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The article explains the mechanisms of informal value transfer systems (IVTS) and illustrates the obstacles to domestic and international IVTS regulation including lax recordkeeping, language barriers and lack of communication between federal and international regulatory regimes. It highlights the steps taken by the U.S. to regulate IVTS and discusses the ongoing challenges to the U.S. approach. It compares the regulatory attempts of foreign countries including India, Pakistan and Afghanistan.

Among several other countries, India has launched numerous digital initiative programmes aimed at integrating and upgrading various socioeconomic, political and health and social care arenas. One such area is child adoption, where a move away from the analogue system and towards digitalisation began in 2015. The Indian Ministry of Women & Child Development introduced the Child Adoption Resource Information and Guidance System (CARINGS), a digital adoption formalisation platform, under the Central Adoption Resource Authority, a nodal body that monitors and regulates both in-country and intercountry adoptions. This government initiative centralised adoption data from all over India, including the number of children declared free for adoption and the number of prospective parents registered and seeking to adopt. Against this context, this study aims to map the development of adoption in India through digital systems and the influence of digitilisation on those involved in the pre- and post-adoption phases. Drawing on both Western and Indian literature, as well as observations from an ongoing qualitative study on adoption digitalisation in India, this study discusses the benefits and limitations of digital systems for the people connected to them. The findings provide a comprehensive view of the interaction of technology and society and how this operates in the sociocultural context of adoption in India. Future implications for researchers and adoption social workers and consultants are discussed. Plain Language Summary: The process of adoption in India was largely paper based until 2015. With the launch of the Digital India movement in 2015, newer digital facilities were introduced in various socioeconomic, political, health and social care sectors. Adoption was one such area: the Indian Ministry of Women and Child Development introduced a digital adoption formalisation platform called the Child Adoption Resource Information and Guidance System (CARINGS). It was established under the Central Adoption Resource Authority, which is responsible for monitoring and regulating both in-country and intercountry adoptions. CARINGS is a centralised database of the children waiting for adoption and prospective parents registered and seeking to adopt. It aims to streamline the adoption process and make it more efficient and transparent. A qualitative study was conducted to explore the impact of digital adoption on those involved in the pre- and post-adoption phases. The study included the perspectives of adoption social workers, adoption consultants, prospective adopters and adoptive parents. The present paper maps the influence of digital adoption in the pre- and post-adoption phases and discusses the advantages and challenges that arise from the interaction of technology and society. The paper concludes by presenting the future implications of digital adoption for researchers, adoption social workers and consultants. [ABSTRACT FROM AUTHOR]

The paper examines Peer to Peer (P2P) lending in India, its growth and the way lending platforms have fared following the introduction of regulations by Reserve Bank of India. The paper analyses the transaction practices of these lending platforms, their margins and makes a comparison with the micro finance model of lending. The paper observes that there was an increase in the number of platform-based lending entities from 2010 to 2017. Subsequently, the growth of peer to peer lending platforms has been subdued following regulations introduced by the RBI. The paper finds that their operations belie their claim of being transparent. The desired lower cost to borrowers is yet to be witnessed in this novel segment of lending. [ABSTRACT FROM AUTHOR]

The Changing dynamics of the Indian Reinsurance market has promoted the Insurance Regulatory and Development Authority of India (IRDAI) to introduce the IRDAI (Re-insurance) Regulations, 2018 which came into force on January 1, 2019 and repeal the previous regulations applicable to reinsurance (i.e. the IRDAI (General Insurance - Reinsurance) Regulations 2016, ("GIR Regulations") and the IRDAI (Life Insurance - Re-insurance) Regulations, 2013). This paper discusses the major changes that have been introduced under the new Re-insurance regulations and the need for the same. The paper seeks to understand the broad Reinsurance regulatory framework in India, the major players in the industry and what necessitated the comprehensive review of the erstwhile Re-insurance regulations. The paper briefly explores the role of the General Insurance Corporation of India and explores the changes brought about by the Insurance Law (Amendment) Act, 2015 which led to the establishment of branch offices of the foreign companies engaged in the reinsurance business. The new Reinsurance regulations have introduced a new order of preference that has been criticised as being anti-competitive. The paper thus seeks to explore in detail the new order of preference that has been introduced under the new regulations. [ABSTRACT FROM AUTHOR]

The novel Corona virus is a pandemic that has affected every human being on this planet, either directly by the virus itself, or by the social and economic consequences of the same. Needless to say, this pandemic has also had an effect on the administrations of most, if not all, the nations. This research paper seeks to draw a comparative analysis between the powers of the Executive in India and the United States of America during this pandemic. As we know, India follows a Parliamentary form of governance where the Prime Minister is the Head of the Government and a system of collective leadership is followed, whereas the USA follows a Presidential form of governance where the President is the Head of the State and the principle of individual leadership is followed. A comparative analysis of the two States' powers of the Executive will enable an enhanced comprehension by highlighting important details about pandemic related legislations like the Pandemic and All-Hazards Preparedness Act, 2006 (USA) and the Epidemic Act of India, 1897; and help making abstract ideas more concrete. In this research paper, using the doctrinal method of research, we will analyse the background of the pandemic via medical papers and WHO mandates, and further delve into the executive powers of both, India and the USA during a pandemic by analysing constitutional provisions like that of the 10th Amendment of the Constitution of the USA and the Emergency Provisions under Articles 352 to 360 of the Indian Constitution and different legislations. In conclusion, we shall see that in India, including pandemics as a valid ground to give power to the President to impose a nationwide lockdown, under the National Emergency clause in Article 352 of the Indian Constitution, shall prove to be beneficial. [ABSTRACT FROM AUTHOR]

