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Over the years, survival of children with chronic diseases has significantly improved and a large proportion of them now are entering into adulthood. Transition of Care (ToC) of such patients with having childhood onset of chronic diseases to the adult health care system is well organized in developed countries, although it is an emerging concept in India. In situations where the systems for ToC are not in place, such cases are fraught with unsatisfactory health outcomes. With proper ToC in place, these patients are likely to receive uninterrupted care by the adult care physicians and hence reach their full potential. This document highlights the need, rationale and way forward for ToC of youth with special health care needs (YSHCN) across the country. It also describes the standard operating procedures to develop the ToC at a hospital level for clinicians and administrators. [ABSTRACT FROM AUTHOR]

Background: Digitization of health records and health delivery processes in health care settings may have an impact on the Patient-Physician communication, wait times, that affect the overall patient satisfaction with the health care services. Aim & Objective: We ascertained the effect of digitization of medical case files on the doctor patient relationship (DPR) domain of patient satisfaction at an urban primary health center in India. Settings and Design: Comparative, cross-sectional study in primary health centres. Methods and Material: The patient satisfaction was compared between the patients attending the Public Health Dispensary (PHD) that uses digitized medical case file system and a Civil Dispensary (CD) which follows the conventional paper based medical records, using a Patient Satisfaction Questionnaire (PSQ). Statistical analysis used: Univariate analysis was done by chi-square test and adjusted analysis was done by multiple linear regression. Results: Patient satisfaction in DPR was found to be similar between the digitized medical case files based and conventional OPD (p=0.453). Significantly higher overall patient satisfaction was reported in the conventional paper based OPD than the digitized OPD (p<0.001). Conclusions: Patient satisfaction towards the doctor-patient relationship (DPR) was similar between paper based OPD and the digitized medical case files based OPD. [ABSTRACT FROM AUTHOR]

Medical social work plays a pivotal role in ensuring comprehensive and quality healthcare delivery, particularly in hospital settings. This paper delineates the multifaceted responsibilities undertaken by medical social workers, encompassing ethical treatment, transparency in hospital management, and advocacy for the welfare of vulnerable patients. It examines the historical evolution of medical social work in India, tracing its roots to the pioneering efforts of institutions like the Dorabji Tata Graduate School of Social Work. Furthermore, it elucidates the guidelines set forth by the Medical Council of India, emphasizing the critical need for medical social workers in both rural and urban healthcare facilities. In exploring the possibility of establishing dedicated departments for medical social work, this paper proposes a complementary framework to the existing department of community medicine. By delineating the roles and responsibilities of medical social workers in rural and urban health training centers, it underscores their significance in addressing community health determinants and facilitating access to essential services. It also highlights the potential for medical social workers to contribute as multidisciplinary team members across various hospital departments, thereby amplifying their impact on patient care and rehabilitation processes. In conclusion, the paper underscores the imperative of recognizing and strengthening the role of medical social workers in healthcare delivery systems. By fostering greater awareness, professional development, and institutional support, we can harness the full potential of medical social work to promote health equity and social justice for all individuals. [ABSTRACT FROM AUTHOR]

Purpose: As Covid-19 became a pandemic, numerous people were forced to stay at home, leading to increased intimate partner violence (IPV) in many countries, particularly in developing and least-developed ones. This paper aims to highlight the IPV based on 15 different cases formed from the practical evidence of five developing countries. Design/methodology/approach: The authors interviewed 15 women from five countries who were the victims of IPV during the early periods of Covid-19 outbreak. Due to geographical remoteness, the authors conducted informal telephone interviews to collect the participants' personal experiences. The conversations were recorded with participants' permission; afterwards, the authors summarized participants' experiences into 15 different cases without revealing their original identities (instead, disguised names were used). Findings: It was revealed that the women were the primary victims of such violence, particularly from their intimate partners (husbands). In most cases, such IPV, as reported by the interviewees, originated or increased after the pandemic when they were forced to stay at home, losing their partners' jobs or income sources. Originality/value: The authors summarized the causes of IPV and put forward a few action recommendations based on the interviewees' practical experience and existing literature. This paper will open a new window for research investigations on IPV during emergencies such as Covid-19 outbreak. [ABSTRACT FROM AUTHOR]

In recent years, rapidly changing disease profile patterns, shortage & uneven utilization of healthcare professionals contributed massive burden on the Indian healthcare system, which resulted in varying, fragmented, inconsistent healthcare delivery to the patients and poor patient management. Patients often face and experience many challenges like lack of accessibility, poor patient-healthcare provider relationships, and inadequate quality of care, resulting in unnecessary economic burden in managing their health conditions. Thus Indian healthcare reform is essential in enhancing its capacity to fulfill patients' health needs that can be addressed by focusing on key sustainable strategies and initiatives meant for enhancing coordination of care, expanding services accessibility, redeveloping healthcare infrastructure, implementing workforce innovation and strong governance with the incorporation of core principles such as patient-centeredness, integrated care and collaborative care approaches. The clinical and ambulatory pharmacy practice are fragment of the healthcare delivery which delivers pharmaceutical care and fulfils the needs of patients across healthcare settings. This paper focuses on the present & future perspectives of ambulatory pharmacy practice in India and the factors to be considered for implementing it in patient care. [ABSTRACT FROM AUTHOR]

Background: Kerala has initiated many Universal Health Coverage (UHC) reforms in the last decade. The Aardram Mission launched in 2017 stands out owing to its scope, objectives, and commitments for strengthening Primary Health Care (PHC) in the State. The current study proposes to explore access and financial protection through the lens of equity in Kerala especially in the context of major UHC reforms carried out during the last decade. This paper will also highlight the key lessons from Kerala's approach towards UHC and health systems strengthening through a political economy approach. Methods: Data from the Kerala state sample of 75th Round (2017-18) National Sample Survey is used for this study. Comparison is also drawn from the 71st Round Sample Survey, 2014, to measure the state's progress in terms of access and financial protection. Logistic regression was used for the calculation. The findings were further explored through a political economy approach. Results: The share of public facilities for outpatient care is 47.5%, which is a significant increase from 34.0% (in 2014) in the state. The share of public sector for out-patient care has increased for the lower socio-economic population in the state. The share of public sector for in-patient care has also increased to 37.3% in 2017-18 from 33.9% in 2014, but not to the extent as the increase shown in outpatient care. The average out-of-pocket-expenditure during hospitalization has increased more in private facilities as compared to public for both outpatient care and hospitalization. Conclusions: Overall increase in the share of public facilities for both outpatient care and hospitalization is indicative of the enhanced trust among the people at large of the public healthcare delivery system in Kerala, post the launch of UHC reforms in the State. The insurance linked UHC reforms would be insufficient for the State to progress further towards UHC. Kerala with a long and successful history in 'public provisioning' should focus more on strengthening PHC through Aardram Mission in its journey towards pursuit of UHC. [ABSTRACT FROM AUTHOR]

