Journal of Health Management

Published by SAGE Publications
Print ISSN: 0972-0634
Publications
In India, 90% of street children are working children with regular family ties who live with their families, but are on the streets due to poverty and their parents' unemployment. The remaining 10% are either working children with few family ties who view the streets as their homes or abandoned and neglected children with no family ties. The National Policy for Children established in 1974 emphasizes the provision of equal opportunities for the development to all children during their growing years. Policy stresses programs to maintain, educate, and train destitute children and orphans. Policy is also to protect children against neglect, cruelty, and exploitation, but this is only on paper. An UNICEF study found that almost 40,000 children die every day in developing countries, 25% of whom are in India. Studies in some major cities indicate that the street children in India are of moderate health status, suffering from various chronic diseases and undernourishment. They are deprived of all health programs, but seem to prefer government hospitals in case of dire need. Street children often have to pay for water. Almost 97% in Calcutta, 99% in Bangalore, and 90% in Madras reported having no access to toilet and bathing facilities; 83% in Kanpur, however, had access to such facilities. Nothing has been heard in recent years of the National Children's Board established in 1975. Apparently the board has gradually waned. Various schemes were planned in 1992 by the Union Welfare Ministry in association with UNICEF. Extending extra health facilities, establishing nutrition programs, providing vocational training, protecting children from abuse, distributing dry-food polypacks, providing night shelters, providing ration cards, and creating bathing and toilet facilities would go far in improving the quality of life and the future of street children in India.
 
The production frontier and returns to scale
The production frontier and returns to scale 
Descriptive statistics of variables for grant-in-aid hospitals 
Descriptive statistics of spooled data 
This study focuses on analysing the hospital efficiency of district level government hospitals and grant-in-aid hospitals in Gujarat. The study makes an attempt to provide an overview of the general status of the health care services provided by hospitals in the state of Gujarat in terms of their technical and allocative efficiency. One of the two thrusts behind addressing the issue of efficiency was to take stock of the state of healthcare services (in terms of efficiency) provided by grant-in-aid hospitals and district hospitals in Gujarat. The motivation behind addressing the efficiency issue is to provide empirical analysis of government's policy to provide grants to not-for-profit making institutions which in turn provide hospital care in the state. The study addresses the issue whether grant-in-aid hospitals are relatively more efficient than public hospitals. This comparison between grant-in-aid hospitals and district hospitals in terms of their efficiency has been of interest to many researchers in countries other than India, and no consensus has been reached so far as to which category is more efficient. The relative efficiency of government and not-for-profit sector has been reviewed in this paper. It is expected that the findings of the study would be useful to evaluate this policy and help policy makers to develop benchmarks in providing the grants to such institutions.
 
The present study was undertaken with the intention of examining the nature of role stress and job satisfaction among doctors, and to explore the relationship between these variables. A group of 35 junior doctors working at the primary health centres and another group of 35 senior doctors attached to various district level hospital served as sample of the study. To attain the objectives of the study, two psychometric instruments – the Organizational Role Stress Scale(Pareek, 1983) and the Employees’ S-D Inventory (Pestonjee, 1981) – were administered to the sample population to obtain data pertaining to role stress and job satisfaction variables. The data were analysed in terms of the t-test and coefficients of correlation. Results of the study revealed no significant differences between the two groups except in the case of management area of job satisfaction and inter-role distance (IRD) dimension of role stress. Further, job satisfaction variables correlated negatively with all the dimensions of role stress in the case of both groups.
 
Most empirical investigations into economic vulnerability focus on the national level. Although some recent contributions investigate vulnerability from a sub-national perspective they contribute to the literature in an aspatial manner, as they do not explicitly account for the relative locations of areas and for the potential of spillovers between contiguous areas. This paper extends the current literature on a number of important fronts. First, we augment a principle components model to take explicit account of spatial autocorrelation and apply it to South African magisterial district level data. Second, by comparing spatial and aspatial models estimates, our empirical results illustrate the presence and importance of spatial spillovers in local vulnerability index estimates. Third, we augment the methodology on the vulnerability intervention index and present results which highlight areas that are performing better and worse than would be expected. After accounting for spatial spillovers, the results illustrate a clear urban-rural vulnerability divide.
 
Given the growing complexities and challenges the health sector faces, reforms in this sector are inevitable. Often health sector reforms aimed to address many of these deficiencies and ensuring effectiveness and efficiency of resource use, they focus on making the health systems responsive through strengthening financial systems, ensuring local participation and public private partnerships, and autonomy of health facilities. The reform process, among other things, intrinsically makes some fundamental assumptions some of which are as follows: high organisational commitment of health care providers, high professional commitment of health care providers, and adequate skills of health care providers. This paper examines the commitment of district level health officials in the newly carved out state of Chhattisgarh in India. Since development oriented HR practices (HRD) are powerful tools to commit people working in health sector to enhance the quality of care, we believe that health sector reforms will have to concentrate on human resource issues and practices more than ever before in near future. The papers attempts to examine the following questions: (i) what is status of professional commitment, organisational commitment and technical competencies of health officials? (ii) what are the characteristics of human resource management practices in the health sector in the state? and (iii) how these management practices are linked with professional and organisational commitment? Finally the paper discusses the implications of these to health sector reform process.
 