Purpose: The rapid spread of the COVID-19 pandemic upended societies across the world, with billions forced into lockdowns. As countries contemplated instating and rolling back lockdown measures, and considered the impact of pandemic fatigue on policy measures, and furthermore to prepare for the improved management of future pandemics, this study examines the effectiveness of policy measures in limiting the spread of infections and fatalities. Design/methodology/approach: The methodological approach in the study centres on a fixed effects panel regression analysis and employs the COVID-19 Government Response Stringency Index, which comprises eight containment measures and three health campaigns, with progressive degrees of stringency, in order to investigate the efficacy of government policies. Findings: Findings suggest that some government policies were effective at reducing implicit mortality rates, infection cases and fatalities during the first four months of the COVID-19 pandemic. Solid stringency measures to reduce mortality rates include public gathering restrictions on more than 100 attendees, and international travel limits for developed countries and islands. Fatalities can further be reduced through the closing of public transport, whereas infection cases also experience benefits from public information campaigns. Comparable results are observed in a robustness test across 12 months. Originality/value: Some non-pharmaceutical policies are shown to be more effective than others at reducing the spread of infections, fatalities and mortality rates, and support policymakers to manage future pandemics more effectively. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to compare India's public health expenditure at the international and state levels. The paper also empirically examines the regional disparities in NRHM spending across the 21 selected states of India. Design/methodology/approach: The tools of absolute β-and σ-convergence are used in the analysis to test the regional convergence. The average annual growth rate across the states is the dependent variable for β-convergence, and time is the second dependent variable but is used for s-convergence. In contrast, the initial value of NRHM expenditure and the coefficient of variation of NRHM expenditure are used as independent variables, respectively. Descriptive statistics are also used for the study. The data are annual and cover the panel from 2007 to 2020. Findings: The study attests to the hypothesis of β-and σ-convergence for the selected states in the period mentioned. The observed convergence in NRHM expenditure is due to the shift in the government's attention from the non-high focus high focus states to high states through the national rural health mission policy. The coefficient of variation across the states also shows a declining trend and provides the robustness of the σ-convergence. Originality/value: As far as the literature is concerned, none of the existing studies examines the convergence of a public health expenditure scheme like the National Rural Health Mission across the Indian states by applying the techniques of β-and σ-convergence. The novelty of the study is using the newly updated dataset and validating the convergence hypotheses in the National Rural Health Mission expenditure case. [ABSTRACT FROM AUTHOR]

This paper explores the political economy of three significant policy decisions of the Congress-United Progressive Alliance government between November 2005 and February 2006. These decisions improved the regulatory incentives for the smaller and efficient firms in the Indian GSM industry, which were heavily dependent on foreign investment for their expansion. India's telecommunications sector became more attractive to foreign investors as a result of these regulatory changes. This was a notable departure from the past when government policy had favoured large domestic investors using CDMA technology who were not dependent on foreign capital. A globalisation friendly policy change occurred after a Centre-Left United Progressive Alliance coalition came to power. The paper argues that these decisions, which promoted both competition and foreign investment, occurred due to the increased sensitivity of the Department of Telecommunications towards the needs of the relatively smaller GSM service providers, driven by considerations of efficiency. They were not driven by a crisis of private investment, foreign pressure, or stealth. The shift occurred in normal times when the Department of Telecommunications under a persistent ministerial stewardship took on a regulator, which was less interested in engineering this shift. This globalisation-friendly strategy depended to a large extent on the particular industrial sub-sector that the ruling party or coalition supported for spreading telecommunications in India. [ABSTRACT FROM AUTHOR]

The ongoing debates and discussions about sharing economy revolve round its definition, regulations and impact on economy, business and consumers. The paper attempts to develop a theoretical framework that define the sharing economy and analyse the possible association between the sharing economy and sustainability. The paper also assesses the need for an institutional and regulatory framework to strengthen sharing economy as an economic driver, potentially contributing to the more sustainable growth of the world economy. [ABSTRACT FROM AUTHOR]

Using an unexpected government regulation that restricted the ability of microfinance institutions to recover loans in one Indian state, I examine whether this intervention affected bank loan performance. The bank loan delinquency rate significantly increased as a result. In response, the ex post bank credit supply declined by more than half. For identification, I compare loans from branches located in regions subject to this intervention with loans from nearby branches of the same bank located in regions not subject to the intervention. I conclude that political interventions in credit markets could have significant spillover effects. Received October 29, 2016; editorial decision November 28, 2017 by Editor Philip Strahan. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online. [ABSTRACT FROM AUTHOR]

This paper explores the dynamics of access under the state-funded universal health insurance scheme in Chhattisgarh, India, and specifically the relationship between choice, affordability and acceptability. A qualitative case study of patients from the slums of Raipur City incurring significant heath expenditure despite using insurance, was conducted, examining the way patients and their families sought to navigate and negotiate hospitalisation under the scheme. Eight purposefully selected ('revelatory') instances of patients (and their families) utilising private hospitals are presented. Patients and their family exercised their agency to the extent that they could. Negotiations on payments took place at every stage, from admission to post-hospitalisation. Once admitted, however, families rapidly lost the initiative, and faced mounting costs, and increasingly harsh interactions with providers. The paper analyses how these outcomes were produced by a combination of failures of key regulatory mechanisms (notably the 'smart card'), dominant norms of care as a market transaction (rather than a right), and wider cultural acceptance of illegal informal healthcare payments. The unfavourable normative and cultural context of (especially) private sector provisioning in India needs to be recognised by policy makers seeking to ensure financial risk protection through publicly financed health insurance. [ABSTRACT FROM AUTHOR]

