Jharkhand Research Articles

Seroprevalence of Hepatitis C Virus Among Blood Donors in a Tribal-Preponderant Region of India.

Hepatitis C isa global health burden with significant morbidity and mortality. It primarily affects the liver and causes acute hepatitis, chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Common modes of transmission of hepatitis C virus (HCV) infection are blood transfusion, needlestick injury, and mother-fetus transmission, among which transmission, blood transfusion is one of the most important causes. Blood transfusion is one of the pillars in the management of patients that saves lives and improves morbidity. Blood donation in India is done by voluntary and replacement blood donors of both sexes.The aim of this study is to determine the seroprevalence of HCV among blood donors in the Jharkhand state, a tribal-preponderant region of India, and to see the trend over the years. This is a nine-yearretrospective observational study from 2015 to 2023 that screened for anti-HCV antibodies (third-generation kit: Abbott Diagnostics) using the chemiluminescence technique. In this study, in total, 249,461 units of blood were collected, of which the majority of donations were by male and replacement donors (RDs) comprising230,757 (92.50%) and 188,047 (75.38%), respectively. The meannumber of blood donations by replacement and male donors (MDs) was more than for voluntary donors (VDs) and female donors (FDs) (20894.11 ± 3041.71 RDs vs. 6823.77 ± 2332.96 VDs, p < 0.0001 and 25639.66 ± 2810.08 MDs vs. 2078.22 ± 828.16 FD, p < 0.0001), respectively. The overall prevalence of HCV was 0.63%, and all seropositive donors were male. Replacement blood donation contributes to the major part of blood donation and is primarily done by males in this tribal population-dominant region of India. Seroprevalence of HCV is high in the population of this part of India, and there is a constant or slightly upward trend in hepatitis C infection among individuals.

Participation, assertion and aspiration-indigenous teacher agency in higher education

ABSTRACT Educational research often silences teachers’ voices, distorting perspectives. This article delves into the marginalized voices of educators and administrators, focusing on Indigenous agencies within higher education (HE) in the state of Jharkhand, India. Employing the narrative interview method of oral history, it elucidates life stories through lived experiences amidst conflicting educational paradigms. Drawing from the author’s doctoral research, the article provides a historical and socio-political context of colonial legacies and contemporary challenges faced by Indigenous communities in India self-identifying as ‘Adivasi.’ Synthesizing an analytical framework through a ground-up approach, agency theories uncover new themes within HE’s temporal, spatial, and personal-social space. The findings describe counter-strategies against systemic denial of Indigenous agency within HE, contributing to discussions on the requirement of context-specific epistemic frameworks for India’s Tribal communities to assert their voices and choices in HE.

Assessment of Patient Awareness Regarding Chronic Kidney Disease Management in Santhal Parganas

Background: Chronic kidney disease (CKD) is a global health challenge, and effective self-management is crucial for optimal outcomes. Assessing the prevailing knowledge about CKD in patients can help strategies information education communication program to better manage the disease. This study evaluated the current knowledge of self-management of CKD among patients suffering from CKD in Santhal Parganas of Jharkhand state in India. Materials and Methods: This cross-sectional survey was conducted in a tertiary care teaching hospital situated in Deoghar, Jharkhand, India from June to December 2023. Patients suffering from CKD were enrolled for this study from the Outpatient Department. The Chronic Kidney Disease Self-Management Knowledge Tool (CKD-SMKT) was used to measure patients’ knowledge through face-to-face interviews conducted by a trained local surveyor. Results: A total of 228 patients with a mean age of 52.63±10.65 years (men 136 [59.65%], women 92 [40.35%]) participated in the survey. All the patients (100%) gained knowledge about CKD from doctors, followed by other patients (63.6%) and relatives (41.23%). On average, 53.61% did not have proper knowledge about overall kidney disease. Correct knowledge about maintaining kidney health was among 38.1% of patients with 36.59% unsure about their knowledge and 25.31% declaring their lack of knowledge. Conclusion: A low level of knowledge about kidney health was found among the patients suffering from CKD in Santhal Parganas, a region with a tribal population with a low literacy rate. The identified knowledge gap emphasizes the need for a tailored educational program for CKD patients by doctors and patients relative.

