Private Schooling and Mental Models about Girls' Schooling in India

ERIC Educational Resources Information Center

Srivastava, Prachi

2006-01-01

This paper presents disadvantaged households' "mental models" about low-fee private (LFP) schooling for their daughters in a study in Lucknow District, Uttar Pradesh. It argues that assumptions in the dominant discourse on girls' schooling in India obscure the complex negotiations and trade-offs disadvantaged families make when…

Sustainability of integrated leprosy services in rural India: perceptions of community leaders in Uttar Pradesh.

PubMed

Raju, M S; Rao, P S S

2011-01-01

As part of a community-based action research to reduce leprosy stigma, village committees were formed in 3 hyper endemic states of India. From a total of 10 village committees with nearly 200 members from Uttar Pradesh, a systematic random sample of 69 men and 23 women were interviewed in-depth regarding their views on sustainability of integrated leprosy services, as currently adopted. Their recommendations were also sought for further enhancement. Percentages were computed and compared for statistical significance using the z-normal test. The findings show that less than 50% of the respondents were confident that the present trend in voluntary early reporting for MDT and management of complications was adequate to sustain the integrated leprosy services. There were no differences by men or women members and they felt that lack of proper facilities, training and orientation of staff are most influencing factors. Many suggestions were given for improving the sustainability.

Outcomes of polio eradication activities in Uttar Pradesh, India: the Social Mobilization Network (SM Net) and Core Group Polio Project (CGPP)

PubMed Central

2011-01-01

Background The primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities and routine immunization coverage in priority districts with a focus on 107 high-risk blocks of western Uttar Pradesh and central Bihar. Villages or urban areas with a history of wild poliovirus transmission, or hard-to-reach or resistant populations are categorized as high-risk areas within blocks. The Social Mobilization Network (SM Net) was formed in Uttar Pradesh in 2003 to support polio eradication efforts through improved planning, implementation and monitoring of social mobilization activities in those high-risk areas. In this paper, we examine the vaccination outcomes in districts of SM Net where the CORE Group works. Methods We carried out a secondary data analysis of routine monitoring information collected by the SM Net and the Government of India. These data include information about vaccination outcomes in SM Net areas and non-SM Net areas within the districts where the CORE Group operates. Statistical analysis was used to compare, between SM Net and non-SM Net areas, vaccination outcomes considered sensitive to social mobilization efforts of the SM Net. We employed Generalized Estimating Equations (GEE) statistical method to account for Intra-cluster Correlation (ICC), and used 'Quasi-likelihood under the independence model criterion (QIC)' as the model selection method. Results Vaccination outcomes in SM Net areas were as high as or higher than in non-SM Net areas. There was considerable variation in vaccination outcomes between districts. Conclusions While not conclusive, the results suggest that the social mobilization efforts of the SM Net and the CORE Group are helping to increase vaccination levels in high-risk areas of Uttar Pradesh. Vaccination outcomes in CORE Group areas were equal or higher than in non-CORE, non-SM Net areas. This occurred even though SM Net areas are those with more community resistance to polio vaccination and/or are have harder-to-reach populations than non-SM Net areas. Other likely explanations for the relatively good vaccination performance in SM Net areas are not apparent. PMID:21569256

Out-of-pocket expenditure on maternity care for hospital births in Uttar Pradesh, India.

PubMed

Goli, Srinivas; Rammohan, Anu; Moradhvaj

2018-02-27

The studies measured Out-of-Pocket Expenditure (OOPE) for hospital births previously suffer from serious data limitations. To overcome such limitations, we designed a hospital-based study for measuring the levels and factors of OOPE on maternity care for hospital births by its detailed components. Data were collected from women for non-complicated deliveries 24-h before the survey and complicated deliveries 48-h prior to the survey at the hospital settings in Uttar Pradesh, India during 2014. The simple random sampling design was used in the selection of respondents. Bivariate analyses were used to estimate mean expenditure on Antenatal care services (ANCs), Delivery care and Total Maternity Expenditure (TME). Multivariate linear regression was employed to examine the factor associated with the absolute and relative share of expenditure in couple's annual income on ANCs, delivery care, and TME. The findings show that average expenditure on maternal health care is high ($155) in the study population. Findings suggest that factors such as income, place, and number of ANCs, type, and place of institutional delivery are significantly associated with both absolute and relative expenditure on maternity care. The likelihood of incidence of catastrophic expenditure on maternity care is significantly higher for women delivered in private hospitals (β = 2.427, p < 0.001) compared to the government hospital (β = 0). Also, it is higher among caesarean or forceps deliveries (β = 0.617, p < 0.01), deliveries conducted on doctor advise (β = 0.598, p < 0.01), than in normal deliveries (β = 0) and self or family planned deliveries (β = 0). The findings of this study suggest that the OOPE on maternity care for hospital births reported in this study is much higher as it was collected with a better methodology, although with smaller sample size. Therefore, ongoing maternity benefit scheme in India in general and Uttar Pradesh in particular need to consider the levels of OOPE on maternity care and demand-side and supply-side factors determining it for a more effective policy to reduce the catastrophic burden on households and help women to achieve better maternity health outcomes in poor regional settings like Uttar Pradesh in India.

An acute flaccid paralysis surveillance-based serosurvey of poliovirus antibodies in Western Uttar Pradesh, India.

PubMed

Bahl, Sunil; Gary, Howard E; Jafari, Hamid; Sarkar, Bidyut K; Pathyarch, Surendra K; Sethi, Raman; Deshpande, Jagadish

2014-11-01

Despite intensified use of monovalent oral poliovirus type 1 vaccine and improved coverage of immunization campaigns, wild poliovirus type 1 persisted in Indian states of Uttar Pradesh and Bihar during 2006 to 2009. A serosurvey was conducted among cases of acute flaccid paralysis in the 25 high-polio-incidence districts of western Uttar Pradesh. Children were recruited by age group (6-11 months, 12-24 months, and 25-69 months) from among cases reported through the acute flaccid paralysis surveillance system between November 2008 and August 2009. Seroprevalence for type 1 wild poliovirus was >96.4% for each age group. The seroprevalence of wild poliovirus types 2 and 3 increased with age, from 36.7% to 73.4% for type 2 and from 39.0% to 74.1% for type 3. In addition to the number of type-specific vaccine doses, father's level of education, being from a Muslim family, height for age, and female sex were the socioeconomic risk factors associated with seronegativity to poliovirus. The seroprevalence and risk factors identified in this study were consistent with the epidemiology of polio, and the findings were instrumental in optimizing vaccination strategy in western Uttar Pradesh with respect to the choice of OPV types, the frequency of supplementary immunization campaigns, and the urgency to improve routine immunization services. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Who Makes It to Secondary School? Determinants of Transition to Secondary Schools in Rural India

ERIC Educational Resources Information Center

Siddhu, Gaurav

2011-01-01

Despite considerable progress made, a significant proportion of children continue to drop out before reaching secondary school in India. This study investigates factors influencing parental decision-making with regard to children's secondary schooling in the context of a rural area of Uttar Pradesh. The study finds that cost, distance to the…

Recurrent floods and prevalence of diarrhea among under five children: observations from Bahraich district, Uttar Pradesh, India.

PubMed

Joshi, Pooran C; Kaushal, Sonia; Aribam, Bijaya S; Khattri, Prashant; D'Aoust, Olivia; Singh, Mongjam M; Marx, Michael; Guha-Sapir, Debarati

2011-01-01

Diarrhea is an important problem among the under-five children in India. The paper examines long-term impacts of recurrent floods on diarrhea among under-five children in Uttar Pradesh, India. A two stage stratified cluster survey was conducted in flood affected (exposed) and non-flood affected areas (unexposed). The long-term impact of the floods was not clearly marked in the overall prevalence of diarrhea with the exposed group having prevalence of 55.1% as against 56.2% in the unexposed group of children under five. Economic condition of the household is associated with the prevalence of diarrhea in both exposed and unexposed strata. Anemia was found to be a significant risk factor for diarrhea among children in both the flood exposed and non-flood exposed populations. The recurrent floods did not have any significant effect on the prevalence of diarrhea in relation to gender, religion, caste, and household size. The study indicates that the long-term impacts of floods are very differently manifested than the immediate impacts.

Recurrent floods and prevalence of diarrhea among under five children: observations from Bahraich district, Uttar Pradesh, India

PubMed Central

Joshi, Pooran C.; Kaushal, Sonia; Aribam, Bijaya S.; Khattri, Prashant; D'Aoust, Olivia; Singh, Mongjam M.; Marx, Michael; Guha-Sapir, Debarati

2011-01-01

Background Diarrhea is an important problem among the under-five children in India. Objective The paper examines long-term impacts of recurrent floods on diarrhea among under-five children in Uttar Pradesh, India. Design A two stage stratified cluster survey was conducted in flood affected (exposed) and non-flood affected areas (unexposed). Results The long-term impact of the floods was not clearly marked in the overall prevalence of diarrhea with the exposed group having prevalence of 55.1% as against 56.2% in the unexposed group of children under five. Economic condition of the household is associated with the prevalence of diarrhea in both exposed and unexposed strata. Anemia was found to be a significant risk factor for diarrhea among children in both the flood exposed and non-flood exposed populations. The recurrent floods did not have any significant effect on the prevalence of diarrhea in relation to gender, religion, caste, and household size. Conclusions The study indicates that the long-term impacts of floods are very differently manifested than the immediate impacts. PMID:21695069

Can Choice Promote Education for All? Evidence from Growth in Private Primary Schooling in India

ERIC Educational Resources Information Center

Harma, Joanna

2009-01-01

This paper examines whether the recent growth in "low-fee private" (LFP) schools is able to promote Education for All by being accessible to the poor. Based primarily on a 13-village survey of 250 households and visits to 26 private and government schools in rural Uttar Pradesh, India, this paper explores who "chooses" private…

Phenetic, genetic diversity and symbiotic compatibility of rhizobial strains nodulating pigeon pea in Northern India.

PubMed

Arora, Naveen Kumar; Khare, Ekta; Singh, Sachin; Tewari, Sakshi

2018-01-01

Pigeon pea ( Cajanus cajan ) is one of the most important legumes grown in the northern province of Uttar Pradesh, India. However, its productively in Uttar Pradesh is lower than the average yield of adjoining states. During the course of the present study, a survey of pigeon pea growing agricultural fields was carried out and it was found that 80% of plants were inadequately nodulated. The study was aimed to evaluate the pigeon pea symbiotic compatibility and nodulation efficiency of root nodulating bacteria isolated from various legumes, and to explore the phenetic and genetic diversity of rhizobial population nodulating pigeon pea growing in fields of Uttar Pradesh. Amongst all the 96 isolates, 40 isolates showed nodulation in pigeon pea. These 40 isolates were further characterized by phenotypic, biochemical and physiological tests. Intrinsic antibiotic resistance pattern was taken to generate similarity matrix revealing 10 phenons. The study shows that most of the isolates nodulating pigeon pea in this region were rapid growers. The dendrogram generated using the NTSYSpc software grouped RAPD patterns into 19 clusters. The high degree of phenetic and genetic diversity encountered is probably because of a history of mixed cropping of legumes. The assessment of diversity is a very important tool and can be used to improve the nodulation and quality of pigeon pea crop. It is also concluded that difference between phenetic and RAPD clustering pattern is an indication that rhizobial diversity of pigeon pea is not as yet completely understood and settled.

Family planning use among urban poor women from six cities of Uttar Pradesh, India.

PubMed

Speizer, Ilene S; Nanda, Priya; Achyut, Pranita; Pillai, Gita; Guilkey, David K

2012-08-01

Family planning has widespread positive impacts for population health and well-being; contraceptive use not only decreases unintended pregnancies and reduces infant and maternal mortality and morbidity, but it is critical to the achievement of Millennium Development Goals. This study uses baseline, representative data from six cities in Uttar Pradesh, India to examine family planning use among the urban poor. Data were collected from about 3,000 currently married women in each city (Allahabad, Agra, Varanasi, Aligarh, Gorakhpur, and Moradabad) for a total sample size of 17,643 women. Participating women were asked about their fertility desires, family planning use, and reproductive health. The survey over-sampled slum residents; this permits in-depth analyses of the urban poor and their family planning use behaviors. Bivariate and multivariate analyses are used to examine the role of wealth and education on family planning use and unmet need for family planning. Across all of the cities, about 50% of women report modern method use. Women in slum areas generally report less family planning use and among those women who use, slum women are more likely to be sterilized than to use other methods, including condoms and hormonal methods. Across all cities, there is a higher unmet need for family planning to limit childbearing than for spacing births. Poorer women are more likely to have an unmet need than richer women in both the slum and non-slum samples; this effect is attenuated when education is included in the analysis. Programs seeking to target the urban poor in Uttar Pradesh and elsewhere in India may be better served to identify the less educated women and target these women with appropriate family planning messages and methods that meet their current and future fertility desire needs.

Lung function impairment in women exposed to biomass fuels during cooking compared to cleaner fuels in Uttar Pradesh, India.

PubMed

Bihari, Vipin; Iqbal, S M; Srivastava, L P; Kesavachandran, C; Siddique, M J A

2013-11-01

A national survey has shown that approximately 75-80% use of fire wood and chips, 10% of dung cake rural women in Uttar Pradesh, India. Considering the respiratory health risk of biomass fuel exposure to women, a cross sectional study was conducted to elucidate the relationship between cooking smoke and lung function impairments. The present study showed significant decline in air flow limitation based on reduced PEFR (3.69 | sec(-1)) and FEV1 (1.34 | sec(-1)) in women cooking with biomass fuels compared to PEFR (4.26 | sec(-1)) and FEV1 (1.73 | sec(-1)) in women cooking with cleaner fuels. The noxious gases and particles generated from biomass fuels during cooking reported in earlier studies may be the reason for the slight decline in airway status PEFR (3.69 | sec(-1)) and lung volumes FEV1 (1.34 | sec(-1)). The higher mean bio-fuels exposure index (52.5 hr-yrs) can attribute to reduced lung function in rural women.

The Effect of Early Childhood Developmental Program Attendance on Future School Enrollment in Rural North India

ERIC Educational Resources Information Center

Hazarika, Gautam; Viren, Vejoya

2013-01-01

This paper examines the effect of prior participation in early childhood developmental programs, considered endogenous, upon 7-18 years olds' school enrollment in rural North India. Analyses by age group of data from the World Bank's 1997-98 Survey of Living Conditions in Uttar Pradesh and Bihar reveal that 7-10 year olds, 11-14 year olds, and…

A surprising exception. Himachal's success in promoting female education.

PubMed

Dreze, J

1999-01-01

Gender inequalities in India are derived partly from the economic dependence of women on men. Low levels of formal education among women reinforce the asymmetry of power between the sexes. A general pattern of sharp gender bias in education levels is noted in most Indian states; however, in the small state of Himachal Pradesh, school participation rates are almost as high for girls as for boys. Rates of school participation for girls at the primary level is close to universal in this state, and while gender bias persists at higher levels of education, it is much lower than elsewhere in India and rapidly declining. This was not the case 50 years ago; educational levels in Himachal Pradesh were no higher than in Bihar or Uttar Pradesh. Today, the spectacular transition towards universal elementary education in Himachal Pradesh has contributed to the impressive reduction of poverty, mortality, illness, undernutrition, and related deprivations.

75 FR 21151 - Designation of Two Individuals Pursuant to Executive Order 13224

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

..., Pakistan; DOB 5 Oct 1951; POB Azamgarh, Uttar Pradesh, India; nationality Pakistan; Passport KZ 550207 (Pakistan); alt. Passport G154297 (Pakistan); alt. Passport KC550207 (Pakistan) (individual) [SDGT]. 2...; a.k.a. ``USTAAD SHEHEB''), Karachi, Pakistan; DOB circa 1955; alt. DOB circa 1964; POB Sarghoda...

Poland syndrome

PubMed Central

Sharma, Chandra Madhur; Kumar, Shrawan; Meghwani, Manoj K.; Agrawal, Ravi P.

2014-01-01

Poland's syndrome is a rare congenital condition, characterized by the absence of the sternal or breastbone portion of the pectoralis major muscle, which may be associated with the absence of nearby musculoskeletal structures. We hereby report an 8-year-old boy with typical features of Poland syndrome, the first documented case from Uttar Pradesh, India. PMID:24959021

Poland syndrome.

PubMed

Sharma, Chandra Madhur; Kumar, Shrawan; Meghwani, Manoj K; Agrawal, Ravi P

2014-01-01

Poland's syndrome is a rare congenital condition, characterized by the absence of the sternal or breastbone portion of the pectoralis major muscle, which may be associated with the absence of nearby musculoskeletal structures. We hereby report an 8-year-old boy with typical features of Poland syndrome, the first documented case from Uttar Pradesh, India.

Counseling during Maternal and Infant Health Visits and Postpartum Contraceptive use in Uttar Pradesh, India

PubMed Central

Rajan, Sowmya; Speizer, Ilene S.; Calhoun, Lisa M.; Nanda, Priya

2017-01-01

Context Postpartum family planning is a compelling concern of global significance due to its salience to unplanned pregnancies, and to maternal and infant health in developing countries. Yet, women face the highest level of unmet need for contraception in the year following a birth. A cost-effective way to inform women about their risk of becoming pregnant after the birth of a child is to integrate family planning counseling and services with maternal and infant health services. Methods We use recently collected survey data from 2733 women from six cities in Uttar Pradesh, India who had a recent birth (since 2011) to examine the role of exposure to family planning information at maternal and infant health visits on (1) any contraceptive use in the postpartum period, and (2) choice of modern method in the postpartum period. We use discrete-time event history multinomial logit models to examine the duration to contraceptive use, and choice of modern method, in the 12 months following the last birth since 2011. Results We find that receiving counseling in an institution at the time of delivery has the strongest influence on women’s subsequent uptake of modern contraception (female sterilization and IUD). Being visited by a CHW in the extended postpartum period was also strongly associated with subsequent uptake of modern contraception (IUD, condom and hormonal contraception). Conclusion Providing postpartum family planning counseling at key junctures during maternal health visits has the potential to increase uptake of modern contraceptive method in urban Uttar Pradesh. PMID:28649295

Social Network and Mental Health Among Older Adults in Rural Uttar Pradesh, India: A Cross-Sectional Study.

PubMed

Singh, Lucky; Singh, Prashant Kumar; Arokiasamy, Perianayagam

2016-06-01

The rapid growth of the older population in India draws attention to the factors that contribute to their changing health realities. However, there has hardly been any study in India that has looked at the effects of specific social networks with children, relatives, friends and confidant on depression among older adults. The objective of the study is to investigate the association between social network and depression among the rural elderly. The study population comprised over 630 older adults (aged 60 and above) from the rural areas of Varanasi, Uttar Pradesh. We adopted Berkman's theoretical model of the impact of social relations on depression among the elderly in the Indian context. Results of the Confirmatory Factor Analysis (CFA) demonstrated that the four specific social network types: children, relatives, friends and confidant were tenable. The results showed that a better social network with 'friends/neighbours' was protective against depression among the rural elderly. This clearly points to the need for more social network centres for older adults, so that they can interact with friends within the community or between communities and participate in group activities.

Dust Quantization and Effects on Agriculture Over Uttar Pradesh, India

NASA Astrophysics Data System (ADS)

Munshi, Pavel; Tiwari, Shubhansh

2017-01-01

Dust plays a very important role in the atmosphere and the biosphere. In this communication, the effect of atmospheric dust on the yields of certain crops grown in Uttar Pradesh, India is assessed. Coherent physical and thermodynamic fingerprints of dust parameters such as from Satellite data- KALPANA-1, MODIS, OMI, CALIPSO; Model data- DREAM, HYSPLIT, ECMWF; have been considered to run the APSIM model to derive the impacts. This paper assesses dust as a physical atmospheric phenomenon including its Long Range Transport (LRT) and dispersion along with considerable variations of Aerosol Optical Depths (AODs) over the subcontinent of India. While AODs significantly increase by more dust concentration, the local dispersion of pollutants is a major concern with deposition of atmospheric dust such as sulphates and other chemical constituents that affect agricultural land. An approach in atmospheric physics is also taken to parameterize the model outputs. This communication indicates dust to be a positive factor for the cultivation of certain crops such as wheat, maize in the experimental location. Initial results suggest that LRT dust is a viable counterpart to decrease the concentration of soil acidity and related parameters thus enhancing the vitality of crops.

Appropriate Strategy for Rehabilitating the Rural Blind: Education of Parents and Counselling of Visually Handicapped Persons in Bhagwanpur Block (District Saharanpur, Uttar Pradesh, India). Brief Research Report.

ERIC Educational Resources Information Center

Mathur, M. L.; And Others

1986-01-01

Fifty-two visually handicapped persons (mean age 48.8 years) were identified in 21 of 82 rural villages surveyed by trained local field workers in India. Assessment, rehabilitation planning, parent/trainer counseling and education, and training in such areas as daily living skills and orientation and mobility were provided as appropriate. (JW)

Low use of contraceptives among rural women in Maitha, Uttar Pradesh, India.

PubMed

Saroha, Ekta; Altarac, Maja; Sibley, Lynn M

2013-05-01

Low contraceptive utilisation and high fertility in rural Uttar Pradesh (UP), India, is a major concern for the world's second most populous country. The association between reasons for low contraceptive utilisation and maternal factors has been inadequately researched. Data from the 'morbidity and performance assessment' study were analysed to explore reasons for low contraceptive utilisation and their association with maternal factors among 308 women in Maitha, rural UP, India. Chi-square, t-test, ANOVA, and logistic regression analyses were conducted. Majority (84.2%) of the rural women in Maitha, UP, India were not using any contraceptives. Upper caste, literate wives, and wives whose husbands were literate were more likely to use contraceptives. About one-third of the women did not want to use a contraceptive because they wanted another child. Large numbers (65.3%) of women wanted to use contraceptives but were unable to do so due to lack of knowledge (38.9%), fear of side-effects (15.5%), husband/family disapproval (15.5%), inconvenience (10.7%), and other reasons (19.1%). Maternal parity, wives' and husband's literacy were significantly associated with the reasons for low contraceptive utilisation (p < 0.05). Contraceptive utilisation can be Improved by taking into consideration such maternal characteristics. All state subsidised contraceptives should be more widely known, understood and made available.

Human Resource Building--An Approach to Service Learning

ERIC Educational Resources Information Center

Rajan, Sonika

2009-01-01

Background: Isabella Thoburn College at Lucknow, Uttar Pradesh, India has initiated Service Learning Program for its students through 4 issue based centers. One of the centers AIDS Awareness Center for Counseling, Education, and Training (AACCET) is in the field of HIV/AIDS. It follows 6 pronged approach to achieve its objectives and one of the…

Site specific toxicological risk from fluoride exposure through ingestion of vegetables and cereal crops in Unnao district, Uttar Pradesh, India.

PubMed

Jha, S K; Nayak, A K; Sharma, Y K

2011-05-01

A study was carried out to assess toxicological risk from the fluoride (F) exposure due to ingestion of vegetables and cereal crops such as rice and wheat grown in potentially fluoridated area (brick kiln and sodic areas), of different age groups in Unnao district, Uttar Pradesh, India. Fluoride contents in vegetables and cereal were found to be in the order brick kiln sites>sodic sites>normal sites. Among vegetables maximum F concentration was found in spinach and mint, whereas in cereal crops, wheat accumulated more F than rice. The exposure dose of F was determined using estimated daily intake (EDI) and bio-concentration factor (BCF) of F. The children of age group 3-14 years in the potentially fluoridated area were found to be at the risk of fluorosis. The mean BCF value of F was the highest in mint (36.6 mg/kg(dwt) plant/mg/kg(dwt) soil), followed by spinach (33.99 mg/kg(dwt) plant.mg/kg(dwt) soil). Copyright © 2011 Elsevier Inc. All rights reserved.

Couple Interaction and Predicting Vulnerability to Domestic Violence in Uttar Pradesh, India.

PubMed

Singh, Brijesh P; Singh, Kaushalendra K; Singh, Neha

2014-08-01

Domestic violence, when conducted against women, is a type of gender-based violence that negatively impacts a woman's physical and psychological health, causing insecurity, lack of safety, and loss of health and self-worth. Domestic violence is an important consideration for sexual, reproductive, and child health, as it can affect contraceptive behaviors of couples as well as levels of infant mortality. In the present analysis, an attempt has been made to study the relationship between women's experience of domestic violence and couple interaction after controlling for certain socioeconomic and demographic variables using logistic regression. This study looks at data from the National Family Health Survey-III conducted from 2005 to 2006 in Uttar Pradesh, the most populous state of India. Findings reveal that 43% of women suffer from domestic violence in the society as a whole; however, if a couple makes joint decisions in household matters, the prevalence of domestic violence is observed to be 24% less. Education and occupation of women, standard of living, media exposure, and partner's alcoholic behaviors are also found to be possible predictors of domestic violence. © The Author(s) 2014.

School Choice for the Poor? The Limits of Marketisation of Primary Education in Rural India. CREATE Pathways to Access. Research Monograph No. 23

ERIC Educational Resources Information Center

Harma, Joanna

2010-01-01

In recent years India has seen an explosion in low-fee private (LFP) schooling aimed at the poorer strata of society. This marketisation of primary education is a reaction to the well-documented failings of the government system. This paper looks at LFP schooling in one rural district of Uttar Pradesh, and compares government to low cost private…

Seeking to Bridge the Divide: Linking Formal and Non-Formal Education in Uttar-Pradesh, India. IBE Collaborative Projects: Strengthening Capacities through Action

ERIC Educational Resources Information Center

Zutshi, Bupinder

2004-01-01

The new monograph series, IBE Collaborative Projects: Strengthening Capacities through Action, documents projects initiated and managed by local or national level institutions in diverse countries, which have been technically or academically assisted by UNESCO's International Bureau of Education (IBE). This first publication in the series…

Cephalometric norms for orthognathic surgery for North India (Eastern Uttar Pradesh).

PubMed

Gulati, Rajeev; Jain, Shikha

2011-01-01

The present study was aimed at development of the cephalometric norms for orthognathic surgery for the population of eastern Uttar Pradesh in North India. This study was conducted at a dental college. The study sample consisted of 50 males and 50 females. Each lateral cephalogram was taken in occlusion and subsequently traced. All reference points, landmarks, and measurements were made according to cephalometrics for orthognathic surgery (COGS) system. The statistical analysis involved calculation of mean and standard deviation for each of the 23 parameters assessed for each subject. The data was subsequently compared with COGS study by using Normal (Z) test. The norms were derived for the purvanchal population of North India and these were found to be quite distinct compared to those obtained from COGS study with respect to specific parameters. Male subjects indicated greater prominence of chin relative to the face, decreased posterior divergence, infraeruption of upper and lower molar as well as lower incisors, decreased total effective length of the maxilla, tendency towards Class III occlusion, and procumbent lower incisors. Female subjects, however, indicated increased anterior cranial base length, greater prominence of chin relative to the face, prognathic maxilla and mandible, increased middle third facial height, infraerupted lower incisors, increased mandibular body length, and procumbent lower incisors.

How do People in Rural India Perceive Improved Stoves and Clean Fuel? Evidence from Uttar Pradesh and Uttarakhand

PubMed Central

Bhojvaid, Vasundhara; Jeuland, Marc; Kar, Abhishek; Lewis, Jessica J.; Pattanayak, Subhrendu K.; Ramanathan, Nithya; Ramanathan, Veerabhadran; Rehman, Ibrahim H.

2014-01-01

Improved cook stoves (ICS) have been widely touted for their potential to deliver the triple benefits of improved household health and time savings, reduced deforestation and local environmental degradation, and reduced emissions of black carbon, a significant short-term contributor to global climate change. Yet diffusion of ICS technologies among potential users in many low-income settings, including India, remains slow, despite decades of promotion. This paper explores the variation in perceptions of and preferences for ICS in Uttar Pradesh and Uttarakhand, as revealed through a series of semi-structured focus groups and interviews from 11 rural villages or hamlets. We find cautious interest in new ICS technologies, and observe that preferences for ICS are positively related to perceptions of health and time savings. Other respondent and community characteristics, e.g., gender, education, prior experience with clean stoves and institutions promoting similar technologies, and social norms as perceived through the actions of neighbours, also appear important. Though they cannot be considered representative, our results suggest that efforts to increase adoption and use of ICS in rural India will likely require a combination of supply-chain improvements and carefully designed social marketing and promotion campaigns, and possibly incentives, to reduce the up-front cost of stoves. PMID:24473110

How do people in rural India perceive improved stoves and clean fuel? Evidence from Uttar Pradesh and Uttarakhand.

PubMed

Bhojvaid, Vasundhara; Jeuland, Marc; Kar, Abhishek; Lewis, Jessica J; Pattanayak, Subhrendu K; Ramanathan, Nithya; Ramanathan, Veerabhadran; Rehman, Ibrahim H

2014-01-27

Improved cook stoves (ICS) have been widely touted for their potential to deliver the triple benefits of improved household health and time savings, reduced deforestation and local environmental degradation, and reduced emissions of black carbon, a significant short-term contributor to global climate change. Yet diffusion of ICS technologies among potential users in many low-income settings, including India, remains slow, despite decades of promotion. This paper explores the variation in perceptions of and preferences for ICS in Uttar Pradesh and Uttarakhand, as revealed through a series of semi-structured focus groups and interviews from 11 rural villages or hamlets. We find cautious interest in new ICS technologies, and observe that preferences for ICS are positively related to perceptions of health and time savings. Other respondent and community characteristics, e.g., gender, education, prior experience with clean stoves and institutions promoting similar technologies, and social norms as perceived through the actions of neighbours, also appear important. Though they cannot be considered representative, our results suggest that efforts to increase adoption and use of ICS in rural India will likely require a combination of supply-chain improvements and carefully designed social marketing and promotion campaigns, and possibly incentives, to reduce the up-front cost of stoves.

Caste and maternal health care service use among rural Hindu women in Maitha, Uttar Pradesh, India.

