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Thesis Shodhganga

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with the electronic transfer of funds up to district level in almost all states. The CRM teams visiting Maharashtra, Assam and Kerala had reported a number of innovations like evening OPD, scaled up boat clinics from Kerala and Assam as the innovation in palliative care in Kerala . Sustained increase in institutional delivery reflecting the continuing gains of Reproductive and Child Health ...

Missions or CRMs reviews by independent authorities and publications of
several scholars on National Rural Health Mission could fall in the third
category Finally the reports of National Family Health Surveys District Level
Family Health Survey the Sample Registration System or SRS Bulletins and
Survey on rural health or RHS could be termed as a fourth major category of
literature under the research Some of such materials cited but some not cited
though they definitely helped in creating opinion
Reading books enable to understand the meaning of health the sociology of
health and health determinants This was important because without such
acquaintance it was not possible to measure and evaluate any public health
National Rural Health Mission was having a mechanism to generate reports on
the work done and performance of different programs Such reports provided an
extensive gamut of status related to the progress and performance of a particular
program During the research such reports pertaining to national state and
district levels of different years were analyzed to depict logical conclusions
But solely relying on internal reports of the National Rural Health Mission it
was not possible to measure the final outcome of National Rural Health Mission
because it would form somehow a weak basis for putting valid arguments in
support of the outcome of National Rural Health Mission Also for this sake the
reports of Common review missions also not fully accepted by the research
scholar Therefore further reports related to different other agencies especially
World health organization were also examined and compared Further the study
and evaluation based on reports of the National family health survey reports
Sample registration system reports rural health survey reports provided some
more justifiable and logical inferences on outcome of National Rural Health
Mission and thus research scholar adopted those sources or literatures
However very few of the studies had considered that National Rural Health
Mission failed in several disciplines and its implementation was not adequate
Some had reported about the malpractices on a large scale in some states as
more and more cases of corruption reported from states like Jharkhand Bihar
and Uttar Pradesh Research scholar had also come across several such
literatures which had doubted the future of personnel employed under the
National Rural Health Mission Some reports had specifically mentioned about
the drawbacks of various aspects related to National Rural Health Mission such
as contractual appointments low salary and engagement as voluntary basis
lack of work culture and cadre conflicts Ganguly 2011 In addition some
studies had pinpointed about vested interests in the health sector and so much so
that they declared the overall health sector reforms being implemented under
some international pressure therefore international guidelines followed and
framework had promoted foreign vested interests as the supply of equipments
drugs and know how were too expensive However it was required developing
cheap medicines vaccines and logistics within the country Although research
scholar considered all such literatures and never termed them incorrect or biased
despite most of them were not according to academic traditions and also not
adequately substantiated with means of some evidences and correct hypothesis
Some scholars had opinioned that National Rural Health Mission was
successful in the initial stages and then its progress became stagnant and not
progressed adequately on several core issues Those negative issues studies and
reporting also not put aside and considered in this study without finding them
irrelevant R Tyagi 2011
Thus the literatures review under the research could describe as hereafter in
alphabetic orders
6 1 Action Points and Time line of activities prescribed under NRHM by
Ministry of health and family welfare Government of India This document
provided information about various action points and the timeline prescribed to
accomplish those action points and this was a major source of information for
various aspects of overall execution of NRHM MOHFW 2005
6 2 A paradigm shift in HR policy under NRHM this document provided
information about one of the major shifts in public health scenario under NRHM
especially in the field of HR which noticed as hiring and engaging a large
number of employees on contract basis In most cases medical management
nurses paramedics technicians and IT experts were extended limited period of
contracts ranging from 2 5 years Prasad 2009
6 3 All States Common Review Mission Reports by the Ministry of
health and family welfare Government of India A Common Review
Mission or CRM was set up as part of the Mission Reviewing Steering Group s
mandate of review and concurrent evaluation of the NRHM on yearly basis The
common review mission had submitted its three reports in the year 2007 2008
2009 2010 and 2011 The all CRMs declared that NRHM was mostly
successful in its core strategies MOHFW CRMs Periodical
Reports of different years take up different issues Reports also talked of
advocacy and prioritization of policies to promote rational drug prescription and
hospital pharmacy based prescription with free drugs in every public health
facility procurement and supply of Generic drugs at reasonable rates with
assured quality for social protection of the poor against the rising costs of health
care especially the rising costs of essential drugs
CRM report also emphasized on continuation of contract service providers and
