Critical policy capacity factors in the implementation of the community health worker program in India

This paper employs the policy capacity framework to develop multidimensional and nested policy analysis that is able to examine how different types of capacity - analytical, organizational, and political from different related levels of the health system - have contributed to both policy success and failure during the implementation of a politically significant national community health worker (CHW) program in India. Directed toward rural and urban marginalized populations in India, this CHW has become the world's largest CHW program. Launched in 2006, it has targeted communitization, strengthening of the primary health-care system, and universal health-care coverage, ultimately receiving an international award in 2022. We argue that, in a context of capacity deficits and tensions between different capacity domains, the individual political capacity has been more critical to policy success and strengthening. The analysis not only clarifies the ways in which the government took some initiatives to build up capacity but also highlights capacity deficits along different competency dimensions. This approach demonstrates the value of understanding and creating awareness concerning complex poor - resource settings and low organizational capacity while concomitantly building up the capacities needed to foster (workforce and leadership) strengthening

Association Of Handgrip Strength, Body Mass Index, Waist Circumference And Depression Scale Among Adults: A Hospital Based Cross-Sectional Observational Study

In the northeastern region of India, particularly, there has been limited research on the connection between handgrip strength, body mass index (BMI), and depression. The current study aimed to investigate whether obesity in adult women (aged 20 to 80) influenced the relationship between handgrip strength and the risk of depression. This research was conducted at Kolkata's Peerless Hospital from February 2022 to March 2023, involving a cross-sectional observational study with a total of 458 participants, both male and female, aged 18 to 80. Ethical clearance for the study was obtained from the Ethics Committee of Peerless Hospital and B K Roy Research Center, located at 360 Pancha Sayar Rd, Sahid Smirity Colony, Pancha Sayar, Kolkata, West Bengal 700094 (PHH&RCLCREC/ 4020/2023). The study adhered to the ethical guidelines established by the institution's research committee and followed the principles outlined in the 1964 Helsinki Declaration and its subsequent revisions to ensure consistent ethical standards in all procedures involving human participants. Prior to commencing the study, informed written consent was obtained from all participants. Older women with thyroid dysfunction, or hormone replacement therapy, amenorrhea, those taking vitamin D supplements and individuals with physical or mental challenges, and those who were generally uncooperative were excluded from the study. The results of the present study demonstrated a statistically significant association between depression and handgrip strength, as indicated by the Chi-Square test. Handgrip strength also displayed a significant negative correlation with BMI. Waist circumference (WC) showed a significant association with handgrip strength, with an odds ratio (OR) of 2.66. Furthermore, there was a significant negative correlation between WC and handgrip strength. When considering body fat percentage, the OR for handgrip strength was 2.92, and a significant association was observed between handgrip strength and body fat percentage

Restructuring Public Sector Hospital Services: Marginalising the Poor

The paper examines the state of public sector hospitals, how they are being compelled to transform into profit churning units through reforms, and in the process alienating poor and the underprivileged groups from public hospital inpatient care.public sector hospitals, economic reforms, health care reforms, in-patient care, user charges, Sociology, Health Studies

‘TOP HEAVY’ SYSTEMS AND QUALITY OF HEALTH CARE

The paper is based on a primary survey of 1095 patients from the Medicine, General Surgery and Cardiac departments in R.G. Kar Medical College and Hospital (a major public sector health care institution in the metropolitan city of Kolkata, India). The results show that public health care institutions remain a vital life support system of the poorer sections of the population. However, this is not a matter of choice, but necessity. The breakdown of the three tiered referral system in the region has resulted in the Hospital, originally conceived as a super specialty hospital and referral health care institution for patients from the adjacent district of North 24 Parganas, functioning as a diagnosis unit. The resultant pressure has exceeded the carrying capacity of the institution and led to poor quality of health care in the Hospital. Revitalizing lower level institutions is therefore essential not only to increase accessibility of health services, but also to ensure efficiency in higher level health care institutions