Prinja S.,Post Graduate Institute of Medical Education and Research |
Gupta R.,Office of Chief Minister |
Bahuguna P.,Post Graduate Institute of Medical Education and Research |
Sharma A.,Post Graduate Institute of Medical Education and Research |
And 3 more authors.
Health Policy and Planning | Year: 2017
Background There is limited work done on developing methods for measurement of universal health coverage. We undertook a study to develop a methodology and demonstrate the practical application of empirically measuring the extent of universal health coverage at district level. Additionally, we also develop a composite indicator to measure UHC. Methods A cross-sectional survey was undertaken among 51 656 households across 21 districts of Haryana state in India. Using the WHO framework for UHC, we identified indicators of service coverage, financial risk protection, equity and quality based on the Government of India and the Haryana Government's proposed UHC benefit package. Geometric mean approach was used to compute a composite UHC index (CUHCI). Various statistical approaches to aggregate input indicators with or without weighting, along with various incremental combinations of input indicators were tested in a comprehensive sensitivity analysis. Findings The population coverage for preventive and curative services is presented. Adjusting for inequality, the coverage for all the indicators were less than the unadjusted coverage by 0.1-6.7% in absolute term and 0.1-27% in relative term. There was low unmet need for curative care. However, about 11% outpatient consultations were from unqualified providers. About 30% households incurred catastrophic health expenditures, which rose to 38% among the poorest 20% population. Summary index (CUHCI) for UHC varied from 12% in Mewat district to 71% in Kurukshetra district. The inequality unadjusted coverage for UHC correlates highly with adjusted coverage. Conclusion Our paper is an attempt to develop a methodology to measure UHC. However, careful inclusion of others indicators of service coverage is recommended for a comprehensive measurement which captures the spirit of universality. Further, more work needs to be done to incorporate quality in the measurement framework. © 2016 The Author.
News Article | April 18, 2017
DUBLIN--(BUSINESS WIRE)--Research and Markets has announced the addition of the "Construction in India, Key Trends and Opportunities to 2021" report to their offering. In real terms, the Indian construction industry registered an average annual growth rate of 3.5% during the review period (2012-2016). This growth was supported by the 12th Five-Year Plan 2012-2017, under which the government invested heavily in infrastructure, industrial parks and residential buildings. In addition, government flagship programs such as the Jawaharlal Nehru National Urban Renewal Mission, the National Rural Health Mission (NRHM) and Indira Awas Yojana supported review-period growth. The industry is expected to continue to expand over the forecast period (2017-2021), driven by investments in residential, infrastructure and energy projects under flagship programs such as the 100 Smart Cities Mission, Housing for All 2022, the Atal Mission for Urban Rejuvenation and Transformation (AMRUT), the National Skill Development Mission (NMSD), Pradhan Mantri Gram Sadak Yojana (PMGSY), Make in India, and Power for All (PFA) by various governments. In 2015, the government launched the Smart City Mission and the Atal Mission for Rejuvenation and Urban Transformation (AMRUT) scheme. Under the Smart City Mission, the government plans to develop the infrastructure of 100 selected cities with an investment of INR480 billion (US$7.2 billion), whereas under the AMRUT scheme it plans to spend INR500 billion (US$7.4 billion) to develop 500 cities by 2022. The industry's output value in real terms is expected to rise at a compound annual growth rate (CAGR) of 4.16% over the forecast period; up from 3.95% during the review period. For more information about this report visit http://www.researchandmarkets.com/research/p94g9q/construction_in
Dare A.J.,University of Toronto |
Ng-Kamstra J.S.,University of Toronto |
Patra J.,University of Toronto |
Fu S.H.,University of Toronto |
And 6 more authors.
