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Failure of in-service oil and gas steel pipelines can have disastrous environmental, social and economic impacts. Preventing or alleviating those negative impacts requires a methodology to predict the service life of corroded steel pipes that enables implementing preventive maintenance and repairs measures. Such predictions involve uncertainty and vary in time. This paper puts forward a time-variant reliability-based approach to assess the failure of corroded offshore pipelines. The proposed approach accounts for the uncertainty in the corrosion rate and mechanical characteristics of pipes. Two methods are proposed: One that employs the Monte Carlo sampling and one that is based on the first-order reliability method. The methodology is then applied to three corroded offshore gas pipelines located in India and the timevariant failure probability is estimated considering target reliability. Next, variability and sensitivity analyses are conducted to identify the most influential sources of uncertainty on the failure probability of pipelines. It can be asserted that corrosion rate has a substantial role in estimating the structural reliability of pipelines. [ABSTRACT FROM AUTHOR]

The paper reflects on how feudal, caste-ridden and corruption-infested rural India had its first brush with the newly introduced democratic and governmental administrative institutions, culture and practices, much of the latter inherited from the late colonial times. It does it by visiting Shivpalganj, a fictious village in the "Hindi heartland" region, as depicted in the celebrated novel Raag Darbari, published more than five decades ago. Reading the satirical text shows vividly how the institutions were subverted by the local politics that was infested by factionalism, corruption and patronage. It also exposes the misconception that the bureaucratic "system" inherited from the British raj could be "adapted" for very different purpose of facilitating development and welfare than for what it was set up originally. The essay argues that despite significant social, political and economic transitions that have taken place over the last five decades, one finds a great degree of similarity in the way the "system" continues to work in the region which still in many ways represents "most of India." It looks into the possible explanations for the continuity and change, if any. [ABSTRACT FROM AUTHOR]

While there are a growing number of interventions and evaluations of programmes aimed at changing gender norms and violence against women and girls, there remains a dearth of documentation outlining the challenges faced in conducting these interventions and evaluations, particularly in traditional and low literacy settings. The Do Kadam Barabari Ki Ore (Two Steps Towards Equality) programme sought to understand what works to prevent violence against women and girls in Bihar, India. This paper draws insights from process evaluation data. It describes promising features and challenges of implementation, and characteristics which weaken the potential effects of complex, community based, social sector programmes that aim to change deeply entrenched gender power hierarchies. We drew on the Medical Research Council framework for process evaluation in analysing our process evaluation data, and focus on mechanisms of impact, and factors inhibiting programme success, including contextual and implementation challenges. The paper also outlines measures that may help overcome observed challenges and areas that require modifications and/or further investigation. The programme experienced several challenges. These included contextual issues, such as the lack of leadership skills of those delivering the intervention and the gap between expected responsibilities and activities of government platforms and reality. Implementation challenges were encountered in reaching men and boys, younger women and the community at large and ensuring their regular attendance; and in maintaining the fidelity of the intervention activities. Our insights call for an evidence-supported dialogue on these challenges and how best to anticipate and address them. [ABSTRACT FROM AUTHOR]

This paper draws on findings from a qualitative study of two government hospitals in Mumbai, India, which aimed to provide a better understanding of the institutional drivers of disrespect and abuse (D&A) in childbirth. The paper describes the structural context, in which government hospital providers can exercise considerable power over patients, yet may be themselves vulnerable to violence and external influence. Decisions that affect care are made by a bureaucracy, which does not perceive problems with the same intensity as providers who are directly attending to patients. Within this context, while contrasting organisational cultures had evolved at the two hospitals, both were characterised by social/professional inequality and hierarchical functioning, and marginalising women. This context generates invisible pressures on subordinate staff, and creates interpersonal conflicts and ambiguity in the division of roles and responsibilities that manifest in individual actions of D&A. Services are organised around the internal logic of the institution, rather than being centred on women. This results in conditions that violate women's privacy, and disregards their choice and consent. The structural environment of resource constraints, poor management and bureaucratic decision-making leads to precarious situations, endangering women’s safety. With the institution's functioning based on hierarchies and authority, rather than adherence to universal standards or established protocols, irrational, harmful practices endorsed by senior staff are institutionalised and reproduced. A deeper focus on organisational culture, embedded in the discourse of D&A, would help to evolve effective strategies to address D&A as systemic problems. [ABSTRACT FROM AUTHOR]

Health financing equity analysis rarely goes below the state level in India. This paper assesses the equity and effectiveness of public spending on health in the state of Odisha. Using district-level public spending data for the first time, it sheds light on the incidence of public spending by geography and by type of services. There are three key findings. First, it identifies the weak link between district spending and district need, proxied by poverty rates or lagging sectoral outcomes, highlighting the potential for a more needs-based approach to public resource allocation. Second, the results indicate that at the household level health spending by the state is not pro-poor, especially in public hospitals, underscoring the need to improve access to care for the bottom 40% at these facilities. Third, an exhaustive analysis of micro-level treasury data brings into focus the importance of reforming public finance data systems to support evidence-based policy at the sub-state level. Significant district-wise variation in key health financing and equity indicators, combined with growing policy interest in the district level, underscore the utility of further empirical work in this area. [ABSTRACT FROM AUTHOR]

Rice crop is one of the major cultivating crops in India, especially in south India. Fertiliser plays an important role to achieve the highest rice yield. Each crop needs an adequate amount of fertiliser for its growth. Inadequate and overdose of fertiliser leads to nutrient deficiency and lesser yield of crops. Rice has a unique fertiliser recommendation based on climatic conditions and soil types but the issue is the random use of fertilisers by the farmer, without knowing their own land soil nutrition. Soil consists of primary nutrients and secondary nutrients. This supplement is used for crop growth. This paper discusses a proposed methodology of an optimised fertiliser simulation model for Cuddalore and Salem district and its sub talukas for rice and maize crops. In this research work, the fuzzy logic technique is used because this is one of the best ways for problem-solving techniques. In this fuzzy logic, Mamdani fuzzy logic-based tool is used. The Mamdani fuzzy logic tool is used for the suggestion of the fertilisers required according to the minerals present in their soil. In result total 45 rules are created for recommending the fertiliser use for paddy and maize crops. [ABSTRACT FROM AUTHOR]

Sustainability is critical to the delivery of cultural heritage tourism (CHT) since its foundation to attract tourist relies on the preservation of the historic and cultural offerings of the host community. CHT destinations within urban and semi-urban heritage sites in emerging economies find this particularly challenging. To explore this issue and its associated challenges, this paper brings together an interdisciplinary team representing disciplines of heritage management, architectural and cultural history, economics, environmental planning and sustainability to establish the extent to which sustainability principles are integrated within CHT destinations in the semi-urban destinations of emerging economies. An interdisciplinary analysis of the case study of Srirangapatna-Mysore region in India, using a framework for evaluating sustainability principles within CHT reveals environmental considerations to be the weakest link. Accordingly, Strategic Environmental Assessment (SEA) is proposed as a tool that can compensate some of the caveats identified in the case study by potentially enhancing stakeholder involvement, raising heritage and environmental awareness, facilitating regional approach and avoiding costly mistakes. [ABSTRACT FROM AUTHOR]

