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Social Diagnosis Of Neonatal Deaths In Haryana: The Impact Of Contextual Factors On Pathways Of Survival Of Newborns         

Funding Agency: ICMR-ICSSR                                               

Team: Preetha G S and BS Singh     

The fall in neonatal mortality has not matched up to the more dramatic fall in infant and child mortality in the last two decades. Most of the neonatal deaths are due to preventable causes of prematurity, birth asphyxia or incidents during child birth and infections. The study will provide critical information as to how the access and utilization of interventions for neonatal survival are guided by social, behavioral and health system factors at the local level. The objective of the study is to delineate the contextual factors which affected access and utilization of interventions for neonatal survival through social autopsy of neonatal deaths. The study is of 2 year duration starting from April 2017 and will be carried out in four districts of Haryana- two high infant mortality districts and two low infant mortality districts. A total of 350 neonatal deaths of the previous year will be extracted from the records of the district hospital and community health centres (CHC) and primary health centres (PHC) of two blocks. The principal caretaker of the deceased newborn will be the key informant. The study population will also include the staff of the health facilities as well as members of the community. The technique of data collection will be social autopsy. The social autopsy tool is semi structured and uses a mix of open ended and closed ended questions to elicit information of the social, behavioural and health system factors which contributed to the death of the newborn. This study intends to use the conceptual framework of ‘Pathways to Survival’ to capture the non biological factors which acted as contributing factors to the death of the neonates and evolve a framework of action points at different levels - community, care centre and their interfaces, which would improve chances of their survival.

Climate Variability, Human Health Impact And Economic Burden In Tribal Communities Of Selected Geographical Regions In India                               

Funding Agency: DST                                                         

Team: Vinay Tripathi, Rais Akhtar, Preetha GS and Pradeep Panda

There is a wider consensus now, among the scientific community as well as policy makers, that the phenomenon of climate change is happening not only due to natural variability, but mainly due to anthropogenic causes and it is going to impact each and every sphere of human life including health. Indigenous populations or tribal populations are few communities which are most vulnerable to climate change impact. There are limited studies which have examined how these communities perceive climate change, how does it impact their life (including their health) and what are its economic consequences. This study, which is being funded by the DST, attempts to address this gap by (i) studying how tribal communities residing in selected geographic regions comprehend climate variability, their vulnerability to it and perceive its different impacts (including health); (ii) studying how tribal communities respond to vector-borne diseases (mainly malaria), water borne diseases (mainly diarrhoea) and heat stress in different geographies; and (iii) studying the economic burden of vector-borne and water-borne diseases as well as heat stress related health impact in tribal communities. The three-year long study has just been started (April 2017) and will adopt mixed method approach to achieve the objectives. Participatory tools and techniques will be an integral part of the study. The study will be conducted in five states of India, namely, Orissa, Madhya Pradesh, Jammu & Kashmir, Kerala, and Meghalaya.  Currently, the literature review is being prepared for the study.

Pretesting Of Iec Materials (Training Videos, Awareness Videos And Print Materials) On Maternal Infant And Young Child Nutrition (Miycn) For Front-Line Workers And Community Mobilization

Funding Agency: Alive & Thrive

Team: R. Sarala, Pradeep Panda and Veena Nair

At the 65th World Health Assembly, May 2012 as a WHO member state, India has endorsed the comprehensive implementation plan for Maternal Infant and Young Child Nutrition (MIYCN) and reaffirmed commitment for achieving the set targets. Despite India achieving, substantial gains in the health and nutrition front, 39% of India’s under 5 year children are stunted and 15% are wasted. In order to support behavior change strategy for MYICN, we wish to know the effectiveness of the communication materials in reaching out to the target audiences. The objective is to pretest the developed communication materials with the intention of understanding whether they have the capability to convey the intended message and motivate the audiences to change behaviour. The specific questions of the study are: (a) Can the audiences comprehend the material? (b) Is the material persuasive enough to induce change in audiences and nudge them towards the desired behaviour? and (c) Is there any negative reaction/feeling generated by the material and how to fine tune the material to replace the negative elements and make them positive? The pre-testing of print materials and videos will be conducted in rural and urban areas of Barabanki district in UP and Nalanda district in Bihar. In total, 18 Focused Group Discussions (FGDs) and 38 In-depth Interviews (IDIs) will be conducted to pre-test 6 types of print materials such as family calendar on diet, flip chart on MIYCN, Job aid- reminder card and flyer on MYICN. In addition, 8 small group discussion (4 Small group discussion* 2 state) and 16 IDIs (8 IDIs * 2 states) will be conducted to pre-test 6 type of videos on maternal nutrition, complementary feeding and diet. The key target audiences to be considered are mother-in-laws, husbands, pregnant women, community leaders, Auxiliary-nurse Midwives, Anganwadi Workers, self-help group members and private doctors/chemists. We will conduct content analysis of the responses from the FGDs and IDIs, determining the categories for the relevant variables specific to the objectives.

