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Item A Vision for Nutrition Research in Asia(Food Nutr. Bull., 2019) Shweta Khandelwal; Anura KurpadItem Charting a roadmap for heart failure research in India: Insights from a qualitative survey(Indian Journal of Medical Research, 2023) Sivadasanpillai Harikrishnan; Linda Koshy; Sanjay Ganapathi; Panniyammakal Jeemon; Raman Krishna Kumar; Adrija Roy; S. Reethu; Surya Ramachandran; L. R. Lakshmikanth; Meenakshi Sharma; Vijay Kumar ChopraThis study aims to identify the lacunae and to suggest recommendations to improve HF research.Item Abortion service provision in South Asia: A comparative study of four countries(Contraception, 2020) Susheela Singh; Aparna Sundaram; Altaf Hossain; Mahesh C. Puri; Zeba Sathar; Chander Shekhar; Marjorie Crowell; Ann M. MooreObjectives: Nationally representative evidence on abortion service provision is scarce in South Asia. To inform improvements in service provision, this paper assesses the availability of facility-based postabortion services in Nepal, India (six states), Bangladesh and Pakistan, and legal abortion services in India and Nepal and Bangladesh (where the official term used is menstrual regulation or MR). Study design: The paper presents comparable indicators on three aspects of abortion service provision from representative surveys of public and private sector facilities, conducted over 2012-2015. Indicators cover three areas: (a) need for abortion-related care (total number of abortions and percent of abortions that are legal and the postabortion treatment rate); (b) availability and accessibility of facility-based abortion-related services (percent of facilities offering only one of the two services, percent which are public and percent located in rural areas); (c) quality of facility-based abortion care (percent of legal abortions using procedures not recommended by WHO and percent of women turned away when seeking abortion or MR services). Results: The proportion of all abortions that are illegal ranges from 58% to almost 78% in the three countries where abortion is permitted under broad criteria. The annual treatment rate for abortion complications ranges from about 4 to 26 per 1000 women ages 15-49 across the countries and states covered. In India and Nepal, less than 40% of public sector facilities that are permitted to provide abortion services do so; in Bangladesh, the situation is somewhat better, at 53% providing MR. Across the six Indian states, 4- 43% of facilities that offer abortion care are located in rural areas, disproportionately lower than the proportion of women living in rural areas (49-87%). About 30-60% of facilities offered only postabortion care and did not offer legal services in the three countries where legal services are permitted (with the sole exception of Tamil Nadu where this proportion was only 11%); of the remaining facilities, the large major ity offered both services. Medication abortion is offered by the large majority of facilities that provide induced abortion and accounts for 40-45%, of facility-based abortions in Nepal and four of the states of India; in Assam and Bihar, this proportion was much lower (13% and 27% respectively). Invasive procedures that are not recommended by WHO are more widely used in India (up to 25-37% of facility-based abortions are D&C procedures; the large majority of this group are D&C, and a small proportion may be D&E, a WHO-recommended abortion procedure, that could not be separated out in this study because providers use the two labels interchangeably); by comparison, the proportion is much smaller in Nepal (5%). Between 22% to a little over half of facilities turned away some women who would otherwise be eligible for an abortion or MR procedure in Nepal, the six Indian states, and Bangladesh. Conclusions: There is an urgent need to increase access to abortion, MR and postabortion services, especially for rural women. Greater access to legal abortion/MR services in the three countries that permit these procedures would increase the proportion of abortions that are legal and safe, reduce morbidity and the need for facility-based treatment for complications. Broadening the legal criteria under which abortion is permitted in Pakistan, and implementing access under such broader criteria, is needed to achieve the same improvements in Pakistan. Ensuring that these services are of high quality and comprehensive-meeting WHO-recommended standards-is essential to protect women's reproductive health and rights. (C) 2020 Elsevier Inc. All rights reserved.Item A summative content analysis of how programmes to improve the right to sexual and reproductive health address power(BMJ Glob. Health, 2022) Marta Schaaf; Victoria Boydell; Stephanie M. Topp; Aditi Iyer; Gita Sen; Ian AskewIntroduction Power shapes all aspects of global health. The concept of power is not only useful in understanding the current situation, but it is also regularly mobilised in programmatic efforts that seek to change power relations. This paper uses summative content analysis to describe how sexual and reproductive health (SRH) programmes in low-income and middle-income countries explicitly and implicitly aim to alter relations of power. Methods Content analysis is a qualitative approach to analysing textual data; in our analysis, peer-reviewed articles that describe programmes aiming to alter power relations to improve SRH constituted the data. We searched three databases, ultimately including 108 articles. We extracted the articles into a spreadsheet that included basic details about the paper and the programme, including what level of the social ecological model programme activities addressed. Results The programmes reviewed reflect a diversity of priorities and approaches to addressing power, though most papers were largely based in a biomedical framework. Most programmes intervened at multiple levels simultaneously; some of these were 'structural' programmes that explicitly aimed to shift power relations, others addressed multiple levels using a more typical