A study on knowledge, attitude and practices regarding antenatal care among pregnant women attending antenatal clinic at a tertiary care hospital

Background: The maternal health level of Indian women was noticed to be inferior as compared to other developed countries. Antenatal care is the clinical assessment of both mother and foetus, during the period of pregnancy. Safe motherhood by providing good antenatal care (ANC) is very crucial to reduce maternal mortality ratio and infant mortality rate and to achieve millennium development goals. The objectives of this study aimed to assess the level of knowledge, attitude, and practice on ANC among pregnant women attending the antenatal clinic and their association with several sociodemographic factors.Methods: A cross-sectional study was undertaken among 200 pregnant women in their 3rd trimester attending the OPD in a Tertiary Care Hospital of Gurugram, Haryana. Predesigned questionnaire was used for collecting data by interview after obtaining informed consent.Results: This study revealed that about 55% women had adequate knowledge regarding ANC. It was found that almost all the variables such as age, parity, level of education, occupation and type of family had a significant association with awareness about ANC. 90% women were having a positive attitude towards ANC. Around 70%, women were practicing this adequately.Conclusions: These results can be used to design a Health Intervention Program targeting to upgrade the maternal health practices and ultimately progress the health status of the women

Fetomaternal outcome in high-risk parturients receiving epidural analgesia using fentanyl with ropivacaine versus iv tramadol: a comparative study

Background: Labour analgesia has been recommended but sufficient data on use of labour epidural analgesia with ropivacaine and fentanyl combination during labour is not available.Methods: A comparative study was conducted on 40 high risk labouring partuirents, randomly allocated to group A (iv tramadol) and group B (epidural analgesia with ropivacaine plus fentanyl). Assessments were done for fetal heart rate abnormality, mode of delivery, duration of labour, and Apgar score. The VAS score, patient satisfaction score, and complications were recorded.Results: Group A had more number of instrumental deliveries compared to group B, the later had higher number of caesarean sections. No difference was observed in vaginal deliveries in both the groups. Pain relief was significant in patients of epidural group. The neonatal outcome was same in both the groups. Significant number of patients had a higher degree of satisfaction score in group B compared to group A.Conclusions: Tramadol and epidural analgesia in labour are safe and effective. Patient satisfaction is significantly higher in epidural group as compared to the tramadol group

Facilitating India-Pakistan trade through the land route

Improvements in the land route between India and Pakistan can help lower transaction costs which can play in important role in realizing the trade potential between the two countries. Connecting India and Pakistan by the land route offers gains not only to the two countries but would spread over a wide geography covering several countries. With the vision of connecting India and Pakistan to Central Asia and East Asia, this paper makes an attempt to examine trade between India and Pakistan by different modes of transport, identify physical and non-physical impediments to transporting goods by rail and road while taking into account the implications of trade policy for transporting goods; suggests measures to address these constraints which are also in compliance with the provisions in the recently signed WTO Agreement on Trade Facilitation. The paper also suggests how acceding to international conventions will make it easier for the two countries to connect with the rest of the world

An analysis of Nepal's transit through India

Nepal, a landlocked country, relies on transit access from neighbouring countries to participate in international trade. For Nepal, the nearest sea-port is that of Kolkata in India and the transit arrangements between the two countries are governed by two main legal instruments: India-Nepal Treaty of Trade and Transit and the India-Nepal Rail Services Agreement. However, there are a large number of inadequacies in the prevailing India-Nepal transit treaty encompassing issues with regard to documentation requirements, transhipment procedures, sensitive items, arbitrary bank guarantees, and poor infrastructure The study undertakes a detailed review of the transit treaties and the existing procedures with a view to identifying documentation and procedural impediments, infrastructure constraints and other non-physical barriers. In particular the current transhipment modality has been examined and bottlenecks related to the procedure have been identified. The relevance of WTO Trade Facilitation Agreement (TFA) has also been discussed in the context of Nepal's transit. Recommendations for improving transit by road and rail have been made to streamline India-Nepal transit and revise the prevailing treaties as per international standards

India-Pakistan trade: Opportunities for medical value travel

Despite an uncertain political relationship, and tensions between India and Pakistan, healthcare is a sector for trade that has the potential to grow. It is a soft sector, offering a win-win situation for both countries as producers will get a larger market for their products while consumers will have more options and superior quality products to choose from. Given India's growth in the area of providing medical value travel facilities in South Asia, the objective of the study is to explore the potential of enhancing trade in the health sector, between India and Pakistan. Based on a survey of hospitals, intermediaries and patients, the study examines the key characteristics and constraints of India-Pakistan trade in health services. The study also documents lessons that India can learn from its South-East Asian competitors in the medical tourism industry and finally recommends policies that will improve trade in health services between India and Pakistan

Tapping the untapped potential: India-Ireland trade & investment opportunities post-Brexit

Recent events, particularly Brexit, have propelled India to diversify its trade and investment markets in the European Union (EU). Within the EU, India has trade and investment synergy with Ireland. The paper explores business opportunities between India and Ireland, by analysing their bilateral trade in goods and services, and foreign direct investments. The paper analyses disaggregated bilateral trade data and uses the trade possibilities approach to estimate India's goods trade with Ireland and India's potential exports to Ireland. It is found that India has an untapped export potential of US$19 billion in the Irish market with the top 50 items accounting for 71 percent of the total potential. Exports of pharmaceuticals, organic chemicals and surgical goods dominate India's goods exports to Ireland, with there being potential to enhance such trade. Further, services are the largest component of India-Ireland trade and there is potential for increasing India's services export to Ireland, especially in business services, education, tourism, and medical services. Foreign direct investments from India to Ireland are predominantly in the manufacturing sector, particularly in manufacturing of medical and pharmaceutical items while FDIs from Ireland to India have been rising especially in business services, with potential to strengthen investment ties further through investments and collaborations in emerging technologies. The paper suggests that further boost to bilateral ties can come from the opportunities that are likely to be unleashed from the forthcoming India-EU free trade agreement and an India-EU bilateral trade and investment agreement

Normalizing India-Pakistan Trade

With the trade normalization process between India and Pakistan gathering momentum since November 2011, new opportunities for enhancing bilateral trade have opened between the two countries. This study estimates the trade potential between India and Pakistan, and examines how this potential can be realized. Using the Trade Possibility Approach for all items traded, followed by selecting only those items in which the countries have a Revealed Comparative Advantage (RCA) to export, the trade potential between India and Pakistan is estimated to lie between US$10.9 billion and US$19.8 billion. Of the US$10.9 billion trade potential, India's export potential accounts for US$7.9 billion and import potential US$3 billion. With a large number of items belonging to the negative or sensitive lists, the study estimates the trade potential accounted for by these items. Sectorwise analysis depicts that bilateral trade shall receive a boost if the textile sector is liberalized in both countries, with Pakistan liberalizing its automobile sector too. In the services sector, trade possibilities have been identified in Information Technology (IT), Business Process Outsourcing (BPO), health and entertainment services. The study finds that this trade potential remains unrealized largely due to impediments in transport and transit facilities, restrictive visa regime, continuation of large informal trade flows, and presence of 'perceived' non-tariff barriers to trade between India and Pakistan. As the Foreign Direct Investment (FDI) regime between the two countries is liberalized, the study identifies sectors which hold potential for investments, and are likely to deepen the trade linkages between India and Pakistan