The push for digital technologies during the Covid-19 pandemic has put a question mark on the relationship between the state and society in India. In particular, it has highlighted the gap between the lofty promises of digital welfare by political leaders and businesses, and the widespread discontent with digitalization as evident on the ground. In this paper, I take this gap as a starting point to conceptualize the nature of politics in the data state, drawing on Polanyian themes to understand how the contentions are gradually "embedding" the digital economy in society. Tracing the arc of the interactions between domestic ideas, interests and institutions alongside the development of digital capitalism, I also show that caught in these entanglements, digital economy can no longer remain a one-way street for data "extraction". More specifically, I argue that at the end of its first decade of since the emergence of surveillance capitalism in 2010s, politics has ensured that it confronts ground level resistance that revolves around themes of inclusion, welfare and pluralism rather than the liberal conceptions of privacy and individual consent. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic of 2020-21 has acted as an inflection point, exposing the fragility of liberal democracy in India, already beleaguered by the rise of majoritarian populism since 2014, buttressed by a process of expansion of bureaucratic power and autocratic legalism while marginalizing the processes of political accountability – étatisation, and normalization of state violence. The combined impact of such developments has been an erasure of basic rights to life and livelihood for the poor, rooted not only in state incapacity but also in state acquiring impunity for its acts of coercion and violence against its own citizens. Many of these processes have come into stark focus during the Covid-19 pandemic, but have longer histories and are likely to have impact far beyond the pandemic. The paper examines some of these processes with the help of three interlinked but conceptually distinct strands: (a) étatisation and suspension of politics; (b) (en)forcement of a new normal during the health emergency; and (c) erasure of right to life and livelihood. [ABSTRACT FROM AUTHOR]

A well-designed strategy for effective solid waste management is a compelling necessity of the modern world. Today, solid waste management is gaining so much of an importance because lack of planning could affect the quality of social, economic and environmental sustainability. Most of the studies have illustrated production of solid waste is due to human needs and desires and the best strategy of solid waste management is to tackle at the point of origin. However, to measure such pro-environmental behaviours among residents, an appropriate and a replicable scale is important. Hence, the purpose of this paper is to explain the processes undertaken to develop a valid instrument to measure the antecedents of solid waste management behaviour. The constructs were assessed using Ajzen's theory of planned behaviour and data was collected from a survey of 233 students belonging to three different colleges of Udupi district, India. The specific validation processes used were: mixed methods approach of content validity, face validity, construct validity, reliability, internal consistency, Cronbach's alpha correlation coefficient, discriminant validity and convergent validity. Measurement invariance for urban and rural groups was established and the measured model adopted confirmatory factor analysis and structural equation modelling technique for assessing the psychometric properties of constructs. A final and fifth version of questionnaire was designed with 57 items from the initial indicators of 132 items. The findings of this research indicate that psychometrics used in this study are reliable and valid, and can be extended to other research contexts for its higher purpose in environmental protection. [ABSTRACT FROM AUTHOR]

This paper assesses Land Use/Land Cover (LULC) classification and Land Surface Temperature (LST) in Wayanad district during the years 2004 and 2018. The LULC classification of Wayanad district is identified using IRS P6 (Linear Imaging Self Scanner) LISS- III, and LST using thermal band of (Enhanced Thematic Mapper Plus) ETM+ imageries. Maximum likelihood classification (MLC) technique is opted to categorize six land-use features: water body, paddy field, forest, dense, agricultural crops and built-up. From 2004 to 2018, impacts of changes in features are correlated with the raised LST. Overall vegetation cover shows an increasing pattern during the study period. The water bodies in Wayanad district improved from 4.30 to 32.68 sq.km due to construction of two dams: Banasurasagar and Karappuzha. However, agricultural crops and paddy field area have decreased by 4.7% in last 14 years. Decreasing rate of agricultural crops can be directly linked to population growth, thereby developing various built-up zones for basic needs. Forest and dense vegetated cover area are increased nearly 2.3 and 3.0%, respectively, during the study period, while bamboo degradation has also been witnessed from 2008 to 2013. The built-up class shows growth from 1.48 to 5.69% of total land area during 2004 and 2018. LULC have noticeable influences on LST with a negative correlation between vegetation cover and LST with a decrease of 1.75oC. The study findings can help the local authorities to implement urban planning regulations for public awareness and policy makers for a sustainable planning and management in forthcoming years. [ABSTRACT FROM AUTHOR]

This paper presents a hybrid approach for stormwater runoff modelling and pollutant load estimation in a hilly catchment. The stormwater runoff hydrograph was simulated by developing a conceptual hybrid model (HM) using transfer function. Model parameters were estimated by non-linear optimization. The simulated runoff hydrographs showed an excellent match with the observed data. Next, a relationship was developed between runoff and pollutant load and the developed relationship was used for estimation of pollutant load. A novelty of this hybrid approach is that it could bring out a generic HM. By using the derived model, the pollutant load was successfully predicted from simulated runoff (R2 > 0.75) by considering rainfall as the only input. In addition, assessment, characterization and analysis of the first flush of urban runoff also form part of the study. The HM was tested and validated by applying it to 25 storm events monitored during two monsoon seasons in the Nainital Lake catchment (approx. 1900 m a.m.s.l.), India. [ABSTRACT FROM AUTHOR]

This paper explores the conceptualization of Urban Green Space (UGS) within India's urban planning process. In doing so, the context of the Smart Cities Mission (SCM), which is a flagship programme for urban transformation in the country, is chosen. We identified four key elements of UGS planning in the literature – quantity, accessibility, multifunctionality, and connectivity. Using this as a framework for analysis, we reviewed the national SCM guidelines and plans of four cities – Gwalior, Bhagalpur, Chandigarh, and Udaipur – in depth. We find that multifunctionality does not feature in the planning of UGS, and the notable absence of a connected, strategic vision suggests the need for strategic-level planning and assessment that goes beyond the project level in India. [ABSTRACT FROM AUTHOR]

This paper examines Indian strategy through the lens of military innovation. Comparing three major indigenous defense projects undertaken within a decade of each other, it asks why the Indian defense establishment managed to deliver on the Naval project while those of the Army and the Air Force were delayed by decades. To explain these differing outcomes, the paper argues, we need to analyze three inter-related issues: institutional capacity within the services; innovation strategy; and project management structures and accountability. [ABSTRACT FROM AUTHOR]