technical and management support staff into the next plan period to promote
long term planning of services
The Fourth Common Review Mission had found appreciable improvement in
Integrated Disease Surveillance Project infrastructure and flow of information
through Health Management Information Systems particularly in Orissa and
Chhattisgarh as in Punjab and Chandigarh There had been substantial
improvements in the process of accounting with the addition of staff with
improved leadership arrangements with the use of customized software and
with the electronic transfer of funds up to district level in almost all states
The CRM teams visiting Maharashtra Assam and Kerala had reported a
number of innovations like evening OPD scaled up boat clinics from Kerala
and Assam as the innovation in palliative care in Kerala Sustained increase in
institutional delivery reflecting the continuing gains of Reproductive and Child
Health program assured referral transport and emergency response system
especially in Assam Tamil Nadu Uttaranchal improved availability of
essential drugs increased incidence of Male sterilization in States like Assam
Punjab Maharashtra are some of the main findings of CRM Report Nutrition
Rehabilitation Centres were found functional in the States of Assam Madhya
Pradesh Rajasthan Jharkhand Maharashtra Chhattisgarh and Uttar
Pradesh Most states had reported good coordination between the Auxiliary
Nurse Midwife Aanganwadi Workers and the Accredited Social Health
Activist In maternal health there had been considerable progress with almost
76 health facilities with C section capabilities being functional in the 30 districts
visited and a network of PHCs and CHCs providing institutional care for the
pregnant women The facility based care for the sick newborn and child
similarly scaled up in the coming year Other major positive findings included
the expansion in nursing education MOHFW CRMs Periodical
6 4 An integrated approach towards Public Private Partnership PPP
This article highlighted several weaknesses in the public health system also put
forward notions about the inadequacy of the health coverage and suggested
public private partnerships as a method to tackle those shortcomings CII 2010
6 5 Assessment of human resource management practices in Lebanese
hospitals by Fadi El Jardali Victoria Tchaghchagian and Diana Jamal
This document provided information and considered sound human resources
HR management practices were essential for retaining effective professionals
in hospitals Given the recruitment and retention reality of health workers in the
twenty first century the role of HR managers in hospitals and those who
combined the role of HR managers with other responsibilities not
underestimated The objective of this study was to assess the perception of HR
managers about the challenges they faced and the current strategies adopted
The study also aimed at assessing enabling factors including the role education
experience and HR training Fadi El Jardali 2006
6 6 Block Granting Performance Based Incentives and Fiscal Space Issue
the New Generation of HRH Reforms in Rwanda This power point
presentation delivered at the first forum meeting on human resources for health
in Kampala It reviewed a study of how Rwanda faced with constrained fiscal
conditions had implemented innovative reforms to create fiscal space for
human resources and to make these resources more responsive to needs through
an analysis of budget documents and policy and regulatory changes and key
informant interviews The presentation was considered equally good for India
by the research scholar as he cited human resources for the health sector in India
weakest Research scholar saw no harm in implementing those HR practices if
there were some funds scarcities Granting 2006
6 7 Qualitative research Methods and Chapter Research questions and
hypothesis by Devi Pawar This book by the author provided information
about the qualitative research methods By reading this book research scholar
get aqcuited with research atomosphere
6 8 Building capacity in human resources management for health sector
reform and the organizations and institutions comprising the sector by
Sarah Johnson This article said about the importance of human resources
management for the health sector reforms It also prescribed tools for
assessment of HRD Research scholar found HRD assessment tool highly
suitable and it required assessment of health organizations in India with such
tools The assessment methods used by the author were logical and perusable
6 9 Burden of Disease in India this article described the burden of diseases
in India It identified 17 diseases conditions that public policy needed to take
note of on priority The list included both the set of pre transition diseases or
diseases of underdevelopment as they disproportionately affected the poor more
and post transition diseases or diseases of affluence normally referred to as
lifestyle diseases which believed to affect the rich more Based on an
exhaustive literature review the experts attempted to provide a baseline of
disease prevalence today and causal analysis indicating the various direct and
indirect factors that contributed to the persistence of these diseases
Surprisingly we found it difficult to provide even current level estimates for
diseases conditions that implemented with substantial donor funding under the
National Health Programs We therefore could not come up with any estimates
for malaria or other vector borne diseases reproductive health several
childhood diseases such as respiratory infections etc Even for tuberculosis
TB arriving at any projections for 2015 under the emerging scenario of the
rising HIV AIDS epidemic was impossible For those reasons it was difficult to
come up with any specific targets achieved within a limited period NCMH
6 10 Building Capacity in Human Resources Management for Health
Sector Reform and the Organizations and Institutions Comprising the
Sector This technical brief was focused on the relationship between human
resource management and health sector reform in Latin America and Caribbean
