How well do India's social service programs serve the poor?

Reaching India's poor calls for greatly improved social service delivery systems, better targeting of the poor, more coordination between agencies, policies aimed at income generation, and more involvement of the poor and of nongovernmental organizations. The authors of this paper found that India's social services were used relatively little by the poor. The health and education of the poor has improved but not as much for the population as a whole. The reasons that all social service programs did so little to alleviate poverty are similar. Physical access to education and health services has improved but inequalities exist because of biases in locating facilities. The access of the poor to housing, social security, and social welfare services has been limited because these services were inadequate relative to needs and because services leak to the nonpoor. Social service policies are not comprehensive enough and the quality of services is low. Issues common to the social sector delivery systems are weak management, ineffective targeting, and inflexible service delivery systems that result in a mismatch between perceived needs and services delivered. The bureaucracy is inadequate to reach the poor. Existing capacity and resources are inadequate, particularly for education and health.Health Monitoring&Evaluation,Health Economics&Finance,Poverty Assessment,Safety Nets and Transfers,Rural Poverty Reduction

A study of the obstetric and perinatal outcomes of eclampsia and the use of levetiracetam in its management

Background: Hypertensive disorders are a common cause of maternal morbidity and mortality complicating 3 to 10% of pregnancies. Eclampsia is a major complication of hypertensive disorders of pregnancy, particularly in developing countries, resulting in poor foeto-maternal outcomes. In some cases of eclampsia use of the gold standard i.e. magnesium sulphate, is restricted and is sometimes ineffective when used as monotherapy. Levetiracetam is an anti-epileptic drug that is relatively safe in pregnancy, does not require intensive monitoring and has potential use in eclampsia. The primary aim of this study was to establish the incidence of eclampsia and its maternal and perinatal outcomes. It also aimed at studying the utility of levetiracetam in the treatment of eclampsia.Methods: It is a retrospective, observational study conducted at Seth G. S. Medical College and K.E.M Hospital, Mumbai (a tertiary care centre). Data of a period of one year was collected from hospital records. The eclamptic patients’ demographic profile, maternal and perinatal outcomes and the use of levetiracetam were noted.Results: The incidence of hypertensive disorders of pregnancy was 7.53% while that of eclampsia was 0.737%. The maternal and perinatal case fatality rates were 18% and 26% respectively. 50% of the cases had other concurrent maternal complications. 44.11% of the live births required neonatal intensive care unit admission. 55% of the cases who were treated with levetiracetam, either as monotherapy or in combination with magnesium sulphate, made a complete recovery.Conclusions: The significant number of hypertensive disorders of pregnancy complicated by eclampsia and its associated co-morbidities indicate the need for early detection of hypertension in pregnancy and timely intervention

Successful maternal and perinatal outcome of hepatitis E in pregnancy with fulminant hepatic failure

Hepatitis E infection is an important cause of fulminant hepatic failure (FHF) in pregnancy in developing countries like India, with a high mortality rate. It is postulated that immunological and hormonal changes in pregnant women predispose them to developing FHF secondary to hepatitis E infection as compared to the less severe form seen in the non-pregnant population. A variation in the natural course of the disease is also seen amongst different geographical areas. Hepatitis E infection is seen to be less severe in parts of the world like Egypt, Europe and the USA as against the Indian subcontinent. The mainstay of management of acute viral hepatitis (AVH) and fulminant hepatic failure secondary to hepatitis E virus is supportive treatment. Since an increased severity of the disease is associated with the pregnant state, termination of pregnancy to alter its course is an option worth considering. Our case study showed promising results of induction of labour in a case of FHF (hepatic encephalopathy with disseminated intravascular coagulation) caused by hepatitis E, in the third trimester of pregnancy

Analysis Of The Packaging House Program In Batu Bara Regency: Enhancing The Competitiveness Of Msme Products For Regional Economic Development In Batu Bara Regency

This study aims to analyze the influence of several factors on the competitiveness of Micro, Small, and Medium Enterprises (UMKM) products in Rumah Kemasan, Batu Bara Regency, and its impact on the regional economy. Employing the method of multiple linear regression analysis, this research explores the relationships between independent variables such as packaging, branding, product legality, marketing strategy, and market digitalization with the dependent variables of product competitiveness and regional economy. The research findings reveal that all independent variables exert a significant influence on the competitiveness of UMKM products. Specifically, packaging exhibits a stronger impact compared to other variables. Furthermore, all independent variables also significantly affect the regional economy, with product legality and branding standing out as primary factors. Based on these findings, the study recommends UMKM stakeholders enhance online promotion, maintain product quality, develop packaging design, and uphold consumer trust. These efforts are anticipated to enhance product competitiveness and contribute to the regional economic growth

Successful management of a young patient with yolk sac tumour

Yolk sac tumours, synonymous with endodermal sinus tumours, are rare, malignant germ cell neoplasms occurring usually in gonads. Yolk sac tumours are more commonly seen in patients of early age group, the median age being 18 years. We report a case of a yolk sac tumour of the ovary in a 21 year old female, managed by surgery and chemotherapy