Modern states have to reckon with the problem of corruption because of its derailing influence on the functioning of government. This paper argues that state–society relations frame the context in which the incidence of corruption and the state's response to corruption become mutually reinforcing processes. We define this as "structures of irresolution" wherein an idealized abstract image of the state is constructed and corruption is blamed upon individual aberrations rather than the deviant nature of the state itself. We apply this framework to examine the functions of Karnataka Lokayukta, an anticorruption institution in India. Our data comes from the Annual Reports of this Lokayukta between 1987 and 2015 and corruption cases from Crime in India statistics. Our analysis shows that Lokayukta targeted officials disproportionately from lower sections of the bureaucracy. We recommend decentralized accountability mechanisms that redefine the relations between the individual, institutions, and the state to combat corruption effectively. [ABSTRACT FROM AUTHOR]

This paper presents an analysis of trends in six drought variables at 566 stations across India over the period 1901–2002. Six drought variables were computed using standardized precipitation index (SPI). The Mann-Kendall (MK) trend test and Sen's slope estimator were used for trend analysis of drought variables. Discrete wavelet transform (DWT) was used to identify the dominant periodic components in trends, whereas the significance of periodic components was examined using continuous wavelet transform (CWT) based global wavelet spectrum (GWS). Our results show an increasing trend in droughts in eastern, northeastern and extreme southern regions, and a decreasing trend in the northern and southern regions of the country. The periodic component influencing the trend was 2–4 years in south, 4–8 years in west, east and northeast, 8–64 years in central parts and 32–128 years in the north; however, most of the periodic components were not statistically significant. [ABSTRACT FROM AUTHOR]

This paper scrutinizes environmental impact assessment (EIA) in India and its potential environmental justice implications. We focused on procedural aspects of environmental justice and concentrated specifically on public interest litigation. Using a qualitative case study (document review, semi-structured interviews, participant observation, transect walks, thematic analysis), we examined conflict and litigation in an EIA of a proposed industrial development affecting a wetland and agricultural livelihoods in the state of Gujarat. The study 1) describes aspects of the EIA that triggered opposition, including litigation before the National Green Tribunal (NGT), 2) explains the extent to which the EIA addressed concerns of potentially affected local communities, and 3) assesses the effectiveness of the court system and the NGT in resolving disputes arising from the EIA. We found: that important gaps in the EIA report and lack of public participation opportunities were important triggers for litigation; crucial disconnects between issues addressed in the EIA and concerns of affected communities; and formidable challenges to gaining full access to legal representation, technical expertise and judicial remedies. Addressing these shortcomings would improve the EIA regime, enhance procedural aspects of environmental justice in India, and improve the prospects for distributive, recognitional and restorative justice by ensuring that EIAs reflect local knowledge, values and aspirations. [ABSTRACT FROM AUTHOR]

The probable availability of renewable power sources is unexceptionable, and the government of India is setting high goals for the use of renewable energy. Renewable distributed generation (DG) reduces the need for fossil fuels, relieve environment change, and decrease radiations of CO2 and other perfluorocarbons. DGs and capacitors are more desirable choices to balance power demand closer to the load centres than centralized power generation. Optimal position and capacity of DGs play an essential role in enhancing the performance of distribution systems in terms of system loss mitigation, voltage profile enhancement and stability concerns. This paper introduces Harris Hawk Optimization (HHO) and Teaching Learning-Based Optimization (TLBO) approaches for efficient distribution of different types of DGs in the radial distribution system (RDS) to enhance system loss minimization, voltage profile, yearly energy savings and decreasing the greenhouse gas emissions. The aim is to depreciate system energy losses, cost of energy losses and more reliable voltage regulation within the frame-work of RDS planning. Four different cases are considered to assess the suggested algorithms. Simulations are carried out on IEEE 33-bus and 69-bus test RDSs. The preponderance of the recommended approaches has been shown by analysing the results with techniques available in the literature. The comparison is made based on the power losses and voltage profile of RDS. The outcomes reveal that a significant decrease in power loss, enrichment of the voltage profile across the network and exactness of the suggested methods. [ABSTRACT FROM AUTHOR]

Geopolitical interests and concerns motivate India's renewed push for subregional connectivity. The evolving subregional approach aims at re-integrating India's immediate neighborhood with the aim of protecting New Delhi's traditional regional primacy. Historically, the Partition of the Indian subcontinent terminated a well-connected common space. Decades after its independence, India has turned toward reconnecting with its immediate neighbors clustered in subregions in the changing geopolitical context. India's subregional approach has emerged as a key area of foreign policy priority. This paper attempts to map out India's evolving subregional approach and explicates the strategic rationale behind it. Even as India has pushed to expand subregional connectivity, there are both domestic as well as external challenges. The article examines how India has been addressing some of the major hurdles underlining their policy implications. First, the conceptual underpinnings of India's evolving subregional approach are explicated followed by an analysis of the factors driving this push. Subsequently, key subregional projects initiated by India are discussed. Finally, the challenges facing India in managing subregional initiatives are examined. [ABSTRACT FROM AUTHOR]

Menstruation frequently poses psychological, social, and health challenges for young women living in low- and middle-income countries. In countries such as India, where menstruation is stigmatised, it can be particularly difficult. This paper examines challenges related to menstruation for young women living in slums in Lucknow, Uttar Pradesh, India. The research was informed by the socio-ecological model. Life course interviews were conducted with 70 young women ages 15–24 living in the slums of Lucknow. Thematic analysis was used to identify salient themes regarding individual, social, and systemic challenges related to menstruation. On the individual level, young women lack knowledge about menstruation. In the social sphere, young women experience stigma around menstruation, lack opportunities to discuss menstruation, and experience limitations around mobility and other activities during menstruation. At the institutional level, for example in school, there are few resources to support menstruating young women as toilets are dirty and doors are broken. Therefore, menstruating adolescents and young women in Lucknow, Uttar Pradesh, India, face an array of challenges at multiple levels. These findings suggest that multi-level interventions are warranted to create a supportive context for menstruation. [ABSTRACT FROM AUTHOR]

Why did India launch and later withdraw from the exercise in coercive diplomacy – Operation Parakram – against Pakistan in response to the attack on India's Parliament by terrorists based in that country? This paper marshals factors operating at the systemic, state and individual/small-group levels of analysis to show that, despite the paucity of evidence on decisionmaking of the kind required for an effective foreign policy analysis (FPA) approach, a reasonably clear picture can be developed. It combines deductive logic relating to state behavior in a nuclearized environment with the limited empirical evidence available to show that India never intended to go to war and that the operation was essentially a bluff that, having eventually reached a dead end, was called off. [ABSTRACT FROM AUTHOR]