The United Nations Development Programme’s Millennium project argues for the importance of sexual and reproductive health in the achievement of all Millennium Development Goals. Sex education programmes, aimed principally at the youth, are thus emphasised and are in line with the specific Millennium Development Goals of reducing the incidence of HIV and improving maternal health. In this paper I analyse recent South African sex education and Life Orientation (a learning area containing sex education) manuals. Danger and disease feature as guiding metaphors for these manuals, with early reproduction and abortion being depicted as wholly deleterious and non-normative relationships leading to disease. I argue, firstly, that these renditions ignore well-designed comparative research that calls into questions the easy assumption of negative consequences accompanying ‘teenage pregnancy’ and abortion, and, secondly, that the persistence of danger and disease in sex education programmes is premised on a discourse of ‘adolescence’. ‘Adolescence’ as a concept is always already saturated with the colonialist foundation of phylogeny re-capitulating ontogeny. Individual development is interweaved with collective development with the threat of degeneration implied in both. This interweaving allows for the instrumentalist goal of sex education in which social changes are sought through changing individuals’ sexual attitudes and behaviour.
 
A national cross-sectional survey was carried out in South Africa to gain an understanding of the perceptions and priorities of the likely members of a future social health insurance (SHI). More than 1,000 employees were interviewed in a variety of employment sectors, including state and parastatal organisations, formal and informal private sectors. This article reports on respondents’ level of support for a compulsory contribution towards a hospital insurance scheme funding care at public sector hospitals in South Africa. The results showed that only 11 per cent of employees supported an SHI scheme if public hospitals remain as they are. Support increased to 53 per cent if preferential access to treatment was offered to those contributing to the scheme. Support was almost unanimous (87 per cent) if public hospitals were improved. The levels of support differed by current type of health insurance. Thus, support for a compulsory SHI tax to fund care in public hospitals was conditional upon either improving the hospitals or providing differential treatment to contributing members. If one or both of these conditions are not met, its long-term success will be compromised.
 
Traditional Birth Attendants (TBA) training has been an important component of public health policy interventions to improve maternal and child health in developing countries since the 1970s. More recently, since the 1990s, the TBA training strategy has been increasingly seen as irrelevant, ineffective or, on the whole, a failure due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Although, worldwide data show that, by choice or out of necessity, 47 percent of births in the developing world are assisted by TBAs and/or family members, funding for TBA training has been reduced and moved to providing skilled birth attendants for all births. Any shift in policy needs to be supported by appropriate evidence on TBA roles in providing maternal and infant health care service and effectiveness of the training programmes.
 
This paper briefly explores the history of quality management principles and their application to health care. Defining some of the principles that have evolved in quality management, especially in health care management, the paper discusses the analysis of and means used to improve quality using structure, process and outcome variables, with special focus on examples of the use of these in developing countries' health care systems. Finally, the paper describes some of the measurement and implementation challenges for those interested in quality management in health care.
 
This paper uses data from in-depth group interviews with family planning workers in Bangladesh to demonstrate both the dysfunctional influence of family planning targets on quality of care as well as the strong connection between targets and the manage ment system. The findings show that the presence of targets influenced the advice and information workers provided, pushing them towards long-term methods such as steril isation and the IUD rather than helping clients select methods most suited to their needs. The paper then shows the connection between the target system and the struc ture of official and unofficial incentives, the pattern of supervision, the system of accountability and a hierarchically organised and gender-biased organisational cul ture. The authors argue that unless these underlying managerial determinants of qual ity of care are addressed, the hope for reaching the goals of the International Conference on Population and Development (ICPD) will remain illusory. Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/69103/2/10.1177_097206349900100206.pdf
 
The present article discusses the nature of quality of life (QOL) in general and critically evaluates its application in the area of health and illness. As regards health related quality of life (HRQoL), it is now widely recognised that treating a disease in a purely biomedical framework, where emphasis is only on curing the disease and on providing prolonged life to the patient, is not sufficient. Now the focus is also on how to enhance the QOL of patients. In this context this article attempts to identify and critically evaluate some of the contemporary issues relevant in the area of HRQoL. The issues covered in this article include relatively simple issues related to the meaning, importance, usefulness and prevalent approaches in the area of HRQoL research and complex issues such as (i)who would be accountable for a patient's HRQoL (ii)being HRQoL stable or it changing over time (response shift) for people facing chronic diseases and (iii)whether gender differences exist in this regard. Lastly, the article also discusses the implication of HRQoL in the area of health management and intervention.
 
Over the years various plans and programmes have been initiated and implemented by the state government of Orissa. But, state’s health indicators have not improved substantially. Moreover, in recent years, health seeking behaviour of the people has been affected due to increasing cost of health care. Health care is not free of cost any more due to introduction of user fee, increasing trend of privatization and the technological innovation. As a result, out of pocket expenditure has increased enormously affecting the socio-economically disadvantaged groups the most. In consequence, they tend to depend more upon borrowing, dis-saving, selling valuable assets and curtailing expenditure on education of their children. Hence, in this paper we try to investigate broadly into three main aspects, namely, health seeking behaviour, health care burden and most importantly the source of financing of their health expenditure across socio-economic groups by using bi-variate and regression techniques (logit) to provide policy suggestions with respect to health care financing, especially focusing health insurance. Our findings show that there exists a statistical significant difference in health seeking behaviour, health expenditure and financing health care among socio-economic groups. Socio-economic groups fall behind in terms of health care utilization and experiencing higher health care burden as well as depending more on inefficient mechanism to finance their health expenditure. Hence, we advocate that state government should increase its expenditure share towards health sector substantially to achieve desired outcomes and also provide comprehensive health insurance to the targeted socio-economic backward groups.
 