6 11 Case study as a research method by Yin and Soy This article had
defined the case study research method as an empirical inquiry that investigated
a contemporary phenomenon within its real life context when the boundaries
between phenomenon and context were not evident and in which multiple
sources of evidence used
6 12 Census of India reports 2001 2011 by the Census office of
Government of India By comparing data of two census reports especially for
the 2001 and 2011 several results verified under the research Changes in
decade growth rates sex ratios percent of population in reproductive age it s
confirmed It noted here that it was highly fortunate to have the census report for
the year 2011 also which became available at a later stage of the research
especially towards the end of the research and its availability was extremely
important for this research Census of India 2001 2011
6 13 Community medicine in India The author of this book which published
by Jaypee publications New Delhi had said that NRHM appeared to be a well
designed program with all components of a successful community based
program where the existing health system utilized with community
involvement and participation supported by a community volunteer Lahariya
6 14 Comparative Analysis of the Changes in Nursing Practice Related to
Health Sector Reform in Five Countries of the Americas This study
provided initial information about current nursing issues that had arisen because
of health care reform initiatives Regardless of differences in service models or
phases of health sector reform implementation in all the countries the
participating nurses had identified many common themes trends and changes
in nursing practice The driving forces for change and their intensity had been
different in the five countries It emphasized on implementing country specific
plans for management of health work force
6 15 Concurrent Evaluation of percent JSY II This document was related
to the findings of concurrent evaluations of JSY in eight districts of Rajasthan
Concurrent evaluation started under the National Rural Health Mission proved
beneficial where it executed MOHFW 2009
6 16 Constitution of Empowered Action Group by Government of India
This document provided information about how the EAG constituted and how
some backward states of the country were identified and how it had
recommended some special arrangements for backward states of the country
MOHFW 2003
6 17 Creating Project Based Organizations to Deliver Value by Michel
Thiry Project Based Organizations or PBOs were fast emerging as a serious
trend but many organizations still did not understood how to structure
themselves effectively create a strategic advantage from projects PBOs needed
to be structured to create synergy between strategy project program and
portfolio management and the project approach needs to both generate tangible
value for the stakeholders and be sustainable PBOs referred to a variety of
organizational forms that involved the creation of temporary systems for the
performance of project tasks or activities They included matrix organizations
projected organizations and other forms of organizations that privilege a project
approach for conducting their activities PBOs were receiving increased
consideration as an emerging organizational form but many researchers
reported that there was very little knowledge on how project based
organizations actually operate in practice There were also very few references
on how the extensive use of unique and temporary endeavors like projects and
programs can influence the strategy and the design of organizations As the
application of project management was spreading in organizations one needed
to understand the different project based organizational models that could
accommodate various situations and address the issues of compartmentalization
typical of traditionally structured organizations versus integration typical of
networked organizations as they structured their project based organizations
Thiry M 2008
6 18 Data by Schostak John This article defined a data for a research This
article also defined the term data under a research and made research scholar
able to understanding the meaning of varied data Schostak J 2005
6 19 Decentralization and Health System Reform This document offered
some help in addressing decentralization for health sector actors interested in
designing decentralization policies and strategies implementing them and or
operating within decentralized health systems
6 20 Defining health by Meenakshi This document provided several
definitions of health and relevant issues Meenakshi 2003
6 21 Delivering Micro Health Insurance through the National Rural Health
Mission This article had thought about the stimulation of the health insurance
The success of NRHM as well as micro insurance development was interrelated
This was especially true of health micro insurance for which few were truly
6 22 Delivery of rural health care services by T V Sekher This article
explained the delivery of rural healthcare services in India though the networks
of the health department had spread to almost every village the availability and
utilization of the services continued to be very poor and grossly inadequate In
this situation could the Punchayati Raj institutions or PRIs make a difference in
the delivery of rural health care services The philosophy behind bringing the
line departments including health responsible for providing essential services
under the supervision of local elected bodies was to achieve an overall
improvement in the delivery of services at the grass roots level This facilitated
through the interventions of PRIs by making health services responsive to local
needs more accountable to the local population focusing on local problems
prioritizing the requirements generating public demand for the services and
efficient use of available resources
6 23 Directory of innovations in public health sector of India by the
Ministry of health and family welfare Government of India in coperation
