scholarly journals Regional inequality in the Janani Suraksha Yojana coverage in India: A Geo-spatial Analysis

2020 ◽  
Author(s):  
Prem Shankar Mishra ◽  
Pradeep Kumar ◽  
SHOBHIT SRIVAST

Abstract IntroductionAlthough India has made significant progress in institutional delivery after the implementation of the National Rural Health Mission under which the Janani Suraksha Yojana (JSY) is a sub-programme which played a vital role in the increase of institutional delivery in public facilities. Therefore, this paper aims to provide an understanding of the JSY coverage at the district level in India. Further, it tries to carve out the factors responsible for the regional disparity of JSY coverage at district levels.MethodsThe study used the National Family Health Survey data, which is a cross-sectional survey conducted in 2015-16, India. The sample size of this study was 148,145 women aged 15-49 years who gave last birth in the institution during five years preceding the survey. Bivariate and multivariate regression analysis was used to fulfill the study objectives. Additionally, Moran’s I statistics and bivariate Local Indicator for Spatial Association (LISA) maps were used to understand spatial dependence and clustering of JSY coverage. Ordinary least square, spatial lag and spatial error models were used to examine the correlates of JSY utilization.ResultsThe value of spatial-autocorrelation for JSY was 0.71 which depicts the high dependence of the JSY coverage over districts of India. The overall coverage of JSY in India is 36.4% and it highly varied across different regions, districts, and even socioeconomic groups. The spatial error model depicts that if in a district the women with no schooling status increase by 10% then the benefits of JSY get increased by 2.3%. Similarly, if in a district the women from poor wealth quintile, it increases by 10% the benefits of JSY also increased by 4.6%. However, the coverage of JSY made greater imperative to understand it due to its clustering among districts of specific states only.ConclusionIt is well reflected in the EAGs states in terms of spatial-inequality in service coverage. There is a need to universalize the JSY programme at a very individual level. And, it is required to revisit the policy strategy and the implementation plans at regional or district levels.

2020 ◽  
Author(s):  
Prem Shankar Mishra ◽  
Pradeep Kumar ◽  
Shobhit Srivast

Abstract Introduction Although India has made significant progress in institutional delivery after the implementation of the National Rural Health Mission under which the Janani Suraksha Yojana (JSY) is a sub-programme which played a vital role in the increase of institutional delivery in public facilities. Therefore, this paper aims to provide an understanding of the JSY coverage at the district level in India. Further, it tries to carve out the factors responsible for the regional disparity of JSY coverage at district levels. Methods The study used the National Family Health Survey data, which is a cross-sectional survey conducted in 2015-16, India. The sample size of this study was148,145 women aged 15-49 years who gave last birth in the institution during five years preceding the survey. Bivariate and multivariate regression analysis was used to fulfill the study objectives. Additionally, Moran’s I statistics and bivariate Local Indicator for Spatial Association (LISA) maps were used to understand spatial dependence and clustering of JSY coverage. Ordinary least square, spatial lag and spatial error models were used to examine the correlates of JSY utilization.Results The value of spatial-autocorrelation for JSY was 0.71 which depicts the high dependence of the JSY coverage over districts of India. The overall coverage of JSY in India is 36.4% and it highly varied across different regions, districts, and even socioeconomic groups. The spatial error model depicts that if in a district the women with no schooling status increase by 10% then the benefits of JSY get increased by 2.3%. Similarly, if in a district the women from poor wealth quintile, it increases by 10% the benefits of JSY also increased by 4.6%. However, the coverage of JSY made greater imperative to understand it due to its clustering among districts of specific states only.Conclusion It is well reflected in the EAGs states in terms of spatial-inequality in service coverage. There is a need to universalize the JSY programme at a very individual level. And, it is required to revisit the policy strategy and the implementation plans at regional or district levels.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Prem Shankar Mishra ◽  
Pradeep Kumar ◽  
Shobhit Srivastava