In this race the Indian legislature, fortunately, has not lagged far behind and has shown great concern for degradation of environment" and made specific legislative attempts to control different environmental pollution in particular. On the other hand, the second limb of the state, the executive, has been moving at a snail's pace or what Justice Krishna Iyer says, the bureaucratic machinery, which difunctionally, has passion for files, not for the people." Whereas, the judiciary is trying its best to balance the environment and development. In view of the degrading environment which poses a problem for the very survival of living things, the environmental law academics lately started paying attention to this underdeveloped field. Out of the three components of the state, the academics in India have generally confined their discussions to the approach of the legislature. The executive approach in environment has yet to attract serious attention of the law academics' writings. However, the judicial approach finds some place in the law writings. The present paper makes an attempt to take further the discussion on Indian judicial approach in the field of environment. Such academic exercise is all the more necessary in the present time because Indian judiciary since 1980 is taking special cognizance of the pollution explosion and there is a substantial increase in the case law in environment. Is not the time ripe to take stock of the direction of environmental legality in India? The present paper makes a humble attempt in this direction. It confines discussion to the cases of 1987 decided by the Supreme Court of India and the High Courts. This specific year has been selected because the graph of case law in environment from the year 1950 to 1990 shows its highest peak in 1987. [ABSTRACT FROM AUTHOR]

Why do multinational corporations (MNCs) frequently encounter corporate social responsibility (CSR) crises in leading emerging markets in the new century? Existing research about institutional impacts on MNC CSR has developed a void-based account about how the flawed institutional system allows misdeeds to happen. But the fact that such misdeeds have turned into increasing CSR crises in the new century along with institutional change is rarely taken into account. This paper combines studies of institutional voids, institutional entrepreneurship, and stakeholder theory to develop a concept of institutional sophistication, which refers to both the top-down maturation of the regulatory system that standardizes firm behavior and the bottom-up diversification and intensification of grassroots initiatives that redefine stakeholder membership. Based on this concept, we developed a framework to comprehensively demonstrate how both institutional voids and sophistication drive the MNC CSR crisis in leading emerging markets. Empirically, we established an original database that includes 309 publicized CSR crises encountered by major foreign MNCs in China, India, and Russia, 2000-2011. Through a content analysis, the paper reveals six common sophistication processes that drive the MNC crisis across contexts and also specifies stakeholder strategies that make these processes happen and vary by social problems and national contexts. We also discussed the value of studying corporate social irresponsible behavior in understanding the institution-MNC relationship. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to identify the input, process and output factors (along with their manifest variables) of small and medium enterprises (SMEs), and to establish cause and effect relationships amongst the factors and sub-factors. Systems thinking, a holistic approach, is used to carry out qualitative analysis of the feedback loops. Design/methodology/approach: A well-structured questionnaire was developed to gather the relevant data to identify the factors affecting the performance of SMEs in a holistic manner. A total of 150 responses were collected during November 2015–March 2016. Factor analysis and path analysis were used to establish causal relationships between input, process and output factors. The systems thinking approach has been used for qualitative analysis. Findings: Feedback loops have been identified amongst input-process-output-input factors and amongst sub-factors. They enabled authors to infer that the managers/owners of SMEs are systems thinkers, if not completely, at least partially. Six negative feedback loops and one positive feedback loop prevail. System behaviour arises out of the interaction of positive and negative feedback loops; it appears that in the long-run, the SMEs attain their target levels. The following inferences are drawn: circular relationships are identified amongst input, processes and organisational performance (OP), modern management tools such as just in times, Kanban have long-term benefits and are perceived as ineffective by small enterprises and formal financing and functional transparency enhances OP. Originality/value: Systems thinking, a holistic approach, has been used to study the effect of input, process and output factors on one another. Such studies are sparse, especially, in the Indian context. Many studies have been conducted to study the effect of input and of processes on performance such as innovation, information technology, human resource, technology, government regulation on performance of SMEs in a silo but, rarely all together. The qualitative analysis adds value to the research. Many of the outcomes of the research have been largely discussed in Indian print media which indicates the pragmatic approach of the research. [ABSTRACT FROM AUTHOR]

This paper generally explores the role of legislative counsel within the lawmaking process. It considers different ways that legislative counsel work to strengthen the democratic principle within that process. It also considers how the context of a small maturing government may impact this role. The case of underdeveloped instructions is explored throughout this paper as a means to investigate how legislative counsel can ensure that, in working with clients, their actions strengthen the democratic principle as oppose to weaken it. [ABSTRACT FROM AUTHOR]

Objective: To investigate how health issues affect voting behaviour by considering the COVID-19 pandemic, which offers a unique opportunity to examine this interplay., Design: We employ a survey experiment in which treatment groups are exposed to key facts about the pandemic, followed by questions intended to elicit attitudes toward the incumbent party and government responsibility for the pandemic., Setting: The survey was conducted amid the lockdown period of 15-26 April 2020 in three large democratic countries with the common governing language of English: India, the United Kingdom and the United States. Due to limitations on travel and recruitment, subjects were recruited through the M-Turk internet platform and the survey was administered entirely online. Respondents numbered 3648., Results: Our expectation was that respondents in the treatment groups would favour, or disfavour, the incumbent and assign blame to government for the pandemic compared with the control group. We observe no such results. Several reasons may be adduced for this null finding. One reason could be that public health is not viewed as a political issue. However, people do think health is an important policy area (>85% agree) and that government has some responsibility for health (>90% agree). Another reason could be that people view public health policies through partisan lenses, which means that health is largely endogenous, and yet we find little evidence of polarisation in our data. Alternatively, it could be that the global nature of the pandemic inoculated politicians from blame and yet a majority of people do think the government is to blame for the spread of the pandemic (~50% agree)., Conclusions: While we cannot precisely determine the mechanisms at work, the null findings contained in this study suggest that politicians are unlikely to be punished or rewarded for their failures or successes in managing COVID-19 in the next election., Trial Registration: Initial research hypotheses centred on expected variation between two treatments, as set forth in a detailed pre-analysis plan, registered at E-Gap: http://egap.org/registration/6645. Finding no difference between the treatments, we decided to focus this paper on the treatment/control comparison. Importantly, results that follow the pre-analysis plan strictly are entirely consistent with results presented here: null findings obtained throughout., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)