with DFID United Kingdom This document listed the innovations performed
in different states of the country under the aegis of NRHM RCH II The term
innovations had been used in a flexible manner and covered new approaches as
well as testing out known approaches in different contexts The majority of the
227 innovations listed in this report were those that supported through central
funds Innovations that piloted by non governmental organizations NGOs
Development Partners DPs and State Governments had also been included
Some innovations spanned several states while many were state specific The
innovations were all being piloted in the context of substantial investments from
national and state levels on improving the health infrastructure strengthening
health systems promoting social mobilization and community participation
enabling decentralized health planning and implementation incentivizing
performance and quality to retain and attract human resources and strengthening
program management and monitoring The innovations categorized into themes
that roughly followed those laid out in the National Program Implementation
Plan of RCH II and in the Implementation Framework of the NRHM Nine
major themes along with sub categories for three themes identified that span the
major thematic areas of RCH II NRHM DFID 2009
6 24 District level household surveys DLHS District level household
surveys DLHS were an extremely important source of secondary data under
this research It was a household survey on the district level and in DLHS 3 the
survey covered 611 districts in India The DLHS 3 provided information on
family planning maternal and child health reproductive health of ever married
women and adolescent girls utilization of maternal and child health care
services at the district level for India In addition DLHS 3 also provided
information on newborn care post natal care within 48 hours role of ASHA in
enhancing the reproductive and child health care and coverage of Janani
Suraksha Yojna JSY An important component of DLHS 3 was the integration
of Facility Survey of health institution Sub Centre Primary Health Centre
Community Health Centre and District Hospital access to the sampled villages
The focus of DLHS 3 was also to provide health care and utilization indicators
at the district level for the enhancement of the activities under the National
Rural Health Mission DLHS 2011
6 25 District program management unit Delhi government and
recruitments of personnel under NRHM On Contract basis by the IDHS
NW This document provided information about the vacancy advertisement of
Delhi government health society seeking applications for various positions It
provides information on qualifications essential for different categories of
employees under NRHM salary offered and job terms Delhi 2009
6 26 Economic Survey 2008 09 Lack of doctors shoddy infrastructure
hampering health sector According to this article there was acute shortage
of trained medical personnel and adequate health Centre were hindering a
steady improvement of India s health sector According to the Economic Survey
2008 09 India was short by 28 000 healths Centre which included 20 855 Sub
Centre 4 833 primary healths Centre PHC and 2 525 Community Health
Centre CHC Almost 34 percent of the existing health infrastructure was in
rented buildings Poor upkeep and maintenance and high absenteeism of
workforce in rural areas were the main problems in the health delivery system in
the public sector the Survey said While there are 1 5 million nurses in the
country doctors in the modern system of medicine number just 84 852 The
survey highlighted the achievements of the National Rural Health Mission
NRHM It said 6 49 health workers had been selected up to December 2008 to
work under NRHM of which 0 563 million had already been given orientation
training Around 0 412 million of these workers already had drug kits with
them Around 9 073 doctors 1 875 specialists and 20 977 staff nurses appointed
on contract in the states Around 243 Mobile Medical Units were operating in
the states Over 15 992 million women brought under the Janani Suraksha
Yojna for institutional deliveries in the last three years The Survey said NRHM
aims to make PHCs function round the clock Of the 22 370 PHCs in the
country only 1 263 were working round the clock on March 31 2005 before
the NRHM The number of round the clock PHCs today as reported by the
states was 7 212 signifying a big leap forward in getting patients to the
government system Indian Public Health IPH standards had been finalized
and a first grant of 2 million had been provided to all district hospitals in the
country to improve their basic services the Survey said The Survey also
highlighted the achievements in AIDS control It said the health ministry was
providing life saving anti retro viral treatment ART to more than 217 000 HIV
patients As per the Survey in the National AIDS Control Program major
achievements during 2008 09 included scaling up targeted interventions for
high risk groups to 1 271 counseling and HIV testing 10 1 million persons of
which 4 15 million were pregnant women G o India 2009
6 27 Eight percent households become poor due to medical expenses
According to this news clipping about eight percent of households in India were
pushed to below the poverty line due to heavy medical expenses said a new
report on the Indian health sector According to the report about 7 8 per cent of
households pushed below the poverty line because of expenses incurred for
health care The report also said Indian government needed to shift focus away
from food grains towards the intake of a variety of food in correct proportion
as there was an urgent need ameliorate the nourishment among children The
report stated that the focus required to adequately empowering the institutions
that govern India s healthcare sector and making them answer for health
outcomes It had recommended that the ministry of health and family welfare
needed strengthening in terms of both scale and scope and it needed made more
answerable for India s poor health outcomes Times 2009