PubMed

Saroha, Ekta; Altarac, Maja; Sibley, Lynn M

2008-01-01

The objective of this study was to examine the association between caste and maternal health care service use among rural Hindu women in India. We analyzed data from the Morbidity and Performance Assessment, a population-based cross-sectional study, for 482 Hindu women who were pregnant during January 1998 to January 1999 in Maitha, Uttar Pradesh, India. Maternal health care service use among both upper and lower caste women was very low. Upper caste women were almost three times more likely to use antenatal care (odds ratio [OR] = 2.72; 95% confidence interval [CI], 1.40-5.30), tetanus toxoid (OR = 2.50; 95% CI, 1.48-4.21), and contraceptives (OR = 2.66; 95% CI, 1.28-5.54) and almost five times (OR = 4.77; 95% CI, 1.81-12.54) more likely to have a trained birth attendant compared to the lower caste women. Caste was a significant determinant of tetanus toxoid use and trained birth attendant even after adjusting for sociodemographic factors. Besides caste, maternal literacy was the one sociodemographic factor that was significantly associated with the use of all maternal health care services. Information dissemination and awareness generation can improve the use of subsidized maternal health care services among women of all caste groups.

Tuneful Weeping: A Mode of Communication. Working Papers in Sociolinguistics Number 27.

ERIC Educational Resources Information Center

Tiwary, K. M.

In the states of Bihar and Uttar Pradesh in northern India the speech styles of men and women differ markedly in a number of ways. One mode of communication, tuneful weeping, is exclusive to women. This behavior is distinguished from spontaneous crying caused by pain, and is used only in certain prescribed social situations, and not necessarily in…

Poor Affordability and Low Access to Primary Education with Special Reference to Eastern Uttar Pradesh: Reflections from DISE Data

ERIC Educational Resources Information Center

Sulochana, Rosy

2015-01-01

"Access to basic education" continues to be a matter of serious concern in India. While the quantitative expansion of the system appears to be very impressive, the achievement of the goal of universalisation of primary education has still remained elusive. This is because the government continues its celebration through reflecting on…

Simultaneous Education for Women and Girls. Report of a Project.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and the Pacific.

This project focuses on non-formal and adult education for women in rural areas of Uttar Pradesh, India. The objectives of the project were: (1) to provide non-formal education to girls and adult education to women in a coordinated manner; (2) to raise civic and social awareness of women; (3) to decentralize planning and implementation of programs…

Linkages between public and non-government sectors in healthcare: A case study from Uttar Pradesh, India.

PubMed

Srivastava, Aradhana; Bhattacharyya, Sanghita; Gautham, Meenakshi; Schellenberg, Joanna; Avan, Bilal I

2016-12-01

Effective utilisation of collaborative non-governmental organisation (NGO)-public health system linkages in pluralistic health systems of developing countries can substantially improve equity and quality of services. This study explores level and types of linkages between public health sector and NGOs in Uttar Pradesh (UP), an underprivileged state of India, using a social science model for the first time. It also identifies gaps and challenges for effective linkage. Two NGOs were selected as case studies. Data collection included semi-structured in-depth interviews with senior staff and review of records and reporting formats. Formal linkages of NGOs with the public health system related to registration, participation in district level meetings, workforce linkages and sharing information on government-supported programmes. Challenges included limited data sharing, participation in planning and limited monitoring of regulatory compliances. Linkage between public health system and NGOs in UP was moderate, marked by frequent interaction and some reciprocity in information and resource flows, but weak participation in policy and planning. The type of linkage could be described as 'complementarity', entailing information and resource sharing but not joint action. Stronger linkage is required for sustained and systematic collaboration, with joint planning, implementation and evaluation.

Screening of native plants and algae growing on fly-ash affected areas near National Thermal Power Corporation, Tanda, Uttar Pradesh, India for accumulation of toxic heavy metals.

PubMed

Dwivedi, S; Srivastava, S; Mishra, S; Dixit, B; Kumar, A; Tripathi, R D

2008-10-30

The present investigation was carried out to screen native plants growing in fly-ash (FA) contaminated areas near National Thermal Power Corporation, Tanda, Uttar Pradesh, India with a view to using them for the eco-restoration of the area. A total number of 17 plants (9 aquatic, 6 terrestrial and 2 algal species) were collected and screened for heavy metal (Fe, Zn, Cu, Mo, B, Si, Al, Cr, Pb, Cd, Hg and As) accumulation. Differential accumulation of various heavy metals by different species of plants was observed. Hydrilla verticillata was found to be the most efficient metal accumulator among 9 aquatic plants, Eclipta alba among 6 terrestrial plants and Phormedium papyraceum between 2 algal species. In general, the maximum levels of most metals were found in terrestrial plants while the lowest in algal species. However, translocation of the metals from root to shoot was found to be higher in aquatic plants than terrestrial ones. These results suggest that various aquatic, terrestrial and algal species of plants may be used in a synergistic way to remediate and restore the FA contaminated areas.

Costs and consequences of a cash transfer for hospital births in a rural district of Uttar Pradesh, India.

PubMed

Coffey, Diane

2014-08-01

The Janani Suraksha Yojana, India's "safe motherhood program," is a conditional cash transfer to encourage women to give birth in health facilities. Despite the program's apparent success in increasing facility-based births, quantitative evaluations have not found corresponding improvements in health outcomes. This study analyses original qualitative data collected between January, 2012 and November, 2013 in a rural district in Uttar Pradesh to address the question of why the program has not improved health outcomes. It finds that health service providers are focused on capturing economic rents associated with the program, and provide an extremely poor quality care. Further, the program does not ultimately provide beneficiaries a large net monetary transfer at the time of birth. Based on a detailed accounting of the monetary costs of hospital and home deliveries, this study finds that the value of the transfer to beneficiaries is small due to costs associated with hospital births. Finally, this study also documents important emotional and psychological costs to women of delivering in the hospital. These findings suggest the need for a substantial rethinking of the program, paying careful attention to incentivizing health outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Pregnancy risk during menstrual cycle: misconceptions among urban men in India.

PubMed

Verma, Prashant; Singh, Kaushalendra Kumar; Singh, Anjali

2017-06-12

In India, where men take most decisions in the family, it is useful that they have adequate knowledge about pregnancy risks during women's menstrual cycles. Since traditional contraceptive methods are still employed by a large population in India, the knowledge regarding the pregnancy risk during the menstrual cycle is indispensable. This research paper attempts to assess the knowledge among urban men in Uttar Pradesh, India about the fertile window of the menstrual cycle; it also attempts to discover the rationales behind the misconceptions about the concept. This study utilizes the baseline data of the Measurement, Learning, and Evaluation project for the Urban Reproductive Health Initiative in Uttar Pradesh. Descriptive Statistics has been used to assess the prevalence of knowledge among urban men regarding the concept. Using the Discriminant Analysis, we also investigate the rationales behind the misconceptions among urban men about the concept. Only one-fifth of the men have the correct knowledge about the concept. Further, we find that education, societal perception, caste, and spousal discussion about the reproductive issues are the primary factors affecting the knowledge about the pregnancy risk during the menstrual cycle. There is an urgent need for sex education in the region to make the urban men more educated about the reproductive process of women; this may reduce unwanted births and abortion due to an unwanted pregnancy as well. The study promotes the higher education and motivates couples to discuss the reproductive health issues among them. In this manner, we can provide better reproductive health to the women of urban India.

Towards an understanding of the multilevel factors associated with maternal health care utilization in Uttar Pradesh, India

PubMed Central

Sridharan, Sanjeev; Dey, Arnab; Seth, Aparna; Chandurkar, Dharmendra; Singh, Kultar; Hay, Katherine; Gibson, Rachael

2017-01-01

ABSTRACT Background: This paper explores the multilevel factors associated with maternal health utilization in India’s most populous state, Uttar Pradesh. 3 key utilization practices: registration of pregnancy, receipt of antenatal care, and delivery at home are examined for district and individual level predictors. The data is based on 5666 household surveys conducted as part of a baseline evaluation of the Uttar Pradesh Technical Support Unit (UPTSU.) program. Objectives: This intervention aims to assist the Government of Uttar Pradesh in increasing the efficiency, effectiveness, and equity of service delivery across a continuum of reproductive, maternal, new-born, child, and adolescent health (RMNCH+A) outcomes. Methods: The paper employs multilevel models that control for individuals being nested within districts in order to understand the predictors of maternal health care utilization. Results: The study identifies several individual-level predictors of health care utilization, including: literacy of the woman, the husband’s schooling, age at marriage, and socio-economic factors. Key predictors of pregnancy registration include husband’s schooling (OR 1.49, 95% CI 1.26–1.76), having a bank account (OR 1.36, 95% CI 1.11–1.68), and owning a house (OR 2.28, 95% CI 1.85–2.80). Factors affecting antenatal care include the woman’s literacy (OR 1.49, 95% CI 1.28–1.73), the respondent having had a job in the last year (OR 1.39, 95% CI 1.10–1.77), and owning a house (OR 2.83, 95% CI 2.27–3.53). Home delivery tends to be associated with woman’s literacy (OR 0.62, 95% CI 0.54–0.72) and marriage age of 15 and younger (OR 1.48, 95% CI 1.26–1.73). Conclusions: Interventions having equity considerations need to disrupt existing patterns of the health gradient. Successful implementation of such interventions, necessitate understanding the mechanisms that can disrupt the unequal utilization patterns and target domains of disadvantage. Knowledge of key predictors of utilization can aid in the implementation of such complex interventions. PMID:28681668

Spatial and gender scenario of literate life expectancy at birth in India.

PubMed

Chattopadhyay, Aparajita; Sinha, Kumar Chiman

2010-10-01

Measuring human quality of life is academically challenging. The human development index (HDI) substantially captures the overall country level status on human welfare. However, this index has some drawbacks. Therefore, Lutz composed a simple index in 1995 combining life expectancy and literacy, called literate life expectancy (LLE). LLE can be calculated for subpopulations depending on availability of data. This article captures the LLE in major states in India and the gender differences in LLE at rural and urban levels. The authors have tried to highlight the social development scenario in India and its major states by using this pure social indicator that intentionally does not use any economic measurement. The state scenario comprehensively depicts gender differentials in social development, and it calls for implementing development measures more seriously in states like Haryana, Bihar, Rajasthan, Madhya Pradesh, and Uttar Pradesh to reduce the gender gap. Being highly correlated with the HDI, the LLE index proves to be a very clear and simple comprehensive measure of social development for different subpopulations.

Sources of occupational stress in the police personnel of North India: An exploratory study

PubMed Central

Singh, Shweta; Kar, Sujita Kumar

2015-01-01

Background: Police personnel in India are subjected to several distinct occupational stressors which impact their mental health and their work performance negatively. Aim: The study aimed to explore various sources of stress among police personnel. Method: In this study, 100 constables, 100 inspectors and 100 police officers of Uttar Pradesh, were evaluated using the occupational stress questionnaire. This was subjected to the quantitative as well as the qualitative analysis. Result: Occupational stress was commonly perceived among all police personnel, but the major attributes of stress in various groups were diverse. PMID:26023272

Burden of Severe Pneumonia, Pneumococcal Pneumonia and Pneumonia Deaths in Indian States: Modelling Based Estimates

PubMed Central

Farooqui, Habib; Jit, Mark; Heymann, David L.; Zodpey, Sanjay

2015-01-01

The burden of severe pneumonia in terms of morbidity and mortality is unknown in India especially at sub-national level. In this context, we aimed to estimate the number of severe pneumonia episodes, pneumococcal pneumonia episodes and pneumonia deaths in children younger than 5 years in 2010. We adapted and parameterized a mathematical model based on the epidemiological concept of potential impact fraction developed CHERG for this analysis. The key parameters that determine the distribution of severe pneumonia episode across Indian states were state-specific under-5 population, state-specific prevalence of selected definite pneumonia risk factors and meta-estimates of relative risks for each of these risk factors. We applied the incidence estimates and attributable fraction of risk factors to population estimates for 2010 of each Indian state. We then estimated the number of pneumococcal pneumonia cases by applying the vaccine probe methodology to an existing trial. We estimated mortality due to severe pneumonia and pneumococcal pneumonia by combining incidence estimates with case fatality ratios from multi-centric hospital-based studies. Our results suggest that in 2010, 3.6 million (3.3–3.9 million) episodes of severe pneumonia and 0.35 million (0.31–0.40 million) all cause pneumonia deaths occurred in children younger than 5 years in India. The states that merit special mention include Uttar Pradesh where 18.1% children reside but contribute 24% of pneumonia cases and 26% pneumonia deaths, Bihar (11.3% children, 16% cases, 22% deaths) Madhya Pradesh (6.6% children, 9% cases, 12% deaths), and Rajasthan (6.6% children, 8% cases, 11% deaths). Further, we estimated that 0.56 million (0.49–0.64 million) severe episodes of pneumococcal pneumonia and 105 thousand (92–119 thousand) pneumococcal deaths occurred in India. The top contributors to India’s pneumococcal pneumonia burden were Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan in that order. Our results highlight the need to improve access to care and increase coverage and equity of pneumonia preventing vaccines in states with high pneumonia burden. PMID:26086700

Performance and determinants of routine immunization coverage within the context of intensive polio eradication activities in Uttar Pradesh, India: Social Mobilization Network (SM Net) and Core Group Polio Project (CGPP)

PubMed Central

2013-01-01

Background Studies that have looked at the effect of polio eradication efforts in India on routine immunization programs have provided mixed findings. One polio eradication project, funded by US Agency for International Development (USAID) and carried out by the CORE Group Polio Project (CGPP) in the state of Uttar Pradesh of India, has included the strengthening of routine immunization systems as a core part of its polio eradication strategy. This paper explores the performance of routine immunization services in the CGPP intervention areas concurrent with intensive polio eradication activities. The paper also explores determinants of routine immunization performance such as caretaker characteristics and CGPP activities to strengthen routine immunization services. Methods We conduct secondary data analysis of the latest project household immunization survey in 2011 and compare these findings to reports of past surveys in the CGPP program area and at the Uttar Pradesh state level (as measured by children’s receipt of DPT vaccinations). This is done to judge if there is any evidence that routine immunization services are being disrupted. We also model characteristics of survey respondents and respondents’ exposure to CGPP, communication activities against their children’s receipt of key vaccinations in order to identify determinants of routine immunization coverage. Results Routine immunization coverage has increased between the first survey (2005 for state level estimates, 2008 for the CGPP program) and the latest (2011 for both state level and CGPP areas), as measured by children’s receipt of DPT vaccination. This increase occurred concurrent with polio eradication efforts intensive enough to result in interruption of transmission. In addition, a mothers’ exposure to specific communication materials, her religion and education were associated with whether or not her children receive one or more doses of DPT. Conclusions A limitation of the analysis is the absence of a controlled comparison. It is possible routine immunization coverage would have increased even more in the absence of polio eradication efforts. At the same time, however, there is no evidence that routine immunization services were disrupted by polio eradication efforts. Targeted health communications are helpful in improving routine immunization performance. Strategies to address other determinants of routine immunization, such as religion and education, are also needed to maximize coverage. PMID:23680228

Padma Kant Shukla 1950-2013

NASA Astrophysics Data System (ADS)

Bingham, Robert; Eliasson, Bengt; Mendonca, Tito; Stenflo, Lennart; Stenflo

2013-03-01

Professor Padma Kant Shukla passed away on the 26th of January in New Delhi, India, just after receiving the prestigious Hind Rattan (Jewel of India) Award. He was born in the village Tulapur, Uttar Pradesh (UP), India and was educated there. After his Ph.D. in Physics from Banaras Hindu University in Varanasi, he obtained his second doctorate degree in Theoretical Plasma Physics from Umea University under the supervision of one of us (Lennart Stenflo). He worked at the Faculty of Physics & Astronomy, Ruhr-University Bochum, Germany since January 1973, where he was a permanent faculty member and Professor of International Affairs, a position that was created for him to honour his international accomplishments and reputation.

Using Technology to Claim Rights to Free Maternal Health Care: Lessons about Impact from the My Health, My Voice Pilot Project in India.

PubMed

Dasgupt, Jashodhara; Sandhya, Y K; Lobis, Samantha; Verma, Pravesh; Schaaf, Marta

2015-12-10

My Health, My Voice is a human rights-based project that pilots the use of technology to monitor and display online data regarding informal payments for maternal health care in two districts of Uttar Pradesh, India. SAHAYOG, an organization based in Uttar Pradesh, partnered with a grassroots women's forum to inform women about their entitlements, to publicize the project, and to implement a toll-free hotline where women could report health providers' demands for informal payments. Between January 2012 and May 2013, the hotline recorded 873 reports of informal payment demands. Monitoring and evaluation revealed that the project enhanced women's knowledge of their entitlements, as well as their confidence to claim their rights. Anecdotal evidence suggests that health providers' demands for informal payments were reduced in response to the project, although hospital and district officials did not regularly consult the data. The use of technology accorded greater legitimacy among governmental stakeholders. Future research should examine the sustainability of changes, as well as the mechanisms driving health sector responsiveness. Copyright © 2015 Dasgupta et al. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Successful polio eradication in Uttar Pradesh, India: the pivotal contribution of the Social Mobilization Network, an NGO/UNICEF collaboration

PubMed Central

Coates, Ellen A; Waisbord, Silvio; Awale, Jitendra; Solomon, Roma; Dey, Rina

2013-01-01

ABSTRACT In Uttar Pradesh, India, in response to low routine immunization coverage and ongoing poliovirus circulation, a network of U.S.-based CORE Group member and local nongovernmental organizations partnered with UNICEF, creating the Social Mobilization Network (SMNet). The SMNet's goal was to improve access and reduce family and community resistance to vaccination. The partners trained thousands of mobilizers from high-risk communities to visit households, promote government-run child immunization services, track children's immunization history and encourage vaccination of children missing scheduled vaccinations, and mobilize local opinion leaders. Creative behavior change activities and materials promoted vaccination awareness and safety, household hygiene, sanitation, home diarrheal-disease control, and breastfeeding. Program decision-makers at all levels used household-level data that were aggregated at community and district levels, and senior staff provided rapid feedback and regular capacity-building supervision to field staff. Use of routine project data and targeted research findings offered insights into and informed innovative approaches to overcoming community concerns impacting immunization coverage. While the SMNet worked in the highest-risk, poorly served communities, data suggest that the immunization coverage in SMNet communities was often higher than overall coverage in the district. The partners' organizational and resource differences and complementary technical strengths posed both opportunities and challenges; overcoming them enhanced the partnership's success and contributions. PMID:25276518

Measurement of unmet need for family planning: Longitudinal analysis of the impact of fertility desires on subsequent childbearing behaviors among urban women from Uttar Pradesh India

PubMed Central

Speizer, Ilene S.; Calhoun, Lisa; Hoke, Theresa; Sengupta, Ranajit

2013-01-01

Background The measure of unmet need relies on women’s reported fertility desires; previous research has demonstrated that fertility desires may be fluid and not firm. Study design Our study uses recently collected longitudinal data from four cities in Uttar Pradesh India to examine whether women’s fertility desires and family planning (FP) use at baseline predict pregnancy/birth experience in the two-year follow-up period. Results Multivariate models demonstrate that women who were using any method of FP and reported an intention to stop childbearing were the least likely to experience a pregnancy/birth in the two-year follow-up period. The stated desire to delay childbearing, whether or not the woman was using FP did not distinguish pregnancy/birth experience. Ninety- two percent of pregnancies/births over the follow-up period were considered “wanted then” suggesting post hoc rationalization of the pregnancy/birth even among those women who reported a desire to stop childbearing two years earlier. Conclusions More nuanced assessments of fertility intentions may be needed to adequately gauge latent family planning needs. Non-users of FP may be ambivalent about future childbearing and the timing of future births; these women may not have an unmet need for FP as typically defined. PMID:23706906

Gender-Based Power and Couples' HIV Risk in Uttar Pradesh and Uttarakhand, North India

PubMed Central

Agrawal, Alpna; Bloom, Shelah S.; Suchindran, Chirayath; Curtis, Sian; Angeles, Gustavo

2015-01-01

Context Gender inequality is a long-recognized driver of the HIV epidemic. However, few studies have investigated the association between gender-based power and HIV risk in India, which has the world's third largest HIV epidemic. Methods Population-based data collected in 2003 from 3,385 couples residing in Uttar Pradesh and Uttarakhand, North India, were used to examine associations between gender-based power (wife's autonomy and husband's inequitable gender attitudes) and indicators of couples' HIV risk (whether the husband had had premarital sex with someone other than his eventual spouse, extramarital sex in the past year or STI symptoms in the past year). Structural equation modeling was used to create composite variables for the gender-based power measures and test their associations with HIV risk measures. Results Twenty-four percent of husbands had had premarital sex, 7% had had extramarital sex in the past year and 6% had had STI symptoms in the past year. Structural equation models indicated that wives who reported higher levels of autonomy were less likely than other wives to have husbands who had had extramarital sex in the past year (direct association) and STI symptoms in the past year (indirect association). Moreover, husbands who endorsed more inequitable gender attitudes were more likely than others to report having had premarital sex with someone other than their spouse, which in turn was associated with having had extramarital sex and STI symptoms in the past year. Conclusions If the associations identified in this study reflect a causal relationship between gender-based power and HIV risk behavior, then HIV prevention programs that successfully address inequitable gender roles may reduce HIV risks in North India. PMID:25565347

Gender-based power and couples' HIV risk in Uttar Pradesh and Uttarakhand, north India.

PubMed

Agrawal, Alpna; Bloom, Shelah S; Suchindran, Chirayath; Curtis, Siân; Angeles, Gustavo

2014-12-01

Gender inequality is a long-recognized driver of the HIV epidemic. However, few studies have investigated the association between gender-based power and HIV risk in India, which has the world's third largest HIV epidemic. Population-based data collected in 2003 from 3,385 couples residing in Uttar Pradesh and Uttarakhand, North India, were used to examine associations between gender-based power (wife's autonomy and husband's inequitable gender attitudes) and indicators of couples' HIV risk (whether the husband had had premarital sex with someone other than his eventual spouse, extramarital sex in the past year or STI symptoms in the past year). Structural equation modeling was used to create composite variables for the gender-based power measures and test their associations with HIV risk measures. Twenty-four percent of husbands had had premarital sex, 7% had had extramarital sex in the past year and 6% had had STI symptoms in the past year. Structural equation models indicated that wives who reported higher levels of autonomy were less likely than other wives to have husbands who had had extramarital sex in the past year (direct association) or STI symptoms in the past year (indirect association). Moreover, husbands who endorsed more inequitable gender attitudes were more likely than others to report having had premarital sex with someone other than their spouse, which in turn was associated with having had extramarital sex and STI symptoms in the past year. If the associations identified in this study reflect a causal relationship between gender-based power and HIV risk behavior, then HIV prevention programs that successfully address inequitable gender roles may reduce HIV risks in North India.

Sex composition and its impact on future childbearing: a longitudinal study from urban Uttar Pradesh.

PubMed

Rajan, Sowmya; Nanda, Priya; Calhoun, Lisa M; Speizer, Ilene S

2018-02-27

The sex composition of existing children has been shown to influence childbearing decision-making and behaviors of women and couples. One aspect of this influence is the preference for sons. In India, where son preference is deeply entrenched, research has normally focused on rural areas using cross-sectional data. However, urban areas in India are rapidly changing, with profound implications for childbearing patterns. Yet, evidence on the effect of the sex composition of current children on subsequent childbearing intentions and behavior in urban areas is scant. In this study, we analyze the impact of sex composition of children on subsequent (1) parity progression, (2) contraceptive use, and (3) desire for another child. We analyze prospective data from women over a four year period in urban Uttar Pradesh using discrete-time event history logistic regression models to analyze parity progression from the first to second parity, second to third parity, and third to fourth parity. We also use logistic regression models to analyze contraceptive use and desire for another child. Relative to women with no daughters, women with no sons had significantly higher odds of progressing to the next birth (parity 1 - aOR: 1.31; CI: 1.04-1.66; parity 2 - aOR: 4.65; CI: 3.11-6.93; parity 3 - aOR:3.45; CI: 1.83-6.52), as well as reduced odds of using contraception (parity 2 - aOR:.58; CI: .44-.76; parity 3 - aOR: .58; CI: .35-.98). Relative to women with two or more sons, women with two or more daughters had significantly higher odds of wanting to have another child (parity 1 - aOR: 1.33; CI: 1.06-1.67; parity 2 - aOR: 3.96; CI: 2.45-6.41; parity 3-4.89; CI: 2.22-10.77). Our study demonstrates the pervasiveness of son preference in urban areas of Uttar Pradesh. We discuss these findings for future programmatic strategies to mitigate son preference in urban settings.

Agricultural practices and irrigation water demand in Uttar Pradesh

NASA Astrophysics Data System (ADS)

O'Keeffe, J.; Buytaert, W.; Brozovic, N.; Mijic, A.

2013-12-01

Changes in farming practices within Uttar Pradesh, particularly advances in irrigation technology, have led to a significant drop in water tables across the region. While the acquisition of monitoring data in India is a challenge, current water use practices point towards water overdraught. This is exacerbated by government and state policies and practices, including the subsidising of electricity, seeds and fertilizer, and an agreement to buy all crops grown, promoting the over use of water resources. Taking India's predicted population growth, increases in industrialisation and climate change into account, both farmland and the water resources it depends upon will be subject to increased pressures in the future. This research is centred around irrigation demands on water resources within Uttar Pradesh, and in particular, quantifying those demands both spatially and temporally. Two aspects of this will be presented; the quantification of irrigation water applied and the characterisation of the spatial heterogeneity of water use practices. Calculating the volumes of applied irrigation water in the absence of observed data presents a major challenge and is achieved here through the use of crop models. Regional crop yields provided by statistical yearbooks are replicated by the crop models AquaCrop and InfoCrop, and by doing so the amount of irrigation water needed to produce the published yields is quantified. In addition, proxy information, for example electrical consumption for agricultural use, is used to verify the likely volumes of water abstracted from tubewells. Statistical analyses of borehole distribution and the characterisation of the spatial heterogeneity of water use practices, particularly farmer decision making, collected during a field trip are also presented. The evolution of agricultural practices, technological advancement and water use for irrigation is reconstructed through the use of multiple regression and principle component analysis, allowing the identification of drivers of current water use practices. The importance of undertaking this research to model set up and for the advancement of overall understanding of the hydrological system is emphasised along with its significance in developing policy and informing water allocation models; a platform for more sustainable future water resource management in the region.

Costs and Consequences of a Cash Transfer for Hospital Births in a Rural District of Uttar Pradesh, India

PubMed Central

Coffey, Diane

2014-01-01

The Janani Suraksha Yojana, India’s “safe motherhood program,” is a conditional cash transfer to encourage women to give birth in health facilities. Despite the program’s apparent success in increasing facility-based births, quantitative evaluations have not found corresponding improvements in health outcomes. This study analyses original qualitative data collected between January, 2012 and November, 2013 in a rural district in Uttar Pradesh to address the question of why the program has not improved health outcomes. It finds that health service providers are focused on capturing economic rents associated with the program, and provide an extremely poor quality care. Further, the program does not ultimately provide beneficiaries a large net monetary transfer at the time of birth. Based on a detailed accounting of the monetary costs of hospital and home deliveries, this study finds that the value of the transfer to beneficiaries is small due to costs associated with hospital births. Finally, this study also documents important emotional and psychological costs to women of delivering in the hospital. These findings suggest the need for a substantial rethinking of the program, paying careful attention to incentivizing health outcomes. PMID:24911512

History of initial fifty years of ARIES: A Major National Indian Facility for Optical Observations

NASA Astrophysics Data System (ADS)

Sanwal, Basant Ballabh; Pandey, Anil Kumar; Uddin, Wahab; Kumar, Brijesh; Joshi, Santosh

2018-04-01

The idea of starting an astronomical observatory in the state of Uttar Pradesh in India germinated through the initiative of a scholarly statesman Babu Sampurnanandji. His interest in astrology coupled with his academic bent of mind got him interested in modern astronomy. Being then Education Minister and later Chief Minister of Uttar Pradesh, he established an astronomical observatory at Varanasi on April 20, 1954. Later on it was shifted to Manora Peak, Nainital. Four reflectors were commissioned at Manora Peak. For solar research an H alpha petrol unit and a horizontal solar spectrograph was setup. A detailed project report for installation of a 4-m class optical telescope was prepared indigenously in late 1980, however, the project could not take off. With the generous support of the Department of Science and Technology, the institute established a 3.6-m new technology optical telescope and a 1.3-m wide field optical telescope at a new observing site called Devasthal. Now a 4-m liquid mirror telescope is also being installed at the same observing site. I present here a brief journey of the observatory beginning right from its birth in 1954 till now.

Out of pocket expenditure to deliver at public health facilities in India: a cross sectional analysis.

PubMed

Issac, Anns; Chatterjee, Susmita; Srivastava, Aradhana; Bhattacharyya, Sanghita

2016-08-24

To expand access to safe deliveries, some developing countries have initiated demand-side financing schemes promoting institutional delivery. In the context of conditional cash incentive scheme and free maternity care in public health facilities in India, studies have highlighted high out of pocket expenditure (OOPE) of Indian families for delivery and maternity care. In this context the study assesses the components of OOPE that women incurred while accessing maternity care in public health facilities in Uttar Pradesh, India. It also assesses the determinants of OOPE and the level of maternal satisfaction while accessing care from these facilities. It is a cross-sectional analysis of 558 recently delivered women who have delivered at four public health facilities in Uttar Pradesh, India. All OOPE related information was collected through interviews using structured pre-tested questionnaires. Frequencies, Mann-Whitney test and categorical regression were used for data reduction. The analysis showed that the median OOPE was INR 700 (US$ 11.48) which varied between INR 680 (US$ 11.15) for normal delivery and INR 970 (US$ 15.9) for complicated cases. Tips for getting services (consisting of gifts and tips for services) with a median value of INR 320 (US$ 5.25) contributed to the major share in OOPE. Women from households with income more than INR 4000 (US$ 65.57) per month, general castes, primi-gravida, complicated delivery and those not accompanied by community health workers incurred higher OOPE. The significant predictors for high OOPE were caste (General Vs. OBC, SC/ST), type of delivery (Complicated Vs. Normal), and presence of ASHA (No Vs. Yes). OOPE while accessing care for delivery was one among the least satisfactory items and 76 % women expressed their dissatisfaction. Even though services at the public health facilities in India are supposed to be provided free of cost, it is actually not free, and the women in this study paid almost half of their mandated cash incentives to obtain delivery care.

Spatial and Temporal Variation of Japanese encephalitis Disease and Detection of Disease Hotspots: a Case Study of Gorakhpur District, Uttar Pradesh, India

NASA Astrophysics Data System (ADS)

Verma, S.; Gupta, R. D.