Discursive social psychologists have examined various ways in which political talk and participation in politics are accomplished. In this paper, I examine talk related to a populist policy to examine how it is that members of the general public informally participate in populist political practices. I examined transcripts of broadcast on‐air interviews with those experiencing outcomes of a controversial monetary policy in India introduced by Prime Minister Narendra Modi, namely, demonetization. Discursive psychological analyses show that interviewers and interviewees treated talk on policy as implicating political subjectivities for the interviewees. They flexibly offered various forms of assessments on the policy in ways to negotiate implications that they were predisposed to the policy and Modi. Their political subjectivities as those who were "Modi supporters," for example, were attended to and negotiated in ways to accomplish interview participation. The findings show the relevance of personal/subjective assessments and positions in political talk. These are discussed in relation to contemporary understandings of populism. [ABSTRACT FROM AUTHOR]

India and the global community are facing a critical crisis of antimicrobial resistance (AMR), significantly contributed to by on-going and increasing antimicrobial misuse. Information as to what drives misuse of antimicrobials within India is essential to inform strategies to address the crisis. This papers aims to identify perceived influences on antimicrobial use in Hyderabad, India. We conducted semi-structured qualitative interviews conducted with thirty participants (15 doctors, 15 pharmacists) around their experiences of antimicrobials in Hyderabad, India. Thematic analysis was performed and four themes identified around (1) Perceptions of the problem of resistance and antimicrobial use; (2) Social pressures to prescribe/dispense; (3) Financial pressures driving antimicrobial over-use; and (4) Lack of regulation around training and qualifications. We conclude that antimicrobial use within India is embedded with, and occurs as a result of, complex social and economic factors including issues of resource limitation, structural/governance limitations and social relationships. Strategies to address misuse without acknowledging and addressing the critical driving forces of use will be unlikely to induce significant change. [ABSTRACT FROM AUTHOR]

Indian roads are deemed to be the most dangerous, considering the number of annual fatalities, which touched 151,113 in the year 2019, the highest in the world. Causes ranging from poorly designed roads, tardy enforcement of traffic rules, delay in giving medical assistance, ill equipped hospitals, refusal of treatment by hospitals, all contribute to this unenviable predicament. A lax regulatory environment with minor penalties, has accentuated the crisis. Having held the pivotal position amongst 199 countries, there is a dire need for concrete action by Government. While 2,211,439 road accidents in the US in the year 2016 took away 37,461 lives,a relatively lower number of 480,652 accidents snuffed out 150,785 lives in India. Creating comparable safety levels could take decades for a developing country. But with the country's share constituting about 11% of road accident casualties worldwide and the estimated social cost hovering around $58 billion, the problem begs for an immediate fix. Tightening regulations would be a practical solution for both short and long-term gains. Enough deterrents need to be put in rules governing road safety; the Motor Vehicles Act to ensure defensive driving. This paper examines how certain loopholes need to be plugged in the new Motor Vehicles Act 2019 to achieve the higher goal of road safety. [ABSTRACT FROM AUTHOR]

This paper primarily discusses the judgment of the Delhi High Court on the government's ban on the use of Oxytocin. Part 1 recapitulates the events leading up to the ban and Part 2 discusses the legal issues considered by the Court before pronouncing its judgment. The paper outlines how life and death issues caused by the ban on a drug have finally been settled by legal considerations, apparently obscure to the non-specialist, but necessary to be understood by health policy makers.

India's cities are characterised by strong land use controls, but their impacts on city growth and the urban poor have drawn little attention. This paper deals with strong land use regulations prevalent in India's cities, which have negative impacts on urban form, the consumption of floor space and affordable housing. The impact of land use controls, such as floor area ratio and urban land ceiling, on suburbanisation in India is studied using standard econometric techniques. It is found that population suburbanises in response to a relaxation of floor area ratio norms in the suburbs. However, land use controls have no impact on the suburbanisation of jobs in India's cities. The paper concludes by summarising policy implications of the research. [ABSTRACT FROM AUTHOR]

Purpose: This study proposed and tested three comprehensive models of the usage intention of proximity mobile payment services after a government regulation, by integrating the theory of planned behaviour (TPB) and the norm-activation model (NAM). The purpose of this paper is to investigate the effects of moral norms, merchant pro-activeness and perceived government regulation (demonetisation) on users' continuance intention of proximity mobile payment services. Design/methodology/approach: In total, 387 users of proximity mobile payment services in India were surveyed using a structured questionnaire. This study was carried out with shoppers in the Mumbai Metropolitan Region and New Delhi because of the diverse and large population of these cities. Findings: The results of this study indicated that: integrating the variables of NAM into the original TPB model enhanced the prediction effect; perceived demonetisation regulation exerted a direct determinant effect as well as moderate effect on continuance usage intention of mobile payment services; also, extended TPB model with perceived demonetisation regulation as moderator could satisfactorily predict the continuance usage intention. Research limitations/implications: The results provided insightful evidence for the government and policymakers to outline more effective mandatory regulation policies. Originality/value: This investigation attempts to enhance the theoretical understanding of the antecedents of in-store proximity mobile payment services after government regulation (demonetisation) in India. [ABSTRACT FROM AUTHOR]

Background: Compensation for research related injuries is a subject that is increasingly gaining traction in developing countries which are burgeoning destinations of multi center research. However, the existence of disparate compensation rules violates the ethical principle of fairness. The current paper presents a comparison of the policies of Brazil, Russia, India, China and South Africa (BRICS)., Methods: A systematic search of good clinical practice guidelines was conducted employing search strategies modeled in line with the recommendations of ADPTE Collaboration (2007). The search focused on three main areas namely bibliographic data bases, clinical practice guidelines data bases and a restricted internet search. A manual search of references cited in relevant guideline documents was also conducted. The search terms, Medical Subject Headings (MeSH) and key words were developed for a PubMed platform and then adapted for all other data bases. The search terms were kept constant for each country with the only difference being the country name. The documents so obtained were subjected to systematic content analysis., Results: The study revealed that there is vast panoply of regulations which exist on a continuum. On one extreme is India with comprehensive regulations that are codified into law, and on the other end there is China which does not have specific laws regulating research related injuries. There are a number of differences and similarities such as mandatory insurance requirements, existence of no fault compensation, compensable injuries and the role of research ethics committees., Conclusions: It is imperative to enact legislations that protect participants without stifling the research enterprise. There is need for consistency and ideally harmonization of such regulations at a global level. A model policy on compensation for research related injuries should borrow from the best aspects of the different country policies and should be informed by the cardinal ethics principles of autonomy, justice and beneficence.