A Pilot Study on the Knowledge, Attitude, and Practice of Mothers About Their Children's Vaccination in a Medical Institute in Jharkhand, India.

Introduction Immunisation is one of the key public health instruments to combat childhood morbidity and mortality. However, the lack of mothers' knowledge and motivation to vaccinate their children has affected vaccination programs and vaccination coverage rate in the state of Jharkhand. Therefore, addressing this knowledge gap, our study aims to evaluate the extent of mothers' understanding of the effects and aspects of vaccination for their children. Materials and method This is a cross-sectional study conductedat the paediatric vaccination clinic of Rajendra Institute of Medical Sciences (RIMS), Ranchi between October 2022 and September 2023. The sample population included 200 mothers as participants (18 years and above). The survey was done with a self-administered questionnaire of questions about socio-demographic factors, mothers' knowledge, and mothers' practices, and answers were consolidated in the form of a table. Results The majority of participants in this study were below 25 years of age and were literate. The missed vaccination percentage was also significantly higher among illiterates, mothers below 30 years of age, and unemployed ones. Among the respondents, 73.3% of illiterate mothers, 56% of those below 30 years of age, and 64% of unemployed mothers missed their children's vaccination schedule. Among the mothers, 75% did not know the names of vaccine-preventable diseases. Of the respondents, 50% believed intercurrent illnesses like fever and the common cold to be side effects and contraindications of vaccines. Among the mothers, 65% never posed any questions to the paediatrician. Of the mothers, 97% safely kept the vaccination card and 82% relied on government or public health centres for vaccination purposes. Conclusion The majority of our population was in favour of vaccinating their children but there existed a huge lacuna in their knowledge about vaccination. This study concludes that firmer measures have to be exercised to bridge this knowledge gap. Only this can improve the vaccination coverage rate.

Comparative Evaluation of Pulmonary Function in Male Street Vendors Versus Smokers: Insights into Occupational and Lifestyle Impact.

Occupational and lifestyle factors, such as smoking and street vending, may pose risks to pulmonary health. Previous studies explored the effect of both smoking and exposure to street pollutants on health. However, a study comparing the pulmonary functions of street vendors (who do not smoke) and smokers has not been conducted before. The objective of this study was to compare the pulmonary function parameters among three groups consisting of smokers, street vendors and controls in order to discern potential differences in respiratory health between the three groups. This cross-sectional study was conducted in the Deoghar district of the Jharkhand state, in India, over a period of five months (between January 2023 and May 2023). A total of 90 male participants, including 30 smokers, 30 street vendors and 30 age-matched control research participants, underwent pulmonary function testing (forced spirometry) using standardized methods. The comparison among the three groups was conducted by one-way analysis of variance with the post-hoc test. A total of 30 controls with a mean age of 33.77±6.01 years, street vendors with a mean age of 32.93±6.29 years and smokers with a mean age of 32.27±7.86 years participated in the present study. There was an average exposure to road pollutants for 13.47±9.48 years and smoking for 13.23±8.29 years (P=0.92). Lung function parameters, except for the forced expiratory volume in one second divided by the forced vital capacity (FEV1/FVC), were lower in street vendors and smokers than controls. Street vendors in Deoghar, Jharkhand, have lung function parameters comparable to smokers. Hence, although they are not smoking tobacco, their lung health is at risk. Hence, early interventions are required to protect them from pollutants.

Association of Child Growth Failure Indicators With Household Sanitation Practices in India (1998-2021): Spatiotemporal Observational Study.