2014-11-01

In recent times, Japanese Encephalitis (JE) has emerged as a serious public health problem. In India, JE outbreaks were recently reported in Uttar Pradesh, Gorakhpur. The present study presents an approach to use GIS for analyzing the reported cases of JE in the Gorakhpur district based on spatial analysis to bring out the spatial and temporal dynamics of the JE epidemic. The study investigates spatiotemporal pattern of the occurrence of disease and detection of the JE hotspot. Spatial patterns of the JE disease can provide an understanding of geographical changes. Geospatial distribution of the JE disease outbreak is being investigated since 2005 in this study. The JE incidence data for the years 2005 to 2010 is used. The data is then geo-coded at block level. Spatial analysis is used to evaluate autocorrelation in JE distribution and to test the cases that are clustered or dispersed in space. The Inverse Distance Weighting interpolation technique is used to predict the pattern of JE incidence distribution prevalent across the study area. Moran's I Index (Moran's I) statistics is used to evaluate autocorrelation in spatial distribution. The Getis-Ord Gi*(d) is used to identify the disease areas. The results represent spatial disease patterns from 2005 to 2010, depicting spatially clustered patterns with significant differences between the blocks. It is observed that the blocks on the built up areas reported higher incidences.

"Tinni" Rice ( Oryza rufipogon Griff.) Production: An Integrated Sociocultural Agroecosystem in Eastern Uttar Pradesh of India

NASA Astrophysics Data System (ADS)

Singh, Ranjay K.; Turner, Nancy J.; Pandey, C. B.

2012-01-01

This study reports how Traditional Ecological Knowledge (TEK) and informal cultural institutions have conserved key varieties of the wildgrowing rice, ` tinni' (red rice, or brownbeard rice, Oriza rufipogon Griff.), within the Bhar community of eastern Uttar Pradesh, India. The study was conducted, using conventional and participatory methods, in 10 purposively selected Bhar villages. Two distinct varieties of tinni (` tinni patali' and ` tinni moti') with differing habitats and phenotypic characters were identified. Seven microecosystems (Kari, Badaila, Chammo, Karmol, Bhainsiki, Bhainsala and Khodailia) were found to support these varieties in differing proportions. Tinni rice can withstand more extreme weather conditions (the highest as well as lowest temperatures and rainfall regimes) than the `genetically improved' varieties of rice ( Oriza sativa L.) grown in the region. Both tinni varieties are important bioresources for the Bhar's subsistence livelihoods, and they use distinctive conservation approaches in their maintenance. Bhar women are the main custodians of tinni rice agrobiodiversity, conserving tinni through an institution called Sajha. Democratic decision-making at meetings organized by village elders determines the market price of the tinni varieties. Overall, the indigenous institutions and women's participation seem to have provided safeguards from excessive exploitation of tinni rice varieties. The maintenance of tinni through cultural knowledge and institutions serves as an example of the importance of locally maintained crop varieties in contributing to people's resilience and food security in times of rapid social and environmental change.

Feasibility of community neonatal death audits in rural Uttar Pradesh, India.

PubMed

Patel, Z; Kumar, V; Singh, P; Singh, V; Yadav, R; Baqui, A H; Santosham, M; Awasthi, S; Singh, J V; Darmstadt, G L

2007-09-01

Medical audit is a widely promoted strategy in hospitals, but experience within community settings is scant. Community neonatal death audit is a form of audit, which involves a systematic analysis of the quality of care provided in the home, danger sign recognition and care seeking decision making for neonatal illness. This research was conducted in Uttar Pradesh, India, to investigate the feasibility and cultural acceptability of community neonatal death audits. During November-December 2004, we conducted three in-depth interviews with family members of deceased neonates, and six focus group discussions with family and community members. Three approaches were evaluated: in-depth interview with the family before engaging them in an audit with the community; preliminary meeting to build rapport with the family and community before conducting an audit; and audit with the family and community in a single focus group. Approaches were interactive processes, involving the community, to identify avoidable factors in a particular death and discuss solutions. Carried out in a culturally sensitive and non-punitive manner, community neonatal death audit was found to be acceptable and feasible. All approaches provoked formal investigation by community members, and stimulated sharing of views, leading to the self-discovery that community perception was a cumulatively amplified effect of individual perceptions. Presence of an educated/experienced community member or health worker served as a catalyst. No one optimal approach was identified. Community neonatal audit is an acceptable approach that shows promise as an effective intervention for improving neonatal health outcomes.

Spatial variation of chemical constituents from the burning of commonly used biomass fuels in rural areas of the Indo-Gangetic Plain (IGP), India

NASA Astrophysics Data System (ADS)

Saud, T.; Saxena, M.; Singh, D. P.; Saraswati; Dahiya, Manisha; Sharma, S. K.; Datta, A.; Gadi, Ranu; Mandal, T. K.

2013-06-01

In the present paper, we have determined emission factor of chemical composition of the emission from the burning of biomass (e.g. Dung cake, Acacia, Neem, Mulberry, Indian Rosewood, Pigeon pea etc.) commonly used as a residential fuel in the rural sector of Indo-Gangetic Plain (IGP) (Delhi, Punjab, Haryana, Uttar Pradesh, Bihar and West Bengal), India. For comparison, we have selected only those biomass fuels, which are used in at least three of the above mentioned states. Dung cake from all the states reports highest emission of particulate matter (PM) (15.68 g kg-1), Organic Carbon (OC) (4.32 g kg-1) and Elemental Carbon (EC) (0.51 g kg-1). Among all biomass fuels studied, agricultural residue reports substantial amount of emission of Na+ (104 mg kg-1), K+ (331 mg kg-1) and Cl- (447 mg kg-1) particularly in Pigeon pea and Mustard stem. Eucalyptus (fuel wood) emits large amounts of Ca2+ (21.47 mg kg-1) and NO3- (614 mg kg-1). The emission of PM from dung cake is higher in Delhi (19.31 g kg-1) and followed by Uttar Pradesh (17.58 g kg-1) > Haryana (15.46 g kg-1) > Bihar (14.99 g kg-1) > Punjab (12.06 g kg-1) > West Bengal (5.90 g kg-1). Carbonaceous aerosols (OC and EC) and dominant Ionic species (Cl-, K+, SO42-, NO3- and PO43-) are altogether contributing 40-70% of total emissions. Characteristics and ratios of chemical species of emissions may help to develop a methodology of discriminating the sources of ambient particulate matter. Using a laboratory determined emission factor of chemical species, we have determined the emission budget over IGP, India.

The Uttar Pradesh State Observatory --- some recollections and some history (1954-1982)

NASA Astrophysics Data System (ADS)

Sinvhal, S. D.

2006-03-01

An attempt is made to present a picture of pre-historic and initial formative years of the well known Uttar Pradesh State Observatory, Nainital. The development of academic activities along with infrastructure are described. The emphasis on the frontline research work, self-reliance and international interaction was given during the formative years of the observatory. The largest telescope 104-cm of the observatory was installed in 1972 and has produced good scientific results.

Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states.

PubMed

Peters, David H; Chakraborty, Subrata; Mahapatra, Prasanta; Steinhardt, Laura

2010-11-25

Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private sectors. Cross-sectional surveys of 1916 public and private sector health workers in Andhra Pradesh and Uttar Pradesh, India, were conducted using a standardized instrument to identify health workers' satisfaction with key work factors related to motivation. Ratings were compared with how important health workers consider these factors. There was high variability in the ratings for areas of satisfaction and motivation across the different practice settings, but there were also commonalities. Four groups of factors were identified, with those relating to job content and work environment viewed as the most important characteristics of the ideal job, and rated higher than a good income. In both states, public sector health workers rated "good employment benefits" as significantly more important than private sector workers, as well as a "superior who recognizes work". There were large differences in whether these factors were considered present on the job, particularly between public and private sector health workers in Uttar Pradesh, where the public sector fared consistently lower (P < 0.01). Discordance between what motivational factors health workers considered important and their perceptions of actual presence of these factors were also highest in Uttar Pradesh in the public sector, where all 17 items had greater discordance for public sector workers than for workers in the private sector (P < 0.001). There are common areas of health worker motivation that should be considered by managers and policy makers, particularly the importance of non-financial motivators such as working environment and skill development opportunities. But managers also need to focus on the importance of locally assessing conditions and managing incentives to ensure health workers are motivated in their work.

Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states

PubMed Central

2010-01-01

Background Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private sectors. Methods Cross-sectional surveys of 1916 public and private sector health workers in Andhra Pradesh and Uttar Pradesh, India, were conducted using a standardized instrument to identify health workers' satisfaction with key work factors related to motivation. Ratings were compared with how important health workers consider these factors. Results There was high variability in the ratings for areas of satisfaction and motivation across the different practice settings, but there were also commonalities. Four groups of factors were identified, with those relating to job content and work environment viewed as the most important characteristics of the ideal job, and rated higher than a good income. In both states, public sector health workers rated "good employment benefits" as significantly more important than private sector workers, as well as a "superior who recognizes work". There were large differences in whether these factors were considered present on the job, particularly between public and private sector health workers in Uttar Pradesh, where the public sector fared consistently lower (P < 0.01). Discordance between what motivational factors health workers considered important and their perceptions of actual presence of these factors were also highest in Uttar Pradesh in the public sector, where all 17 items had greater discordance for public sector workers than for workers in the private sector (P < 0.001). Conclusion There are common areas of health worker motivation that should be considered by managers and policy makers, particularly the importance of non-financial motivators such as working environment and skill development opportunities. But managers also need to focus on the importance of locally assessing conditions and managing incentives to ensure health workers are motivated in their work. PMID:21108833

The Policy of the Bharatiya Janata Party, 1980 and 2008: Possible Influence of Hindu Nationalism on Indian Politics

DTIC Science & Technology

2009-06-01

portray the true essence of parties, as in ‘what they are,’…”15 The party’s ideology is laid down in a party manifesto. These manifestos serve two main...which most politicians and political parties seek to exploit for expedient, electorial gains.” Jasmine Zerinini-Brotel, “The BJP in Uttar Pradesh...Hinduism. Home University Library of Modern Knowledge 247. Oxford University Press: 1962. Zerinini-Brotel, Jasmine . “The BJP in Uttar Pradesh: From

Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study.

PubMed

Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Srivastava, Ashish; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

2017-06-22

Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes-specifically Janani Suraksha Yojana (JSY)-for maternity service delivery. Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. The major factors serving as barriers to participation of private practitioners in JSY-which emerged on thematic analysis-were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public-private partnerships under JSY. Simplifying and strengthening the processes, communication strategies and branding can help revitalise it. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study

PubMed Central

Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

2017-01-01

Objective Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes—specifically Janani Suraksha Yojana (JSY)—for maternity service delivery. Design Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Setting Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Participants Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. Results The major factors serving as barriers to participation of private practitioners in JSY—which emerged on thematic analysis—were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Conclusion Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public–private partnerships under JSY. Simplifying and strengthening the processes, communication strategies and branding can help revitalise it. PMID:28645984

Extent of Anaemia among Preschool Children in EAG States, India: A Challenge to Policy Makers

PubMed Central

Singh, Rakesh Kumar; Patra, Shraboni

2014-01-01

Background. India is the highest contributor to child anemia. About 89 million children in India are anemic. The study determines the factors that contributed to child anemia and examines the role of the existing programs in reducing the prevalence of child anemia particularly in the EAG states. Methods. The data from the latest round of the National Family Health Survey (NFHS-3) is used. Simple bivariate and multinomial logistics regression analyses are used. Results. About 70% children are anemic in all the EAG states. The prevalence of severe anemia is the highest (6.7%) in Rajasthan followed by Uttar Pradesh (3.6%) and Madhya Pradesh (3.4%). Children aged 12 to 17 months are significantly seven times (RR = 7.99, P < 0.001) more likely to be severely anemic compared to children of 36 to 59 months. Children of severely anemic mothers are also found to be more severely anemic (RR = 15.97, P < 0.001) than the children of not anemic mothers. Conclusions. The study reveals that the existing government program fails to control anemia among preschool children in the backward states of India. Therefore, there is an urgent need for monitoring of program in regular interval, particularly for EAG states to reduce the prevalence of anemia among preschool children. PMID:25140250

Neonatal mortality in the empowered action group states of India: trends and determinants.

PubMed

Arokiasamy, Perianayagam; Gautam, Abhishek

2008-03-01

In India, the eight socioeconomically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh, referred to as the Empowered Action Group (EAG) states, lag behind in the demographic transition and have the highest infant mortality rates in the country. Neonatal mortality constitutes about 60% of the total infant mortality in India and is highest in the EAG states. This study assesses the levels and trends in neonatal mortality in the EAG states and examines the impact of bio-demographic compared with health care determinants on neonatal mortality. Data from India's Sample Registration System (SRS) and National Family and Health Survey (NFHS-2, 1998-99) are used. Cox proportional hazard models are applied to estimate adjusted neonatal mortality rates by health care, bio-demographic and socioeconomic determinants. Variations in neonatal mortality by these determinants suggest that universal coverage of all pregnant women with full antenatal care, providing assistance at delivery and postnatal care including emergency care are critical inputs for achieving a reduction in neonatal mortality. Health interventions are also required that focus on curtailing the high risk of neonatal deaths arising from the mothers' younger age at childbirth, low birth weight of children and higher order births with short birth intervals.

Men's attitudes on gender equality and their contraceptive use in Uttar Pradesh India.

PubMed

Mishra, Anurag; Nanda, Priya; Speizer, Ilene S; Calhoun, Lisa M; Zimmerman, Allison; Bhardwaj, Rochak

2014-06-04

Men play crucial role in contraceptive decision-making, particularly in highly gender-stratified populations. Past research examined men's attitudes toward fertility and contraception and the association with actual contraceptive practices. More research is needed on whether men's attitudes on gender equality are associated with contraceptive behaviors; this is the objective of this study. This study uses baseline data of the Measurement, Learning, and Evaluation (MLE) Project for the Urban Health Initiative in Uttar Pradesh, India. Data were collected from a representative sample of 6,431 currently married men in four cities of the state. Outcomes are current use of contraception and contraceptive method choice. Key independent variables are three gender measures: men's attitudes toward gender equality, gender sensitive decision making, and restrictions on wife's mobility. Multivariate analyses are used to identify the association between the gender measures and contraceptive use. Most men have high or moderate levels of gender sensitive decision-making, have low to moderate levels of restrictions on wife's mobility, and have moderate to high levels of gender equitable attitudes in all four cities. Gender sensitive decision making and equitable attitudes show significant positive association and restrictions on wife's mobility showed significant negative relationship with current contraceptive use. The study demonstrates that contraceptive programs need to engage men and address gender equitable attitudes; this can be done through peer outreach (interpersonal communication) or via mass media. Engaging men to be more gender equal may have an influence beyond contraceptive use in contexts where men play a crucial role in household decision-making.

Groundwater quality in Ghaziabad district, Uttar Pradesh, India: Multivariate and health risk assessment.

PubMed

Chabukdhara, Mayuri; Gupta, Sanjay Kumar; Kotecha, Yatharth; Nema, Arvind K

2017-07-01

This study aimed to assess the quality of groundwater and potential health risk due to ingestion of heavy metals in the peri-urban and urban-industrial clusters of Ghaziabad district, Uttar Pradesh, India. Furthermore, the study aimed to evaluate heavy metals sources and their pollution level using multivariate analysis and fuzzy comprehensive assessment (FCA), respectively. Multivariate analysis using principle component analysis (PCA) showed mixed origin for Pb, Cd, Zn, Fe, and Ni, natural source for Cu and Mn and anthropogenic source for Cr. Among all the metals, Pb, Cd, Fe and Ni were above the safe limits of Bureau of Indian Standards (BIS) and World Health Organization (WHO) except Ni. Health risk in terms of hazard quotient (HQ) showed that the HQ values for children were higher than the safe level (HQ = 1) for Pb (2.4) and Cd (2.1) in pre-monsoon while in post-monsoon the value exceeded only for Pb (HQ = 1.23). The health risks of heavy metals for the adults were well within safe limits. The finding of this study indicates potential health risks to the children due to chronic exposure to contaminated groundwater in the region. Based on FCA, groundwater pollution could be categorized as quite high in the peri-urban region, and absolutely high in the urban region of Ghaziabad district. This study showed that different approaches are required for the integrated assessment of the groundwater pollution, and provides a scientific basis for the strategic future planning and comprehensive management. Copyright © 2017 Elsevier Ltd. All rights reserved.

Levels and trends in contraceptive prevalence, unmet need, and demand for family planning for 29 states and union territories in India: a modelling study using the Family Planning Estimation Tool.

PubMed

New, Jin Rou; Cahill, Niamh; Stover, John; Gupta, Yogender Pal; Alkema, Leontine

2017-03-01

Improving access to reproductive health services and commodities is central to development. Efforts to assess progress on this front have been largely focused on national estimates, but such analyses can mask local disparities. We assessed progress in reproductive health services subnationally in India. We developed a statistical model to generate estimates and projections of levels and trends in family planning indicators for subpopulations. The model builds onto the UN Population Division's Family Planning Estimation Model and uses data from multiple rounds of the Demographic and Health Survey, the District Level Household & Facility Survey, and the Annual Health Survey. We present annual estimates and projections of levels and trends in the prevalence of modern contraceptive use, and unmet need and demand for family planning for 29 states and union territories in India from 1990 to 2030. We also compared projections of demand satisfied with modern methods with the proposed goal of 75%. There is a large amount of heterogeneity in India, with a difference of up to 55·1 percentage points (95% uncertainty interval 46·4-62·1) in modern contraceptive use in 2015 between subregions. States such as Andhra Pradesh, with 92·7% (90·9-94·2) demand satisfied with modern methods, are performing well above the national average (71·8%, 56·7-83·6), whereas Manipur, with 26·8% (16·7-38·5) of demand satisfied, and Meghalaya, with 45·0% (40·1-50·0), consistently lag behind the rest of the country. Manipur and Meghalaya require the highest percentage increase in modern contraceptive use to achieve 75% demand satisfied with modern methods by 2030. In terms of absolute numbers, Uttar Pradesh requires the greatest increase, needing 9·2 million (5·5-12·6 million) additional users of modern contraception by 2030 to meet the target of 75%. The demand for family planning among the states and union territories in India is highly diverse. Greatest attention is needed in Uttar Pradesh, Manipur, and Meghalaya to meet UN targets. The analysis can be generalised to other countries as well as other subpopulations. Avenir Health through a grant from the Bill & Melinda Gates Foundation. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Effect of arsenic contaminated drinking water on human chromosome: a case study.

PubMed

Singh, Asha Lata; Singh, Vipin Kumar; Srivastava, Anushree

2013-10-01

Arsenic contamination of ground water has become a serious problem all over the world. Large number of people from Uttar Pradesh, Bihar and West Bengal of India are suffering due to consumption of arsenic contaminated drinking water. Study was carried out on 30 individuals residing in Ballia District, UP where the maximum concentration of arsenic was observed around 0.37 ppm in drinking water. Blood samples were collected from them to find out the problem related with arsenic. Cytogenetic study of the blood samples indicates that out of 30, two persons developed Klinefelter syndrome.

Persistent Drought Social-Ecological Regime Shift and Migration among Agricultural Communities in Bundelkhand Region India

NASA Astrophysics Data System (ADS)

Alam, Parvej

2017-04-01

Drought is a hydro-meteorological syndrome of 'prolonged period of water scarcity affecting natural resources, environment and, thereby, the people'. Different parts of India suffer from drought incidences of varying periodicity, with all 13 districts of Bundelkhand region repeatedly declared as drought-prone. Spread over the states of Uttar Pradesh and Madhya Pradesh, Bundelkhand falls in the rain shadow, semi-arid zone of the northern extreme of Peninsular India. In recent years, because of changing pattern of monsoons across India, rainfall in Bundelkhand in addition to being deficient has also become unpredictable. Such unpredictability has made agriculture in Bundelkhand region a risky and less attractive proposition and farmers are increasingly forgoing agriculture in villages in favour of livelihood opportunities in urban areas. Thus, there has been a constant flow of rural to urban migration in towns and cities in Bundelkhand. The present study analyses the changing land use pattern of Bundelkhand with the help of land use classification and explores the trend of rural-urban migration in Bundelkhand in the light of Galor's Model of Migration. In the current work, Climate Change is taken as a major driver behind migration decision and with the help of primary survey, a two-generational, inter regional model based on Galor's model has been developed. Keywords: Bundelkhand, Drought, Migration, Galor's Model

Meeting the community halfway to reduce maternal deaths? Evidence from a community-based maternal death review in Uttar Pradesh, India

PubMed Central

Raj, Sunil Saksena; Maine, Deborah; Sahoo, Pratap Kumar; Manthri, Suneedh; Chauhan, Kavita

2013-01-01

ABSTRACT Background: Uttar Pradesh (UP) is the most populous state in India with the second highest reported maternal mortality ratio in the country. In an effort to analyze the reasons for maternal deaths and implement appropriate interventions, the Government of India introduced Maternal Death Review guidelines in 2010. Methods: We assessed causes of and factors leading to maternal deaths in Unnao District, UP, through 2 methods. First, we conducted a facility gap assessment in 15 of the 16 block-level and district health facilities to collect information on the performance of the facilities in terms of treating obstetric complications. Second, teams of trained physicians conducted community-based maternal death reviews (verbal autopsies) in a sample of maternal deaths occurring between June 1, 2009, and May 31, 2010. Results: Of the 248 maternal deaths that would be expected in this district in a year, we identified 153 (62%) through community workers and conducted verbal autopsies with families of 57 of them. Verbal autopsies indicated that 23% and 30% of these maternal deaths occurred at home and on the way to a health facility, respectively. Most of the women who died had been taken to at least 2 health facilities. The facility assessment revealed that only the district hospital met the recommended criteria for either basic or comprehensive emergency obstetric and neonatal care. Conclusions: Life-saving treatment of obstetric complications was not offered at the appropriate level of government facilities in a representative district in UP, and an inadequate referral system provided fatal delays. Expensive transportation costs to get pregnant women to a functioning medical facility also contributed to maternal death. The maternal death review, coupled with the facility gap assessment, is a useful tool to address the adequacy of emergency obstetric and neonatal care services to prevent further maternal deaths. PMID:25276519

Differential effects of community health worker visits across social and economic groups in Uttar Pradesh, India: a link between social inequities and health disparities.

PubMed

Seth, Aparna; Tomar, Shweta; Singh, Kultar; Chandurkar, Dharmendra; Chakraverty, Amit; Dey, Arnab; Das, Arup K; Hay, Katherine; Saggurti, Niranjan; Boyce, Sabrina; Raj, Anita; Silverman, Jay G

2017-03-07

Uttar Pradesh (UP) accounts for the largest number of neonatal deaths in India. This study explores potential socio-economic inequities in household-level contacts by community health workers (CHWs) and whether the effects of such household-level contacts on receipt of health services differ across populations in this state. A multistage sampling design identified live births in the last 12 months across the 25 highest-risk districts of UP (N = 4912). Regression models described the relations between household demographics (caste, religion, wealth, literacy) and CHW contact, and interactions of demographics and CHW contact in predicting health service utilization (> = 4 antenatal care (ANC) visits, facility delivery, modern contraceptive use). No differences were found in likelihood of CHW contact based on caste, religion, wealth or literacy. Associations of CHW contact with receipt of ANC and facility delivery were significantly affected by religion, wealth and literacy. CHW contact increased the odds of 4 or more ANC visits only among non-Muslim women, increased the odds of both four or more ANC visits and facility delivery only among lower wealth women, increased the odds of facility delivery to a greater degree among illiterate vs. literate women. CHW visits play a vital role in promoting utilization of critical maternal health services in UP. However, significant social inequities exist in associations of CHW visits with such service utilization. Research to clarify these inequities, as well as training for CHWs to address potential biases in the qualities or quantity of their visits based on household socio-economic characteristics is recommended.

Women's status and experiences of mistreatment during childbirth in Uttar Pradesh: a mixed methods study using cultural health capital theory.

PubMed

Sudhinaraset, May; Treleaven, Emily; Melo, Jason; Singh, Kanksha; Diamond-Smith, Nadia

2016-10-28

Mistreatment of women in healthcare settings during childbirth has been gaining attention globally. Mistreatment during childbirth directly and indirectly affects health outcomes, patient satisfaction, and the likelihood of delivering in a facility currently or in the future. It is important that we study patients' reports of mistreatment and abuse to develop a deeper understanding of how it is perpetrated, its consequences, and to identify potential points of intervention. Patients' perception of the quality of care is dependent, not only on the content of care, but importantly, on women's expectations of care. This study uses rich, mixed-methods data to explore women's characteristics and experiences of mistreatment during childbirth among slum-resident women in Uttar Pradesh, India. To understand the ways in which women's social and cultural factors influence their expectations of care and consequently their perceptions of respectful care, we adopt a Cultural Health Capital (CHC) framework. The quantitative sample includes 392 women, and the qualitative sample includes 26 women. Quantitative results suggest high levels of mistreatment (over 57 % of women reported any form of mistreatment). Qualitative findings suggest that lack of cultural health capital disadvantages patients in their patient-provider relationships, and that women use resources to improve care they receive. Participants articulated how providers set expectations and norms regarding behaviors in facilities; patients with lower social standing may not always understand standard practices and are likely to suffer poor health outcomes as a result. Of importance, however, patients also blame themselves for their own lack of knowledge. Lack of cultural health capital disadvantages women during delivery care in India. Providers set expectations and norms around behaviors during delivery, while women are often misinformed and may have low expectations of care.

A study of trace element contamination using multivariate statistical techniques and health risk assessment in groundwater of Chhaprola Industrial Area, Gautam Buddha Nagar, Uttar Pradesh, India.

PubMed

Kumar, Manoj; Ramanathan, A L; Tripathi, Ritu; Farswan, Sandhya; Kumar, Devendra; Bhattacharya, Prosun

2017-01-01

This study is an investigation on spatio-chemical, contamination sources (using multivariate statistics), and health risk assessment arising from the consumption of groundwater contaminated with trace and toxic elements in the Chhaprola Industrial Area, Gautam Buddha Nagar, Uttar Pradesh, India. In this study 33 tubewell water samples were analyzed for 28 elements using ICP-OES. Concentration of some trace and toxic elements such as Al, As, B, Cd, Cr, Mn, Pb and U exceeded their corresponding WHO (2011) guidelines and BIS (2012) standards while the other analyzed elements remain below than those values. Background γ and β radiation levels were observed and found to be within their acceptable limits. Multivariate statistics PCA (explains 82.07 cumulative percent for total 6 of factors) and CA indicated (mixed origin) that natural and anthropogenic activities like industrial effluent and agricultural runoff are responsible for the degrading of groundwater quality in the research area. In this study area, an adult consumes 3.0 L (median value) of water therefore consuming 39, 1.94, 1461, 0.14, 11.1, 292.6, 13.6, 23.5 μg of Al, As, B, Cd, Cr, Mn, Pb and U from drinking water per day respectively. The hazard quotient (HQ) value exceeded the safe limit of 1 which for As, B, Al, Cr, Mn, Cd, Pb and U at few locations while hazard index (HI) > 5 was observed in about 30% of the samples which indicated potential health risk from these tubewells for the local population if the groundwater is consumed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Marital violence and women's reproductive health care in Uttar Pradesh, India.

PubMed

Sudha, S; Morrison, Sharon

2011-01-01

Although the impact of marital violence on women's reproductive health is recognized globally, there is little research on how women's experience of and justification of marital violence in developing country settings is linked to sexually transmitted infection (STI) symptom reporting, and seeking care for the symptoms. This study analyzes data on 9,639 currently married women from India's 2006-2007 National Family Health Survey-3 from the Central/Northern Indian state of Uttar Pradesh. The likelihood of currently married women's reporting STIs or symptoms, and the likelihood of seeking care for these, are analyzed using multivariate logistic regression techniques. Currently married women's experience of physical, sexual, and emotional marital violence in the last 12 months was significantly associated with greater likelihood of reporting a STI or symptom (odds ratio [OR], 1.364 [95% confidence interval (CI), 1.171-1.588] for physical violence; OR, 1.649 [95% CI, 1.323-2.054] for sexual violence; OR, 1.273 [95% CI, 1.117-1.450] for emotional violence). Experience of physical violence (OR, 0.728; 95% CI, 0.533-0.994) and acceptance of any justification for physical violence (OR, 0.590; 95% CI, 0.458-0.760) were significantly associated with decreased chance of seeking care, controlling for other factors. This study suggests that experiencing marital violence may have a negative impact on multiple aspects of women's reproductive health, including increased self-report of STI symptoms. Moreover, marital physical violence and accepting justification for such violence are associated with decreased chance of seeking care. Thus, policies and programs to promote reproductive health should incorporate decreasing gender-based violence, and overcoming underlying societal gender inequality. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

NGO facilitation of a government community-based maternal and neonatal health programme in rural India: improvements in equity.

PubMed

Baqui, Abdullah H; Rosecrans, Amanda M; Williams, Emma K; Agrawal, Praween K; Ahmed, Saifuddin; Darmstadt, Gary L; Kumar, Vishwajeet; Kiran, Usha; Panwar, Dharmendra; Ahuja, Ramesh C; Srivastava, Vinod K; Black, Robert E; Santosham, Mathuram

2008-07-01

Socio-economic disparities in health have been well documented around the world. This study examines whether NGO facilitation of the government's community-based health programme improved the equity of maternal and newborn health in rural Uttar Pradesh, India. A quasi-experimental study design included one intervention district and one comparison district of rural Uttar Pradesh. A household survey conducted between January and June 2003 established baseline rates of programme coverage, maternal and newborn care practices, and health care utilization during 2001-02. An endline household survey was conducted after 30 months of programme implementation between January and March 2006 to measure the same indicators during 2004-05. The changes in the indicators from baseline to endline in the intervention and comparison districts were calculated by socio-economic quintiles, and concentration indices were constructed to measure the equity of programme indicators. The equity of programme coverage and antenatal and newborn care practices improved from baseline to endline in the intervention district while showing little change in the comparison district. Equity in health care utilization for mothers and newborns also showed some improvements in the intervention district, but notable socio-economic differentials remained, with the poor demonstrating less ability to access health services. NGO facilitation of government programmes is a feasible strategy to improve equity of maternal and neonatal health programmes. Improvements in equity were most pronounced for household practices, and inequities were still apparent in health care utilization. Furthermore, overall programme coverage remained low, limiting the ability to address equity. Programmes need to identify and address barriers to universal coverage and care utilization, particularly in the poorest segments of the population.