Purpose: India's Mental Healthcare Act 2017 provides a right to mental healthcare, revises admission and review procedures, effectively decriminalises suicide and has strong non-discrimination measures, among other provisions. The purpose of this paper is to examine Indian mental health professionals' views of these changes as they relate to stigma and inclusion of the mentally ill. Design/methodology/approach: The authors held nine focus groups in three Indian states, involving 61 mental health professionals including 56 psychiatrists. Findings: Several themes relating to stigma and inclusion emerged: stigma is ubiquitous and results in social exclusion; stigma might be increased rather than remedied by certain regulations in the 2017 Act; stigma is not adequately dealt with in the legislation; stigma might discourage people from making "advance directives"; and there is a crucial relationship between stigma and education. Practical implications: Implementation of India's 2017 Act needs to be accompanied by adequate service resourcing and extensive education, including public education. This has commenced but needs substantial resources in order to fulfil the Act's potential. Social implications: India's mental health legislation governs the mental healthcare of 1.3bn people, one sixth of the planet's population; seeking to use law to diminish stigma and enhance inclusion in such a large country sets a strong example for other nations. Originality/value: This is the first study of stigma and inclusion since India's 2017 Act was commenced and it highlights both the potential and the challenges of such ambitious rights-based legislation. [ABSTRACT FROM AUTHOR]

Genome-editing offers great potential applications in various sectors including healthcare, agriculture and environment. With the advent of CRISPR technology, which is easily available and inexpensive, the advancement in this domain has been rapid in the recent times. However, there have been various concerns raised around the possible unintended consequences of its application, particularly in reference to human germline modifications; and the associated ethical issues and challenges related to its regulation and governance. This paper discusses the genome-editing technology, its applications, existing regulatory paradigm (with special reference to India), emerging ethical concerns and challenges related to its governance. Finally, it concludes by suggesting a way forward. [ABSTRACT FROM AUTHOR]

Purpose – This study aims to understand the structure of downstream network from a supply chain (SC) perspective using a case of an Indian alcoholic beverage manufacturing company. In the SC literature, many researchers and practitioners have studied the design of upstream supplier network. Very few studies have documented the design of downstream network comprising distributors, warehouses, retailers, etc. and current study attempts to contribute to this limited literature. In addition, this study also tries to understand the influence of downstream SC, if any, on top management strategies. Finally, it assesses the SC quality using the standard set of factors and provides insights for its improvement. Design/methodology/approach – Single case study approach has been utilized to understand the configuration of downstream SC. A distillery in southern part of India which distributes a variety of liquor products across the market has been chosen for this study. Different data collection approaches have been adopted to understand the distribution channels prevailing in the market. In addition to the internal documents, semi-structured interviews were conducted with salesmen employed by the distillery for different group of outlets, top management of the distillery, outlet owners and counter sales person. Findings – Different distribution channels constituting the downstream SC network of the industry in the market studied have been identified to be retails and bars, institutions, clubs, modern trade, maximum retail price and Mysore Sales International Limited. Each of the distribution channels has clearly defined their boundaries for reaching different segment of consumers. Significant influence of the existing distribution channels on strategic decisions such as new product development and pricing were noticed. Interesting inferences were obtained on the relationships existing between the distilleries and different distribution channels. Insights were also gathered on the regulatory role played by the government between the manufacturers and distributors. Few marketing and promotional strategies adopted by companies to strengthen their downstream relationships with distribution channels and, in turn, with consumers have also been discussed. The quality of alcoholic beverage SC has been assessed and was found to perform on par with the set standards of quality in robustness factors and enabling factors. Training factor needs to be further improved by providing salesmen with exposure to best practices. Effort also needs to be taken to improve in the complicating factors, i.e. the testability and time. Research limitations/implications – This study is limited to the experience of a single alcoholic beverage manufacturer in the Karnataka state in India. SC of alcoholic beverage industry in India varies across states and depends on State Government regulations. Hence, the obtained results and inferences cannot be generalized across the industries and geographies. Future studies can be carried out in different locations across the country to understand the structure and dynamics of downstream SC in this industry. Scope also exists to study how the deficiencies identified in the SC can be improved and how alcoholic beverage firms entering India adapt to the prevailing SC structure. Comparative study of downstream SC of different industries can also be conducted. Practical implications – Academicians and practitioners can consider this paper as a source to understand the configuration of downstream SC of alcoholic beverage industry. More than that, this study provides a counter-intuitive inference for researchers and practitioners that choice of distribution channels have influence on the strategic decisions such as pricing and product development. Therefore, it becomes necessary to factor in the target distribution channel at the product design phase itself. This study may also help in performing a comparat [ABSTRACT FROM AUTHOR]

Abortion laws in India, like other laws, are premised on the 1861 British Penal Code. The Medical Termination of Pregnancy Act was passed in 1971 to circumvent the criminality clause around abortion. Yet the law continues to render invisible women's right to choose. Legal procedures have often hindered in permitting abortion, resulting in the death of a mother or the foetus. Despite the latest techno-medical advances, the laws have remained stagnant or rather restrictive, complicated further by selective female foetus abortions. Legal resistance to abortion-seeking after 20 weeks gestation adversely affects women, depriving them of autonomy of choice. In this paper, raising important gender, health and ethical issues are illustrated through a recent legal case in India. Feminist campaigns against the legal mindset in India are emerging. [ABSTRACT FROM AUTHOR]

