The effect of surveillance and appreciative inquiry on puerperal infections : a longitudinal cohort study in India

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Factors associated with preterm delivery and low birth weight: a study from rural Maharashtra, India

Background: Although preterm delivery and low birth weight (LBW) have been studied in India, findings may not be generalisable to rural areas such as the Marathwada region of Maharashtra state. There is limited information available on maternal and child health indicators from this region. We aimed to present some local estimates of preterm delivery and LBW in the Osmanabad district of Marathwada and assess available maternal risk factors. Methods: The study used routinely collected data on all in-hospital births in the maternity department of Halo Medical Foundation’s hospital from 1 (st )January 2008 to 31 (st )December 2014. Multivariable logistic regression analysis provided odds ratios (OR) with 95% confidence intervals (CI) for preterm delivery and LBW according to each maternal risk factor. Results: We analysed 655 live births, of which 6.1% were preterm deliveries. Of the full term births (N=615), 13.8% were LBW (<2.5 kilograms at birth). The odds of preterm delivery were three times higher (OR=3.23, 95% CI 1.36 to 7.65) and the odds of LBW were double (OR=2.03, 95% CI 1.14 to 3.60) among women <22 years of age compared with older women. The odds of both preterm delivery and LBW were reduced in multigravida compared with primigravida women regardless of age. Anaemia (Hb<11g/dl), which was prevalent in 91% of women tested, was not significantly related to these birth outcomes. Conclusions: The odds of preterm delivery and LBW were much higher in mothers under 22 years of age in this rural Indian population. Future studies should explore other related risk factors and the reasons for poor birth outcomes in younger mothers in this population, to inform the design of appropriate public health policies that address this issue

Cost of hospitalization for childbirth in India: how equitable it is in the post-NRHM era?

BACKGROUND AND OBJECTIVE: Information on out-of-pocket (OOP) expenditure during childbirth in public and private health facilities in India is needed to make rational decisions for improving affordability to maternal care services. We undertook this study to evaluate the OOP expenditure due to hospitalization from childbirth and its impact on households. METHODS: This is a secondary data analysis of a nationwide household survey by the National Sample Survey Organization in 2014. The survey reported health service utilization and health care related expenditure by income quintiles and type of health facility. The recall period for hospitalization expenditure was 365 days. OOP expenditure amounting to more than 10% of annual consumption expenditure was termed as catastrophic. RESULTS: Median expenditure per episode of hospitalisation due to childbirth was US$54. The expenditure incurred was about six times higher among the richest quintile compared to the poorest quintile. Median private sector OOP hospitalization expenditure was nearly nine times higher than in the public sector. Hospitalization in a private sector facility leads to a significantly higher prevalence of catastrophic expenditure than hospitalization in a public sector (60% vs. 7%). Indirect cost (43%) constituted the largest share in the total expenditure in public sector hospitalizations. Urban residence, poor wealth quintile, residing in eastern and southern regions of India and delivery in private hospital were significantly associated with catastrophic expenditure. CONCLUSIONS: We strongly recommend cash transfer schemes with effective pro-poor targeting to reduce the impact of catastrophic expenditure. Strengthening of public health facilities is required along with private sector regulation

Evaluation of a virtual, simulated international public health peer-to-peer exchange learning experience

Introduction: Public Health’s (PH) global rise is accompanied by an increasing focus on training the new generation of PH graduates in interdisciplinary skills for multisectoral and cross-cultural engagement to develop an understanding of commonalities in health system issues and challenges in multi-cultural settings. Online teaching modalities provide an opportunity to enhance global health skill development through virtual engagement and peer exchange. However, current teaching pedagogy is limited in providing innovative modes of learning global health issues outside of traditional classroom settings with limited modalities of evidence-informed implementation models. Methods: This study designed, implemented, and evaluated a novel global health online synchronous module as proof of concept that incorporated elements of virtual Practice-based learning (PBL) using a case study approach offered to currently enrolled public health students at the University of Canberra (UC) and a partnering public health university from India, the Indian Institute of Public Health Gandhinagar (IIPH-G). Using constructive learning theory and the Social Determinants of Health framework, four online sessions were designed and implemented in August–September 2022. Formal process and outcome evaluation using a quantitative adapted survey of the validated International Student Experience survey (IES) at session end and findings provided. Results: Over 100 participating public health students from Australia and India provided narrative feedback and quantitative responses from the adapted IES instrument across four key dimensions, namely “motivation,” “personal development,” intellectual development, and “international perspectives” reporting an overall high mean impact of 4.29 (out of 5) across all four themes seen together. In essence, the sessions supported students to explore global health issues from a different cultural perspective while developing intercultural communication skills and enhancing their global exposure in real-time. Discussions: This innovation, implemented as a proof of concept, provided evidence, and demonstrated the implementation feasibility of a flexible virtual integrated practice-based module that can supplement classroom teaching. It provides participating students with the opportunity to develop intercultural understanding and communication competence as well as support global mindedness by engaging with international peers around focused global health case studies.</p

Hyperfine and spin-orbit coupling effects on decay of spin-valley states in a carbon nanotube

The decay of spin-valley states is studied in a suspended carbon nanotube double quantum dot via leakage current in Pauli blockade and via dephasing and decoherence of a qubit. From the magnetic field dependence of the leakage current, hyperfine and spin-orbit contributions to relaxation from blocked to unblocked states are identified and explained quantitatively by means of a simple model. The observed qubit dephasing rate is consistent with the hyperfine coupling strength extracted from this model and inconsistent with dephasing from charge noise. However, the qubit coherence time, although longer than previously achieved, is probably still limited by charge noise in the device

Hyperfine and Spin-Orbit Coupling Effects on Decay of Spin-Valley States in a Carbon Nanotube

The decay of spin-valley states is studied in a suspended carbon nanotube double quantum dot via the leakage current in Pauli blockade and via dephasing and decoherence of a qubit. From the magnetic field dependence of the leakage current, hyperfine and spin-orbit contributions to relaxation from blocked to unblocked states are identified and explained quantitatively by means of a simple model. The observed qubit dephasing rate is consistent with the hyperfine coupling strength extracted from this model and inconsistent with dephasing from charge noise. However, the qubit coherence time, although longer than previously achieved, is probably still limited by charge noise in the device. © 2017 American Physical Society

Photon-assisted tunneling and charge dephasing in a carbon nanotube double quantum dot

We report microwave-driven photon-assisted tunneling in a suspended carbon nanotube double quantum dot. From the resonant linewidth at a temperature of 13 mK, the charge-dephasing time is determined to be 280 ± 30 ps. The linewidth is independent of driving frequency, but increases with increasing temperature. The moderate temperature dependence is inconsistent with expectations from electron-phonon coupling alone, but consistent with charge noise arising in the device. The extracted level of charge noise is comparable with that expected from previous measurements of a valley-spin qubit, where it was hypothesized to be the main cause of qubit decoherence. Our results suggest a possible route towards improved valley-spin qubits