Patterns of Maxillofacial Fractures in Uttar Pradesh, India

PubMed Central

Agarwal, Padmanidhi; Mehrotra, Divya; Agarwal, Rajul; Kumar, Sumit; Pandey, Rahul

2016-01-01

This study aimed to obtain dependable epidemiologic data of the variation in cause and characteristics of maxillofacial fractures by identifying, describing, and quantifying trauma. This retrospective study was conducted in the state of Uttar Pradesh, India, over 1 year, based on a systematic computer-assisted database search from March 2015 to March 2016 for maxillofacial fractures. The demographics, etiology, geographic distribution, date of injury, site and number of fractures, and type of intervention were recorded for each. The study population consisted of 1,000 patients with 1,543 fractures. The male:female ratio was 8:1. A peak incidence of fractures was seen in the third decade (mean age: 30.3) with maximum patients younger than 40 years (80.8%). The incidence of fractures was highest in spring (42.9%). Road traffic accidents were the most common cause of trauma (64.4%) and mainly involved two wheelers (60.2%). Single-site fractures were most common. Mostly zygomatic (45.1%) and mandibular fractures (44.4%) were encountered, accounting for approximately 90% of all fractures. The main site of mandibular fractures was the body (34.4%); 46.2% of fractures underwent open reduction and internal fixation (ORIF) while 53.8% were treated by closed methods. The study provides important data to contrive future plans for injury prevention. The trend of most traffic-related injuries continues with the increasing traffic on roads. Zygomatic complex and mandibular fractures remain the most frequent. The major populations at risk are young men and those driving two wheelers. The use of helmets could achieve a large reduction in maxillofacial fractures. Awareness for preventive measures and safety guidelines should be propagated and legislation on traffic rules strictly reinforced. PMID:28210408

Men’s attitudes on gender equality and their contraceptive use in Uttar Pradesh India

PubMed Central

2014-01-01

Background Men play crucial role in contraceptive decision-making, particularly in highly gender-stratified populations. Past research examined men’s attitudes toward fertility and contraception and the association with actual contraceptive practices. More research is needed on whether men’s attitudes on gender equality are associated with contraceptive behaviors; this is the objective of this study. Methods This study uses baseline data of the Measurement, Learning, and Evaluation (MLE) Project for the Urban Health Initiative in Uttar Pradesh, India. Data were collected from a representative sample of 6,431 currently married men in four cities of the state. Outcomes are current use of contraception and contraceptive method choice. Key independent variables are three gender measures: men’s attitudes toward gender equality, gender sensitive decision making, and restrictions on wife’s mobility. Multivariate analyses are used to identify the association between the gender measures and contraceptive use. Results Most men have high or moderate levels of gender sensitive decision-making, have low to moderate levels of restrictions on wife’s mobility, and have moderate to high levels of gender equitable attitudes in all four cities. Gender sensitive decision making and equitable attitudes show significant positive association and restrictions on wife’s mobility showed significant negative relationship with current contraceptive use. Conclusion The study demonstrates that contraceptive programs need to engage men and address gender equitable attitudes; this can be done through peer outreach (interpersonal communication) or via mass media. Engaging men to be more gender equal may have an influence beyond contraceptive use in contexts where men play a crucial role in household decision-making. PMID:24894376

An external evaluation of the Diarrhea Alleviation through Zinc and ORS Treatment (DAZT) program in Gujarat and Uttar Pradesh, India.

PubMed

Lamberti, Laura M; Taneja, Sunita; Mazumder, Sarmila; LeFevre, Amnesty; Black, Robert E; Walker, Christa L Fischer

2015-12-01

To address inadequate coverage of oral rehydration salts (ORS) and zinc supplements for the treatment of diarrhea among children under-five, the Diarrhea Alleviation through Zinc and ORS Treatment (DAZT) program was carried out from 2011-2013 in Gujarat and from 2011-2014 in Uttar Pradesh (UP), India. The program focused on improving the diarrhea treatment practices of public and private sector providers. We conducted cross-sectional household surveys in program districts at baseline and endline and constructed state-specific logistic regression models with generalized estimating equations to assess changes in ORS and zinc treatment during the program period. Between baseline and endline, zinc coverage increased from 2.5% to 22.4% in Gujarat and from 3.1% to 7.0% in UP; ORS coverage increased from 15.3% to 39.6% in Gujarat but did not change in UP. In comparison to baseline, children with diarrhea in the two-weeks preceding the endline survey had higher odds of receiving zinc treatment in both Gujarat (odds ratio, OR = 11.2; 95% confidence interval (CI) 6.4-19.3) and UP (OR = 2.4; 95% CI 1.4-3.9), but the odds of receiving ORS only increased in Gujarat (OR = 3.6; 95% CI 2.7-4.8; UP OR = 0.9; 95% CI 0.7-1.2). Seeking care outside the home, especially from a public sector source, was associated with higher odds of receiving ORS and zinc. During the duration of the DAZT program, there were modest improvements in the treatment of diarrhea among young children. Future programs should build upon and accelerate this trend with continued investment in public and private sector provider training and supply chain sustainability, in addition to targeted caregiver demand generation activities.

Aetiology of acute encephalitis syndrome in Uttar Pradesh, India from 2014 to 2016.

PubMed

Jain, Parul; Prakash, Shantanu; Khan, Danish N; Garg, Ravindra Kumar; Kumar, Rashmi; Bhagat, Amit; Ramakrishna, V; Jain, Amita

2017-01-01

It is imperative to know the aetiology of acute encephalitis syndrome (AES) for patient management and policy making. The present study was carried out to determine the prevalence of common aetiological agents of AES in Uttar Pradesh (UP) state of India. Serum and/or CSF samples were collected from AES patients admitted at Gandhi Memorial and Associated Hospital, King George's Medical University, Lucknow, a tertiary care centre, UP during 2014-16. Cerebrospinal fluid (CSF) and serum samples from cases were tested for IgM antibodies against Japanese encephalitis virus (anti-JEV), and dengue virus (anti-DENV) by ELISA; and for enterovirus, herpes simplex virus (HSV) and varicella zoster virus (VZV) by real-time PCR. Serum samples of cases having sufficient CSF volume, were also tested for anti-scrub typhus IgM antibodies and for Neisseria meningitides, Streptococcus pneumoniae and Haemophilus influenzae. JEV and DENV (8% each) were the most common identified aetiology from the 4092 enrolled patients. Enterovirus, HSV and VZV, each were detected in <1% AES cases. Co-positivity occurred in 48 cases. Scrub typhus (31.8%) was the most common aetiology detected. Haemophilus influenzae and S. pneumoniae were detected in 0.97 and 0.94% cases, respectively, however, N. meningitides was not detected in any of the cases. About 40% of the JEV/DENV positive AES cases were adults. The gap between the total number of AES cases and those with JEV/ DENV infection increased during monsoon and post-monsoon seasons. Scrub typhus, JEV and DENV are the main aetiological agents of AES in UP. DENV and JEV can no longer be considered paediatric diseases. The prevalence of non-JEV/DENV aetiology of AES increases in the monsoon and post-monsoon seasons.

Treatment practices in pulmonary tuberculosis by private sector physicians of Meerut, Uttar Pradesh.

PubMed

Yadav, A; Garg, S K; Chopra, H; Bajpai, S K; Bano, T; Jain, S; Kumar, A

2012-01-01

Majority of the qualified medical practitioners in the country are in the private sector and more than half of patients with tuberculosis (TB) seek treatment from them. The present study was conducted with the objective of assessing the treatment modalities in pulmonary tuberculosis by the private physicians in Meerut City, Uttar Pradesh, India. A cross-sectional study was carried out covering all the private physicians (graduates and postgraduates in Medicine and Chest Diseases) registered under the Indian Medical Association, Meerut Branch (n = 154). The physicians were interviewed by a pre-designed and pre-tested questionnaire about the treatment modalities practiced by them. Only 43.5% private physicians had attended any Revised National Tuberculosis Control Programme (RNTCP) training in the past five years. Only 33.1% of them were aware of the International Standards of Tuberculosis Care (ISTC). Fifty-three different regimens were used to treat the patients. Majority of physicians (76%) prescribed daily regimens while 24% administered both daily and intermittent treatment. None of the private physicians prescribed exclusive intermittent regimen. Eighty-seven different treatment regimens were used for the treatment of multidrug-resistant TB (MDR-TB) with none of them prescribing standard treatment under RNTCP. As majority of private practitioners do not follow RNTCP guidelines for treating TB, there is an urgent need for their continued education in this area.

Incidence of Burkholderia mallei infection among indigenous equines in India.

PubMed

Malik, Praveen; Singha, Harisankar; Goyal, Sachin K; Khurana, Sandip K; Tripathi, Badri Naryan; Dutt, Abha; Singh, Dabal; Sharma, Neeraj; Jain, Sanjay

2015-01-01

Burkholderia mallei is the causative agent of glanders which is a highly contagious and fatal disease of equines. Considering the nature and severity of the disease in equines, and potential of transmission to human beings, glanders is recognised as a 'notifiable' disease in many countries. An increasing number of glanders outbreaks throughout the Asian continents, including India, have been noticed recently. In view of the recent re-emergence of the disease, the present study was undertaken to estimate the prevalence of glanders among indigenous equines from different parts of India. Serum samples were analysed by complement fixation test (CFT) and ELISA for the detection of B mallei specific antibodies. A total of 7794 equines, which included 4720 horses, 1881 donkeys and 1193 mules were sampled from April 2011 to December 2014 from 10 states of India. Serologically, 36 equines (pony=7, mules=10, horses=19) were found to be positive for glanders by CFT and indirect-ELISA. The highest number of cases were detected in Uttar Pradesh (n=31) followed by Himachal Pradesh (n=4) and Chhattisgarh (n=1). Isolation of B mallei was attempted from nasal and abscess swabs collected from seropositive equines. Four isolates of B mallei were cultured from nasal swabs of two mules and two ponies. Identity of the isolates was confirmed by PCR and sequencing of fliP gene fragment. The study revealed circulation of B mallei in northern India and the need for continued surveillance to support the eradication.

Incidence of Burkholderia mallei infection among indigenous equines in India

PubMed Central

Malik, Praveen; Singha, Harisankar; Goyal, Sachin K; Khurana, Sandip K; Tripathi, Badri Naryan; Dutt, Abha; Singh, Dabal; Sharma, Neeraj; Jain, Sanjay

2015-01-01

Burkholderia mallei is the causative agent of glanders which is a highly contagious and fatal disease of equines. Considering the nature and severity of the disease in equines, and potential of transmission to human beings, glanders is recognised as a ‘notifiable’ disease in many countries. An increasing number of glanders outbreaks throughout the Asian continents, including India, have been noticed recently. In view of the recent re-emergence of the disease, the present study was undertaken to estimate the prevalence of glanders among indigenous equines from different parts of India. Serum samples were analysed by complement fixation test (CFT) and ELISA for the detection of B mallei specific antibodies. A total of 7794 equines, which included 4720 horses, 1881 donkeys and 1193 mules were sampled from April 2011 to December 2014 from 10 states of India. Serologically, 36 equines (pony=7, mules=10, horses=19) were found to be positive for glanders by CFT and indirect-ELISA. The highest number of cases were detected in Uttar Pradesh (n=31) followed by Himachal Pradesh (n=4) and Chhattisgarh (n=1). Isolation of B mallei was attempted from nasal and abscess swabs collected from seropositive equines. Four isolates of B mallei were cultured from nasal swabs of two mules and two ponies. Identity of the isolates was confirmed by PCR and sequencing of fliP gene fragment. The study revealed circulation of B mallei in northern India and the need for continued surveillance to support the eradication. PMID:26457190

Kerala reaps low fertility dividends.

PubMed

1992-01-01

Unlike much of India, the state of Kerala has promoted the development of human resources, resulting in lower fertility rates. If current UN projections are correct, India will overtake China as the most populous nation in the world by 2025. Within India, however, great differences exist in fertility rates, reflecting the level of commitment from state governments. In India, state governments control much of the policy and spending on health, education, etc. While the state of Kerala has been among the most committed to human resource development in the developing world, India's 5 northern states (Rajasthan, Uttar Pradesh, Madhya Pradesh, Bihar, and Orissa) have been among the least committed. As a result, Kerala's fertility rate has fallen to 2.3 children/women--a rate lower than that of Thailand, China, the formers USSR, or Ireland. Kerala has a contraceptive prevalence rate 3 times the national average and the lowest infant mortality rate in all of India--only 26/1000 live births (infant mortality is 4-5 times higher in the 5 northern states). Only 27% of Kerala's population lives in poverty, compared to 34-49.5% in the northern states. Real incomes and industrialization have been growing faster in Kerala. And industrialization does not appear to have come at the expense of the environment. 2 factors are responsible for Kerala' accomplishments: 1) State government support of human development--the state has invested in health, education, and has conducted a land reform benefiting 3 million landless peasants. 2) The status of women--in Kerala, women are viewed as an asset, not a liability (as in the north). Kerala's female literacy is 66%, compared to 11-21% in the northern states. Kerala also enjoys the highest level of female labor force participation (35%) anywhere in India.

A cultural critique of community psychiatry in India.

PubMed

Jain, Sumeet; Jadhav, Sushrut

2008-01-01

This article is the first comprehensive cultural critique of India's official community mental health policy and program. Data are based on a literature review of published papers, conference proceedings, analyses of official policy and popular media, interviews with key Indian mental health professionals, and fieldwork in Kanpur district, Uttar Pradesh (2004-2006). The authors demonstrate how three influences have shaped community psychiatry in India: a cultural asymmetry between health professionals and the wider society, psychiatry's search for both professional and social legitimacy, and WHO policies that have provided the overall direction to the development of services. Taken together, the consequences are that rural community voices have been edited out. The authors hypothesize that community psychiatry in India is a bureaucratic and culturally incongruent endeavor that increases the divide between psychiatry and local rural communities. Such a claim requires sustained ethnographic fieldwork to reveal the dynamics of the gap between community and professional experiences. The development of culturally sensitive psychiatric theory and clinical services is essential to improve the mental health of rural citizens who place their trust in India's biomedical network.

Forensic revolution need maintenance of dental records of patients by the dentists: A descriptive study.

PubMed

Gupta, Anamika; Mishra, Gaurav; Bhutani, Hemant; Hoshing, Chetan; Bhalla, Ashish

2016-01-01

With the growth of forensic odontology, dental records have become an essential source of information, especially for medicolegal cases in general practice. It is mandated by the law that every dentist must keep some kind of records for every patient they treat. After the death of an individual, remnants of teeth are usually damaged at the last among all body parts. Dental records assist in personal identification in cases of mass disasters, criminal investigations, and medicolegal issues. However, in India, rules for maintaining dental records are not very strictly followed. Thus, the aim of this study was to evaluate the knowledge regarding the maintenance of dental records among dentists in Punjab and Uttar Pradesh. Data collection was performed via a questionnaire. The study population responded to the questions pertaining to knowledge regarding forensic odontology methods and the mode of maintaining dental records in their regular practice through a personal interview. A descriptive analysis was carried out for the data. The data were summarized and analyzed using the statistical software Statistical Package for the Social Sciences (SPSS) version 18.0. A very low percentage (22%) of the dentists were seen to be maintaining records on a regular basis. Seventy-eight percent of the dentists were not maintaining any records. This study clearly indicates that the dentists in Punjab and Uttar Pradesh need to be properly trained for any kind of forensic and medicolegal needs.

Community Based Maternal and Child Health Nutrition Project, Uttar Pradesh: An Innovative Strategy Focusing on “At Risk” Families

PubMed Central

Vir, Sheila C

2013-01-01

Research Question: Use of community based volunteers, frequently reaching and counseling a selected group of prioritized families, can make a substantial difference in improving maternal and child care practices and in reducing child undernutrition. Setting: Program Rural Uttar Pradesh, India. Study Design: A comparison of baseline and endline surveys following 4 years of community based project intervention Participants: “At risk” undernutrition families comprising mothers of under twos, newlyweds, and severely undernourished children below 6 years. Intervention: Mapping and counseling of “at risk” families. Measuring impact on maternal-child care practices, underweight status. Results: Trained community mobilizers identified and counseled selected “at risk” families. Following 4 years of implementation in 907 villages of 8 blocks of four districts, significant improvement was noted in practices of early initiation of breastfeeding, feeding colostrum, timely introduction of complementary feeding, and washing the hands after defecation. Percentage of mothers exclusively breastfeeding at 6 months was only 2.1% with 78% receiving prelacteal feeds. A small increase in normal and mild malnutrition and a significant reduction of 43% in severe malnutrition was noted. Conclusion: Frequently counseling by accredited social health activists by focusing on selected defined “at risk” families of under twos and those with severe malnourished children could result in increasing acceptability of correct child health, feeding, and care practices and in contributing to improving nutritional status scenario. PMID:24302825

Characteristics of childhood tuberculosis patients registered under RNTCP in Varanasi, Uttar Pradesh.

PubMed

Thakur, Harshad P

2013-01-01

Childhood tuberculosis (TB) reflects on-going transmission. Data on childhood TB from TB registers under Revised National Tuberculosis Control Program of 2008 and 2009 in Varanasi district was analyzed. Proportion of childhood TB was 8.3% of total registered cases 12,242. It was lower than estimated 10-20% in endemic areas. In rural Tuberculosis Units childhood case detection was poor. Case detection in ≤5 years was very less. The childhood cases were detected mainly in adolescent age group. Thus, childhood TB is remaining a under diagnosed/under reported disease in India. It needs attention to increase the detection of childhood TB cases to control TB in general population.

The burden of iron-deficiency anaemia among women in India: how have iron and folic acid interventions fared?

PubMed

Rai, Rajesh Kumar; Fawzi, Wafaie W; Barik, Anamitra; Chowdhury, Abhijit

2018-04-01

Iron-deficiency anaemia (IDA) among women in India is a problem of major public health significance. Using data from three waves of the National Family Health Survey, this article discusses the burden of and trend in IDA among women in India, and discusses the level of iron and folic acid (IFA) supplementation and its potential role in reducing the burden of IDA. Between 2005-2006 and 2015-2016, IDA in India decreased by only 3.5 percentage points (from 56.5% in 2005-2006 to 53.0% in 2015-2016) for women aged 15-49 years. However, during the same period, of 27 states compared, IDA increased in eight: Delhi, Haryana, Himachal Pradesh, Kerala, Meghalaya, Tamil Nadu, Punjab and Uttar Pradesh; furthermore, some of these (e.g. Kerala) are states that rank among the highest on the state Human Development Index but had failed to contain the burden of IDA. Although there is a standard guideline for IFA supplementation in place, the IFA intervention appears to be ineffective in reducing the burden of IDA in India (nationally only 30.3 % of mothers consumed IFA for 100 days or more when they were pregnant), probably due to irregular consumption of IFA where the provision of screening under the National Iron+ Initiative scheme appears to be unsuccessful. To strengthen the IFA intervention and its uptake, a concerted effort of community-level health workers (accredited social health activists, auxiliary nurse midwives and anganwadi workers) is urgently needed. In addition, food-based strategies (dietary diversification and food fortification), food supplementation and improvement of health services are required to reduce the burden of anaemia among women in India.

Y-chromosomal insights into the genetic impact of the caste system in India.

PubMed

Zerjal, Tatiana; Pandya, Arpita; Thangaraj, Kumarasamy; Ling, Edmund Y S; Kearley, Jennifer; Bertoneri, Stefania; Paracchini, Silvia; Singh, Lalji; Tyler-Smith, Chris

2007-03-01

The caste system has persisted in Indian Hindu society for around 3,500 years. Like the Y chromosome, caste is defined at birth, and males cannot change their caste. In order to investigate the genetic consequences of this system, we have analysed male-lineage variation in a sample of 227 Indian men of known caste, 141 from the Jaunpur district of Uttar Pradesh and 86 from the rest of India. We typed 131 Y-chromosomal binary markers and 16 microsatellites. We find striking evidence for male substructure: in particular, Brahmins and Kshatriyas (but not other castes) from Jaunpur each show low diversity and the predominance of a single distinct cluster of haplotypes. These findings confirm the genetic isolation and drift within the Jaunpur upper castes, which are likely to result from founder effects and social factors. In the other castes, there may be either larger effective population sizes, or less strict isolation, or both.

Ten years of negotiating rights around maternal health in Uttar Pradesh, India

PubMed Central

2011-01-01

Background Preventable maternal mortality and morbidity have been globally recognized as human rights issues. Maternal mortality in India is among the highest in the world, and reflects inequity in access to healthcare: women from certain states as well as poorer women and less literate women appear to be significantly disadvantaged. The government of India has been attempting to improve maternal outcomes through a cash transfer within the National Rural Health Mission to encourage women to come to hospitals for childbirth. Methods This paper reviews documents of the last ten years describing the experiences of a Non-Governmental Organisation, SAHAYOG, in working with a civil society platform, the Healthwatch Forum, to develop ‘rights based’ strategies around maternal health. The paper builds an analysis using recent frameworks on accountability and gendered rights claiming to examine these experiences and draw out lessons regarding rights claiming strategies for poor women. Results The examination of documents over the last ten years indicates defined phases of development in the evolution of SAHAYOG’s understanding and of the shifts in strategy among SAHAYOG and its close allies, and responses by the state. The first three stages depict the deepening of SAHAYOG’s understanding of the manner in which poor and marginalized women negotiate their access to health care; the fourth stage explores a health system intervention and the challenges of working from within civil society in alliance with poor and marginalized women. Conclusion The findings from SAHAYOG’s experiences with poor Dalit women in Uttar Pradesh reveal the elements of social exclusion within the health system that prevent poor and marginalized women from accessing effective lifesaving care. Creating a voice for the most marginalised and carving space for its articulation impacts upon the institutions and actors that have a duty to meet the claims being made. However, given the accountability deficit, the analysis indicates the importance of going beyond the normative to developing actor-oriented perspectives within rights based approaches, to take into account the complexity of the negotiating process that goes into claiming any kind of entitlements. PMID:22376057

Ten years of negotiating rights around maternal health in Uttar Pradesh, India.

PubMed

Dasgupta, Jashodhara

2011-12-16

Preventable maternal mortality and morbidity have been globally recognized as human rights issues. Maternal mortality in India is among the highest in the world, and reflects inequity in access to healthcare: women from certain states as well as poorer women and less literate women appear to be significantly disadvantaged. The government of India has been attempting to improve maternal outcomes through a cash transfer within the National Rural Health Mission to encourage women to come to hospitals for childbirth. This paper reviews documents of the last ten years describing the experiences of a Non-Governmental Organisation, SAHAYOG, in working with a civil society platform, the Healthwatch Forum, to develop 'rights based' strategies around maternal health. The paper builds an analysis using recent frameworks on accountability and gendered rights claiming to examine these experiences and draw out lessons regarding rights claiming strategies for poor women. The examination of documents over the last ten years indicates defined phases of development in the evolution of SAHAYOG's understanding and of the shifts in strategy among SAHAYOG and its close allies, and responses by the state. The first three stages depict the deepening of SAHAYOG's understanding of the manner in which poor and marginalized women negotiate their access to health care; the fourth stage explores a health system intervention and the challenges of working from within civil society in alliance with poor and marginalized women. The findings from SAHAYOG's experiences with poor Dalit women in Uttar Pradesh reveal the elements of social exclusion within the health system that prevent poor and marginalized women from accessing effective lifesaving care. Creating a voice for the most marginalised and carving space for its articulation impacts upon the institutions and actors that have a duty to meet the claims being made. However, given the accountability deficit, the analysis indicates the importance of going beyond the normative to developing actor-oriented perspectives within rights based approaches, to take into account the complexity of the negotiating process that goes into claiming any kind of entitlements.

Haemovigilance: A Current Update in Indian Perspective

PubMed Central

Mukherjee, Somnath

2016-01-01

Haemovigilance is an organised scheme of monitoring, identifying, reporting, investigating and analysing adverse events and reactions pertinent to transfusion and manufacturing blood products. This system is also an elemental part of quality control in a blood system, bringing about corrective and preventive measures, and for the perpetual advancement of the quality and safety of blood products and the transfusion process. Nowadays haemovigilance setups have been enforced throughout the globe in most developed countries, to monitor the adverse reactions and episodes associated with blood donations and transfusions. Indian Pharmacopoeia Commission has started a Haemovigilance Program of India (HvPI) in 2012 under its Pharmacovigilance Program of India (PvPI) in collaboration with National Institute of Biologicals, Noida, Uttar Pradesh, under Ministry of Health and Family welfare, Government of India with a primary objective to track adverse reactions/events and incidences associated with blood transfusion and blood product administration and to identify trends, recommend best practices and interventions required to improve patient care and safety. This review article is a detail update of current scenario of haemovigilance in India. PMID:28050389

Report: Hospital waste management--awareness and practices: a study of three states in India.

PubMed

Rao, P Hanumantha

2008-06-01

The study was conducted in Andhra Pradesh, Maharashtra and Uttar Pradesh in India. Hospitals/nursing homes and private medical practitioners in urban as well as rural areas and those from the private as well as the government sector were covered. Information on (a) awareness of bio-medical waste management rules, (b) training undertaken and (c) practices with respect to segregation, use of colour coding, sharps management, access to common waste management facilities and disposal was collected. Awareness of Bio-medical Waste Management Rules was better among hospital staff in comparison with private medical practitioners and awareness was marginally higher among those in urban areas in comparison with those in rural areas. Training gained momentum only after the dead-line for compliance was over. Segregation and use of colour codes revealed gaps, which need correction. About 70% of the healthcare facilities used a needle cutter/destroyer for sharps management. Access to Common Waste Management facilities was low at about 35%. Dumping biomedical waste on the roads outside the hospital is still prevalent and access to Common Waste facilities is still limited. Surveillance, monitoring and penal machinery was found to be deficient and these require strengthening to improve compliance with the Bio-medical Waste Management Rules and to safeguard the health of employees, patients and communities.

The BetterBirth Program: Pursuing Effective Adoption and Sustained Use of the WHO Safe Childbirth Checklist Through Coaching-Based Implementation in Uttar Pradesh, India.

PubMed

Kara, Nabihah; Firestone, Rebecca; Kalita, Tapan; Gawande, Atul A; Kumar, Vishwajeet; Kodkany, Bhala; Saurastri, Rajiv; Pratap Singh, Vinay; Maji, Pinki; Karlage, Ami; Hirschhorn, Lisa R; Semrau, Katherine Ea

2017-06-27

Shifting childbirth into facilities has not improved health outcomes for mothers and newborns as significantly as hoped. Improving the quality and safety of care provided during facility-based childbirth requires helping providers to adhere to essential birth practices-evidence-based behaviors that reduce harm to and save lives of mothers and newborns. To achieve this goal, we developed the BetterBirth Program, which we tested in a matched-pair, cluster-randomized controlled trial in Uttar Pradesh, India. The goal of this intervention was to improve adoption and sustained use of the World Health Organization Safe Childbirth Checklist (SCC), an organized collection of 28 essential birth practices that are known to improve the quality of facility-based childbirth care. Here, we describe the BetterBirth Program in detail, including its 4 main features: implementation tools, an implementation strategy of coaching, an implementation pathway (Engage-Launch-Support), and a sustainability plan. This coaching-based implementation of the SCC motivates and empowers care providers to identify, understand, and resolve the barriers they face in using the SCC with the resources already available. We describe important lessons learned from our experience with the BetterBirth Program as it was tested in the BetterBirth Trial. For example, the emphasis on relationship building and respect led to trust between coaches and birth attendants and helped influence change. In addition, the cloud-based data collection and feedback system proved a valuable asset in the coaching process. More research on coaching-based interventions is required to refine our understanding of what works best to improve quality and safety of care in various settings.Note: At the time of publication of this article, the results of evaluation of the impact of the BetterBirth Program were pending publication in another journal. After the impact findings have been published, we will update this article with a reference to the impact findings. © Kara et al.

Assessing stability and performance of a digitally enabled supply chain: Retrospective of a pilot in Uttar Pradesh, India.

PubMed

Gilbert, Sarah Skye; Thakare, Neeraj; Ramanujapuram, Arun; Akkihal, Anup

2017-04-19

Immunization supply chains in low resource settings do not always reach children with necessary vaccines. Digital information systems can enable real time visibility of inventory and improve vaccine availability. In 2014, a digital, mobile/web-based information system was implemented in two districts of Uttar Pradesh, India. This retrospective investigates improvements and stabilization of supply chain performance following introduction of the digital information system. All data were collected via the digital information system between March 2014 and September 2015. Data included metadata and transaction logs providing information about users, facilities, and vaccines. Metrics evaluated include adoption (system access, timeliness and completeness), data quality (error rates), and performance (stock availability on immunization session days, replenishment response duration, rate of zero stock events). Stability was defined as the phase in which quality and performance metrics achieved equilibrium rates with minimal volatility. The analysis compared performance across different facilities and vaccines. Adoption appeared sufficiently high from the onset to commence stability measures of data quality and supply chain performance. Data quality stabilized from month 3 onwards, and supply chain performance stabilized from month 13 onwards. For data quality, error rates reduced by two thirds post stabilization. Although vaccine availability remained high throughout the pilot, the three lowest-performing facilities improved from 91.05% pre-stability to 98.70% post-stability (p<0.01; t-test). Average replenishment duration (as a corrective response to stock-out events) decreased 52.3% from 4.93days to 2.35days (p<0.01; t-test). Diphtheria-tetanus-pertussis vaccine was significantly less likely to be stocked out than any other material. The results suggest that given sufficient adoption, stability is sequentially achieved, beginning with data quality, and then performance. Identifying when a pilot stabilizes can enable more predictable, reliable cost estimates, and outcome forecasts in the scale-up phase. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Leveraging the private sector for child health: a qualitative examination of caregiver and provider perspectives on private sector care for childhood pneumonia in Uttar Pradesh, India.