Capitalizing on the hype surrounding stem cell research, numerous clinics around the world offer 'stem cell therapies' for a variety of medical conditions. Despite questions about the safety and efficacy of these interventions, anecdotal evidence suggests a relatively large number of patients are traveling to receive these unproven treatments - a practice called 'stem cell tourism.' Because these unproven treatments pose risks to individual patients and to legitimate translational stem cell research, stem cell tourism has generated substantial policy concern and inspired attempts to reduce these risks through the development of guidelines for patients and medical practitioners. This paper examines the roles and responsibilities of physicians in patients' home countries with respect to patients' decisions to try unproven stem cell therapies abroad. Specifically, it examines professional guidance from two organizations - the American Medical Association and the International Society for Stem Cell Research - and assesses physicians' professional and legal obligations to patients considering unproven stem cell therapies. Then, drawing on qualitative interviews conducted with patients who traveled abroad for unproven stem cell treatments, it explores the roles that physicians actually play in patients' decisions and compares these actual roles with their professional and legal responsibilities. The paper concludes with a discussion of strategies to help improve the guidance physicians provide to patients considering unproven treatments. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore regulation in India's healthcare sector and makes recommendations needed for enhancing the healthcare service., Design/methodology/approach: The literature was reviewed to understand healthcare's regulatory context. To understand the current healthcare system, qualitative data were collected from state-level officials, public and private hospital staff. A patient survey was performed to assess service quality (QoS)., Findings: Regulation plays a central role in driving healthcare QoS. India needs to strengthen market and institutional co-production based approaches for steering its healthcare in which delivery processes are complex and pose different challenges., Research Limitations/implications: This study assesses current healthcare regulation in an Indian state and presents a framework for studying and strengthening regulation. Agile regulation should be based on service delivery issues (pull approach) rather than monitoring and sanctions based regulatory environment (push approach)., Practical Implications: Healthcare pitfalls across the world seem to follow similar follies. India's complexity and experience is useful for emerging and developed economies., Originality/value: The author reviewed around 70 publications and synthesised them in healthcare regulatory contexts. Patient's perception of private providers could be a key input towards steering regulation. Identifying gaps across QoS dimensions would be useful in taking corrective measures.

End-of-life care (EOLC) exemplifies the joint mission of intensive and palliative care (PC) in their human-centeredness. The explosion of technological advances in medicine must be balanced with the culture of holistic care. Inevitably, it brings together the science and the art of medicine in their full expression. High-quality EOLC in the ICU is grounded in evidence, ethical principles, and professionalism within the framework of the Law. Expert professional statements over the last two decades in India were developed while the law was evolving. Recent landmark Supreme Court judgments have necessitated a review of the clinical pathway for EOLC outlined in the previous statements. Much empirical and interventional evidence has accumulated since the position statement in 2014. This iteration of the joint Indian Society of Critical Care Medicine--Indian Association of Palliative Care (ISCCM--IAPC) Position Statement for EOLC combines contemporary evidence, ethics, and law for decision support by the bedside in Indian ICUs. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has profoundly impacted the country's health systems and diminished its capability to provide safe and effective healthcare. This article attempts to review patient safety issues during COVID-19 pandemic in India, and derive lessons from national and international experiences to inform policy actions for building a 'resilient health system'. Methods: Systematic review of existing published articles, government and media reports was undertaken. Online databases were searched using key terms related to patient safety during COVID-19 and health systems resilience. Seventy-three papers were included dependent on their relevance to research objectives. Findings: Patient safety was impacted during COVID-19, owing to sub-optimal infection prevention and control measures coupled with reduced access to essential health services. This was largely due to inadequate infrastructure, human and material resources resulting from chronic underinvestment in public health systems, paucity of reliable data for evidence-based actions and limited leadership and regulatory capacity. Conclusions: India's health systems were found ill prepared to tackle large-scale pandemic, which has major implications for patient safety. The shortcomings observed in the COVID-19 response must be rectified and comprehensive health sector reforms should be initiated for building agile and resilient health systems that can withstand future pandemics. [ABSTRACT FROM AUTHOR]

The Indian Council of Medical Research and the Central Drugs Standards Control Organization of the Directorate General of Health Services of the Ministry of Health and Family Welfare' draft guidelines for compensation of research-related injury have evoked strong responses from the clinical research community. All stakeholders, including academic researchers, teachers in medical colleges, the pharmaceutical industry and even members of Institutional Review Boards and Ethics Committees have expressed grave reservations about several clauses in the guidelines. Moreover, these two guidelines differ from each other in important areas, reiterating that more thought and discussion is necessary to refine the guidelines. We present an academic researcher's perspective of the guidelines and our views on how they will affect clinical research in the country. The paper covers the types of research-related injury that are entitled for compensation, controversies on whether injury resulting from standard care should be entitled for compensation, whether causality needs to be established as a prerequisite for eligibility for compensation and whether all forms of research should have mandatory provision for compensation. We also put forward the potential dangers of such recommendations, which could potentially be inducement for patients to participate in clinical research. Finally, we raise the philosophical issue of infringement of an individual's fundamental rights regarding what research he/she wishes to participate in. While these points are based on several formal and informal discussions with stakeholders from various fields of clinical research, the views expressed are the authors' own personal thoughts.

The problems in developing risk-based regulation are particularly compounded for a developing country like India, owing to a lack of resources, expertise and regulatory mandate. Nevertheless, it is of utmost importance considering that in the event of some of the risks materializing, developing countries would be ill-equipped to handle and mitigate them. This paper attempts to examine the existing regulatory framework, taking the particular case of the chemicals legislation, and examine whether it could be extended to the regulation of nanomaterials and their risks. Our study indicates that the Manufacture, Storage and Import of Hazardous Chemical Rules, 1989 could be applied to nanomaterials but would require substantial amendments. The legislation is very laudable in that it provides for very detailed and minute information reporting and disclosures. This is believed to be very crucial for 'information regulation' of nanotechnology as an intermediate step between unfettered self-regulation and traditional 'command and control' regulation and which could help address the present information deficit and help gain regulatory experience.

