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Item Does the Nae Umeed group intervention improve mental health and social participation? A pre-post study in Uttarakhand, India(Cambridge Prisms-Global Mental Health, 2023) Christopher R. Bailie; Pooja S. Pillai; Atul Goodwin Singh; Jed Leishman; Nathan J. Grills; Kaaren MathiasThis pre-post study aimed to evaluate whether Nae Umeed improved mental health and social participation for people with mental distress, including caregivers.Item Health status of Koraga community: A pilot study among a particularly vulnerable tribal group of Udupi District, Karnataka, India(Indian Journal of Medical Research, 2022) Sneha Deepak Mallya; Shyamsundar Shreedhar; Deepak Sudhakaran; Aravindhkumar B; Suma Nair; Shetty; Ranjitha SBackground & objectives: Undertaking tribe-specific assessment of health status provides the required data for planning appropriate interventions. Malnutrition was prevalent among Koraga adults and children, which warrants designing and implementing appropriate social and health interventions in this population.Item The legacy of a standard of normality in child nutrition research(SSM - Population Health, 2021) Austin SandlerThis paper focuses on the evolution of anthropometry as a science and its associated measurements, indices, indicators, standards, references, and best practices.Item A technological approach to Reaching the Unreached - Leveraging teleophthalmology services in Rural Gujarat(Indian Journal of Ophthalmology, 2023) Zalak Shah; Uma Shroff; Uday Gajiwala; B R ShamannaThis study evaluated the role of teleophthalmology in underserved rural areas along with cost-saving estimates for the end user.Item Adaptation to health outcomes of climate change and variability at the city level: An empirical decision support tool(Sust. Cities Soc., 2019) Samraj SahayAdaptation to health risk due to climate variability and change at the city level is inadequate, particularly in developing economies. Here, coping strategies with short-term benefits, adopted by the residents contribute significantly to their resilience. Decision on effective adaptation, therefore, requires economic evaluation of the coping and adaptation strategies in practise. In the present paper a novel framework using household health production function (HPF) approach has been developed for evaluation of coping and adaptation strategies to serve as a decision tool for planners. The outcome informs decision makers about the benefits and effectiveness of coping, and shortcomings in the existing adaptation strategies, thus, contributing to stocktaking. The approach has been validated using a case of vector-borne disease of dengue, an important climate-sensitive health impact of climate change. A five step cyclical framework has been proposed which addresses uncertainty by avoiding the need for future projection of health outcomes and scenario building as it can be applied at any point of time in future and considers the current risk only. The strengths and weaknesses of the proposed tool are compared with other similar tools. The decision support tool has applicability for all climate-sensitive health outcomes at the city level.Item Ecosystems Determinants of Nutritional Adequacy Among the Indian Preschool Children(Journal of the Indian Institute of Science, 2022) Bita Afsharinia; Anjula Gurtoo; Hasheem MannanGiven the specified importance of dietary diversity in reducing the burden of malnutrition, our study explores the reasons for the high malnutrition rate in India through an assessment of a comprehensive range of ecosystem factors leading to poor nutrient intake.Item Achieving Maternal and Neonatal Mortality Development Goals Effectively: A Cost-Benefit Analysis(Journal of Benefit-Cost Analysis, 2023) Nyovani Madise; Arindam Nandi; Brad Wong; Saleema RazviThis article analyses the most cost-effective way to reduce maternal and neonatal deaths - Increase coverage of basic emergency obstetric and newborn care from 68 to 90 % combined with increased family planning services in 55 low-income and lower-middle-income countries which account for around 90 % of the burden of maternal and neonatal mortality globally.Item Health in Food Systems Policies in India: A Document Review(International Journal of Health Policy and Management, 2021) Adithya Pradyumna; Arima Mishra; J黵g Utzinger; Mirko S. WinklerFood systems affect nutritional and other health outcomes. Recent literature from India has described policy aspects addressing nutritional implications of specific foods (eg, fruits, vegetables, and trans-fats), and identified opportunities to tackle the double burden of malnutrition. This paper attempts to deepen the understanding on how health concerns and the role of the health sector are addressed across food systems policies in India. Methods: This qualitative study used two approaches; namely (i) the framework method and (ii) manifest content analysis, to investigate national-level policy documents from relevant sectors (ie, food security, agriculture, biodiversity, food processing, trade, and waste management, besides health and nutrition). The documents were selected purposively. The textual data were coded and compared, from which themes were identified, described, and interpreted. Additionally, mentions of various health concerns and of the health ministry in the included documents were recorded and collated. Results: A total of 35 policy documents were included in the analysis. A variety of health concerns spanning