PubMed

Brunie, Aurélie; Lenzi, Rachel; Lahiri, Anamika; Izadnegahdar, Rasa

2017-02-22

The private health sector is a primary source of curative care for childhood illnesses in many low- and middle-income countries. Therefore ensuring appropriate private sector care is an important step towards improving outcomes from illnesses like pneumonia, which is the leading infectious cause of childhood mortality worldwide. This study aimed to provide evidence on private sector care for childhood pneumonia in Uttar Pradesh, India, by simultaneously exploring providers' knowledge and practices and caregivers' experiences. We conducted in-depth interviews with a purposive sample of 36 practitioners and 34 caregivers in two districts. Practitioners included allopathic doctors, AYUSH providers, and drug sellers. Caregivers were mothers of children under the age of five with symptoms consistent with pneumonia who had seen one of those practitioners. Interview transcripts were analyzed thematically. Caregivers were generally prompt in seeking care outside the home, but many initially favored local informal providers based on access and cost. Drug sellers were not commonly consulted for treatment. Formal providers had imperfect, but reasonable, knowledge of pneumonia and followed appropriate steps for diagnosis, though some gaps were noticed that were primarily related to lack of (or failure to use) diagnostic tools. Most practitioners prescribed antibiotics and supportive symptomatic treatment. Relational and structural factors encouraged overuse of antibiotics and treatment interruption. Caregivers often had a limited understanding of treatment but wanted rapid symptomatic improvements, frequently leading to sequentially consulting multiple providers and interrupting treatment when symptoms improved. Providers were confronted with these expectations and care-seeking patterns. This study contributes in-depth evidence on private sector care for childhood pneumonia in UP. Achieving appropriate care requires an enriched perspective that simultaneously considers the critical role of provider-caregiver interactions and of the context in which they occur in shaping treatment outcomes.

Effectiveness of a WHO Safe Childbirth Checklist Coaching-based intervention on the availability of Essential Birth Supplies in Uttar Pradesh, India.

PubMed

Maisonneuve, Jenny J; Semrau, Katherine E A; Maji, Pinki; Pratap Singh, Vinay; Miller, Kate A; Solsky, Ian; Dixit, Neeraj; Sharma, Jigyasa; Lagoo, Janaka; Panariello, Natalie; Neal, Brandon; Kalita, Tapan; Kara, Nabihah; Kumar, Vishwajeet; Hirschhorn, Lisa R

2018-04-30

Evaluate the impact of a World Health Organization Safe Childbirth Checklist coaching-based intervention (BetterBirth Program) on availability and procurement of essential childbirth-related supplies. Matched pair, cluster-randomized controlled trial. Uttar Pradesh, India. 120 government-sector health facilities (60 interventions, 60 controls). Supply-availability surveys were conducted quarterly in all sites. Coaches collected supply procurement sources from intervention sites. Coaching targeting implementation of Checklist with data feedback and action planning. Mean supply availability by study arm; change in procurement sources for intervention sites. At baseline, 6 and 12 months, the intervention sites had a mean of 20.9 (95% confidence interval (CI): 20.2-21.5); 22.4 (95% CI: 21.8-22.9) and 22.1 (95% CI:21.4-22.8) items, respectively. Control sites had 20.8 (95% CI: 20.3-21.3); 20.9 (95% CI: 20.3-21.5) and 21.7 (95% CI: 20.8-22.6) items at the same time-points. There was a small but statistically significant higher availability in intervention sites at 6 months (difference-in-difference (DID) = 1.43, P < 0.001), which was not seen by 12 months (DID = 0.37, P = 0.53). Greater difference between intervention and control sites starting in the bottom quartile of supply availability was seen at 6 months (DID = 4.0, P = 0.0002), with no significant difference by 12 months (DID = 1.5, P = 0.154). No change was seen in procurement sources with ~5% procured by patients with some rates as high as 29% (oxytocin). Implementation of the BetterBirth Program, incorporating supply availability, resulted in modest improvements with catch-up by control facilities by 12 months. Supply-chain coaching may be most beneficial in sites starting with lower supply availability. Efforts are needed to reduce reliance on patient-funding for some critical medications. ClinicalTrials.gov #NCT02148952; Universal Trial Number: U1111-1131-5647.

Integration of family planning with maternal health services: an opportunity to increase postpartum modern contraceptive use in urban Uttar Pradesh, India.

PubMed

Achyut, Pranita; Mishra, Anurag; Montana, Livia; Sengupta, Ranajit; Calhoun, Lisa M; Nanda, Priya

2016-04-01

Maternal health (MH) services provide an invaluable opportunity to inform and educate women about family planning (FP). It is expected that this would enable women to choose an appropriate method and initiate contraception early in the postpartum period. In this study we examined interactions with health providers for MH services, and the effect of FP information provision during these interactions on the postpartum use of modern contraceptive methods. This study used midline data collected from 990 women who had delivered a live birth between January 2010 and the date of the midline survey in 2012. These women were asked a series of questions about their last delivery, including interactions with health providers during pregnancy, delivery and the postpartum period, if they received FP information during these interactions, and their contraceptive use during the postpartum period. The study found that FP information provision as part of antenatal care in the third trimester, delivery and the postpartum period have a positive association with postpartum modern contraceptive use in urban Uttar Pradesh. However, health providers often miss these opportunities. Despite a high proportion of women coming into contact with health providers when utilising MH services, only a small proportion received FP information during these interactions. Integration of FP with MH services can increase postpartum modern contraceptive use. With the launch of the National Urban Health Mission, there now exists appropriate policy and programmatic environments for integration of FP and MH services in urban settings in India. However, this will require a concentrated effort both to enhance the capacity of health providers and encourage supportive supervision. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Multiple introductions of a reassortant H5N1 avian influenza virus of clade 2.3.2.1c with PB2 gene of H9N2 subtype into Indian poultry.

PubMed

Tosh, Chakradhar; Nagarajan, Shanmugasundaram; Kumar, Manoj; Murugkar, Harshad V; Venkatesh, Govindarajulu; Shukla, Shweta; Mishra, Amit; Mishra, Pranav; Agarwal, Sonam; Singh, Bharati; Dubey, Prashant; Tripathi, Sushil; Kulkarni, Diwakar D

2016-09-01

Highly pathogenic avian influenza (HPAI) H5N1 viruses are a threat to poultry in Asia, Europe, Africa and North America. Here, we report isolation and characterization of H5N1 viruses isolated from ducks and turkeys in Kerala, Chandigarh and Uttar Pradesh, India between November 2014 and March 2015. Genetic and phylogenetic analyses of haemagglutinin gene identified that the virus belonged to a new clade 2.3.2.1c which has not been detected earlier in Indian poultry. The virus possessed molecular signature for high pathogenicity to chickens, which was corroborated by intravenous pathogenicity index of 2.96. The virus was a reassortant which derives its PB2 gene from H9N2 virus isolated in China during 2007-2013. However, the neuraminidase and internal genes are of H5N1 subtype. Phylogenetic and network analysis revealed that after detection in China in 2013/2014, the virus moved to Europe, West Africa and other Asian countries including India. The analyses further indicated multiple introductions of H5N1 virus in Indian poultry and internal spread in Kerala. One of the outbreaks in ducks in Kerala is linked to the H5N1 virus isolated from wild birds in Dubai suggesting movement of virus probably through migration of wild birds. However, the outbreaks in ducks in Chandigarh and Uttar Pradesh were from an unknown source in Asia which also contributed gene pools to the outbreaks in Europe and West Africa. The widespread incidence of the novel H5N1 HPAI is similar to the spread of clade 2.2 ("Qinghai-like") virus in 2005, and should be monitored to avoid threat to animal and public health. Copyright © 2016 Elsevier B.V. All rights reserved.

District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data

PubMed Central

Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

2016-01-01

Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3–200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector’s non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with private registered facilities by developing a standardized and simple system with consistent communication and follow up. PMID:27591205

Knowledge of and attitudes to leprosy among patients and community members: a comparative study in Uttar Pradesh, India.

PubMed

Barkataki, Pramila; Kumar, Sheo; Rao, P S S

2006-03-01

The roles of literacy and gender in enhancing help seeking behaviour in leprosy need further research in order to maximize the effectiveness of health education programmes. A study on leprosy knowledge and attitudes was carried out in Uttar Pradesh, one of the hyper endemic states for leprosy in north India, on a random sample of 130 leprosy patients, 120 non-leprosy patients, and 150 community members. A questionnaire was prepared, tested and administered in Hindi, the local language, by a qualified interviewer. Statistical analyses were done in each group by gender and literacy, and compared. Almost everyone in the three groups knew of leprosy, but only a larger proportion of leprosy patients (60%) mentioned anaesthetic patch, as compared to about 20% or less in the other groups. A vast majority in all groups mentioned bad blood, or divine curse as the cause. Even among leprosy patients, less than 10% of illiterates and only about 40% of literates cited infection as the cause of leprosy. Literates had a better, though still quite a poor knowledge on the symptoms as well as the causation of leprosy. However, almost all stated that leprosy was curable, though they couldn't mention MDT specifically. They felt that not all patients need have deformity. About 20-30% of the leprosy affected, but nearly 50-60% in the other groups stated that there was discrimination. Nearly 70% felt that leprosy affected social participation, over 90% attributing this to adverse social stigma. Multivariate analyses, adjusted for sex, confirmed the significant association of literacy with both knowledge and attitudes. In the light of massive health education and IEC campaigns, the findings from this study are disappointing. Adult literacy programmes combined with more innovative focused approaches to suit various target audiences can impact knowledge and attitudes better.

"Neither we are satisfied nor they"-users and provider's perspective: a qualitative study of maternity care in secondary level public health facilities, Uttar Pradesh, India.

PubMed

Bhattacharyya, Sanghita; Issac, Anns; Rajbangshi, Preety; Srivastava, Aradhana; Avan, Bilal I

2015-09-27

Quality of care provided during childbirth is a critical determinant of preventing maternal mortality and morbidity. In the studies available, quality has been assessed either from the users' perspective or the providers'. The current study tries to bring both perspectives together to identify common key focus areas for quality improvement. This study aims to assess the users' (recently delivered women) and care providers' perceptions of care to understand the common challenges affecting provision of quality maternity care in public health facilities in India. A qualitative design comprising of in-depth interviews of 24 recently delivered women from secondary care facilities and 16 health care providers in Uttar Pradesh, India. The data were analysed thematically to assess users' and providers' perspectives on the common themes. The common challenges experienced regarding provision of care were inadequate physical infrastructure, irregular supply of water, electricity, shortage of medicines, supplies, and gynaecologist and anaesthetist to manage complications, difficulty in maintaining privacy and lack of skill for post-delivery counselling. However, physical access, cleanliness, interpersonal behaviour, information sharing and out-of-pocket expenditure were concerns for only users. Similarly, providers raised poor management of referral cases, shortage of staff, non-functioning of blood bank, lack of incentives for work as their concerns. The study identified the common themes of care from both the perspectives, which have been foundrelevant in terms of challenges identified in many developing countries including India. The study framework identified new themes like management of emergencies in complicated cases, privacy and cost of care which both the group felt is relevant in the context of providing quality care during childbirth in low resource setting. The key challenges identified by both the groups can be prioritized, when developing quality improvement program in the health facilities. The identified components of care can match the supply with the demand for care and make the services truly responsive to user needs. The study highlights infrastructure, human resources, supplies and medicine as priority areas of quality improvement in the facility as perceived by both users and providers, nevertheless the interpersonal aspect of care primarily reported by the users must also not be ignored.

Measles mortality in high and low burden districts of India: estimates from a nationally representative study of over 12,000 child deaths.

PubMed

Morris, Shaun K; Awasthi, Shally; Kumar, Rajesh; Shet, Anita; Khera, Ajay; Nakhaee, Fatemeh; Ram, Usha; Brandao, Jose R M; Jha, Prabhat

2013-09-23

Direct estimates of measles mortality in India are unavailable. Our objective is, to use a nationally-representative study of mortality to estimate the number and distribution of, measles deaths in India with a focus on 264 high burden districts. We used physician coded verbal autopsy data from the Million Death Study which surveyed, over 12,000 deaths in children aged 1 month to under 15 years from 1.1 million nationally, representative households in 2001-2003. We estimate there were 92,000 (99% CI 63,000-137,000) measles deaths in children 1-59, months of age in India in 2005, representing a mortality rate of 3.3 (99% CI 2.3-5.0) per 1000 live, births and about 6% of all 1-59 month deaths. In children under 15 years of age, there were 107,000, (99% CI 74,000-158,000) measles deaths. The measles mortality rate was nearly 70% greater in girls, than in boys, and 60% of the deaths were in three populous states Uttar Pradesh, Bihar, and Madhya, Pradesh. The 1-59 month measles mortality rate in high burden districts was 4.48 (99% CI 3.94-5.02) compared to 2.40 (99% CI 2.28-2.52) per 1000 live births in other districts. Measles killed over 100,000 children in India in 2005 and girls were at higher risk than boys. The majority of measles deaths occurred in a few states and high burden districts. The results of this study highlight the importance of focusing measles supplementary immunization activities in high burden districts. Copyright © 2013 Elsevier Ltd. All rights reserved.

Estimated impact and cost-effectiveness of rotavirus vaccination in India: effects of geographic and economic disparities.

PubMed

Rheingans, Richard; Anderson, John D; Anderson, Benjamin; Chakraborty, Poulomy; Atherly, Deborah; Pindolia, Deepa

2014-08-11

India accounts for 23% of global rotavirus mortality in under-five children, with more than 100,000 deaths from rotavirus annually. Introduction of a vaccine in India is considered to be the most effective intervention for preventing rotavirus mortality. Recent research suggests that there is considerable variation in rotavirus mortality burden across regional, gender and socio-economic subpopulations within India. In addition, there is potential variability in who would likely receive rotavirus vaccine if introduced. We use available household data to estimate heterogeneity in rotavirus mortality risk, vaccination benefits, and cost-effectiveness across geographic and socio-economic groups within India. We account for heterogeneity by modeling estimated three-dose routine vaccinations as a proxy for a generalized rotavirus vaccine, and mortality for subpopulations of children aggregated by region and state, socio-economic status and sex, separately. Results are presented for six geographic regions and for Bihar, Uttar Pradesh, and Madhya Pradesh, three high mortality states accounting for 56% of national mortality estimates. Impact estimates accounting for disparities predict rotavirus vaccine introduction will prevent 35,000 deaths at an average cost of $118/DALY averted (7292 INR/DALY averted). Rotavirus vaccines are most cost-effective for the poor living in high mortality regions and states. Reductions in geographic and socio-economic disparities based on regional estimates could prevent an additional 9400 deaths annually, while reductions in socio-economic disparities in the three highest morality states alone could prevent an additional 10,600 deaths annually. Understanding the impact of heterogeneity can help improve strategies to maximize the benefits of rotavirus vaccination introduction, leading to fewer lives lost as a result of rotavirus disease. Copyright © 2014. Published by Elsevier Ltd.

Determinants of nutritional status of pre-school children in India.

PubMed

Bharati, Susmita; Pal, Manoranjan; Bharati, Premananda

2008-11-01

The aim of this paper is to assess the spatial distribution of nutritional status of children of less than three years through Z-scores of weight-for-age, height-for-age and weight-for-height using data collected by the National Family Health Survey (NFHS-2, 1998-99), India. The nutritional status of pre-school children was regressed on different socio-demographic factors after eliminating the effect of age. The data show that there are gender differences and spatial variations in the nutritional status of children in India. Gender difference is not very pronounced and almost disappears when the effects of age and socio-demographic variables are removed. The spatial difference, especially the rural-urban difference, was found to be very large and decreased substantially when the effects of age and socioeconomic variables were removed. However, the differences were not close to zero. All the variables were found to affect significantly the nutritional status of children. However, the literacy of mothers did not affect height-for-age significantly. The weight-for-age and height-for-age scores showed a dismal picture of the health condition of children in almost all states in India. The worst affected states are Bihar, Madhya Pradesh, Orissa and Uttar Pradesh. Assam and Rajasthans are also lagging behind. Weight-for-height scores do not give a clear picture of state-wise variation. Goa, Kerala and Punjab are the three most developed states in India and also have the lowest percentages of underweight children according to the Z-scores. Along with these three states come the north-eastern states where women are well educated. Thus overall development, enhancement of level of education and low gender inequality are the key factors for improvement in the health status of Indian children.

Sustained progress, but no room for complacency: Results of 2015 HIV estimations in India

PubMed Central

Pandey, Arvind; Dhingra, Neeraj; Kumar, Pradeep; Sahu, Damodar; Reddy, D.C.S.; Narayan, Padum; Raj, Yujwal; Sangal, Bhavna; Chandra, Nalini; Nair, Saritha; Singh, Jitenkumar; Chavan, Laxmikant; Srivastava, Deepika Joshi; Jha, Ugra Mohan; Verma, Vinita; Kant, Shashi; Bhattacharya, Madhulekha; Swain, Pushpanjali; Haldar, Partha; Singh, Lucky; Bakkali, Taoufik; Stover, John; Ammassari, Savina

2017-01-01

Background & objectives: Evidence-based planning has been the cornerstone of India's response to HIV/AIDS. Here we describe the process, method and tools used for generating the 2015 HIV estimates and provide a summary of the main results. Methods: Spectrum software supported by the UNAIDS was used to produce HIV estimates for India as a whole and its States/Union Territories. This tool takes into consideration the size and HIV prevalence of defined population groups and programme data to estimate HIV prevalence, incidence and mortality over time as well as treatment needs. Results: India's national adult prevalence of HIV was 0.26 per cent in 2015. Of the 2.1 million people living with HIV/AIDS, the largest numbers were in Andhra Pradesh, Maharashtra and Karnataka. New HIV infections were an estimated 86,000 in 2015, reflecting a decline by around 32 per cent from 2007. The declining trend in incidence was mirrored in most States, though an increasing trend was detected in Assam, Chandigarh, Chhattisgarh, Gujarat, Sikkim, Tripura and Uttar Pradesh. AIDS-related deaths were estimated to be 67,600 in 2015, reflecting a 54 per cent decline from 2007. There were variations in the rate and trend of decline across India for this indicator also. Interpretation & conclusions: While key indicators measured through Spectrum modelling confirm success of the National AIDS Control Programme, there is no room for complacency as rising incidence trends in some geographical areas and population pockets remain the cause of concern. Progress achieved so far in responding to HIV/AIDS needs to be sustained to end the HIV epidemic. PMID:29168464

Excess under-5 female mortality across India: a spatial analysis using 2011 census data.

PubMed

Guilmoto, Christophe Z; Saikia, Nandita; Tamrakar, Vandana; Bora, Jayanta Kumar

2018-06-01

Excess female mortality causes half of the missing women (estimated deficit of women in countries with suspiciously low proportion of females in their population) today. Globally, most of these avoidable deaths of women occur during childhood in China and India. We aimed to estimate excess female under-5 mortality rate (U5MR) for India's 35 states and union territories and 640 districts. Using the summary birth history method (or Brass method), we derived district-level estimates of U5MR by sex from 2011 census data. We used data from 46 countries with no evidence of gender bias for mortality to estimate the effects and intensity of excess female mortality at district level. We used a detailed spatial and statistical analysis to highlight the correlates of excess mortality at district level. Excess female U5MR was 18·5 per 1000 livebirths (95% CI 13·1-22·6) in India 2000-2005, which corresponds to an estimated 239 000 excess deaths (169 000-293 000) per year. More than 90% of districts had excess female mortality, but the four largest states in northern India (Uttar Pradesh, Bihar, Rajasthan, and Madhya Pradesh) accounted for two-thirds of India's total number. Low economic development, gender inequity, and high fertility were the main predictors of excess female mortality. Spatial analysis confirmed the strong spatial clustering of postnatal discrimination against girls in India. The considerable effect of gender bias on mortality in India highlights the need for more proactive engagement with the issue of postnatal sex discrimination and a focus on the northern districts. Notably, these regions are not the same as those most affected by skewed sex ratio at birth. None. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Is Oral Health of the Sugar Mill Workers Being Compromised?

PubMed Central

Pandita, Venisha; Patthi, Basavaraj; Singla, Ashish; Jain, Swati; Kundu, Hansa; Malhi, Ravneet; Vashishtha, Vaibhav

2015-01-01

Introduction Occupational environment has an immense influence on the general as well as oral health. The specific exposure to sugar and its byproducts might influence the dental health of sugar mill workers. Aim and Objectives The present study was conducted to assess and compare the oral health status of production line workers and administration staff working in the sugar mills of Western Uttar Pradesh. Materials and Methods A cross-sectional study was conducted in four Government aided and four Private sugar mills of West Uttar Pradesh, India among the production line workers and administration staff. Multistage random sampling methodology was employed to select total of 600 sugar mill factory workers (449 production line workers and 151 administration staff). The oral health status of the study subjects was assessed using the modified WHO Oral health survey Performa 1997. Statistical Analysis SPSS 19 Version was used for statistical analysis. Mean, Standard Deviation and proportions were calculated for each clinical parameter. Student t-test and Chi-square analysis was done to analyse inter group comparison. Results Mean DMFT for production and non production line workers was 7.67± 2.99 and 0.15 ± 1.34 (p= 0.001) respectively. 80.17% of production line workers had maximum CPI score 2 in contrast to 63.57% of administration staff (p=0.324). Conclusion The dental health was found to be debilitated among the production line workers of Sugar mill as compared to the Administrative staff. It is therefore recommended to raise the awareness among the sugar mill workers regarding the same. PMID:26266207

Use of complementary and alternative medicine for work related musculoskeletal disorders associated with job contentment in dental professionals: Indian outlook.

PubMed

Gupta, Devanand; Bhaskar, Dara John; Gupta, Kumar Rajendra; Karim, Bushra; Kanwar, Alpana; Jain, Ankita; Yadav, Ankit; Saini, Priya; Arya, Satya; Sachdeva, Neha

2014-04-01

High prevalence rates of work-related musculoskeletal disorders (WRMSD) among dentists have been reported. Complementary and alternative medicine (CAM) therapies can be helpful in managing and preventing work-related musculoskeletal disorders. The purpose of this study was to determine if dental professionals are using CAM for work-related musculoskeletal disorders. Who have greater job satisfaction: dentist who uses Complementary and alternative medicine (CAM) or conventional therapy (CT) as a treatment modality for WRMSD. Dentists who registered in Uttar Pradesh state, India under Indian Dental Council, Uttar Pradesh branch (n=1134) were surveyed. Data were analyzed using univariate and bivariate analyses and logistic regression. A response rate of 53% (n=601) was obtained, revealing that 82% (n=487) of the respondents suffered from work-related musculoskeletal disorders. The use of complementary and alternative medicine or conventional therapy was reported among 80% (n=390) of the dentists with work-related musculoskeletal disorders. Complementary and alternative medicine users reported greater overall health compared to conventional therapy users (P<0.001). Of those with work-related musculoskeletal disorders, 35.5% (n=172) considered a career change for once, and 4.0% (n=19) reported having left dentistry. Complementary and alternative medicine therapies may improve quality of life, reduce work disruptions and enhance job satisfaction for dentists who suffer from work-related musculoskeletal disorders. It is important that dentists incorporate complementary and alternative medicine strategies into practice to facilitate musculoskeletal health that will enable longer and healthier careers, increase productivity, provide safer workplace and prevent musculoskeletal disorders.

Scaling-up public sector childhood diarrhea management program: Lessons from Indian states of Gujarat, Uttar Pradesh and Bihar.

PubMed

Kumar, Sanjeev; Roy, Rajashree; Dutta, Sucharita

2015-12-01

Diarrhea remains a leading cause of death among children under five in India. Public health sector is an important source for diarrhea treatment with oral rehydration salts (ORS) and zinc. In 2010, Micronutrient Initiative started a project to improve service delivery for childhood diarrhea management through public health sector in Gujarat, Uttar Pradesh (UP) and Bihar. This paper aims to highlight feasible strategies, experiences and lessons learned from scaling-up zinc and ORS for childhood diarrhea management in the public sector in three Indian states. The project was implemented in six districts of Gujarat, 12 districts of UP and 15 districts of Bihar, which includes 10.5 million children. Program strategies included capacity building of health care providers, expanding service delivery through community health workers (CHWs), providing supportive supervision to CHWs, ensuring supplies and conducting monitoring and evaluation. The lessons described in this paper are based on program data, government documents and studies that were used to generate evidence and inform program scale-up. 140 000 health personnel, including CHWs, were trained in childhood diarrhea management. During three years, CHWs had sustained knowledge and have treated and reported more than three million children aged 2-59 months having diarrhea, of which 84% were treated with both zinc and ORS. The successful strategies were scaled-up. It is feasible and viable to introduce and scale-up zinc and ORS for childhood diarrhea treatment through public sector. Community-based service delivery, timely and adequate supplies, trained staff and pro-active engagement with government were essential for program success.

Faunal diversity during rainy season in reclaimed sodic land of Uttar Pradesh, India.

PubMed

Singh, S K; Srivastava, S P; Tandon, Pankaj; Azad, B S

2009-07-01

Faunal diversity is an indicator of soil amelioration. Estimating the population size or density of an animal species in an area is fundamental to understand its status and demography and to plan for its management and conservation. Considering this, faunal diversity in reclamed sodic land was monitored during rainy season 2000-01 at different locations of district viz., Aligarh, Etah, Fatehpur, Mainpuri and Raebareli in Uttar Pradesh. The Shannon-Weiner species diversity index (H) of different fauna complex of each location was compared with zero years (1995-1996) indexes (before reclamation). Insects diversity index, in reclaimed sodic soil, varied from 3.8178 (Fatehpur: Bariyampur) to 4.623 (Fatehpur: Katoghan), which was 3.028 in zero year at Katoghan in Fatehpur 'H' index of other-arthropods ranged widely from 0.9743 (Etah: Bawali) to 2.0674 (Mainpuri: Pundari). The species diversity index of molluscs registered as high as 1.8637 at Ladhauwa site in Aligarh, which exhibited identical with Saripur site of Raebareli. 'H' index of mammal resulted with the highest (2.19) at Pundari in district Mainpuri. The avifauna and amphibian's indices were recovered maximal at Saripur site of Raebareli and Bariyampur site of Fatehpur respectively. Our result revealed that various fauna enriched with soil reclamation, which is good indicator of restoration of land, primarily due to soil-arthropods and earthworms and its eventual improvement along with succeeding rice-wheat cropping system widespread over there. It clearly shows that soil fauna strongly affects the composition of natural vegetation and we suggest that this knowledge might improve the restoration and conservation of biodiversity.

Use of Complementary and Alternative Medicine for Work Related Musculoskeletal Disorders Associated With Job Contentment in Dental Professionals: Indian Outlook

PubMed Central

Gupta, Devanand; Bhaskar, Dara John; Gupta, Kumar Rajendra; Karim, Bushra; Kanwar, Alpana; Jain, Ankita; Yadav, Ankit; Saini, Priya; Arya, Satya; Sachdeva, Neha

2014-01-01

Background High prevalence rates of work-related musculoskeletal disorders (WRMSD) among dentists have been reported. Complementary and alternative medicine (CAM) therapies can be helpful in managing and preventing work-related musculoskeletal disorders. The purpose of this study was to determine if dental professionals are using CAM for work-related musculoskeletal disorders. Who have greater job satisfaction: dentist who uses Complementary and alternative medicine (CAM) or conventional therapy (CT) as a treatment modality for WRMSD Method Dentists who registered in Uttar Pradesh state, India under Indian Dental Council, Uttar Pradesh branch (n=1134) were surveyed. Data were analyzed using univariate and bivariate analyses and logistic regression. Result A response rate of 53% (n=601) was obtained, revealing that 82% (n=487) of the respondents suffered from work-related musculoskeletal disorders. The use of complementary and alternative medicine or conventional therapy was reported among 80% (n=390) of the dentists with work-related musculoskeletal disorders. Complementary and alternative medicine users reported greater overall health compared to conventional therapy users (P<0.001). Of those with work-related musculoskeletal disorders, 35.5% (n=172) considered a career change for once, and 4.0% (n=19) reported having left dentistry. Conclusion Complementary and alternative medicine therapies may improve quality of life, reduce work disruptions and enhance job satisfaction for dentists who suffer from work-related musculoskeletal disorders. It is important that dentists incorporate complementary and alternative medicine strategies into practice to facilitate musculoskeletal health that will enable longer and healthier careers, increase productivity, provide safer workplace and prevent musculoskeletal disorders. PMID:24795512

A brief and critical review on hydrofluorosis in diverse species of domestic animals in India.

PubMed

Choubisa, Shanti Lal

2018-02-01

India is one of the fluoride-endemic countries where the maximum numbers of ground or drinking water sources are naturally fluoridated. In India, a total of 23, out of 36 states and union territories have drinking water contaminated with fluoride in varying concentration. In the present scenario, especially in rural India, besides the surface waters (perennial ponds, dams, rivers, etc.), bore wells and hand pumps are the principal drinking water sources for domestic animals such as cattle (Bos taurus), water buffaloes (Bubalus bubalis), sheep (Ovis aries), goats (Capra hircus), horses (Equus caballus), donkeys (Equus asinus) and dromedary camels (Camelus dromedarius). Out of 23 states, 17 states, namely Andhra Pradesh, Assam, Bihar, Chhattisgarh, Gujarat, Haryana, Jharkhand, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Odisha (Orissa), Punjab, Rajasthan, Telangana, Uttar Pradesh and West Bengal, have fluoride beyond the maximum permissible limit of 1.0 or 1.5 ppm in drinking water. This situation is a great concern for the animal health because fluoride is a slow toxicant and causes chronic diverse serious health hazards or toxic effects. Despite the fact that domestic animals are the basic income sources in rural areas and possess a significant contributory role not only in the agriculture sector but also in the strengthening of economy as well as in sustainable development of the country, research work on chronic fluoride intoxication (hydrofluorosis) due to drinking of fluoridated water in domestic animals rearing in various fluoride-endemic states is not enough as compared to work done in humans. However, some interesting and excellent research works conducted on different aspects of hydrofluorosis in domesticated animals rearing in different states are briefly and critically reviewed in the present communication. Author believes that this review paper not only will be more useful for researchers to do some more advance research work on fluoride-induced toxicosis in different species of animals but will also be helpful in the making of health policy for domestic animals at state and national level for the mitigation of hydrofluorosis in India.

Variation in gymnemic acid content and non-destructive harvesting of Gymnema sylvestre (Gudmar).

PubMed

Pandey, Ashok Kumar; Yadav, Swati

2010-09-01

Madhunashini (Gymnema sylvestre R. Br.) commonly known as 'Gudmar' in Hindi is an important medicinal climber and extensively used in almost all Indian System of Medicine as a remedy for diabetes, rheumatism, cough, ulcer, jaundice, dyspepsia, constipation, eyes pain and also in snakebite. In India, it is found growing in Andhra Pradesh, Bihar, Chhattisgarh, Karnataka, Kerala, Madhya Pradesh, Maharastra, Orissa, Tamil Nadu, Uttar Pradesh and West Bengal. The major phytoconstituents are gymnemic acids, gudmarin and saponins. In the present study, Gymnema germplasm collected from various regions of Madhya Pradesh was evaluated on the basis of their morphological characteristics and gymnemic acid content. Gymnemic acid content in the leaves was estimated by HPLC. We have also standardized the non-destructive harvesting practices of Gudmar. Selective harvesting was done without harming the main plant. Only mature leaves (60%) were hand plucked in the month of October. Second harvest was done in the month of June. Data revealed that gymnemic acid content varied between 0.96% ± 0.03 (Seoni) to 1.58% ±0.03 (Amarkantak). It was also observed that the leaves left at the time of 1(st) harvest during October matured in June at the time of 2(nd) harvest. Non destructive harvesting practice did not have any negative impact on overall development of the plant. It is evident that there is wide variation in the morphological characteristics and gymnemic acid content in G. sylvestre collected from various locations, which can be exploited for further crop improvement programmes.