The Lancet Global Health | Year: 2015
Background: Few population-based studies quantify mortality from surgical conditions and relate mortality to access to surgical care in low-income and middle-income countries. Methods: We linked deaths from acute abdominal conditions within a nationally representative, population-based mortality survey of 1·1 million households in India to nationally representative facility data. We calculated total and age-standardised death rates for acute abdominal conditions. Using 4064 postal codes, we undertook a spatial clustering analysis to compare geographical access to well-resourced government district hospitals (24 h surgical and anaesthesia services, blood bank, critical care beds, basic laboratory, and radiology) in high-mortality or low-mortality clusters from acute abdominal conditions. Findings: 923 (1·1%) of 86 806 study deaths at ages 0-69 years were identified as deaths from acute abdominal conditions, corresponding to 72 000 deaths nationally in 2010 in India. Most deaths occurred at home (71%) and in rural areas (87%). Compared with 567 low-mortality geographical clusters, the 393 high-mortality clusters had a nine times higher age-standardised acute abdominal mortality rate and significantly greater distance to a well-resourced hospital. The odds ratio (OR) of being a high-mortality cluster was 4·4 (99% CI 3·2-6·0) for living 50 km or more from well-resourced district hospitals (rising to an OR of 16·1 [95% CI 7·9-32·8] for >100 km). No such relation was seen for deaths from non-acute surgical conditions (ie, oral, breast, and uterine cancer). Interpretation: Improvements in human and physical resources at existing government hospitals are needed to reduce deaths from acute abdominal conditions in India. Full access to well-resourced hospitals within 50 km by all of India's population could have avoided about 50 000 deaths from acute abdominal conditions, and probably more from other emergency surgical conditions. Funding: Bill & Melinda Gates Foundation, Dalla Lana School of Public Health, Canadian Institute of Health Research. © 2015 Dare et al.
Jaisoorya T.S.,Government Medical College |
Janardhan Reddy Y.C.,NIMHANS |
Thennarasu K.,NIMHANS |
Beena K.V.,National Rural Health Mission |
And 2 more authors.
Comprehensive Psychiatry | Year: 2015
Objectives There is scarce data on the prevalence of OCD among adolescents in India. This study reports point prevalence of OCD among school students (age 12-18 years) in the Kerala state of India and examines its association with ADHD, psychological distress, tobacco/alcohol abuse, suicide risk and history of sexual abuse. Method 7560 students of 73 schools were self-administered the OCD subsection of Clinical Interview Schedule-Revised, the Composite International Diagnostic Interview (CIDI) for obsessive compulsive symptoms and other relevant instruments to identify OCD and related clinical measures. A diagnosis of ICD-10 OCD was derived through the CIS-R algorithm which required duration of at least 2 weeks and at least a thought/behavior to be resisted along with a cut-off score for severity and impairment. Results In the sample, 50.3% were males with a mean age of 15.2 years (range of 12-18 years). The response rate was 97.3% (7380 valid responses). 0.8% (n = 61) fulfilled criteria for OCD with a male predominance (1.1 vs. 0.5%, p = 0.005). Prevalence was higher among Muslims and increased with age. Taboo thoughts (62.3%) and mental rituals (45.9%) were the commonest symptoms. Those with OCD had significantly higher suicidal thoughts (59 vs. 16.3%, p < 0.01) suicide attempts (24.6 vs. 3.8%, p < 0.01), ADHD (28 vs. 4%, p < 0.001), sexual abuse (24.6 vs. 4.2%, p < 0.01), and tobacco use (23 vs. 6.8%, p = 0.01). They also reported greater psychological distress and poorer academic performance. Conclusions OCD is common among adolescents in India. Its associations with ADHD, sexual abuse, psychological distress, poorer academic performance and suicidal behavior are additional reasons for it to be recognized and treated early. © 2015 Elsevier Inc.
Singh K.,Child Nutrition and Development Programme |
Badgaiyan N.,Child Nutrition and Development Programme |
Ranjan A.,Child Nutrition and Development Programme |
Dixit H.O.,National Rural Health Mission |
And 3 more authors.
