ABSTRACT
Ajeerna (Indigestion) is the state of unfinished process of digestion of ingested food. Kana Kajjali is a classical formulation indicated in the treatment of Ajeerna. It is prepared by Kana (Piper longum)- a herbal drug and herbomineral preparation Kajjali (Black sulphide of mercury). In the present study, an effort has been made to assess the effect of herbomineral formulation Samaguna (Hg:S=1:1) Kana Kajjali and Shadadguna (Hg:S=1:6) Kana Kajjali (Black sulphide of Mercury with Piper longum)on indigestion. Materials and methods: The study was carried out on 83 patients of indigestion. Patients were divided into three groups with simple random sampling method: Group A was treated with Samaguna Kana Kajjali tablet at the dose of 125 mg; Group B was treated with Kana tablet 250 mg; while group C was treated Shadaguna Kana Kajjali tablet at the dose of 125 mg; twice a day after meal. Duration of the treatment was 10 days. Assessment was done on the basis grading of classical signs and symptoms of the disease with application of paired t- test. Results: Highly significant (p<0.001) effect was seen in Samaguna Kana Kajjali group on symptoms like Angamarda, Tiktoamlodgara and Shadguna Kana Kajjali on one Vataja symptom viz. Pravahanam and three Kaphaja symptom viz. Utlesha, Arochaka and Avipaka with best result with Shadguna Kana Kajjali especially on Kaphaja symptoms. Conclusion: Above study confirms that an increase in the concentration of Gandhaka in Parada enhances the therapeutic efficacy of the later drug.
ABSTRACT
Background & objectives: The evidence-base of the impact of community-based health insurance (CBHI) on access to healthcare and financial protection in India is weak. We investigated the impact of CBHI in rural Uttar Pradesh and Bihar States of India on insured households’ self-medication and financial position. Methods: Data originated from (i) household surveys, and (ii) the Management Information System of each CBHI. Study design was “staggered implementation” cluster randomized controlled trial with enrollment of one-third of the treatment group in each of the years 2011, 2012 and 2013. Around 40-50 per cent of the households that were offered to enroll joined. The benefits-packages covered outpatient care in all three locations and in-patient care in two locations. To overcome self-selection enrollment bias, we constructed comparable control and treatment groups using Kernel Propensity Score Matching (K-PSM). To quantify impact, both difference-in-difference (DiD), and conditional-DiD (combined K-PSM with DiD) were used to assess robustness of results. Results: Post-intervention (2013), self-medication was less practiced by insured HHs. Fewer insured households than uninsured households reported borrowing to finance care for non-hospitalization events. Being insured for two years also improved the HH’s location along the income distribution, namely insured HHs were more likely to experience income quintile-upgrade in one location, and less likely to experience a quintile-downgrade in two locations. Interpretation & conclusions: The realized benefits of insurance included better access to healthcare, reduced financial risks and improved economic mobility, suggesting that in our context health insurance creates welfare gains. These findings have implications for theoretical, ethical, policy and practice considerations.
ABSTRACT
Background & objectives: Despite remarkable progress in airborne, vector-borne and waterborne diseases in India, the morbidity associated with these diseases is still high. Many of these diseases are controllable through awareness and preventive practice. This study was an attempt to evaluate the effectiveness of a preventive care awareness campaign in enhancing knowledge related with airborne, vector-borne and waterborne diseases, carried out in 2011 in three rural communities in India (Pratapgarh and Kanpur-Dehat in Uttar Pradesh and Vaishali in Bihar). Methods: Data for this analysis were collected from two surveys, one done before the campaign and the other after it, each of 300 randomly selected households drawn from a larger sample of Self-Help Groups (SHGs) members invited to join community-based health insurance (CBHI) schemes. Results: The results showed a significant increase both in awareness (34%, p<0.001) and in preventive practices (48%, P=0.001), suggesting that the awareness campaign was effective. However, average practice scores (0.31) were substantially lower than average awareness scores (0.47), even in post-campaign. Awareness and preventive practices were less prevalent in vector-borne diseases than in airborne and waterborne diseases. Education was positively associated with both awareness and practice scores. The awareness scores were positive and significant determinants of the practice scores, both in the pre- and in the post-campaign results. Affiliation to CBHI had significant positive influence on awareness and on practice scores in the post-campaign period. Interpretation & conclusions: The results suggest that well-crafted health educational campaigns can be effective in raising awareness and promoting health-enhancing practices in resource-poor settings. It also confirms that CBHI can serve as a platform to enhance awareness to risks of exposure to airborne, vector-borne and waterborne diseases, and encourage preventive practices.