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The healthcare industry worldwide is undergoing a radical transformation. An enthusiastic healthcare system of the Government of India (GOI) continually tries to tackle numerous challenges facing the system. The Rashtriya Swasthya Bima Yojana (RSBY) program has provided secondary level healthcare facilities to more than 36 million families across most states in India. This particular health insurance initiative was taken by the GOI with the purpose to safeguard the pitiable or marginalized Indian population or those households who are facing economic risks due to hospitalization and their everyday expenditures. RSBY provides affordable and accessible healthcare services along with insurance coverage for secondary care. However, it is limited to inpatient treatment or hospitalization. For outpatient coverage many strategies have been applied but low enrolment is still an existing flaw under this streamer. The present paper discusses various features of RSBY, outpatient projects undertook, and various obstacles that can be removed to integrate this insurance scheme with primary healthcare in India.

International audience ; Socio-legal scholars have suggested that, as a ubiquitous social system, law shapes social reality and provides interpretive frameworks for social relations. Across 5 studies, we tested the idea that the law shapes social reality by fostering the assumptions that people are self-interested, untrustworthy, and competitive. In Studies 1 and 2, we found that people implicitly associated legal concepts with competitiveness. Studies 3 - 5 showed that these associations had implications for social perceptions, self-interested attitudes, and competitive behavior. After being primed with constructs related to the law, participants perceived social actors as less trustworthy and the situation as more competitive (Study 3), became more against a political issue when it conflicted with their normative self-interest (Study 4), and made more competitive choices during a prisoner's dilemma game when they believed that social relations were basically zero-sum in nature (Study 5). The implications and applications of these results are discussed.

AbstractSeveral natural and anthropogenic activities, as well as rapid urbanization and industrialization, have caused freshwater bodies and their water quality to deteriorate rapidly over the past two decades. This study utilizes ArcGIS to map water quality parameters in the Baner and Gaj rivulets, tributaries of the river Beas in Himachal Pradesh, with the objective of gaining insights into their potential impact on the main river. So, the main aim of the present research was to assess the impact of anthropogenic actions on the ecology and the fitness of the rivulets basin to perpetuate freshwater diversity. A total of six sampling zones were selected; three sampling zones on Baner and three sampling zones on Gaj rivulets, in order to assess the water quality during the period of one year, from January 2022 to December 2022. During the present study, the Water Quality Index (WQI) was used to assess the status of water quality in both rivulets. Fourteen physicochemical parameters were examined using appropriate techniques and then compared to international standards. A slight upsurge was observed in some physicochemical parameters, such as pH, hardness, TDS, nitrate, and phosphate, at sampling zone 3 (S3) of the Baner rivulet. The results of WQI ranged from 45.5 at S1 to 50.2 at S3 in Gaj and 48.5 at S1 to 55.2 at S3 in Baner, which reflected a slight impact of natural and anthropogenic activities. The status of the water quality in both rivulets confirmed the abundance of aquatic species. Human activities, such as riverbed mining, also negatively impacted the water quality at some sample zones. There is, however, a need to monitor and evaluate these types of activities. However, further research and monitoring are necessary to validate the study's findings and extend its scope to other regions.

AbstractThe Ganga and Indus riverine systems are the major freshwater resources in the western Himalaya. The aim of this review was to critically analyze the status of inland fisheries in both the Ganga and Indus Riverine systems of the western Himalaya. Data from secondary sources such as research publications, scientific documents, technical advisories, and books were retrieved. The fish diversity of both riverine systems reveals that the number of endemic and native species like Tor tor, Tor putitora, Glyptothorax spp., Nemacheilus spp., and Schizothorax richardsonii is decreasing. Moreover, in most of the rivers of both riverine systems, exotic species, especially those belonging to the Cyprinidae family, for example, Cyprinus carpio, are increasing and are also dominant, followed by the families Cobitidae and Sisoridae. The Ganga and Indus riverine systems' diverse fish populations have declined because of various anthropogenic activities, especially water pollution and dam construction, which are responsible for the change in river hydrology. Frequent data were available on the Ganga riverine system, which shows a continuous decline in fish diversity. A similar trend was observed in the lower stretches of the Indus riverine system. But negligible information was available on the upper stretches of the Indus riverine system; this may be due to a large research gap. However, adequate knowledge of both river systems is necessary to develop conservation and management strategies for the sustainable development of fishery resources in India in the future.

BACKGROUND: The Government of India launched the Ayushman Bharat (AB) program in 2018 which aims to transform 150,000 existing Sub Health Centres and Primary Health Centres into Ayushman Bharat Health and Wellness Centres (HWCs). In this study, we assessed health system readiness for establishment of HWCs. METHODS: The assessment comprised of a cross sectional facility assessment and a knowledge assessment of community health officers (CHOs) and female multipurpose health workers also known as auxiliary nurse midwives (ANMs), in 26 HWCs in one community development block of Punjab state. HWCs were assessed for key input and process parameters such as a human resource, physical infrastructure, supplies, capacity building etc., and processes including health promotion, community participation, digitization of management information system, and service delivery. RESULTS: It was observed that only 7 of the 26 HWCs had all human resources as per guidelines. The median knowledge score of CHOs and ANMs was 54% and 51% respectively. 11 of the 26 HWCs were co-located with Zila Parishad SHCs. Out of the 15 standalone HWCs, while 9 had independent buildings, 5 were located in buildings of other community level institutions. 50 percent of the HWCs were not able to perform diabetes screening due to lack of glucometers or testing supplies. While services for non-communicable diseases were available, a two-way referral tracking system for patients was missing. The mean job satisfaction rated by the newly appointed CHOs was 3.12 on a scale of 1 to 5, where 5 represented very high job satisfaction. CONCLUSION: The operationalization of HWCs requires State and local level interventions for strengthening of existing physical infrastructure, ensuring a regular supply of medicines and consumables, development of referral mechanisms for patients and enhancing community participation.

The COVID-19 pandemic created an unprecedented burden on health systems, including surgical services, which have been indirectly affected by the growing number of cases due to cancellation of operations, delayed screening and a lack of adequate resources such as PPE and ventilators. In addition to logistical challenges, the pandemic also raised imminent clinical questions that required immediate answers. Global collaborations have been vital to identifying challenges by pooling data and collecting evidence to provide critical information to guide clinical and surgical care. Research partnerships have been the driving force behind global surgery research; however, since the pandemic, there has been an increased need for equitable collaboration and innovation between high-income and low-income research institutions to continue making steady progress towards providing access to safe, affordable surgical care. This article explores academic research partnerships formed during the pandemic and identifies challenges and opportunities presented to researchers and institutions. Finally, this paper recommends that further collaborations be made between HIC and LMICs to ensure policies that global surgery ensures that key stakeholders are at the centre of research. Such policies need to focus on the access to education and mentorship, micro-grants for researchers, and publication opportunities.