2008 can be considered a watershed year for generic medicine in India, as it saw the launch of the Jan Aushadi scheme, to provide cost-effective quality medicines to its populace, through special stores called Jan Aushadi stores. With more than 8800 stores, the scheme is touted as one of the world's largest pharmaceutical retail chains. Since then, many generic medicine start-ups have also launched operations in the country- Zeno Health, One India Pharmacy, Generic Aadhaar and StayHappi Generics. These supply side developments will however have to be complemented with commensurate demand side responses for it make a sustainable impact towards the push for affordable and accessible healthcare for all (Sustainable Development Goal 3). Many studies have established that, on the demand side, owing to the lack of requisite medical knowledge on part of the patients, there exists a strong agency relationship, where patients rely heavily on their physicians (prescribers) to make decisions on choice of treatments. Though promotion of generic medicines requires a coordinated effort from many stakeholders, analysis reveals that the prescribers, and hence their perception of generics, plays a pivotal role in their adoption. This study undertakes a bibliometric analysis of the top 100 most-cited research papers published between 2012 and 2022 on the perception of prescribers towards generic medicine from SCOPUS database. Suitable keywords have been incorporated to reach the relevant publications and VOSviewer (version 1.6.10) has been used for analysis. The findings of the study recommend further research on interventions aimed at improving prescriber's perception towards generic medicines to enhance their adoption and promote cost effective healthcare delivery. [ABSTRACT FROM AUTHOR]

This paper aims to apply a multi-criteria decision-making (MCDM) framework to evaluate the environmental performance of the medical service supply chain using a case study in India. An application of MCDM method, the fuzzy TOPSIS (Technique for order of preference by similarity to ideal solution) model, is used for Medical Support Service Provide firms (MSSPF) environmental performance evaluation. We require multiple and conflicting criteria to fix real-life decision-making challenges, which in turn led to the inception of (MCDM). However, MCDM is contracted with various contradictory requirements in which the knowledge of decision-makers is generally vague and thereby more challenging. In this situation, inclusions of fuzzy set theory in MCDM Methods would be good to solve the MCDM problem. In this study, the authors used a fuzzy TOPSIS MCDM model to solve the evaluation framework. Data were collected from the experts from the MSSPF about the more perfect criteria to assess environmental performance using a questionnaire. Case assesses the environmental performance, based on defined criteria, of three MSSPF by the experts. Fuzzy TOPSIS Method ranks three MSSPF according to environmental performance in the following order: Firm B, Firm A and Firm C. The result suggested that 'Firm B' performed superior environmental performance followed by 'Firm A' and 'Firm C'. This evaluation framework will help MSSPF to identify potential areas of further improvement in Environmental performance, and thereby creates strategies to overcome and formulate new innovations. Notably, this is one of the few studies to have used this method to gauge the environmental performance of the medical service supply chain in India. [ABSTRACT FROM AUTHOR]

Background: According to the renowned and Oscar award-winning American actor and film director Marlon Brando, "privacy is not something that I am merely entitled to, it is an absolute prerequisite." Privacy threats and data breaches occur daily, and countries are mitigating the consequences caused by privacy and data breaches. The Indian healthcare industry is one of the largest and rapidly developing industry. Overall, healthcare management is changing from disease-centric into patient-centric systems. Healthcare data analysis also plays a crucial role in healthcare management, and the privacy of patient records must receive equal attention. Purpose: This paper mainly presents the utility and privacy factors of the Indian healthcare data and discusses the utility aspect and privacy problems concerning Indian healthcare systems. It defines policies that reform Indian healthcare systems. The case study of the NITI Aayog report is presented to explain how reformation occurs in Indian healthcare systems. Findings: It is found that there have been numerous research studies conducted on Indian healthcare data across all dimensions; however, privacy problems in healthcare, specifically in India, are caused by prevalent complacency, culture, politics, budget limitations, large population, and existing infrastructures. This paper reviews the Indian healthcare system and the applications that drive it. Additionally, the paper also maps that how privacy issues are happening in every healthcare sector in India. Originality/Value: To understand these factors and gain insights, understanding Indian healthcare systems first is crucial. To the best of our knowledge, we found no recent papers that thoroughly reviewed the Indian healthcare system and its privacy issues. The paper is original in terms of its overview of the healthcare system and privacy issues. Social Implications: Privacy has been the most ignored part of the Indian healthcare system. With India being a country with a population of 130 billion, much healthcare data are generated every day. The chances of data breaches and other privacy violations on such sensitive data cannot be avoided as they cause severe concerns for individuals. This paper segregates the healthcare system's advances and lists the privacy that needs to be addressed first. [ABSTRACT FROM AUTHOR]

Communication is the key tool to success. When it comes to healthcare communication, there is a vast gap between medical professionals and patients especially people with a lesser education and people belonging to rural areas. Communication is very much essential in providing quality medical care and content to patients. The effect of the languages and the scientific terms used by medical professionals becomes difficult for the common audience to understand; hence, the understanding gap also increases. This study demonstrates how language becomes a hurdle in healthcare communication depending on the location or locality of the hospital. The main objective of this research paper is to find how language becomes a barrier in health communication depending on the location of the hospital and the communication challenges experienced by rural and urban audiences in hospitals. It will also focus on how infographic designs can help the audience in reducing the communication gap in understanding healthcare information. We have collected 300 samples from 20 different hospitals from both Rural & Urban areas of Jaipur-I City, Rajasthan India. The paper also highlights some of the challenges posed by the language barrier and recommends a few suggestions. This research finding indicates that the language barrier in health communication can be minimized with the use of infographic designs for communication with the audience. [ABSTRACT FROM AUTHOR]

