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

Ayurvedic management of Corneal Ectasia - A Conceptual Study

Corneal ectasia is a disorder that results in thinning of the central, paracentral, or peripheral cornea that leads to progressive myopia and irregular astigmatism. Keratoconus, Pellucid marginal corneal degeneration (PMCD), Terrien's marginal degeneration (TMD), Keratoglobus, Posterior keratoconus are the conditions/types of corneal ectatia. In Ayurveda there is no direct reference of corneal ectasia, based on signs and symptoms it can be correlated with Vataja Timira. Timira is the Drustigata Roga which further leads to Linganasha if not treated initially. Based on symptoms and Dosha-Dushya involvement Brhumhana and Vatahara line of treatment should be followed in the form of Virechana, Nasya, Tarpana, Putapaka and Pindi. These treatment modalities are more beneficial in corneal ectasia

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Not AvailableThe study reported an ectoparasitic isopod, Tachaea spongillicola infestation in fish as new host, in wild caught species of Labeo rohita and Cirrhinus mrigala of family Cyprinidae and Notopterus notopterus of family Notopteridae from reservoir ecosystem. The prevalence of infestation was 100% in all the three fish species with mean intensity 29% for C. mrigala followed by 25% in L. rohita and 11% in N. notopterus. The Mann-Whitney U test analysis showed a significant (p < 0.01) difference between C. mrigala and N. notopterus, and L. rohita and N. notopterus, while no significant (p = 0.15) difference was observed between C. mrigala and L. rohita, underlining the preference of parasitic infestation towards carps species, that contributes a major share to the world's fish production. T. spongillicola infestation resulted in interesting pathology of conspicuous gill lamellae necrosis, like chondroptosis, and thinning of cartilaginous matrix resulting in curvature of primary gill lamella were recorded. In addition, rupture of pillar cells, erythrocytes migration through epithelial rupture, hypertrophied erythrocytes, extensive proliferation and hypertrophy goblet cells were observed in gills. Till date, Tachaea spp. is being reported as ectoparasites in shrimps and with few cases in sponges. This is the first report of Tachaea sp. viz. Tachaea spongillicola as ectoparasite, recorded in fish species, since after 114 years of its first record in freshwater sponge. As these fish species particularly of Indian major carps, are widely cultured in South Asian and Southeast Asian countries, knowledge on T. spongillicola infestation in fish would add on parasitic diseases list for better preparedness in open water aquaculture system.Not Availabl