Most studies looking at India's external policies continue to "black-box" the actual process of how Indian foreign policy is made. More specifically, most studies generally overlook how India's complex domestic polity and bureaucratic apparatus shape India's foreign policy outlook. Unlike works on India's security policy which have built from and contributed to broader academic debates, studies on India's foreign policy have failed to directly engage with concepts and theories developed by the sub-discipline of Foreign Policy Analysis (FPA). Why have these concepts and approaches not been consistently applied to the Indian context? There are various reasons for this, ranging from these disciplines' excessive reliance on Western case studies, or the lack of interest in mainstream International Relations scholarship by South Asianists (in contrast to disciplines such as economics, political theory, and developmental studies, all of which have benefited from the Indian experience). This special issue is a step towards bridging this gap and to encourage a greater dialogue between FPA and the systematic study of Indian foreign policy. Through the careful analysis of specific case studies, the different papers offer a conceptually grounded and empirically innovative reading of India's foreign policy across time, space, and themes. [ABSTRACT FROM AUTHOR]

The USD 12 billion steel project of POSCO in Odisha, India, conceived in 2005, was to be one of the largest investments in the country. But the project could not materialize, and in 2017 POSCO withdrew from the project after a lot of controversies. For this classic example of a lose-lose situation, the role of impact assessment (IA) has not been discussed adequately. Using a single case study method, this paper analyzes various dimensions of IA exercises conducted for the project. These IA exercises failed to notice the complex livelihood systems and potential dissent among the people of the area. Stakeholders' consultations were weak, IA reports did not highlight the negative impacts, and the potential loss of livelihoods was not noticed. Questions have also been raised on the legitimacy and authenticity of the claims made in these IA studies. However, the role of IA was also found be to be limited and the expectation from IA was also low. This negates the role of an ideal IA that should have been a comprehensive one and should have taken note of issues that are detrimental for the society, and particularly for the project. [ABSTRACT FROM AUTHOR]

India's government under Narendra Modi represents a return to single party rule. This paper investigates whether and why single party governments in India differ in their extremity of foreign policies from coalition governments. It particularly focuses on how different forms of government influence the saliency, contestation, and enactment of national conceptions about India's global role. First, I situate India within the academic debate regarding coalitional governments and foreign policy. I suggest that one reason why India challenges scholars' assumption is the missing link between partisan conceptions of India's global role and their institutional representation. Second, I propose a role theoretical approach and argue that the process of self-identification, consisting of ego and anticipated alter expectations, conditions a state's role set and extreme foreign policy. It is hypothesized that the nature of contestation of national role conceptions varies between factions and fractions because of the nature of India's party system, as well as the relative significance of external others for India's identity. Third, I examine instances of role-taking in the field of nuclearization and Sino-Indian relations. Findings suggest that contested role conceptions during single-party rule caused more extreme variances in international role-taking, while coalition governments proved to induce more complementary role-taking processes. [ABSTRACT FROM AUTHOR]

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

In this research paper, an innovative solution by proposing a novel mechanism for implementation of regulatory approach—based new deviation settlement scheme for frequency control is suggested. Power systems of many developing countries have to face sustained generation deficiency, large frequency fluctuations and are susceptible to even small disturbance. Operating such a system is a difficult task and innovative solutions are needed to solve this situation. To overcome this situation, India has adopted commercial mechanism known as Availability-based Tariff (ABT), which has a component linked with frequency. A commercial mechanism is a paradigm shift in the operational strategies from the conventional frequency control to new deviation control. This proposed scheme satisfies Central Electricity Regulatory Commission (CERC) criteria and inclusive future norms. The MATLAB used to enable to analyze proposed rules and the strength of the approach, is to segregate the conventional Automatic Generation Control (AGC) with new UI-based AGC. The enhancement of AGC algorithms is to meet increased demand by efficient implementation of algorithm for generators rescheduling, as per new CERC norms. [ABSTRACT FROM AUTHOR]

This series of papers on Globalization, Institutional Change, and Politics of reforms in India highlights some of the key characteristics of institutional change and globalization in India. This special issue points in the direction of three important conjectures on globalization and change by bringing together a few key aspects of the process of institutional change and engagement with the global in India. First, India's liberal democracy has embraced globalization and globally influenced institutional change in an embedded liberal way. Second, this is a saga of gradual and largely endogenous change. India is deeply affected by the demonstration effect of global best practices but builds rather more after its own internal consensus. Finally, even though India is not a classic developmental state, the state is an important factor in promoting change. [ABSTRACT FROM AUTHOR]

The caste system is a complex social stratification system which has been abolished, but remains deeply ingrained in India. Scheduled Caste (SC) women are one of the historically deprived groups, as reflected in poor maternal health outcomes and low utilisation of maternal healthcare services. Key government schemes introduced in 2005 mean healthcare-associated costs should now be far less of a deterrent. This paper examines the factors contributing to this low use of maternal health services by investigating the perceptions, health-seeking behaviours and access of SC women to maternal healthcare services in Bihar, India. Eighteen in-depth, semi-structured interviews were conducted with SC women in Bihar. Data were analysed using Framework Analysis and presented using the AAAQ Toolbox. Main facilitating factors included the introduction of accredited social health activists (ASHAs), free maternal health services, the Janani Shishu Suraksha Karyakram (JSSK), and changes in the cultural acceptability of institutional delivery. Main barriers included inadequate ASHA coverage, poor information access, transport costs and unauthorised charges to SC women from healthcare staff. SC women in Bihar may be inequitably served by maternal health services, and in some cases may face specific discrimination. Recommendations to improve SC service utilisation include research into the improvement of postnatal care, reducing unauthorised payments to healthcare staff and improvements to the ASHA programme. [ABSTRACT FROM AUTHOR]

The paper examines if the business sector in India has had a tangible influence on India’s foreign policy. It suggests several factors for which private business failed to have any influence on India’s foreign policy during the first three decades after Independence. It suggests a conceptual typology of the principal drivers of India’s foreign policy, which, according to the author, provides an effective framework for understanding the role of the private sector since it began to wield some influence in the mid-1980s. The paper uses this threefold classification to argue that, in the period from the 1980s to today, contrary to the general perception, the role of the Indian business sector (and especially of industry associations) on India’s foreign policy has been marginal and restricted to some specific sectors. [ABSTRACT FROM PUBLISHER]

In 2009, the Government of India asked all Indian states and Union Territories to prepare State Action Plans on Climate Change, making it one of the largest efforts at sub-national climate planning globally. Through an examination of state climate plans in five Indian states, the paper explores the implications of sub-national climate measures by examining two questions: First, how do state action plans on climate change link with India’s national and international climate efforts in the context of multi-level governance of climate change? Second, do these plans serve as laboratories of experimentation in addressing climate change? Through an empirically driven inductive analysis, the paper argues that because state climate plans, at least in the initial stages, followed a centrally driven, and sometimes ambiguous agenda, their scope and room to experiment was circumscribed. While they did initiate a process and a conversation, the scope and impact of the plans was limited because they tended to follow conventional bureaucratic planning processes and were limited by a central mandate. The plan process did create some space for local innovation, particularly by enterprising bureaucrats, but this was limited by both restricted space and time for innovation. As a result, the plans made only initial steps toward bringing climate-resilient sustainability to the forefront of state development planning. There is however scope for improvement as states and stakeholders begin examining the plans with a view to implement recommendations, finance projects and even consider fresh iterations. [ABSTRACT FROM PUBLISHER]

