Background : The collaborative quality improvement approach proposed by the Institute for Healthcare Improvement has the potential to improve coverage of evidence-based maternal and newborn health practices. The Safe Care, Saving Lives initiative supported the implementation of 20 evidence-based maternal and newborn care practices, targeting labour wards and neonatal care units in 85 public and private hospitals in Telangana and Andhra Pradesh, India. Objective : We present a protocol for the evaluation of this programme which aims to (a) estimate the effect of the initiative on evidence-based care practices and mortality; (b) evaluate the mechanisms leading to changes in adherence to evidence-based practices, and their relationship with contextual factors; (c) explore the feasibility of scaling-up the approach. Methods : The mixed-method evaluation is based on a plausibility design nested within a phased implementation. The 29 non-randomly selected hospitals comprising wave II of the programme were compared to the 31 remaining hospitals where the quality improvement approach started later. We assessed mortality and adherence to evidence-based practices at baseline and endline using abstraction of registers, checklists, observations and interviews in intervention and comparison hospitals. We also explored the mechanisms and drivers of change in adherence to evidence-based practices. Qualitative methods investigated the mechanisms of change in purposefully selected case study hospitals. A readiness assessment complemented the analysis of what works and why. We used a difference-in-difference approach to estimate the effects of the intervention on mortality and coverage. Thematic analysis was used for the qualitative data. Discussion : This is the first quality improvement collaborative targeting neonatal health in secondary and tertiary hospitals in a middle-income country linked to a government health insurance scheme. Our process evaluation is theory driven and will refine hypotheses about how this quality improvement approach contributes to institutionalization of evidence-based practices.

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Background: Depression is commonly reported by university students due to change in environment, academic demands, developing new relations and more financial freedom. If that professional course happens to be medical education, the transition is even more drastic. Studies have also shown that Quality of Life (QOL) is negatively affected by the presence of anxiety and depression. Aim: Present study aims to find the prevalence of anxiety, depression and stress among students who have recently joined medical college. Materials & Method: This cross-sectional study was undertaken at Private medical college in north India. Depression, Anxiety and Stress Scale (DASS) was used for the data collection. MBBS students who have joined the institution in August 2019 were included in the study. Statistical Analysis Used: Data was entered in excel and analysed using Statistical Package for Social Science (SPSS) Version 21. Result: We found that almost half of the students who participated in the study had scores above 10 (meaning thereby depressed) on the depression scale, with 23.5% of respondents showing moderate or severe depression. Two-third students experienced anxiety, with 20% students having severe to very severe anxiety. Stress levels amongst the students were also high, with 47% of the students reporting stress. 3.4% students experienced severe or very severe stress. Conclusion: Medical students have high prevalence of stress, anxiety and depression. It is recommended that medical colleges should implement appropriate and timely measures to address students’ well-being and offer comprehensive intervention and preventive programs to help students cope with this transition phase.

Introduction: Under-nutrition contributes to more than one-third of all deaths in children. It does this by diminishing children's immunity and making illness more dangerous. The primary aim of the study is to assess the nutritional status of children aged from 0 to 14 years in a slum area of Kolkata and secondary aim is to determine the prevalence of under-nutrition and its association with various risk factors among the study population. Materials and Methods: Community-based cross-sectional analytical study was carried out in urban slum of Chetla, Kolkata involving children of age group (0-14 years) from February to May 2012. All children (120) were examined clinically; their anthropometric measurements such as weight, height, mid upper arm circumference (MUAC) were taken using the standard operating procedures, after obtaining verbal consent from their parents with the help of a predesigned and pre-tested schedule. The anthropometric data was analyzed using World Health Organization Anthro and Anthro Plus Softwares. Results: The overall prevalence of under-nutrition among the study population was found to be 54 (45%). Among infants 9 (25%) were underweight, 3 (8.3%) were stunted, 22 (61.1%) were wasted and 23 (63.9%) showed thinness. Among 1-5 years aged children, 18 (30.5%) were underweight, 17 (28.8%) were stunted, 17 (28.8%) were wasted, 12 (20.3%) had MUAC 12.5-13.5 cm and 17 (28.8%) showed thinness. Among 5-14 years aged children, 11 (44%) were underweight, 10 (40%) were stunted and 12 (48%) showed thinness. Conclusion: The nutritional status of children in Chetla slum is not satisfactory in spite of proper immunization coverage and institutional deliveries. Special emphasis should be given for promotion of nutritional education to the mothers.