Learning from socially driven frugal innovation to design the future of healthcare: A case of mobile Primary Health Center.

Background and Aim: Despite their flaws, the low-cost but powerful economical solutions can ensure everyone has access to health. The main aim of this study is to extract characteristics of frugal innovation (FI) and social innovation (SI) for Primary Health Centers (PHCs) in low resource settings (LRS) for sustainable development. We will use the gained insights to design the mobile primary healthcare infrastructure using FI and SI strategies. There is a lack of methodology to design sustainable healthcare infrastructure for LRS. There is a gap in the literature about building sustainable infrastructure to provide basic healthcare facilities essential to the community. This article studies several factors necessary for designing sustainable infrastructure from the lens of FI, SI, and sustainability to develop a mobile healthcare infrastructure for last-mile people. Methods: Started with purposive sampled case studies to find out factors and criteria that most affect the success for an innovation to be frugal, social, and sustainable. The established criteria were used to design, develop, and deploy the mobile Primary Health Center (mPHC). Moving forward, we tested the system designed with stakeholders to gather insights. At this stage we found the feedback loop from the stakeholders and the role of interdisciplinary discussions between experts, medical officers, nurses, patient, and other staff of PHCs during the design, development, deployment, and test stage to be useful in taking design decisions efficiently. Results: The designed healthcare infrastructure of mPHC through the aspects of FI and SI proves to be efficient in providing key healthcare services to LRS. Conclusion: Focusing on essential capabilities and optimizing performance with technology, methodologies, and processes reduces costs in an innovation. Focus on socially inclusive and rebalancing power disparities, overcome societal challenges and improve human capabilities will create a sustainable and novel solution.

Primary Health Center: Can it be made mobile for efficient healthcare services for hard to reach population? A state-of-the-art review.

Indian healthcare system is in immediate need of a new healthcare delivery model to increase healthcare accessibility and improve the health outcomes of the marginalized. Inaccessibility and underutilization of Primary Health Centers (PHCs) disproportionately affect people living in remote areas. It is thus imperative for the designers, engineers, health professionals, and policymakers to come together with a collaborative mindset to develop innovative interventions that sustainably manage the accessibility of PHCs at large, promote preventive health, and thus improve the health outcomes of hard-to-reach communities. This article examines the available literature on barriers to primary healthcare in Indian context, the reason of failure of PHCs and the way forward. The article further analysis literature on existing Mobile Medical Units (MMUs) as an alternate solution to conventional PHCs and attempt to extract the major lessons to propose a mobile Primary Health Center (mPHC) in contrast to the existing conventional static PHCs. The intention is to find out the research gaps in the existing literature and try to address the same for future researchers, designers, engineers, health professionals and policy makers to think forward to make this idea of a mobile Primary Health Center (mPHC), as the main delivery model to cater basic healthcare services to the underserved communities.

Making primary healthcare delivery robust for low resource settings: Learning from Mohalla Clinics.

The present healthcare scenario is still in its compromised state, whether it is the lack of infrastructure, medicines and human resources, especially in rural India. Moreover, the condition worsens in rural areas due to several reasons like lack of awareness, proper roads to access, and lack of proper delivery of healthcare model. The state government of Delhi, India, set up the "Mohalla" Clinics to provide essential healthcare to residents of Delhi and the surrounding areas, focusing on the urban poor. Essential health services, such as vaccinations, family planning, and counselling, are available at the Mohalla Clinics, where a doctor, a nurse, a pharmacist, and a lab technician are staffed. Despite a strong start and low operating costs, the Mohalla Clinic initiative still struggles to cover all Delhi state as envisioned. This study analyses the operational challenges of Delhi's "Mohalla" Clinics and proposes lessons to be implemented for other primary healthcare infrastructure services for remote areas. The analysis is based on the systems (infrastructure, facilities, and services) strengths and limitations from a literature review and qualitative interview conducted among 55 respondents, including doctors, nurses, and patients among 11 Mohalla Clinics using the SUTD-MIT (Singapore University of Technology and Design-Massachusetts Institute of Technology Industrial Design Centre) interview template for Product Service System (PSS). The results show that there are lessons to learn from the model of Delhi Mohalla Clinics for other states to implement in their primary healthcare sectors. To achieve Universal Health Coverage (UHC), the Delhi Mohalla Clinic falls short due to several limitations. Thus, to achieve UHC, the Indian healthcare system needs a new healthcare delivery model. Hence, we ought to propose a new healthcare delivery model based on the gained insights from the study. One such delivery model proposed is a mobile Primary Health Center (mPHC). This collapsible system can be taken to far-flung regions, deployed for some hours, run the Out-Patient Department (OPD), collapsed, and returned to base.

Anti-bacterial and arsenic remediation insights in aqueous systems onto heterogeneous metal oxide (Cu0.52Al0.1Fe0.47O4)/rGO hybrid: an approach towards airborne microbial degradation.

