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    A snapshot of reproductive and sexual health and rights of women living with HIV in Asia
    (Oral Dis., 2020) Anandi Yuvaraj; Paramita Kundu
    Objective A brief review of status of sexual and reproductive health and rights of women living with human immunodeficiency virus (HIV) in Asia with a focus on their access to related services. Subject(s) and methods The content has primarily emerged from several meetings, workshops and research studies that regional networks of women living with HIV have conducted in the region. We used published and unpublished literature in English after the year 2000. Results We found many hindrances to realization of sexual and reproductive rights by HIV-positive women and their access to related health services. Rampant stigma and discrimination by service providers take the form of denial of contraceptive and maternal health services, forced sterilization, breach of confidentiality and disclosure of status to others without the consent of the woman. Families blaming women for bringing HIV and male partners objecting to using condoms affect the well-being of HIV-positive women. Sexual rights specifically aspects of positive sexuality such as sexual pleasure have not received attention. Conclusion Findings suggest the need to enhance capacities of HIV-positive women's organizations to meaningfully participate in decisions on positive women's sexual, reproductive health and rights and sensitize service providers to adequately address HIV-positive women's concerns.
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    A comparative study of health outcomes between elderly Migrant and non-migrant population in India: Exploring health disparities through propensity score matching
    (SSM - Population Health, 2024) Bittu Mandal; Kalandi Charan Pradhan
    This study aims to bridge this gap by exploring health disparities between these two groups by leveraging data from a nationally representative, large-scale Longitudinal Ageing Study in India.
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    A community-based intervention to improve screening, referral and follow-up of non-communicable diseases and anaemia amongst pregnant and postpartum women in rural India: study protocol for a cluster randomised trial
    (Trials, 2023) Jane Elizabeth Hirst; Nicole Votruba; Laurent Billot; Varun Arora; Eldho Rajan; Sudhir Raj Thout; David Peiris; Anushka Patel; Robyn Norton; Edward Mullins; Ankita Sharma
    BackgroundMedical complications during pregnancy, including anaemia, gestational diabetes mellitus and hypertensive disorders of pregnancy place women are at higher risk of long-term complications. Scalable and low-cost strategies to integrate non-communicable disease screening into pregnancy care are needed. We aim to determine the effectiveness and implementation components of a community-based, digitally enabled approach, SMARThealth Pregnancy, to improve health during pregnancy and the first year after birth.MethodsA pragmatic, parallel-group, cluster randomised, type 2 hybrid effectiveness-implementation trial of a community-based, complex intervention in rural India to decrease anaemia (primary outcome, defined as haemoglobin < 12g/dL) and increase testing for haemoglobin, glucose and blood pressure (secondary outcomes) in the first year after birth. Primary Health Centres (PHCs) are the unit of randomisation. PHCs are eligible with (1) > 1 medical officer and > 2 community health workers; and (2) capability to administer intravenous iron sucrose. Thirty PHCs in Telangana and Haryana will be randomised 1:1 using a matched-pair design accounting for cluster size and distance from the regional centre. The intervention comprises (i) an education programme for community health workers and PHC doctors; (ii) the SMARThealth Pregnancy app for health workers to support community-based screening, referral and follow-up of high-risk cases; (iii) a dashboard for PHC doctors to monitor high-risk women in the community; (iv) supply chain monitoring for consumables and medications and (v) stakeholder engagement to co-develop implementation and sustainability pathways. The comparator is usual care with additional health worker education. Secondary outcomes include implementation outcomes assessed by the RE-AIM framework (reach, effectiveness, adoption, implementation, maintenance), clinical endpoints (anaemia, diabetes, hypertension), clinical service delivery indicators (quality of care score), mental health and lactation practice (PHQ9, GAD7, EuroQoL-5D, WHO IYCF questionnaire).DiscussionEngaging women with screening after a high-risk pregnancy is a challenge and has been highlighted as a missed opportunity for the prevention of non-communicable diseases. The SMARThealth Pregnancy trial is powered for the primary outcome and will address gaps in the evidence around how pregnancy can be used as an opportunity to improve women's lifelong health. If successful, this approach could improve the health of women living in resource-limited settings around the world.