The present study was aimed to assess the effect of socio-demographic, economic and dietary factors on nutritional status among children of 6–11 years of age in an urban megacity of India. It was a descriptive cross-sectional study conducted among 251 urban children living in slums, non-slums and squatters of North Kolkata. The study reveals that prevalence of underweight was much higher among children of squatters (66.7%), whereas a significant proportion of children belonged to non-slums were found overweight (23.7%). Although the prevalence of both underweight and overweight was more among girls (16.8% and 34.5%), stunting was found marginally higher among boys (18.9%) than girls (17.7%). The risk of being malnourished increases significantly with increasing number of own siblings, low educational status of mother, improper food intake, etc. Multi-pronged strategies are required to implement comprehensive nutrition–education programme for improving dietary habits among children.
 
Background The COVID-19 pandemic has profoundly impacted the country’s health systems and diminished its capability to provide safe and effective healthcare. This article attempts to review patient safety issues during COVID-19 pandemic in India, and derive lessons from national and international experiences to inform policy actions for building a ‘resilient health system’. Methods Systematic review of existing published articles, government and media reports was undertaken. Online databases were searched using key terms related to patient safety during COVID-19 and health systems resilience. Seventy-three papers were included dependent on their relevance to research objectives. Findings Patient safety was impacted during COVID-19, owing to sub-optimal infection prevention and control measures coupled with reduced access to essential health services. This was largely due to inadequate infrastructure, human and material resources resulting from chronic underinvestment in public health systems, paucity of reliable data for evidence-based actions and limited leadership and regulatory capacity. Conclusions India’s health systems were found ill prepared to tackle large-scale pandemic, which has major implications for patient safety. The shortcomings observed in the COVID-19 response must be rectified and comprehensive health sector reforms should be initiated for building agile and resilient health systems that can withstand future pandemics.
 
Discussion of ethics in the public health arena has primarily focused on the practices of public health doctors and professionals. The community could not get the required attention in terms of their role in compliance with the communication in the form of public health advisory in times of public health crisis. Even though public health is the societal approach to protecting and promoting health, ethics in public health have prioritised behaviours of and moral dilemmas faced by public health professionals only. Leaving out the community’s responsibility makes the entire gamut of public health efforts incomplete and deficient. Amid the COVID-19 pandemic, non-compliance to the public health advisory raised an important aspect of expectation of ethical behaviour by the community and what could facilitate and hinder compliance of ethical behaviour ensuring the safety of self and others. Public health ought to consider the community as not only an important but also responsible stakeholder in its pursuit of promotion of health and prevention of disease.
 
The novel coronavirus disease (COVID-19) pandemic has created a crisis with a severe effect on the masses, particularly the young students across the world. Framed by the transactional theory of stress and coping, this study investigates the factors influencing psychological well-being (PWB) of the students in higher education during the peri-traumatic phase of COVID-19. A cross-sectional survey using a questionnaire was employed. The study aimed at prediction and theory building and was carried out in India. Data were collected online from 173 higher education students. Partial least squares structural equation modelling (PLS-SEM) was used to test the hypothesised relationships among the constructs. Results indicated resilience significantly predicts PWB both directly and indirectly. Further, the study revealed perceived distress and PWB are not on the same continuum. This study has a contribution to theory and health promotion. Furthermore, the findings have several practical implications for counselling psychologists, academicians, and mental health workers associated with the higher education sector. These findings will put them in a better position to design interventions to enhance resilience in students in the backdrop of the relevance of both positive and negative mental health during the outbreak of diseases. Based on the findings, future directions were discussed.
 
Public health discourse about COVID-19 pandemic has mostly been framed around biomedical interventions, although there is evidence of the effective use of traditional medicine (TM) to manage the pandemic by some Asian countries such as China, Thailand, Vietnam and India. This article aims to place on record the policy of medical pluralism in the two South Indian states of Tamil Nadu and Kerala in their respective deployment of Siddha and Ayurveda in the management of COVID-19. Based on interviews with physicians of TM and health administrators, press reports, social media posts and published research, this article reconstructs the crucial yet undocumented process of incorporating TM in the biomedicine-based health bureaucracy in Tamil Nadu and Kerala to deal with infectious fevers such as dengue and chikungunya in the past and COVID-19 in the present. It is our argument that those methods of TM which are safe and in long recent use could provide low-cost and accessible means of prevention and early treatment of infectious fevers. They have to be identified and subjected to further investigation as innovations in social medicine brought forth by the state and its officials and are different from the highly expensive projects of the corporate pharmaceutical sector.
 
Lockdown Vices: Indians Turn to TV and TikTok Source: https://www.statista.com/chart/21428/expected-change-in-media-consumption-india-covid-19/
Why Social Distancing Is So Important? Source: https://www.statista.com/chart/21146/why-social-distancing-measures-are-so-important/
Social distancing refers to a host of public health measures aimed at reducing social interaction between people based on touch or physical proximity. It is a non-pharmaceutical intervention to slow the spread of infectious diseases in the communities. It becomes particularly important as a community mitigation strategy before vaccines or drugs become widely available. This essay describes how a protracted adherence to social distancing guidelines could affect the Indian society. Changes are expected in some of the prevalent cultural norms such as personal space and common good. Gender relations within the family are likely to change in favour of greater sharing of domestic responsibilities between men and women. Older adults may particularly experience stress due to social distancing because of their physical dependency and emotional vulnerability. Working patterns are likely to become more flexible and promotive of social distancing. Human interaction based on digital technology is likely to increase. The implications for public health in India due to such changes are also discussed.
 