Background: From conception to 6 months of age, an infant is entirely dependent for its nutrition on the mother: via the placenta and then ideally via exclusive breastfeeding. This period of 15 months - about 500 days - is the most important and vulnerable in a child's life: it must be protected through policies supporting maternal nutrition and health. Those addressing nutritional status are discussed here. Objective and design: This paper aims to summarize research on policies and programs to protect women's nutrition in order to improve birth outcomes in low- and middle-income countries, based on studies of efficacy from the literature, and on effectiveness, globally and in selected countries involving in-depth data collection in communities in Ethiopia, India and Northern Nigeria. Results of this research have been published in the academic literature (more than 30 papers). The conclusions now need to be advocated to policy-makers. Results: The priority problems addressed are: intrauterine growth restriction (IUGR), women's anemia, thinness, and stunting. The priority interventions that need to be widely expanded for women before and during pregnancy, are: supplementation with iron-folic acid or multiple micronutrients; expanding coverage of iodine fortification of salt particularly to remote areas and the poorest populations; targeted provision of balanced protein energy supplements when significant resources are available; reducing teenage pregnancies; increasing interpregnancy intervals through family planning programs; and building on conditional cash transfer programs, both to provide resources and as a platform for public education. All these have known efficacy but are of inadequate coverage and resourcing. The next steps are to overcome barriers to wide implementation, without which targets for maternal and child health and nutrition (e.g. by WHO) are unlikely to be met, especially in the poorest countries. Conclusions: This agenda requires policy decisions both at Ministry and donor levels, and throughout the administrative system. Evidence-based interventions are established as a basis for these decisions, there are clear advocacy messages, and there are no scientific reasons for delay. [ABSTRACT FROM AUTHOR]

The conventional wisdom among many analysts and policy-makers is that India’s central government has followed a fairly consistent internal security policy by deploying an “iron first in a velvet glove” that attacks irreconcilable armed groups, while holding open the door to mainstream politics for moderates. This article argues that this wisdom is incorrect. It instead offers a more political explanation of government strategy, showing that Delhi cares much more about some kinds of groups and conflicts than others, leading to a diverse pattern of strategies toward armed actors. Central government strategy is driven by varying political resolve for crackdowns and varying political space for either deal-making or neglect. Rather than a shared general approach, there is a far more selective and complex pattern of strategy. The paper examines both counterinsurgent conflicts and the murkier realm of private armies and armed political parties that blend “normal” politics with violence. [ABSTRACT FROM AUTHOR]

The tenets of sustainable development are often ignored by growing cities in developing countries. Salt Lake City, located on the eastern fringes of Kolkata, despite being a planned township, has failed to manage its water resources in a sustainable way. Results from the study show that the water supplied at the households is hard in nature, saline, and replete with dissolved solids. The problem is further aggravated due to over-extraction of groundwater resources, resulting in an intense fall of the groundwater level in the area. This paper attempts to suggest measures for sustainable water resource management, with particular emphasis on rainwater harvesting. [ABSTRACT FROM AUTHOR]

The west coast of India is affected by tsunamigenic earthquake along the Makran subduction zone. On 28 November 1945 at 21:56 coordinated universal time (UTC), a massive Makran earthquake (M8.0) generated a destructive tsunami that propagated across the Northern Arabian Sea and the Indian Ocean. This tsunamigenic earthquake was responsible for the loss of life and great destruction along the coasts of India, Pakistan, Iran and Oman. Modelling of tsunami stages has been made for the coasts of Pakistan, Iran, India and Oman using NAMI-DANCE computer code. The fault parameters of the earthquakes for the generation of tsunami are epicentre (25.15° N, 63.48° E), fault area (200 km length and 100 km width), angle of strike, dip and rake (246°, 7° and 90°), focal depth (15 km), slip magnitude (7 m). The bathymetry data are taken from General Bathymetric Chart of the Oceans (GEBCO) and land topography data were collected using Shuttle Radar Topography Mission (SRTM). The present simulation is carried out for a duration of 360 min. It is observed that the maximum calculated tsunami run-ups were about 0.7–1.1 m along the coast of Oman, 0.5 m near Muscat, 0.1 m near Sur, 0.7–1.35 m along the western coast of India, 0.5–2.3 m along the southern coast of Iran and 1.2–5.8 m along the southern coast of Pakistan. After the tsunamigenic earthquake, the tsunami wave reached the Gulf of Kachchh in about 240 min, Okha in about 185 min, Dwarka in about 150 min, Porbandar in about 155 min, Mumbai in about 300 min and Goa in about 210 min. The calculated 2-hr tsunami travel time to the Indian coast is in good agreement with the available reports and published data. If the tsunami strikes during high tide, we should expect more serious hazards which would impact local coastal communities. The results obtained in this study are converted to be compatible with the geographic information system based applications for display and spatial analysis of modelling results. The paper also presents classification of tsunami risk zones based on elevation vulnerability. We expect that the results presented here will be supportive to the tsunami emergency response system and useful in planning the protection measures due to tsunami. [ABSTRACT FROM PUBLISHER]

This paper provides a brief overview of the progress made towards active fault research in India. An 8 m high scarp running for more than 80 km in the Rann of Kachchh is the classical example of the surface deformation caused by the great earthquake (1819 Kachchh earthquake). Integration of geological/geomorphic and seismological data has led to the identification of 67 active faults of regional scale, 15 in the Himalaya, 17 in the adjoining foredeep with as many as 30 neotectonic faults in the stable Peninsular India. Large-scale trenching programmes coupled with radiometric dates have begun to constraint the recurrence period of earthquakes; of the order of 500–1000 years for great earthquakes in the Himalaya and 10,000 years for earthquakes of >M6 in the Peninsular India. The global positioning system (GPS) data in the stand alone manner have provided the fault parameters and length of rupture for the 2004 Andaman Sumatra earthquakes. Ground penetration radar (GPR) and interferometric synthetic aperture radar (InSAR) techniques have enabled detection of large numbers of new active faults and their geometries. Utilization of modern technologies form the central feature of the major programme launched by the Ministry of Earth Sciences, Government of India to prepare geographic information system (GIS) based active fault maps for the country. [ABSTRACT FROM PUBLISHER]