Indian Pediatrics | Year: 2014
Objective: To assess the effectiveness of facility-based care for children with severe acute malnutrition (SAM) in Nutrition Rehabilitation Centers (NRC). Design: Review of data. Setting: 12 NRCs in Uttar Pradesh, India. Participants: Children admitted to NRCs (Jan 1, 2010 - Dec 31, 2011). Intervention: Detection and treatment of SAM with locally-adapted protocols. Outcomes: Survival, default, discharge, and recovery rates. Results: 54.6% of the total 1,229 children admitted were boys, 81.6% were in the age group 6-23 months old, 86% belonged to scheduled tribes, scheduled castes, or other backward castes, and 42% had edema or medical complications. Of the 1,181 program exits, 14 (1.2%) children died, 657 (47.2%) children defaulted, and 610 (51.7%) children were discharged The average (SD) weight gain was 12.1 (7.3) g/kg body weight/day and the average (SD) length of stay was 13.2 (5.6) days. 206 (46.8%) children were discharged after recovery (weight gain ≥15%) while 324 (53.2%) were discharged, non-recovered (weight gain <15%) Conclusions: NRCs provide life-saving care for children with SAM; however, the protocols and therapeutic foods currently used need to be improved to ensure the full recovery of all children admitted. © 2014 Indian Academy of Pediatrics.
Pal B.B.,Regional Medical Research Center |
Khuntia H.K.,Regional Medical Research Center |
Samal S.K.,Regional Medical Research Center |
Kerketta A.S.,Regional Medical Research Center |
And 3 more authors.
Epidemiology and Infection | Year: 2013
A large outbreak of cholera reported during April-July 2009 in the Kendrapada district of Odisha, India was investigated. Forty-one rectal swabs and 41 water samples, collected from diarrhoeal patients and from different villages were bacteriologically analysed for the isolation of bacterial enteriopathogens, antibiogram profile and detection of various toxic genes. The bacteriological analysis of rectal swabs and environmental water samples revealed the presence of V. cholerae O1 Ogawa biotype El Tor. The V. cholerae strains were resistant to ciprofloxacin, co-trimoxazole, chloramphenicol, streptomycin, ampicillin, furazolidone and nalidixic acid. The multiplex polymerase chain reaction (PCR) assay on V. cholerae strains revealed the presence of ctxA and tcpA genes. The mismatch amplification of mutation assay (MAMA) PCR on clinical and environmental isolates of V. cholerae revealed that the strains were El Tor biotype, which harboured the ctxB gene of the classical strain. The random amplified polymorphic DNA PCR analysis and pulsed-field gel electrophoresis results indicated that the V. cholerae isolates belonged to the same clone. This investigation gives a warning that the El Tor variant of V. cholerae has spread to the coastal district causing a large outbreak that requires close monitoring and surveillance on diarrhoeal outbreaks in Odisha. Copyright © Cambridge University Press 2013.
Ryman T.K.,Centers for Disease Control and Prevention |
Trakroo A.,The United Nations Childrens Fund |
Ekka J.B.,National Rural Health Mission |
Watkins M.,Centers for Disease Control and Prevention
Vaccine | Year: 2012
Recommended childhood vaccines have typically been provided through routine immunization programs. Recently, implementation of strategies that use campaign-like features for providing all the recommended childhood immunizations have been utilized to increase vaccination coverage. Between January 2006 and January 2008, Assam, India, conducted Immunization Weeks (IWs), a periodic campaign-like approach for providing the recommended childhood vaccines generally administered through the routine Universal Immunization Program (UIP). Using data from a household vaccination coverage survey conducted in 5 districts of Assam in late-2007/early-2008 among children 12-28 months of age, a secondary analysis was conducted for a subset of children with vaccination cards to assess the impacts of implementing the IW-strategy. Sixty-five percent of the 3310 surveyed children received at least one vaccine dose through an IW. Without IWs, coverage would likely have been lower for all vaccines (e.g., 75% measles vaccine coverage including IWs doses and an estimated 61% without IWs). The proportion of children receiving at least one IW dose was significantly different depending on the child's residence; 72% in hard-to-reach char areas, 66% in rural areas and 53% in urban areas (p=0.01). Overall, 2085 (63%) of children were fully vaccinated; of these 60% received a combination of IW and UIP doses, 35% received doses only through the UIP, and 5% received doses only through IWs. A delay in administration later than the recommended ages was found for both UIP doses and for IW doses (e.g., for measles vaccine, UIP doses were 6.9 weeks delayed and IW doses 13.6 weeks delayed). Among this sample of vaccinated children, IWs appeared to increase vaccination coverage and improve access to services in hard-to-reach areas. However, the UIP appeared to be a better system for ensuring that children received all doses in the recommended vaccination series. © 2012.
