Cultura

A Study On Local Self Government “Sevanam” With Asha Workers In Kerala

VOLUME 22, 2025

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Archana salim
Dr. S gurumoorthy

Abstract

Local Self Government (LSG) institutions in Kerala have played a pivotal role in strengthening decentralised governance and citizen-centric service delivery. Among the various initiatives implemented, Vaathilpadi Sevanam has emerged as a significant reform aimed at ensuring timely, transparent, and doorstep delivery of essential government services. ASHA workers, as frontline community health volunteers, often serve as key intermediaries between citizens and local governments, particularly in rural and marginalised communities.

This study examines the functioning, effectiveness, and challenges of LSG Sevanam services with a specific focus on the role of ASHA workers in selected districts of Kerala. Using a mixed-method research approach, data were collected through structured questionnaires, interviews, and field observations. The findings reveal that ASHA workers significantly contribute to enhancing accessibility to LSG services by facilitating communication, supporting documentation, and guiding citizens through service procedures.

The analysis underscores the need for strengthened institutional support, capacity-building programmes, and streamlined digital service platforms to improve the efficiency of Vaathilpadi Sevanam. The study concludes that empowering ASHA workers within the framework of LSG service delivery can substantially enhance community outreach, ensure inclusive governance, and promote effective decentralisation in Kerala.

Keywords : .
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty