to discuss the evidence on the perception, practices, and understanding related to teenage pregnancy among adolescent girls in the Indian context. Method: The Arksey and O'Malley scoping review framework and Joanna Briggs Institute Reviewers' Manual were used for the scoping review. The Population, Concept, and Context strategy (PCC) ensured the review questions, eligibility criteria, and search strategy. The Systematic Review and Meta-analysis: Extension for Scoping Review (PRISMA-ScR) was used. A literature search was done using electronic databases by specific keywords such as "teenage", "adolescences", "pregnancy", "perception", "knowledge", "awareness", etc. Relevant grey literature was identified through further searching. The review included studies that fulfil inclusion criteria having female adolescent groups aged from 10 to 19 years in the Indian context between the years 2000 and 2021. Result: We found 40 eligible studies; more than half of these were from southern (35%) and northern (27.5%) regions, and studies from the rest of India were very sporadically distributed. Most studies (72.5%) were published in the last 10 years. The relevant extracted data from individual studies were synthesized and presented in the two major sections, perception, practices, and the second one, understanding and experiences among teenage girls. The understanding of pregnancy and teenage pregnancy-related preventive methods was detailed analysis in about 72% of papers whereas other aspects, such as perception (22.5%), practices (25%), and experiences (7.5%) were discussed in the remaining papers related to pregnancy among adolescent girls. Conclusion: Evidence in the selected studies shows that understanding and practices are the major areas that were primarily explored, where perception, practices and experiences are the topics that are relatively less investigated. Literature synthesis derives misconception, lack of understanding, and practices without knowing the consequences are the key factors responsible for early pregnancies. Future interventions like increasing awareness, providing comprehensive reproductive knowledge, convenient health care aids, and proper counselling are adequate measures for minimalising the problem. The present analysis showed that studies are limited in their scope concerning various aspects of teenage pregnancy in India, so this scoping review gives essential perspectives on future research and implementation plans and policies in this field. [ABSTRACT FROM AUTHOR]

Background: Historical marginalisation and ongoing trust deficits in health and government systems shape present-day vaccine perceptions among marginalised communities. This paper sought to understand the role of trust in decision-making about COVID-19 vaccine uptake in the transgender and disability communities in India. Methods: Using a participatory approach we interviewed 24 community representatives, identifying themselves as transgender individuals or as persons with disability, and 21 key informants such as vaccine programme managers, vaccine providers, and community advocates. We undertook an inductive thematic analysis of the data using a socio-ecological model. Results: Fear of side effects in relation to specific needs of the two communities and mistrust of systems involved in vaccination shaped four different pathways for vaccine decision-making. Mistrust of systems was influenced by past negative experiences with the health system, creating contexts in which information and misinformation are shared and interpreted. Participants negotiated their doubts about safety and mistrust of systems by interacting with different sources of influence showing patterns of decision-making that are dynamic, context-dependent, and intersectional. Conclusion: These findings will help in determining the content, strategies and approaches to equitable vaccine communication for these two communities. The two communities ought to be included in vaccine trials. Vaccine information must respond to the specific needs of these two communities which could be enabled by collaboration and engagement with community members and influencers. Finally, long-term investment towards the needs of marginalised communities is vital to dismantle cycles of marginalisation and distrust and in turn improve vaccine acceptance and uptake. [ABSTRACT FROM AUTHOR]

Purpose: India has been on the pathway of improvement concerning healthcare and health outcomes of its population. However, India must overcome its unique challenges and cover a long journey ahead. This mandates a need for a high-quality, contemporary and community-based health system that promises consistent and quality healthcare, is trusted and valued by all its citizens, considers the changing population needs and should be affordable and accessible. Design/methodology/approach: The study examines various dimensions and elements associated with the integrated healthcare system in India and uses input, process and output structural measures. Findings: The present paper proposes an integrated, comprehensive healthcare system in India that endorses participation from diverse stakeholders such as the government, organizations, the community and individuals who can contribute uniquely. It also focuses on defined and measurable output that can make health a topic of social movement or "Jan Andolan" and create a sustainable and integrated care system. Originality/value: The study is unique as it focuses on the role of stakeholders in health care. The research emphasized the involvement of the government, community, people and organizations in developing an integrated healthcare ecosystem that includes modern technology, skilled employees, enough finance, governance, efficient delivery platforms and top-tier infrastructure. The model's output is focused on healthcare that is inexpensive, accessible, available, accountable and user-centered. This would gradually improve everyone's health and well-being. [ABSTRACT FROM AUTHOR]

While the worldwide ergonomics community increases its sophistication in solving global problems, specific systemic challenges still plague Indians in urban mega-cities such as Mumbai. This paper aims to highlight the gaps using the knowns-unknowns framework, which exists in the Indian ergonomics community's capability to address such systemic challenges. Within this framework, the epistemological category of 'unknown-knowns' is explicated further using a case study of urban accidental deaths and injuries in Mumbai, India. These systemic casualties are essential to note because they are not only hidden from public awareness but can be avoided by proper ergonomics interventions. The article concludes with four main directions for the Indian ergonomics community in solving systemic problems in terms of, (a) capacity-building, (b) advocacy; (c) developing all realms of ergonomics with particular emphasis on complex systems; (d) developing India-centric pathways for ergonomics as a discipline. Practitioner's summary: This paper aims to highlight gaps in the academic Indian ergonomics community's capacity to solve public systemic problems. An India-centric way forward for awareness, engagement, and academic capacity building is suggested to develop a comprehensive national ergonomics mission. [ABSTRACT FROM AUTHOR]

Along with the logistic planning, the important focus of international student mobility programmes in social work is on the field supervision process and measuring its outcome. Without a social work council in India for setting uniform standards in field education, this paper proposes a framework for field supervision to support inbound mobility students in India. The study predominantly explores the qualitative experiences of field supervisors from India, Israel, and Australia on fieldwork supervision. The themes evolved from the study are focused on the supervision process, strategies followed, challenges faced, and outcome measurement. [ABSTRACT FROM AUTHOR]

Purpose: Verbal abuse of the aged people in later life is a matter of grave concern in contemporary times. Aged people are abused by family members, relatives and neighbors in the form of yelling, taunting, swearing and threats, among other things. These abusive behaviors have the greatest influence on their social standing and well-being, and they cause society and families to dismantle their social networks as a result. This study aims to understand the nature of verbal elder abuse as a social phenomenon under the theoretical framework of sociocultural paradigm and examines the causes. Design/methodology/approach: The descriptive phenomenology method has been applied in this study. The study has been conducted on a sample of 60 elderly living in Kanpur district of Uttar Pradesh. The concern of using descriptive phenomenology in the present study is to understand the nature of verbal abuse against the elderly systematically by exploring cultural, situational and social aspects of verbal abuse in Indian society. This method analyzes the reality behind the verbal elder abuse as a social phenomenon and relationship between elderly and their abusers. Findings: The study finds an increase in verbal elder abuse in Indian families, which can range from psychological torture to physical torture, and includes insults, humiliation and neglecting the needs of the elderly for food, clothing, shelter and medical attention. The study also points out that reduction in attachment is as a responsible factor for verbal abuse with the elderly in modern times. Originality/value: This is an original paper. This paper talks about the most concerning issue of verbal abuse which is faced by aged people in their family and society. Basically, this paper has applied the descriptive phenomenological method for the analysis of verbal elder abuse as a social phenomenon in the sociocultural context of Indian society. [ABSTRACT FROM AUTHOR]

Drawing on biographical narratives of two gay men in mixed-orientation marriage who have later gone on to establish re-partnership with another gay man, this paper seeks to critique the inherent heteronormativity in the discussion around re-partnership. It examines the consequential kinship dynamics among concerned social actors such as gay men, straight women, and their biological children, and their ongoing negotiations with the social institutions of marriage and family. Further, the discussion around re-partnership between two gay men in a Western context does not necessarily consider the alternative negotiations that characterize South Asian queer experiences. Borrowing from De Villiers' concept of queer opacity (2012) and Jingshu Zhu's (2017) ambivalence, the paper demonstrates that the kinning process of gay men in mixed-orientation marriage forging partnership with other gay men exists in a continuum. The boundary between what needs to be undone and what needs to be redone is porous, ambiguous, and interpenetrative. In that case, this paper suggests a non-Western framework to understand re-partnership in non-normative conjugality. [ABSTRACT FROM AUTHOR]

Covid-induced lockdowns have increased the importance of technology in education. Though access to technology as well as availability of the internet remain a major concern for a lot of children in the global south, children with intellectual disabilities are disadvantaged even more as most of the e-content is developed keeping in mind the average learner. Unstructured interviews were conducted with children with intellectual disabilities studying in government schools in Haryana as well as their teachers and parents. Thematic analysis of the interviews was conducted to understand the use-patterns of mobile phones by children with intellectual disabilities. Findings suggest that these children are learning to use mobile phones on their own or with some support and are able to navigate the complexities of these smartphones quite well. They use these devices mostly for their entertainment. This paper then reflects on the need and strategies to develop these technologies in ways that they can be used as effective tools for teaching children with intellectual disabilities, especially in the inclusive education system in developing countries. The paper reflects on the need to develop technology and tools using flexible and exploratory designs to enhance the learning processes for children with intellectual disabilities from the lower income strata. This study highlights the importance of being able to use mobile phones by children with intellectual disabilities belonging to low income families. Following this, the article argues for designing of mobile phones suitable for use by children with intellectual disabilities using playfulness and explorations, and Building e-content keeping the elements of playfulness and exploration which can enhance the learnings of this group of students which is often ignored. [ABSTRACT FROM AUTHOR]

Servant leadership has emerged as a novel area of Management research. One of the most debated leadership styles is servant leadership, which indicates that a person must first be a human and then a leader. This literature review comprehensively examines the historical origins of servant leadership, its core attributes, the measurements that have been developed, and the findings obtained from pertinent empirical investigations. The primary objective of the present paper is to study the leadership style using various analyses, evaluations, and research from available sources to identify proposed facts about leadership activities using bibliometric analysis of servant leadership theory. [ABSTRACT FROM AUTHOR]

Deficits in social verbal communication in individuals with Social Communication Disorder (SCD) is of concern and SCD in the human community is prevalent in large population throughout the globe. Deficits in verbal social communication are prevalent in a large population. This paper aimed to propose internet connected multi-system architecture which is capable to support verbal communication in a social environment for individuals with social communication deficits. Implementation methodology was included with corpus collection for specific communication, deep learning based machine training for intelligent communication, and implementation of the trained algorithm on internet connected electronic multiple social communication devices. The implemented system is smart enough to initiate and maintain two types of communication; the first type includes communication between multiple individuals on the remote location and the second type includes communication with the individual present in the physical listening range. The system was investigated in terms of its algorithmic parameters and found 97% to 100% in terms of training and testing accuracy with negligible mean squared error. Vocal-Friend analysed results based on audio-bot simulative conditions provide more than 91% accuracy, interaction rate and fallback rate. On the basis of the satisfaction analysis, above average results were noticed. In terms of technical implementations and satisfaction analysis, results found acceptable with above average score. Proposed framework is easy to use by caregivers with even having little knowledge. Support individual with deficit to learn social verbal communication skill to survive in society. Aiding parents, caregivers and professionals to understand the communication needs of individuals with communication deficits. Since technology is also grooming in the domain of rehabilitation, so this system could be used in various future applications such as social robots, social virtual assistants etc. [ABSTRACT FROM AUTHOR]

The construction sector of India is the best representation of the informal workforce, which employs 36.12 million workers. These laborers flock together in a particular place on early morning every day in order to find a wage provider for them. It is a sale of labor for the day, where workers stand and make themselves available for a day to be hired by contractors or individual house owners. These places are known as labor stands, a stop for finding daily laborers for construction work, which is the distinctive addition of this research to the scant literature. This paper tries to explore the labor process among these unique informal construction workers' labor assemblies consisting of 15,000 laborers per day and explore their employment conditions and labor relations. The paper also aims to examine the role of various actors of industrial relations such as trade unions and the government in regulating this employment relationship. The paper is based on a field study encompassing the transcribed records of observation, field interaction with 84 migrant construction workers, and 118 still photographs. The data were analyzed by using qualitative analysis software and adopting open thematic coding and later by developing categories and hierarchy and doing comparative analysis. The findings reveal that these laborers experience precariousness and are challenged by nonavailability of regular work, shortages of food, burden of large family size, and social evils of living in a slum, and also face being harassed by goons as well as contractors with minimal support from trade unions and government. Employers are apathetic toward their legal obligations. With labor stands being a primary source of labor supply to the construction sector, the findings of this paper will help in enriching labor relations and policy measures for its regulation. [ABSTRACT FROM AUTHOR]

The demand for vehicles in India is on a continuous rise, primarily attributed to increasing income levels. The Indian government has initiated steps to decarbonize the transport sector, offering incentives for alternate vehicles' adoption. This study introduces a qualitative framework, employing a causal structure to comprehend the dynamics of vehicle demand. The framework takes into account critical feedback loops that influence the demand for alternate vehicles and, consequently, the overall vehicle demand. The causal loop diagram for vehicle demand encompasses five key domains: socio‐economic development, infrastructure development, environmental awareness, fuel supply market and alternate vehicle technology. Notably, economic activity, urban sprawl, vehicle demand, alternate vehicle technology improvement, and the sustainability and fuel constraints linked with internal combustion engine vehicles emerge as the critical aspects governing the dynamics of the model. The leverage and intervention points influencing the vehicle demand are also identified. Further, based on the evolving interaction of the various reinforcing and balancing loops, this work identifies three distinct phases of the evolution of vehicle demand dynamics in India, namely, the emerging phase (2020–2040), the growth phase (2040–2060) and the stagnation phase (2060–2080). The paper discusses the crucial features of these phases. [ABSTRACT FROM AUTHOR]

