Background Verbal autopsies with physician assignment of cause of death (COD) are commonly used in settings where medical certification of deaths is uncommon. It remains unanswered if automated algorithms can replace physician assignment. Methods We randomized verbal autopsy interviews for deaths in 117 villages in rural India to either physician or automated COD assignment. Twenty-four trained lay (non-medical) surveyors applied the allocated method using a laptop-based electronic system. Two of 25 physicians were allocated randomly to independently code the deaths in the physician assignment arm. Six algorithms (Naïve Bayes Classifier (NBC), King-Lu, InSilicoVA, InSilicoVA-NT, InterVA-4, and SmartVA) coded each death in the automated arm. The primary outcome was concordance with the COD distribution in the standard physician-assigned arm. Four thousand six hundred fifty-one (4651) deaths were allocated to physician (standard), and 4723 to automated arms. Results The two arms were nearly identical in demographics and key symptom patterns. The average concordances of automated algorithms with the standard were 62%, 56%, and 59% for adult, child, and neonatal deaths, respectively. Automated algorithms showed inconsistent results, even for causes that are relatively easy to identify such as road traffic injuries. Automated algorithms underestimated the number of cancer and suicide deaths in adults and overestimated other injuries in adults and children. Across all ages, average weighted concordance with the standard was 62% (range 79–45%) with the best to worst ranking automated algorithms being InterVA-4, InSilicoVA-NT, InSilicoVA, SmartVA, NBC, and King-Lu. Individual-level sensitivity for causes of adult deaths in the automated arm was low between the algorithms but high between two independent physicians in the physician arm. Conclusions While desirable, automated algorithms require further development and rigorous evaluation. Lay reporting of deaths paired with physician COD assignment of verbal autopsies, despite some limitations, remains a practicable method to document the patterns of mortality reliably for unattended deaths. Trial registration ClinicalTrials.gov , NCT02810366. Submitted on 11 April 2016. Electronic supplementary material The online version of this article (10.1186/s12916-019-1353-2) contains supplementary material, which is available to authorized users.

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This research paper attempts to collate literature from various sources, in an attempt to answer three pertinent questions related to healthcare in India. Firstly, what is it meant by ‘private sector’ in healthcare delivery system of India, secondly how has the private sector evolved over the decades and what has been the role of the government in propelling the growth. Finally, the paper tries to highlight some of the factors that have promoted the growth of private sector in India with specific reference to quality of medical care. The paper explicitly indicates that the deficiencies in the public health delivery system of India, was the key to growth of private infrastructure in healthcare. The shift of hospital industry for ‘welfare orientation’ to ‘business orientation’ was marked by the advent of corporate hospitals, supported by various policy level initiatives made by the government. Today, there are over 20 international healthcare brands in India with several corporate hospitals. However, a large section of the ‘private healthcare delivery segment’ is scattered and quality of medical care continues to remain a matter of concern. This paper tracks the various government initiatives to promote private investment in healthcare and attempts to explore the reasons for preference of the private sector. Surprisingly, in contrast to contemporary belief, quality of medical care doesn’t seem to be the leading cause for preference of the private sector. Except for a few select corporate and trust hospitals, quality of medical care in private sector seems to be poor and at times compromised.

Neurocysticercosis (NCC) is the most common parasitic infestation of the central nervous system and is one of the major public health problems in developing nations like Nepal. This study was conducted to find out total number of neurocysticercosis cases in BPKIHS from 2005 to 2013 AD and to know the duration for which cases were admitted and improvement seen in them. This is a hospital based retrospective study conducted from 31st March to 13th April 2014 to see the number of NCC in B P Koirala Institute of Health Sciences, Dharan of Nepal, a tertiary level referral hospital in the Eastern Nepal. It was study in which secondary data, consistent with the diagnosis of Neurocysticercosis was collected from the Medical Record Section of BPKIHS and reviewed. One hundred fourteen cases of neurocysticercosis were enrolled. The patients were predominantly males (nearly 63.2%) and it was more commonly seen in 2-20 years age group (42%). Most of the cases were from Sunsari District. Most of the patients (63.2%) were admitted in Medicine wards. Almost 90.4% of admitted Neurocysticercosis cases were improved in BPKIHS. The trend of Neurocysticercosis cases did not show any showed any consistent pattern in the past nine years. We conclude that the problem of Neurocysticercosis is common and has become a key public health concern for all.

Background and Aims: Faith healing is a method of treating illnesses through the exercise of faith rather than medical methods. The current study was done with the objective to find out demographic variables of faith healers, various conditions for which the people approach them, various practices and processes used and to look for scope of integrated approach to healthcare with faith healers. Settings and Design: RHTC village was a sub center village of PHC Morad. Hence, for the study, all the villages which comes under PHC Morad were selected. The design of the study was a cross-sectional study. Methods and Material: The study was a cross sectional study where faith healers were interviewed based on a semi structured questionnaire comprising of both close and open-ended questions. Statistical Analysis Used: Absolute numbers. Results: Different reasons for which the persons usually came for ranged from supernatural possession, unemployment, family problems etc., and various different processes were used by these healers to solve the problems included giving charms and amulets, personal sacrifices like “ baddha” (Nischay/praan) and many others. Conclusion: The study concludes that faith healers in many conditions and situations became the first point of contact as the faith of the community in these faith healers is deeply rooted.