Districts Of Jharkhand Research Articles

Blended Tele-mentoring Support for Strengthening Antenatal Care by Private Health care Facilities: FOGSI VISTRIT INITIATIVE.

The objective of the present initiative was to build capacity of health care providers in private sector along with standardisation of care during antenatal period for common antenatal problems of GDM and iron deficiency anaemia in private sector. A pilot project for all levels of health care providers including doctors, nurses, counsellors and laboratory technicians of 34 private facilities in six districts of Jharkhand was planned. Training modules for GDM and anaemia based on government of India guidelines were developed. End line evaluation included data collection and descriptive analysis of quantitative data quality scores from assessment standards on GDM and anaemia in pregnancy. Knowledge assessment of health care providers and doctors through baseline and end line knowledge assessment survey questionnaire showed that 100% health care providers who were trained scored 85% or more in knowledge assessment questionnaires as seen by baseline and end line questionnaire results. All project hospitals (n = 34) in Jharkhand achieved quality standards of care in intervention period for gestational diabetes mellitus and anaemia in pregnancy. They achieved total score more than 80% and exceeded target of 80% of the quality standards. A systematic strengthening of private health care facilities through a blended tele-mentoring and onsite support is possible. The online version contains supplementary material available at 10.1007/s13224-023-01866-5.

Modelling spatiotemporal patterns of visceral leishmaniasis incidence in two endemic states in India using environment, bioclimatic and demographic data, 2013-2022.

As of 2021, the National Kala-azar Elimination Programme (NKAEP) in India has achieved visceral leishmaniasis (VL) elimination (<1 case / 10,000 population/year per block) in 625 of the 633 endemic blocks (subdistricts) in four states. The programme needs to sustain this achievement and target interventions in the remaining blocks to achieve the WHO 2030 target of VL elimination as a public health problem. An effective tool to analyse programme data and predict/ forecast the spatial and temporal trends of VL incidence, elimination threshold, and risk of resurgence will be of use to the programme management at this juncture. We employed spatiotemporal models incorporating environment, climatic and demographic factors as covariates to describe monthly VL cases for 8-years (2013-2020) in 491 and 27 endemic and non-endemic blocks of Bihar and Jharkhand states. We fitted 37 models of spatial, temporal, and spatiotemporal interaction random effects with covariates to monthly VL cases for 6-years (2013-2018, training data) using Bayesian inference via Integrated Nested Laplace Approximation (INLA) approach. The best-fitting model was selected based on deviance information criterion (DIC) and Watanabe-Akaike Information Criterion (WAIC) and was validated with monthly cases for 2019-2020 (test data). The model could describe observed spatial and temporal patterns of VL incidence in the two states having widely differing incidence trajectories, with >93% and 99% coverage probability (proportion of observations falling inside 95% Bayesian credible interval for the predicted number of VL cases per month) during the training and testing periods. PIT (probability integral transform) histograms confirmed consistency between prediction and observation for the test period. Forecasting for 2021-2023 showed that the annual VL incidence is likely to exceed elimination threshold in 16-18 blocks in 4 districts of Jharkhand and 33-38 blocks in 10 districts of Bihar. The risk of VL in non-endemic neighbouring blocks of both Bihar and Jharkhand are less than 0.5 during the training and test periods, and for 2021-2023, the probability that the risk greater than 1 is negligible (P<0.1). Fitted model showed that VL occurrence was positively associated with mean temperature, minimum temperature, enhanced vegetation index, precipitation, and isothermality, and negatively with maximum temperature, land surface temperature, soil moisture and population density. The spatiotemporal model incorporating environmental, bioclimatic, and demographic factors demonstrated that the KAMIS database of the national programmme can be used for block level predictions of long-term spatial and temporal trends in VL incidence and risk of outbreak / resurgence in endemic and non-endemic settings. The database integrated with the modelling framework and a dashboard facility can facilitate such analysis and predictions. This could aid the programme to monitor progress of VL elimination at least one-year ahead, assess risk of resurgence or outbreak in post-elimination settings, and implement timely and targeted interventions or preventive measures so that the NKAEP meet the target of achieving elimination by 2030.