6 28 Evolving terms of human resources management and development
by A Haslinda This article said that the term HRM and HRD had been used
by scholars academics and practitioners differently However confusion
created on the terms or labels for HRM HRD and its position in a management
function The purpose of this paper was to examine the evolving terms in human
resource management HRM and human resource development HRD Based
on a review of the literature this paper draws the concepts surrounding the
terms in human resource management and development The findings
highlighted that the terms HRM and HRD had evolved along with globalization
and rapid technological advances Due to these changes in the environment new
terms were seen to be necessary to describe new ideas concepts and
philosophies of HRM and HRD Currently and in the near future new terms
would emerge to describe the philosophy of HRM and HRD Haslinda 2009
6 29 Experience of the Latin America and Caribbean Observatory of
Human Resource for Health document reviewed the observatory of human
resources in health in the health sector reform processes in Latin America and
Caribbean It was a cooperative initiative among the countries of the Americas
aimed at producing information and knowledge in order to improve human
resource policy decisions as well as contributing to human resources
development within the health sector based on sharing experiences
6 30 Four years of NRHM 2005 2009 Making a Difference Everywhere
Ministry of Health and Family Welfare May 2009 This document indicated
and summarized the early gains of NRHM According to its External
assessments confirmed the gains that the Mission had made The Maternal
Mortality Ratio had reduced from 301 per 100 000 births in 2001 03 periods of
254 in the 2004 06 periods IMR was down to 55 per 1000 births as per the data
for 2007 Institutional deliveries had also reported major gains in the District
level Household Survey III carried out in 2007 08 The Mission had done four
years and the gains made in many of the States of the country are nothing short
of dramatic What is even more interesting was the fact that hitherto States with
unsatisfactory Health indicators had moved swiftly to improve their health
system Poor people had voted with their feet for public system of health care
wherever doctors drugs and diagnostics are available at these facilities Untied
funds had completely changed the look of public facilities from dilapidated
hovels into well maintained facilities providing service guarantees Over the
last four years over 9 000 doctors 60 000 nurses ANMs and over 690 000
Community Health Workers ASHAs One in each village added to the
system By intensive demand side financing for institutional deliveries the
NRHM had put unprecedented pressure on public systems to deliver quality
services Nearly 20 million women had availed of this facility over the last four
years substantially increasing the rate of institutional deliveries in hitherto
backward provinces with high maternal and infant mortality Through a network
of ambulances and emergency transport arrangements in many provinces
households linked to health facilities more effectively MOHFW 2009
6 31 Framework for developing health insurance programs some
suggestions for states This document was unfolded by the Ministry of Health
Family Welfare Government of India New Delhi through which a framework
of providing health insurance has been prescribed MOHFW 2008
6 32 Guidelines on rogi kalyan samiti by the Ministry of health and
family welfare Government of India This document provided information on
the constitution working and memberships of different rogi kalyan samists or
hospital management societies to be constituted at different levels On the basis
of this document rogi kalyan Semites were constituted in the country MOHFW
6 33 Guidelines on Janani Suraksha Yojna by the Ministry of health and
family welfare Government of India This document contained information
and guidelines about the one of the major scheme of NRHM namely Janai
Surakaha Yojna which aimed at promoting safe and institutional delivery in the
country It established the basis of how financial incentives would be provided
to pregnant women Time to time certain modifications were also done in the
scheme which became essential in order to accommodate certain specific
requirements of different states MOHFW 2005
6 34 Guidelines for the preparation of health action plans by the
Ministry of health and family welfare Government of India This was major
document which suggested mechanism and formats for preparation of health
action plan at the district and state levels It was almost mandatory for each
district and state level societies to prepare and submit an advance health action
plan for their respective districts and states for each financial year This formed
the basis of funds sanction and release MOHFW 2006
6 35 Guidelines on accredited social health activists by the Ministry of
health and family welfare Government of India This document provided
details about the scheme which was launched in the country for appointments of
ASHAs in the country The guidelines on provision related to Accredited
Social Health Activists also known as ASHA in the country were prescribed
with their selection training and work MOHFW 2006
6 36 Health insurance in India by K Sujatha Rao Secretary of National
Commission on Macroeconomics and health Govt Of India This article
said about public and private health insurance players in India some insurance
enactments and provisions of some insurance schemes such as employee state
insurance Act Central Government Health Scheme CGHS Universal Health
Insurance Scheme UHIS and Community Based Health Insurance
6 27 Health related PPP in India by R Shankar This article provided
information about health related public private partnerships in the country which
enabled research scholar to know about public private partnerships
6 38 Health Sector Reform and Deployment Training and Motivation of
Human Resources towards Equity in Health Care Issues and Concerns in
Ghana This document stated about Ghana underwent a health sector reform