Life Skill Assessment - Baseline Survey (With Iihmr Jaipur)

Funding Agency: Room to Read

Team: Ratna Kumayat, Anadhi Ramachnadran, and Sumesh Kumar

Life Skills Education (LSE) is an important activity which enables children to identify the problems in their lives, think of probable solutions and practice them. Room to Read has included LSE as a part of its Girls Education Program in all their project countries. Ten dimensions of life skills such as self-confidence, communication, decision making, perseverance and others according to WHO framework are incorporated in the training provided to girl students from grade 6 to 12 using a pre-tested pilot tool. In India Room to Read conducts such programs in many states including Delhi, Uttarakhand, Chattisgarh. The purpose of this project is to complete a baseline measurement of a range of life skills among both participants and non-participants in Room to Read’s Girls’ Education Program in the three states in selected schools. This project will contribute to Room to Read’s ability to measure our progress toward developing girls’ life skills, share our successes to date, and continue improving our programs over the long term. A total of 1200 students in Grade 6 among 48 Secondary Schools across the three states were assessed.

Association Between Outdoor Air Pollutants And Childhood Asthma In Delhi

Funding Agency: IIHMR In-house Grant

Team: Nitish Dogra

Asthma is a common pediatric problem in India. The link between air pollution aggravation and exacerbation of asthma is widely established. The problem assumes greater significance in Delhi due to extremely high pollution. Currently there are no studies associating air pollution and asthma in different locations over time. In order to address this gap, the current study is being undertaking by taking into account data from various monitoring stations in the city over the last 5 years and hospitals in the vicinity.

Impact of A Community Based Intervention on Utilisation Of Health Services Of U-Phc In Delhi

funding agency: iihmr in-house grant

Team: B.s. Singh

In India about one –third of urban population is urban poor including vulnerable population such as homeless, rag-pickers, street children, rickshaw pullers, and other temporary migrants.  National health policy prioritizes addressing the primary health care needs of the urban population with special focus on poor populations living in listed and unlisted slums, other vulnerable populations such as homeless, rag-pickers, street children, rickshaw pullers, construction workers, sex workers and temporary migrants. Under this study, objectives are to provide technical support to urban primary health centre (UPHC) for providing quality health services to urban poor and examine and Implement evidence-based program at the UPHC level to improve access to health services.  These objectives will be achieved through following project strategies- 1. strengthening the community group, providing information about UPHS Service to community, convergence with other programme/other departments and technical support to UPHC; 2. NHM, Delhi will be involved in each stage i.e planning, implementation, monitoring and evaluation of project and 3. Through leveraging the resource of IIHMR Delhi such as time of students and faculty, infrastructure etc.

Four UPHC located near Dwarka, New Delhi is being selected and 4 Slums corresponding to selected UPHC covering approximately 4000 households (1000 households per slums), is being identified.   We will adopt pre test- post test experimental study design which will be used to analyse the situation by comparing before and after intervention. Under this study, following research techniques are proposed: Mapping and listing of Slum, Quantitative household survey for utilization of services and barriers to access and information services, Secondary data analysis on facility indicator pertaining to  area of concern of Quality management and Outcomes and Community Indicator such as  No of MAS meeting, Fund utilize by MAS, no of UHND etc,  Baseline Assessment of UPHC,  Mapping of public & private health facility near by slum and Formative qualitative research, which was used to explore the facilitating factor and the information barriers for utilising UPHC service. Activity wise Indicators and its mean of verification will be developed at initial stage and will be tracked by students & faculty of IIHMR Delhi on quarterly basis. In addition, Baseline and end line evaluation of project will be done by students & faculty of IIHMR Delhi.

Baseline Assessment Of The Knowledge And Attitude Of Urban Residents On Depressive Illness

Funding Agency: IIHMR In-house Grant

Team: Kirti Udayai, Vinay Tripathi and Madhuri Dutta

Depression is a common psychological disorder effecting all cross section of population across the world. It leads to poor quality of life at individual levels, adding up to a huge social and economic impact at national levels and subsequently contributing to a significant disease burden. The disease includes a range of conditions that are disabling in nature and may vary in severity and duration. Depression often exhibits a chronic course that has a relapsing and recurring trajectory over time. As per Global Burden of Disease report 2004, as much as 13% of total DALYs occurs due to mental disorders, with depression being the leading cause. Therefore, the present study seeks to assess the knowledge level of community with respect to signs, symptoms and treatment of depression and to assess the attitude of community towards those who are suffering from depression in South -West district of Delhi.

Longitudinal Ageing Study In India (Lasi) Wave-1, Punjab And Chandigarh

Agency:   IIPS, Mumbai

Team: Arindam Das, B S Singh, Nitish Dogra, Anandhi Ramachandran, Pankaj Talreja, Sumesh Kumar, Sumant Swain and Vidyasagar Trigun

The Longitudinal Ageing Study in India (LASI) is a national survey of scientific investigation of the health, economic, and social, determinants and consequences of population ageing in India. LASI is a nationally representative survey of older adults aged 45+ in all 30 States and 6 Union Territories that will be conducted every 2 years for the period of 25 year. LASI is developed as per the needs of the Indian’s elderly population but at the same time it is internationally harmonized enabling not only cross-state analyses within India but cross- country analyses. The main goal of LASI is to collect credible scientific data on burden of disease, mental health, social and economic wellbeing of elderly population in India. LASI is designed to cover six major subject and policy domains of adult and older population of India namely: Demography, Migration and Marital status, and Housing and Environment, Health: Disease Burden & Risk factors (reported and measured),  Health Care and Health Care Financing, Social: Family and Social Network, Economic: Income, Wealth, Consumption, Expenditure, Work and Employment, Retirement and Pension and Welfare Programs for Elderly.

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