The paper discusses how volunteerism, especially among nursing students, helps solve health crises. The study emphasizes community preparedness and volunteers' unique role in supporting healthcare professionals during crises. Volunteers seek out opportunities to help, unlike emergency responders. Nursing students, a major employment source, are shown to be capable of first aid and emotional support. The COVID-19 pandemic highlights the unprecedented need for volunteers. Research shows that nursing students worldwide are willing to help in health emergencies. Professional ethics, humanity, and learning motivate. Self-care issues, system support issues, and psychological impacts are obstacles. The study uses a mixed-methods technique and the PRISMA framework to examine nursing students' health crisis volunteering experiences, goals, and perceptions. The data show volunteer nursing students' pleasures and problems. Although volunteering is rewarding, worries about self-care, family well-being, and psychological effects arise. Emotional stress, burnout, compassion fatigue, anxiety, sleep difficulties, guilt, and a lack of support affect nursing students' mental health. Witnessing and experiencing health emergencies can cause emotional stress, highlighting the need for personalized solutions. The report recommends cash incentives, extensive training, and explicit protocols to increase student volunteering. Nursing students can safely volunteer in high-stress situations by recognizing and addressing the mental health risks and providing support and tools. The article recommends a holistic approach to volunteerism that recognizes its benefits and promotes the mental health and well-being of motivated nursing students. Nursing students helping in health emergencies need sufficient training, psychological support, and self-care to protect their mental health, according to the study. Providing support, shifting schedules, and understanding the emotional toll of employment are vital. Nursing schools should include emergency response training to prepare students for pandemic leadership. [ABSTRACT FROM AUTHOR]

Introduction: The healthcare delivery system of Assam faces several challenges to provide affordable, accessible and quality care services. GNRC (Guwahati Neurological Research Center) is the first super-speciality hospital to address many of these gaps by delivering integrated affordable healthcare services to the populations of Assam and other parts of North-eastern India. Description & Discussion: This paper describes the implementation of a care delivery model which provides integrated care delivery services through linking hospitals to primary healthcare services, including preventive, promotive, and curative care, along with delivering easily accessible and affordable care to the people of Assam and other parts of North-eastern India. Conclusion: The proposed model is the first innovative approach from Northeastern India, Assam, to deliver affordable, accessible and patient-centric hospital led community-based preventive, promotive, and primary, secondary, and tertiary hospital-based care. It is anticipated that GNRC's "Affordable Health Mission" will help redesign and integrate the way primary, secondary and tertiary healthcare is delivered to the population of Assam in helping patients manage their own health and reduce the numbers that needs to be admitted to secondary care and tertiary care by improving patients' independence and well-being as well as dramatically reducing the cost to the overall health system. [ABSTRACT FROM AUTHOR]

Background: The burden of the COVID-19 pandemic on healthcare systems worldwide has been compromising the progress made in the fight against HIV. This paper aims to determine how the COVID-19 pandemic has impacted HIV comprehensive care service delivery globally as well as to consolidate the evidence and recommendations that may be useful in averting future crisis. Methods: This review adheres to PRISMA guidelines. PubMed, DOAJ, Science Direct and other sources like Google Scholar and citations from included studies were searched methodically to locate studies evaluating the effects of COVID on services for HIV care. The NIH and JBI quality assessment tools were used for the quality assessment of individual studies. Results: In the present review 31 eligible studies were included and the impact on HIV care cascade were summarised under six themes: Lab services, Treatment and allied services, Counselling services, Outreach services, Psycho-social impact and Implementation of sustainable strategies. The studies also presented many innovative alternatives which were lucidly highlighted in the present article. Conclusion: Current evidence depicts multiple factors are responsible for the interruption of HIV care service delivery during the pandemic, especially in low resources settings. The prospective, alternative solutions that have been used to circumvent the threat have also been addressed in this review, in addition to the negative aspects that have been observed. Transition with new innovative, sustainable care paradigms may prove to be the building blocks in removing HIV-AIDS as a public health threat. Registration: Open Science Framework (DOI: 10.17605/OSF.IO/74GHM). [ABSTRACT FROM AUTHOR]

Corona virus disease, COVID-19, has emerged as a pandemic covering the entire world, almost every country is effected by COVID-19. Numbers of infected people across the world are increasing at an exponential rate. Such large number of patients put extra ordinary demand of health care facilities. Although every country is putting tremendous efforts in frontline to fight with this pandemic but shortage of medical facilities, especially for densely populated countries like India, it becomes a serious challenge. The fear of pandemic has arrested everyone in homes due to which various sectors are affected badly. Pandemic situations are badly deteriorating the hospitality and tourism business. Smart healthcare tourism is the new prominence application of IoT based healthcare tourism. This paper presents an IoT based health monitoring framework, which may be helpful for medical tourists as well as the hotel management to monitor the health of guests and staff. The framework will detect and check the various vital signs of body and then report to the admin about health status of persons. The paper focuses on use of Internet of Things technology involving wearable sensors for monitoring the health status, detecting the disease and providing online health services for medical tourism sector. [ABSTRACT FROM AUTHOR]

This article discusses the Proceedings of the 19th International Conference of the Telemedicine Society of India (TSI) and the International Society for Telemedicine and eHealth (ISfTeH). The conference focused on emerging technologies connecting the Indian healthcare system and included presentations on topics such as tele-ICU management, telemedicine consultations in remote areas, and future trends in healthcare. The conference attracted delegates from various disciplines and included sessions, workshops, and exhibitions. The article highlights the acceptance of virtual remote healthcare in India and expresses gratitude to the editors of Telehealth and Medicine Today for reviewing conference papers. [Extracted from the article]

The current study presents a comprehensive narrative review examining the challenges faced by mental health professionals in India during the COVID-19 pandemic. Prior to COVID-19, India's mental health infrastructure was already under strain, characterized by a substantial treatment gap, scarcity of professionals, and a concentration of services in urban areas. The pandemic exacerbated these challenges, necessitating a swift transition to tele-counselling and online interventions, despite inherent limitations and ethical dilemmas. Increased cases of domestic violence, loneliness, and mood disorders during lockdowns highlighted the urgent need for effective mental health support. The paper discusses pre-existing issues such as stigma, lack of training institutes, and misconceptions about mental health in rural areas. It also explores innovative solutions, including the integration of spiritual and community leaders into mental health initiatives, to address the unique cultural context of India. The study underscores the urgent need for policy reforms, enhanced training, and collaborative approaches to bridge the treatment gap and ensure accessible mental health care in both urban and rural settings. [ABSTRACT FROM AUTHOR]