Health care markets in China and India have expanded rapidly. The regulatory response has lagged behind in both countries and has followed a different pathway in each. Using the examples of front-line health providers and health insurance, this paper discusses how their different approaches have emerged from their own historical and political contexts and have led to different ways to address the main regulatory questions concerning quality of care, value for money, social agreement, and accountability. In both countries, the challenge is to build trust-based institutions that rely less on state-dominated approaches to regulation and involve other key actors.

India has a comprehensive legal and regulatory framework and large public health delivery system which are disconnected from the realities of health care delivery and financing for most Indians. In reviewing the current bureaucratic approach to regulation, we find an extensive set of rules and procedures, though we argue it has failed in three critical ways, namely to (1) protect the interests of vulnerable groups; (2) demonstrate how health financing meets the public interests; (3) generate the trust of providers and the public. The paper reviews the state of alternative approaches to regulation of health services in India, using consumer and market based approaches, as well as multi-actor and collaborative approaches. We argue that poor regulation is a symptom of poor governance and that simply creating and enforcing the rules will continue to have limited effects. Rather than advocate for better implementation and expansion of the current bureaucratic approach, where Ministries of Health focus on their roles as inspectorate and provider, we propose that India's future health system is more likely to achieve its goals through greater attention to consumer and other market oriented approaches, and through collaborative mechanisms that enhance accountability. Civil society organizations, the media, and provider organizations can play more active parts in disclosing and using information on the use of health resources and the performance of public and private providers. The overview of the health sector would be more effective, if Indian Ministries of Health were to actively facilitate participation of these key stakeholders and the use of information.

There has been much recent interest in the trade in human organs in India. This paper examines both the extent to which regulatory controls through the Transplantation of Human Organs Act (1994) are effective in curbing commercialization and the nature of the constraints on the effective implementation of this Act. The study, a politico-economic analysis of health sector regulation, is based on a stakeholder analysis drawing on the views of key decision makers, service providers, organ donors and recipients. The findings indicate widespread acknowledgement of an organs trade and highlight four major constraints on the effective implementation of the Act: the commercial interests of middlemen and service providers, the ambiguities and loopholes in the Act; the low monitoring capacity of the regulatory authorities, and the pressures and responsibilities exerted upon the Authorizing Committees. A feature of the Act is that its implementation is subject to a major incentive compatibility constraint - it is seemingly not in the interests of any of the key players, including the regulatory authorities, to restrict the organ trade. To some extent, this institutional problem is created by the specific nature of the regulatory intervention, and, as a consequence, measures involving straightforward redrafting of the regulation might go some way to addressing this incentive problem. Another solution may entail a 'harm-reduction' strategy involving a controlled trade where procurement and organ matching is carried out by a government agency (this would require, however, the prior resolution of the broader ethical question concerning the legitimacy of such trade).

Background India’s Cigarettes and Other Tobacco Products Act bans tobacco sales and advertisements within 100 yards of educational institutions. In schooladjacent neighbourhoods in Mumbai, we assessed adherence to these policies and whether tobacco vendor and advertisement densities were associated with students' tobacco use. Methods High school students' tobacco use was measured using a multistage cluster sampling survey (n=1533). Field geographic information systems data were obtained for all tobacco vendors and advertisements within 500 m of schools (n=26). Random-effects multilevel logistic regression was used to estimate associations of tobacco vendor and advertisement densities with ever tobacco use, current smokeless tobacco use and current tobacco use. Results There were 1741 tobacco vendors and 424 advertisements within 500 m of schools, with 221 vendors (13%) and 42 advertisements (10%) located within 100 m. School-adjacent tobacco vendor density within 100 m was not associated with the tobacco use outcomes, but tobacco advertisement density within 100 m was associated with all outcomes when comparing highest to lowest density tertiles: ever use (OR: 2.01; 95% CI 1.00 to 4.07), current use (2.23; 1.16, 4.28) and current smokeless tobacco use (2.01; 1.02, 3.98). Tobacco vendor density within 200, 300, 400 and 500 m of schools was associated with current tobacco use and current smokeless tobacco use, but not ever use. Conclusions The tobacco sales ban near educational institutions could be expanded beyond 100 m. Greater enforcement is needed regarding the current bans, particularly because advertisement density within 100 m of schools was associated with all students' tobacco use outcomes. [ABSTRACT FROM AUTHOR]

The article examines the economic and political aspects of microfinance expansion in Andhra Pradesh, India to identify the real driving force behind the crash of microfinance institutions (MFI). The paper discusses government regulation, projects and the banking system in place. Also included are the political competition on welfare and development programs, the competition between the government and private sectors, and a comparative analysis with the MFI outcomes in Karnataka.

The origins of the powerful sugar lobby in Maharashtra date back to the 1950s. Post Independence, cooperatives formed an integral part of the Congress vision of 'rural development with local initiative'. A 'special' status was accorded to the sugar cooperatives and the government assumed the role of a mentor by acting as a stakeholder, guarantor and regulator. Persistence of the maze of regulations instituted five decades ago, despite its stated rationale being thwarted, suggests that it is maintained by entrenched vested interests. This paper calls for a fresh start with minimal regulations. The teething problems and initial market failures that may occur cannot be worse than the continuing saga of government failure. [ABSTRACT FROM AUTHOR]