Misuse of prenatal diagnostic technology for sex-selected abortions and its consequences in India.

PubMed

Sharma, B R; Gupta, N; Relhan, N

2007-11-01

During 1800, the British Government found that there were no daughters in a village in the Eastern Uttar Pradesh region of India. According to the 2001 Census, there were less than 93 women for every 100 men in the Indian population. The prevailing concept that the birth of a female child can signal the beginning of financial ruin and extreme hardship for a poor Indian family is understandable. What is surprising is that even high-income families do not want a female child. The Government of India in its 10th Plan recognized the rights of the female child to equal opportunity, to be free from hunger, illiteracy, ignorance and exploitation. In the National Policy for the Empowerment of Women 2001, a policy framework was laid down for the elimination of discrimination against, and violation of, the rights of the female child. However, the situation continues to worsen, and studies have revealed that sex-selected abortions are practised among all communities despite enactment of laws prohibiting prenatal sex determination. In this paper, we examine the functioning and consequences of the misuse of this technology.

Innovatively addressing the challenge of maintaining binocular microscopes under Tuberculosis Programme in India - Is this feasible?

PubMed

Chadha, Sarabjit; Nagaraja, Sharath Burugina; Prasad, Banaru Muralidhara; Kelamane, Santosha; Satyanarayana, Srinath; Sachdeva, Kuldeep Singh

2016-01-01

India is a high TB burden country. The preferred first line diagnostic tool under National TB Programme is sputum smear microscopy through binocular microscopes (BMs) from 13,000 designated microscopy centres across the country. The programme had devised innovative strategy for maintenance of BMs. A study was conducted to look into the operational feasibility of an external agency to provide maintenance services for BMs engaged through newer strategy. A cross-sectional study was conducted in the states of Uttar Pradesh, Bihar and Rajasthan during 2010-2013. A total of 9314 BMs were serviced during the period 2011-2013, of which 1104 (11.8%) had major repairs, 2204 (23.6%) had minor repairs, 1054 (11.3%) were provided emergency breakdown services and 223 (2.4%) were condemned. The bold initiative and newer strategy of the programme to engage agencies for BMs maintenance services is worthwhile and should be continued and could be considered for replication across the country. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Association of tomato leaf curl Gujarat virus and tomato leaf curl Bangladesh betasatellite on papaya showing typical leaf curl symptoms in North India.

PubMed

Varun, Priyanka; Saxena, Sangeeta

2018-05-01

Papaya leaf curl is an economically important disease occurring in papaya growing tropical and subtropical areas. Papaya leaf curl virus, a begomovirus, is the main causative agent for the disease, but many other begomoviruses as well as betasatellites have also been reported on papaya leaf curl disease. Rapidly evolving host range of begomoviruses is a major issue for developing successful resistance strategies against begomoviral infection considering their expanding host range and mixed infection. In our study, we have identified the presence of begomovirus and associated satellite molecule on papaya showing severe leaf curl symptoms in Lucknow, India. Analysis of complete DNA-A component of this isolate (MG757245) revealed the highest similarity (91%) with tomato leaf curl Gujarat virus (ToLCuGuV), while sequence data of betasatellite (MG478451) showed maximum (89%) identity with tomato leaf curl Bangladesh betasatellite (ToLCuBB). This is the first report on identification of ToLCuGuV and ToLCuBB coinfecting papaya plants in Lucknow, Uttar Pradesh (India).

Y-chromosomal insights into the genetic impact of the caste system in India

PubMed Central

Zerjal, Tatiana; Pandya, Arpita; Thangaraj, Kumarasamy; Ling, Edmund Y. S.; Kearley, Jennifer; Bertoneri, Stefania; Paracchini, Silvia; Singh, Lalji; Tyler-Smith, Chris

2008-01-01

The caste system has persisted in Indian Hindu society for around 3,500 years. Like the Y chromosome, caste is defined at birth, and males cannot change their caste. In order to investigate the genetic consequences of this system, we have analysed male-lineage variation in a sample of 227 Indian men of known caste, 141 from the Jaunpur district of Uttar Pradesh and 86 from the rest of India. We typed 131 Y-chromosomal binary markers and 16 microsatellites. We find striking evidence for male substructure: in particular, Brahmins and Kshatriyas (but not other castes) from Jaunpur each show low diversity and the predominance of a single distinct cluster of haplotypes. These findings confirm the genetic isolation and drift within the Jaunpur upper castes, which are likely to result from founder effects and social factors. In the other castes, there may be either larger effective population sizes, or less strict isolation, or both. PMID:17075717

Study of noise pollution for three consecutive years during Deepawali festival in Meerut City, Uttar Pradesh (India).

PubMed

Singh, Digvijay; Joshi, B D

2012-07-01

The present paper deals with monitoring of noise pollution at different places of Meerut City (India) on the night of Deepawali festival. During the present study the noise levels were measured with the help of sound meter. The noise pollution is decreasing considerably for the last three years and it is recorded minimum in 2009 as compared to 2008 and 2007. The main reason of this decrement is the growing environmental awareness in the people of Meerut City. Needless to say, students of most of the school in Meerut City now prefer to celebrate Deepawali, festival of lights without sound and smoke. The campaign for eco-friendly Deepawali is expected to catch on with people in Meerut City which has already demonstrated its commitment towards environment conservation. Mainly fire crackers are used during Deepawali. The present paper is an attempt to create awareness among the people of Meerut City about the bitter truth of fire crackers.

Study of archaeological coins of different dynasties using libs coupled with multivariate analysis

NASA Astrophysics Data System (ADS)

Awasthi, Shikha; Kumar, Rohit; Rai, G. K.; Rai, A. K.

2016-04-01

Laser Induced Breakdown Spectroscopy (LIBS) is an atomic emission spectroscopic technique having unique capability of an in-situ monitoring tool for detection and quantification of elements present in different artifacts. Archaeological coins collected form G.R. Sharma Memorial Museum; University of Allahabad, India has been analyzed using LIBS technique. These coins were obtained from excavation of Kausambi, Uttar Pradesh, India. LIBS system assembled in the laboratory (laser Nd:YAG 532 nm, 4 ns pulse width FWHM with Ocean Optics LIBS 2000+ spectrometer) is employed for spectral acquisition. The spectral lines of Ag, Cu, Ca, Sn, Si, Fe and Mg are identified in the LIBS spectra of different coins. LIBS along with Multivariate Analysis play an effective role for classification and contribution of spectral lines in different coins. The discrimination between five coins with Archaeological interest has been carried out using Principal Component Analysis (PCA). The results show the potential relevancy of the methodology used in the elemental identification and classification of artifacts with high accuracy and robustness.

The effects of high altitude on age at menarche and menopause

NASA Astrophysics Data System (ADS)

Kapoor, A. K.; Kapoor, Satwanti

1986-03-01

The age at menarche and menopause of three groups of Bhotia females living at high altitude, Himalayan region — Uttar Pradesh, North India, were studied. The Johari Bhotia women had earliest menarche (¯X=15.1±1.1 years) as compared to Rang Bhotias, settled (¯X=15.6±0.9 years) and Rang Bhotias, migratory (¯X=16.0±1.0 years). The differences between all these three groups for age at menarche were significant. A trend towards increase in age at menarche with an increase in altitude has been observed, but the total fertility period in the three groups remained similar as early menarche has been found to be associated with early onset of menopause and late menarche with late menopause.

Impact of highway construction on water bodies: a geospatial assessment.

PubMed

Vijay, Ritesh; Kushwaha, Vikash K; Mardikar, Trupti; Labhasetwar, P K

2017-08-01

India has witnessed a massive infrastructure boom in the past few years. One of such projects is National Highway-7 (NH-7), a North-South highway connecting Kanyakumari, Tamil Nadu, to Varanasi, Uttar Pradesh, traversing many water bodies. The present study aims to assess the pre- and post-construction impact due to existing, new and widened NH-7 on the physical status of the water bodies, using remote sensing techniques. Satellite images spanning 22 years were procured and analysed for change detection in land use and land cover within the waterbodies. The study indicates that construction activities have led to transformation within the water bodies regarding reduction in area and inter-changing of land use and land cover classes, in turn leading to siltation and reduction of recharge.

Effect and cost-effectiveness of educating mothers about childhood DPT vaccination on immunisation uptake, knowledge, and perceptions in Uttar Pradesh, India: A randomised controlled trial

PubMed Central

Fabbri, Camilla; Singh, Kultar

2018-01-01

Background To assess the effect of health information on immunisation uptake in rural India, we conducted an individually randomised controlled trial of health information messages targeting the mothers of unvaccinated or incompletely vaccinated children through home visits in rural Uttar Pradesh, India. Methods and findings The study tested a brief intervention that provided mothers face-to-face with information on the benefits of the tetanus vaccine. Participants were 722 mothers of children aged 0–36 months who had not received 3 doses of diphtheria–pertussis–tetanus (DPT) vaccine (DPT3). Mothers were randomly assigned in a ratio of 1:1:1 to 1 of 3 study arms: mothers in the first treatment group received information framed as a gain (e.g., the child is less likely to get tetanus and more likely to be healthy if vaccinated), mothers in the second treatment group received information framed in terms of a loss (e.g., the child is more likely to get tetanus and suffer ill health if not vaccinated), and the third arm acted as a control group, with no information given to the mother. Surveys were conducted at baseline (September 2015) and after the intervention (April 2016). The primary outcome was the proportion of children who had received DPT3 measured after 7 months of follow-up. The analysis was by intention to treat. A total of 16 (2.2%) participants were lost to follow-up. The coverage of DPT3 was 28% in the control group and 43% in the pooled information groups, giving a risk difference of 15 percentage points (95% CI: 7% to 22%, p < 0.001) and a relative risk of 1.52 (95% CI: 1.2 to 1.9, p < 0.001). The information intervention increased the rate of measles vaccination by 22 percentage points (risk difference: 22%, 95% CI: 14% to 30%, p < 0.001; relative risk: 1.53, 95% CI: 1.29 to 1.80) and the rate of full immunisation by 14 percentage points (risk difference: 14%, 95% CI: 8% to 21%, p < 0.001; relative risk: 1.72, 95% CI: 1.29 to 2.29). It had a large positive effect on knowledge of the causes, symptoms, and prevention of tetanus but no effect on perceptions of vaccine efficacy. There was no difference in the proportion of children with DPT3 between the group that received information framed as a loss and the group that received information framed as a gain (risk difference: 4%, 95% CI: −5% to 13%; p = 0.352; relative risk: 1.11, 95% CI: 0.90 to 1.36). The cost per disability-adjusted life year averted of providing information was US$186, making the intervention highly cost-effective with respect to the WHO-recommended threshold of once the gross domestic product per capita (US$793 in the case of Uttar Pradesh). Key study limitations include the modest sample size for this trial, limiting power to detect small differences in the framing of information, and the potential for contamination among households. Conclusions Providing mothers of unvaccinated/incompletely vaccinated children with information on tetanus and the benefits of DPT vaccination substantially increased immunisation coverage and was highly cost-effective. The framing of the health information message did not appear to matter. Trial registration The trial is registered with ISRCTN, number ISRCTN84560580. PMID:29509769

Regional inventory of soil surface nitrogen balances in Indian agriculture (2000-2001).

PubMed

Prasad, V Krishna; Badarinath, K V S; Yonemura, S; Tsuruta, H

2004-11-01

Nitrogen regulates several ecological and biogeochemical processes and excess reactive nitrogen in the environment can lead to pollution problems, including the deterioration of air quality, disruption of forest processes, acidification of lakes and streams, and degradation of coastal waters. Much of the excess nitrogen inputs are related to food and energy production. An important step to understanding the sources of nitrogen and ultimately defining solutions to excess nitrogen is to describe the geographic distribution of agricultural nitrogen contributions from different regions. In this study, soil surface nitrogen loads were quantified for different states of India for the period 2000-2001. Nearly 35.4 Tg of nitrogen has been estimated as inputs from different sources, with output nitrogen from harvested crops of about 21.20 Tg. The soil surface nitrogen balance, estimated as inputs minus outputs, is found to be about 14.4 Tg surplus from the agricultural land of India. Livestock manure constituted a major percentage of total inputs (44.06%), followed by inorganic fertilizer (32.48%), atmospheric deposition (11.86%) and nitrogen fixation (11.58%). Nitrogen balance varied from deficit to surplus for different states. The highest nitrogen surplus was found in Uttar Pradesh (2.50 Tg) followed by Madhya Pradesh (1.83 Tg), Andhra Pradesh (1.79 Tg), etc. A negative nitrogen balance was found in Orissa (-0.01 Tg), Andaman Nicobar Islands (-0.32 Tg) and for some of the northeastern states. Major fertilizer consumption states were found to be Tamilnadu (204 kg/ha), Haryana (132 kg/ha), Punjab (148 kg/ha), followed by others. Similarly, nitrogen inputs from total livestock excretions were found to be high for Kerala (616 kg/ha), Jammu and Kashmir (389 kg/ha), Tamil Nadu (338 kg/ha), etc. The average nitrogen surplus of about 54 kg/ha observed for the agricultural land of the entire country of India is comparatively higher than the average surplus of about 31 kg/ha reported for European countries. These results, obtained from nutrient mass balance calculations, will be useful to formulate nutrient management plans relating to fertilizer usage, livestock management and for adopting some best management strategies at a state level in India.

Determinants of performance of supplemental immunization activities for polio eradication in Uttar Pradesh, India: social mobilization activities of the Social mobilization Network (SM Net) and Core Group Polio Project (CGPP)

PubMed Central

2013-01-01

Background The primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities (SIAs) and routine immunization coverage in priority districts. The CORE Group, part of the Social Mobilization Network (SM Net), has been successful in improving SIA coverage in high-risk areas of Uttar Pradesh (UP). The SM Net works through community level mobilisers (from the CORE Group and UNICEF) and covers more than 2 million children under the age of five. In this paper, we examine the reasons the CORE Group had been successful through exploration of which social mobilization activities of the CORE Group predicted better performance of SIAs. Methods We carried out a secondary data analysis of routine monitoring information collected by the CORE Group and the Government of India for SIAs. These data included information about vaccination outcomes of SIAs in CORE Group areas and non-CORE Group areas within the districts where the CORE Group operates, along with information about the number of various social mobilization activities carried out for each SIA. We employed Generalized Linear Latent and Mixed Model (GLLAMM) statistical analysis methods to identify which social mobilization activities predicted SIA performance, and to account for the intra-class correlation (ICC) between multiple observations within the same geographic areas over time. Results The number of mosque announcements carried out was the most consistent determinant of improved SIA performance across various performance measures. The number of Bullawa Tollies carried out also appeared to be an important determinant of improved SIA performance. The number of times other social mobilization activities were carried out did not appear to determine better SIA performance. Conclusions Social mobilization activities can improve the performance of mass vaccination campaigns. In the CORE Group areas, the number of mosque announcements and Bullawa Tollies carried out were important determinants of desired SIA outcomes. The CORE Group and SM Net should conduct sufficient numbers of these activities in support of each SIA. It is likely, however, that the quality of social mobilization activities (not studied here) is as or more important than the quantity of activities; quality measures of social mobilization activities should be investigated in the future as to how they determine vaccination performance. PMID:23327427

Learning before leaping: integration of an adaptive study design process prior to initiation of BetterBirth, a large-scale randomized controlled trial in Uttar Pradesh, India.

PubMed

Hirschhorn, Lisa Ruth; Semrau, Katherine; Kodkany, Bhala; Churchill, Robyn; Kapoor, Atul; Spector, Jonathan; Ringer, Steve; Firestone, Rebecca; Kumar, Vishwajeet; Gawande, Atul

2015-08-14

Pragmatic and adaptive trial designs are increasingly used in quality improvement (QI) interventions to provide the strongest evidence for effective implementation and impact prior to broader scale-up. We previously showed that an on-site coaching intervention focused on the World Health Organization Safe Childbirth Checklist (SCC) improved performance of essential birth practices (EBPs) in one facility in Karnataka, India. We report on the process and outcomes of adapting the intervention prior to larger-scale implementation in a randomized controlled trial in Uttar Pradesh (UP), India. Initially, we trained a local team of physicians and nurses to coach birth attendants in SCC use at two public facilities for 4-6 weeks. Trained observers evaluated adherence to EBPs before and after coaching. Using mixed methods and a systematic adaptation process, we modified and strengthened the intervention. The modified intervention was implemented in three additional facilities. Pre/post-change in EBP prevalence aggregated across facilities was analyzed. In the first two facilities, limited improvement was seen in EBPs with the exception of post-partum oxytocin. Checklists were used <25 % of observations. We identified challenges in physicians coaching nurses, need to engage district and facility leadership to address system gaps, and inadequate strategy for motivating SCC uptake. Revisions included change to peer-to-peer coaching (nurse to nurse, physician to physician); strengthened coach training on behavior and system change; adapted strategy for effective leadership engagement; and an explicit motivation strategy to enhance professional pride and effectiveness. These modifications resulted in improvement in multiple EBPs from baseline including taking maternal blood pressure (0 to 16 %), post-partum oxytocin (36 to 97 %), early breastfeeding initiation (3 to 64 %), as well as checklist use (range 32 to 88 %), all p < 0.01. Further adaptations were implemented to increase the effectiveness prior to full trial launch. The adaptive study design of implementation, evaluation, and feedback drove iterative redesign and successfully developed a SCC-focused coaching intervention that improved EBPs in UP facilities. This work was critical to develop a replicable BetterBirth package tailored to the local context. The multi-center pragmatic trial is underway measuring impact of the BetterBirth program on EBP and maternal-neonatal morbidity and mortality. NCT02148952 .

Protocol for the evaluation of a social franchising model to improve maternal health in Uttar Pradesh, India.

PubMed

Pereira, Shreya K; Kumar, Paresh; Dutt, Varun; Haldar, Kaveri; Penn-Kekana, Loveday; Santos, Andreia; Powell-Jackson, Timothy

2015-05-26

Social franchising is the fastest growing market-based approach to organising and improving the quality of care in the private sector of low- and middle-income countries, but there is limited evidence on its impact and cost-effectiveness. The "Sky" social franchise model was introduced in the Indian state of Uttar Pradesh in late 2013. Difference-in-difference methods will be used to estimate the impact of the social franchise programme on the quality and coverage of health services along the continuum of care for reproductive, maternal and newborn health. Comparison clusters will be selected to be as similar as possible to intervention clusters using nearest neighbour matching methods. Two rounds of data will be collected from a household survey of 3600 women with a birth in the last 2 years and a survey of 450 health providers in the same localities. To capture the full range of effects, 59 study outcomes have been specified and then grouped into conceptually similar domains. Methods to account for multiple inferences will be used based on the pre-specified grouping of outcomes. A process evaluation will seek to understand the scale of the social franchise network, the extent to which various components of the programme are implemented and how impacts are achieved. An economic evaluation will measure the costs of setting up, maintaining and running the social franchise as well as the cost-effectiveness and financial sustainability of the programme. There is a dearth of evidence demonstrating whether market-based approaches such as social franchising can improve care in the private sector. This evaluation will provide rigorous evidence on whether an innovative model of social franchising can contribute to better population health in a low-income setting.

Scrub typhus in Uttarakhand & adjoining Uttar Pradesh: Seasonality, clinical presentations & predictors of mortality.

PubMed

Bhargava, Anurag; Kaushik, Reshma; Kaushik, Rajeev Mohan; Sharma, Anita; Ahmad, Sohaib; Dhar, Minakshi; Mittal, Garima; Khanduri, Sushant; Pant, Priyannk; Kakkar, Rajesh

2016-12-01

Scrub typhus is a re-emerging mite-borne rickettsiosis, which continues to be underdiagnosed, with lethal consequences. The present study was conducted to determine the seasonality, clinical presentation and predictors of mortality in patients with scrub typhus at a tertiary care teaching hospital in northern India. Scrub typhus was suspected in patients attending the hospital as per the standard case definition and serological evidence was obtained by performing an IgM ELISA. A total of 284 patients with scrub typhus from urban and rural areas were seen, predominantly from July to November. The most common clinical presentation was a bilateral community-acquired pneumonia (CAP), which resembled pneumonia due to atypical pathogens and often progressed to acute respiratory distress syndrome (ARDS). An acute undifferentiated febrile illness (AUFI) or a febrile illness associated with altered sensorium, aseptic meningitis, shock, abdominal pain, gastrointestinal bleeding or jaundice was also seen. Eschars were seen in 17 per cent of patients, and thrombocytopenia, transaminitis and azotaemia were frequent. There were 24 deaths (8.5%) caused predominantly by ARDS and multi-organ dysfunction. The mortality in patients with ARDS was high (37%). ARDS [odds ratio (OR)=38.29, 95% confidence interval (CI): 9.93, 147.71] and acute kidney injury (OR=8.30, 95% CI: 2.21, 31.21) were the major predictors of death. The present findings indicate that scrub typhus may be considered a cause of CAP, ARDS, AUFI or a febrile illness with multisystem involvement, in Uttarakhand and Uttar Pradesh, especially from July to November. Empiric therapy of CAP may include doxycycline or azithromycin to ensure coverage of underlying unsuspected scrub typhus.

Accessibility and potency of uterotonic drugs purchased by simulated clients in four districts in India.

PubMed

Stanton, Cynthia; Nand, Deepak Nitya; Koski, Alissa; Mirzabagi, Ellie; Brooke, Steve; Grady, Breanne; Mullany, Luke C

2014-11-13

Surveillance of drug quality for antibiotics, antiretrovirals, antimalarials and vaccines is better established than surveillance for maternal health drugs in low-income countries, particularly uterotonic drugs for the prevention and treatment of postpartum hemorrhage. The objectives of this study are to: assess private sector accessibility of four drugs used for uterotonic purposes (oxytocin, methylergometrine, misoprostol, valethamate bromide); and to assess potency of oxytocin and methylergometrine ampoules purchased by simulated clients. The study was conducted in Hassan and Bagalkot districts in Karnataka state and Agra and Gorakhpur districts in Uttar Pradesh state. A sample of 877 private pharmacies was selected (using a stratified, systematic sampling with random start), among which 847 were successfully visited. The target sample size for assessment of accessibility was 50 pharmacies per drug, per district. The target sample size for potency assessment was 100 purchases each of oxytocin and methylergometrine across all districts. Successful drug purchases varied by state. In Agra and Gorakhpur, 90%-100% of visits for each of the drugs resulted in a purchase. In Bagalkot and Hassan, only 29%-52% of visits for each drug resulted in a purchase. Regarding potency, the percent of active pharmaceutical ingredient was assessed using United States Pharmacopeia monograph #33 for both drugs; 193 and 188 ampoules of oxytocin and methylergometrine, respectively, were assessed. The percent of oxytocin ampoules outside manufacturer specification ranged from 33%-40% in Karnataka and from 22%-50% in Uttar Pradesh. In Bagalkot and Hassan, 96% and 100% of the methylergometrine ampoules were outside manufacturer specification, respectively. In Agra and Gorakhpur, 54% and 44% were outside manufacturer specification, respectively. Private sector accessibility of uterotonic drugs in study districts in Karnataka warrants attention. Most importantly, interventions to assure quality oxytocin and particularly methylergometrine are needed in study districts in both states.

Determinants of Prelacteal Feeding in Rural Northern India

PubMed Central

Roy, Manas Pratim; Mohan, Uday; Singh, Shivendra Kumar; Singh, Vijay Kumar; Srivastava, Anand Kumar

2014-01-01

Background: Prelacteal feeding is an underestimated problem in a developing country like India, where infant mortality rate is quite high. The present study tried to find out the factors determining prelacteal feeding in rural areas of north India. Methods: A crosssectional study was conducted among recently delivered women of rural Uttar Pradesh, India. Multistage random sampling was used for selecting villages. From them, 352 recently delivered women were selected as the subjects, following systematic random sampling. Chi-square test and logistic regression were used to find out the predictors for prelacteal feeding. Results: Overall, 40.1% of mothers gave prelacteal feeding to their newborn. Factors significantly associated with such practice, after simple logistic regression, were age, caste, socioeconomic status, and place of delivery. At multivariate level, age (odds ratio (OR) = 1.76, 95% confidence interval (CI) = 1.13-2.74), caste and place of delivery (OR = 2.23, 95% CI = 1.21-4.10) were found to determine prelacteal feeding significantly, indicating that young age, high caste, and home deliveries could affect the practice positively. Conclusions: The problem of prelacteal feeding is still prevalent in rural India. Age, caste, and place of delivery were associated with the problem. For ensuring neonatal health, the problem should be addressed with due gravity, with emphasis on exclusive breast feeding. PMID:24932400

Variation in gymnemic acid content and non-destructive harvesting of Gymnema sylvestre (Gudmar)

PubMed Central

Pandey, Ashok Kumar; Yadav, Swati

2010-01-01

Background: Madhunashini (Gymnema sylvestre R. Br.) commonly known as ‘Gudmar’ in Hindi is an important medicinal climber and extensively used in almost all Indian System of Medicine as a remedy for diabetes, rheumatism, cough, ulcer, jaundice, dyspepsia, constipation, eyes pain and also in snakebite. In India, it is found growing in Andhra Pradesh, Bihar, Chhattisgarh, Karnataka, Kerala, Madhya Pradesh, Maharastra, Orissa, Tamil Nadu, Uttar Pradesh and West Bengal. The major phytoconstituents are gymnemic acids, gudmarin and saponins. Methods: In the present study, Gymnema germplasm collected from various regions of Madhya Pradesh was evaluated on the basis of their morphological characteristics and gymnemic acid content. Gymnemic acid content in the leaves was estimated by HPLC. We have also standardized the non-destructive harvesting practices of Gudmar. Selective harvesting was done without harming the main plant. Only mature leaves (60%) were hand plucked in the month of October. Second harvest was done in the month of June. Results: Data revealed that gymnemic acid content varied between 0.96% ± 0.03 (Seoni) to 1.58% ±0.03 (Amarkantak). It was also observed that the leaves left at the time of 1st harvest during October matured in June at the time of 2nd harvest. Conclusion: Non destructive harvesting practice did not have any negative impact on overall development of the plant. It is evident that there is wide variation in the morphological characteristics and gymnemic acid content in G. sylvestre collected from various locations, which can be exploited for further crop improvement programmes. PMID:21589758

Maternal Health Situation in Bihar and Madhya Pradesh: A Comparative Analysis of State Fact Sheets of National Family Health Survey (NFHS)-3 and 4.

PubMed

Dehury, Ranjit Kumar; Samal, Janmejaya

2016-09-01

Maternal health constitutes the health of women during pregnancy, childbirth and the postpartum period. Bihar and Madhya Pradesh (MP) constitute the Empowered Action Group (EAG) states under National Rural Health Mission (NRHM) and are consistently having poor maternal health indicators. The main objective of this study was to assess the maternal health situation of Bihar and MP based on National Family Health Survey (NFHS-3) and 4 fact sheets. The study adopted a narrative description in which the NFHS fact sheets (NFHS-3 & 4) of both these states were obtained from appropriate sources and compared for various maternal health indicators. Albeit progress has been observed from NFHS-3 to NFHS-4 however, the progress is very dismal compared with the progress of other similar Indian states. Relatively MP has shown better progress compared to Bihar. Poor performance is being observed in all the three levels of maternal health; pregnancy {Ante-Natal Care (ANC), Tetanus toxoid (TT) and Iron and Folic Acid (IFA)}, child birth (Institutional delivery by Skilled Birth Attendant (SBA), Caesarean Section (CS) and post partum care (hospital stay and Janani Suraksha Yojna (JSY). The poor performance of both these states in all these indicators requires multipronged approach strong political will, health system strengthening, community mobilization and awareness. Given the status of maternal health in India and more especially in states BIMARU (Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh) and EAG states (Empowered action group), improvement in the performance of maternal health related activities is highly necessary.

District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data.