Empowering Women Agripreneurs through Government Livelihood Initiatives: A Case Study of Jharkhand, India

The study evaluates the impacts of targeted interventions implemented by the Central and state government in Jharkhand, India. Being a part of Ph.D. thesis, 260 beneficiaries from 13 blocks in three districts of Jharkhand were selected, and data was conducted during the year 2023-24. Conclusions were derived using descriptive and inferential statistics. The research revealed that all respondents were beneficiaries of the National Rural Livelihood Mission (NRLM), followed by Jharkhand Opportunities for Harnessing Rural Growth (JOHAR) (92.7%) and Jharkhand Horticulture Intensification by Micro Drip Irrigation (JHIMDI) (14.2%). The investigation also identified a substantial increase in the ownership of assets such as poly houses, poultry sheds, and micro drip systems. Income, expenditure, and savings in these areas demonstrated statistical significance after association with the programs. Income in agriculture, livestock, fisheries, and agribusiness improved significantly after receiving benefits. Principal component analysis identified three principal components with Eigen values &gt; 1.0, with a cumulative variance of 71.03. Four entrepreneurial behavior traits-Innovativeness, Risk-bearing ability, Self-confidence, and Planning Orientation-were highly influenced by Principal Component 1, explaining 29.6 per cent of the total variance.

Nutritional supplementation to prevent tuberculosis incidence in household contacts of patients with pulmonary tuberculosis in India (RATIONS): a field-based, open-label, cluster-randomised, controlled trial

In India, tuberculosis and undernutrition are syndemics with a high burden of tuberculosis coexisting with a high burden of undernutrition in patients and in the population. The aim of this study was to determine the effect of nutritional supplementation on tuberculosis incidence in household contacts of adults with microbiologically confirmed pulmonary tuberculosis. In this field-based, open-label, cluster-randomised controlled trial, we enrolled household contacts of 2800 patients with microbiologically confirmed pulmonary tuberculosis across 28 tuberculosis units of the National Tuberculosis Elimination Programme in four districts of Jharkhand, India. The tuberculosis units were randomly allocated 1:1 by block randomisation to the control group or the intervention group, by a statistician using computer-generated random numbers. Although microbiologically confirmed pulmonary tuberculosis patients in both groups received food rations (1200 kcal, 52 grams of protein per day with micronutrients) for 6 months, only household contacts in the intervention group received monthly food rations and micronutrients (750 kcal, 23 grams of protein per day with micronutrients). After screening all household contacts for co-prevalent tuberculosis at baseline, all participants were followed up actively until July 31, 2022, for the primary outcome of incident tuberculosis (all forms). The ascertainment of the outcome was by independent medical staff in health services. We used Cox proportional hazards model and Poisson regression via the generalised estimating equation approach to estimate unadjusted hazard ratios, adjusted hazard ratios (aHRs), and incidence rate ratios (IRRs). This study is registered with CTRI-India, CTRI/2019/08/020490. Between Aug 16, 2019, and Jan 31, 2021, there were 10 345 household contacts, of whom 5328 (94·8%) of 5621 household contacts in the intervention group and 4283 (90·7%) of 4724 household contacts in the control group completed the primary outcome assessment. Almost two-thirds of the population belonged to Indigenous communities (eg, Santhals, Ho, Munda, Oraon, and Bhumij) and 34% (3543 of 10 345) had undernutrition. We detected 31 (0·3%) of 10 345 household contact patients with co-prevalent tuberculosis disease in both groups at baseline and 218 (2·1%) people were diagnosed with incident tuberculosis (all forms) over 21 869 person-years of follow-up, with 122 of 218 incident cases in the control group (2·6% [122 of 4712 contacts at risk], 95% CI 2·2-3·1; incidence rate 1·27 per 100 person-years) and 96 incident cases in the intervention group (1·7% [96 of 5602], 1·4-2·1; 0·78 per 100 person-years), of whom 152 (69·7%) of 218 were patients with microbiologically confirmed pulmonary tuberculosis. Tuberculosis incidence (all forms) in the intervention group had an adjusted IRR of 0·61 (95% CI 0·43-0·85; aHR 0·59 [0·42-0·83]), with an even greater decline in incidence of microbiologically confirmed pulmonary tuberculosis (0·52 [0·35-0·79]; 0·51 [0·34-0·78]). This translates into a relative reduction of tuberculosis incidence of 39% (all forms) to 48% (microbiologically confirmed pulmonary tuberculosis) in the intervention group. An estimated 30 households (111 household contacts) would need to be provided nutritional supplementation to prevent one incident tuberculosis. To our knowledge, this is the first randomised trial looking at the effect of nutritional support on tuberculosis incidence in household contacts, whereby the nutritional intervention was associated with substantial (39-48%) reduction in tuberculosis incidence in the household during 2 years of follow-up. This biosocial intervention can accelerate reduction in tuberculosis incidence in countries or communities with a tuberculosis and undernutrition syndemic. Indian Council of Medical Research-India TB Research Consortium.