The Sundarban Biosphere Reserve in West Bengal, India, is part of the largest mangrove forest ecosystem in the world. The reserve is a world heritage site and the last refuge for the endangered Bengal tiger at a crucial time when global climate change threatens their existence. The mangrove ecosystem and wildlife conservation have become the priority for the state government of West Bengal. However, in becoming so, the state government imposes restrictions on catching fish in the core and buffer areas of the biosphere reserve, which intensify fishermen's everyday resource-access struggles in the mangrove forest. This paper examines the conflict between local fishermen and conservation needs, broadening the understanding of human-environment relationships in the Sundarbans region of India. [ABSTRACT FROM AUTHOR]

The remote Himalayan region of Kinnaur in northwestern India is known for its carved wooden homes with decorative features. Relatively recent environmental policies have prompted limitations on wood collection. This, coupled with an increase in access to modern building materials, has resulted in dramatic changes in vernacular housing styles. Landscape analysis and interviews reveal that house form, building methods, and construction materials are all changing. However, decorative features are among the last remaining characteristics of the traditional house. This paper argues that small-scale architectural features are a significant part of an enduring vernacular landscape and allow a region to preserve traditional styles and identity, while also moving forward as a modernizing society. [ABSTRACT FROM AUTHOR]

Public consultation is an important decision-aiding process in environmental impact assessment (EIA) and aids in building up consensus between various stakeholders, primarily the local public. In this meta-analysis, proceedings of 100 public hearings (PHs) recorded in the Indian state of Gujarat were analysed for the views of local public between environmental issues and others while an industry is being set up across five sectors – bulk drug and drug intermediates, cement, highway projects, oil and gas exploration and thermal power plants. The analysis shows that environmental issues are only 33% of the total issues raised, while socio-economic, infrastructure, PH process, track record and other general issues cover 21%, 13%, 2%, 12% and 19%, respectively. This implies that irrespective of sector or project local socio-economic and developmental concerns outweigh environmental issues and the current PH process is not able to get the appropriate inputs and insights from the stakeholders in improving the environmental decision-making. In light of these, some alternatives for strengthening the EIA-PH process is proposed in the paper. [ABSTRACT FROM PUBLISHER]

There is a significant need to improve the highway safety during roadway planning, design and operations in developing countries like India. To receive appropriate consideration, safety needs to be dealt objectively within the transportation planning and highway design processes. Lack of available tools is a deterrent to quantify safety of a transportation facility during the planning or highway design process. The objective of this paper is to develop safety performance functions considering various elements involved in the planning, design and operation of a section on four-lane National Highway (NH)-58 located in the state of Uttarakhand, India. The mixed traffic on Indian multilane highways comes with a lot of variability within, ranging from different vehicle types to different driver characteristics. This could result in variability in the effect of explanatory variables on crashes across locations. Hence, explanatory variables for highway segment safety analysis considered were geometric characteristics like curvature change rate, slope change rate, transverse slope and traffic characteristics in the form of average daily traffic, light vehicle traffic, light commercial vehicle traffic, heavy vehicle traffic, two-wheelers, non-motorised traffic volume and operating speed were analysed against dependent variable as crash count per 200 m per year. Safety performance functions involving the explanatory variables are calibrated to predict crash frequency using Poisson Weibull technique and crash types are predicted using ordered logit model. Model results suggest that increase in traffic volume leads to higher probability of crash risk and traffic safety is significantly distorted by higher curvature change rate values. [ABSTRACT FROM AUTHOR]

This article reviews the impact and effectiveness in implementation of the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) at state level as well as at village level with focus on inclusiveness, rural labor markets and agriculture. The paper finds that some states are more effective in implementation then others. The states which effectively integrated MGNREGA works with local planning gained much in terms of employment generation and asset creation leading to increased agricultural potential. The scheme is more inclusive of vulnerable sections of the society including scheduled castes and tribes and also women. Study also highlight the village level differences in implementation and effective implementation leads to reduction of hunger and poverty. More importantly the scheme increased bargaining power of rural laborer in agricultural sector, resulted in higher wage rates, better work environment and less exploitation. [ABSTRACT FROM AUTHOR]

Background: This paper explores the heterogeneities in antenatal care (ANC) utilization in India's most populated state, Uttar Pradesh. Taking an intersectionality lens, multiple individual- and district-level factors are used to identify segments of any antenatal care usage in Uttar Pradesh Objective: This paper seeks to understand the multilevel contexts of ANC utilization. The planning and programming challenge is that such knowledge of contextual specificity is rarely known upfront at the initial stages of planning or implementing an intervention. Exploratory data analysis might be needed to identify such contextual specificity. Methods: Tree-structured regression methods are used to identify segments and interactions between factors. The results from the tree-structured regression were complemented with multilevel models that controlled for the clustering of individuals within districts. Results: Heterogeneities in utilization of any ANC were observed. The multiple segments of ANC utilization that were developed went from a low utilization of 23.7% for respondents who were not literate and did not have home ownership to a high of 82.4% for respondents who were literate and at the highest level of wealth. Key variables that helped define the segments of ANC utilization include: woman's literacy, ownership of home, wealth index, and district-level sex ratio. Based on the multilevel model of any ANC utilization, cross-level interactions also were obtained between sex ratio and ownership of home as well as between sex ratio and literacy. Increases in sex ratio increased the influence of ownership of home on any ANC, while increases in sex ratio reduced the impact of woman's literacy on receiving any ANC. Conclusion: We argue that a focus on heterogeneous segments of utilization can help build knowledge of the mechanisms that underlie inequities in maternal health utilization. Such knowledge of heterogeneity needs to be incorporated in contextualizing interventions to meet a variety of recipients' needs. [ABSTRACT FROM AUTHOR]

Background: A large state-wide tobacco survey was conducted using modified version of pretested, globally validated Global Adult Tobacco Survey (GATS) questionnaire in 2015–22016 in Tamil Nadu, India. Due to resource constrains, data collection was carrid out using paper-based questionnaires (unlike the GATS-India, 2009–2010, which used hand-held computer devices) while data entry was done using open access tools. The objective of this paper is to describe the process of data entry and assess its quality assurance and efficiency. Methods: In EpiData language, a variable is referred to as ‘field’ and a questionnaire (set of fields) as ‘record’. EpiData software was used for double data entry with adequate checks followed by validation. Teamviewer was used for remote training and trouble shooting. The EpiData databases (one each for each district and each zone in Chennai city) were housed in shared Dropbox folders, which enabled secure sharing of files and automatic back-up. Each database for a district/zone had separate file for data entry of household level and individual level questionnaire. Results: Of 32,945 households, there were 111,363 individuals aged ≥15 years. The average proportion of records with data entry errors for a district/zone in household level and individual level file was 4% and 24%, respectively. These are the errors that would have gone unnoticed if single entry was used.The median (inter-quartile range) time taken for double data entry for a single household level and individual level questionnaire was 30 (24, 40) s and 86 (64, 126) s, respectively. Conclusion: Efficient and quality-assured near-real-time data entry in a large sub-national tobacco survey was performed using innovative, resource-efficient use of open access tools. [ABSTRACT FROM PUBLISHER]

