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Impact of an Employment Guarantee Scheme on Utilisation of Maternal Healthcare Services: Results from a Natural Experiment in India
We assess the impact of Indiaâs National Rural Employment Guarantee (NREG) scheme, the worldâs largest workfare scheme, on healthcare utilisation â specifically maternal healthcare. The primary objective of NREG is to improve the income of rural households by guaranteeing 100 days of employment. We expect that by improving household income, thereby reducing some of the financial barriers, such as out-of-pocket payments, NREG can increase utilisation of maternal health services. Using a nationally representative household survey and a difference-in-differences approach that exploits the phased rollout of the scheme, we estimate the impact of NREG on utilisation of maternal health services: mainly deliveries at health facilities. We find that NREG did not increase overall facility deliveries, even though it led to an increase in deliveries at public facilities. There is weak evidence to suggest that deliveries at private facilities reduced due to NREG. Furthermore, sub-group analyses reveal that among poorer households, who are more likely to participate in NREG, there is a reduction in facility deliveries while home deliveries increased. Among richer households, NREG increased deliveries at public facilities. There was no impact on households belonging to marginalised castes. We conclude by discussing the possible mechanisms for these effects and its impact on equity in healthcare utilisation
Process Parameters Optimization of Resistance Spot Welding of Galvanized Steel Using Taguchi Method
Spot welding is a resistance welding process for joining metal sheets by directly applying opposite forces with pointed tips. The current and the heat generation are localized by the form of electrode. The amount of heat produced is a function of current, time and resistance between the work pieces. The present work attempts experimental investigations to study influence of important process parameters of resistance spot welding on weld strength, current and cycle time are varied at three different levels for different thickness and manufactured specimens are tested for weld strength.. Experiment have been conducted as per Taguchi method and fixed the levels for the parameters Analysis of variance (ANOVA) and F-test has been used for determining most significant parameters affecting the spot weld parameters
Prediction of performance parameters in Wire EDM of HcHcr steel using Artificial Neural Network
Electrical discharge machining has been extensively used for cutting intricate contours or delicate cavities that would be difficult to produce with a conventional machining methods or tools. Wire EDM is in use for a long time for cutting punches and dies, shaped pockets and other complex shaped parts. Performance of the process is mainly depends on many parameters used during process. Machining input parameters provided by the machine tool builder cannot always meet the operatorâs requirements. So, artificial neural network is introduced as an efficient approach to predict the values of performance parameters. In the present research, experimental investigations have been conducted to develop predictive models for the effect of input parameters on the responses such as Material Removal Rate, surface finish and kerf width. Material tested was HcHcr steel material. Molybdenum wires of diameters 0.18 mm were used for the WEDM machine. A feed forward back propagation artificial neural network (ANN) is used to model the influence of current, pulse-ON and pulse-OFF time on material removal rate, kerf width & surface roughness. Multilayer perception model has been constructed with feed forward back propagation algorithm using peak current, pulse-ON and pulse-OFF time as input parameters and MRR and surface roughness and kerf width as the output parameters. The predicted results based on the ANN model are found to be in very close agreement with the unexposed experimental data set. The modeling results confirm the feasibility of the ANN and its good correlation with the experimental results
Sickle cell anemia: Review and remedial hope
Genetic diseases and disabilities have been described as the most ubiquitous and burdensome to the populations. The hereditary anemia especially due to sickle cell is common globally with variably high prevalence in indigenous populations. In India, several endogamous tribal pockets that have been malaria endemic harbor sickle cell gene in strikingly high frequency. In this background management of sickle cell patients in context of contemporary health care system remains limited and requires integration of appropriate strategies into the existing health care delivery system. This may involve research, diagnosis, training, genetic counseling and possible remedial interventions for urban as well as rural populations. Remedial interventions that are possible in existing health care delivery system and potential therapies under investigation have been discussed.Key Words: Sickle cell anemia, infant mortality, pre-reproductive mortality, Indian tribes, malaria, sickle cell crisis management, remedial hope for sickle cell patients
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Political agency and public healthcare
The development of institutions of self-governance in India, and specifically the 2005 reformâthe National Rural Health Mission that introduced village health and sanitation committeesâprovide a unique opportunity to study the effects of the strengthening of the political agency on collective healthcare decision-making in rural areas. We use data from the District Level Household Survey and take advantage of the heterogeneity of maternal and child healthcare use, before and after the introduction of village health and sanitation committees. Specifically, we examine the effect of village health and sanitation committees on use of both public and preventive healthcare among children. Our results suggest that local democracy has increased access to preventive child healthcare services. Part of the effect is driven by an increase in the utilization of the public healthcare network. We find some evidence of an effect of village residence heads of a Panchayat on preventive healthcare use
Stressed Out: Endogenous Aldehydes Damage Hematopoietic Stem Cells
Despite a well-defined role for the Fanconi anemia (FA) pathway in mediating DNA repair, the mechanisms underlying the bone marrow failure in FA patients are poorly defined. Recently in Nature, Garaycoechea et al. (2012), identify aldehyde-mediated genotoxicity of hematopoietic stem cells as a cause for bone marrow failure
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