Background: Every society has persons with illness who do not have any family support. Taking care of such uncared-for patients requires a well-structured system providing medical, psychological, emotional, and rehabilitory support. The first ever rehabilitation ward among government hospitals in Tamil Nadu was created at Rajiv Gandhi Government General Hospital (RGGGH), Chennai with the motto of "Caring for the uncared for." This paper highlights the organizational structure, functionality, profile of patients admitted, challenges faced, and the outcome of patients admitted in the rehabilitation ward. Methods: A retrospective study was done on the "untended" patients, who were admitted in the rehabilitation ward at Rajiv Gandhi Government General Hospital (RGGGH), Chennai, Tamil Nadu, India from December 2020 to June 2022. Sociodemographic and clinical characteristics and outcome of the patients were analyzed. Results: A total of 201 adults with physical disabilities or mixed physical and psychiatric disabilities were admitted for intensive rehabilitation. Common medical illnesses included orthopedic disorders in 80 (39.8%), followed by neurological illness in 43 (21.4%) patients. The median length of stay was 50 (24.5-103.5) days with longest stay of 447 days. Of those patients who recovered, 54 patients (26.9%) reunited with family and returned home and 125 (62.2%) patients were sent to old age homes/asylums. Conclusion: A dedicated ward for untended patients is the first of its kind in the state of Tamil Nadu, India. Such a venture has proved to be of benefit, considering the positive outcome in a significant proportion of the beneficiaries. [ABSTRACT FROM AUTHOR]

The unprecedented healthcare demand due to sudden outbreak of coronavirus disease 2019 (COVID-19) pandemic has almost collapsed the health care systems especially in the developing world. Given the disastrous outbreak of COVID-19 second wave in India, the health system of country was virtually at the brink of collapse. Therefore, to identify the factors that resulted into breakdown and the challenges, Indian healthcare system faced during the second wave of COVID-19 pandemic, this paper analysed the health system challenges in India and the way forward in accordance with the six building blocks of world health organization (WHO). Applying integrated review approach, we found that the factors such as poor infrastructure, inadequate financing, lack of transparency and poor healthcare management resulted into the overstretching of healthcare system in India. Although health system in India faced these challenges from the very beginning, but early lessons from first wave should have been capitalized to avert the much deeper crisis in the second wave of the pandemic. To sum-up given the likely future challenges of pandemic, while healthcare should be prioritized with adequate financing, strong capacitybuilding measures and integration of public and private sectors in India. Likewise fiscal stimulus, risk assessment, data availability and building of human resources chain are other key factors to be strengthened for mitigating the future healthcare crisis in country. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic lockdown introduced to break the chain of disease transmission brought numerous challenges to people living with Type 2 diabetes. The present paper attempts to explore and understand the challenges faced by people living with diabetes and the variation in experiences based on their socioeconomic context. This qualitative study was conducted during the pandemic’s first and second waves in rural areas of West Jaintia Hills District, predominantly inhabited by the Pnar tribe. In-depth interviews with 90 Pnar men and women living with diabetes were undertaken. Findings from the present study reveal the perception that COVID-19 is not severe, limited knowledge about complications of diabetes, and impact of the COVID-19 pandemic lockdown, multiply to increase the vulnerability of the tribal populations living in the hilly and difficult terrain of the district. Therefore, addressing the burden of chronic illnesses in rural tribal areas in times of emerging infectious pandemics by providing comprehensive care and services at public health facilities is the need of the hour. The COVID-19 pandemic lockdown introduced to break the chain of disease transmission brought numerous challenges to people living with Type 2 diabetes. The present paper attempts to explore and understand the challenges faced by people living with diabetes and the variation in experiences based on their socioeconomic context. This qualitative study was conducted during the pandemic’s first and second waves in rural areas of West Jaintia Hills District, predominantly inhabited by the Pnar tribe. In-depth interviews with 90 Pnar men and women living with diabetes were undertaken. Findings from the present study reveal the perception that COVID-19 is not severe, limited knowledge about complications of diabetes, and impact of the COVID-19 pandemic lockdown, multiply to increase the vulnerability of the tribal populations living in the hilly and difficult terrain of the district. Therefore, addressing the burden of chronic illnesses in rural tribal areas in times of emerging infectious pandemics by providing comprehensive care and services at public health facilities is the need of the hour. [ABSTRACT FROM AUTHOR]

Purpose: In January 2021, India launched the world's most extensive vaccination campaign against COVID-19. It is estimated that India would need to vaccinate over a billion people to achieve herd immunity. Even though the Indian Government focuses on improving and delivering its vaccination programme, significant challenges still exist. This paper aims to discuss current challenges to scale up India's vaccination campaign and addresses strategies for achieving this. Design/methodology/approach: The paper is based on a review of secondary sources, including journal articles from scholarly and grey literature and information available in the public domain. The search focused explicitly on the COVID-19 scenario, vaccination programme, public health management and systems leadership in the Indian health care system. Findings: The analysis revealed that various factors have disrupted India's vaccination campaign, including shortage of vaccine doses, mandatory prior online registration, lack of infrastructure, safety concerns for older people, untrained workforce and absence of a solid public health framework. Furthermore, India appears to have struggled to reduce tensions and instill trust in its ability to effectively manage the COVID-19 pandemic and vaccination programme due to a lack of cooperation between union government, state governments and other stakeholders, namely, policymakers, hospitals, industry and community. Originality/value: The findings indicate that scaling up India's anti-COVID vaccination programme would require system-level leadership strategies that work within the country's limited resources. Deeper reforms in vaccine development, storage, delivery, training and regulatory frameworks are also needed to extend the world's largest anti-COVID-19 vaccination campaign. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate the utilization of Lean & Six Sigma quality initiatives in healthcare sector in India. Methodology: The survey questionnaires were sent to 454 hospitals through registered postal in all the states of India. The survey questionnaire was designed to assess different quality initiatives; currently implemented in Indian hospitals, factors align with organization's objectives, reasons for not implementing Lean & Six Sigma and contribution of Lean & Six Sigma projects in healthcare improvement projects etc. A separate section in the questionnaire provides the feedback on implementation of Lean & Six Sigma in various hospitals. The relationships between Lean & Six Sigma and healthcare performance have also been established in this paper. Findings: It is found that 15 Nos. of hospitals have implemented the Lean tools while 14 Nos. have implemented the Six Sigma tools out of 109 collected responses. This shows the utilization of Lean & Six Sigma in Indian healthcare sector. The 'Lack of knowledge' and 'Availability of resources' are the major reasons for not implementing Lean & Six Sigma. It is also observed that 22% running projects were related to Lean & Six Sigma out of various improvement projects running in various hospitals. Originality: There is lack of evidences of similar studies that determines the utilization of Lean & Six Sigma in Indian healthcare sector at the national level. This paper will provide important breakthrough to academicians and healthcare practitioners, who are involved in Lean & Six Sigma research. Social implications: The present study will create awareness among healthcare practitioners across India for utilization of quality tools that will provide direct benefits to the society. [ABSTRACT FROM AUTHOR]