process aimed achieving greater access to services improved efficiencies in
resource utilization development of wider linkages with communities and
partners as well as improved quality of health services These reforms had
strong influences on issues of human resources development deployment and
6 39 Health Sector Reform Initiatives under NRHM by Dr K Roy
Barman Senior Consultant National Health Systems Resource Centre
Delhi This document provided information about Basic Concepts philosophy
Definition of HSR in Indian context
6 40 Health sector reform initiatives in India by Ministry of health and
family welfare Government of India This document recognized the need for
evidence based information about and assessment of the various initiatives
undertaken as part of the health reform process in India The Ministry of Health
Family Welfare Government of India in collaboration with the WHO
Country Office India had undertaken a review and documentation of health
sector reform initiatives in India One of such document which documented by
the World Health Organization declared that in India since the early 1990s
considerable work had been undertaken related to health sector reforms which
had involved various governments international multilateral agencies and other
6 42 Health statistics of countries 2005 and 2010 by the World health
organization This document provided information on varied health indicator
of different countries Both statistics for the year 2005 and 2010 were
considered under this research The document was a major source of
information about the existing public health status of India prior to launch of
6 43 Health Worker Benefits in a Period of Broad Civil Service Reform
The Philippine Experience According to this document developing countries
that had to cope with pressures to reform their bureaucracies had to contend
with increasing health worker benefits and salaries that were often intended to
retain these health workers in government service In the Philippines national
and local efforts in health forced to focus on guaranteeing some of these
benefits and local governments were feeling the financial limitations of their
local funds
6 44 Health Worker Motivation and Health Sector Reform According to
this document it was becoming increasing important that policymakers be
aware of health worker motivation and its impact on health sector performance
Health care delivery was highly labor intensive and service quality efficiency
and equity all directly mediated by workers willingness to apply themselves to
their tasks While resource availability and worker competencies are essential
decision makers should know that they were not sufficient in themselves to
ensure desired worker performance Worker performance is also dependent on
workers level of motivation stimulating them to come to work regularly work
diligently and be flexible and willing to carry out the necessary tasks
6 45 Health Workforce This issue focused on the health workforce and
contained the articles Could health worker migration bring benefits to Malawi
Removal of childbirth delivery fees the impact on health workers in Ghana
Regulation of dual job holding public sector doctors in Peru Health worker
responses to health sector reforms and Motivating Tanzanian primary health
care workers
6 46 Health Worker Shortages and Inequalities The Reform of United
States Policy by Paula O Brien and Lawrence O Gostin This paper said
that the United States and other rich countries had done very little to address the
dire global shortage of health workers In some instances the conduct of the
world s richest countries had exacerbated the shortages experienced in poor
countries They advocated that the Obama administration adopt two principal
strategies to assist with solving the global health workforce crisis The first
strategy required that a significant part of the U S s development assistance for
health be shifted towards building health systems in partner countries in
particular training and employing health workers to deal holistically with the
most pressing health problems experienced by the poor Secondly the U S
should pursue a high level of national self sufficiency in its health workforce
and not continue its heavy reliance on recruitment of migrant health workers to
fulfill the demand for health workers in the U S
6 47 Health Worker Shortages and Inequalities the Reform of United
States Policy This paper advocates multiple strategies for the United States to
further assist with solving the global health workforce crisis
6 48 History of Indian medicine by Mittal Shivdutt This book defined the
history of Indian medicine and public health system How the public health in
India travelled from the earliest version of the modern form was described in
6 49 History of medicine in India by R N Sharma This book defined the
history of medicine in India How with spent of time new methods established
in India and how older methods become irrelevant were described in great detail
with precise accuracy and authenticity
6 50 HR and new approaches to public sector management improving
HRM capacity by Dr Stephen Bach This paper examined why building HR
capacity is important to effective health care reform assesses the existing
evidence on HR capability in the health sector and draws out lessons from
existing practice Developing HR capability requires investing in the training
and development of both HR specialists and line managers professionals with
staff management responsibilities It was vital that any investment in specialist
HR capacity evaluated the different ways to deliver the HR function To be
effective the HR function must develop both an operational and a strategic HR
6 51 Human Resource Management and Public Sector Reforms Trends
and Origins of a New Approach This paper presented as a contribution to a
new approach to human resource management that will take account of
developments in public sector reform in the nineteen eighties and 1990s The
intent was to show that those reforms especially in their opening stages