Abstract Introduction Although India has made significant progress in institutional delivery after the implementation of the National Rural Health Mission under which the Janani Suraksha Yojana (JSY) is a sub-programme which played a vital role in the increase of institutional delivery in public facilities. Therefore, this paper aims to provide an understanding of the JSY coverage at the district level in India. Further, it tries to carve out the factors responsible for the regional disparity of JSY coverage at district levels. Methods The study used the National Family Health Survey data, which is a cross-sectional survey conducted in 2015–16, India. The sample size of this study was 148,145 women aged 15–49 years who gave last birth in the institution during 5 years preceding the survey. Bivariate and multivariate regression analysis was used to fulfill the study objectives. Additionally, Moran’s I statistics and bivariate Local Indicator for Spatial Association (LISA) maps were used to understand spatial dependence and clustering of JSY coverage. Ordinary least square, spatial lag and spatial error models were used to examine the correlates of JSY utilization. Results The value of spatial-autocorrelation for JSY was 0.71 which depicts the high dependence of the JSY coverage over districts of India. The overall coverage of JSY in India is 36.4% and it highly varied across different regions, districts, and even socioeconomic groups. The spatial error model depicts that if in a district the women with no schooling status increase by 10% then the benefits of JSY get increased by 2.3%. Similarly, if in a district the women from poor wealth quintile, it increases by 10% the benefits of JSY also increased by 4.6%. However, the coverage of JSY made greater imperative to understand it due to its clustering among districts of specific states only. Conclusion It is well reflected in the EAGs states in terms of spatial-inequality in service coverage. There is a need to universalize the JSY programme at a very individual level. And, it is required to revisit the policy strategy and the implementation plans at regional or district levels.


Author(s):  
Prem Shankar Mishra ◽  
Pradeep Kumar ◽  
SHOBHIT SRIVAST

Abstract IntroductionAlthough India has made significant progress in Iinstitutional delivery after the implementation of National Rural Health Mission under which the Janani SurakshaYojna (JSY) is a sub-programme which played a vital role in the increase of institutional delivery in public facilties. However, a huge gap still, persists in terms of coverage and utilization of the JSY scheme, not only across socio-economic groups but also at district level in India. Therefore, this paper aims to provide an understanding of the JSY coverage at the district level in India. further, it tries to carve out the factors responsible for regional disparity of JSY coverage at district levels. MehtodsThe study used the fourth round of National Family Health Survey data and restricts sample size (n=148,145) to the women aged 15-49 years who gave recent birth in the institution during five years preceding the survey. Bivariate and multivariate regression analysis wasused to fulfill the study objectives. Additionally, Moran’s I statistics and bivariate Local Indicator for Spatial Association (LISA) maps were used to understand spatial dependence and clustering of JSY coverage. Ordianry least square, spatial lag and spatial error models were used to examine the correlates of JSY utilization.ResultsThe value of spatial-autocorrelation for JSY was 0.71 which depicts high dependence of the JSY coverage over districts of India. The overall coverage of JSY in India is 36.4% and it highly varied across different regions, districts, and even socioeconomic groups. The spatial error model depicts that if in a district the women with no schooling status increase by 10% than the benefits of JSY get increased by 2.3%. Similarly, if in a district the women from poor wealth quintile increases by 10% the benefits of JSY also increased by 4.6%. However coverage of JSY made greater imperative to understand it due to its clustering among distrcits of specific states only.ConclusionIt is well reflected in the EAGs states in terms of spatial-inequality in service coverage. There is aneed to universalize the JSY programme at a very individual level. And, it is required to revisit the policy strategy and the implementation plans at regional or district levels.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Werku Etafa ◽  
Gosa Gadisa ◽  
Shibiru Jabessa ◽  
Tagay Takele