Analysing the Commercial Viability of Tamarind (The Minor Forest Produce) for the Tribal in Jharkhand

Forest plays a very important role in the socioeconomic lives of Tribal. They collect and sell the forest products in local markets and earn their livelihood. The present study is conducted to study the commercial viability of Tamarind production in Jharkhand taking into consideration both primary and secondary data. The four districts of Jharkhand namely Khunti, Chaibasa, Simdega, and Gumla were selected for the study. Primary data has been gathered through field monitoring carried out in different villages in four districts of Jharkhand. Structured interviews, FGDs (Focus Group Discussions), observation and visit to local markets were also done and used as the tools to closely examine the activities involved in studying the commercial viability of Tamarind in the State. Present study entitled “Analysing the commercial viability of Tamarind” was carried out to understand the commercial value of Tamarind production in Jharkhand, and analyse the benefits derived from the government schemes. Jharkhand, despite being one of the largest tamarind producing state, the involved producers gets very less share in whole of the value chain. This is because of lack of knowledge of market, Less support from co-operatives and Van Dhan Vikas Kendras, no/less information about government schemes and more importantly till date there is no fully mechanized production unit to make the finished products out of the minor forest produce namely Tamarind. The middlemen and wholesalers mostly earn by semi-processing it and then exporting to other states namely West Bengal, Andhra Pradesh, Tamil Nadu, Karnataka, Orissa and Delhi. Keywords: Non-timber forest products, Minor Forest Produce, Minimum Support Price, tribal, Joint Forest Management.

Informal healthcare providers of abortion services among three scheduled tribes of Jharkhand.

There is a dominant role of informal healthcare providers (IHPs) in the current cultural and sociological context of tribal communities. They outnumber formal health-care providers, thus bridging the gap between existing and nonexisting public health facilities despite not having formal training or accreditation. The study examines the role, relevance, and extent of abortion services provided by IHPs- in Jharkhand among three Scheduled Tribe groups. Based on in-depth interviews with 15 IHPs and 42 married women among three Scheduled Tribe groups in three districts of Jharkhand, a qualitative study was conducted. Interview guidelines addressed reasons for preferring IHP services, their scope of practice, dissemination, and quality of services. The majority of women seeking abortions used traditional contraceptives, which often resulted in unwanted pregnancies. The economic, cultural, social, access to services, and confidence factors encouraged women to seek abortion services from IHPs. There were differences in the nature of access to abortion services among tribal groups. The Chero and Korwa tribes continued to rely heavily on simpler life technologies that shaped their beliefs and practices regarding reproduction. The Ho tribe, however, preferred to use the formal health-care system since they were close to a more complex society. IHP plays a significant role in the social structure of Tribes, demonstrating their marginalization in access to formal health-care services. Eventually, they replaced traditional healers with their function as physicians.

A Comparative Analysis of Reproductive and Productive Performance of Jharkhand State Cooperative Milk Producers’ Federation

Background: The reproductive and productive performance play significant role in judging the qualitative and quantitative traits in a dairy animal and has direct effect on the milk production and profitability in any dairy enterprise. Methods: The present study was conducted in Jharkhand State, wherein 180 members of Jharkhand State Cooperative Milk Producers’ Federation and 180 non-member dairy farmers were randomly selected from three districts of Jharkhand. The data was collected from a total of 360 respondents using structured interview schedule. For present study, 135 crossbred, 58 indigenous cattle and 82 buffaloes were selected from the members; whereas 102 crossbred cattle, 36 indigenous cattle and 79 buffaloes were selected from non-members. Result: The findings revealed that dairy animals reared by cooperative members showed better reproductive and productive performance that their non-member counterparts. This is attributed to reason that JMF members adopted better dairy management practices due to availability of timely veterinary services, quality feed and training on improved dairy practices. Therefore, through increased participation in JMF; creating awareness and training regarding improved dairy management, adequate extension, breeding policy and financial support would further enhance the productivity among the dairy animals in the state.