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Full Final Thesis -

Full Final Thesis -

104 k?k –100 3. –100 – –100 2 ?–k 3 2 k? –100 og k? – 2 0.051 –2.931 – 2.3.5 2 20 –45 ?C at fixed concentrations of BS 3 3 2 4 3 4 4 3 –100 4.

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Padmalal final thesis 10 12 14 - Shodhganga

Padmalal final thesis 10 12 14 - Shodhganga

Multiple-Instance Learning Based on Color Correlogram Features,” 34 th Annual International Conference of IEEE September 2012, PP 1462-1465. [10]. Neera Singh., Ramesh Chandra Tripathi., “Automated Early Detection of Diabetic Retinopathy Using Image Analysis Techniques,” International Journal of Computer Applications (0975 – 8887) Volume 8– No.2, October 2010 PP 18- 23. [11]. Nathan ...

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5. Finite Element Analysis of Bellows - Shodhganga

5. Finite Element Analysis of Bellows - Shodhganga

Ph. D. thesis on “Study of Design Aspects of Expansion Joints with Metallic Bellows and their Performance Evaluation” 143 properties are assigned to a particular finite element, it is possible to account for non-homogeneity by assigning different material properties to different finite elements in the assemblage. 5. Assembly of the ...

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REFERENCES - Shodhganga

REFERENCES - Shodhganga

Singh, J. (2004). “padma Shree Milkha Singh – Lege ndary Athlete Sports Administrator and Sports Promoter- A Case Study”, Ph.D. Thesis, Punjab University Chandigarh. Singh, R. (2006). “Padma Shree Kartar Singh, Legendary Wrestler, Sports Administrator and Sports Promoter- A Case Study”, Ph.D. Thesis, Punjab University, Chandigarh.

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