Maternal Health Financing in Gujarat: Preliminary Results from a Household Survey of Beneficiaries under Chiranjeevi Scheme

The objective of this paper is to provide preliminary analysis of information collected at household level from beneficiaries of the Chiranjeevi scheme and from those who have not used the scheme (non-user group). The key findings have been discussed. Some of the questions which have guided this exercise are: understanding the socio-economic profile and differences of the households who have used the scheme and those who have not used the scheme, ability of scheme to target the poor and out-of-pocket expenditures incurred both users and non-users of the scheme. We have discussed this by analysing education, land holding, number of earning members in the family, possession of specific assets, age of women at the time of delivery, ANC services received, place of delivery, distance and time taken to reach the facility, status (normal or complication) of delivery, complications experienced, and cost incurred during the process. The total sample size consists of 656 respondents from 3 talukas of Dahod District. Of these total 656 respondents, 262 (40 per cent) are Chiranjeevi clients and 394 (60 per cent) comprise the non-user group. Key findings of the study are: * The Chiranjeevi scheme is being used by relatively younger mothers and having lesser number of children at the time of index delivery. * Most of the Chiranjeevi users have income levels less than Rs. 12,000 per annum indicating the scheme is able to target the poor families in these three blocks of the district, * The expenditure incurred by non-user group on index (recent) delivery at a private facility is Rs. 4000. * The average expenditure incurred by the Chiranjeevi beneficiary on their previous delivery was Rs. 3070. On index delivery a Chiranjeevi client has spent out-of- pocket on an average Rs. 727 per delivery on medicine (self Rs. 297, child Rs. 358) and transportation Rs.72 indicating that the delivery is not really cash-less. However, the average amount saved by the Chiranjeevi client by availing the benefit of the scheme is Rs 3273 (Rs. 4000 minus Rs. 727). * The average distance travelled by a Chiranjeevi client to reach the health care facility is 13.79 kms and the average time taken is 44 minutes. * The average expenditure on transportation using mostly private transport by a Chiranjeevi client is Rs.272 as compared to Rs. 200 which the Chiranjeevi client is reimbursed, * Private doctors have conducted 41 per cent of deliveries where as rest of the deliveries have been conducted by staff at the private health care facility under the Chiranjeevi scheme, * ANMs have been the source of information to 55 per cent of Chiranjeevi scheme users. Anganwadi workers provided information to 17 percent of the clients and Female Health Workers to 10 per cent of the Chiranjeevi clients. Thus, 82 per cent of the total beneficiaries of the Chiranjeevi scheme were provided information by the community health workers.

Maternal Healthcare Financing: Gujarat's Chiranjeevi Scheme and Its Beneficiaries

Maternal mortality is an important public-health issue in India, specifically in Gujarat. Contributing factors are the Government's inability to operationalize the First Referral Units and to provide an adequate level of skilled birth attendants, especially to the poor. In response, the Gujarat state has developed a unique public-private partnership called the Chiranjeevi Scheme. This scheme focuses on institutional delivery, specifically emergency obstetric care for the poor. The objective of the study was to explore the targeting of the scheme, its coverage, and socioeconomic profile of the beneficiaries and to assess financial protection offered by the scheme, if any, in Dahod, one of the initial pilot districts of Gujarat. A household-level survey of beneficiaries (n=262) and non-users (n=394) indicated that the scheme is well-targeted to the poor but many poor people do not use the services. The beneficiaries saved more than Rs 3,000 (US$ 75) in delivery-related expenses and were generally satisfied with the scheme. The study provided insights on how to improve the scheme further. Such a financing scheme could be replicated in other states and countries to address the cost barrier, especially in areas where high numbers of private specialists are available