Abstract Background Globally, Coronavirus disease-19 has created unprecedented challenges to public health. Healthcare workers (HCWs) are at risk of COVID-19 because of their profession. There are limited studies conducted in Ethiopia among HCWs regarding their compliance with COVID-19 preventive measures. Therefore, this study intended to assess HCWs’ compliance with measures to prevent COVID-19, and its potential determinants in public hospitals in Western Ethiopia. Methods A self-administered, multicenter hospital-based cross-sectional survey was proposed to 422 randomly selected HCWs working in seven public hospitals in Western Ethiopia identified as COVID-19 referral centers. Data were entered into Epi Data version 3.1 and analyzed using SPSS version 24. Binary logistic regression was used to identify potential determinants of outcome variables at p-value < 0.05. Results Out of 422 completed questionnaires, the overall HCWs’ compliance with COVID-19 prevention is 22% (n = 404). In multivariate regression analysis, factors such as spending most of caring time at bedside (AOR = 1.94, 95%CI, 1.06–3.55), receiving training on infection prevention/COVID-19 (AOR = 1.86, 95%CI, 1.04–3.33), reading materials on COVID-19 (AOR = 2.04, 95%CI, 1.14–3.63) and having support from hospital management (AOR = 2.09, 95%CI, 1.20–3.64) were found to be significantly associated with COVID-19 preventive measures. Furthermore, inadequate supplies of appropriate personal protective equipment (83.2%), insufficient supportive medications (78.5%), and lack of provision of adequate ventilation (77.7%) were the barriers to COVID-19 prevention most frequently mentioned by participants. Conclusion Our findings highlight HCWs’ poor compliance with COVID-19 preventive measures. Providing information and refreshing training to improve the level of healthcare workers’ adherence with COVID-19 prevention is as imperative as increasing staff commitment to supply resources necessary to protect HCWs and to reduce healthcare-associated infections transmission of SARS-COV-2.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Yuan ◽  
Chunying Shen ◽  
Chengnan Wang ◽  
Gang Shen ◽  
Bing Han

Background: Drug interactions are the most common preventable cause of adverse drug reaction, which may result in drug toxicity or undesired therapeutic effect with harmful outcomes to patients. Given the rising use of combination therapies, the main objectives of this study were to estimate the degree to which physicians can identify potential drug-drug interactions (PDDIs) correctly and to describe the common source of information used by physicians when they need to check PDDIs.Methods: A cross-sectional survey utilizing a self-administered online questionnaire was conducted among physicians in China. Participants were asked to classify 20 drug pairs as “no interaction,” “may be used together with monitoring,” “contraindication,” and “not sure.” We also collected data on the physician's source of information and altitude toward the PDDIs. An ordinary least square regression model was performed to investigate the potential predictors of PDDI knowledge.Results: Eligible questionnaires were obtained from 618 physicians. The respondents classified correctly 6.7 out of 20 drug pairs, or 33.4% of the drug interactions investigated. The number of drug pairs recognized by respondents was ranged from 0 to 16. The percentage of physicians who recognized specific drug pairs ranged from 8.3% for no interactions between conjugated estrogens and raloxifene, to 64.0% for the interaction between dopamine and phenytoin. When the respondents want to check PDDI information, the most commonly used source of information was package inserts (n = 572, 92.6%), followed by the Internet or mobile Apps (n = 424, 68.6%), consultation with clinical pharmacists (n = 384, 62.1%), medical textbooks (n = 374, 60.5%), knowledge base in Chinese (n = 283, 45.8%), and other physicians (n = 366, 59.2%). In the multiple regression analysis, the significant predictors of a higher number of recognized drug pairs were years of practice and altitudes toward PDDIs.Conclusion: In this online survey accessing physician's ability to detect PDDIs, less than half of the drug pairs were recognized, indicating unsatisfactory level of knowledge about the clinically significant drug interactions. Continuing education and accessible electronic database can help physicians detecting PDDIs and improve drug safety.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e052495
Author(s):  
Rebecca M Lovett ◽  
Lauren Opsasnick ◽  
Andrea Russell ◽  
Esther Yoon ◽  
Sophia Weiner-Light ◽  
...  