Legislations for persons with disabilities emerged in the 1990s in India, providing them with rights and entitlements. Aligned with the UNCRPD, the Rights of Persons with Disabilities Act (2016) supports improved programmes and services. There are no exclusive policies for those with intellectual and developmental disabilities. Different government departments and non‐government organisations provide services including centrally sponsored programmes to persons with disabilities and enable them to exercise their rights. For example, rehabilitation and provision of aids and appliances lie with the Ministry of Social Justice and Empowerment, right to education is with the Ministry of Education, and, early intervention and health services and related supports are with the Ministry of Health. In India, non‐government organisations also play a vital role in health care services. In this paper, we discuss the existing health care systems including medical services in India for persons with disabilities with a specific focus on persons with intellectual and developmental disabilities. The discussion include how the system was evolved and what is in place today, the coverage, strengths, and limitations in the system. We have tried to provide a comprehensive description of existing policies, and practices of health care as well as the cultural influences with regard to health care for people with intellectual and developmental disabilities in India. [ABSTRACT FROM AUTHOR]

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In the healthcare system, a surgical teamis a unit of experienced personnel who provide medical care to surgical patients during surgery. Selecting a surgical team is challenging for a multispecialty hospital as the performance of its members affects the efficiency and reliability of the hospital's patient care. The effectiveness of a surgical team depends not only on its individual members but also on the coordination among them. In this paper, we addressed the challenges of surgical team selection faced by a multispecialty hospital and proposed a decision-making framework for selecting the optimal list of surgical teams for a given patient. The proposed framework focused on improving the existing surgical history management system by arranging surgery-bound patients into optimal subgroups based on similar characteristics and selecting an optimal list of surgical teams for a new surgical patient based on the patient's subgroups. For this end, two population-based meta-heuristic algorithms for clustering of mixed datasets and multi-objective optimizationwere proposed. The proposed algorithmswere tested using different datasets and benchmark functions. Furthermore, the proposed framework was validated through a case study of a real postoperative surgical dataset obtained from the orthopedic surgery department of a multispecialty hospital in India. The results revealed that the proposed framework was efficient in arranging patients in optimal groups aswell as selecting optimal surgical teams for a given patient. [ABSTRACT FROM AUTHOR]

This commentary describes how a grassroot-led partnership initiated by members of the organisations World Federation of NeuroRehabilitation and Collaboration of Aphasia Trialists is addressing the marginalisation of people with aphasia, through education and knowledge exchange related to communication partner training of health professionals. A partnership between academics and healthcare professionals across Austria, Denmark, Egypt, Ireland, Greece, India, Serbia and the United Kingdom was established in 2020. Through bimonthly online sessions in 2021–2022 a Danish communication partner training program was introduced while six teams adapted and translated the training and its materials to their local contexts. A collaborative partnership enabled multiple translations of an existing communication partner training program for healthcare professionals working with people with aphasia to support a sustainable delivery model that is linguistic and culturally sensitive. This commentary paper focusses on Sustainable Development Goal (SDG) 17 and also addresses SDG 10. [ABSTRACT FROM AUTHOR]

India is currently in a good position to design a particularly Indian set of health reforms to help the health system meet the growing demands of its consumers and personnel. There are several managerial obstacles to ensuring availability, access, affordability, and equity in delivering health services to fulfil community requirements efficiently and effectively for Healthy India's Sustainable Development. In this paper, an attempt has been made to analyse the opinions of users who avail of services offered by Primary Health Centres (PHCs) in selected villages of Vadodara District. The data were analysed using descriptive statistics and the hypothesis is assessed by using Chi Square test as well as Friedman Rank Test was applied to know the preferences and measure perception of users considering the selected criteria of services offered by the PHCs. [ABSTRACT FROM AUTHOR]

Background: Speech–language pathologists are often involved in the assessment and management of communication, cognition and swallowing deficits in people with Parkinson's. However, speech–language pathologists' self‐perceived competency levels in serving people with Parkinson's remain elusive, especially in the Indian context where there is an increasing disability burden due to Parkinson's disease. Additionally, the challenges faced by speech–language pathologists in India to provide efficient services to this population are unidentified. Aims: To determine speech–language pathologists' self‐perceived competence and challenges faced when providing services to people with Parkinson's in India. Methods & Procedures: A survey questionnaire was sent to speech–language pathologists through emails and social media asking them questions to evaluate self‐perceived competency in serving people with Parkinson's and to identify the challenges to their service delivery. A total of 69 speech–language pathologists responded to the survey. Outcomes & Results: The majority of respondents reported to be competent in dealing with various domains of assessment and management of people with Parkinson's. Although competent, they reportedly faced a few challenges during their service delivery. Conclusions & Implications: This study provides an insight into the speech–language pathologists' self‐perceived competency in serving people with Parkinson's in India, and also identifies the challenges related to interprofessional service delivery. The findings of the study have educational and clinical implications. What this paper adds: The study delineates speech–language pathologists' self‐perceived competency in working with people with Parkinson's in India, a nation that is seeing a constant rise in the incidence of Parkinson's disease.The study the unique challenges within India to speech–language pathologists' service delivery for people with Parkinson's, thus having educational and clinical implications in Parkinson's disease care. [ABSTRACT FROM AUTHOR]

High burden of acute malnutrition among children less than 5 years is a major public health problem in India. A "Two-days National Consultation on Addressing Acute Malnutrition" was organized to gather experiences and evidence from 13 states of India on prevention and management of acute malnutrition among children and documenting viewpoints from experts and government counterparts on the same. The consultation centered around five key themes of addressing acute malnutrition: 1) capacity building, 2) strengthening screening, 3) nutritional care of wasting, 4) tracking progress, and 5) scale-up. The paper highlights the experiences and key recommendations around the above key themes. It emerged that there is a need to further accelerate the efforts toward strengthening existing platforms and services to address acute malnutrition among children. Regular trainings of the frontline workers, increased convergence, regular monitoring, and continued service delivery during the pandemic should be undertaken for better outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB PM-JAY) has enabled the Government of India to become a strategic purchaser of health care services from private providers. To generate base cost evidence for evidence-based policymaking the Costing of Health Services in India (CHSI) study was commissioned in 2018 for the price setting of health benefit packages. This paper reports the findings of a process evaluation of the cost data collection in the private hospitals. Methods: The process evaluation of health system costing in private hospitals was an exploratory survey with mixed methods (quantitative and qualitative). We used three approaches–an online survey using a semi-structured questionnaire, in-depth interviews, and a review of monitoring data. The process of data collection was assessed in terms of time taken for different aspects, resources used, level and nature of difficulty encountered, challenges and solutions. Results: The mean time taken for data collection in a private hospital was 9.31 (± 1.0) person months including time for obtaining permissions, actual data collection and entry, and addressing queries for data completeness and quality. The longest time was taken to collect data on human resources (30%), while it took the least time for collecting information on building and space (5%). On a scale of 1 (lowest) to 10 (highest) difficulty levels, the data on human resources was the most difficult to collect. This included data on salaries (8), time allocation (5.5) and leaves (5). Discussion: Cost data from private hospitals is crucial for mixed health systems. Developing formal mechanisms of cost accounting data and data sharing as pre-requisites for empanelment under a national insurance scheme can significantly ease the process of cost data collection. [ABSTRACT FROM AUTHOR]