Undernutrition among children younger than 5 years is a subtle indicator of a country's health and economic status. Despite substantial macroeconomic progress in India, undernutrition remains a significant burden with geographical variations, compounded by poor access to water, sanitation, and hygiene services. This study aimed to explore the spatial trends of child growth failure (CGF) indicators and their association with household sanitation practices in India. We used data from the Indian Demographic and Health Surveys spanning 1998-2021. District-level CGF indicators (stunting, wasting, and underweight) were cross-referenced with sanitation and sociodemographic characteristics. Global Moran I and Local Indicator of Spatial Association were used to detect spatial clustering of the indicators. Spatial regression models were used to evaluate the significant determinants of CGF indicators. Our study showed a decreasing trend in stunting (44.9%-38.4%) and underweight (46.7%-35.7%) but an increasing prevalence of wasting (15.7%-21.0%) over 15 years. The positive values of Moran I between 1998 and 2021 indicate the presence of spatial autocorrelation. Geographic clustering was consistently observed in the states of Madhya Pradesh, Jharkhand, Odisha, Uttar Pradesh, Chhattisgarh, West Bengal, Rajasthan, Bihar, and Gujarat. Improved sanitation facilities, a higher wealth index, and advanced maternal education status showed a significant association in reducing stunting. Relative risk maps identified hotspots of CGF health outcomes, which could be targeted for future interventions. Despite numerous policies and programs, malnutrition remains a concern. Its multifaceted causes demand coordinated and sustained interventions that go above and beyond the usual. Identifying hotspot locations will aid in developing control methods for achieving objectives in target areas.

Depleting Medicinal and Aromatic Plants of Jharkhand State

The newly created state of Jharkhand is very rich in the plant wealth and other natural resources. The area has maxium concentration of tribal population in North India. The forests have several medicinal and aromatic plants that are being used as a source of medicines in various systems viz., Ayurveda, Siddha Unani and Homoeopathy. Due to continous habitat destruction fragmentation of forests, urbanization coupled with population explosion and agricultural growth, there is unprecedented pressure on plants wealth culminating into loss of biodiversity at an alarming rate. The authors have regularly been surveying the state for the last fifteen years. Based on the field survey literature and screening ca 24 medicinal plants whose populations have been continously depleting are identified and reported in the present communication.

Evaluation of Oxidative Stress and Antioxidant Biomarkers in Chronic Cigarette Smokers: A Pilot Study.

Introduction The present study was undertaken to assess the status of oxidative stress in chronic cigarette smokers. Materials and methods Thirty adult male chronic cigarette smokers and an equal number of age and sex-matched normal subjects from the Deoghar district of Jharkhand state, India, were included in the study. The status of lipid peroxidation was determined using malondialdehyde (MDA), and the activities of enzymic antioxidants, such as superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx), were determined using standard protocols. Results Results showed that the serum MDA levels were significantly increased, and the enzymic antioxidants were markedly decreased in chronic cigarette smokers compared to the normal subjects. Conclusion Our study demonstrated that oxidative stress is more pronounced in cigarette smokers compared to non-smokers. The number of cigarettes smoked plays a crucial role in increasing the reactive oxygen species and decreasing the cellular antioxidants.

Mapping coexisting hotspots of multidimensional food market (in)accessibility and climate vulnerability

With the increasing likelihood of agricultural production failures under a warmer global climate, the importance of markets in providing access to nutrient-dense foods (NDFs) through trade is predicted to grow. However, regions with relatively poor access to markets and supporting infrastructures (e.g. roads and storage facilities) are potentially ill-equipped to deal with both short-term hydrometeorological hazards such as droughts and floods, and longer-term shifts in agricultural productivity. Despite the increasing focus upon markets within academic and policymaking circles, a regional-scale assessment of these potentially coexisting hotspots of vulnerability has not been conducted. We conduct a two-stage geospatial analysis integrating three publicly available datasets across the Indian states of Bihar, Chhattisgarh, Jharkhand, and Odisha. Combining the 2011 national census with the new PMGSY-GeoSadak database, we conduct nearest neighbour analysis to measure multidimensional market inaccessibility by: (i) distance from a settlement to its nearest village, town or city with a market, (ii) distance from a settlement to its nearest major road, and (iii) distance from a settlement to its subdistrict headquarters. We then correlate these measures with India’s only district-wise assessment of climate vulnerability to identify hotspots of market inaccessibility and climate hazards. We find that the three market access measures are spatially autocorrelated and positively interrelated at the settlement (n = 129 555) and district (n = 107) levels, meaning that settlements located further from their nearest market tend to experience poorer road connectivity and access to the subdistrict economic hub. Approximately 18.5-million people live in districts with relatively high climate vulnerability and relatively high and multidimensional market inaccessibility. Hotspots of coexisting vulnerabilities are also disproportionately populated by ‘Schedule Castes and Schedule Tribes’ (SC/ST) communities. The identification of coexisting hotspots has important implications for the development of equitable and resilient markets that bolster NDF access for climate vulnerable and nutritionally insecure populations.