ObjectivesTo examine the prevalence of mental health symptoms during the first surge of COVID-19 in the USA, and their associations with COVID-19-related emotional distress, health self-management and healthcare utilisation.DesignCross-sectional analysis of wave 3 (1–22 May 2020) survey data from the ongoing Chicago COVID-19 Comorbidities (C3) study.SettingSeven academic and community health centres in Chicago, Illinois.Participants565 adults aged 23–88 with one or more chronic conditions completing at least one prior C3 study wave.Primary and secondary outcome measuresClinically relevant anxiety and depressive symptoms as measured using Patient-Reported Outcomes Measurement Information System short forms. Self-reported emotional and health-related responses to COVID-19 were measured through a combination of single-item questions and validated measures.ResultsRates of anxiety and depressive symptoms were 14% (81/563) and 15% (84/563), respectively. Anxiety and depressive symptoms were then each separately associated with greater worry about contracting COVID-19 (relative risk (RR) 2.32, 95% CI 1.52 to 3.53; RR 1.67, 95% CI 1.10 to 2.54), greater stress (RR 4.93, 95% CI 3.20 to 7.59; RR 3.01, 95% CI 1.96 to 4.61) and loneliness (RR 3.82, 95% CI 2.21 to 6.60; RR 5.37, 95% CI 3.21 to 8.98), greater avoidance of the doctor (RR 1.62, 95% CI 1.06 to 2.49; RR 1.54, 95% CI 1.00 to 2.36) and difficulty managing health (least square means (LS Means) 6.09, 95% CI 5.25 to 6.92 vs 4.23, 95% CI 3.70 to 4.75; LS Means 5.85, 95% CI 5.04 to 6.65 vs 4.22, 95% CI 3.70 to 4.75) and medications (LS Means 3.71, 95% CI 2.98 to 4.43 vs 2.47, 95% CI 2.02 to 2.92) due to the pandemic.ConclusionsIdentifying and addressing mental health concerns may be an important factor to consider in COVID-19 prevention and management among high-risk medical populations.


2021 ◽  
Author(s):  
Helex Kayembe ◽  
Yunjian Lin ◽  
George N. Chidimbah Munthali ◽  
Wu Xuelian ◽  
Lazarus Obed Livingstone Banda ◽  
...  

Abstract Background: Micro Finance Institutions (MFIs) have been used as a tool for poverty alleviation in many developing economies globally, including Malawi. However, their sustainability in many countries has been dependent solely on loan repayment, donor aid, and subsidies. Aim: This study aimed at investigating the factors that influence the sustainability of MFIs in Malawi. Methods: A cross-sectional survey was conducted from November to December 2020 among the MFIs employees in the central region of Malawi. Convenience and purposive sampling techniques were used to collect data online using a google form sent via social media platforms. Data were analyzed using IBM SPSS software with Statistical significance placed at .05. Results: 120 respondents completed the survey representing a 79.3% response rate, of which 63% were male. The majority of the respondents fell within the age group of 31-40 years, representing 58%, having attained universities and vocational colleges' education level, representing 32.8%. With an experience of above 16 years, representing 41.2% of which were branch managers, representing 49.6%. The results of the ordinary least square regression indicated that reporting and loan management system (RLMS) (β=0.200, P=0.021), corporate-governance (β=0.257, P=0.004), and commercialization (β=0.161, P=0.047) were positively significantly influencing the sustainability of MFI. On the other hand, loan design/type (β =-0.211, P=0.006), loan portfolio management (β =-0.179, P=0.050) were found to be negatively impacting the MFI. Lastly, variables of over-indebtedness (B= 0.077, P=0.426), loan disbursement (β =0.121, P=0.104) were found statistically insignificant. Conclusion: Our study argues that commercialization, standardized reporting, and effective loan portfolio management systems, stakeholder-based approach to corporate governance, and favored board independence through scale and cost management is critical to improving MFIs' financial sustainability.


Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Mohan Thanikachalam ◽  
Shasha Bai ◽  
Vijayakumar Harivanzan ◽  
Ragavendra R Baliga ◽  
William T Abraham ◽  
...  