programme theory that sought to change individual behaviours and proximate drivers. This prevailing focus on proximate behaviours is somewhat mismatched with the broader literature on the power-related drivers of SRH health inequities, which explores the role of embedded norms and structures. Conclusion This paper adds value by summarising what the academic public health community has chosen to test and research in terms of power relations and SRH, and by raising questions about how this corresponds to the significant task of effecting change in power relations to improve the right to SRH.Item A retrospective approach to assess human health risks associated with growing air pollution in urbanized area of Thar Desert, western Rajasthan, India(J. Environ. Health Sci. Eng, 2014) Harcharan Singh Rumana; Ramesh Chandra Sharma; Vikas Beniwal; Anil Kumar SharmaAir pollution has been a matter of great concern globally because of the associated health risks to individuals. The situation is getting worse in developing countries with more urbanization, industrialization and more importantly the rapidly growing population posing a threat to human life in the form of pulmonary, cardiovascular, carcinogenic or asthmatic diseases by accumulating toxic pollutants, harmful gases, metals, hydrocarbons etc. Objective: The present study was undertaken to assess the magnitude of ambient air pollutants and their human health risks like respiratory ailments, infectious diseases, cardiovascular diseases and cancer using a Retrospective Approach of Bart Ostra. Methodology: The parameters PM2.5, PM10, NOx, SO2, NH3 and O-3 were monitored at all selected study sites monitored through a high volume sampler (APM 451 Envirotech, Envirotech Instruments Pvt. Ltd., New Delhi, India). Retrospective Approach was used for assessment of risk factors and disease burden of respiratory and cardiopulmonary health problems. Results: Environmental burden of disease showed that the problem of health related to air pollution is a main concern particularly in the growing cities of India. High to critical level of air pollution including PM10, PM2.5, NOx, SO2, NH3 and O-3 was observed in all seasons at traffic intersections and commercial sites. The respiratory infections (25% incidence in population exposed to indoor smoke problems) and a prevalence of asthma/COPD (4.4%) in households exposed to high vehicular pollution along with signs of coronary artery/heart disease and/or hypertension and cancers (37.9-52.2%), were reported requiring preventive measures. Conclusion: The study reflects a great concern for the mankind with the need of having streamline ways to limit air pollution and emphasize upon efficiently determining the risk of illness upon exposure to air pollution.Item Access and barriers to maternal health program: a community perspective in a tribal area of Odisha, India(Asia Pac. J. Soc. Work Dev., 2023) Ranjit Kumar DehuryThe janani surakhya yojana (JSY), a flagship programme of the national health mission (NHM), was implemented to reduce maternal and neonatal mortality by promoting institutional delivery among marginalised pregnant women in India. This study provides an account of the challenges faced by tribal pregnant women in accessing reproductive health care services. Primary data was collected from various maternal health stakeholders and expectant mothers using qualitative methods. The study adopted data collection methods like focus group discussions (FGDs) and in-depth interviews regarding the programme implementation of JSY at Jaleswar. Secondary data were analysed to understand the effectiveness of government policy in improving maternal health. The study indicates that despite an elaborate programme of action, there is low community perception and trust in bio-medical (mostly) procedures among the tribal population. The government programmes rarely compliment the tribal cultural construction of pregnancy and child birthing with existing medical and professional discourse.Item A cross-sectional study of diabetic knowledge in West Bengal, India: an analysis based on access to health care(Int. Diabetes Dev. Ctries., 2015) Paul Long; Katelyn N. G. Long; Ankit Kedia; Lisa H. Gren; Andrew Smith; Jatrik BiswasIn India, the rising prevalence of diabetes is a major public health challenge. The purpose of this study was to measure the level of diabetes knowledge in West Bengal, India, and to assess for a gradient in knowledge among those with varying levels of access to health care in both urban and rural environments. A validated questionnaire on diabetes knowledge was developed and administered in two health care settings in West Bengal: community clinics in low-income rural and urban communities representing the low-access group and a multi-specialty outpatient department (OPD) in Kolkata, India, representing the high-access group. Of the respondents in the low-access community clinic group, (n = 198), less than half knew what diabetes was (42.9 %) compared to 89.9 % in the high-access OPD group (n = 275) (p < 0.001). Those in the urban community clinics knew what diabetes was more often than those in the rural community clinics (49.5 vs. 36.1 %, p = 0.058). Additional questions testing basic knowledge of diabetes, risk factors, and disease complications showed a similar trend that people in the low-access setting had limited knowledge regarding diabetes and significantly less knowledge when compared to those in the high-access setting. Multivariate regression analysis demonstrated that clinic setting (high-access vs. low-access, p < 0.0001) and formal education (p = 0.001) were independent predictors of diabetic knowledge, while age and sex were not. Diabetes knowledge among respondents with low access to health care in urban and rural community clinics was significantly poorer than those with higher access to health care in an urban hospital outpatient department. To help bridge this gap, diabetes education and prevention campaigns should be targeted towards populations with low access to health care in West Bengal.