Choudhury M.,National Rural Health Mission |
Das P.,Assam Agricultural University |
Baroova B.,Assam Agricultural University
Journal of Food Science and Technology | Year: 2011
For better utilization of millets, two processing techniques, viz., popping and malting were standardized using two local varieties of foxtail millet (Setaria italica). In popped samples, crude fat and crude fibre contents were significantly lower than raw millet in both the yellow and purple varieties, while the carbohydrate and energy values were significantly higher. In malted samples, crude protein and fat contents were significantly lower than in raw millet in both the varieties, whereas the carbohydrate contents were higher. Starch digestibility was highest (42.4%) in yellow popped samples and lowest in yellow malted samples (21.8%). Protein digestibility was highest (13.2%) in purple popped and lowest (2.4%) in yellow malted samples. © 2010 Association of Food Scientists & Technologists (India).
Viswanathan A.A.,National Rural Health Mission |
Gawde N.C.,Tata Institute of Social Sciences
Lung India | Year: 2014
Context: There is conflicting evidence of effect of diabetes on treatment of tuberculosis (TB). There is a need to investigate effect of diabetes on outcomes of TB treatment under field conditions in India. Aims: To compare treatment outcomes among TB patients with diabetes with those without diabetes. Setting and Design: Study was conducted in Cuddalore, Tamil Nadu, among patients registered with Revised National TB Control Programme. Prospective observational study design was used. Materials and Methods: Registered TB patients aged 30 and above were invited to participate in the study. Those who were not aware of their diabetic status were diagnosed using oral glucose tolerance test. A total of 89 diabetic and 120 non-diabetic patients were recruited in the study. They were followed up till the end of treatment and outcomes were recorded. Statistical Analysis Used: Treatment outcomes in the two groups were compared using bi-variate and multi-variate analysis. Results: Bi-variate (unadjusted) analysis showed similar treatment success rates in the two groups. But, the adjusted odds ratios for successful treatment among diabetic patients were significantly lower (0.191, 95% CI 0.04-0.90) for pulmonary TB patients and for smear positive pulmonary TB patients (odds ration 0.099, 0.013-0.761). Diabetes was found to be predictor for sputum positivity at end of treatment. Conclusions: Diabetes increases risk of poor treatment outcomes among pulmonary TB patients. The study highlights need of screening of TB patients for diabetes. There is need to see the effect of glycemic control on treatment outcomes among diabetics.
PubMed | Office of Chief Minister, National Rural Health Mission and Post Graduate Institute of Medical Education and Research
Type: | Journal: Health policy and planning | Year: 2016
There is limited work done on developing methods for measurement of universal health coverage. We undertook a study to develop a methodology and demonstrate the practical application of empirically measuring the extent of universal health coverage at district level. Additionally, we also develop a composite indicator to measure UHC.A cross-sectional survey was undertaken among 51 656 households across 21 districts of Haryana state in India. Using the WHO framework for UHC, we identified indicators of service coverage, financial risk protection, equity and quality based on the Government of India and the Haryana Governments proposed UHC benefit package. Geometric mean approach was used to compute a composite UHC index (CUHCI). Various statistical approaches to aggregate input indicators with or without weighting, along with various incremental combinations of input indicators were tested in a comprehensive sensitivity analysis.The population coverage for preventive and curative services is presented. Adjusting for inequality, the coverage for all the indicators were less than the unadjusted coverage by 0.1-6.7% in absolute term and 0.1-27% in relative term. There was low unmet need for curative care. However, about 11% outpatient consultations were from unqualified providers. About 30% households incurred catastrophic health expenditures, which rose to 38% among the poorest 20% population. Summary index (CUHCI) for UHC varied from 12% in Mewat district to 71% in Kurukshetra district. The inequality unadjusted coverage for UHC correlates highly with adjusted coverage.Our paper is an attempt to develop a methodology to measure UHC. However, careful inclusion of others indicators of service coverage is recommended for a comprehensive measurement which captures the spirit of universality. Further, more work needs to be done to incorporate quality in the measurement framework.