This paper explores the different insider employee-led cyber frauds (IECF) based on the recent large-scale fraud events of prominent Indian banking institutions. Examining the different types of fraud and appropriate control measures will protect the banking industry from fraudsters. In this study, we identify and classify Cyber Fraud (CF), map the severity of the fraud on a scale of priority, test the mitigation effectiveness, and propose optimal mitigation measures. The identification and classification of CF losses were based on a literature review and focus group discussions with risk and vigilance officers and cyber cell experts. The CF was analyzed using secondary data. We predicted and prioritized CF based on machine learning-derived Random Forest (RF). An efficient fraud mitigation model was developed based on an offender-victim-centric approach. Mitigation is advised both before and after fraud occurs. Through the findings of this research, banks and fraud investigators can prevent CF by detecting it quickly and controlling it on time. This study proposes a structured, sustainable CF mitigation plan that protects banks, employees, regulators, customers, and the economy, thus saving time, resources, and money. Further, these mitigation measures will improve the reputation of the Indian banking industry and ensure its survival. [ABSTRACT FROM AUTHOR]

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

Background: The implementers of the tobacco control policy in the field have been neglected by the policymakers. They are the ones who have first-hand knowledge and their experiences in the field are not being used to bring about changes in the area of tobacco control. Objective: The objective of this paper is to critically examine how Michael Lipsky's concept of street-level bureaucracy can be used to address tobacco control in the health department in district Jalandhar of Punjab. Methods: Semi-structured interview schedules were used to interview Senior Medical Officers/Nodal Officers and Health Supervisors/Sanitary inspectors in four out of ten Community Health Centers and District hospital in Jalandhar. Data so collected were subjected to the process of inductive analysis and themes developed within the framework given by Lipsky. Results: The street-level bureaucrats (SLBs) were not given adequate training, and various organizational resources for tobacco control are missing in the district. There are threats and challenges which are faced by them in the field, and they do not exercise decision-making power to handle these barriers for effective implementation of the tobacco control program. Conclusion: The government needs to be inclusive in the process of policymaking meaning that it can be more accommodative of the suggestions given by the SLBs and provide them with discretionary powers to exercise their role efficiently. [ABSTRACT FROM AUTHOR]

Purpose: This paper explored the reliability of self-reported health and the impact of the social position in determining the inconsistent health response (IHR), in late life. Reliability of self-reported health is important to evaluate, as it is the primary step for asking health-care facility. As self-reported health is a subjective measure, elderly people might have a tendency of under-reporting the health problem because of lower socioeconomic status. This incidence can cause inaccurate estimate of the health problem of the aged at the time of formulating health policy or providing health-care infrastructure. Therefore, the purpose of this study is to explore the sources of inconsistent responses of self-reported health by comparing it with the existence of chronicle ailment and to identify the vulnerable group that health care supports. Design/methodology/approach: The study uses nationally representative unit-level data from the National Sample Survey of India. Using the bi-variate probit model, joint estimation of reported health and IHRs is determined. The study compares perceived and actual health status and explores how individual characteristics and socioeconomic position contributes to IHRs among the elderly population. Findings: Major findings of this study are as follows: firstly, self-reported health has little reliability, as it is compared with the existence of chronicle ailment. Older people in the rural areas have greater tendency to under-estimate the health problem, whereas urban elders tend to over-estimate it; and secondly, the inconsistency in health response is significantly associated with social caste, economic status and attainment of education. Social implications: The results of this study from bivariate probit model offer deeper understandings about the reliability of self-reported health and provide further insights to improve policy design formulated to mitigate the health inequality among the elders. This study might be helpful to design an inexpensive and easily available health measure, which is very important for a highly populated aging country with limited health-care resources. Originality/value: To the best of author's knowledge, it is the first study that has identified the sources of inconsistent health and direction of inconsistency that is where self-reported health over- or under-estimates the actual health response among the elderly in a developing country like India, where the growth rate of population aging is faster than the world. [ABSTRACT FROM AUTHOR]

Rapid advances in education domain demand the design and customization of educational technologies for a large scale and variety of evolving requirements. Here, scale is the number of systems to be developed and variety stems from a diversified range of instructional designs such as varied goals, processes, content, teaching styles, learning styles and, also for eLearning Systems for 22 Indian Languages and variants. In this paper, we present a family of software product lines as an approach to address this challenge of modeling a family of instructional designs as well as a family of eLearning Systems and demonstrate it for the case of adult literacy in India (287 million learners). We present a multi-level product line that connects product lines at multiple levels of granularity in education domain. We then detail two concrete product lines (http://rice.iiit.ac.in), one that generates instructional design editors and two, which generates a family of eLearning Systems based on flexible instructional designs. Finally, we demonstrate our approach by generating eLearning Systems for Hindi and Telugu languages, which led to significant cost savings of 29 person-months for 9 eLearning Systems. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to highlight the ethical, health, and technical concerns around manual scavenging in urban India. Subject and methods: As a country, India is passing through a transitional phase of urban development, with concepts of Smart Cities and Resilient Cities taking center stage on the urban development discourse. But the country is lagging in managing crucial indicators of social and human progress within a city, especially on issues of proper sewage and sanitation facilities. In view of this light, the horrendous practice of manual scavenging has been declared an illegal profession by Indian laws; however, the profession is still rampant, even in urban areas such as Delhi and Bengaluru. Thus, this paper discusses the ethical and health implications of this practice and simultaneously reviews the technologies being implemented in several countries. Additionally, an analysis is carried out on grave issues; for instance, the number of workers engaged in such practices and their death cases in recent years. Lastly, this study presents new thinking and approaches of technological advancement that could bring an end to this rather unethical practice. Results: The review paper shows that, although the field of manual scavenging has been highly mechanized in many countries, India is yet to find a permanent solution that separates human beings from manually cleaning sewers. Conclusion: This paper brings forth a combination of measures that are legislative and technical in nature, including societal awareness, to eradicate manual scavenging in Indian cities. [ABSTRACT FROM AUTHOR]