Cholesterol Granuloma of Maxillary Sinus – An Unusual Case

Introduction Cholesterol granuloma is a type of foreign body granuloma found in tissues wherein the cholesterol crystals get accumulated. Quite unusual to be present in maxillary sinus owing to its pathogenesis. Case Report A 12 year old male child diagnosed with antrochoanal polyp, underwent endoscopic sinus surgery and the microscopic analyses revealed maxillary sinus cholesterol granuloma. Discussion Cholesterol granuloma is an uncommon tissue reaction to cholesterol crystals in the maxillary sinus owing to its well-ventilated state and is frequently associated with chronic sinuses disease or trauma. Since its signs and symptoms are non–specific, histopathological analysis is essential for correct diagnosis

BOBMEX: the Bay of Bengal monsoon experiment

The first observational experiment under the Indian Climate Research Programme, called the Bay of Bengal Monsoon Experiment (BOBMEX), was carried out during July-August 1999. BOBMEX was aimed at measurements of important variables of the atmosphere, ocean, and their interface to gain deeper insight into some of the processes that govern the variability of organized convection over the bay. Simultaneous time series observations were carried out in the northern and southern Bay of Bengal from ships and moored buoys. About 80 scientists from 15 different institutions in India collaborated during BOBMEX to make observations in most-hostile conditions of the raging monsoon. In this paper, the objectives and the design of BOBMEX are described and some initial results presented. During the BOBMEX field phase there were several active spells of convection over the bay, separated by weak spells. Observation with high-resolution radiosondes, launched for the first time over the northern bay, showed that the magnitudes of the convective available potential energy (CAPE) and the convective inhibition energy were comparable to those for the atmosphere over the west Pacific warm pool. CAPE decreased by 2-3 kJ kg-1 following convection, and recovered in a time period of 1-2 days. The surface wind speed was generally higher than 8 m s-1. The thermohaline structure as well as its time evolution during the BOBMEX field phase were found to be different in the northern bay than in the southern bay. Over both the regions, the SST decreased during rain events and increased in cloud-free conditions. Over the season as a whole, the upper-layer salinity decreased for the north bay and increased for the south bay. The variation in SST during 1999 was found to be of smaller amplitude than in 1998. Further analysis of the surface fluxes and currents is expected to give insight into the nature of coupling

PSR J2322-2650 - a low-luminosity millisecond pulsar with a planetary-mass companion

We present the discovery of a binary millisecond pulsar (MSP), PSR J2322-2650, found in the southern section of the High Time Resolution Universe survey. This system contains a 3.5-ms pulsar with a ~10 -3 M⊙ companion in a 7.75-h circular orbit. Follow-up observations at the Parkes and Lovell telescopes have led to precise measurements of the astrometric and spin parameters, including the period derivative, timing parallax, and proper motion. PSR J2322-2650 has a parallax of 4.4 ± 1.2 mas, and is thus at an inferred distance of 230 +90 -50 pc, making this system a candidate for optical studies. We have detected a source of R ~ 26.4 mag at the radio position in a single R-band observation with the Keck telescope, and this is consistent with the blackbody temperaturewewould expect from the companion if it fills its Roche lobe. The intrinsic period derivative of PSR J2322-2650 is among the lowest known, 4.4(4) × 10 -22 s s -1 , implying a low surface magnetic field strength, 4.0(4) × 10 7 G. Its mean radio flux density of 160 μJy combined with the distance implies that its radio luminosity is the lowest ever measured, 0.008(5) mJy kpc 2 . The inferred population of these systems in the Galaxy may be very significant, suggesting that this is a common MSP evolutionary path

An all-sky search for continuous gravitational waves in the Parkes Pulsar Timing Array data set