PubMed

Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

2016-09-01

Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3-200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector's non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with private registered facilities by developing a standardized and simple system with consistent communication and follow up. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

The BetterBirth Program: Pursuing Effective Adoption and Sustained Use of the WHO Safe Childbirth Checklist Through Coaching-Based Implementation in Uttar Pradesh, India

PubMed Central

Kara, Nabihah; Firestone, Rebecca; Kalita, Tapan; Gawande, Atul A; Kumar, Vishwajeet; Kodkany, Bhala; Saurastri, Rajiv; Pratap Singh, Vinay; Maji, Pinki; Karlage, Ami; Hirschhorn, Lisa R; Semrau, Katherine EA

2017-01-01

Shifting childbirth into facilities has not improved health outcomes for mothers and newborns as significantly as hoped. Improving the quality and safety of care provided during facility-based childbirth requires helping providers to adhere to essential birth practices—evidence-based behaviors that reduce harm to and save lives of mothers and newborns. To achieve this goal, we developed the BetterBirth Program, which we tested in a matched-pair, cluster-randomized controlled trial in Uttar Pradesh, India. The goal of this intervention was to improve adoption and sustained use of the World Health Organization Safe Childbirth Checklist (SCC), an organized collection of 28 essential birth practices that are known to improve the quality of facility-based childbirth care. Here, we describe the BetterBirth Program in detail, including its 4 main features: implementation tools, an implementation strategy of coaching, an implementation pathway (Engage-Launch-Support), and a sustainability plan. This coaching-based implementation of the SCC motivates and empowers care providers to identify, understand, and resolve the barriers they face in using the SCC with the resources already available. We describe important lessons learned from our experience with the BetterBirth Program as it was tested in the BetterBirth Trial. For example, the emphasis on relationship building and respect led to trust between coaches and birth attendants and helped influence change. In addition, the cloud-based data collection and feedback system proved a valuable asset in the coaching process. More research on coaching-based interventions is required to refine our understanding of what works best to improve quality and safety of care in various settings. (After publication of this article, the impact results of the BetterBirth intervention were published in the New England Journal of Medicine [volume 377, pages 2313-2324, doi: 10.1056/NEJMoa1701075]. The results showed that the intervention had no significant effect on maternal or perinatal mortality or maternal morbidity, despite having positive effects on essential birth practices.) PMID:28655801

Support for children identified with acute flaccid paralysis under the global polio eradication programme in Uttar Pradesh, India: a qualitative study

PubMed Central

2012-01-01

Background Cases of polio in India declined after the implementation of the polio eradication programme especially in these recent years. The programme includes surveillance of acute flaccid paralysis (AFP) to detect and diagnose cases of polio at early stage. Under this surveillance, over 40,000 cases of AFP are reported annually since 2007 regardless of the number of actual polio cases. Yet, not much is known about these children. We conducted a qualitative research to explore care and support for children with AFP after their diagnosis. Methods The research was conducted in a district of western Uttar Pradesh classified as high-risk area for polio. In-depth interviews with parents of children with polio (17), with non-polio AFP (9), healthcare providers (40), and key informants from community including international and government officers, religious leaders, community leaders, journalists, and academics (21) were performed. Results Minimal medicine and attention were provided at government hospitals. Therefore, most parents preferred private-practice doctors for their children with AFP. Many were visited at homes to have stool samples collected by authorities. Some were visited repetitively following the sample collection, but had difficulty in understanding the reasons for these visits that pertained no treatment. Financial burden was a common concern among all families. Many parents expressed resentment for their children's disease, notably have been affected despite receiving multiple doses of polio vaccine. Both parents and healthcare providers lacked information and knowledge, furthermore poverty minimised the access to available healthcare services. Medicines, education, and transportation means were identified as foremost needs for children with AFP and residual paralysis. Conclusions Despite the high number of children diagnosed with AFP as part of the global polio eradication programme, we found they were not provided with sufficient medical support following their diagnosis. Improvement in the quality and sufficiency of the healthcare system together with integration of AFP surveillance with other services in these underprivileged areas may serve as a key solution. PMID:22439606

Predictors of Sexually Transmitted Infections among Female Sex Workers (FSWs) in a City of Northern India.

PubMed

Shukla, Pallavi; Masood, Jamal; Singh, J V; Singh, V K; Gupta, Abhishek; Krishna, Asuri

2015-01-01

Sexually transmitted infections (STIs) and Reproductive tract infections RTIs are important public health problems in India. The prevalence of these infections is considerably higher among high risk groups (HRGs) ranging from 20-30%. It is high time that a study should be conducted to explore different factors and conditions responsible for the practice of unsafe sex among female sex workers (FSWs) in Uttar Pradesh (UP) and the impact of this on social life and health of FSWs. As Lucknow provides a comprehensive opportunity in terms of tourism, occupation, and economy, it becomes a potential hub for sex work. Studying FSW in Lucknow can thus be considered as a yardstick for the entire FSW population of UP population. The present study was thus planned with the objective of knowing the STI prevalence and its determinants among FSWs. A cross-sectional descriptive study was conducted on FSWs registered with Targeted Intervention-Non-government Organization (TI-NGO), registered with Uttar Pradesh State Acquired Immuno Deficiency Syndrome (AIDS) Control Society (UPSACS) of Lucknow city. Total 288 subjects were studied. The average age of FSWs was 31 years. FSWs were mostly Hindus and illiterate. The overall prevalence of STI as per Syndromic diagnosis was found to be 35.8%. However, the percentage of FSWs with STI was higher in street-based (50.6%) than home-based (29.8%). Majority (42.7%) of sex workers with STI had non-regular partners only while majority (52.4%) of sex workers without any STI had only regular partners. Condom usage with regular partners was poor. However, with the non-regular partners the condom usage was better. On multivariate analysis being single, having sex work as a sole means of earning, duration of sex work > 2 years, having pallor, and giving in to client's demand for unsafe sex were found to be significant in causing STI. Prevalence of STI among the female sex workers as per Syndromic diagnosis was found to be 35.8%. Unemployment, anemia, and having sex without condom for extra money, failure to persuade the client and not doing anything were found to be important predictors for presence of STI.

Serum IgG and IgA levels in polio and non-polio acute flaccid paralysis cases in western Uttar Pradesh, India.

PubMed

Mohanty, Madhu C; Nalavade, Uma P; Deshpande, Jagadish M

2015-03-08

IgG and IgA immunocompetence of children with wild poliovirus poliomyelitis and non-polio acute flaccid paralysis. 932 cases of acute flaccid paralysis, reported in 2008-2009, were tested for presence of polio and non-polio enteroviruses according to the WHO standards. Serum IgA and IgG levels were determined by sandwich ELISA. Mean (SD) IgA levels [0.87 (0.62)g/L; n=28] of virologically confirmed poliomyelitis cases were lower than those of virus negative [1.21 (0.83)g/L; n=612] and non-polio Enterovirus positive [1.22 (0.79)g/L; n=240] cases of acute flaccid paralysis. No significant difference was observed in the concentration of IgG among these groups. IgA plays an important role in protection against poliomyelitis.

Reviewing responsibilities and renewing relationships: an intervention with men on violence against women in India.

PubMed

Das, Abhijit; Mogford, Elizabeth; Singh, Satish K; Barbhuiya, Ruhul Amin; Chandra, Shishir; Wahl, Rachel

2012-01-01

Violence against women is increasingly seen as a key women's rights issue in India. Some efforts to address it have started to engage men. The current study focuses on the impacts of Men's Action to Stop Violence Against Women (MASVAW), a network of men working on gender-based violence in the state of Uttar Pradesh, in India. The purpose of the study was to determine the extent to which MASVAW activists incorporate gender-equitable attitudes and practices into their own lives and to identify their influence on men around them. The cross-sectional study includes three groups: activists, men living in an area where activists conducted outreach activities and a control group living in an area with no MASVAW activities. Both activists and activist influenced men scored higher on measures of gender-equitable beliefs and practices than controls, suggesting that MASVAW activism is successful. Furthermore, men from the activist influenced group scored higher in gender progressiveness even if they did not have contact with MASVAW themselves, suggesting a diffusion effect of social change. However, there were some areas where the activists had low scores, suggesting need for additional inputs.

Spatial access to inpatient health care in northern rural India.

PubMed

Ranga, Vikram; Panda, Pradeep

2014-05-01

Access to health care in rural areas is a major concern for local populations as well as for policy makers in developing countries. This paper examines spatial access to in-patient health care in northern rural India. In order to measure spatial access, impedance-based competition using the Three-Step floating Catchment Area (3SFCA) method, a modification of the simple gravity model, was used. 3SFCA was chosen for the study of the districts of Pratapgarh and Kanpur Dehat in the Uttar Pradesh state and Vaishali in the Bihar state, two of India's poorest states. This approach is based on discrete distance decay and also considers more parameters than other available methods, hence is believed to be a robust methodology. It was found that Vaishali district has the highest spatial access to in-patient health care followed by Pratapgarh and Kanpur Dehat. There is serious lack of health care, in Pratapgarh and Kanpur Dehat with 40% and 90% of the villages having shortage of in-patient care facilities in these respective districts. The most important factor affecting spatial access was found to be the distance to the nearest major urban agglomeration.

A study on community-based approaches to reduce leprosy stigma in India.

PubMed

Raju, M S; Rao, P S S; Mutatkar, R K

2008-01-01

There is a global awareness that reduction of leprosy stigma is not at par with the technological developments and the resulting cognitive changes pertaining to leprosy, which can be attributed to lack of active community participation in the programmes. With a major aim of identifying the best methods using active participation of the society, the Leprosy Mission in India initiated a multi-state community-based interventional trial of leprosy stigma reduction in 2 similar rural blocks located beyond 25 km. from the three hospitals, from 3 states, at Faizabad in Uttar Pradesh, Purulia in West Bengal and Champa in Chhattisgarh of India during 2005. A baseline survey was done which confirmed a high level of leprosy stigma. A stigma reduction organizing committee (SROC) in each village, thus a total of 60 SROCs from 3 states @ 10 from each block were formed. One trained social worker appointed by the project as community organizer in each block acted as a facilitator for all the stigma reduction activities taken up by the committees. The outcome of the project shows, the SROCs' interventions are well accepted by the communities. Education and counseling through SROC members in local circumstances are very much feasible and effective.

Approach to population control.

PubMed

Bose, A

1983-01-26

Due to the fact that India was the 1st nation to adopt population control as a state policy and that targets for various family planning methods are set by the Department of Family Planning, it is assumed that family planning is basically the concern of the Department of Family Planning. Consequently, family planning is viewed as a public sector activity that requires little participation on the part of the people. This presents a great danger to the success of the family planning program. Family planning needs to be the primary concern of the people and not the government. The new 20 point program emphasizes that family planning should be promoted on a voluntary basis as a people's movement. This has been interpreted by many to mean that increasingly more funds should be given to voluntary agencies working in the field of family planning. Yet, there is deep distrust on the part of the government departments regarding doling out funds to voluntary agencies. It is suggested that the government should adopt a new approach to the problem of population control through the promotion and mobilization of voluntary effort in rural areas. In view of the clear demonstration of the impact of female education on fertility levels, the Family Planning Department should announce a new scheme to help all voluntary agencies which focus attention on the education of girls in neglected rural areas and should launch a special schooling program for girls in the area of nutrition. In addition, the informal education of women through the mobilization of local talent and resources to generate social awareness should be undertaken. In India, Kerala has the distinction of having the highest literacy rate, the highest life expectancy, the lowest mortality and infant mortality rates, and the lowest birthrate. The birthrate in rural Kerala is 27/1000 in contrast to 40/1000 in rural Uttar Pradesh. A high average marriage age has contributed substantially to lowering the birthrate. The key variables in explaining the interstate fertility differentials in India are the level of education and the marriage age. At least in the States of Uttar Pradesh, Bihar, Madhya Pradesh, and Rajasthan, the basic thrust of the family planning program for the next 5 years should be on raising the marriage age. In sum, decline in the rural birthrate can be accomplished if a 4-fold strategy is adopted: a special program for female education in neglected rural areas; an increase in the marriage age in rural areas to at least 18-20 years for girls and the strict enforcement of the Prevention of Child Marriage Act; massive support of the Health Guide Scheme in order to realize the goal of health for all by the year 2000; and innovative steps to generate and mobilize initiative in the field of health and education within local rural communities.

Role of Social Mobilization (Network) in Polio Eradication in India.

PubMed

Siddique, Anisur Rahman; Singh, Prem; Trivedi, Geetali

2016-08-07

In 2009, India contributed to over half the global cases of poliomyelitis. Many believed that India would be the last country to be polio free. India proved them wrong and was certified polio free in 2014. In January 2016, India celebrated 5 years of being polio free. One of the major reasons behind the interruption of polio transmission in the Polio endemic states of Uttar Pradesh and Bihar was the deployment of Social Mobilization Network (SMNet). A three tiered structure, the 7300 strong SMNet is now the gold standard in public health communication. It mobilizes communities by spearheading civil society participation; and works at district, block and community levels. The SMNet's social mobilization has evolved into an accelerated approach for achieving results with principles of mobilization at its core. The SMNet targets resistance to polio immunization through a multipronged approach by using local religious leaders, community influencers, interpersonal communication, counseling, mothers meetings, announcements from religious institutions and rallies. The success of the SMNet has been its ability to identify and convert resistant families into advocates for polio immunization. Deeply respected in the community, the SMNet mobilizers (98 percent of whom are women) are themselves models for gender empowerment. The SMNet model shows how mobilization techniques can be harnessed for short term and long term goals and can be replicated in other health programs to achieve the same results as were achieved for Polio.

Validation of accuracy and community acceptance of the BIRTHweigh III scale for categorizing newborn weight in rural India.

PubMed

Darmstadt, G L; Kumar, V; Shearer, J C; Misra, R; Mohanty, S; Baqui, A H; Coffey, P S; Awasthi, S; Singh, J V; Santosham, M

2007-10-01

To determine the accuracy and acceptability of a handheld scale prototype designed for nonliterate users to classify newborns into three weight categories (>or=2,500 g; 2,000 to 2,499 g; and <2,000 g). Weights of 1,100 newborns in Uttar Pradesh, India, were measured on the test scale and validated against a gold standard. Mothers, family members and community health stakeholders were interviewed to assess the acceptability of the test scale. The test scale was highly sensitive and specific at classifying newborn weight (normal weight: 95.3 and 96.3%, respectively; low birth weight: 90.4 and 99.2%, respectively; very low birth weight: 91.7 and 98.4%, respectively). It was the overall agreement of the community that the test scale was more practical and easier to interpret than the gold standard. The BIRTHweigh III scale accurately identifies low birth weight and very low birth weight newborns to target weight-specific interventions. The scale is extremely practical and useful for resource-poor settings, especially those with low levels of literacy.

Dynamics of contraceptive use in India: apprehension versus future intention among non-users and traditional method users.

PubMed

Rai, Rajesh Kumar; Unisa, Sayeed

2013-06-01

This study examines the reasons for not using any method of contraception as well as reasons for not using modern methods of contraception, and factors associated with the future intention to use different types of contraceptives in India and its selected states, namely Uttar Pradesh, Assam and West Bengal. Data from the third wave of District Level Household and Facility Survey, 2007-08 were used. Bivariate as well as logistic regression analyses were performed to fulfill the study objective. Postpartum amenorrhea and breastfeeding practices were reported as the foremost causes for not using any method of contraception. Opposition to use, health concerns and fear of side effects were reported to be major hurdles in the way of using modern methods of contraception. Results from logistic regression suggest considerable variation in explaining the factors associated with future intention to use contraceptives. Promotion of health education addressing the advantages of contraceptive methods and eliminating apprehension about the use of these methods through effective communication by community level workers is the need of the hour. Copyright © 2013 Elsevier B.V. All rights reserved.

Human mtDNA hypervariable regions, HVR I and II, hint at deep common maternal founder and subsequent maternal gene flow in Indian population groups.

PubMed

Sharma, Swarkar; Saha, Anjana; Rai, Ekta; Bhat, Audesh; Bamezai, Ramesh

2005-01-01

We have analysed the hypervariable regions (HVR I and II) of human mitochondrial DNA (mtDNA) in individuals from Uttar Pradesh (UP), Bihar (BI) and Punjab (PUNJ), belonging to the Indo-European linguistic group, and from South India (SI), that have their linguistic roots in Dravidian language. Our analysis revealed the presence of known and novel mutations in both hypervariable regions in the studied population groups. Median joining network analyses based on mtDNA showed extensive overlap in mtDNA lineages despite the extensive cultural and linguistic diversity. MDS plot analysis based on Fst distances suggested increased maternal genetic proximity for the studied population groups compared with other world populations. Mismatch distribution curves, respective neighbour joining trees and other statistical analyses showed that there were significant expansions. The study revealed an ancient common ancestry for the studied population groups, most probably through common founder female lineage(s), and also indicated that human migrations occurred (maybe across and within the Indian subcontinent) even after the initial phase of female migration to India.

Disparity in maternal, newborn and child health services in high focus states in India: a district-level cross-sectional analysis.

PubMed

Awasthi, Ashish; Pandey, C M; Chauhan, Rajesh K; Singh, Uttam

2016-08-05

To examine the level and trend in the coverage gap of a set of interventions of maternal and child health services using a summary index and to assess the disparity in usage of maternal and child health services in the districts of high focus states of India. Data for the present study are taken from the Annual Health Survey (AHS), 2010-2013 and Census of India, 2011. This study used secondary data from states having higher mortality and fertility rates, termed as high focus states in India. District-level information regarding children aged 12-23 months and ever married women aged 15-49 years has been extracted from the AHS (2010-2013), and household amenities, female literacy and main workforce information has been obtained from the Census of India 2011. 2 summary indexes were calculated first for maternal and child health services and another for socioeconomic and development status, using data from AHS and Census. Cronbach's α was used to assess the internal consistency of the items used in the index. The result shows that the coverage gap is highest in Uttar Pradesh (37%) and lowest in Madhya Pradesh (21%). Converge gap and socioeconomic development are negatively correlated (r=-0.49, p=0.01). The average coverage gap was highest in the lowest quintile of socioeconomic development. There was an absolute change of 1.5% per year in coverage gap during 2009-2013. In regression analysis, the coefficient of determination was 0.24, β=-30.05, p=0.01 for a negative relationship between socioeconomic development and coverage gap. There is a significant disparity in the usage of maternal and child healthcare services in the districts of India. Resource-rich people (urban residents and richest quintile) are way ahead of marginalised people (rural residents and poorest quintile) in the usage of healthcare services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Has the Janani Suraksha Yojana (a conditional maternity benefit transfer scheme) succeeded in reducing the economic burden of maternity in rural India? Evidence from the Varanasi district of Uttar Pradesh.

PubMed

Mukherjee, Saradiya; Singh, Aditya

2018-02-05

One of the constraints in the utilisation of maternal healthcare in India is the out-of-pocket expenditure. To improve the utilisation and to reduce the out-of-pocket expenditure, India launched a cash incentive scheme, Janani Suraksha Yojana (JSY), which provides monetary incentive to the mothers delivering in public facility. However, no study has yet examined the extent to which the JSY payments reduce the maternal healthcare induced catastrophic out-of-pocket expenditure burden of the households. This paper therefore attempts to examine the extent to which the JSY reduces the catastrophic expenditure estimate household expenditure on maternity, i.e. , all direct and indirect expenditure. The study used data on 396 mothers collected through a primary survey conducted in the rural areas of the Varanasi district of Uttar Pradesh state in 2013-2014. The degree and variation in the catastrophic impact of households' maternity spending was computed as share of out-of-pocket payment in total household income in relation to specific thresholds, across socioeconomic categories. Logistic regression was used to understand the determinants of catastrophic expenditure and whether the JSY has any role in influencing the expenditure pattern. Results revealed that the JSY beneficiaries on an average spent about 8.3% of their Annual Household Consumption Expenditure on maternity care. The JSY reimbursement could reduce this share only by 2.1%. The study found that the expenditure on antenatal and postnatal care made up a significant part of the direct medical expenditure on maternity among the JSY beneficiaries. The indirect or non-medical expenditure was about four times higher than the direct expenditure on maternity services. The out-of-pocket expenditure across income quintiles was found to be regressive i.e. the poor paid a greater proportion of their income towards maternity care than the rich. Results also showed that the JSY reimbursement helped only about 8% households to escape from suffering catastrophic burden due to maternity payments. It can be concluded that the JSY appeared to have achieved only a limited success in reducing the economic burden due to maternity. To reduce the catastrophic burden, policy makers should consider increasing the JSY reimbursement to cover not only antenatal and postnatal services but also non-medical expenditure due to maternity. The government should also take appropriate measures to curb non-medical or indirect expenditure in public health facilities.

Child rape: facets of a heinous crime.

PubMed

Gangrade, K D; Sooryamoorthy, R; Renjini, D

1995-01-01

This article discusses the extent of child rape in India, case studies of girl children in legal procedures, rape settings and perpetrators, public morality, and the nature of rape laws in India. It is concluded that there is no safe place for children. Currently, rapists are allowed to go free or are acquitted. Prevention and control of child rape must involve punishment of rapists. It is not appropriate that society ostracize the victim and her family. Victims should not remain silent. National Crime Records Bureau statistics reveal increases in rape during 1986-91. State figures are given for 1986-88. Madhya Pradesh had the highest reported incidence of rape in 1988. In 1993, Madhya Pradesh had a total of 2459 rapes. Nationally, 10,425 women were reported as raped in 1991. 51.7% were 16-30 years old. There were 1099 cases of pedophilia in 1991, which was an increase over 1990. Over 50% of the pedophilia cases were reported in Uttar Pradesh. The record of convictions shows very low figures. 1992 trial results of 276 rape cases indicated that only 46 persons were convicted. Victims suffer from psychological effects of embarrassment, disgust, depression, guilt, and even suicidal tendencies. There is police and prosecution indifference as well as social stigma and social ostracism of the victim and her family. Many cases go unreported. The case studies illustrate the difficulties for the victim of experiencing the rape and the social responses: police harassment, shame and fear, and occasionally public outrage. The case studies illustrate rape in familiar settings, such as schools, family homes, and neighbors and friends' homes; rape by policemen; and rape by political influentials. Most offenders are young, married, and socioeconomically poor. Mass media portrayals fuel the frustrations of poor and lonely men in cities. Rapists exhibit anti-social behavior or psychopathology. Sexual offenses are related to society's moral values.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khan, F.A.; Iqbal, M.; Ghouse, A.K.M.

The Kasimpur Thermal Power Plant Complex (located in the District Aligarh, Uttar Pradesh, India) runs on a low grade, sulphur rich, bituminous type of coal with a daily average consumption rte of about 3,192 metric tons during winter season. Its effluents, mainly consisting of oxides of sulphur, nitrogen and carbon as well as particulate matters, were noted to affect the reproductive behavior of Melilotus indica-a winter season weed growing wild as a component of a grassland community. The samples consisting of 10 plants were collected at monthly intervals from 5 sites located about 0.5, 2, 6, 12 and 20 kmmore » leaward from the Complex. Emergence of inflorescence was delayed at the polluted sites. However, fruit formation started simultaneously (in March) at all the five sites. The pollution induced senescence of floral buds, flowers and fruits, but did not alter markedly weight of seed and fruit.« less

Petro-mineralogical Studies of the Paleoproterozoic Phosphorites in the Sonrai basin, Lalitpur District, Uttar Pradesh, India

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dar, Shamim A., E-mail: sjshamim@gmail.com; Khan, K. F.; Khan, Saif A.

2015-09-15

The Paleoproterozoic phosphorites constitute an economically significant component of the Sonrai basin of Lalitpur district. These are associated with ferruginous shale, ironstone, limestone and quartz breccia. Petro-mineralogical studies of samples of the phosphorites, using X-ray diffractometry and scanning electron microscopy, reveal that the collophane (carbonate-fluorapatite) is the dominant phosphate mineral. Calcite, dolomite, quartz, mica and haematite are the dominant gangue constituents. The phosphate minerals occur as oolites mutually replaced by carbonate and silica. The presence of iron oxides has been found in most of the thin sections. There is meagre evidence of organic matter in the form of filaments ofmore » microbial phosphate laminae in the samples of phosphorite. The mineral assemblages, their texture and various forms in these phosphorites may be due to some environmental vicissitudes followed by replacement processes and biogenic activities.« less

Bio-Ecology of the Louse, Upupicola upupae, Infesting the Common Hoopoe, Upupa epops

PubMed Central

Agarwal, G. P; Ahmad, Aftab; Rashmi, Archna; Arya, Gaurav; Bansal, Nayanci; Saxena, A.K.

2011-01-01

The population characteristics of the louse, Upupicola upupae (Shrank) (Mallophaga: Philopteridae: Ishnocera), infesting the Common Hoopae, Upupa epops L. (Aves: Upupiformes), were recorded during 2007–08 in District Rampur, Uttar Pradesh India. The pattern of frequency distribution of the louse conformed to the negative binomial model. The lice and its nits were reared in vitro at 35 ± 1° C, 75–82 % RH, on a feather diet. The data obtained was used to construct the life table and to determine the intrinsic rate of natural increase (0.035 female/day), the net reproductive rate was 3.67 female eggs/female, the generation time was 37 days, and the doubling time of the population was 19 days. The chaetotaxy of the three nymphal instars has also been noted to record their diagnostic characteristics. Information on egg morphology and antennal sensilla is also presented. PMID:21861650

Hydrogeological framework and water balance studies in parts of Krishni Yamuna interstream area, Western Uttar Pradesh, India

NASA Astrophysics Data System (ADS)

Ahmed, Izrar; Umar, Rashid

2008-02-01

The Krishni Yamuna interstream area is a micro-watershed in the Central Ganga Plain and a highly fertile track of Western Uttar Pradesh. The Sugarcane and wheat are the major crops of the area. Aquifers of Quaternary age form the major source of Irrigation and municipal water supplies. A detailed hydrogeological investigation was carried out in the study area with an objective to assess aquifer framework, groundwater quality and its resource potential. The hydrogeological cross section reveals occurrence of alternate layers of clay and sand. Aquifer broadly behaves as a single bodied aquifer down to the depth of 100 m bgl (metre below ground level) as the clay layers laterally pinch out. The depth to water in the area varies between 5 and 16.5 m bgl. The general groundwater flow direction is from NE to SW with few local variations. An attempt has been made to evaluate groundwater resources of the area. The water budget method focuses on the various components contributing to groundwater flow and groundwater storage changes. Changes in ground water storage can be attributed to rainfall recharge, irrigation return flow and ground water inflow to the basin minus baseflow (ground water discharge to streams or springs), evapotranspiration from ground water, pumping and ground water outflow from the basin. The recharge is obtained in the study area using Water table fluctuation and Tritium methods. The results of water balance study show that the total recharge in to the interstream region is of the order of 185.25 million m3 and discharge from the study area is of the order of 203.24 million m3, leaving a deficit balance of -17.99 million m3. Therefore, the present status of groundwater development in the present study area has acquired the declining trend. Thus, the hydrogeological analysis and water balance studies shows that the groundwater development has attained a critical state in the region.

Prevalence and Predictors of Unmet Needs among the Elderly Residents of the Rural Field Practice Area of a Tertiary Care Centre from Northern India

PubMed Central

Singh, Abhishek; Bairwa, Mohan; Goel, Shewtank; Bypareddy, Ravi; Mithra, Prassana

2016-01-01

Background Surrogate markers simple enough to be used by primary care workers have not been closely investigated by the community experts in rural Uttar Pradesh. We assessed the physical disabilities in activities of daily living (ADL) and unmet need in physical disabilities among rural elderly. Predictors of unmet needs in physical disabilities among the elderly were also identified. Methods A community based cross-sectional study was conducted among elderly residents of the rural field practice area of a tertiary care centre in rural Uttar Pradesh. Three hundred and thirty five (335) participants aged 60 years and above from 9 villages were selected using the Probability Proportional to Size (PPS) sampling technique. Study tools were the proforma regarding socio-demographic details, socio-economic status and Stanford Health Assessment Questionnaire. Multivariate logistic regression analysis was performed to identify predictors of unmet needs. Results 185 (55.2%) had physical disability in one or more activity limitation. Gender wise elderly females had more physical disability in one or more ADL categories than elderly males (66.8% vs. 42.0%). Almost one third (32.5%) of subjects had unmet need for one or more physical disabilities. the predictors of unmet needs that were identified in the study were female gender (P = 0.046), elderly aged 70 years and above (P = 0.032), those living alone (P = 0.035), low monthly family income (P = 0.044), financially fully dependent elderly (P = 0.0002), and those having 3 or more physical disabilities (P = 0.033). Conclusions The findings of the study highlight that large number of needs of the disabled are still unmet. Greater, targeted efforts are needed to identify at-risk elderly people living in the community. These predictors would act as surrogate markers and can be easily used by primary care workers to plan and provide services to the elderly people in rural communities. PMID:27904424

Effect of a multifaceted social franchising model on quality and coverage of maternal, newborn, and reproductive health-care services in Uttar Pradesh, India: a quasi-experimental study.

PubMed

Tougher, Sarah; Dutt, Varun; Pereira, Shreya; Haldar, Kaveri; Shukla, Vasudha; Singh, Kultar; Kumar, Paresh; Goodman, Catherine; Powell-Jackson, Timothy

2018-02-01

How to harness the private sector to improve population health in low-income and middle-income countries is heavily debated and one prominent strategy is social franchising. We aimed to evaluate whether the Matrika social franchising model-a multifaceted intervention that established a network of private providers and strengthened the skills of both public and private sector clinicians-could improve the quality and coverage of health services along the continuum of care for maternal, newborn, and reproductive health. We did a quasi-experimental study, which combined matching with difference-in-differences methods. We matched 60 intervention clusters (wards or villages) with a social franchisee to 120 comparison clusters in six districts of Uttar Pradesh, India. The intervention was implemented by two not-for-profit organisations from September, 2013, to May, 2016. We did two rounds (January, 2015, and May, 2016) of a household survey for women who had given birth up to 2 years previously. The primary outcome was the proportion of women who gave birth in a health-care facility. An additional 56 prespecified outcomes measured maternal health-care use, content of care, patient experience, and other dimensions of care. We organised conceptually similar outcomes into 14 families to create summary indices. We used multivariate difference-in-differences methods for the analyses and accounted for multiple inference. The introduction of Matrika was not significantly associated with the change in facility births (4 percentage points, 95% CI -1 to 9; p=0·100). Effects for any of the other individual outcomes or for any of the 14 summary indices were not significant. Evidence was weak for an increase of 0·13 SD (95% CI 0·00 to 0·27; p=0·053) in recommended delivery care practices. The Matrika social franchise model was not effective in improving the quality and coverage of maternal health services at the population level. Several key reasons identified for the absence of an effect potentially provide generalisable lessons for social franchising programmes elsewhere. Merck Sharp and Dohme Limited. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licence. Published by Elsevier Ltd.. All rights reserved.

Implementation and results of an integrated data quality assurance protocol in a randomized controlled trial in Uttar Pradesh, India.

PubMed

Gass, Jonathon D; Misra, Anamika; Yadav, Mahendra Nath Singh; Sana, Fatima; Singh, Chetna; Mankar, Anup; Neal, Brandon J; Fisher-Bowman, Jennifer; Maisonneuve, Jenny; Delaney, Megan Marx; Kumar, Krishan; Singh, Vinay Pratap; Sharma, Narender; Gawande, Atul; Semrau, Katherine; Hirschhorn, Lisa R

2017-09-07

There are few published standards or methodological guidelines for integrating Data Quality Assurance (DQA) protocols into large-scale health systems research trials, especially in resource-limited settings. The BetterBirth Trial is a matched-pair, cluster-randomized controlled trial (RCT) of the BetterBirth Program, which seeks to improve quality of facility-based deliveries and reduce 7-day maternal and neonatal mortality and maternal morbidity in Uttar Pradesh, India. In the trial, over 6300 deliveries were observed and over 153,000 mother-baby pairs across 120 study sites were followed to assess health outcomes. We designed and implemented a robust and integrated DQA system to sustain high-quality data throughout the trial. We designed the Data Quality Monitoring and Improvement System (DQMIS) to reinforce six dimensions of data quality: accuracy, reliability, timeliness, completeness, precision, and integrity. The DQMIS was comprised of five functional components: 1) a monitoring and evaluation team to support the system; 2) a DQA protocol, including data collection audits and targets, rapid data feedback, and supportive supervision; 3) training; 4) standard operating procedures for data collection; and 5) an electronic data collection and reporting system. Routine audits by supervisors included double data entry, simultaneous delivery observations, and review of recorded calls to patients. Data feedback reports identified errors automatically, facilitating supportive supervision through a continuous quality improvement model. The five functional components of the DQMIS successfully reinforced data reliability, timeliness, completeness, precision, and integrity. The DQMIS also resulted in 98.33% accuracy across all data collection activities in the trial. All data collection activities demonstrated improvement in accuracy throughout implementation. Data collectors demonstrated a statistically significant (p = 0.0004) increase in accuracy throughout consecutive audits. The DQMIS was successful, despite an increase from 20 to 130 data collectors. In the absence of widely disseminated data quality methods and standards for large RCT interventions in limited-resource settings, we developed an integrated DQA system, combining auditing, rapid data feedback, and supportive supervision, which ensured high-quality data and could serve as a model for future health systems research trials. Future efforts should focus on standardization of DQA processes for health systems research. ClinicalTrials.gov identifier, NCT02148952 . Registered on 13 February 2014.