This paper critically reviews and reflects on the processes for providing Assistive Technology (AT) services to Persons with Disabilities (PWD) in Bangladesh, India and Nepal. The aim is to investigate the AT service delivery systems in these countries and suggest improvements where weaknesses are identified. We carried out a descriptive qualitative exploratory study in Bangladesh, India and Nepal by conducting key informant interviews with policymakers (5), AT service providers (22) and mobility and hearing related AT service users (21). We used a directed content analysis approach guided by a seven-point AT service delivery process model to thematically analyse the existing processes for AT service delivery, from first contact through to follow-up and maintenance. AT service delivery processes are sub-optimal in all three countries, and improvements are needed. No common AT service delivery process was found, although there are common features. In general, it is easier for PWDs in India and Nepal to access AT than for those in Bangladesh, but all three countries are failing to live up to their commitments to uphold the human rights of PWDs. Although good elements of AT service delivery processes can be identified, the systems in all three countries are fragmented and generally weak. A more holistic approach of looking at the process of AT service delivery, from first contact right through to follow-up and device maintenance, with a single door service delivery system, free of cost at the point of service is recommended in these countries. Although we found significant weaknesses in AT delivery in all three countries, there are some good AT service delivery practices and opportunities for these countries to learn from one another. A systematic and stepwise approach to assessing current AT service delivery processes in the three countries – examining the delivery system as a whole, from initiation to repair and management – can help identify opportunities to improve the process for (prospective) AT users. A more coherent single door system of AT service delivery will increase the quality and efficiency of the fragmented AT service delivery practices in Bangladesh, India and Nepal. [ABSTRACT FROM AUTHOR]

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

The 'Cost of Health Services in India (CHSI)' is the first large scale multi-site facility costing study to incorporate evidence from a national sample of both private and public sectors at different levels of the health system in India. This paper provides an overview of the extent of heterogeneity in costs caused by various supply-side factors.A total of 38 public (11 tertiary care and 27 secondary care) and 16 private hospitals were sampled from 11 states of India. From the sampled facilities, a total of 327 specialties were included, with 48, 79 and 200 specialties covered in tertiary, private and district hospitals respectively. A mixed methodology consisting of both bottom-up and top-down costing was used for data collection. Unit costs per service output were calculated at the cost centre level (outpatient, inpatient, operating theatre, and ICU) and compared across provider type and geographical location.The unadjusted cost per admission was highest for tertiary facilities (₹ 5690, 75 USD) followed by private facilities (₹ 4839, 64 USD) and district hospitals (₹ 3447, 45 USD). Differences in unit costs were found across types of providers, resulting from both variations in capacity utilisation, length of stay and the scale of activity. In addition, significant differences in costs were found associated with geographical location (city classification).The reliance on cost information from single sites or small samples ignores the issue of heterogeneity driven by both demand and supply-side factors. The CHSI cost data set provides a unique insight into cost variability across different types of providers in India. The present analysis shows that both geographical location and the scale of activity are important determinants for deriving the cost of a health service and should be accounted for in healthcare decision making from budgeting to economic evaluation and price-setting. [ABSTRACT FROM AUTHOR]

Quality health care is the essential need for all the citizens of the country. It forms the basis for equitable and sustainable economic development. India has made significant progress in basic health care over the past few decades. However, still most people do not have access to essential health care services. Health insurance is very important for every citizen, especially in India, where there is a large rural population. As everyone cannot afford private Health insurance coverage, so government must take initiatives to provide health insurance coverage to poor people. Government of India has been taking initiatives to provide financial assistance for health care costs for vulnerable and needy families. Rastriya Swasthya Bima Yojana (RSBY) was launched in the year 2008, but was not very successful. Prime Recently, Ayushman Bharat Jana Arogya Yojana (PMJAY) was launched on 23rd September 2018. It provides health insurance cover of Rs. 5 lakhs per year, per family for secondary and tertiary care hospitalization to more than 10.74 crore poor and vulnerable families. Ayushman Bharat PMJAY card holders can claim cashless services at all the empanelled hospitals or at the private hospitals (approximately 20,000 plus) those have registered to offer PMJAY. The total number of Ayushman Bharat Cards issued till 21st March 2022 are 17,86,97,235 and Hospital admissions under PMJAY as of 21st March 2022 since launch are 3,11,27,750. Ayushman Bharat PMJAY has shown a good progress since its launch. It is a successful health insurance scheme till now. This paper studies about reasons of perceived failure of Rastriya Swasthya Bima Yojana (RSBY), Introduction of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY), its features, coverages and benefits, the factors behind the success of Ayushman Bharat PMJAY scheme, its challenges and about the future of the scheme. [ABSTRACT FROM AUTHOR]

In the new paradigm of health-centric governance, policymakers are in constant need of appropriate metrics to determine suitable policies in a non-arbitrary fashion. To this end, in this paper, a compartmentalized model for the transmission of COVID-19 is developed, with a socially distanced compartment added to the model. The modification allows for administrators to quantify the extent to which voluntary social distancing norms are followed, and address restrictions accordingly. Modifications are also made to incorporate inter-region migration, and suitable metrics are proposed to quantify the impact of migration on the rise of cases. The healthcare capacity is modeled and a method is developed to study the consequences of the saturation of the healthcare system. The model and related measures are used to study the nature of the transmission and spread of COVID-19 in India, and appropriate insights are drawn. [ABSTRACT FROM AUTHOR]

