Unseen, unheard, unnamed: The matchless and unsung heroes of the textile art and craft of Rajasthan

Rajasthan is known for its exquisite handicrafts, especially the textiles. In spite of having the most vibrant and glorious traditions, this sector has been grossly unorganized due to the poor socio-economic status of the artisans. The educational background of the artisans also is not satisfactory; hence, they lack public relations skills. They are totally dependent on big traders and middlemen for marketing purposes. Moreover, in this era of labels and designers, the artisans, however skilled or endowed they may be, have to work under some renowned brand or name to have a regular livelihood. However, not all artisans are lucky to be in the right place at the right time. These artisans work according to the design directions given to them including the decision of fabric, the formation/placement of motifs, color palette, the overall design or look of the fabric or the garment in accordance with the latest trends, styling, and forecast. They lack experience with the latest technology, and its advancement, too, due to the lack of economic and financial stability. As a result, in spite of their hard work, they find themselves in a difficult position in the present competitive environment. These artisans, therefore, remain largely unheard and unseen. They work in the background, and most of the time the limelight is on the professional “designers.” The present paper discusses some popular and exquisite traditional handicraft and textile art of Rajasthan such as gotta patti, lehriya, block printing, blue pottery, etc

Predicting the impact of patient and private provider behavior on diagnostic delay for pulmonary tuberculosis patients in India: A simulation modeling study.

BackgroundTuberculosis (TB) incidence in India continues to be high due, in large part, to long delays experienced by patients before successful diagnosis and treatment initiation, especially in the private sector. This diagnostic delay is driven by patients' inclination to switch between different types of providers and providers' inclination to delay ordering of accurate diagnostic tests relevant to TB. Our objective is to quantify the impact of changes in these behavioral characteristics of providers and patients on diagnostic delay experienced by pulmonary TB patients.Methods and findingsWe developed a discrete event simulation model of patients' diagnostic pathways that captures key behavioral characteristics of providers (time to order a test) and patients (time to switch to another provider). We used an expectation-maximization algorithm to estimate the parameters underlying these behavioral characteristics, with quantitative data encoded from detailed interviews of 76 and 64 pulmonary TB patients in the 2 Indian cities of Mumbai and Patna, respectively, which were conducted between April and August 2014. We employed the estimated model to simulate different counterfactual scenarios of diagnostic pathways under altered behavioral characteristics of providers and patients to predict their potential impact on the diagnostic delay. Private healthcare providers including chemists were the first point of contact for the majority of TB patients in Mumbai (70%) and Patna (94%). In Mumbai, 45% of TB patients first approached less-than-fully-qualified providers (LTFQs), who take 28.71 days on average for diagnosis. About 61% of these patients switched to other providers without a diagnosis. Our model estimates that immediate testing for TB by LTFQs at the first visit (at the current level of diagnostic accuracy) could reduce the average diagnostic delay from 35.53 days (95% CI: 34.60, 36.46) to 18.72 days (95% CI: 18.01, 19.43). In Patna, 61% of TB patients first approached fully qualified providers (FQs), who take 9.74 days on average for diagnosis. Similarly, immediate testing by FQs at the first visit (at the current level of diagnostic accuracy) could reduce the average diagnostic delay from 23.39 days (95% CI: 22.77, 24.02) to 11.16 days (95% CI: 10.52, 11.81). Improving the diagnostic accuracy of providers per se, without reducing the time to testing, was not predicted to lead to any reduction in diagnostic delay. Our study was limited because of its restricted geographic scope, small sample size, and possible recall bias, which are typically associated with studies of patient pathways using patient interviews.ConclusionsIn this study, we found that encouraging private providers to order definitive TB diagnostic tests earlier during patient consultation may have substantial impact on reducing diagnostic delay in these urban Indian settings. These results should be combined with disease transmission models to predict the impact of changes in provider behavior on TB incidence