Daily Cumulative Cases of COVID-19 Recorded for Every 15 Days-Countries with Total Cumulative Cases ≤50,000 as on 21 April 2020 Source: https://www.worldometers.info/coronavirus/ The total cases per million showed a weak correlation with population density (r = 0.14, p = 0.58, N = 17) and a moderate correlation with urban population (r = 0.44, p = 0.07, N = 17) (Table 2). Tests per million (r = 0.67, p = 0.003, N = 17) and elderly population (r = 0.70, p = 0.002, N = 17) showed a strong correlation with total cumulative cases per million (Figure 5). This association was found to be more prominent in countries with community transmission. The case fatality rate showed a weak correlation with test per million (r = 0.02, p = 0.934, N = 17). It was observed that population density (r = 0.38, p = 0.12, N = 17), urban population (r = 0.49, p = 0.04, N = 17) and elderly population (r = 0.45, p = 0.06, N = 17) showed a moderate correlation with case fatality rate (Figure 6).
Total COVID-19 Cases Per Million and Their Association with Population Density, Urban Population, Elderly Population and Tests Per Million Source: The authors.
Case Fatality Rate of COVID-19 and Their Association with Population Density, Urban Population, Elderly Population and Tests Per Million Source: The authors.
Total Cases (Per 1,000,000 Population), Case Fatality Rate Per 100 Cases and Their Association with Population Density, Urban Population, Tests Per Million and Elderly Population (>65 Years) by Country as on 21 April 2020
As the COVID-19 pandemic marches exponentially, epidemiological data is of high importance to analyse the current situation and guide intervention strategies. This study analyses the epidemiological data of COVID-19 from 17 countries, representing 85 per cent of the total cases within first 90 days of lockdown in Wuhan, China. It follows a population-level observational study design and includes countries with 20,000 cases (or higher) as of 21 April 2020. We sourced the data for these 17 countries from worldometers. info, a digital platform being used by several media and reputed academic institutions worldwide. We calculated the prevalence, incidence, case fatality rate and trends in the epidemiology of COVID-19, and its correlation with population density, urbanisation and elderly population. The analysis represents 85 per cent ( N = 2,183,661) of all cases within the first 90 days of the pandemic. Across the analysed period, the burden of the pandemic primarily focused on high- and middle-income countries of Asia, Europe and North America. While the total number of cases and deaths are highest in USA, the prevalence, incidence and case fatality rates are higher in the European countries. The prevalence and incidence vary widely among countries included in the analysis, and the number of cases per million and the case fatality rate are correlated with the proportion of the elderly population and to a lesser extent with the proportion of the urban population.
 
Introduction: The coronavirus disease (COVID-19) pandemic has impacted everyone, including students. Accurate information about the disease, its spread, preventive measures and government-issued advisories is critical for containing an outbreak. We evaluated the knowledge, attitudes and practices, and the key behavioural determinants of clinical outcomes, among university students. Materials and methods: We conducted a cross-sectional study among IIHMR University students (31 March to 10 April 2020), soon after the nationwide lockdown in India. Through purposive sampling, we enrolled 529 students, who completed a semi-structured questionnaire (44% completion rate). Knowledge level of the participants was assessed using a scoring system, and chi-squared test and t-test were performed to detect significant ( p < 0.05) differences among various groups. Results: More than 70 per cent of students had good knowledge of COVID-19 symptoms, mode of transmission and preventive measures, and 66 per cent knew about treatment approaches. Social media (83%) and TV (77%) were their primary sources of information. Most students showed a willingness to follow social distancing and lockdown guidelines; however, only 27 per cent perceived the risk of infection. Nearly all students reported compliance with government health advisories. Conclusions: We evaluated COVID-19 awareness and impacts of various information sources on effective outbreak containment. Improved community engagement activities and effective communication are needed during widespread disease outbreaks.
 
Showing Economic Elastic Behaviour During Previous Epidemics Source: KPMG (2020b).
Changes in Consumer Shopping Journey Before, During and After the Pandemic Source: Deloitte (2020).
Concern of Indian Population Related to COVID-19 Source: McKinsey (2020).
A critical situation pushes human behaviour towards different directions with some aspects of behaviour being irrevocable. COVID-19 pandemic is not a normal crisis, and to control the spread of disease various measures were taken including complete and then partial lockdown. Since all elements of the economy are intricately interrelated with public health measures and lockdown, this resulted in economic instabilities of the nations hinting towards change in market dynamics. In every market, consumers are the drivers of the market competitiveness, growth and economic integration. With economic instability, consumers are also experiencing a transformation in behaviour, though how much of transformation experienced during the crisis will sustain is a question. This article looks at the consumer behaviour during COVID-19 crisis and in the subsequent lockdown period when the world stood still for more than a quarter of a year. Further, the article attempts to weave through the maze of literature available about consumer behaviour in normal times and in crisis times, strengthens it with the rapid assessment reports culled out by the different consulting organisations during lockdown phase, substantiates the same with first-hand telling and retelling of experiences by consumers and professionals with marketing background to bring up a hypothesis of the pandemic affecting a paradigm shift from consumer materialism to consumer spiritualism. The proposition offers further testable hypotheses for future research to understand consumer sentiments or requirement in buying ‘what is enough’ within the marketing context and how it can be reinforced post-COVID crisis for ensuring sustainability of business models. It would also be interesting to explore the correlates of this forced consumer behaviour with other variables such as learning from crisis, changing needs, personality, nationality, culture, new market segment and age to develop new models of consumer behaviour.
 
