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BackgroundThe Clinton Health Access Initiative implemented a program from 2012-2016 to increase use of oral rehydration salts (ORS) and zinc to treat diarrhea in children under five in three states in India: Gujarat, Madhya Pradesh, and Uttar Pradesh. The program interventions included detailing and development of a rural supply chain to reach private rural health care providers, training of Accredited Social Health Activists (ASHAs), technical support to the state governments, and a mass media campaign targeted at caregivers. In Gujarat and Uttar Pradesh, some of the program activities, such as detailing and ASHA trainings, were targeted to high-burden focal districts, thus providing an opportunity to study their effect compared to statewide activities that covered all districts, such as the mass media campaign. Our study aimed to estimate the effect of activities on ORS and zinc use.MethodsHousehold surveys were conducted at two points during the program and in both focal and non-focal districts. We used a difference-in-difference quasi-experimental approach to estimate the effect of the enhanced activities in focal districts and mass media campaign on the odds of a child being treated with ORS and zinc.FindingsFocal district interventions were associated with a significant increase in the odds of a diarrhea episode receiving ORS in Gujarat and Uttar Pradesh. Living in focal districts increased the odds of receiving ORS in Gujarat and Uttar Pradesh by factors of 3.42 (95% CI = 1.39-8.33) and 2.29 (95% CI = 1.19-4.39), respectively. Focal district interventions were also associated with 15.02 (95% CI = 2.97-75.19) greater odds of receiving both ORS and zinc in Gujarat. In Uttar Pradesh, where the mass media campaign was focused, exposure to the campaign further modified the odds of receiving ORS and combined ORS and zinc by 1.38 (95% CI = 1.04-1.84) and 1.57 (95% CI = 1.01-2.46), respectively.ConclusionComprehensive public and private provider interventions combined with mass media are effective strategies for increasing ORS and zinc use.

objectives In India, frontline workers (FLWs)public accredited social health activists (ASHAs) and private rural medical providers (RMPs)are important for early detection and treatment of childhood diarrhoea and pneumonia. This cross-sectional study aims to measure knowledge and skills, and the gap between the two ('know-can' gap), regarding assessment of childhood diarrhoea with dehydration and pneumonia among FLWs, and to explore factors associated with them.methods We surveyed 473 ASHAs and 447 RMPs in six districts of Uttar Pradesh. We assessed knowledge and skills using face-to-face interviews and video vignettes, respectively, about key signs of both conditions. The 'know-can' gap corresponds to absent skills among FLWs with correct knowledge. We used logistic regression to identify the correlates of knowledge and skills.results FLWs' correct knowledge ranged from 23% to 48% for dehydration signs and 27% to 37% for pneumonia signs. Their skills ranged from 3% to 42% for dehydration and 3% to 18% for pneumonia. There was a significant 'know-can' gap in all the signs, except 'sunken eyes'. Training and supervisory support was associated with better knowledge and skills for diarrhoea with dehydration, but only better knowledge for pneumonia.conclusions FLWs are crucial to the Indian health system, and high-quality FLW services are necessary for continued progress against under-five deaths. The gap between FLWs' knowledge and skills warrants immediate attention. In particular, our results suggest that knowledge-focused trainings are insufficient for FLWs to convert knowledge into appropriate assessment skills. Tropical Medicine and International Health volume 25 no 4 pp 454-466 april 2020 L. Ray Saraswati et al. 'Know-can' gap among frontline workers in India 62.6 (56.1, 68.7) NA ASHA received training on ASHA module 60.4 (55.7, 64.9) NA Exposure and training on childhood diarrhoea management Received focused training on diarrhoea 51.0 (45.7, 56.4) 10.0 (5.3, 18.1) Presence of job-aid related to childhood diarrhoea management 52.5 (47.0, 58.0) 37.2 (28.3, 47.1) Received information about childhood diarrhoea from TV 55.2 (49.3, 60.9) 60.6 (50.5, 69.8) Received information about childhood diarrhoea from a government health worker 87.7 (83.9, 90.7) 39.8 (30.1, 50.4) Received information about childhood diarrhoea from a non-government health worker 17.9 (14.2, 22.4) 49.2 (38.8, 59.7) Personally seen at least one case of childhood diarrhoea in last 7 days 25.2 (20.5, 30.5) 52.2 (42.3, 61.9) Exposure and training on childhood pneumonia management: Received focused training on pneumonia 43.1 (37.6, 48.7) 8.3 (4.0, 16.6) Presence of job-aid related to childhood pneumonia management 33.2 (28.4, 38.4) 9.8 (4.2, 21.5) Received information about childhood pneumonia from TV 40.1 (34.9, 45.5) 59.1 (49.1, 68.4) Received information about childhood pneumonia from a government health worker 79.4 (73.9, 83.9) 31.8 (21.5, 44.3) Received information about childhood pneumonia from a non-government health worker 14.7 (11.0, 19.3) 46...

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Adaptation towards digitalization in pharmaceuticals leads to the utilization and development of Artificial Intelligence (AI). Significantly it is reducing human workload with the help of an algorithm. Already AI is acting as a key in clinical trial, health care, quality management, manufacturing, product development, and management. Top pharmaceutical companies have adopted AI in different applications within the pharma sector. Different AI models like Machine learning, Artificial Neural Network, Deep Learning, robotics, and Natural Language Processing are being used in pharmaceuticals and healthcare systems. The Worldwide AI market is growing remarkably with a compound annual growth rate of 49.6% and is expected to reach $18,119 million by 2025. So, for better regulation, concerning safety, privacy regulatory strategy is heading towards a better framework. Different regulatory authorities like China, Europe, and United States (US) have adopted AI for economic and policy aspects. Emerging countries are using these tools for administrative work. US has begun implementing frameworks for AI adaptation, research, and development. The AI policy strategy started in 2016 with a series of workshops conducted under the Obama administration. Federal Food and Drug Administration (FDA) has also published draft guidance for regulatory oversight of AI and Machine Learning. In 2021 FDA published a draft regulation for software as a medical device. This review article provides a snapshot of AI implementation in pharmaceuticals and health care with the regulatory approach in the US.