50 research outputs found

    Maternal mental health in primary care in five low- and middle-income countries: a situational analysis

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    Measurement of single top-quark production in the s-channel in proton–proton collisions at √s = 13 TeV with the ATLAS detector

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    A measurement of single top-quark production in the s-channel is performed in proton–proton collisions at a centre-of-mass energy of 13 TeV with the ATLAS detector at the CERN Large Hadron Collider. The dataset corresponds to an integrated luminosity of 139 fb−1. The analysis is performed on events with an electron or muon, missing transverse momentum and exactly two b-tagged jets in the final state. A discriminant based on matrix element calculations is used to separate single-top-quark s-channel events from the main background contributions, which are top-quark pair production and W-boson production in association with jets. The observed (expected) signal significance over the background-only hypothesis is 3.3 (3.9) standard deviations, and the measured cross-section is σ=8.2+3.5−2.9 pb, consistent with the Standard Model prediction of σSM=10.32+0.40−0.36 pb

    Taking stock of 10 years of published research on the ASHA programme: Examining India’s national community health worker programme from a health systems perspective

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    Background: As India’s accredited social health activist (ASHA) community health worker (CHW) programme enters its second decade, we take stock of the research undertaken and whether it examines the health systems interfaces required to sustain the programme at scale. Methods: We systematically searched three databases for articles on ASHAs published between 2005 and 2016. Articles that met the inclusion criteria underwent analysis using an inductive CHW–health systems interface framework. Results: A total of 122 academic articles were identified (56 quantitative, 29 mixed methods, 28 qualitative, and 9 commentary or synthesis); 44 articles reported on special interventions and 78 on the routine ASHA program. Findings on special interventions were overwhelmingly positive, with few negative or mixed results. In contrast, 55% of articles on the routine ASHA programme showed mixed findings and 23% negative, with few indicating overall positive findings, reflecting broader system constraints. Over half the articles had a health system perspective, including almost all those on general ASHA work, but only a third of those with a health condition focus. The most extensively researched health systems topics were ASHA performance, training and capacity-building, with very little research done on programme financing and reporting, ASHA grievance redressal or peer communication. Research tended to be descriptive, with fewer influence, explanatory or exploratory articles, and no predictive or emancipatory studies. Indian institutions and authors led and partnered on most of the research, wrote all the critical commentaries, and published more studies with negative results. Conclusion: Published work on ASHAs highlights a range of small-scale innovations, but also showcases the challenges faced by a programme at massive scale, situated in the broader health system. As the programme continues to evolve, critical comparative research that constructively feeds back into programme reforms is needed, particularly related to governance, intersectoral linkages, ASHA solidarity, and community capacity to provide support and oversight

    Respectful Maternity Care in South Asia: What Does the Evidence Say? Experiences of Care and Neglect, Associated Vulnerabilities and Social Complexities

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    Background: Respectful maternity care encompasses the right to continuity of care and dignified support for women during the reproductive period, enabling informed choice. However, the evidence is limited in the context of South Asia region where maternal, perinatal and newborn mortality is still a critical challenge to health systems. Evidence is required to better understand the context of respectful maternity care to inform directions for appropriate policy and practice. Objective: The objective of this scoping review was to explore facilitators and barriers of respectful maternity care practice in South Asia. Design: CINAHL, EMBASE, PubMed, Medline, SCOPUS and Cochrane databases were used to identify related studies. Data were systematically synthesized and analysed thematically. Findings: There was considerable heterogeneity in the 61 included studies from seven South Asian countries, with most of the research conducted in Nepal and India. While the experience of abuse and neglect was common, 10 critical themes emerged related to neglected choices and compromised quality of care (particularly where there were health inequities) in the context of institutional care experiences; and the imperative for improved investment in training and significant policy and legislative change to enforce equitable and respectful maternity care practice. Conclusions and Implications for Practice: Evidence about respectful maternity care in South Asia indicates that women accessing professional and facility-based services experienced high levels of disrespect, abuse and maltreatment. Women from vulnerable, socially disadvantaged and economically poor backgrounds were more likely to experience higher level abuse and receive poor quality of care. There is an urgent need for a well-resourced, sustained commitment to mandate and support the provision of respectful and equitable maternity care practice in South Asia
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