The World Health Organization declared the Coronavirus Disease 2019 (COVID-19) pandemic a public health emergency of international concern on 30 January, which caused difficulties among the healthcare professionals (HCPs). Since this pandemic led to strict use of rules and regulations in maintaining physical distancing, a turn was experienced in communication. This study is aimed at assessing communication skills between HCPs and patients before, during and to compare communication skills between them before and during the COVID-19 pandemic. A descriptive cross-sectional study was conducted at Pravara Rural Hospital, Loni, Maharashtra. Samples were included based upon the inclusion and exclusion criteria. Results were obtained with the help of statistical analysis. The present study shows that certain components of communication are changed when comparing before and during the COVID-19 pandemic. To curb the fear of HCP, certain measures can be implemented to reduce anxiety such as informative videos, images, brochures and many more.
 
The COVID-19 pandemic caused by a novel virus SARS-CoV-2 has swept the world, leaving behind a trail of free-falling economy, misery and death. The most vulnerable are the hardest hit—the elderly, those with chronic noncommunicable diseases and the poor and marginalised in society. The experience of various countries in handling the pandemic has shown that robustness of health system with surge capacity is critical to take the pandemic head-on. In the process important lessons for health systems have emerged. Countries with political leaders who led with a principled approach, while adopting an early and comprehensive strategy to contain the virus, have done better. Vulnerable populations should not be left to be further marginalised. To deal with the ‘infodemic’, communities should be engaged early. For successful handling of future challenges investment in public health is a must. National readiness and response capacity for epidemic control and disease surveillance need to be strengthened, leveraging modern technology. Institutional capacity building, pooling resources and harnessing innovations through partnerships would be key for mounting effective response now and in the future.
 
This study investigates the relations between COVID-19-related stay-at-home-tendencies and various health insurance coverages of people across US states. To this aim, the K-means clustering and panel regression analysis with cross-sectional dependence are applied. The main empirical finding reveals that various health insurance coverages have different level impacts on COVID-19-related stay-at-home-tendencies. People who are uninsured tend to stay at home the most as compared with people with private, Medicaid, Medicare and military health insurance coverages. As a result, it may be interpreted that uninsured people have serious concerns about affording healthcare costs associated with COVID-19 and, thereby, stay at home. However, people with private health insurance coverages tend to stay at home the least. This may also lead to the interpretation that people with private health insurance coverages feel safer and better protected against the rising risks of this pandemic outside their homes.
 
Financial Risk Management Source: A Structured Approach towards a Best in Class Financial Risk Management Framework | Zanders Treasury & Finance Solutions.
COVID-19, 2020 Source: Provided by the author.
Before the imposition of the strict lockdowns and the spread of COVID-19, the disruptions in China caused a ripple effect on the global supply chains. Emphasis has been laid on minimisation of costs and timely delivery of essential products. In India, as the situation worsens due to the outbreak, we have seen disruptions in the logistics supply chain. There are several reasons attributed to the increase in demand and slowing of the supply. There are several workable solutions available to look into this situation. We should work towards promoting Indian markets and amend policies to help the local workforce lessen the interdependencies of imports on other countries. This will help in strengthening the logistics supply chain in India. This will create employment opportunities and increase the GDP growth.
 
Perent distrition of migrant workers by of migration
Migrant Workers (other than cultivators and agricultural labourers) in India by Occupation (percentage)
Subsector-wise Industrial Employment Trends in India
Types of Employment in Non-farm Sectors in India (in million)
This article discussed some of the important issues regarding the effect of epidemics like COVID-19 on the migrant population. These impacts are most troubling for low-income households, which are less well positioned to cope with earnings losses during a recession, have no alternative earnings and have no social security available. Most of these workers earn little more than a subsistence wage and have no other means to protect their incomes if they lose their jobs. Migrant workers constitute quite a large proportion of such vulnerable population. Millions of migrant workers are anticipated to be left unemployed in India due to the lockdown and subsequent fear of recession. Many of the migrant workers have returned to their villages, and many more are just waiting for the lockdown to be lifted. The risk is particularly higher for those who are working in unorganised sectors, and those who do not have writer contracts, or those whose contracts are at the verge of completion. The lockdown and the subsequent recession are likely to first hit contract workers across many of the industries. On the one hand, lockdowns and social distancing measures are drying up jobs and incomes, whereas they are likely to disrupt agricultural production, transportation systems, and supply chains on the other. This poses a challenge of ensuring food security and controlling already rampant malnutrition, particularly among children, which is likely to result in increased infant and child mortality. There is a need to relook at the national migration policies, which should accommodate the assistance and protection of migrants arriving from, or faced with the prospect of returning to, areas affected by health crises. Also, there is a need to establish resilient food systems that could reduce food insecurity and the pressure to return to origin among migrants.
 
Organisation Affiliation. Source: The authors.
Source of Information. Source: The authors.
World is suffering from a pandemic situation due to coronavirus disease (COVID-19) since December 2019. In this emergency, everyone at individual/country/global level is trying to contribute at their best with their available knowledge and resources. However, more and more research and developmental activities are going on but, the reality is far away for a grass-root level health professional. They rely on the indirect sources, that is, published or unpublished literature, social media, internet etc. Many a time, these sources may share an unrealistic or false positive/negative information. Our study was intended to assess the knowledge, attitude and practices related to COVID-19 among the healthcare professionals of different levels. We conducted an online survey after the initiation of the first lockdown in India. Our research team in consultation with the subject experts designed a mix method-based study tool and shared it by sending emails to 1,200 participants. A total of 180 respondents participated in the online survey of which 34% were government health professionals and 24% were working with a research/academic institution. All participants were between 23 and 74 years age group (mean 39 years). Participants shared their views on first, knowledge about symptoms, preventive measures and treatment options for COVID-19. Second, on attitude towards handling COVID-19 pandemic using social distancing, following lockdown and travel advisory, etc. Third, on the practice of non-pharmaceutical measures to prevent COVID-19. We found that the social media platform acted as one of the most important platforms for awareness generation regarding COVID-19 but it was also generating stigma among people. Till the time of the survey, there is still a dearth of knowledge about social distancing and what it means, especially physical distance of 1–3 metres and correct usage of mask in different situations. Various important issues pertaining to infant feeding practices, mother and childcare and disposal of dead bodies of COVID infected persons require deliberations and awareness.
 