Participatory Livelihood Vulnerability Assessment of the Forest Dwellers: A Study of Fifteen Tribes and Particularly Vulnerable Tribal Groups in the Eastern Indian Region

This study aims to undertake the Participatory Livelihood Vulnerability Assessment (PLVA) of forest dwellers in the Jharkhand and Odisha states of eastern Indian region. The study covers 15 tribes that included 8 Particularly Vulnerable Tribal Groups (PVTGs) and 7 other tribes from eight districts of Jharkhand and Odisha. The authors combined both participatory and survey-based approaches and used the simple indexing method for PLVA. They observed that landless families were among the most vulnerable. The forest dwellers have poor access to education and health. Both minor forest produce and social-welfare measures are important safety nets for the forest dwellers. There is, however, better access to banking, pukka houses, toilets and so on. Furthermore, attention is required to strengthen livelihood opportunities for the forest dwelling communities.

Exploring recent groundwater level changes using Innovative Trend Analysis (ITA) technique over three districts of Jharkhand, India

Groundwater is the largest store of available freshwater in the world. With the increasing impact of climate change and human activities, assessment of variations in groundwater levels is essential. This study presents the trend of groundwater levels in three districts (Purbi Singhbhum, Ranchi and Saraikela) of Jharkhand State, India. The depth to groundwater level (DGWL) data from 24 wells over the three districts for 1996–2018 is collected for both pre-monsoon and post-monsoon seasons. The conventional non-parametric trend analysis techniques (e.g., Mann-Kendall, Sen's Slope, Spearman's Rho tests) have several restrictive assumptions, such as Gaussian distributed time series and absence of serial correlation. Innovative Trend Analysis (ITA) technique does not have these restrictive assumptions and therefore, can be effectively used to detect trends in a time series of shorter length. Moreover, ITA is a slope-based technique that provides visual interpretations as well as the statistical significance of trends in a time series, thereby comprehensively acquiring the benefits of multiple conventional methods. Therefore, ITA is employed in this study to investigate the trends in groundwater levels. The results reveal a significantly increasing trend of DGWL for 17 sites in pre-monsoon and 14 sites in post-monsoon seasons. On the other hand, only four and six stations showed negative trends during pre- and post-monsoon seasons, respectively. The increasing DGWL trends at a majority of the sites imply a serious decline in the groundwater levels over the years. This study will be helpful to water resources managers to identify the causes of the declining groundwater levels, take necessary actions to control them, and efficiently manage groundwater at local levels.

Availability of public health facilities and utilization of maternal and child health services in districts of India

ObjectiveThis study aims to address the spatial variation in the availability of public health facilities and utilization of Maternal and Child Health (MCH) services at district level in India. MethodsTwo nationally representative secondary data sources such as the National Family Health Survey 2015-16 and Census of India, 2011 were used to identify districts, which are lagging behind in terms of the availability and utilization of MCH services. Mapping and spatial clustering analyses was performed to identify underperforming districts in India. Further, Ordinary least square and spatial autoregressive models were used to determine the predictor for utilization of MCH services at the district level. ResultsSignificantly, less availability of public health facilities and utilization of MCH services were observed in districts of Jharkhand, Bihar, Uttar Pradesh, Madhya Pradesh, Chhattisgarh, and North-Eastern states as compared to the national average. A shortage of 72,198 (21.9%) doctors and 165,791 (17.5%) paramedical staff found at the country level. After controlling for socio-economic factors, we observed that availability of sub-centre, dispensary, and population hospital bed ratio were significant positive predictors for Antenatal Care (ANC) service utilization whereas, shortage of paramedical staff was a negative predictor for full immunization at district level in India. ConclusionsAdequate availability of health facilities, and human resources are needed in districts, which are underperforming in terms of availability and utilization of MCH services to improve utilization of MCH services.