Biofloc technology (BFT) is an aquaculture technology that uses microbial communities to produce a balanced aquatic environment for fish and crustaceans. This study evaluated the global research trends and measured the performance of researchers, organizations or research centers, countries, and funding agencies participating in BFT research in the last decade. Scientific knowledge mapping was also performed to understand the social and conceptual structure of the research publications. The study was conducted based on journal article publications indexed in the Scopus database between 2013 and 2022. The analysis showed that BFT research was increasing steadily, with a total of 911 documents published in the past 10 years. Brazil, China, and India were the three most productive countries in the field. The most productive journals were Aquaculture, Aquaculture Research, and Aquaculture International. Regarding research topics, the largest share of documents was related to bioflocs and their technologies, followed by Litopenaeus vannamei, water quality, growth performance, shrimp, Nile tilapia, Oreochromis niloticus, etc. Co-authorship network analysis revealed that the largest cluster comprised researchers from Brazil, China, and India. Moreover, the study of societal attention revealed that the BFT research needs more public attention as the research was discussed and mentioned only a few social media platforms. However, the BFT research had significant readers on Mendeley. This study provides a comprehensive overview of the current state of BFT research and the research performance of scientific actors. It can serve as a valuable reference for researchers and policymakers. [ABSTRACT FROM AUTHOR]

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

Background: Interactive teaching methods aid post graduate students in learning qualitative research. Four academic researchers from the United Kingdom had an opportunity to teach qualitative research methods, specifically consensus methods, to the Master of Public Health students (MPH) during a visit to India. This teaching formed part of a work package with All India Institute of Medical Sciences Rishikesh, India exploring the concept of family resilience among families with children under 6 years. Aims: To use the experiences of the MPH students to gain knowledge and create meaning about using the consensus methods. Participants: The participants were the MPH students. Methods: We used the workshop method to introduce the concept of family resilience by using the question, ‘What will be the three top public health priorities in India to support family resilience in the 21st century?’ as a central theme for all the workshops. Furthermore, we introduced qualitative research methods and hands on experience of consensus methods to the students. The students were introduced to Delphi and Group Concept Mapping (GCM) methods during workshop 1. Workshop 2 introduced Nominal Group Technique (NGT) through a short presentation followed by a practical hands on session using GCM data from workshop 1. The last workshop (3) focused on the World Café method. Results: The students evaluated the workshops highly and asked for online sessions on GCM, NGT, and World Café which will be planned in the future. Conclusion: We concluded that the post graduate curriculum for master’s in public health studies would benefit from teaching using interactive research methods which will enhance their critical thinking and autonomy. Second, although the MPH curriculum had quantitative methods in place, introducing qualitative consensus methods will open new avenues into future research. Finally, teaching using practical demonstration gives students a voice and makes learning effective and enjoyable. [ABSTRACT FROM AUTHOR]

Purpose: Fear of crime is an emerging social problem in Indian society that has a significant impact on the quality of life of the elderly. In the view of this fact, the purpose of this paper is to examine the factors such as (prior victimisation, vulnerability and incivility) which contribute their role in bringing fear of crime among the elderly. Design/methodology/approach: Mixed method approach has been applied in this paper. This study has been designed as an exploratory lead-in to a planned wider study into rural–urban context as possible factors in shaping the victimisation experience. The study has been conducted from October 2012 to January 2013 on a sample of 220 elderly living in both rural and urban areas of Lucknow in the state of Uttar Pradesh, India. Findings: The study found that elderly have been victimised by known persons as compared to unknown persons. Further, the study found that immediate neighbourhood was swarming with loiters, unruly teenagers, gangs, beggars and alcoholic people walk in the society which have significantly impact on the elderly and give threat in neighbourhood. Originality/value: This is an original work of researcher. [ABSTRACT FROM AUTHOR]

The ability to exploit students' sentiments using different machine learning techniques is considered an important strategy for planning and manoeuvring in a collaborative educational environment. The advancement of machine learning technology is energised by the healthy growth of big data technologies. This helps the applications based on Sentiment Mining (SM) using big data to become a common platform for data mining activities. However, very little has been studied on the sentiment application using a huge amount of available educational data. Therefore, this paper has made an attempt to mine the academic data using different efficient machine learning algorithms. The contribution of this paper is two-fold: (i) studying the sentiment polarity (positive, negative and neutral) from students' data using machine learning techniques, and (ii) modelling and predicting students' emotions (Amused, Anxiety, Bored, Confused, Enthused, Excited, Frustrated, etc.) using the big data frameworks. The developed SM techniques using big data frameworks can be scaled and made adaptable for source variation, velocity and veracity to maximise value mining for the benefit of students, faculties and other stakeholders. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to assess the role of National Rural Health Mission (NRHM) in reducing Infant Mortality in India. The study will help the government in deciding its future course of action regarding the infant mortality rate (IMR) reduction in India.Design/methodology/approach This paper adopts the interrupted time series analysis (ITSA) approach with a control group to study the role of NRHM in reducing the IMR in India. The authors examined infant mortality in rural areas of India for the level and trend change before and after the implementation of NRHM. The authors then applied a suitable ARMA model to estimate the coefficients of the regression model. From the estimated results, the study predicts the counterfactuals for both the rural IMR and urban IMR and plots the results.Findings The study found the evidence supporting the hypotheses that the NRHM has led to a reduction in the difference between urban IMR and rural IMR. The research shows that the rural IMR declined at steeper rates in the post-NRHM period (2005–2015).Originality/value None of the existing studies analyses the impact of a social scheme like NRHM on the reduction of IMR in India by applying the ITSA. The study is unique as it estimates the counterfactuals and plots the results which show the impact of NRHM on reducing IMR. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to examine the linkages of employment, chronic disease prevalence and medical care of the older population in India. Design/methodology/approach -- This study used the India Human Development Survey data for the analysis. Bivariate, multinomial logit regression and multiple classification analysis are used as methods for the study Findings -- The findings suggest a bi-directional relationship between employment and chronic diseases: the older population who are engaged in regular paid work has lower likelihood to the risk of chronic diseases compared to those who are not working. Conversely, the older population with chronic diseases may be unable to work in regular paid jobs. The greater proportions of not-working older population with savings and retirement pensions are more likely to seek modern treatment for the chronic diseases. Overall, the results foster that employment determines and is determined by chronic disease prevalence among the older population in India. Originality/value -- This paper tor the first time presents evidence on the linkages of employment, chronic disease prevalence and medical care of the older population in India by using a unique and comprehensive data source. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to draw theoretical insight from Sen's capability-approach and attempts to examine the effectiveness of health-insurance-schemes in reducing out-of-pocket-expenditure (OOPE) and catastrophic-health-expenditure (CHE) in India. Design/methodology/approach: Data were extracted from the National-Sample-Survey-Organization, 71st round on Health-2014. Generalized-linear-regression-model was used to investigate the impact of social-protection-schemes on OOPE and CHE. Findings: A notable segment of the Indian population is still not covered under any health-insurance-schemes. The majority of the insured population was covered by publicly-financed-health-insurance-schemes (PFHIs), with a trivial-share of private-insurance. Households from 16–59 age-group, urban, literate, richest, southern-regions, using private-facilities and having ear and skin ailments have reported higher insurance coverage. Reimbursement was higher among elderly, literates, middle-class, central-regions, using private-facilities/insurance and for infections. Access to PFHIs significantly reduces the risk of OOPE and CHE. Unavailability of reimbursement exposes the population to a higher risk of CHE. Research limitations/implications: Being a study based on secondary data sources, its applicability may vary as per the other social indicators. Practical implications: Extending insurance-coverage alone cannot answer the widespread inequalities in health care. Rather, an efficiently managed reimbursement-mechanism could condense OOPE and CHE by enhancing the capability of the population to confront the undue financial burden. Social implications: Extending the health-insurance-coverage to the entire population requires a better understanding of the underlying-dynamics and health-care needs and must make health-care affordable by enhancing the overall capability. Originality/value: This research brings a theoretical and conceptual analysis for improving the health-insurance coverage among the community as a public health strategy. [ABSTRACT FROM AUTHOR]

