Understanding Patients’ Needs and Healthcare Seeking Behavior in Rural Southern India: The Comparison of Providers through Patients’ Perceptions and Cost Issues

This study explores patients’ needs in rural Thanjavur, southern India through understanding how people with diabetes choose providers and perceive care-seeking experience. To measure perception, the study surveyed people regarding six common barriers to care-seeking behavior, selected from both literature and local expert interview. Ninety-one percent of the sampled population goes to public or private allopathic providers out of the six presented providers. The low socioeconomic group and people with more complications or comorbidities are more likely to go to private allopathic providers. What is more, there is no difference between public and private allopathic providers in patients’ perception of care except for perceived cost. Positive perceptions in both providers are very common except for perceptions in blood-sugar management, distance to facilities, and cost of care. Sixty-six percent of patients perceived their blood-sugar control to fluctuate or have no change versus improved control. Twenty-seven percent of patients perceived the distance to facilities as unreasonable, and sixty-two percent of patients perceived the cost as high for them. The results suggest that cost may affect low socioeconomic people’s choice of care significantly. However, for people in middle and higher socioeconomic groups, cost does not appear to be a major factor. For qualitative text analyses, physician’s behavior and reputation emerge as themes, which require further studies.

Aspects of Motives: Finite-dimensionality, Chow-Kunneth Decompositions and Intersections of Cycles

This thesis analyzes the Chow motives of 3 types of smooth projective varieties: the desingularized elliptic self fiber product, the Fano surface of lines on a cubic threefold and an ample hypersurface of an Abelian variety. For the desingularized elliptic self fiber product, we use an isotypic decomposition of the motive to deduce the Murre conjectures. We also prove a result about the intersection product. For the Fano surface of lines, we prove the finite-dimensionality of the Chow motive. Finally, we prove that an ample hypersurface on an Abelian variety possesses a Chow-Kunneth decomposition for which a motivic version of the Lefschetz hyperplane theorem holds.