Stylized Fact Approach to Income Distribution Pattern among Fish Seed Producers in Jharkhand, India

One of the serious impediments to sound policy on freshwater aquaculture is the lack of farm-level data and consistent empirical evidence, especially on income. To understand the income generation through fish seed production through the community participation approach initiative of the Directorate of fisheries, Jharkhand, we analyzed the income distribution pattern of 498 fish seed producers of Jharkhand. The data was collected from different districts of Jharkhand by DoF for the year 2017-18. The results revealed high gender disparity in fish seed production as only 2.41 per cent were found out to be women. It was observed that fish seed production has a high potential to be a very lucrative business as income showed wide variation ranging fromRs.50,000 to Rs.27,50,000. The Lorenz curve analysis showed moderate-income inequality indicating a higher concentration of income with the top 10 per cent of the population. Further investigation showed that the top 10 per cent of the population earned 60 per cent of total cumulative income which was higher than the national average which was 57 per cent while the bottom 50 per cent of the population earned just 20 per cent of total cumulative income. The income inequality from the GINI co-efficient was 0.48 which was lower than the national average which was 0.55. The study concludes that though income inequality is lower than the national average however the concentration of income with top 10 per cent was higher than the national average. A more detailed study on fish seed production is needed to understand the underlying facts for the disparity in income distribution among fish seed producers.

PROMOTING INFLUENZA VACCINATION: INSIGHTS FROM INFLUENZA (H1N1) OUTBREAK IN JHARKHAND

Background and Objectives: Influenza virus is a typical human pathogen causing serious respiratory illness resulting in significant mortality. In the recent years, increase in number of confirmed cases of influenza virus infection has occurred in different districts of Jharkhand. Pandemic influenza A (H1N1) 2009 virus emerged in 2009 and caused pandemic with high morbidity and mortality in India and worldwide. In Jharkhand, influenza virus infection remains an important health issue, since vaccination is not universal. Aim &amp; objective: The study was conducted at Virus Research and Diagnostic Laboratory (VRDL), Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, during January 2019- February 2020. Materials and Methods: Samples of clinically suspected cases of influenza-like illness received in the Virus Research and Diagnostic Laboratory, Department of Microbiology, RIMS, Ranchi, from January 2019 to February 2020 were included in the study. Results: During the study period, a total of 150 samples from clinically suspected cases of influenza like illness belonging to Category C as per case definition were received for testing. Of these 150 samples, 23 samples tested positive for influenza A. Of total suspected cases (150), 58 were females and 92 were males. Conclusion: Active surveillance is required from time to time to timely diagnose the disease and manage the complications and take necessary steps to control them.

Livelihood Assets and Income Generating Activities: A Comparative Analysis in the Scheduled and Non-Scheduled Areas of Jharkhand

The main objective of the article is to identify different types of livelihood assets, income generating activities (IGAs) and choices of these activities by households across social groups in the Fifth and non-Fifth Scheduled areas of Jharkhand in eastern India. It is based on a primary survey of 785 households randomly selected across caste and Scheduled Tribe groups in Giridih and Latehar districts of Jharkhand. K-means clustering is applied for determination of latent class activity clusters and Multinomial Logistic Regression (MLR) model used for understanding the importance of livelihood assets in determining livelihood activity cluster (LC) for income generation. Further, discriminant analysis is applied to obtain probability of choice of individual households in determining livelihood generating activity. The analysis shows that forest-based activity remains a better livelihood support system in the Fifth Scheduled areas, which is less significant and further diminishing in the non-Fifth Scheduled areas. Rural households engaged in a diverse set of IGAs to obtain additional income to reduce risk and maintain a balanced consumption. Occupational transition is marked by the decline of agriculture and increasing reliance on daily-wage activities as the primary source of income. Other traditional livelihood activities such as animal husbandry and the collection of forest produce have less scope for income in the absence of institutional support.

Knowledge, Attitudes, and Practices towards COVID-19 Pandemic among Residents of the Jharkhand State, India: An Online Survey