In this paper, we present a framework to examine the kinds of careers that rural disadvantaged youth would like to know about in a career guidance intervention as also related findings from two different rural disadvantaged contexts in India. Differences across gender, age group, region, and participation/non-participation in youth programmes are also explored. The results validate the importance of comprehensive career needs assessment and provide specific directions for designing and adapting career guidance interventions for rural disadvantaged youth. Implications for research and practice are discussed in general as well as for the specific contexts included in this study. [ABSTRACT FROM AUTHOR]

Background: Equity and justice in healthcare payment form an integral part of health policy and planning. In the majority of low and middle-income countries (LMICs), healthcare inequalities are further aggravated by Out of Pocket Expenditure (OOPE). This paper examines the pattern of health equity and regional disparities in healthcare spending among Indian states by applying Andersen's behavioural model of healthcare utilization. Methods: The present study uses data from the 66th quinquennial round of Consumer Expenditure Survey, of the National Sample Survey Organization (NSSO), conducted in 2009-10 by Ministry of Statistics and Programme Implementation (MoSPI), Government of India (GoI). To measure equity and regional disparities in healthcare expenditure, states have been categorized under three heads on the basis of monthly OOPE i.e., Category A (OOPE > =INR 100); Category B (OOPE between INR 50 to 99) and Category C (OOPE < INR 50). Multiple Generalised Linear Regression Model (GLRM) has been employed to explore the effect of various socio-economic covariates on the level of OOPE. Results: The gap in the ratio of average healthcare spending between the poorest and richest households was maximum in Category A states Category B (richest/poorest = 14.60), followed by (richest/poorest 11.70) and Category C (richest/poorest 11.40). Results also indicate geographical concentration of lower level healthcare spending among Indian states (e.g., Odisha, Chhattisgarh and all the north-eastern states). Results from the multivariate analysis suggest that people residing in urban areas, having higher economic status, belonging to non-Muslim communities, non-Scheduled Tribes (STs), and non-poor households spend more on healthcare than their counterparts. Conclusions: In spite of various efforts by the government to reduce the burden of healthcare spending, widespread inequalities in healthcare expenditure are prevalent. Households with high healthcare needs (SCs/STs, and the poor) are in a more disadvantaged position in terms of spending on health care. It has also been observed that spending on healthcare was comparatively lower among backward or isolated states. No doubt, the overall social security measures should be enhanced, but at the same time, looking at the regional differences, more priority should be assigned to the disadvantaged states to reduce the burden of OOPE. It is proposed that there is need to increase government spending, especially for the disadvantaged states and population, to minimise the burden of OOPE. [ABSTRACT FROM AUTHOR]

This paper reports the results of formative and outcome evaluation of two ongoing community-based intervention programmes for integrated non-communicable disease (NCD) prevention and control in urban low-income settings of Ballabgarh near New Delhi, India, and in Depok, West Java Province of Indonesia. At both sites, a coalition of community members facilitated by academic institution and the World Health Organization, planned and implemented the intervention since 2004. The intervention consisted of advocacy and mediation with stakeholders, training of volunteers and school teachers, communication campaigns, risk assessment camps and reorientation of health services. The formative evaluation was based on the review of documents, and outcomes were assessed using the standardized surveys for NCD risk factors in 2003–2004 and 2006–2007. The baseline surveys showed that tobacco use, low intake of fruits and vegetable, suboptimal levels of physical activity and obesity were prevalent in both the communities. A frequent change in local administrators and lack of perceived priority for health and NCDs limited their involvement. Pre-existing engagement of community-based organizations and volunteers in health activities facilitated its implementation. The reach of the programme among the population was modest (25–32%). Health system interventions resulted in increased diagnosis and better management of NCDs at health facilities. Early outcome measures showed mixed results of change in different risk factors. The experiences gained are being used in both countries to expand and provide technical support to national efforts. This paper adds to the knowledge base on the feasibility of designing and implementing large-scale community-based interventions for integrated prevention of NCDs through modification of risk factors. [ABSTRACT FROM AUTHOR]

This paper examines the role of service climate (SC) in the link connecting human resource management practices (HRMP) to commitment to service quality (CSQ). Data were collected from 1236 hospital staff working in different private hospitals in India. The model linking HRMP to CSQ with the moderation of SC was tested using Hayes PROCESS. Results revealed that human resource management practices found to be influencing CSQ and with the interaction of SC the effect is further augmented. The interacting role service climate has been found to be significant at mean and high levels. [ABSTRACT FROM AUTHOR]

Purpose: Employee engagement has become a hot topic among the global workforce. Both academicians and practitioners tout engagement to have a positive impact on individual and organizational performance. However, despite the enhanced interest, the stagnant engagement levels worldwide pose a grave concern for the researchers. Numerous overlapping and inconsistent definitions of employee engagement lead to a conceptual chaos resulting in poor operationalization of the construct. The purpose of this paper is to develop a multi-dimensional measurement tool for employee engagement based on the evidences from the best companies to work for in India. Design/methodology/approach: Interviews with the top management of the 15 best companies are used for the generation of items using grounded theory methodology. These items are then subjected to content validity assessment by six domain experts. The scale is administered to the middle-level employees of five companies (n = 332) through questionnaire for exploratory and confirmatory factor analysis, reliability assessment and initial evidences for convergent and discriminant validity. Findings: The study aimed at developing and validating an employee engagement assessment instrument, which is well-grounded in theory and built on the conceptual framework proposed by both academicians and practitioners and rigorously tested for its psychometric properties to ensure the precise measurement of employee engagement. A 3-factor/16 item employee engagement measurement tool is the finding of this study, which attempts to bridge the incongruity between the academic and industrial view on employee engagement. Originality/value: Looking at the dearth of measurement tools built in developing countries and with the intent of resolving the issues related with cultural differences in the application of western assessment tools, the developed scale made a notable contribution to engagement theory with prime focus in the Indian context. The three dimensions of employee engagement-alignment, affectiveness and action- orientation- are in a form and language, that is, comprehensible and consequential for practitioners enabling them to take a closer look at the critical engagement elements that align with the organization's human capital strategy and foster improved performance. [ABSTRACT FROM AUTHOR]