Prediction Model and Actual Reported Cases in Rajasthan (Model 1) Source: The authors.
Fitting of Data from Hubei, China (Model 5) Source: The authors.
Prediction Model with Different Social Distancing Scenarios (Model 2) Source: The authors.
Prediction Model Showing Total Number of Cases, Peak and Duration of Pandemic Curve (Model 3) Source: The authors.
Prediction Model for Differential Transfer Rates of People Between Social Distancing Groups SD 1 and SD 2 (Model 4) Source: The authors.
Background: Mathematical modelling of epidemics and pandemics serves as an input to policymakers and health planners for preparedness and planning for the containment of infectious diseases and their progression in the population. The susceptible–exposed–infectious/asymptomatic–recovered social distancing (SEIAR-SD) model, an extended application of the original Kermack–McKendrick and Fred Brauer models, was developed to predict the incidence of the COVID-19 pandemic and its progression and duration in the state of Rajasthan, India. Objective: The study aimed at developing a mathematical model, the SEIAR-SD model, of the COVID-19 pandemic in the state of Rajasthan, for predicting the number of cases, progression of the pandemic and its duration. Materials and methods: The SEIAR-SD model was applied for different values of population proportion, symptomatic and asymptomatic cases and social distancing parameters to evaluate the effect of variations in the number of infected persons, size of the pandemic and its duration, with value of other parameters fixed in the model. Actual reported cases were plotted and juxtaposed on the prediction models for comparison. Results: Social distancing was the crucial determinant of the magnitude of COVID-19 cases, the progression of the pandemic and its duration. In the absence of any proven treatment or vaccine, effective social distancing would reduce the number of infections and shorten the peak and duration of the pandemic. Loosening social distancing will increase the number of cases and lead to a heightened peak and prolonged duration of the pandemic. Conclusions: In the absence of an effective treatment or a vaccine against COVID-19, social distancing (lockdown) and public health interventions—case detection with testing and isolation, contact tracing and quarantining—will be crucial for the prevention of the spread of the pandemic and for saving lives.
 
The coronavirus disease is a respiratory tract disorder which causes pneumonia-like symptoms in severe patients and mild flu-like symptoms in mild symptomatic cases first noticed in Wuhan, China. DNA sequencing and further analysis shows it to be 79% like the 2002 SARS-CoV and 50% like the 2012 MERS-CoV. It was also observed that the novel coronavirus’s spike protein was larger and very different from its previously known strains. For diagnosis, multiple strategies were developed and real time reverse-transcriptase-polymerase chain reaction (RT-PCR) technique was determined to be the best technique. The CT scan was also found effective majorly for the continuous assessment of the disease. Treatment strategies used in previous outbreaks were looked into and put to trial like convalescent plasma therapy. Vaccine development using various genetic engineering strategies are going on across the world. To contain the spread of the disease, countries with positive cases were put under lockdown to break the chain of spread. These lockdowns forced industries, offices, schools, religious places, stadiums, travel, and many more to close which impacted the economies of all the major countries. Lesser human interaction and more use of social media has impacted the social aspects of human life. Cases of domestic violence and mental stress increased among households. Economic stimulus package was announced by various countries to curb the socio-economic impact of the COVID-19 pandemic.
 
The novel coronavirus disease (COVID-19) is spreading very rapidly across the globe because of its highly contagious nature and is declared as a pandemic by the World Health Organization (WHO). Scientists are endeavouring to ascertain the drugs for its efficacious treatment. Because, until now, no full-proof drug is available to cure this deadly disease. Therefore, identifying COVID-19 positive people and quarantining them can be an effective solution to control its spread. Many machine learning and deep learning techniques are being used quite effectively to classify positive and negative cases. In this work, a deep transfer learning-based model is proposed to classify the COVID-19 cases using chest X-rays or CT scan images of infected persons. The proposed model is based on the ensembling of DenseNet121 and SqueezeNet1.0, which is named as DeQueezeNet. The model can extract the importance of various influential features from the X-ray images, which are effectively used to classify the COVID-19 cases. The performance study of the proposed model depicts its effectiveness in terms of accuracy and precision. A comparative study has also been done with the recently published works, and it is observed that the performance of the proposed model is significantly better.
 
Cluster Analysis Using Multidimensional Scaling (MDS) and Pile Sorting as Described by Yeh et al. (2014).
Cluster Analysis Using Multidimensional Scaling (MDS) Highlighting Quantitative Associations of Items as Described by Yeh et al. (2014).
Socio Demographic Characteristics of Participants.
The Details of Coding Frame.
Healthcare establishments are unique and complex. The Indian healthcare system comprises of public and private healthcare establishments. Different challenges are encountered by the healthcare professionals in their daily operations. The sudden emergence of COVID-19 posed a new threat to the already burdened healthcare system. The pandemic changed the healthcare paradox with newer workplace and societal challenges faced by the healthcare personnel. The purpose of this study is to identify the antecedents of workplace and societal challenges faced by the healthcare personnel. Our study conducted in Kolkata and other adjoining areas of West Bengal included respondents who volunteered for individual in-depth interviews. The sample size was kept at n = 20 after due technical considerations. Freelisting and pile sorting was done to generate clusters. The qualitative study identified five constructs with 18 items under workplace challenges and three constructs with five items under societal/community challenges. Workplace challenges included resource availability, adequacy and allocation, financial issues, perceived managerial ineffectiveness, inconsistent guidelines and perceived occupational stress, while societal/community challenges included dread disease, social adaptiveness and challenges related to essential services. A salience threshold was established and the multidimensional scaling provided four major clusters: financial support and sustainability, adaptive resilience, infection risk mitigation and healthcare facility preparedness. Suggestive actions for the identified challenges were summed as enhanced production of diagnostic kits through public–private partnership models and industrial production reforms. Enhanced testing facility for COVID-19 will help to identify new cases. Financial stresses need long-term sustainable alternative that will avoid pay cuts and unemployment. Treatment regimen, diagnostic protocols, waste disposal guidelines should be worked upon and leading national agencies be consulted for technical support, research and development.
 
