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    A performance evaluation framework of public health distribution network for essential medicines: lessons from the select Indian states
    (Int. Trans. Oper. Res., 2023) Rahul Kumar; Debadyuti Das
    The present work has been carried out to develop a performance evaluation framework of distribution network design in public health with specific reference to essential medicines based on six different types of public health distribution networks (PHDNs) prevalent across six Indian states. We evaluated the performance of PHDNs on the criteria of cost and service and also on the sub-criteria of cost and service by following the analytic hierarchy process. We utilized the pairwise comparison method in determining the relative importance of criteria and sub-criteria by seeking responses from several experts and subsequently evaluated the PHDNs on all sub-criteria in a 7-point Likert scale by seeking views from the same experts. Finally, we developed the cost-service matrix, in which cost and service have been depicted in the horizontal and vertical axes, respectively. We demonstrated the performance of six PHDNs in this matrix in terms of cost and service by plotting scores obtained by them on cost and service, respectively. The findings of the study provide rich insights to the policy planners of public health.
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    Abortion care seeking in India: patterns and predictors
    (J. Biosoc. Sci., 2020) Palak Sharma; Manas Ranjan Pradhan
    Unsafe abortions remain a considerable public health problem and continue to be a leading cause of maternal morbidity and mortality throughout the world. This study assessed whether women's choice of type of health care facility for abortion in India varied by their socio-demographic and economic characteristics, and aimed to determine the significant predictors of choice of health care facility. Data were taken from the 2015-16 Indian National Family and Health Survey (NFHS-4). The study sample included women aged 15-49 years, irrespective of their marital status, who had terminated their last pregnancy by induced abortion in the five years before the survey (N= 6876). A bivariate analysis was carried out to assess the pattern in the choice of health care facility type for an abortion, and a multinomial logistic regression model was fitted to assess the predictors affecting the choice of health care facility type for an abortion. The results showed that, at the time of the 2015-16 survey, women in India went to private facilities more than public facilities for abortion care, irrespective of their age, distance to facility and financial constraints. The probability of visiting a private facility increased with women's age, gestational age and the wealth quintile. A wide variation in choice of health facility for abortion care by socioeconomic characteristics was observed.