Background Information on the average and incremental costs of implementing alternative strategies for treating young infants 0-59 days old in primary health facilities with signs of possible serious bacterial infection (PSBI) when a referral is not feasible is limited but valuable for policymakers. Methods Direct activity costs were calculated for outpatient treatment of PSBI and pneumonia in two districts of India: Palwal, Haryana and Lucknow, Uttar Pradesh. These included costs of staff time and consumables for initial assessment, classification, and referrals; recommended treatment of fast breathing (oral amoxicillin for seven days) and PSBI (injection gentamicin and oral amoxicillin for seven days); and daily assessments. Indirect operational costs included staff training; staff time cost for general management, supervision, and coordination; referral transport; and communication. Results The average cost per young infant treated for recommended and acceptable treatment for PSBI was 16 US dollars (US$) (95% CI=US$15.4-16.3) in 2018-19 and US$18.5 in 2022 (adjusted for inflation) when all direct and indirect operational costs were considered. The average cost of recommended treatment for pneumonia was US$10.1 (95% CI=US$9.7-10.6) or US$11.7 in 2022, per treated young infant. The incremental cost 2018-2019 for supplies, medicines, and operations (excluding staff time costs) per infant treated for PSBI was US$6.1 and US$4.3 and for pneumonia was US$3.5 and US$2.2 in Palwal and Lucknow, respectively. Operation and administrative costs were 25% in Palwal and 12% in Lucknow of the total PSBI treatment costs. The average cost per live birth for treating PSBI in each population was US$5 in Palwal and US$3 in Lucknow. Higher operation costs for social mobilisation activities in Palwal led to the empowerment of families and timely care-seeking. Conclusions Costs of treatment of PSBI with the recommended regimen in an outpatient setting, when a referral is not feasible, are under US$20 per treated child and must be budgeted to reduce deaths from neonatal sepsis. The investment must be made in activities that lead to successful identification, prompt care seeking, timely initiation of treatment and follow-up. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Negative perceptions of illnesses can increase caregivers' use of ineffective coping strategies, which may increase their burdens and distress. Scientific and theoretical framework showed that culture and health organization system influence perception of illnesses and thus also has an impact on the coping strategies used. There is a lack of data on comparative perceptions of illnesses and coping styles between India and Switzerland and that is why this hypothesis needs to be confirmed. The comparison between two countries with large cultural and socioeconomics differences will provide a more significant impact., What this paper adds to existing knowledge? This cultural comparative study explores the associations between representations of illness and three forms of coping styles (i.e. problem-focused, emotion-focused and social support-focused coping) among caregivers of people diagnosed with schizophrenia spectrum disorders in Mangalore, India, and in French-speaking Switzerland. Results showed significant differences between Swiss and Indian caregivers practically in all illness' perceptions and coping styles, which is in accord with the theoretical framework. However, two results showed also similarities: the perception that schizophrenia can have cyclical episodes and that it can have negative consequences for caregivers., These differences and similarities allow to confirm the hypothesis that culture and health organization system influence illness' perception which impact the used coping styles. However, to develop specific nursing interventions for each culture, more research is needed to specify qualitatively the content of these differences and similarities., What are the implications for practice? Knowledge of how culture influences perceptions and coping styles is essential to develop quality interventions. Nurses should evaluate caregivers' perceptions and the causes they attribute to illnesses to help them maintain or develop efficient coping strategies. Knowledge of specific cultural differences and similarities can help nurses to provide individualized care that takes into account personal values to ensure recovery processes., Abstract Introduction Scientific and theoretical framework showed that culture and health organization system influence perception of illnesses and thus also has an impact on the coping strategies used. Aim/question This cultural comparative study explores illness' perception and coping styles among the caregivers of people diagnosed with schizophrenia spectrum disorders in Mangalore, India, and Lausanne, Switzerland. Method The answers of 92 Swiss caregivers, using paper or electronic surveys depending on the participants' preference, and 100 Indian caregivers via an interview with a nurse were examined. Results The results confirm the hypothesis that culture and health organization system influence illness' perception which impact the used coping styles. Significant differences between Swiss and Indian caregivers practically in all illness' perceptions and coping styles were present, which is in accord with the theoretical framework. However, two results showed also similarities: the perception that schizophrenia can have cyclical episodes and that it can have negative consequences for caregivers. Discussion These differences will affect the development of interventions for caregivers in both countries. Implications for Practice The cultural differences observed in this study not only will allow interventions to be adapted to the specific needs of the two populations but also to identify their shared needs. [ABSTRACT FROM AUTHOR]

Purpose: Healthcare innovations are one of the drivers of healthcare sector growth in India. Innovation policies are challenging because of the uncertainty regarding the outcome of the innovations. Hence, there is a need to understand the interface between policies and healthcare innovations to identify gaps and propose timely recommendations. Accordingly, this study uses the Indian healthcare start-up sector as a case study to analyse the above linkages, gaps and propose recommendations. Methodology: Quantitative data from the Start-up India portal along with qualitative data from key informant interviews have been analysed to draw insights. Findings: Healthcare start-ups have made significant contributions to the economy and healthcare sector, but there are gaps and room for improvement especially in the areas of awareness, funding and mentoring. Conclusions: Based on the study findings a conceptual framework has been created for understanding the nature of gaps and their linkages in the healthcare innovation lifecycle. [ABSTRACT FROM AUTHOR]

Introduction: There is limited guidance on strategies for delivering complex global health programs. We synthesized available evidence on implementation strategies and outcomes utilized in the global polio eradication initiative (GPEI) across low and middle-income country (LMIC) settings. Methods: We nested our scoping review into a literature review conducted as part of a parent study, STRIPE. This review systematically searched PubMed for articles between 1 January 1988 and 25 April 2018 using polio search terms. Strategies from included studies were organized according to the Expert Recommendations for Implementing Change (ERIC) framework, specified using Proctor's framework, and linked to various outcomes (implementation, services delivery, impact). Results: 152 unique articles fulfilled our inclusion criteria (from 1,885 articles included in the parent study). Only 43 out of the 152 articles described a suitable quantitative study design for evaluating outcomes. We extracted 66 outcomes from the 43 unique studies. Study publication dates ranged from 1989 to 2018 and represented diverse country settings. The most common implementation strategies were developing mechanisms for feedback, monitoring, and evaluation (n = 69); increasing awareness among the population (n = 58); involving stakeholders, workers, and consumers in the implementation efforts (n = 46); conducting workshops (n = 33); using mass media (n = 31); and building robust record systems to capture outcomes (n = 31). Coverage (n = 13) and morbidity (n = 12) were the most frequently identified outcomes, followed by effectiveness (n = 9) and fidelity (n = 6). Feasibility and sustainability were rarely evaluated. Conclusions: This review provides a catalogue of implementation strategies and outcomes relevant for advancing global health services delivery in LMICs drawing from the GPEI. Implementation strategies reviewed were poorly described and not adequately linked to outcomes. It calls for additional implementation research to unravel the mechanisms of implementation strategies and their effectiveness, and adaptation of the ERIC framework in LMICs. [ABSTRACT FROM AUTHOR]