A near-miss case of obstetric haemorrhage managed successfully

Functioning of health systems with respect to maternal health were previously audited using indicators like maternal mortality ratio. However, maternal morbidity as a consequence of pregnancy-related complications is not accounted for in these indicators. Thus, the World Health Organization (WHO) has formulated a maternal near-miss approach to pregnancy complications for a more thorough evaluation of health care systems across the world. In practical terms, women are said to be maternal near-miss cases when they survive lethal conditions during pregnancy or in the postpartum period. We report one such case of traumatic variety of postpartum haemorrhage subsequent to a lower segment caesarean section with immediate post-operative removal of cervical cerclage threads that resulted in a maternal near-miss case

Conservative management options for morbidly adherent placenta

Background: Morbidly adherent placenta is still a very significant cause of obstetric hemorrhage.Methods: A retrospective, descriptive study was undertaken over a period of one and a half year in a tertiary care hospital of all diagnosed cases of morbidly adherent placenta which were managed conservatively and the maternal and perinatal outcomes were noted. Preparation for conservative management of cases of adherent placenta in the antenatal period included informing interventional radiologists and placement of internal iliac balloon catheters just before classical caesarean section. Post-operative methotrexate was used in a few patients.Results: 11 cases of morbidly adherent placenta diagnosed on Doppler ultrasound scan, and confirmed by MRI were identified. All patients underwent classical caesarean section. 9 patients had internal iliac balloon placement. 5 patients received methotrexate. 3 patients required obstetric hysterectomy. 1 maternal and 2 perinatal mortalities were noted.Conclusions: Interventional radiology and methotrexate can be used to avoid peripartum hysterectomy and to optimize maternal and perinatal outcome

Successful management of a near miss case of eclampsia with intracranial haemorrhage requiring craniotomy

Large population-based studies on stroke report that intracerebral haemorrhage is rare in young women however it is a grave and disturbing complication of pregnancy. Preeclampsia is usually clinically silent, but may cause symptoms of neurological dysfunction such as headache, visual disturbances and impairment of consciousness. Eclampsia is in the occurrence of seizures in the context of preeclampsia and is often, but not always, preceded by the above neurological symptoms. Most published data support the view that preeclampsia and eclampsia are important causative factors for pregnancy related ICH. Sparse data is available with respect to the management of such cases. Identification of near miss cases is an important step in reducing mortality. Herein we report a near miss case of eclampsia with intracranial haemorrhage requiring craniotomy

Analisis USAhatani Jambu Madu

Penelitian ini bertujuan untuk mengidentifikasi teknik budidaya USAhatani jambu madu, menentukan komponen biaya produksi yang terbesar dalam USAhatani jambu madu, dan menganalisis kelayakan USAhatani jambu madu. Metode analisis yang digunakan adalah metode analisis deskriptif yaitu dengan wawancara langsung kepada petani, dan untuk mengetahui komponen biaya terbesar dapat dilihat dengan menganalisis kelayakan jambu madu dengan menggunakan perhitungan R/C ratio dan BEP menggunaakan metode analisis deskriptif yaitu dengan wawancara langsung kepada petani yang ada di lokasi penelitian. Hasil penelitian menunjukkan bahwa teknik budidaya USAhatani jambu madu di daerah penelitian dimulai dari teknik penyiapan lahan, teknik media tanam/pot, teknik penanaman, dan pemeliharaan, serta panen dan pasca panen sesuai (intensif) karena sesuai dengan anjuran. Komponen biaya produksi terbesar pada USAhatani jambu madu di daerah penelitian adalah biaya pupuk yaitu sebesar 74,24%. Usahatani jambu madu di daerah penelitian adalah layak untuk diusahakan, dimana volume produksi jambu madu > BEP volume produksi yaitu 9.349 Kg lebih besar dari 4.193 Kg, dengan harga jual jambu madu > BEP harga produksi yaitu, Rp. 30.000 lebih besar dari Rp. 8.596 dan R/C ratio> 1 yaitu 2,23. R/C ratio>1 yaitu 2,23 artinya dengan modal sebesar Rp.1.000.000/musim tanam maka dapat menghasilkan keuntungan sebesar Rp.2.300.000/musimtanam

Analisis Rasio Ketersediaan dengan Konsumsi Pangan di Kota Medan

One way to determine the level of food security is by measuring the ratio of the availability of the food consumption. Food ratio is useful as an input for stakeholders to improve and increase the food supply in order to achieve food security in Medan, which until now food highly depend on food imports. To view the sufficiency availability and consumption, compare between availability and sufficient actual consumption with the availability and consumption standard rate in a energy and protein. Results showed actual energy availability in Medan in 2010 is higher 12% of the rate of energy availability according to recommended rate by the Nutritional Adequacy of government. Availability of actual protein is lower 24% of the value of the standard should be. Actual energy consumption rate is higher 19% of the energy consumption figures according to figures Nutrition Adequacy recommended by the government. Protein consumption figures is lower 20% of the rate of protein intake recommended by the National Work Widya Food and Nutrition (WNPG) 2004. The nine strategic food including rice, corn, red pepper, sugar, onion, chicken, beef, eggs, and palm oil in condition food resistant but vulnerable, which is between 0.8 to 1.2. Highest ratio is in corn 1.1236 point. For the smallest ratio of sugar is equal to 1.0099