Camps are a popular approach to deliver medical care in India. While it is usually a one-off event for physical ailments, it is a long-term affair in Psychiatry. One of the first camps in psychiatry was rolled out as early as in 1967 at Mandar, Ranchi, followed by Raipur Rani (Haryana) in 1976 and at Gunjur, Karnataka in 1977. This camp approach became extremely popular and got expanded across India as they were thought to be synonymous with community-based outreach for mental illnesses. In the past 5 years, however, newer models of community care have emerged, necessitating a relook at this traditional approach. In this paper, the authors trace the origin, utility and future directions of these camps, taking data from community psychiatry camps conducted by the National Institute of Mental Health and Neurosciences, Bengaluru, a premier neuropsychiatric tertiary care institute in India. Data have been collated from the annual reports of the Institute, database from the District Mental health Program, Government of Karnataka, India, and compared with published literature on the same field. While camps remain as one of the important avenues to reach the unreached, there is a need to change the approach of their functioning by incorporating training (primary care providers) aspects and collaborative care. The latter may make the initiative more meaningful and sustainable. [ABSTRACT FROM AUTHOR]

Therapy process research focuses on understanding how therapy is conducted by professionals in the field. It is a nascent field of psychotherapy enquiry in India. This paper explores how novice therapists in India perceive their clients, and how this influences the process of therapy. In depth interviews were conducted with ten novice therapists, with less than six years of practice experience, from Mumbai, India. The data was thematically analysed. The data revealed that therapists' perceptions of their clients were defined by socio‐demographic features of age and gender, along with presenting complaints and personal attributes. Participants had defined beliefs about good clients as contrasted with difficult ones. Distinct preferences for particular client types were identified. The antecedents to these beliefs were attributed to the therapist's worldview, their training and the supervision received. These views, and the conceptualisation of the client, influenced the choice of client, the process of therapy and how they proceeded with sessions, and their methods of referral. The data from the study has implications for therapist training, supervision and further research. [ABSTRACT FROM AUTHOR]

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

Introduction: Presently the leprosy program has no defined surveillance protocols for patients who complete the fixed duration multidrug therapy and are released from treatment (RFT). Hence, the information about the post‑RFT events in these patients is sparse and qualitative and quantitative data regarding their health care requirements is missing. During the DermLep survey carried out by the Indian Association of Dermatologists,Venereologists and Leprologists (IADVL), a number of patients presented to dermatologists during the post RFT period for a variety of symptoms. This paper analyses the events in these patients during the post RFT period. Results: Out of a total of 3701 leprosy patients who presented to 201 dermatologists across India during the DermLep survey, 708 (26.2%) were in the post RFT period (488 males; 220 females). Of these, 21% were PB and 79% MB patients as per their treatment records. Majority were in the age group of 31‑59 years (55.5%); however, a significant proportion of them (20.7%) were elderly (>60 years). Majority of the patients (45.5%) presented within the first year of RFT with variable symptoms; 28% were between 1‑5 years, 5.5% between 5‑10 years; and 11.0% presented more than 10 years after RFT. Most common presenting complaint being persistent skin lesions as perceived by patients in 21.2%, followed by neuritis in 14.5%; trophic ulcers in 13.8%; deformities in 67 (11.8%); lepra reactions in 66 (11.6%); and recurrence of original symptoms in 6.7%. Conclusion: The DermLep Survey highlights the importance of ‘post RFT’ patients as an important subset of leprosy patients who visit dermatologists for various health related issues. The most common complaints in this subset were active/persistent skin lesions, lepra reactions and neuritis. In these patients, who are a sub‑group of ‘persons affected with leprosy’ the disease related issues can persist for many years post RFT. Hence, it is important to provide services in the programme to monitor and manage these complications for the prevention of impairments, disability and the related social issues. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This paper is one of the first studies that identifies factors that inhibit access to healthcare services and healthcare-seeking behaviour (HCSB) in rural India during the COVID-19 pandemic. METHODS: The data source was the household sample survey of the World Bank on 'COVID -19-Related Shocks in Rural India 2020, Rounds 1-3'. Binomial and multinomial regression analysis was carried out to estimate the determinants of health care avoidance and HCSB. RESULTS: Families belonging to low consumption quartiles not only delayed obtaining health care but also underutilized formal health resources at public and private facilities. The majority of non-agricultural households, as well as those that reduced their consumption during the outbreak, were forced to self-medicate through pharmacies. Family planning, immunization, child growth monitoring, and routine medical check-ups were among the services that were not availed during the pandemic. CONCLUSION: The findings of this study emphasize the need of removing financial obstacles to care during the COVID-19, as well as the importance of child-related care continuity (child development monitoring, antenatal care, and immunization) and routine check-ups. [ABSTRACT FROM AUTHOR]

Malnutrition, a word which seems to shake our roots and disturb our future. Today the underdeveloped and many developing countries are battling this threat in many ways. The reason behind malnutrition is the determinants which make it prevail in our neighborhood and our country on the whole. Malnutrition possess a very serious threat to the future of our country especially the children between (1 - 3) years of age. This paper attempts to identify the existing prevalence of malnutrition in Uttarakhand, to explore the predisposing factors contributing to it in under five children and compare the prevalence with the selected neighboring states. An in - depth survey of all the related literatures and published articles in the selected area was made. It has been reported in recent times about the hike in India's hunger problems and the number of reported cases of stunting and wasting has also rocketed though underweight has slightly reduced. The only way to curb malnutrition is by; breaking the shackles of the determinants, thorough regular surveys and screenings, improved and adequate health care services, reaching out to the needy and spreading awareness among the masses. [ABSTRACT FROM AUTHOR]

Telemedicine has been a buzzword in India since the 1990s. In 2020, due to the COVID-19 pandemic in India, a national lockdown limited access to in-person healthcare services. The Ministry of Health & Family Welfare issued India's first set of government guidelines for the use of telemedicine. Emphasis was placed on training doctors and gearing up teleconsultations. This effort led to a significant increase in consultations and the recruitment of additional clinicians to practice telemedicine. However, there remain challenges relating to privacy, patient data storage, unevenness in telecom infrastructure and a systematic approach to integrating teleconsultation data with the overall patient record and public health information systems. This paper will provide an overview of telehealth, examine key interventions that have occurred in India during the pandemic and explore potential future approaches that can leverage the benefits of telehealth across the health care spectrum. [ABSTRACT FROM AUTHOR]