This article examined the impact of the COVID-19 pandemic on the health financing system in Ghana. The COVID-19 pandemic presents two different crises—a health crisis and an economic crisis, and these have implications for the health financing system in Ghana. The pandemic is likely to have adverse effects on the various sources of healthcare financing, including government support, donor support, national health insurance scheme (NHIS) and out-of-pocket payments, which will impact the general delivery of healthcare in the country. Government support to the health sector in general is likely to be rechannelled into fighting the pandemic considering the declining tax and other non-tax revenues as well as huge expenditure commitment. Donor support is also likely to be scaled down and existing funds redirected into dealing with the COVID-19 pandemic. The NHIS will be affected, as many subscribers are not likely to renew their health insurance policies because of the fear of contracting the coronavirus when they visit health facilities. Also, the non-attendance at health facilities by health consumers will impact out-of-pocket payments and the hospitals’ ability to generate sufficient internal resources for their operations. A number of useful recommendations are proffered with the aim of improving health financing system in Ghana during and post-COVID-19 pandemic.
 
The study captures hospital service quality expectations during the COVID-19 crisis and compares the same before the onset of COVID-19. The study also highlights which dimensions of service quality attenuate during a medical crisis. The authors used a service quality measurement instrument based on SERVQUAL to capture service quality expectation from patients between June 2019 and May 2020. A sample of 700 was obtained (pre COVID-19 sample size 350 and during COVID-19 sample size 350). The data was analysed using partial least squares, structural equation modelling (PLS-SEM) and ANOVA. Service quality and its dimensions of assurance, empathy, reliability, responsiveness and tangibility remain relevant during COVID-19 pandemic, however, there is a drop in service quality expectation in India in all the five dimensions of service quality. Service quality expectations in tangibility dropped by 11.59%, reliability dropped by 8.82%, responsiveness dropped by 11.56%, assurance dropped by 9.82% and empathy dropped by 12.29%. From a practical standpoint, the study also identifies service quality dimensions that hospitals need to focus on during a crisis. In India, hospitals handling COVID-19 patients need to pay special heed to reliability and responsiveness to improve their service quality and better manage care during the pandemic situation.
 
Distribution Novel Coronavirus Disease a Pandemic in India Source: https://www.covid19india.org/deepdive
The first-ever global outbreak of COVID-19 has been intensely impacting humanity and continues to affect all segments of the population since its origin While dealing with such public health emergencies, the past experiences have testified generalised public fear and anxieties due to uncertainty, fatality, and lack of public health preparedness. The aim of the article is to explore the impact of this unprecedented environment on mental health of individuals and communities in its current magnitude. It will discuss at length some emerging concepts of the causal pathways of mental distress/disorders and suggest strategies to prevent and promote mental health in individuals during this crisis. For the general population at large, the mental health effects of COVID-19 are as important to address as are the physical health effects.
 
COVID-19 pandemic, the associated economic lockdown and the norms of social distancing have disrupted the business world. Most managers have struggled to make sense of the chaos and complexity around. Health insurance industry mangers are at the forefront of this challenge as new products and services covering COVID-19 had to be launched fast. This was both a market as well as the societal requirement. In the COVID-19 world, in different countries like United States of America (USA), United Kingdom (UK), Germany and India, attempts are being made to develop mobile applications for tracking COVID-19 patients. Emerging technologies have been altering the business landscape in most industries. The health insurance industry has also been witnessing the effects of technologies such as wearables technology, big data analytics, cloud technologies, blockchain, machine learning and such others. The advent of these technologies is fundamentally changing the health insurance industry. Given the realities of the COVID-19 world, the health insurance industry is poised at a crossroad of evolution where the industry would become data-intensive and data-driven. Health insurance firms have to enter into interfirm collaboration with wearable technology firms in the conversation on tracking social distancing from COVID-19 positive and potential cases. Health insurance firms might develop a service mechanism which could while maintaining the anonymity of COVID-19 positive or potential cases, ensure that customers who are using the wearable technology products and following social distancing norms are provided favourable premium for COVID-19 related health insurance products in case they were infected. This would be a novel addition to COVID-19 related products of health insurance firms. Deliberating on these aspects in this article, the authors propose a fundamental shift in the strategic orientation of health insurance firms.
 
A Generic Worksheet for Training Topics.
When one talks about a healthcare organisation, in most instances it is an automatic assumption that we are talking about clinical personnel. This article addresses the critical role that non-clinical personnel played during the COVID-19 pandemic. In particular, the authors delineated the critical roles of the marketing department personnel in healthcare organisations. In light of the pandemic, in the future, there will be a greater need for unique training topics that were not even imagined in the years prior to 2020, and using the concepts of marketing, the authors have provided a list of the potential generic topics as well as how to assess its reach, effectiveness and value.
 