Empowering the Traditional Indigenous Politics through Education: An Agent of Political Socialization

Empowering the Traditional Indigenous Politics through Education: An Agent of Political Socialization

Enhancing COVID-19 Vaccine Uptake among Tribal Communities: A Case Study on Program Implementation Experiences from Jharkhand and Chhattisgarh States, India.

Tribal populations in India have health care challenges marked by limited access due to geographical distance, historical isolation, cultural differences, and low social stratification, and that result in weaker health indicators compared to the general population. During the pandemic, Tribal districts consistently reported lower COVID-19 vaccination coverage than non-Tribal districts. We assessed the MOMENTUM Routine Immunization Transformation and Equity (the project) strategy, which aimed to increase access to and uptake of COVID-19 vaccines among Tribal populations in Chhattisgarh and Jharkhand using the reach, effectiveness, adoption, implementation, and maintenance framework. We designed a qualitative explanatory case study and conducted 90 focus group discussions and in-depth interviews with Tribal populations, community-based nongovernmental organizations that worked with district health authorities to implement the interventions, and other stakeholders such as government and community groups. The active involvement of community leaders, targeted counseling, community gatherings, and door-to-door visits appeared to increase vaccine awareness and assuage concerns about its safety and efficacy. Key adaptations such as conducting evening vaccine awareness activities, holding vaccine sessions at flexible times and sites, and modifying messaging for booster doses appeared to encourage vaccine uptake among Tribal populations. While we used project resources to mitigate financial and supply constraints where they arose, sustaining long-term uptake of project interventions appears dependent on continued funding and ongoing political support.

DYNAMIC TRENDS IN LIVESTOCK, POULTRY, AND FISHERY INDUSTRIES IN JHARKHAND : FUTURE SCOPE FOR EMPLOYMENT, INCOME AND FOOD SECURITY

The state of Jharkhand serves as a prime example of the intricate interaction between geographical, demographic, and economic elements within the Indian subcontinent. Its agriculture, forestry, fishing, and livestock sectors play a crucial role in the state's economy, generating employment opportunities, particularly in rural areas, and contributing to poverty alleviation and economic diversification. Collectively, these sectors shape Jharkhand's GDP, fostering a path of balanced and sustainable economic development. They also provide essential raw materials for industries, ensure food security, and promote environmental conservation. Additionally, livestock and fisheries contribute to foreign exchange earnings, enhancing the state's economic resilience. This article highlights the changing dynamic trends of allied activities of agriculture like livestock, poultry and fishery in Jharkhand that not only diversify the agriculture income but also open new avenues of food and employment security along with propagating sustainable economic development in the state.

Implementation of RTE in Unaided Private Schools: A Study of Tribals of Jharkhand

The Right to Education Act was implemented in Jharkhand state in 2011 to universalize elementary education. One of the most essential components of the RTE was to provide 25 percent reservations to a weaker section of students in private schools. However, the present research found its unsatisfactory implementation and private schools are not interested in proceeding with Section 12 (1) (C) of the RTE Act, 2009.