Background:This paper explores the multilevel factors associated with maternal health utilization in India’s most populous state, Uttar Pradesh. 3 key utilization practices: registration of pregnancy, receipt of antenatal care, and delivery at home are examined for district and individual level predictors. The data is based on 5666 household surveys conducted as part of a baseline evaluation of the Uttar Pradesh Technical Support Unit (UPTSU.) program. Objectives:This intervention aims to assist the Government of Uttar Pradesh in increasing the efficiency, effectiveness, and equity of service delivery across a continuum of reproductive, maternal, new-born, child, and adolescent health (RMNCH+A) outcomes. Methods:The paper employs multilevel models that control for individuals being nested within districts in order to understand the predictors of maternal health care utilization. Results:The study identifies several individual-level predictors of health care utilization, including: literacy of the woman, the husband’s schooling, age at marriage, and socio-economic factors. Key predictors of pregnancy registration include husband’s schooling (OR 1.49, 95% CI 1.26–1.76), having a bank account (OR 1.36, 95% CI 1.11–1.68), and owning a house (OR 2.28, 95% CI 1.85–2.80). Factors affecting antenatal care include the woman’s literacy (OR 1.49, 95% CI 1.28–1.73), the respondent having had a job in the last year (OR 1.39, 95% CI 1.10–1.77), and owning a house (OR 2.83, 95% CI 2.27–3.53). Home delivery tends to be associated with woman’s literacy (OR 0.62, 95% CI 0.54–0.72) and marriage age of 15 and younger (OR 1.48, 95% CI 1.26–1.73). Conclusions:Interventions having equity considerations need to disrupt existing patterns of the health gradient. Successful implementation of such interventions, necessitate understanding the mechanisms that can disrupt the unequal utilization patterns and target domains of disadvantage. Knowledge of key predictors of utilization can aid in the implementation of such complex interventions. [ABSTRACT FROM PUBLISHER]

The high rate of maternal mortality in India is of grave concern. Poor rural Indian women are most vulnerable to preventable maternal deaths primarily because they have limited availability of affordable emergency obstetric care (EmOC) within reasonable geographic proximity. Scarcity of obstetricians in the public sector combined with financial barriers to accessing private sector obstetrician services preclude this underserved population from availing lifesaving functions of comprehensive EmOC such as C-section. In order to overcome this limitation, Government of Gujarat initiated a unique public–private partnership program called Chiranjeevi Yojana (CY) in 2005. The program envisaged leveraging private sector providers to increase availability and thereby accessibility of EmOC care for vulnerable sections of society. Under CY, private sector providers render obstetric care services to poor women at no cost to patients. This paper examines the CY's effectiveness in improving availability of CEmOC services between 2006 and 2012 in three districts of Gujarat, India. Primary data on facility locations, EmOC functionality, and obstetric bed availability were collected in the years 2012 and 2013 in three study districts. Secondary data from Census 2001 and 2011 were used along with required geographic information from Topo sheets and Google Earth maps. ArcGIS version 10 was used to analyze the availability of services using two-step floating catchment area (2SFCA) method. Our analysis suggests that the availability of CEmOC services within reasonable travel distance has greatly improved in all three study districts as a result of CY. We also show that the declining participation of the private sector did not result in an increase in distance to the nearest facility, but the extent of availability of providers for several villages was reduced. Spatial and temporal analyses in this paper provide a comprehensive understanding of trends in the availability of EmOC services within reasonable travel distance. This paper demonstrates how GIS could be useful for evaluating programs especially those focusing on improving availability and geographic accessibility. The study also shows usefulness of GIS for programmatic planning, particularly for optimizing resource allocation. [ABSTRACT FROM AUTHOR]

Background: Countries are increasingly adopting health insurance schemes for achieving Universal Health Coverage. India's state-funded health insurance scheme covers hospital care provided by 'empanelled' private and public hospitals. Objective: This paper assesses geographical equity in availability of hospital services under the universal health insurance scheme in Chhattisgarh state. Methods: The study makes use of district data from the insurance scheme and government surveys. Selected socio-economic indicators are combined to form a composite vulnerability index, which is used to rank and group the state's 27 districts into tertiles, named as highest, middle and lowest vulnerability districts (HVDs, MVDs, LVDs). Indicators of hospital service availability under the scheme - insurance coverage, number of empanelled private/public hospitals, numbers and amounts of claims - are compared across districts and tertiles. Two measures of inequality, difference and ratio, are used to compare availability between tertiles. Results: The study finds that there is a geographical pattern to vulnerability in Chhattisgarh state. Vulnerability increases with distance from the state's centre towards the periphery. The highest vulnerability districts have the highest insurance coverage, but the lowest availability of empanelled hospitals (3.4 hospitals per 100,000 enrolled in HVDs, vs 8.2/100,000 enrolled in LVDs). While public sector hospitals are distributed equally, the distribution of private hospitals across tertiles is highly unequal, with higher availability in LVDs. The number of claims (per 100,000 enrolled) in the HVDs is 3.5-times less than that in the LVDs. The claim amounts show a similar pattern. Conclusions: Although insurance coverage is higher in the more vulnerable districts, availability of hospital services is inversely proportional to vulnerability and, therefore, the need for these services. Equitable enrolment in health insurance schemes does not automatically translate into equitable access to healthcare, which is also dependent on availability and specific dynamics of service provision under the scheme. [ABSTRACT FROM AUTHOR]

Background: Resource allocation in health is universally challenging, but especially so in resource-constrained contexts in the Global South. Pursuing a strategy of evidence-based decision-making and using tools such as Health Technology Assessment (HTA), can help address issues relating to both affordability and equity when allocating resources. Three BRICS and Global South countries, China, India and South Africa have committed to strengthening HTA capacity and developing their domestic HTA systems, with the goal of getting evidence translated into policy. Through assessing and comparing the HTA journey of each country it may be possible to identify common problems and shareable insights. Objectives: This collaborative paper aimed to share knowledge on strengthening HTA systems to enable enhanced evidence-based decision-making in the Global South by: Identifying common barriers and enablers in three BRICS countries in the Global South; and Exploring how South-South collaboration can strengthen HTA capacity and utilisation for better healthcare decision-making. Methods: A descriptive and explorative comparative analysis was conducted comprising a Within-Case analysis to produce a narrative of the HTA journey in each country and an Across-Case analysis to explore both knowledge that could be shared and any potential knowledge gaps. Results: Analyses revealed that China, India and South Africa share many barriers to strengthening and developing HTA systems such as: (1) Minimal HTA expertise; (2) Weak health data infrastructure; (3) Rising healthcare costs; (4) Fragmented healthcare systems; and (5) Significant growth in non-communicable diseases. Stakeholder engagement and institutionalisation of HTA were identified as two conducive factors for strengthening HTA systems. Conclusion: China, India and South Africa have all committed to establishing robust HTA systems to inform evidence-based priority setting and have experienced similar challenges. Engagement among countries of the Global South can provide a supportive platform to share knowledge that is more applicable and pragmatic. [ABSTRACT FROM AUTHOR]

