Background: Persistently high maternal mortality levels are a concern in developing countries. In India, monetary incentive schemes have increased institutional delivery rates appreciably, but have not been equally successful in reducing maternal mortality. Maternal outcomes are affected by quality of obstetric care and socio-cultural norms. In this light there is need to examine the quality of care provided to women delivering in institutions. Objective: This study aimed to examine pregnant women’s expectations of high-quality care in public health facilities in Uttar Pradesh, India, and to contrast this with provider’s perceptions of the same, as well as the barriers that limit their ability to provide high-quality care. Methods: A qualitative descriptive analysis was conducted on data from two studies – focus group discussions with rural women in their last trimester of pregnancy (conducted in 2014) to understand women’s experience and satisfaction with maternal care services, and in-depth interviews with care providers (conducted in 2016–17) to understand provision of person-centred care. Provider perspectives were matched with themes of women’s perspectives on quality of childbirth care in facilities. Results: Major themes of care prioritised by women included availability of doctors at the facility; availability of medicines; food; ambulance services; maintenance of cleanliness and hygiene; privacy; good and safe delivery with no complications; client-provider interaction; financial cost of care. Many women also voiced no expectation of care, indicating disillusionment from the existing system. Providers concurred with women on all themes of care except availability of doctors, as they felt that trained nurses were proficient in conducting deliveries. Conclusions: This study shows that women have clear expectations of quality care from facilities where they go to deliver. Understanding their expectations and matching them with providers’ perspectives of care is critical for efforts to improve the quality of care and thereby impact maternal outcomes.

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We report the synthesis of gold nanotwins (Au NTs) on a solid and transparent glass substrate which in turn has been employed for the selective optoplasmonic detection of Escherichia coli (EC) bacteria in human urine for the point-of-care diagnosis of urinary tract infections (UTIs). As compared to the single nanoparticle systems (Au NPs), the Au NTs show an enriched localized surface plasmon resonance (LSPR) due to the enhancement of the electric field under electromagnetic irradiation, e.g., photon, which helps in improving the limits of detection. For this purpose, initially a simple glass surface has been coated with Au NPs, with the help of the linker 3-aminopropyl-triethoxysilane – APTES. The surface has been linked further with another Au NP with the help of the 1,10-alkane-dithiol linker with two thiol ends, which eventually leads to the development of the optoplasmonic surface with Au NTs and an enhanced LSPR response. Subsequently, the EC specific aptamer has been chemically immobilized on the surface of Au NTs with the blocking of free sites via bovine serum albumin (BSA). Remarkably, Raman spectroscopy unfolds a 7-fold increase in the peak intensities with the Au NTs on the glass surface as compared to the surface coated with isolated Au NPs. The enhancement in the LSPR response of glass substrates coated with Au NTs and the EC specific aptamer has been further utilized for the selective and sensitive detection of UTIs. The results have been verified with the help of UV–visible spectroscopy to establish the utility of the proposed sensing methodology. An extensive interference study with other bacterial species unveils the selectivity and specificity of the proposed optoplasmonic sensors toward EC with a detection range of 5 × 103 to 107 CFU/mL. Intuitively, the method is more versatile in a sense that the sensor can be made specific to any other pathogens by simply changing the design of the aptamer. Finally, a low-cost, portable, and point-of-care optoplasmonic transduction setup is designed with a laser light illumination source, a sample holder, and a sensitive photodetector for the detection of UTIs in human urine.

Urinary tract infection (UTI), which can be caused by various pathogens, if not detected at an early stage can be fatal. It is essential to identify the specific pathogen responsible for UTI for appropriate treatment. This study describes a generic approach to the fabrication of a prototype for the noninvasive detection of a specific pathogen using a tailor-made plasmonic aptamer-gold nanoparticle (AuNP) assay. The assay is advantageous because the adsorbed specific aptamers passivate the nanoparticle surfaces and reduce and/or eliminate false-positive responses to nontarget analytes. Based on the localized surface plasmon resonance (LSPR) phenomena of AuNP, a point-of-care aptasensor was designed that shows specific changes in the absorbance in the visible spectra in the presence of a target pathogen for robust and fast screening of UTI samples. In this study, we demonstrate the specific detection of Klebsiella pneumoniae bacteria with LoD as low as 3.4 × 10 3 CFU/mL.

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