Background: People's adherence to control measures is imperative in the fight against COVID-19. The present study was done to evaluate knowledge, attitudes, and practices towards COVID-19 among residents of Jharkhand and to assist the government in deciding further course of action during the COVID-19 outbreak.&#x0D; Methods: This study was an online cross-sectional survey. The link to the questionnaire was displayed on the official website of Rajendra Institute of Medical Sciences, Ranchi, National Health Mission, Jharkhand, official website of all districts under Jharkhand state administration, Integrated Disease Surveillance Programme and Information &amp; Public Relations department. Participation of residents in the survey was extensively propagated using mass media mainly local television networks, radio channels and newspapers.&#x0D; Results: A total of 4683 responses were received from all districts of Jharkhand. The majority of the participants were young adults (47.5%) and the number of male participants was more than the females (81.4%). The mean correct knowledge score for participants of this study was 10.73+2.2 (maximum attainable score was 14) while the mean practice score for the participants was 4.5+0.69 (maximum attainable score was 5). The knowledge score of the participants was significantly associated with their age, education status and economic class (p&lt;0.0001). The participants largely held an optimistic attitude and healthy practices towards COVID-19. Conclusion: Participants had a positive attitude but were also logically worried and uncertain about the near future. Adequate knowledge of participants was visible in their practices. There was however a gap across age groups, gender, literacy and income levels which should be addressed in future campaigns.

Study on Fluoride Contamination in Ground Water (Drinking water) of Deoghar, Jharkhand, India

Fluoride contamination in groundwater is one of the foremost natural mishaps for the different districts of Jharkhand. The present study was carried out to know the concentration of fluoride in the groundwater of Deoghar city. For this experiment, twelve samples were selected from each zone namely East, West, North and South. In each zone three places were selected to check the fluoride level in groundwater. Overall 36 water samples (36 samples used and the experiment was done in triplicate) from 12 different tube wells of Deoghar city were collected and investigated by using fluoride test kit. The lowest average value observed 0.343 ppm in civil lines (west zone). The highest average value 1.670 ppm observed in the Jaruadih (north part) of the Deoghar city respectively. In this study, it was observed that few locations showed fluoride contamination near the permissible limit or just above the limit (1.5 mg/L) but the remaining all areas are safe as they possess fluoride concentration within desirable limits (0.5-1 mg/L). Thus this study indicated that most of Deoghar city is free from Fluoride contamination and statistically insignificant difference of fluoride concentration was observed in Jhousagari and Jaruadih area when compared with WHO standards. The present study clearly showed that different areas of four zones are free from fluoride contamination but much more study is also needed for further more information.

Intrapartum Fetal Heart Monitoring Practices in Selected Facilities in Aspirational Districts of Jharkhand, Odisha and Uttarakhand

BackgroundThe risk of mortality for the mother and the newborn is aggravated during birth in low- and middle-income countries due to preventable causes, which can be addressed with increased quality of care practices. One such practice is intrapartum fetal heart rate (FHR) monitoring, which is crucial for the early detection of fetal ischemia, but is inadequately monitored in low- and middle-income countries. In India, there is currently a lack of sufficient data on FHR monitoring.MethodsAn assessment using facility records, interviews and observation was conducted in seven facilities providing tertiary, secondary or primary level care in aspirational districts of three states. The study sought to investigate the frequency of monitoring, devices used for monitoring and challenges in usage.ResultsFHR was not monitored as per standard protocol. Case sheets revealed 70% of labor was monitored at least once. Only 33% of observed cases were monitored every half hour during active labor, and none were monitored every 5 min during the second stage of labor. More time was observed for monitoring with a Doppler compared with a stethoscope, as providers reported fluctuation in readings. Reportedly, low audibility and a perceived need of expertise were associated with using a stethoscope. High case load and the time required for monitoring were reported as challenges in adhering to standard monitoring protocols.ConclusionThe introduction of a standardized device and a short refresher training on the World Health Organization and skilled birth attendant protocols for FHR monitoring will improve usage and compliance.

Customary Land-Tenure and the Poor: A Study of Jharkhand and Meghalaya

For most people living in rural India having access and control over land is crucial for their livelihood, more so in the case of tribals. This article analyses the nature of the customary land-tenure system in some districts of Jharkhand and Meghalaya and their impact on livelihood patterns, food security and poverty. Based on both secondary and primary data, the article seeks to examine the nature of the customary land-tenure systems in selected scheduled areas; specifically identifying the status of locals versus non-locals in managing land resources and analysing the extent to which women have been able to secure land rights under customary laws. The article concludes that though there are both positive and negative aspects to community and individual ownership of agricultural land, but on the whole the prevailing system does not helping in bettering the conditions of disadvantaged communities.