Role of Vocational Education in Economic Empowerment of Adivasis of Jharkhand

The Adivasis are categorized as the Scheduled Tribes in the Constitution of India. Adivasis consist of 26% of the total population of State of Jharkhand. 78% of the total Adivasi population lives in the rural areas of the State. At least half of the rural population of the Adivasi lives below the poverty line. The Adivasis of Jharkhand are enslaved in the poverty trap. The per-capita income of the Adivasi community is very low. The majority of the Adivasi youth of the state are poorly equipped for employment in the labour market. Most of the Adivasi youth are neither adequately educated nor equipped with vocation skills. They are unable to succeed in finding productive employment which increases their per capita income and helps them to escape from the poverty trap. In this context the paper tries to study the roles of vocational education in the economic empowerment of the Adivasis of Jharkhand. Vocational education can equip the Adivasis with skills, especially the Adivasi youth, for self-employment and employment in labor market. It can trigger economic change and transformation in the Adivasi community in Jharkhand.

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.

Seasonal Dynamics of Butterfly Communities in Different Habitats of Ranchi, Jharkhand

This research investigates the seasonal dynamics of butterfly communities across various habitats in the Ranchi district of Jharkhand. Butterflies, being sensitive indicators of environmental changes, offer valuable insights into the health and biodiversity of ecosystems. The study aimed to understand the habitat preferences, seasonal distribution patterns, and factors influencing butterfly diversity in different landscapes within the Ranchi region. Butterflies play a crucial role in ecosystems as pollinators and are considered bioindicators of environmental health. The diversity and distribution of butterflies are influenced by various factors, including habitat type, climate, and vegetation. Ranchi, located in the state of Jharkhand, offers a diverse range of habitats, from urban green spaces to forested areas and wetlands. This research seeks to contribute to the understanding of how these diverse habitats influence the seasonal dynamics of butterfly communities. The primary objective of this study was to assess the seasonal variations in butterfly communities across different habitats in Ranchi. Specific goals included identifying key habitat preferences of butterflies, documenting seasonal changes in species composition, and exploring potential factors influencing butterfly diversity. By achieving these objectives, the research aimed to provide valuable information for conservation and management efforts in the region. Field surveys were conducted over a period of 12 months, covering distinct seasons in Ranchi. Sampling sites were selected to represent various habitats, including urban parks, forested areas, wetlands, and rural landscapes. Standard butterfly survey techniques, such as transect walks and netting, were employed to collect data on species composition and abundance. Additionally, environmental variables, including temperature, humidity, and vegetation cover, were recorded to analyze their potential impact on butterfly communities. The study revealed significant seasonal variations in butterfly diversity across different habitats. Urban green spaces exhibited higher butterfly abundance during the warmer months, with a dominance of common urban-adapted species. In contrast, forested areas showcased a diverse community throughout the year, with distinct species assemblages in each season. Wetland habitats exhibited specific butterfly preferences during the monsoon season, highlighting the importance of these ecosystems for certain species. Environmental variables played a crucial role in shaping butterfly communities. Temperature and vegetation cover were identified as key factors influencing species richness, while humidity levels correlated with the presence of specific moisture-dependent species. The observed results suggest that habitat heterogeneity and microclimatic conditions contribute to the varied patterns of butterfly diversity in Ranchi. This research provides valuable insights into the seasonal dynamics of butterfly communities in Ranchi's diverse habitats. The findings contribute to the development of effective conservation strategies by identifying key areas for preservation and restoration. Moreover, understanding the factors influencing butterfly diversity enhances our ability to predict and mitigate the impacts of environmental changes on these important pollinators. The outcomes of this study emphasize the importance of maintaining diverse habitats for sustaining butterfly populations and, by extension, the overall health of ecosystems in the Ranchi region.

Panchayati Raj and Local Leadership in Jharkhand

This paper deals with the Panchayati Raj System and the role of local leaders in the State of Jharkhand. Local leadership plays a pivotal role in ensuring the effectiveness of the Panchayati Raj system in Jharkhand. These leaders, emerging from within their communities, act as agents of change, wielding influence in decision-making, advocating for local needs, and guiding developmental initiatives. They act as a link between the local population and the Panchayat, advocating for policies and decisions aligned with the needs of the people they represent. Local leaders within the framework of the Panchayati Raj system have a diverse role deeply intertwined with governing their communities at the grassroots level. This paper have been able to establish the role and contribution of Panchayati Raj leaders towards their constituency and their attitude and the understanding of the contribution required by the Local Leaders for the overall growth of the villages they belong through the Panchayati Raj System.