Purpose: Eat Right India (ERI) is a flagship initiative by the Food Safety and Standards Authority of India to transform the food system to ensure sustainable, safe and healthy food for all. The study summarizes the strategies, policies and programs using the NOURISHING framework. Design/methodology/approach: This study identifies and reviews documents related to ERI through a comprehensive search of research literature, policy documents and information available from the institutional websites. The NOURISHING framework, which proposes a methodology to categorize, report and monitor actions to promote healthy eating, is used as a guiding framework. Findings: Upon analyzing various strategies put forward by the ERI initiative, it was found that there are many inter-sectoral collaborations, successful institutionalizations and behavioral interventions implemented through the initiative. However, there are a few areas that require attention, which include health taxation, children's exposure to unhealthy food marketing, regulations in food advertisements and the incentivization of retailers and consumers for healthy food delivery and consumption. There is a need for a holistic approach with a congruence of health and food systems in the backdrop of a strong and efficient policy and regulatory framework to tackle the threat of Non-communicable diseases (NCD). Originality/value: This article contributes to a significant discussion about transforming food systems to tackle (NCDs). It summarizes the existing initiatives in India for establishing healthy food environments and also suggests a few strategies for taking it forward. The study calls the policymakers to action for restructuring the food and health system into resilient, contextually relevant and interoperable mechanisms to address the threat of NCDs. [ABSTRACT FROM AUTHOR]

Global recognition that the complex and multicausal problems of malnutrition require all players to collaborate and to invest towards the same objective has led to increased private sector engagement as exemplified through the Scaling Up Nutrition Business Network and mechanisms for blended financing and matched funding, such as the Global Nutrition for Growth Compact. The careful steps made over the past 5 to 10 years have however not taken away or reduced the hesitation and scepticism of the public sector actors towards commercial or even social businesses. Evidence of impact or even a positive contribution of a private sector approach to intermediate nutrition outcomes is still lacking. This commentary aims to discuss the multiple ways in which private sector can leverage its expertise to improve nutrition in general, and complementary feeding in particular. It draws on specific lessons learned in Bangladesh, Côte d'Ivoire, India, Indonesia, and Madagascar on how private sector expertise has contributed, within the boundaries of a regulatory framework, to improve availability, accessibility, affordability, and adequate use of nutritious foods. It concludes that a solid evidence base regarding the contribution of private sector to complementary feeding is still lacking and that the development of a systematic learning agenda is essential to make progress in the area of private sector engagement in nutrition. [ABSTRACT FROM AUTHOR]

Objectives: Antimicrobial resistance poses a major public health threat. Despite Indian retail sector antibiotic consumption per capita increasing by approximately 22% between 2008 and 2016, empirical studies that examine policy or behavioural interventions addressing antibiotic misuse in primary healthcare are scarce. Our study aimed to assess perceptions of interventions and gaps in policy and practice with respect to outpatient antibiotic misuse in India. Methods: We conducted 23 semi-structured, in-depth interviews with a variety of key informants with diverse backgrounds in academia, non-government organisations, policy, advocacy, pharmacy, medicine and others. Data were charted into a framework matrix and analysed using a hybrid, inductive and deductive thematic analysis. Themes were analysed and organised according to the socio-ecological model at various levels ranging from the individual to the enabling environment. Results: Key informants largely focused on the importance of adopting a structural perspective to addressing socio-ecological drivers of antibiotic misuse. There was a recognition that educational interventions targeting individual or interpersonal interactions were largely ineffective, and policy interventions should incorporate behavioural nudge interventions, improve the healthcare infrastructure and embrace task shifting to rectify staffing disparities in rural areas. Conclusions: Prescription behaviour is perceived to be governed by structural issues of access and limitations in public health infrastructure that create an enabling environment for antibiotic overuse. Interventions should move beyond a clinical and individual focus on behaviour change with respect to antimicrobial resistance and aim for structural alignment between existing disease specific programs and between the informal and formal sector of healthcare delivery in India. [ABSTRACT FROM AUTHOR]

Public health/risk communication is the foremost responsibility of a government during a pandemic. Risk communication aims to educate people, enhance their risk perceptions to help them engage and understand the benefits of compliance with recommendations. The existing legal enforcement of recommendations in India is criticized for failing to influence the public's compliance. While existing research provides conceptual and empirical support in explaining compliance during COVID-19, we note a lack of studies that might bring out country-specific areas of improvement. We argue that value-aligned risk communication is more likely to influence the public's behavioral intentions to adopt the government's recommendations. We employed a triangulation mixed-method study to link risk communication attributes to the public's end goals and values. We triangulate these findings using the COVID score survey. We found that timeliness and transparency constitute risk communication's functional component, and empathy and trust constitute risk communication's emotional component. We found a difference in the preference of functional and emotional components among the public and health partners. Irrespective of this divide in perception, the study found that both groups unanimously noted engagement as the crucial aspect for empowerment and involvement to aid the public in teaming with the government to combat the pandemic effectively. [ABSTRACT FROM AUTHOR]

Background: Article 5.3 of the World Health Organization's Framework Convention on Tobacco Control necessitates the governments to take measures to protect health policy from the commercial and other vested interests of the tobacco industry (TI). Considering the vast geographical area and diversity between states within India, it is necessary to evaluate the level of implementation of Article 5.3 at the sub-national level. Hence, this study was conducted to assess the implementation of Article 5.3 in the Karnataka state of southern India. Materials and Method: Southeast Asia Tobacco Control Alliance Tobacco Industry Interference index was adopted and used for the study. A desk review was conducted for 2018. Publicly available evidence of tobacco industry interference was scored based on its frequency, severity, and the government's response to it. Lower the score, effective the level of governance against the TI interference, which predicts well for the state. Results: The study demonstrates a score of 46 out of 95 in the implementation of Article 5.3 in Karnataka, which is lower when compared to the national score of 69 out of 100 for 2018. Corporate social responsibility, conflict of interest, and unnecessary interactions with TI are the major areas that need focus to comply with the provisions of Article 5.3. Conclusion: Overall, Karnataka needs to strengthen the implementation of Article 5.3 and develop a strategy in line with the global best practices. This assessment can help in identifying areas requiring enhanced vigilance to avoid industry interference. [ABSTRACT FROM AUTHOR]