Birth preparedness and complications readiness among women in LekhnathMuniciaplity, Nepal

Improving knowledge on obstetric danger signs and promoting birth preparedness practices is a major strategy to increase the utilization of quality health services during pregnancy and childbirth. The aim of this study was to assess knowledge and practices of women on birth preparedness and complication readiness and factors associated with it. Methods A community-based survey based on proportionate cluster random sampling was conducted among 310 women who gave birth in the last 12 months preceding the study in Lekhnath municipality, Nepal. Results Only 34.8%, 59.0% and 39.7% women had knowledge on at least two danger sign during pregnancy, child birth and post-partum respectively. Only one-third (33.2%) women had knowledge on all five components of birth preparedness and complication readiness (BPACR). About same proportion (34.2%) women were prepared for all five components of BPACR. But very few proportion (8.4%) women utilized all five prepaid items of BPACR. The study found significant association of BPACR with women’s education (p<0.001, Crude OR 38.65, 95% CI 9.26-160.68), antenatal care service (p- 0.003, Crude OR 11.47, 95% CI 1.51-86.73) and awareness on obstetric danger signs during pregnancy (Crude OR 33.25, 95% CI 17.57-68.58), delivery (Crude OR 10.34, 95% CI 5.33.-20.04), and post-partum (Crude OR 15.38, 95% CI 8.61-27.38). Conclusion The study concluded low level of knowledge, preparedness and utilization of all essential components of BPACR and positive influence of women’s education, antenatal care service and awareness on obstetric danger signs in BPACR

Correlation of Alfvén Mach number with field aligned current, polar cap potential and dawn dusk electric field during Quiet and extreme solar wind conditions

128-138This paper has been performed to study the Alfvenic Mach number (M­A) in relation to Field Aligned Currents (FACs), Polar Cap Potential (PCV), Dawn Dusk Electric Field (Ey) during different geomagnetic conditions. The relations of M­A with FACs, PCV and interplanetary electric field (IEF)-EY not solely dependent on any solar wind parameter but also associate with prior, main, and post conditions of geomagnetic storms. This study has shown that Prior to the arrival of interplanetary shock (IS),  and  show good relationship with FAC, PCV, EFY, and solar wind parameters, as the space weather seems unperturbed. The positive correlations among the various parameters have obtained due to the merging of two different interplanetary coronal mass ejections (ICMEs) driven solar storms and consequential intense southward interplanetary magnetic field. The negative relationships among the selected parameters may have been due to the slow recovery of the IMF-Bz component. This study indicate that the preceding solar winds could be associatedon the variance of M­A of a geomagnetic event, in turn might have its effects on FACs, PCV, Ey and in other solar wind parameters

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

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