Presentation Characteristics of Videos and Messages
Communication for all hazards including widespread public health emergencies is a massive task. The crucial element is to reach and cover maximum people in a timely manner. This article is based on a systematic content analysis of videos on coronavirus disease (COVID-19) on National Television by Indian Public Service Broadcaster and Ministry of Health and Family Welfare. A total of 36 videos were telecasted on National Television channel Doordarshan from 3 March to 21 April 2020 in between programme breaks. The article analyses the presentation characteristics of these videos with respect to timing, duration, language, characters, format and key message content of communication videos on COVID-19. The article deliberates about the manner in which the chronology of the communication messages synced with the external events of the trajectory of the pandemic and thereby information-need of the community in India. All the messages which evolved in these videos (real and animated) were built on each other and depicted an information hierarchy (e.g., washing hands to social distancing) which could be viewed as an empowering tool for the community. The videos were analysed based on the nine constructs of conceptual model of emergency risk communication given by Seeger et al. (2018) . The key preventive messages in these videos focused on generating awareness, which was the fundamental necessity in view of the new type of pandemic like COVID-19. The summated scores show that 36 videos were appropriate up to 79 per cent times for the nine constructs, indicating the effectiveness of the messages in communicating the intended message as per the assessed construct. Limitations of the messages were primarily related to the inability to design communication messages with respect to specific understanding, needs and culture of the community.
 
Antivirus Test to Virus Besides the SARS-CoV2.
Antivirus Tests to the SARS CoV2 Virus.
Ongoing Antivirus Test to SARS CoV2 Virus (WHO's list of studies for the treatment of COVID-19, 2020).
Comparison of Guidance of Antiviral Treatment for Confirmed COVID-19 Patients (As of March 2020).
On 31 January 2020, World announced COVID-19 as an Emergency Public Health of International Concern. The number of patients in Indonesia continues to grow. Anti-viral in the COVID-19 Drug Information Laboratory in Indonesia are Lopinavir/Ritonavir, Favipiravir, Remdemsivir, Oseltamivir, Chloroquine Phosphate and Hydroxychloroquine Phosphate. Therefore, it is necessary to know the basis and management of its use. An online systematic search was performed on articles published until 30 March 2020. We use search keywords that are tailored to the purpose of writing. All six antivirals were used for the treatment of RNA virus. Chloroquine, Hydroxychloroquine and Remdesivir effectively control the SARS-CoV2 virus invitro. Lopinavir/Ritonavir, Hydroxychloroquine and Oseltamivir have been used clinically for the treatment of SARS-CoV2 virus. In 2020, there are 42 clinical trials of six antivirals. Guidance of the antivirus are from China, Belgium and Indonesia. Its differences are based on the patient’s condition. There is a lack of evidence of six antiviral effectiveness against the SARS-CoV2 virus. It has been used for other RNA viruses. It is supported by a safety profile. In a pandemic situation and the absence of a specific antivirus, the use of the six antiviruses can be done and be useful.
 
The COVID-19 pandemic is a global health and economic crisis of a scale never witnessed before. Beginning in China, it has within a few months devastated many countries around the globe, requiring an unprecedented mobilisation of health systems. While the disease caused by this novel virus is generally mild and self-limiting, the risk of severe disease is disproportionately high among elderly and those with underlying medical conditions. In the absence of a vaccine or treatment, the public health strategies include: (a) preventing transmission through early detection and isolation, tracing contacts and quarantining them and implementation of measures such as social distancing and hand hygiene and (b) reducing mortality by augmenting clinical management and shielding the most vulnerable populations in the society. The pandemic is yet another reminder that we need to invest in public health, ramp up national capacities to detect a disease early and respond rapidly to emerging infections, strengthen and respect our national institutions and rely on evidence base for policymaking. It is high time that we paid heed to these lessons and strengthened without any further delay our health system capacity, as epidemics and pandemics of this nature will continue to challenge public health well into the future.
 
The current focus on the transmission of COVID-19 infection all over the world may probably distract public attention from psychosocial consequences of the outbreak in the affected individuals and in the general population. However, there is limited empirical information about its psychological impact on the people of diverse regions and nationalities. Hence, the study aims to understand the psychological impacts of COVID-19 and associated pandemic distress on the demographically diverse Indian population and the ways people are adopting to cope with them. A total of 261 respondents aged 18−73 years, representing more than 17 states of India, filled an electronic survey questionnaire. Survey research methodology following the mixed-method approach adopting both qualitative and quantitative methodologies was adopted. Results of the first phase of the study indicated significant psychological impacts of the COVID-19 pandemic on respondents during the first three weeks of lockdown, especially the pandemic anxiety and social isolation. Physical health, fitness, self-care, family connect, learning of the new skill sets and self-growth opportunity were found to be some of the functional ways to cope with pandemic in this phase, whereas passive acceptance was expressed as a dysfunctional strategy to cope with pandemic coupled with negative emotions such as fear, anxiety, frustration and irritability for others. However, phase two of the study with 20% of respondents in the sixth week of lockdown revealed the exhaustion of the learning phase, limited efforts for self-growth and increasing anxiety and frustration. A great proportion of respondents expressed fear of losing global business scenario and its direct or indirect impact on them. A need for consistent and dedicated mental health care was recommended.
 
Top-cited authors
Anoop Khanna
  • Indian Institute of Health Managment Research
Neetu Purohit
  • Indian Institute of Health Managment Research
Prahlad R Sodani
  • IIHMR University
Ramesh Bhat
  • Narsee Monjee Institute of Management Studies
Namita Srivastava