Background: The Global Fund encourages operational research (OR) in all its grants; however very few reports describe this aspect. In India, Project Axshya was supported by a Global Fund grant to improve the reach and visibility of the government Tuberculosis (TB) services among marginalised and vulnerable communities. OR was incorporated to build research capacity of professionals working with the national TB programme and to generate evidence to inform policies and practices. Objectives: To describe how Project Axshya facilitated building OR capacity within the country, helped in addressing several TB control priority research questions, documented project activities and their outcomes, and influenced policy and practice. Methods: From September 2010 to September 2016, three key OR-related activities were implemented. First, practical output-oriented modular training courses were conducted (n = 3) to build research capacity of personnel involved in the TB programme, co-facilitated by The Union, in collaboration with the national TB programme, WHO country office and CDC, Atlanta. Second, two large-scale Knowledge, Attitude and Practice (KAP) surveys were conducted at baseline and mid-project to assess the changes pertaining to TB knowledge, attitudes and practices among the general population, TB patients and health care providers over the project period. Third, studies were conducted to describe the project's core activities and outcomes. Results: In the training courses, 44 participant teams were supported to develop research protocols on topics of national priority, resulting in 28 peer-reviewed scientific publications. The KAP surveys and description of project activities resulted in 14 peer-reviewed publications. Of the published papers at least 12 have influenced change in policy or practice. Conclusions: OR within a Global Fund supported TB project has resulted in building OR capacity, facilitating research in areas of national priority and influencing policy and practice. We believe this experience will provide guidance for undertaking OR in Global Fund projects. [ABSTRACT FROM AUTHOR]

Background: Schools can play an important role in health promotion by improving students’ health literacy, attitudes, health-related behaviours, social connection and self-efficacy. These interventions can be particularly valuable in low- and middle-income countries with low health literacy and high burden of disease. However, the existing literature provides poor guidance for the implementation of school-based interventions in low-resource settings. This paper describes the development and pilot testing of a multicomponent school-based health promotion intervention for adolescents in 75 government-run secondary schools in Bihar, India. Method: The intervention was developed in three stages: evidence review of the content and delivery of effective school health interventions; formative research to contextualize the proposed content and delivery, involving intervention development workshops with experts, teachers and students and content analysis of intervention manuals; and pilot testingin situto optimize its feasibility and acceptability. Results: The three-stage process defined the intervention elements, refining their content and format of delivery. This intervention focused on promoting social skills among adolescents, engaging adolescents in school decision making, providing factual information, and enhancing their problem-solving skills. Specific intervention strategies were delivered at three levels (whole school, student group, and individual counselling) by either a trained teacher or a lay counsellor. The pilot study, in 50 schools, demonstrated generally good acceptability and feasibility of the intervention, though the coverage of intervention activities was lower in the teacher delivery schools due to competing teaching commitments, the participation of male students was lower than that of females, and one school dropped out because of concerns regarding the reproductive and sexual health content of the intervention. Conclusion: This SEHER approach provides a framework for adolescent health promotion in secondary schools in low-resource settings. We are now using a cluster-randomized trial to evaluate its effectiveness and cost-effectiveness. [ABSTRACT FROM PUBLISHER]

Background: Depending on a country’s diagnostic infrastructure, patients and providers play different roles in ensuring that correct and timely diagnosis is made. However, little is known about the work done by patients in accessing diagnostic services and completing the ‘test and treat’ loop. Objective: To address this knowledge gap, we traced the diagnostic journeys of patients with tuberculosis, diabetes, hypertension and typhoid, and examined the work they had to do to arrive at a diagnosis. Methods: This paper draws on a qualitative study, which included 78 semi-structured interviews and 13 focus group discussions with patients, public and private healthcare providers, community health workers, test manufacturers, laboratory technicians, program managers and policymakers. Data were collected between January and June 2013 in rural and urban Karnataka, South India, as part of a larger project on barriers to point-of-care testing. We reconstructed patient diagnostic processes retrospectively and analyzed emerging themes and patterns. Results: The journey to access diagnostic services requires a high level of involvement and immense work from patients and/or their caretakers. This process entails overcoming cost and distance, negotiating social relations, continuously making sense of their illness and diagnosis, producing and transporting samples, dealing with the social consequences of diagnosis, and returning results to the treating provider. The quality and content of interactions with providers were crucial for completion of test and treat loops. If the tasks became overwhelming, patients opted out, delayed being tested, switched providers and/or reverted to self-testing or self-treatment practices. Conclusion: Our study demonstrated how difficult it can be for patients to complete diagnostic journeys and how the health system works as far as diagnostics are concerned. If new point-of-care tests are to be implemented successfully, policymakers, program officers and test developers need to find ways to ease patient navigation through diagnostic services. [ABSTRACT FROM PUBLISHER]

A multiple-strategy community intervention, known as National Rural Health Mission (NRHM), launched in India to improve the availability of and access to better-quality healthcare, especially for rural, poor mothers and children. The final goal of the intervention is to reduce maternal and child health inequalities across geographical areas, socioeconomic status groups, and sex of the child. Extensive, in-depth research is necessary to assess the effectiveness of NRHM, on multiple outcome dimensions. This paper presents the design of a new study, able to overcome the shortcomings of previous research. To propose a comprehensive, methodologically sound protocol to assess the extent of implementation and the effectiveness of NRHM measures to improve maternal and child health outcomes and reduce maternal and child health inequalities. A mixed-methods approach (quantitative and qualitative) is proposed for this study in Haryana, a state in North India. NRHM's health sector plans included health system strengthening, specific maternal and child healthcare strategies, and communitization. Mission documents and reports on progress, financial monitoring, and common and joint review will be reviewed in-depth to assess the extent of the implementation of plans. Data on maternal and child health indicators will be obtained from demographic health surveys held before, during, and after the implementation of the first phase of the NRHM (2005–2012) and compared over time. Differences in maternal and child health indicators will be used to measure maternal and child health inequalities; these will be compared pre- and post-NRHM. Focus group discussions (FGDs) with service providers and in-depth interviews with program managers, community representatives, and mothers will be conducted until data saturation is achieved, in two districts of Haryana. Using Nvivo software, an inductive qualitative content analysis will be performed to search for the broader themes across the interviews and FGDs. Ethical approval was obtained from the Ethics Committee of the Post Graduate Institute of Medical Education and Research. [ABSTRACT FROM AUTHOR]