A STUDY ON IMPACT AND IMPORTANCE OF SECONDARY SECTOR ON ECONOMIC DEVELOPMENT ACROSS JHARKHAND

The industrial sector has a multi-faceted role in the growth and development of Jharkhand. Industrial development unleashes dynamic and competitive economic performance which generates income and employment, facilitates international trade and increases resource efficiency, and is thus a major driver of poverty alleviation and shared prosperity. The industrial sector contributes a share of 42% of its total gross state value added for the year 2019-20. This study has to analysed the impact and importance of secondary sector on economic development across Jharkhand state.

Bamboo And Dhokra Crafts in Jharkhand: Unveiling Demographic Challenges and Government Scheme Awareness Among Women Artisans

‘Cane &amp; Bamboo’ and ‘Dhokra’ crafts are the two main handicrafts in the state of Jharkhand. Dhokra craft is the traditional craft of Jharkhand, while cane &amp; bamboo craft is one of the most practiced craft in the state due to its abundant presence. The paper explores the demographic profile and outreach of government schemes for rural women artisans engaged in practicing two major crafts of Jharkhand, namely cane &amp; bamboo and dhokra craft. It also highlights the importance of the above crafts in uplifting livelihoods of rural women artisans. The present study is based on primary data collected via random sampling in two villages of Lohardaga district, namely Kocha and Hirhi. The data was collected using a structured questionnaire from 50 rural women artisans, 37 cane &amp; bamboo artisans and 13 dhokra artisans respectively. Different attributes of the demographic profile of the respondents were considered, like age, income, marital status, experience in the handicraft industry and time dedicated for making handicraft, measured in terms of number of working days in a year. The findings highlight the need for focused interventions to improve the well-being of craftswomen and highlight their lack of knowledge about government programs.

Exploring private sector perspectives on barriers and facilitators in availing tuberculosis care cascade services: a qualitative study from the Indian state

IntroductionThe private sector plays an important role in tuberculosis (TB) elimination by providing access to quality TB care services like diagnosis and treatment, advocacy for preventive measures, innovation to address challenges in TB elimination, vaccines etc. The study aims to understand the perspectives of private practitioners on patients’ TB care cascade to reinforce existing interventions by assuring the quality of care to TB patients.MethodsThe study utilized a qualitative design through in-depth interviews of private practitioners and was conducted in Ranchi and Purbi Singhbhum District of Jharkhand State from March-August 2021. The pilot-tested, semi-structured, open-ended interview guide questionnaire collected information from private practitioners on various aspects of the TB care cascade. The data from the provider interviews were transcribed into multiple codes and themes on the TB program. An inductive analysis was carried out with a focus on content credibility to eliminate bias. Ethical approval was received from the Institutional Ethics Committee of the Indian Institute of Public Health Gandhinagar (IIPHG), India. Written consent was taken from the private practitioners involved in the study. ResultIn-depth interviews of 17 private practitioners reveal various factors contributing to delays in TB care cascades, especially delay in access to TB diagnosis and TB Care, delay in providing treatment once after diagnosis and poor adherence to the TB treatment. According to the perception of private practitioners, there was an array of client, provider and system side factors affecting the TB care cascade gaps positively and negatively. Positive aspects mainly emerged from interviews: strong governance, consistent supply chain management, innovative PPP models and financial schemes reducing out-of-pocket expenditure (OOPE). Various factors affecting the TB care cascade negatively include awareness among the patient, socio-economic status, approach and decision-making power of providers, adverse effects of drugs, staff capacity building, etc. ConclusionsEngaging private practitioner in TB elimination efforts is critical to achieving global targets and reducing the burden of TB. The study helps to determine geography-specific barriers and facilitators of the TB care cascade to achieve the aim of providing universal access to TB healthcare with the inclusion of private practitioners.