nutritional, communicable and non-communicable diseases (NCDs) were mentioned. Undernutrition received specific attention even beyond nutrition policies. Only few policies mentioned NCDs, infectious diseases, and injuries. Governing and advisory bodies were instituted by 17 of the analysed policies (eg, food safety, agriculture, and food processing), and often included representation from the health ministry (9 of the 17 identified inter-ministerial bodies). Conclusion: We found some evidence of concern for health, and inclusion of health ministry in food policy documents in India. The ongoing and planned intersectoral coordination to tackle undernutrition could inform actions to address other relevant but currently underappreciated concerns such as NCDs. Our study demonstrated a method for analysis of health consideration and intersectoral coordination in food policy documents, which could be applied to studies in other settings and policy domains.Item Addressing reproductive health knowledge, infertility and coping strategies among rural women in India(J. Biosoc. Sci., 2021) Shraboni Patra; Sayeed UnisaAn awareness of fertility and the factors affecting it is crucial to dealing with infertility, though little research has been conducted in the context of rural India. This study assessed Indian women's perceived causes of, and strategies for coping with, infertility and the associations with levels of reproductive health knowledge in rural areas. Primary data were collected through mapping and listing in high infertility prevalence districts of West Bengal in 2014-15. A total of 159 women aged 20-49 years who had ever experienced infertility were interviewed. A Reproductive Health Knowledge Index (RHKI) was computed to indicate respondent's level of reproductive health knowledge, and to show its association with perceived causes of infertility and coping with infertility. The highest mean RHKI score was observed among women in the lowest age group (RHKI=5.75, p<0.001), those with a higher level of education (RHKI=9.39, p<0.001) and those who had exposure to any media (RHK1=5.88, p<0.001). Women with a poor wealth index (RHKI=2.11, p<0.01) and those from Scheduled Caste, Scheduled Tribe and Other Backward Class communities (RHKI=4.20, p<0.05) had lower RHKI scores than richer women and those from General Caste communities. Women with a higher RHKI score were more likely to give biology (98.0%, p<0.001), old age (94.1%, p<0.01) and repeated abortions/accident/injury (92.2%,p<0.001) as reasons for infertility, whereas women with a low RHKI were more likely to give religious (73.2%, p<0.001) and old-age-related causes (75.0%, p<0.01) of infertility. Women with a high RHKI score were more likely to opt for modern allopathic treatments (RHKI=7.04, p<0.001), whereas those with a low RHKI score were more likely to seek treatment from religious and superstitious practitioners, use home remedies or receive no treatment at all (RHKI=1.66, p<0.001). Appropriate reproductive health knowledge is crucial if rural Indian women are to correctly assess their infertility problems and choose effective coping strategies.Item Active case finding among marginalised and vulnerable populations reduces catastrophic costs due to tuberculosis diagnosis(Glob. Health Action, 2018) Hemant Deepak Shewade; Vivek Gupta; Srinath Satyanarayana; Atul Kharate; K. N. Sahai; Lakshmi Murali; Sanjeev Kamble; Madhav Deshpande; Naresh Kumar; Sunil Kumar; Prabhat PandeyBackground: There is limited evidence on whether active case finding (ACF) among marginalised and vulnerable populations mitigates the financial burden during tuberculosis (TB) diagnosis. Objectives: To determine the effect of ACF among marginalised and vulnerable populations on prevalence and inequity of catastrophic costs due to TB diagnosis among TB-affected households when compared with passive case finding (PCF). Methods: In 18 randomly sampled ACF districts in India, during March 2016 to February 2017, we enrolled all new sputum-smear-positive TB patients detected through ACF and an equal number of randomly selected patients detected through PCF. Direct (medical and non-medical) and indirect costs due to TB diagnosis were collected through patient interviews at their residence. We defined costs due to TB diagnosis as 'catastrophic' if the total costs (direct and indirect) due to TB diagnosis exceeded 20% of annual pre-TB household income. We used concentration curves and indices to assess the extent of inequity. Results: When compared with patients detected through PCF (n = 231), ACF patients (n = 234) incurred lower median total costs (US$ 4.6 and 20.4, p < 0.001). The prevalence of catastrophic costs in ACF and PCF was 10.3 and 11.5% respectively. Adjusted analysis showed that patients detected through ACF had a 32% lower prevalence of catastrophic costs relative to PCF [adjusted prevalence ratio (95% CI): 0.68 (0.69, 0.97)]. The concentration indices (95% CI) for total costs in both ACF (-0.15 (-0.32, 0.11)] and PCF [-0.06 (-0.20, 0.08)] were not significantly different from the line of equality and each other. The concentration indices (95% CI) for catastrophic costs in both ACF [-0.60 (-0.81, -0.39)] and PCF [-058 (-0.78, -0.38)] were not significantly different from each other: however, both the curves had a significant distribution among the poorest quintiles. Conclusion: ACF among marginalised and vulnerable populations reduced total costs and prevalence of catastrophic costs due to TB diagnosis, but could not address inequity.