Browsing by Author "Vishal Diwan"

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    An assessment of the impact of the JSY cash transfer program on maternal mortality reduction in Madhya Pradesh, India
    (Glob. Health Action, 2014) Marie Ng; Archana Misra; Vishal Diwan; Manohar Agnani; Alison Levin-Rector; Ayesha De Costa
    Background: The Indian Janani Suraksha Yojana (JSY) program is a demand-side program in which the state pays women a cash incentive to deliver in an institution, with the aim of reducing maternal mortality. The JSY has had 54 million beneficiaries since inception 7 years ago. Although a number of studies have demonstrated the effect of JSY on coverage, few have examined the direct impact of the program on maternal mortality. Objective: To study the impact of JSY on maternal mortality in Madhya Pradesh (MP), one of India's largest provinces. Design: By synthesizing data from various sources, district-level maternal mortality ratios (MMR) from 2005 to 2010 were estimated using a Bayesian spatio-temporal model. Based on these, a mixed effects multilevel regression model was applied to assess the impact of JSY. Specifically, the association between JSY intensity, as reflected by 1) proportion of JSY-supported institutional deliveries, 2) total annual JSY expenditure, and 3) MMR, was examined. Results: The proportion of all institutional deliveries increased from 23.9% in 2005 to 55.9% in 2010 provincewide. The proportion of JSY-supported institutional deliveries rose from 14% (2005) to 80% (2010). MMR declines in the districts varied from 2 to 35% over this period. Despite the marked increase in JSY-supported delivery, our multilevel models did not detect a significant association between JSY-supported delivery proportions and changes in MMR in the districts. The results from the analysis examining the association between MMR and JSY expenditure are similar. Conclusions: Our analysis was unable to detect an association between maternal mortality reduction and the JSY in MP. The high proportion of institutional delivery under the program does not seem to have converted to lower mortality outcomes. The lack of significant impact could be related to supply-side constraints. Demand-side programs like JSY will have a limited effect if the supply side is unable to deliver care of adequate quality.
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    Feasibility assessment of crowdsourcing slogans for promoting household waste segregation in India: a cross-sectional study
    (Frontiers in Public Health, 2023) Kavya Krishnan; Krushna Chandra Sahoo; Madhanraj Kalyanasundaram; Surya Singh; Asha Srinivas; Ashish Pathak; Cecilia Stalsby Lundborg; Salla Atkins; Kamran Rousta; Vishal Diwan
    IntroductionCrowdsourcing is an emerging technique to engage or access a wider set of experts and multiple stakeholders through online platforms, which might effectively be employed in waste management. Therefore, we assessed the feasibility of the crowdsourcing method to provide an alternative approach that can improve household waste segregation using an online-slogan-contest.MethodsThe contest was promoted via targeted emails to various governmental and non-governmental organizations and through social media platforms for around 4 weeks (25 days). The entries were received through a Google form. The slogans were assessed by the experts and analyzed using content analysis methods.ResultsTotal 969 entries were received from different geographic regions in India. Of that, 456 were in English and 513 in Hindi. Five themes of waste segregation emerged from the received slogans: (1) Community awareness, responsibility, and support, (2) Significance of household waste segregation, (3) Use of separate dustbins, (4) Health and well-being, and (5) Environment and sustainability.DiscussionCrowdsourcing approaches can be used by local authorities for improving waste management approaches and are recommended as these involve a wider audience within a short time frame. Moreover, this approach is flexible and integrating crowdsourcing approaches strengthens our understanding of existing waste management activities.
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    Medical schools in India: pattern of establishment and impact on public health - a Geographic Information System (GIS) based exploratory study
    (BMC Public Health, 2020) Yogesh Sabde; Vishal Diwan; Vijay K. Mahadik; Vivek Parashar; Himanshu Negandhi; Tanwi Trushna; Sanjay Zodpey
    This study explores the geographic distribution of medical schools in India to identify such under and over served areas.