To explore themes regarding work-related barriers to access to health care, we conducted 32 interviews, 16 with third gender people and 16 with cisgender women, all of whom were all living with HIV in Hyderabad, India. Most respondents were members of Dalit castes and had been living with HIV for several years at the time of the interview. Using thematic content analysis, interviews were coded by two researchers using a social determinants of health conceptual framework. Themes highlighted in this study include the burden of taking time off from work, the loss of pay associated with missing work, and the interruption of gendered care work responsibilities that respondents faced when seeking treatment. Findings from this study support the claim that equitable work policies and practices for marginalized laborers can increase access to medical care for people living with HIV. [ABSTRACT FROM AUTHOR]

The primary aim of this study is to investigate the factors influencing work-life balance among women teachers in secondary schools, with a focus on the role of training programs, emotional intelligence, stress management and supportive work environments. A cross-sectional research design was employed, and data were collected from 422 women teachers in Durg district, Chhattisgarh, using an online survey during period July to December 2023. Through Partial Least Squares Structural Equation Modeling (PLS-SEM) analysis, the study found that high-quality training programs play a significant role in enhancing work-life balance, with emotional intelligence and stress management acting as crucial mediating factors. Additionally, a supportive work environment was identified as a key moderator in the relationship between training programs and work-life balance. These findings highlight the importance of holistic approaches that integrate training programs, emotional intelligence development, stress management, and supportive work environments to foster a healthy work-life balance among women educators. The implications of these findings for policy and practice in the education sector highlight the necessity of investing in teacher development programs and organizational initiatives aimed at supporting teacher well-being. [ABSTRACT FROM AUTHOR]

Background: Medical abortion with mifepristone and misoprostol can be provided up to 63 days' gestation in India. This accounts for 67.5 percent of all abortions in the country. We conducted an assessment to determine the availability of medical abortion medicines, specifically the combi-pack, in India. Methods: We applied the World Health Organization landscape assessment protocol at the national level. The assessment protocol included a five-step adaptation of an existing availability framework, including online data collection, desk review, country-level key informant interviews, and an analysis to identify barriers and opportunities to improve medical abortion availability. The assessment was conducted between August and March 2021. Results: Medicines for medical abortion are included in the national essential drug list and available with prescription in India. The assessment identified 42 combi-pack products developed by 35 manufacturers. The quality of medical abortion medicines is regulated by national authorities; but as health is devolved to states, there are significant inter-state variations. This is seen across financing, procurement, manufacturing, and monitoring mechanisms for quality assurance of medical abortion medicines prior to distribution. There is a need to strengthen supply chain systems, ensure consistent availability of trained providers and build community awareness on use of medical abortion medicines for early abortions, at the time of the assessment. Conclusion: Opportunities to improve availability and quality of medical abortion medicines exist. For example, uniform implementation of regulatory standards, greater emphasis on quality-assurance during manufacturing, and standardizing of procurement and supply chain systems across states. Regular in-service training of providers on medical abortion is required. Finally, innovations in evidence dissemination and community engagement about the recently amended abortion law are needed. Plain language summary: Medical abortion is popular in India and benefits from a liberal legal context. It is important to understand the availability of quality abortion medicines in the country. Using the World Health Organization country assessment protocol and availability framework for medical abortion medicines we examined the availability of these medicines from supply to demand. We used this information to identify opportunities for increasing availability of quality-assured medical abortion medicines. We found that the context for medical abortion varies across states. Strengthening procurement and supply chain management, with a greater emphasis on quality-assurance and regulation of manufacturing should be instituted at the state-level. Training is also needed to increase provider knowledge of the latest national guidelines and laws to ensure respectful and person-centered services. Finally, the public should be informed about medical abortion as a safe and effective choice, especially for early abortions. [ABSTRACT FROM AUTHOR]

Purpose – This paper seeks to discuss the attitudes and beliefs of the Pakistani/Kashmiri community in Birmingham towards the cultural practice of consanguineous (cousin) marriage and health, and how an understanding of Pakistani/Kashmiri community views may help institute good practice for health care professionals. Design/methodology/approach – A qualitative research study using eight gender- and age-specific focus group discussions and eight in-depth one-to-one interviews with participants who were in consanguineous relationships. All participants were from the Pakistani/Kashmiri community and residents of Springfield ward in Birmingham. Findings – The findings illustrate Pakistani/Kashmiri attitudes towards consanguinity and health. There was awareness of still births and genetic conditions but a poor understanding of genetics; respondents were reluctant to accept the link between cousin marriages and birth issues and explanations for still births and impairments were largely attributed to the "will of God". Female respondents were in favour of screening for genetic conditions but would not terminate pregnancies as this was contrary to Islamic ideas about pre-destiny and all respondents wanted more medical and Islamic scholarly information on cousin marriage and how it is linked to disabilities. Clearly there is a need to improve healthcare outcomes and reduce infant mortality in the Pakistani/Kashmiri community. Research limitations/implications – Research findings correspond with previous studies that have explored ethnic minority knowledge and attitudes to health and healthcare services and the need for culturally competent services. Originality/value – This paper presents some suggestions on effecting behaviour change in this important area. [ABSTRACT FROM AUTHOR]

Analyzing multiple data sources from a global information technology (IT) consulting multinational enterprise (MNE), this research unpacks the configuration of a digitalized HR ecosystem of artificial intelligence(AI)‐assisted human resource management (HRM) applications and HR platforms. This study develops a novel theoretical framework mapping the nature and purpose of a digitalized AI‐assisted HR ecosystem for delivering exceptional employee experience (EX), an antecedent to employee engagement (EE). Employing the theoretical lenses of EX, EE, AI‐mediated social exchange, and engagement platforms, this study's overarching aim of this article is to establish how AI‐assisted HRM fits into an organization's ecosystem and, second, how it impacts EX and EE. Our findings show that AI‐assisted applications for HRM enhance EX and, thus, EE. We also see increases in employee productivity and HR function's effectiveness. Implications for research and practice are also discussed. [ABSTRACT FROM AUTHOR]

The impact of human rights interventions on health outcomes is complex, multiple, and difficult to ascertain in the conventional sense of cause and effect. Existing approaches based on probable (experimental and statistical) conclusions from evidence are limited in their ability to capture the impact of rights-based transformations in health. This paper argues that a focus on plausible conclusions from evidence enables policy makers and researchers to take into account the effects of a co-occurrence of multiple factors connected with human rights, including the significant role of "context" and power. Drawing on a subject-near and interpretive (in other words, with regard to meaning) perspective that focuses on the lived experiences of human rights-based interventions, the paper suggests that policy makers and researchers are best served by evidence arrived at through plausible, observational modes of ascertaining impact. Through an examination of what human rights-based interventions mean, based on the experience of their operationalization on the ground in culturally specific maternal and reproductive health care contexts, this paper contributes to an emerging scholarship that seeks to pluralize the concept of evidence and to address the methodological challenges posed by heterogeneous forms of evidence in the context of human rights as applied to health. [ABSTRACT FROM AUTHOR]

The World Trade Organisation's Trade Related Intellectual Property Rights [TRIPS] agreement aimed to harmonise intellectual property rights and patent protection globally. In India, the signing of this agreement resulted in a sharp increase in clinical trials since 2005. The Indian government, along with larger Indian pharmaceutical companies, believed that they could change existing commercial research cultures through the promotion of basic research as well as attracting international clinical trials, and thus create an international level, innovation-based drug industry. The effects of the growth of these outsourced and off-shored clinical trials on local commercial knowledge production in India are still unclear. What has been the impact of the increasing scale and commercialisation of clinical research on corporate science in India? In this paper we describe Big-pharmaceuticalisation in India, whereby the local pharmaceutical industry is moving from generic manufacturing to innovative research. Using conceptual frameworks of pharmaceuticalisation and innovation, this paper analyses data from research conducted in 2010–2012 and describes how Contract Research Organisations (CROs) enable outsourcing of randomised control trials to India. Focussing on twenty-five semi-structured interviews CRO staff, we chart the changes in Indian pharmaceutical industry, and implications for local research cultures. We use Big-pharmaceuticalisation to extend the notion of pharmaceuticalisation to describe the spread of pharmaceutical research globally and illustrate how TRIPS has encouraged a concentration of capital in India, with large companies gaining increasing market share and using their market power to rewrite regulations and introduce new regulatory practices in their own interest. Contract Research Organisations, with relevant, new, epistemic skills and capacities, are both manifestations of the changes in commercial research cultures, as well as the vehicles to achieve them. These changes have reinvigorated public concerns that stress not only access to new medicines but also the ‘price’ of innovation on research participants. [ABSTRACT FROM AUTHOR]

Background: Absence of better financing mechanism results in higher out of pocket expenditure and catastrophe, which leads to impoverishment and poverty especially among low- and middle-income countries like India. This paper examines the major characteristics associated with the higher out of pocket expenditure and provides an insight from Andersen's behavioural model that how predisposing, enabling and need factors influence the level and pattern of out of pocket expenditure in India. Methods: Data has been extracted from three rounds of nationally representative consumer expenditure surveys, i.e. 1993–1994, 2004–2005 and 2011–2012 conducted by the Government of India. States were categorized based on regional classification, and adult equivalent scale was used to adjust the household size. Multiple Generalized-Linear-Regression-Model was employed to explore the relative effect of various socio-economic covariates on the level of out of pocket expenditure. Results: The gap has widened between advantaged and disadvantaged segment of the population along with noticeable regional disparities among Indian states. Generalized-Linear-Regression-Model indicates that the most influential predisposing and enabling factor determining the level of out of pocket expenditure were age composition, religion, social-group, household type, residence, economic status, sources of cooking and lighting arrangements among the households. Conclusions: Present study suggests the need for strengthening the affordability mechanism of the households to cope with the excessive burden of health care payments. Furthermore, special consideration is required to accommodate the needs of the elderly, rural, backward states and impoverishment segment of population to reduce the unjust burden of out of pocket expenditure in India. [ABSTRACT FROM AUTHOR]

Analyzing qualitative case‐study data from two emerging market multinational corporations (MNCs) from the Indian pharmaceutical industry, we develop two theoretical frameworks based on goal‐setting and cognitive evaluation theories along with indigenous Indian management theories, including the principles of Ayurveda for analyzing performance management systems in an indigenous and modern pharmaceutical MNC. Data were analyzed from multiple data sources, such as interviews, non‐participant observation, multiple site visits, organizational documents, policies, client testimonials, and publically available information through the website and annual reports. The indigenous firm offered a holistic approach to managing multiple stakeholders. Its overarching performance goal focused on all stakeholders collectively contributing to the patient' and others' holistic well‐being. All employees' and stakeholders' unified and singular efforts dovetailed to achieve physical, mental, emotional, spiritual, and environmental well‐being as a proxy for performance. Organizational values, culture, and contextual influences of informal learning, empowerment, and task variability helped achieve its overarching goals. The Western pharmaceutical firm focused on atomistic, granulated, and an objective way of assessing and evaluating performance, wherein cost‐effectiveness, innovation, and high‐performance were vital performance outcomes. Performance coaching and task invariability adversely affected individual outcomes. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

The paper discusses an approach to verbal autopsies that engages with theRashomonphenomenon affectingex post factoconstructions of death and responds to the call for maternal safety. This method differs from other verbal autopsies in its approach to data collection and its framework of analysis. In our approach, data collection entails working with and triangulating multiple narratives, and minimising power inequalities in the investigation process. The framework of analysis focuses on the missed opportunities for death prevention as an alternative to (or deepening of) the Three Delays Model. This framework assesses the behavioural responses of health providers, as well as community and family members at each opportunity for death prevention and categorises them into four groups: non-actions, inadequate actions, inappropriate actions and unavoidably delayed actions. We demonstrate the application of this approach to show how verbal autopsies can delve beneath multiple narratives and rigorously identify health system, behavioural and cultural factors that contribute to avoidable maternal mortality. [ABSTRACT FROM PUBLISHER]

Background: Millennium Development Goal (MDG) 5 is focused on reducing maternal mortality and achieving universal access to reproductive health care. India has made extensive efforts to achieve MDG 5 and in some regions much progress has been achieved. Progress has been uneven and inequitable however, and many women still lack access to maternal and reproductive health care. Objective: In this review, a framework developed by the Commission on Social Determinants of Health (CSDH) is used to categorize and explain determinants of inequity in maternal and reproductive health in India. Design: A review of peer-reviewed, published literature was conducted using the electronic databases PubMed and Popline. The search was performed using a carefully developed list of search terms designed to capture published papers from India on: 1) maternal and reproductive health, and 2) equity, including disadvantaged populations. A matrix was developed to sort the relevant information, which was extracted and categorized based on the CSDH framework. In this way, the main sources of inequity in maternal and reproductive health in India and their inter-relationships were determined. Results: Five main structural determinants emerged from the analysis as important in understanding equity in India: economic status, gender, education, social status (registered caste or tribe), and age (adolescents). These five determinants were found to be closely interrelated, a feature which was reflected in the literature. Conclusion: In India, economic status, gender, and social status are all closely interrelated when influencing use of and access to maternal and reproductive health care. Appropriate attention should be given to how these social determinants interplay in generating and sustaining inequity when designing policies and programs to reach equitable progress toward improved maternal and reproductive health. [ABSTRACT FROM AUTHOR]