Government of Haryana

About: Government of Haryana is a government organization based out in Gurgaon, India. It is known for research contribution in the topics: Pregnancy & Population. The organization has 43 authors who have published 41 publications receiving 861 citations. The organization is also known as: State Government of Haryana.

Lessons from implementation research on community management of Possible Serious Bacterial Infection (PSBI) in young infants (0-59 days), when the referral is not feasible in Palwal district of Haryana, India.

Abstract: Background Neonatal sepsis is a major cause of death in India, which needs hospital management but many families cannot access hospitals. The World Health Organization and the Government of India developed a guideline to manage possible serious bacterial infection (PSBI) when a referral is not feasible. We implemented this guideline to achieve high coverage of treatment of PSBI with low mortality. Methodology The implementation research study was conducted in over 50 villages of Palwal district, Haryana during August 2017-March 2019 and covered a population of 199143. Policy dialogue with central, state and district health authorities was held before initiation of the study. A baseline assessment of the barriers in the implementation of the PSBI intervention was conducted. The intervention was implemented in the program setting. The research team collected data throughout and also co-participated in the implementation of the intervention for the first six months to identify bottlenecks in the health system and at the community level. RE-AIM framework was utilized to document implementation strategies of PSBI management guideline. Implementation strategies by the district technical support unit (TSU) included: (i) empower mothers and families through social mobilization to improve care-seeking of sick young infants 0-59 days of age, (ii) build capacity through training and build confidence through technical support of health staff at primary health centers (PHC), community health centers (CHC) and sub-centers to manage young infants with PSBI signs and (iii) improve performance of accredited social health activists (ASHAs). Findings A total of 370 young infants with signs of PSBI were identified and managed in 5270 live births. Treatment coverage was 70% assuming that 10% of live births would have PSBI within the first two months of life. Mothers identified 87.6% (324/370) of PSBI cases. PHCs and CHCs became functional and managed 150 (40%) sick young infants with PSBI. Twenty four young infants (7-59days) who had only fast breathing were treated with oral amoxicillin without a referral. Referral to a hospital was refused by 126 (84%); 119 had clinical severe infection (CSI), one 0-6 days old had fast breathing and six had critical illness (CI). Of 119 CSI cases managed on outpatient injection gentamicin and oral amoxicillin, 116 (96.7%) recovered, 55 (45.8%) received all seven gentamicin injections and only one died. All 7-59 day old infants with fast breathing recovered, 23 on outpatient oral amoxicillin treatment; and 19 (79%) received all doses. Of 65 infants managed at either district or tertiary hospital, two (3.1%) died, rest recovered. Private providers managed 155 (41.9%) PSBI cases, all except one recovered, but sub-classification and treatment were unknown. Sub-centers could not be activated to manage PSBI. Conclusion The study demonstrated resolution of implementation bottlenecks with existing resources, activated PHCs and CHCs to manage CSI and fast breathers (7-59 day old) on an outpatient basis with low mortality when a referral was not feasible. TSU was instrumental in these achievements. We established the effectiveness of oral amoxicillin alone in 7-59 days old fast breathers and recommend a review of the current national policy.

Effectiveness of India's National Programme to save the girl child: experience of Beti Bachao Beti Padao (B3P) programme from Haryana State.

Abstract: The Government of India launched a nationwide programme to save and educate the girl child, Beti Bachao Beti Padhao (B3P), by stringent prohibition of sex-selective abortion, enforcement of Preconception and Prenatal Diagnostic Technique (PC-PNDT) and Medical Termination of Pregnancy (MTP) Acts, and social mobilization. We undertook this study to assess the effectiveness of intervention in Haryana state to improve sex ratio at birth (SRB). The monthly data on SRB (represented as girls per 1000 boys) were collected from civil registration system for the entire state of Haryana to evaluate the impact of B3P programme. The segmented time-series regression analysis was used to estimate the change in SRB after B3P programme. In this process, the seasonal auto regressive integrated moving average model was used to control the seasonality, autocorrelation and secular trend imbibed in the data before calculating the estimate of change in slope using regression equation. Overall, the sex ratio at birth in Haryana increased from 827 girls per 1000 boys in January 2005 to 900 girls per 1000 boys in September 2016. The estimates from segmented time-series regression analysis show that there was an insignificant change in SRB of -0.012 units before the intervention. Post slope was estimated to be 1.684, which suggested an increase in SRB of 1.696 [(confidence interval: 0.23, 3.15), P = 0.025] in terms of the difference between pre- and post-slope. This indicates a statistically significant increase of SRB by 1.696 per month attributable to B3P programme. B3P programme has resulted in an improvement of SRB in Haryana.

Heavy Metals in Indigenous Preparations Used for Sex Selection During Pregnancy in India.

Abstract: Indigenous preparations (IPs) have evoked a considerable interest in alleviating infections and chronic diseases and improving wellbeing. While such formulations have been a part of traditional practice in several countries and many have been reviewed scientifically for their claims, several of them until date remain to be investigated. A class of IPs for sex selection by Indian pregnant women exists with an aim of begetting a male offspring. In view of the leads obtained from our previous studies on detrimental effects of the newborn, for instance stillbirths and congenital malformations, we attempted to investigate the samples for heavy metal toxicity. Three samples were chosen following phytochemical analysis and reproductive toxicity of such preparations under in vivo conditions. The selected samples were examined for heavy metals—lead, cadmium, arsenic, and mercury using Microwave-assisted atomic absorption spectroscopy. The upper limit level of lead, mercury, and cadmium was found to be 18.56, 0.11, and 0.84 mg/kg respectively whereas arsenic was not detected. The levels of lead and mercury were found to be manifolds high in the IP samples that were primarily contributed by its constituents. The results of our study indicate the potential risk conferred upon, to both the mother and fetus on account of high levels of lead, mercury, and cadmium.

Clade-level Spatial Modelling of HPAI H5N1 Dynamics in the Mekong Region Reveals New Patterns and Associations with Agro-Ecological Factors

Abstract: The highly pathogenic avian influenza (HPAI) H5N1 virus has been circulating in Asia since 2003 and diversified into several genetic lineages, or clades. Although the spatial distribution of its outbreaks was extensively studied, differences in clades were never previously taken into account. We developed models to quantify associations over time and space between different HPAI H5N1 viruses from clade 1, 2.3.4 and 2.3.2 and agro-ecological factors. We found that the distribution of clades in the Mekong region from 2004 to 2013 was strongly regionalised, defining specific epidemiological zones, or epizones. Clade 1 became entrenched in the Mekong Delta and was not supplanted by newer clades, in association with a relatively higher presence of domestic ducks. In contrast, two new clades were introduced (2.3.4 and 2.3.2) in northern Viet Nam and were associated with higher chicken density and more intensive chicken production systems. We suggest that differences in poultry production systems in these different epizones may explain these associations, along with differences in introduction pressure from neighbouring countries. The different distribution patterns found at the clade level would not be otherwise apparent through analysis treating all outbreaks equally, which requires improved linking of disease outbreak records and genetic sequence data.

A systematic approach for the estimation of software risk and cost using esrcTool

Abstract: Software risk evaluation is a process for identifying, analysing, and developing mitigation strategies for risk in a software intensive system while it is in development. This paper presents a systematic approach for the estimation of software risk and cost using esrcTool. This tool is based on software risk assessment and estimation model. In this model function point approach is employed as an input variable to estimate the source of uncertainty, i.e. measurement error, model error, and assumption error. To show the validity of our tool, we have considered the project developed by our students.