Copper-based ternary metal oxide (i.e., Cu0.52Al0.01Fe0.47O4) impregnated reduced graphene oxide nanohybrid is verified for microbial and arsenic treatment. Growth inhibition of colonies are observed around 99.99% (E. coli), and 99.83% (S. aureus) at 10-20 µg/mL of hybrid dosage, respectively. The inhibition rates for both the colonies are increased to 99.9998% at 80 µg/mL. TEM images have shown insight of cell-content/lipid leakage behavior after inoculating with the hybrid. The efficient hindrance towards microbial colony growth is attributed to better charge transfer, reactive oxygen species generation, and metal-ion release. Maximum arsenic sorption capacities are observed around 248 and 314 mg/g for As(III), and As(V), respectively (Ci ~ 500 ppm). Surface morphology studies onto arsenic adsorption are reported with atomic force microscope, and FT-IR/Raman analysis. A detailed discussion onto individual spectra of As 3d spectra confirmed the occurrence of redox transformation in arsenic species [As(III)]. The variation in the quantity (at. %) of oxygen functional groups in O1s spectra (i.e., M-O, M-OH, and -OH2) onto the hybrid supported the ligand-exchange behavior. Cyclic voltammetry study in arsenic electrolytes (10 µM - 1 mM) provides the occurrence of various in-situ electrochemical reactions supporting the redox activity. A significant electromagnetic wave absorption characteristics of the present hybrid is proposed with plausible airborne antimicrobial-agent abilities.

Mapping wheelchair functions and their associated functional elements for stair climbing accessibility: a systematic review.

PURPOSE: Wheelchair (WC) design elements are subjected to the accessibility and assistive needs of a person with locomotor disability. In order to pursue a holistic design for a stairclimbing WC, there is a need for literature review on WC functions reported for both stair climbing and plane surface movement. METHODS: A total of 112 Research articles are reviewed for the purpose of extracting the relationship between WC design elements and the functions associated with them. Stairclimbing technologies are reviewed for their technological assessment in terms of functional elements associated with stairclimbing. Cross-functional mapping between functional elements and their dominant function is performed. Heat map for primary user needs and associated design elements is generated from cross mapping. CONCLUSIONS: A design gap for user's functional needs is indicated from the review of literature on prototypes and products of WC. The literature in stairclimbing technology is primarily focussed on stair climbing capability and not on the other functional needs, such as safety, ride comfort, seat comfort, manoeuvrability, etc.Implications for rehabilitationFor attaining the goal of an effective rehabilitation, it is important to design and develop an assistive technology that can provide maximum accessibility and functioning for a person with disability. In case of locomotor disability, wheelchair (WC) is the most empowering tool that can assist people in both accessibility and activities of daily living. This review of literature was conducted to draw out the functions fulfilled by a WC, such as safety, comfort, propulsion for its users and the associated WC elements like seat, wheels, backrest, etc., that are required to fulfil those functions.WC being the most important technological intervention in the life of a person who cannot walk should be designed with the highest level of empathy. Therefore, each and every aspect of the user's physical and emotional needs should be catered up to the limits of engineering design. The research on stair climbing technologies has also grown exponentially, fuelled by technological growth in engineering mechanisms, ambient awareness sensors, actuators, etc. The review attempts to envelop such technologies and consolidate them on the basis of their capabilities and efficacies.The virtue of stair climbing has been realized through some novel and innovative mechanisms reviewed in this article that can be integrated with the research in field of functional elements required to carry out primary functions of a disabled person, such as safety, comfort, intuitiveness, etc. This review can help in coupling both of them in a more rational way where a designer who is designing the technology is more empathetic towards the design for accessibility. It can also help user in becoming more confident towards adapting a new assistive technology.

Insights of arsenic (III/V) adsorption and electrosorption mechanism onto multi synergistic (redox-photoelectrochemical-ROS) aluminum substituted copper ferrite impregnated rGO.

The understanding of mechanistic insights in environmental remediation and mitigation systems is attracting larger attention, in recent days. Here in, aluminium substituted copper ferrite impregnated rGO hybrid (CAF-rGO) is verified to understand the adsorption/electrosorption mechanism of arsenic in aqueous systems. Near-surface study (XPS: As 3d, Cu 2p, Fe 2p, Al 2p, O 1s, C 1s) proposes redox, and ligand exchange reactions between contaminant, and CAF-rGO. Adsorption capacities are observed around 128.8 mg g-1 [As(III)], 153.5 mg g-1 [As(V)] with Freundlich model isotherms. Kinetics study follows the PSO model with influence of solar light (> 420 nm). Cyclic voltammetry (CV) analysis in different molarity conditions observed with signals around +0.1 and -0.6 V confirm the redox abilities, and N2/O2 purged environments understood that electrosorption occurred through both reduction and sorption. Electrosorption study with pH variation shows the effect of protonation on the redox activity of individual arsenic species. Consistent signal around -0.6 ± 0.05 V in all the CV plots (i.e., Molarity, Environment, pH) recommends the usage of CAF-rGO for arsenic mitigation. Possible influence of photo-current (∼40 µA/cm2 at âˆ¼ 0 V) towards As(III/V) decontamination is understood though photoelectrochemical analysis. Impedance plot shows low-resistance and better diffusion of arsenic oxy-anions during light irradiation. Synergistic nature of CAF-rGO generates reactive oxygen species (i.e., ●OH/●O2-/1O2) in mitigating highly toxic As(III) species is also detailed in the present work.