Role of \u2018patient sensitization on patient charter\u2019 for tuberculosis care and support: The beneficiaries\u2019 perspective

BackgroundImprovement of knowledge regarding the rights and responsibilities of patients with tuberculosis (TB) (patient charter) through sensitization meeting may have a positive effect on their life and yield better treatment outcomes.Participants and methodsWith the objective to understand beneficiaries’ (who availed TB care and support services) perspective, 30 patient interviews from eight districts of Jharkhand were conducted with a semistructured questionnaire. The sample was drawn from 120 cured patients with TB of 770 patients with TB sensitized on patient charter.ResultsOf 30 respondents, 23.3% (7, n=30) are female; 6.6% (2, n=30) belong to extrapulmonary cases; 10% (3, n=30) and 6.6% (2) are diagnosed through fine needle aspiration cytology and chest radiography modes, respectively; and all of them got detected at public health facilities. Most of the respondents are empowered completely or partially. Overall, 56.6% (17, n=30), 13.3% (4, n=30) and 30% (9, n=30) of the respondents are satisfied, unsatisfied, and neutral about patient charter role on treatment outcome. Only 13.3% (4, n=30) acted as TB ambassadors. Three thematic areas emerged out of this study: empowered patients with TB [100%, (30, n=30)], content patients with TB [56.6% (17, n=30)], and TB ambassadors [13.3% (4, n=30)]. Here empowered patients with TB refers to those who acquired the requisite knowledge about TB, content patients with TB refer to those who are satisfied with the information and services of patient charter meeting, and TB ambassadors are those who helped the neighborhood in getting rid of TB. Moreover, empowerment is considered when knowledge-related questions were responded properly, and satisfaction is considered when needed information and services were offered leading to better treatment outcome.ConclusionIt is evident from the study that the patient charter has substantially empowered the attendees in getting positive treatment outcome; however, further improvement is needed with the help of other stakeholders involved in TB control. Moreover, the charter should be creating more TB ambassadors which would help in mobilizing the community to identify the hidden cases of TB for control through ‘word of mouth’.

Soil health characterization in smallholder agricultural catchments in India

Soil health (SH) of managed lands in India is affected by anthropogenic activities such as nutrient mining, excessive tillage, and monocropping, which reduce the productive capacity of soils. A comprehensive SH characterization was conducted in 27 catchments in six districts of Jharkhand, India. Each was stratified into four landscape positions: (i) uncultivated upland in tree vegetation, (ii) cultivated upland in garden or orchard use, and (iii) midland and (iv) lowland areas in rice-fallow fields, yielding 113 soil samples from 0 to 15 cm and 20 from 30 to 40 cm depths. Soil textural separates as well as 15 dynamic physical, biological, and chemical properties were assessed using the Comprehensive Assessment of Soil Health framework. Nutrient analyses indicate low to very low P and K values, but high micronutrient levels. A district level ANOVA shows effects of inherent soil factors on the indicators. The influence of tillage, nutrient extraction as well as landscape hydrology on soil health indicators was apparent, notably showing uncultivated soils with higher overall SH. Puddle tillage affected the surface and subsurface soil, the latter showing reduced water holding capacity and less favorable biological indicators. Multivariate analyses showed directional separation of biological and chemical indicators in the first two principal components. A Best Subsets Regression analysis revealed organic matter, soil respiration and active carbon as the most predictive in determining overall SH scores (R2adj = 0.87). In conclusion, a comprehensive soil health assessment using a spatial framework in Jharkhand, India identified multiple SH constraints related to farmer management, associated organic matter dynamics, and natural factors.

Ethno-medicinal plants used by local folk healers ‘Vaidyas’ in tribal dominated districts of Jharkhand

Ethno-medicinal studies were carried out during last five years in eleven tribal dominated districts of Chatra, Deoghar, Dumka, Giridih, Godda, Jamtara, Koderma, Saraikela Kharsawan, Pakur, Ranchi and West Singhbhum of Jharkhand, India. A total of 105 informants including 30 local folk healers (Vaidyas, Kaviraj and Bhagat) belonging to eleven tribal communities, who had knowledge of the traditional uses of medicinal plants, were interviewed for gathering the information. The study led to documentation of therapeutic application of 98 plant species which are used in preparation of 153 herbal formulations for curing about 60 different ailments. This study describes details of ailments, botanical identity, local name, parts of plants used, mode of preparation, administration of drug, and the disease for which the given plants are used.