Background Arterial stiffness assessed by carotid-femoral pulse wave velocity (PWV) is an independent predictor of cardiovascular morbidity and mortality. We aimed to investigate how various measures of obesity affect arterial stiffness. Methods We conducted a population-based cross-sectional survey in 8,042 South Indians above the age of 20 years. Following completion of a detailed medical history questionnaire, all participants underwent haemodynamic screening including brachial and central blood pressure, and PWV measurements using a high-fidelity applanation tonometry. The study included anthropometric measurements and fasting blood for total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and blood glucose (BG) levels. After the exclusion of people with previous history of diabetes, hypertension and dyslipidemia on drug therapy, 5,841 subjects (mean age 41.6 years; 58% women) constituted the study sample Results In an univariate analysis, PWV correlated positively with age, mean blood pressure (MAP), heart rate (HR), body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), body fat percent (BF%), TC, TG, LDL and BG levels (P <0.001) and negatively with HDL levels (P=0.005). In a multivariate regression analysis, majority of the PWV variability in the model was accounted for by MAP and age, (cumulative adjusted R2 change of 32.79% as compared to the total adjusted R2 change of 35.25%). However, BMI (β= 0.042; adjusted R2 change=2.83%; p<0.001) independently correlated with PWV and its contribution to the PWV variability was far more significant compared to LDL, BG and TG (cumulative adjusted R2 change=1.08%). Multivariate regression analysis using the WC, WHR, or BF% instead of the BMI continued to demonstrate a significant independent effect of obesity parameters on PWV. Conclusion: In a large a population-based cross-sectional survey the study demonstrates a positive, independent association between obesity parameters and increased arterial stiffness.


2019 ◽  
Author(s):  
Dejene Kassa ◽  
Henok Tadele ◽  
Birkneh Tilahun Tadesse ◽  
Akalewold Alemayehu ◽  
Teshome Abuka ◽  
...  

Abstract Background Institutional delivery service utilization is one of the key and proven interventions to reduce maternal death. It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. However, a significant proportion of deliveries in developing countries including Ethiopia occurs at home and is not attended by skilled birth attendants. This study aimed at determining the prevalence of home delivery and associated factors in three districts in Sidama Zone.Methods A cross sectional survey was conducted from 15th- 20th October 2018. A multi-stage sampling design was employed to select 507 women who gave birth 12 months preceding the survey. Quantitative data were collected by using structured, interviewer administered questionnaires. Univariate and multivariate logistic regression models were run to assess factors associated with home delivery. Measures of association between factors and the outcome variable were reported using 95% confidence intervals (CIs) and adjusted odds ratios (aORs).Results The response rate was 495(97.6%). The overall prevalence of home delivery was 113 (28%) with 95%CI (19%, 27%). Maternal rural residence, aOR=7.45(95%CI: 2.23-24.83); illiteracy of mothers, aOR=8.78 (95% CI: 2.33-33.01); those who completed grades 1-4, aOR =3.81(95% CI: 1.16-12.49); mothers who did not know the expected date of delivery, aOR=2.12 (95% CI: 1.21-3.71); mother being merchant, aOR=3.01(95%CI:1.44-6.3) and paternal illiteracy, aOR=3.27, (95% CI: 1.20-8.88) were predictors of home birth.Conclusion The prevalence of skilled birth attendance in the study area has improved from the EDHS 2016 report of 26%. Uneducated, rural and merchant mothers were more likely to deliver at home. Interventions targeting rural and uneducated mothers might help to increase skilled birth attendance in the region.


Author(s):  
Md. Rakibul Hoque ◽  
Adnan Albar ◽  
Jahangir Alam

E-Health is one of the solutions to provide better access for patients and physician to healthcare facilities. In developing countries, e-Health is particularly important due to a shortage of physician and medical workers. Although most physicians in developing countries like Bangladesh acknowledge the benefits of e-Health, low adoption is not uncommon. The objective of this study is to identify the critical factors affecting e-Health adoption among physicians in Bangladesh. A cross-sectional survey questionnaire method was used for this study. The structural equation modeling (SEM) with the partial least square (PLS) approach was used to analyze the data. The study found that Performance Expectancy, Effort Expectancy, Social Influence and Personal Innovativeness had a significant impact on the behavioral intention to use e-Health, while Facilitating Conditions had no significant effect. The findings of this study will facilitate the degree of more acceptance of new technology by the physicians for their own betterment.


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