Arsenic surface complexation behavior in aqueous systems onto Al substituted Ni, Co, Mn, and Cu based ferrite nano adsorbents.

The present study is about surface complexation behavior of arsenic species adsorbed onto ternary metal oxide adsorbents (Ni-Al-Fe, Co-Al-Fe, Mn-Al-Fe, and Cu-Al-Fe). The analysis is carried out by X-ray absorption spectroscopy (XAS) tool. XANES (µ(E) vs. E) spectra close to the absorption edge (i.e., As K-edge) of all samples are observed along with the As(III) and As(V) standards. The first derivative of XANES for Ni-As(V), and Cu-As(V) samples agree with that of As(V) standards, respectively. Whereas, As(III) adsorbed adsorbent systems (i.e., Ni, Co, Mn, and Cu) are observed with mixed oxidation state of arsenic. A total of 65-85 % is observed with initial oxidation state (As(III) or As(V)), and remaining 15-35 % is observed with modified oxidation state (As(V) or As(III)) that explains the occurrence of possible charge transfer. EXAFS analysis shows the As-O bond distances in the range of 1.7-1.8 Å. The corresponding As-M bond distances are around 2.7, 3.2, and 3.6 Å which confirms the formation various edge sharing (2E), and corner sharing (2C, 1V) surface complexes. Surface coverage is understood as an important parameter as bidentate attachments (2E, 2C) are evident in As(III), and As(V), but monodentate attachments (1V) are only observed in As(V).

Redox synergistic Mn-Al-Fe and Cu-Al-Fe ternary metal oxide nano adsorbents for arsenic remediation with environmentally stable As(0) formation.

Arsenic mitigation behavior in aqueous systems is being evaluated for Mn-Al-Fe, Cu-Al-Fe nano adsorbents. Morphological, and vibrational spectroscopy analysis are observed with As-OH, and As-O surface complexes. XPS study of individual As(3d) spectra at different parameters is observed with multiplet peak behavior attributed to redox behavior of Mn-Al-Fe, Cu-Al-Fe. Significant proportions of As(0) signal (∼25 at.% in pH 7, ∼78 at.% in pH 2, ∼58 at.% in pH 12) implicate an environmentally stable behavior of these adsorbents to address the arsenic leaching issue. Adsorption kinetics are observed with Pseudo Second Order (PSO) model, and Freundlich model supported multilayer adsorption behavior is observed for adsorption isotherms. Trace metal voltammetry studies are observed with 75-90 % of As(III) mitigation in aliquot samples. Detailed study of Mn(2p), Cu(2p), Fe(2p), and O(1 s) spectra explains redox active, and surface ligand exchange synergism in arsenic adsorption. Low equilibrium concentrations (Ce < 10 ppb) in As(V) systems (Ci ∼ 100 and 500 ppb) indicate the drinking water application of these systems. Cyclic-voltammetry (CV) studies implicate the mitigation and immobilization of arsenic species onto adsorbent by both reduction, and sorption phenomenon.

Aluminum Substituted Cobalt Ferrite (Co-Al-Fe) Nano Adsorbent for Arsenic Adsorption in Aqueous Systems and Detailed Redox Behavior Study with XPS.

Arsenic [As(III) and As(V)] adsorption on aluminum substituted cobalt ferrite (Co-Al-Fe) ternary metal oxide adsorbent is reported by means of qualitative and quantitative spectroscopy tools. IR and Raman active signals were observed around 810-920 cm-1 band indicate different As-OHcomplexed and As-Ouncomplexed stretching vibrations on to the adsorbent. The adsorption behavior of arsenic (III and V) onto these adsorbents is studied as a function of contact time, different concentrations, and pH conditions. The kinetics study on adsorption were performed to understand nature of adsorption which supports the Pseudo Second Order (PSO) model. The adsorption isotherms study indicates Freundlich type of adsorption. The maximum adsorption capacity of Co-Al-Fe adsorbent is observed around 130 and 76 mg g-1 for As(III) and As(V) systems, respectively. Detailed XPS study of As 3d, Fe 2p, Co 2p, and O 1s spectra has been reported in explaining the redox behavior and ligand exchange reactions in supporting arsenic adsorption mechanism.