Impact of Coastal Pollution on Microbial and Mineral Profile of Edible Oyster (Crassostrea rivularis) in the Coastal Waters of Andaman.

The impact of coastal pollution was studied using edible oysters, Crassostrea rivularis as an indicator at two sites viz., North Wandoor (NW) and Phoenix Jetty (PJ) in Port Blair, Andaman. The hydrographic parameters showed that nitrite, nitrate and phosphate concentration were less and dissolved oxygen were more at NW compared to PJ. The oysters were collected from the study sites and biochemical, microbial, mineral profiles and ATPase activities were estimated. ATPase activity was inhibited in the gill tissue of oysters (p<0.05) of PJ sample. Total microbial load in the water and oyster, and coliform bacteria (MPN) in the water were significantly (p<0.05) higher at PJ compared to the NW. There was no significant difference (p>0.05) in the mineral profile of water collected from both the sites. However, calcium and magnesium were more in the oysters collected from NW (p<0.05), and Cu, Zn and Cd were more in PJ samples (p<0.05).

Availability and distribution of emergency obstetric care services in Karnataka State, South India: access and equity considerations.

BACKGROUND: As part of efforts to reduce maternal deaths in Karnataka state, India, there has been a concerted effort to increase institutional deliveries. However, little is known about the quality of care in these healthcare facilities. We investigated the availability and distribution of emergency obstetric care (EmOC) services in eight northern districts of Karnataka state in south India. METHODS & FINDINGS: We undertook a cross-sectional study of 444 government and 422 private health facilities, functional 24-hours-a-day 7-days-a-week. EmOC availability and distribution were evaluated for 8 districts and 42 taluks (sub-districts) during the year 2010, based on a combination of self-reporting, record review and direct observation. Overall, the availability of EmOC services at the sub-state level [EmOC = 5.9/500,000; comprehensive EmOC (CEmOC) = 4.5/500,000 and basic EmOC (BEmOC) = 1.4/500,000] was seen to meet the benchmark. These services however were largely located in the private sector (90% of CEmOC and 70% of BemOC facilities). Thirty six percent of private facilities and six percent of government facilities were EmOC centres. Although half of eight districts had a sufficient number of EmOC facilities and all eight districts had a sufficient number of CEmOC facilities, only two-fifths of the 42 taluks had a sufficient number of EmOC facilities. With the private facilities being largely located in select towns only, the 'non-headquarter' taluks and 'backward' taluks suffered from a marked lack of coverage of these services. Spatial mapping further helped identify the clustering of a large number of contiguous taluks without adequate government EmOC facilities in northeastern Karnataka. CONCLUSIONS: In conclusion, disaggregating information on emergency obstetric care service availability at district and subdistrict levels is critical for health policy and planning in the Indian setting. Reducing maternal deaths will require greater attention by the government in addressing inequities in the distribution of emergency obstetric care services.

Strengthening of local vital events registration: lessons learnt from a voluntary sector initiative in a district in southern India.

PROBLEM: Birth and death registration rates are low in most parts of India. Poor registration rates are due to constraints in both the government system (supply-side) and the general population (demand-side). APPROACH: We strengthened vital event registration at the local level within the existing legal framework by: (i) involving a non-profit organization as an interface between the government and the community; (ii) conducting supply-side interventions such as sensitization workshops for government officials, training for hospital staff and building data-sharing partnerships between stakeholders; (iii) monitoring for vital events by active surveillance through lay-informants; and (iv) conducting demand-side interventions such as publicity campaigns, education of families and assistance with registration. LOCAL SETTING: In the government sector, registration is given low priority and there is an attitude of blaming the victim, ascribing low levels of vital event registration to "cultural reasons/ignorance ". In the community, low registration was due to lack of awareness about the importance of and procedures for registration. RELEVANT CHANGES: This initiative helped improve registration of births and deaths at the subdistrict level. Vital event registration was significantly associated with local equity stratifiers such as gender, socioeconomic status and geography. LESSONS LEARNT: The voluntary sector can interface effectively between the government and the community to strengthen vital registration. With political support from the government, outreach activities can dramatically improve vital event registration rates, especially in disadvantaged populations. The potential relevance of the data and the data collection process to stakeholders at the local level is a critical factor for success.