We present results of an all-sky search in the Parkes Pulsar Timing Array (PPTA) Data Release 1 data set for continuous gravitational waves (GWs) in the frequency range from 5 × 10−9 to 2 × 10−7 Hz. Such signals could be produced by individual supermassive binary black hole systems in the early stage of coalescence. We phase up the pulsar timing array data set to form, for each position on the sky, two data streams that correspond to the two GW polarizations and then carry out an optimal search for GW signals on these data streams. Since no statistically significant GWs were detected, we place upper limits on the intrinsic GW strain amplitude h0 for a range of GW frequencies. For example, at 10−8 Hz our analysis has excluded with 95 per cent confidence the presence of signals with h0 ≥ 1.7 × 10−14. Our new limits are about a factor of 4 more stringent than those of Yardley et al. based on an earlier PPTA data set and a factor of 2 better than those reported in the recent Arzoumanian et al. paper. We also present PPTA directional sensitivity curves and find that for the most sensitive region on the sky, the current data set is sensitive to GWs from circular supermassive binary black holes with chirp masses of 109  M☉ out to a luminosity distance of about 100 Mpc. Finally, we set an upper limit of 4 × 10−3 Mpc−3 Gyr−1 at 95 per cent confidence on the coalescence rate of nearby (z ≤ 0.1) supermassive binary black holes in circular orbits with chirp masses of 1010  M☉

Precision orbital dynamics from interstellar scintillation arcs for PSR J0437-4715

Intensity scintillations of radio pulsars are known to originate from interference between waves scattered by the electron density irregularities of interstellar plasma, often leading to parabolic arcs in the two-dimensional power spectrum of the recorded dynamic spectrum. The degree of arc curvature depends on the distance to the scattering plasma and its transverse velocity with respect to the line-of-sight. We report the observation of annual and orbital variations in the curvature of scintillation arcs over a period of 16 years for the bright millisecond pulsar, PSR J0437-4715. These variations are the signature of the relative transverse motions of the Earth, pulsar, and scattering medium, which we model to obtain precise measurements of parameters of the pulsar's binary orbit and the scattering medium itself. We observe two clear scintillation arcs in most of our $>$5000 observations and we show that they originate from scattering by thin screens located at distances $D_1 = 89.8 \pm 0.4$ pc and $D_2 = 124 \pm 3$ pc from Earth. The best-fit scattering model we derive for the brightest arc yields the pulsar's orbital inclination angle $i = 137.1 \pm 0.3^\circ$, and longitude of ascending node, $\Omega=206.3\pm0.4^\circ$. Using scintillation arcs for precise astrometry and orbital dynamics can be superior to modelling variations in the diffractive scintillation timescale, because the arc curvature is independent of variations in the level of turbulence of interstellar plasma. This technique can be used in combination with pulsar timing to determine the full three-dimensional orbital geometries of binary pulsars, and provides parameters essential for testing theories of gravity and constraining neutron star masses.Comment: 19 pages, 10 figures. Accepted for publication in Ap

Sequencing Analysis of Genetic Loci for Resistance for Late Leaf Spot and Rust in Peanut (Arachis hypogaea L.)

The aim of this study was to identify candidate resistance genes for late leaf spot (LLS) and rust diseases in peanut (Arachis hypogaea L.). We used a double-digest restriction-site associated DNA sequencing (ddRAD-Seq) technique based on next-generation sequencing (NGS) for genotyping analysis across the recombinant inbred lines (RILs) derived from a cross between a susceptible line, TAG 24, and a resistant line, GPBD 4. A total of 171 SNPs from the ddRAD-Seq together with 282 markers published in the previous studies were mapped on a genetic map covering 1510.1 cM. Subsequent quantitative trait locus (QTL) analysis revealed major genetic loci for LLS and rust resistance on chromosomes A02 and A03, respectively. Heterogeneous inbred family-derived near isogenic lines and the pedigree of the resistant gene donor, A. cardenasii Krapov. & W.C. Greg., including the resistant derivatives of ICGV 86855 and VG 9514 as well as GPBD 4, were employed for whole-genome resequencing analysis. The results indicated the QTL candidates for LLS and rust resistance were located in 1.4- and 2.7-Mb genome regions on A02 and A03, respectively. In these regions, four and six resistance-related genes with deleterious mutations were selected as candidates for LLS and rust resistance, respectively. These delimited genomic regions may be beneficial in breeding programs aimed at improving disease resistance and enhancing peanut productivity