Objectives: This paper explores the role of immigrant-serving agencies in facilitating access to dementia services and supports provided by dementia service agencies (particularly the health authority and local chapters of the Alzheimer Society) through their propensity to develop trusting relationships between staff and clients. Design: Our research is a qualitative case study of Punjabi and Korean speakers living in the Lower Mainland of BC, Canada. Data are drawn from interviews with 15 dyads of persons with dementia and their family caregivers (10 Punjabi, 5 Korean), six focus groups (one focus group with each of 8–10 older men, older women, and mixed gender working age adults in each community). We also interviewed 20 managerial and frontline staff of dementia service agencies, i.e. the health authority and the local Alzheimer Society (n = 11) and two immigrant-serving agencies (n = 9), each dedicated to either Punjabi or Korean-speaking clients. We adopted the Candidacy framework for understanding access to dementia services and supports and the concept of trust as guiding precepts in this study. Results: Families of persons with dementia are pivotal to identification of a problem requiring professional help, navigation to appropriate services and acceptance of services offered. However, trust in family members should not be taken for granted, since family dynamics are complex. Alternative sources of trusted support are therefore needed. Immigrant-serving agencies are more often instrumental in establishing trusted relationships between their staff and clients, but they often lack detailed knowledge about heath conditions, their treatment and management, and they lack power to implement statutory care. Conclusions: Partnerships between mainstream mental health/dementia services and the community sector have proven successful in increasing the accessibility of specialized resources, while maximizing their combined trustworthiness, accessibility and effectiveness. Such partnerships should become fundamental components of health service strategy and provision for vulnerable and underserved immigrant older adults. [ABSTRACT FROM AUTHOR]

The unexpected lockdown announced by the Government of India in March 2020 in response to the pandemic left the coastal community in Kerala deprived of not only essential amenities but also healthcare. Some poverty-ridden, over-crowded coastal regions had been declared as critical containment zones with severe restriction of movement, adding to their vulnerability. People with serious health-related suffering (SHS) in this community required urgent relief. A group of educated youth in the community joined hands with a non-governmental organisation specialised in palliative care (PC) services and strived to find the best possible solutions to address the healthcare needs in their community. This paper reports the collaborative activities done during the pandemic in the coastal region and compares the activities with steps proposed by the WHO to develop community-based PC (CBPC). By engaging, empowering, educating, and coordinating a volunteer network and providing the required medical and nursing support, the programme was able to provide needed services to improve the quality of life of 209 patients and their families who would have been left with next-to-no healthcare during the pandemic. We conclude that even in the context of much poverty, delivery of CBPC with the engagement of compassionate people in the community can successfully reduce SHS. [ABSTRACT FROM AUTHOR]

Care at Doorstep (CAD) is a home care service that includes medical and social care by skilled professionals. The purpose of this paper is to explore the need for CAD among users of the district mental health programme (DMHP) in Ramanagaram, Karnataka, India who have severe mental illness. The design of this study was descriptive where a qualitative inductive methodology was adopted. Data was collected from interviews of 20 caregivers and 7 mental health service providers linked to the DMHP. Socio demographic information was collected from participants and a semi-structured interview guides were used to explore needs and challenges in delivering care at home by the professionals. The themes that emerged from the manually transcribed and coded data were categorized as needs and challenges and used for developing a CAD model. [ABSTRACT FROM AUTHOR]

Over the years, healthcare system in India has been largely centralized, expensive and impersonal. In a country where expenditure on healthcare is low, most healthcare expenditure is out‑of‑pocket and where most of the population continue to live in rural areas or in urban fringes, such a care is inaccessible, unresponsive and unaffordable. COVID pandemic exposed these realities further. Based on experiences of directly managing health services during COVID‑19 pandemic in different settings and across different levels, authors of this paper argue for a decentralized, distributed and responsive health systems for India, that is likely to be more effective and sustainable in normal times, and in times of crisis. [ABSTRACT FROM AUTHOR]

Since Covid-19 or Corona Virus was first discovered, it exploded into a Pandemic -resulting in devastating effects on human lives and livelihood worldwide. The high costs of non-cooperation in responding to the virus and ultimately significant loss of lives have been seen. In spite of favourable demographic structures, climatic conditions and youngpopulations, South Asian countries like India are badly affected in both epidemiological andeconomic terms. South Asian Countries are trying their best to address the health concerns. Regional self- governments are also trying to manage the crisis by implementing day- to-day containment measures and ensuring health care and social services. In this situation, many Non-Governmental Initiatives and multilevel co-ordination mechanisms in regional levels have been developed tocombat the Pandemic. From detecting the disease, contact tracing, measurement of oxygenlevel, Doctors' advice, Medicine supply, oxygen cylinder supply, food supply, and evencremate the dead bodies of Covid patients, local cooperation is doing a commendable job. Iwant to focus in my paper on how regional collaborations take an important role toaddress COVID- 19 Pandemic. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic has long-lasting impact in social, personal, and economic area globally. When we think of the economic recovery of India in the future, we face the challenge of moving forward more sustainably. An international NGO ARUP had published a worldwide report named 'Health.Care.Without.Harm'; mentioning that only healthcare sector itself is accountable for about 4.4 percent of universal net emissions. The present study, therefore, highlights the vulnerabilities in the linear economy and how the pandemic crisis challenges the linear economy and provide opportunity to uptake circular practices and sustainable development within India's healthcare economy. The paper outlines the recommendations on the circular economy by suggesting policy and market-driven solutions for the healthcare sector's sustainability. [ABSTRACT FROM AUTHOR]

The Coronavirus disease 2019 (COVID-19) pandemic has necessitated medical centers across the world to deliver healthcare through telemedicine. We discuss the adoption, delivery of telemedicine services at a tertiary care center and patient satisfaction involving 456 patients in south India. Most respondents had sought telemedicine care at the department of Medicine (16.23%). The maximum satisfaction was reported by patients in OBG (100%). The responses were generally positive across all the age groups. The paper offers insights on best practices adopted at the center, lessons learnt, and provides recommendations for health care systems offering telemedicine during COVID-19 times. [ABSTRACT FROM AUTHOR]

In India, marginalised people with serious or chronic illness face particular challenges to finding sustainable treatment, and often experience financial devastation. One state welfare scheme (the EWS hospital bed quotas) holds the promise of treatment for those in Delhi's margins, through partnerships with corporate hospitals. Yet, the process of gaining access to treatment via the scheme is very frustrating. This ethnography illustrates the ways in which low-income patients' attempts to lay claim to state services often bring them into play with a mode of the state that is, in anthropologists' conceptions, opaque, arbitrary and erratic. In response to the 'illegible' modes of access to the scheme, patients and their families are compelled to construct and reproduce their eligibility to access treatment, through a repertoire of intricate and entwined practices, namely: the attainment of credible low-income documentation, the use of big men to leverage resources, and different kinds of performance. The burden of enacting these practices is further compounded and troubled by the state scheme's blurry entanglement with the private sector, in which roles and responsibilities for a 'duty of care' to citizens with illness are elusive. This paper therefore aims to be an original contribution to the social sciences, in interpreting health-seekers' experiences of state-private schemes in Delhi within anthropological understandings of the state and marginalised people's meaning-making of illegible state processes. [ABSTRACT FROM AUTHOR]