Predictors of Sexually Transmitted Infections among Female Sex Workers (FSWs) in a City of Northern India

PubMed Central

Shukla, Pallavi; Masood, Jamal; Singh, J. V.; Singh, V. K.; Gupta, Abhishek; Krishna, Asuri

2015-01-01

Introduction: Sexually transmitted infections (STIs) and Reproductive tract infections RTIs are important public health problems in India. The prevalence of these infections is considerably higher among high risk groups (HRGs) ranging from 20-30%. It is high time that a study should be conducted to explore different factors and conditions responsible for the practice of unsafe sex among female sex workers (FSWs) in Uttar Pradesh (UP) and the impact of this on social life and health of FSWs. As Lucknow provides a comprehensive opportunity in terms of tourism, occupation, and economy, it becomes a potential hub for sex work. Studying FSW in Lucknow can thus be considered as a yardstick for the entire FSW population of UP population. The present study was thus planned with the objective of knowing the STI prevalence and its determinants among FSWs. Materials and Methods: A cross-sectional descriptive study was conducted on FSWs registered with Targeted Intervention-Non-government Organization (TI-NGO), registered with Uttar Pradesh State Acquired Immuno Deficiency Syndrome (AIDS) Control Society (UPSACS) of Lucknow city. Total 288 subjects were studied. Results: The average age of FSWs was 31 years. FSWs were mostly Hindus and illiterate. The overall prevalence of STI as per Syndromic diagnosis was found to be 35.8%. However, the percentage of FSWs with STI was higher in street-based (50.6%) than home-based (29.8%). Majority (42.7%) of sex workers with STI had non-regular partners only while majority (52.4%) of sex workers without any STI had only regular partners. Condom usage with regular partners was poor. However, with the non-regular partners the condom usage was better. On multivariate analysis being single, having sex work as a sole means of earning, duration of sex work > 2 years, having pallor, and giving in to client's demand for unsafe sex were found to be significant in causing STI. Conclusions: Prevalence of STI among the female sex workers as per Syndromic diagnosis was found to be 35.8%. Unemployment, anemia, and having sex without condom for extra money, failure to persuade the client and not doing anything were found to be important predictors for presence of STI. PMID:25861174

Under the banyan tree--exclusion and inclusion of people with mental disorders in rural North India.

PubMed

Mathias, Kaaren; Kermode, Michelle; San Sebastian, Miguel; Koschorke, Mirja; Goicolea, Isabel

2015-05-01

Social exclusion is both cause and consequence of mental disorders. People with mental disorders (PWMD) are among the most socially excluded in all societies yet little is known about their experiences in North India. This qualitative study aims to describe experiences of exclusion and inclusion of PWMD in two rural communities in Uttar Pradesh, India. In-depth interviews with 20 PWMD and eight caregivers were carried out in May 2013. Interviews probed experiences of help-seeking, stigma, discrimination, exclusion, participation, agency and inclusion in their households and communities. Qualitative content analysis was used to generate codes, categories and finally 12 key themes. A continuum of exclusion was the dominant experience for participants, ranging from nuanced distancing, negative judgements and social isolation, and self-stigma to overt acts of exclusion such as ridicule, disinheritance and physical violence. Mixed in with this however, some participants described a sense of belonging, opportunity for participation and support from both family and community members. These findings underline the urgent need for initiatives that increase mental health literacy, access to services and social inclusion of PWMD in North India, and highlight the possibilities of using human rights frameworks in situations of physical and economic violence. The findings also highlight the urgent need to reduce stigma and take actions in policy and at all levels in society to increase inclusion of people with mental distress and disorders.

Gender inequality and the risk of HIV among married couples in North India.

PubMed

Bloom, Shelah S; Agrawal, Alpna; Singh, Kaushalendra K; Suchindran, Chirayath M

2015-01-01

This study investigated the distribution and determinants of HIV risks among married couples in North India. Gender inequality emerged as a potential driver of HIV risks in this region. Data collection took place in 2003 in a probability survey of 3385 couples living in India's most populous state - Uttar Pradesh - and Uttaranchal. Couples' analyses utilizing generalized estimating equations showed that compared with husbands, wives were less knowledgeable about HIV (OR = 0.31, 95% CI = 0.27-0.36), more likely to consider themselves at risk for infection (OR = 6.86, 95% CI = 4.65-10.13), and less likely to feel that a wife had the right to refuse sex with her husband (OR = 0.50, 95% CI = 0.44-0.58). The proportion of husbands reporting non-marital sex in the past year was 7.1% and transactional sex in the past year, 2.2%. Among their wives, 73.4% were unaware of their husbands' non-marital sexual behaviors and only 28.9% of husbands reported condom use during their last non-marital sexual encounter. Logistic regression analyses showed that husbands' alcohol use, husbands' mobility, and urban residence were positively associated with husbands' non-marital sexual behaviors adjusting for other covariates. The data demonstrate that HIV prevention programs among couples in North India should consider both sexual risks and gender inequalities which potentially fuel HIV spread in this region.

Fertility level changes in India.

PubMed

Sarkar, B N

1989-12-01

Survey data from India consistently show that female education above the primary school-level is the most powerful determinant of lowered fertility. The Government of India's strategies of increasing accessibility to family planning methods and improving the population's quality of life have been impeded by low levels of female education. The finding that rural women experience 0.8 more live births than their urban counterparts is a reflection of the higher education of the latter group. Within Calcutta, females in slum areas had an average of 5.6 live births compared to 3.5 births among those from nonslum parts of the city, again reflecting the influence of education on fertility. In the high-fertility states of Uttar Pradesh, Rajasthan, Bihar, Madhyapradesh, Haryana, and Jammu and Kashmir, the percentage of females with an education above the primary level is under 5%. The intermediate variable of education beyond primary school seems to exert its effect on fertility by both raising the age at marriage and promoting use of modern contraceptive methods. Women with 1-4 years of education comprise the majority of sterilization acceptors; however, this minimal amount of education is not sufficient to motivate women to delay marriage and to use family planning methods to space births. Given the critical importance of female education, authorities in India should design extension programs and door-to-door campaigns to motivate parents to send their daughters to school and keep them enrolled.

Leprosy trends at a tertiary care hospital in Mumbai, India, from 2008 to 2015.

PubMed

Muthuvel, Thirumugam; Isaakidis, Petros; Shewade, Hemant Deepak; Kattuppara, Lucy; Singh, Rajbir; Govindarajulu, Srinivas

2016-01-01

Leprosy remains an important cause of preventable disabilities. After the advent of multidrug therapy, new leprosy cases have come down dramatically. Despite this achievement, India, which contributes 60% of the global leprosy burden, faces some challenges to eliminate the disease, including active transmission in the community and delayed diagnosis of leprosy patients. The objectives of the study were 1) to determine sociodemographic and clinical characteristics of newly diagnosed adults and children (less than 15 years) with leprosy and their trends over time (2008-2015) and 2) to describe the profile of surgical procedures among leprosy patients registered for reconstructive surgeries during 2006-2015. Retrospective descriptive study was conducted involving a record review of new patients with leprosy registered in Vimala Dermatological Centre, Mumbai. A total of 578 new leprosy cases were registered in the hospital during 2008-2015. There has been a steady increase in the trend of child cases (less than 15 years) registered in the facility (from 3% in 2008 to 18% in 2015), x 2 =12.11, p< 0.01. The majority of the patients (68%) were migrants of Uttar Pradesh and Bihar. Targeting children and migrants and ensuring early diagnosis and treatment initiation are essential components for leprosy elimination in an urban metropolis in India.

Undiagnosed mandibular condylar fractures causing temporomandibular joint ankylosis: A problem in northern India.

PubMed

Nagori, Shakil Ahmed; Jose, Anson; Bhutia, Ongkila; Roychoudhury, Ajoy

2014-01-01

Temporomandibular joint (TMJ) ankylosis due to undiagnosed condylar fractures has a high incidence in India compared to western countries. We evaluated the demographics, injury pattern, hospital reporting and referral pattern of undiagnosed condylar fractures complicating TMJ ankylosis in northern India. We did a retrospective analysis by retrieving medical records of patients with post-traumatic TMJ ankylosis reporting to the Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences between 1 July 2012 and 30 June 2013. Of 90 patients with post-traumatic TMJ ankylosis, 74 (82.2%) resided in rural areas. Sixty-three (70%) patients were from the states of Uttar Pradesh, Bihar and Jharkhand. Only 8.8% had higher education and 10% had an annual income of more than `2 lakh. In 69 (84.4%) patients, fall was the aetiological factor. Primary health centres (42%) and private clinics (20.5%) received the major share of patients immediately following injury. Few patients (19.3%) had some radiographic examination done and only 17% were referred by the primary healthcare provider. Of those referred only 3 were examined by a dental practitioner. Only 10% of all were diagnosed with condylar fractures. Patients with TMJ ankylosis presenting to us have poor literacy and income levels. A missed diagnosis of condylar fractures by rural healthcare providers contributes to its high incidence in India. Improving awareness of clinicians and improved rural healthcare infrastructure can help prevent this complication. Copyright 2014, NMJI.

Public health interventions, barriers, and opportunities for improving maternal nutrition in India.

PubMed

Ramakrishnan, Usha; Lowe, Alyssa; Vir, Sheila; Kumar, Shuba; Mohanraj, Rani; Chaturvedi, Anuraag; Noznesky, Elizabeth A; Martorell, Reynaldo; Mason, John B

2012-06-01

Inadequate nutrient intake, early and multiple pregnancies, poverty, caste discrimination, and gender inequality contribute to poor maternal nutrition in India. While malnutrition is seen throughout the life cycle, it is most acute during childhood, adolescence, pregnancy, and lactation. Although nutrition policies are on the books and interventions are in place, child malnutrition and maternal undernutrition persist as severe public health problems. To evaluate the implementation of maternal nutrition programs in India. The research was conducted in two phases. Phase 1 consisted of a desk review of national and state policies pertinent to maternal nutrition and national-level key informant interviews with respondents who have a working knowledge of relevant organizations and interventions. Phase 2 utilized in-depth interviews and focus group discussions at the state, district, and community levels in eight districts of two states: Tamil Nadu and Uttar Pradesh. All data were analyzed thematically. India has a rich portfolio of programs and policies that address maternal health and nutrition; however, systematic weaknesses, logistical gaps, resource scarcity, and poor utilization continue to hamper progress. Elevating the priority given to maternal nutrition in government health programs and implementing strategies to improve women's status will help to address many of the challenges facing India's nutrition programs. Programs can be strengthened by promoting integration of services, ensuring effective procurement mechanisms for micronutrient and food supplements, establishing regional training facilities for improved program implementation, and strengthening program monitoring and evaluation.

Why gender matters in the solution towards safe sanitation? Reflections from rural India.

PubMed

Khanna, Tina; Das, Madhumita

2016-12-01

While the topic of women and water, sanitation and hygiene is a widely accepted concern among academics and activists, it continues to be an issue in developing countries with serious consequences. Based on a qualitative research conducted in rural Uttar Pradesh, India, the paper affirms that sanitation issues for women and girls are compounded by inequitable gender norms that put them at greater risk of experiencing violence and multiple health vulnerabilities. Women, despite having a high demand for safe toilet facilities, continue to practise unsafe sanitation. The findings highlight the role of three structural constraints as the key factors influencing toilet construction and use: poverty, inadequate sanitation policy and its implementation and gender-based power dynamics at the household level. The paper concludes by emphasising the relevance of engendering sanitation programmes and policies by involving women and girls in the planning process to ensure that dignified and gender-sensitive sanitation solutions are developed. The paper also stresses the need to have measures for strengthening and effectively implementing a sanitation policy for the poor and for programmes to work with both men and women to address gender power relations which influence toilet adoption and use.

Cash transfers, maternal depression and emotional well-being: Quasi-experimental evidence from India's Janani Suraksha Yojana programme.

PubMed

Powell-Jackson, Timothy; Pereira, Shreya K; Dutt, Varun; Tougher, Sarah; Haldar, Kaveri; Kumar, Paresh

2016-08-01

Maternal depression is an important public health concern. We investigated whether a national-scale initiative that provides cash transfers to women giving birth in government health facilities, the Janani Suraksha Yojana (JSY), reduced maternal depression in India's largest state, Uttar Pradesh. Using primary data on 1695 women collected in early 2015, our quasi-experimental design exploited the fact that some women did not receive the JSY cash due to administrative problems in its disbursement - reasons that are unlikely to be correlated with determinants of maternal depression. We found that receipt of the cash was associated with an 8.5% reduction in the continuous measure of maternal depression and a 36% reduction in moderate depression. There was no evidence of an association with measures of emotional well-being, namely happiness and worry. The results suggest that the JSY had a clinically meaningful effect in reducing the burden of maternal depression, possibly by lessening the financial strain of delivery care. They contribute to the evidence that financial incentive schemes may have public health benefits beyond improving uptake of targeted health services. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Peri-Urbanism in Globalizing India: A Study of Pollution, Health and Community Awareness.

PubMed

Waldman, Linda; Bisht, Ramila; Saharia, Rajashree; Kapoor, Abhinav; Rizvi, Bushra; Hamid, Yasir; Arora, Meghana; Chopra, Ima; Sawansi, Kumud T; Priya, Ritu; Marshall, Fiona

2017-08-30

This paper examines the intersection between environmental pollution and people's acknowledgements of, and responses to, health issues in Karhera, a former agricultural village situated between the rapidly expanding cities of New Delhi (India's capital) and Ghaziabad (an industrial district in Uttar Pradesh). A relational place-based view is integrated with an interpretive approach, highlighting the significance of place, people's emic experiences, and the creation of meaning through social interactions. Research included surveying 1788 households, in-depth interviews, participatory mapping exercises, and a review of media articles on environment, pollution, and health. Karhera experiences both domestic pollution, through the use of domestic waste water, or gandapani , for vegetable irrigation, and industrial pollution through factories' emissions into both the air and water. The paper shows that there is no uniform articulation of any environment/health threats associated with gandapani . Some people take preventative actions to avoid exposure while others do not acknowledge health implications. By contrast, industrial pollution is widely noted and frequently commented upon, but little collective action addresses this. The paper explores how the characteristics of Karhera, its heterogeneous population, diverse forms of environmental pollution, and broader governance processes, limit the potential for citizen action against pollution.

Maternal dietary diversity and odds of low birth weight: empirical findings from India.

PubMed

Rammohan, Anu; Goli, Srinivas; Singh, Deepti; Ganguly, Dibyasree; Singh, Uma

2018-06-19

India has the highest proportion of low birth weight (LBW) babies born in the developing world. Poor maternal nutrition during pregnancy is associated with adverse infant health outcomes. The main objective of this paper was to assess the socioeconomic factors associated with dietary diversity among pregnant women and to investigate the association between maternal dietary diversity and LBW among their babies. The data for these analyses were derived from a survey conducted in November and December, 2014 among 230 women who had newly delivered in hospitals in Uttar Pradesh, the largest Indian state which has the poorest maternal outcomes in the country. The results from multivariate binary logistic regression model indicated that low maternal education and economic status was significantly associated with poor dietary diversity among participants. Also, women with low maternal dietary diversity had a significantly higher proportion of LBW babies compared to those in the medium to high dietary diversity categories. From a policy perspective, these findings suggest that continuous tracking of pregnant women's nutritional needs through existing monitoring systems, e.g., the Nutrition Resource Platform and Health Management Information System, and necessary interventions through Integrated Child Development Services may yield better results, thereby, addressing maternal under-nutrition and LBW.

Associations between wife-beating and fetal and infant death: impressions from a survey in rural India.

PubMed

Jejeebhoy, S J

1998-09-01

This report examines the linkages between wife-beating and one health-related consequence for women, their experience of fetal and infant mortality. Community-based data are used drawn from women surveyed in two culturally distinct sites of rural India: Uttar Pradesh in the north, in which gender relations are highly stratified, and Tamil Nadu in the south, in which they are more egalitarian. Results suggest that wife-beating is deeply entrenched, that attitudes uniformly justify wife-beating, and that few women can escape an abusive marriage. They also suggest that the health consequences of domestic violence--in terms of pregnancy loss and infant mortality--are considerable and that Indian women's experience of infant and fetal mortality is powerfully conditioned by the strength of the patriarchal social system. Results are tentative because of data limitations, but they are consistent and strong enough to warrant concern. They argue for the integration of services to identify, refer, and prevent domestic violence in the primary or reproductive health programs of the country and for the safe motherhood programs to be particularly vigilant, sensitive, and responsive to the conditions of battered women during pregnancy and the postpartum period.

Molecular Characterization of Geographically Different Banana bunchy top virus Isolates in India.

PubMed

Selvarajan, R; Mary Sheeba, M; Balasubramanian, V; Rajmohan, R; Dhevi, N Lakshmi; Sasireka, T

2010-10-01

Banana bunchy top disease (BBTD) caused by Banana bunchy top virus (BBTV) is one of the most devastating diseases of banana and poses a serious threat for cultivars like Hill Banana (Syn: Virupakshi) and Grand Naine in India. In this study, we have cloned and sequenced the complete genome comprised of six DNA components of BBTV infecting Hill Banana grown in lower Pulney hills, Tamil Nadu State, India. The complete genome sequence of this hill banana isolate showed high degree of similarity with the corresponding sequences of BBTV isolates originating from Lucknow, Uttar Pradesh State, India, and from Fiji, Egypt, Pakistan, and Australia. In addition, sixteen coat protein (CP) and thirteen replicase genes (Rep) sequences of BBTV isolates collected from different banana growing states of India were cloned and sequenced. The replicase sequences of 13 isolates showed high degree of similarity with that of South Pacific group of BBTV isolates. However, the CP gene of BBTV isolates from Shervroy and Kodaikanal hills of Tamil Nadu showed higher amino acid sequence variability compared to other isolates. Another hill banana isolate from Meghalaya state had 23 nucleotide substitutions in the CP gene but the amino acid sequence was conserved. This is the first report of the characterization of a complete genome of BBTV occurring in the high altitudes of India. Our study revealed that the Indian BBTV isolates with distinct geographical origins belongs to the South Pacific group, except Shervroy and Kodaikanal hill isolates which neither belong to the South Pacific nor the Asian group.

Agrobotanical attributes, nitrogen-fixation, enzyme activities and nutraceuticals and tyrosinase enzyme of hyacinth bean (Lablab purpureus L.) - a bio-functional medicinal legume.

USDA-ARS?s Scientific Manuscript database

Hyacinth bean (Lablab purpureus L.) accessions of different origins received from USDA, ARS, Plant Genetic Resources Conservation Unit, Griffin, GA, U.S.A. were evaluated for agrobotanical attributes, enzyme activities, nutraceuticals and quality in pot culture at AMU, Aligarh, Uttar Pradesh. Fresh ...

Girl prostitution in India.

PubMed

Mukhopadhyay, K K

1995-01-01

This article discusses the nature, magnitude, causes, and consequences of female child prostitution in India and offers measures for control and prevention of girl prostitution. Data are obtained from the 6-city study of prostitution and the author's own research. An estimated 85% of all prostitutes in Calcutta and Delhi entered the work at an early age. The numbers are rising. The promotion of tourism is linked with prostitution. Girl prostitutes are primarily located in low-middle income areas and business districts and are known by officials. Brothel keepers regularly recruit young girls. An estimated 33% of prostitutes are young girls. In Bangalore, Calcutta, Delhi, and Hyderabad, there are an estimated 10,000 girl prostitutes. UNICEF estimates about 300,000 child prostitutes. Girl prostitutes are grouped as common prostitutes, singers and dancers, call girls, religious prostitutes or devdasi, and caged brothel prostitutes. Religious prostitutes are mainly found in the South. Caged ones are found in Bombay. A little over 50% of prostitutes come from other countries, such as Nepal and Bangladesh. The girls tend to come from urban slums and poor rural areas. High prostitute supply regions include Andhra Pradesh, Karnataka, Maharashtra, Uttar Pradesh, Tamil Nadu, and West Bengel states. About 85% are Hindus, and about 66% are from scheduled castes and tribes. Bangalore and Bombay have a higher proportion of girl prostitutes. The causes of prostitution include ill treatment by parents, bad company, family prostitutes, social customs, inability to arrange marriage, lack of sex education, media, prior incest and rape, early marriage and desertion, lack of recreational facilities, ignorance, and acceptance of prostitution. Economic causes include poverty and economic distress. Psychological causes include desire for physical pleasure, greed, and dejection. Most enter involuntarily. A brief profile is given of the life of a prostitute.

Care-seeking behavior and out-of-pocket expenditure for sick newborns among urban poor in Lucknow, northern India: a prospective follow-up study.

PubMed

Srivastava, Neeraj M; Awasthi, Shally; Agarwal, Girdhar G

2009-04-02

The state of Uttar Pradesh, India accounts for one-quarter of India's neonatal deaths and 8 percent of those worldwide. More than half (52%) of these deaths occur due to infections. In order to achieve Millennium Development Goal-4 of reducing child mortality by two-thirds by the year 2015, it is important to study factors which affect neonatal health. In Uttar Pradesh there is meager data for spending on health care in general and neonates in particular. The study was conducted at an urban Reproductive and Child Health (RCH) center and a District hospital. Neonates were enrolled within 48 hours of birth and were followed-up once at 6 weeks +/- 15 days at the OPD of the respective hospitals or at home. This study assessed (1) distribution of neonatal illnesses and different health providers sought (2) distribution of out-of-pocket expenditures by type of illness and type of health provider sought (3) socio-economic distribution of neonatal illnesses, care-seeking behavior and out-of-pocket expenditures. Per-protocol analysis was performed. Five hundred and ten neonates were enrolled and 481(94.4%) were followed-up. Parents of 50.3% (242/481) neonates reported at least one symptom of illness. Of these 22.3% (107/481) neonates had illnesses with at least one reported Integrated Management of Neonatal and Childhood Illnesses (IMNCI) danger sign. Among IMNCI illnesses, point prevalence of septicemia was 6.2% and pneumonia was 5.2% while among non-IMNCI illnesses point prevalence of upper respiratory infection was 9.5%, and diarrhea was 7%. Community based non-government dispensers (NGDs) were leading health providers (37.6%). Mean monthly income of families was 2804 Indian Rupees (INR) (range: 800 to 14000; n = 510), where US$ 1 = 42 INR. Mean out-of-pocket expenditure on neonatal illness was 547.5 INR (range: 1 to 15000; n = 202) and mean out-of-pocket expenditure for hospitalization was 4993 INR (range: 41 to 15000; n = 17). All hospitalizations were for IMNCI illnesses. Neonates from lower income strata were less likely to receive any medical care (p < 0.0001) and were also less likely to be seen by a Government provider (p = 0.03). Since more than half of the neonates have morbidity and out-of-pocket expenditure on neonatal illnesses often exceeds the family income of the lower strata of the low income group in the community, there is a need to either introduce health insurance scheme or subsidize health care for them. Also, since NGDs, half of which could be unqualified are leading health providers, qualified medical care-seeking for sick newborns should be promoted in urban Lucknow.

Care-seeking behavior and out-of-pocket expenditure for sick newborns among urban poor in Lucknow, northern India: a prospective follow-up study

PubMed Central

Srivastava, Neeraj M; Awasthi, Shally; Agarwal, Girdhar G

2009-01-01

Background The state of Uttar Pradesh, India accounts for one-quarter of India's neonatal deaths and 8 percent of those worldwide. More than half (52%) of these deaths occur due to infections. In order to achieve Millennium Development Goal-4 of reducing child mortality by two-thirds by the year 2015, it is important to study factors which affect neonatal health. In Uttar Pradesh there is meager data for spending on health care in general and neonates in particular. Methods The study was conducted at an urban Reproductive and Child Health (RCH) center and a District hospital. Neonates were enrolled within 48 hours of birth and were followed-up once at 6 weeks ± 15 days at the OPD of the respective hospitals or at home. This study assessed (1) distribution of neonatal illnesses and different health providers sought (2) distribution of out-of-pocket expenditures by type of illness and type of health provider sought (3) socio-economic distribution of neonatal illnesses, care-seeking behavior and out-of-pocket expenditures. Per-protocol analysis was performed. Results Five hundred and ten neonates were enrolled and 481(94.4%) were followed-up. Parents of 50.3% (242/481) neonates reported at least one symptom of illness. Of these 22.3% (107/481) neonates had illnesses with at least one reported Integrated Management of Neonatal and Childhood Illnesses (IMNCI) danger sign. Among IMNCI illnesses, point prevalence of septicemia was 6.2% and pneumonia was 5.2% while among non-IMNCI illnesses point prevalence of upper respiratory infection was 9.5%, and diarrhea was 7%. Community based non-government dispensers (NGDs) were leading health providers (37.6%). Mean monthly income of families was 2804 Indian Rupees (INR) (range: 800 to 14000; n = 510), where US$ 1 = 42 INR. Mean out-of-pocket expenditure on neonatal illness was 547.5 INR (range: 1 to 15000; n = 202) and mean out-of-pocket expenditure for hospitalization was 4993 INR (range: 41 to 15000; n = 17). All hospitalizations were for IMNCI illnesses. Neonates from lower income strata were less likely to receive any medical care (p < 0.0001) and were also less likely to be seen by a Government provider (p = 0.03). Conclusion Since more than half of the neonates have morbidity and out-of-pocket expenditure on neonatal illnesses often exceeds the family income of the lower strata of the low income group in the community, there is a need to either introduce health insurance scheme or subsidize health care for them. Also, since NGDs, half of which could be unqualified are leading health providers, qualified medical care-seeking for sick newborns should be promoted in urban Lucknow. PMID:19341473

Willingness to pay for cattle and buffalo insurance: an analysis of dairy farmers in central India.

PubMed

Khan, Mohd Ameer; Chander, Mahesh; Bardhan, Dwaipayan

2013-02-01

In India, insurance market especially in agricultural sector is usually underdeveloped. The idea of livestock insurance emerged in India before three decades, yet, it has not operated in a significant way till date. It is well noted that livestock insurance scheme is the relevant strategy in managing different risks related to livestock farming but very little attention has been paid to address the livestock insurance needs of the dairy farmers. This study, therefore, addresses the basic question that how many people and to what extent they are willing to pay for livestock insurance and determine the main factors which influence insurance participation of dairy farmers. The data was collected from Gorakhpur district of Uttar Pradesh in India with a sample survey of 120 cattle and buffalo farmers. For eliciting willingness to pay, a contingent valuation scenario was presented to dairy animal owners in the group of five to six. A logit discrete binary regression model was used to know the factors influencing adoption of livestock insurance. The results suggest that most of the farmers were willing to participate in cattle and buffalo insurance. The amount of premium varies across different breeds of dairy animals. The low level of education of many dairy farmers have negatively influenced the decision to purchase livestock insurance. Farmers having more experience in rearing dairy animals are more likely to be willing to pay for cattle and buffalo insurance.

Complete genome sequence of mumps viruses isolated from patients with parotitis, pancreatitis and encephalitis in India.

PubMed

Vaidya, Sunil R; Chowdhury, Deepika T; Jadhav, Santoshkumar M; Hamde, Venkat S

2016-04-01

Limited information is available regarding epidemiology of mumps in India. Mumps vaccine is not included in the Universal Immunization Program of India. The complete genome sequences of Indian mumps virus (MuV) isolates are not available, hence this study was performed. Five isolates from bilateral parotitis and pancreatitis patients from Maharashtra, a MuV isolate from unilateral parotitis patient from Tamil Nadu, and a MuV isolate from encephalitis patient from Uttar Pradesh were genotyped by the standard protocol of the World Health Organization and subsequently complete genomes were sequenced. Indian MuV genomes were compared with published MuV genomes, including reference genotypes and eight vaccine strains for the genetic differences. The SH gene analysis revealed that five MuV isolates belonged to genotype C and two belonged to genotype G strains. The percent nucleotide divergence (PND) was 1.1% amongst five MuV genotype C strains and 2.2% amongst two MuV genotype G strains. A comparison with widely used mumps Jeryl Lynn vaccine strain revealed that Indian mumps isolates had 54, 54, 53, 49, 49, 38, and 49 amino acid substitutions in Chennai-2012, Kushinagar-2013, Pune-2008, Osmanabad-2012a, Osmanabad-2012b, Pune-1986 and Pune-2012, respectively. This study reports the complete genome sequences of Indian MuV strains obtained in years 1986, 2008, 2012 and 2013 that may be useful for further studies in India and globally. Copyright © 2016 Elsevier B.V. All rights reserved.

Genomic characterization of two new enterovirus types, EV-A114 and EV-A121.

PubMed

Deshpande, Jagadish M; Sharma, Deepa K; Saxena, Vinay K; Shetty, Sushmitha A; Qureshi, Tarique Husain I H; Nalavade, Uma P

2016-12-01

Enteroviruses cause a variety of illnesses of the gastrointestinal tract, central nervous system and cardiovascular system. Phylogenetic analysis of VP1 sequences has identified 106 different human enteroviruses classified into four enterovirus species within the genus Enterovirus of the family Picornaviridae. It is likely that not all enterovirus types have been discovered. Between September 2013 and October 2014, stool samples of 6274 apparently healthy children of up to 5 years of age residing in Gorakhpur district, Uttar Pradesh, India were screened for enteroviruses. Virus isolates obtained in RD and Hep-2c cells were identified by complete VP1 sequencing. Enteroviruses were isolated from 3042 samples. A total of 87 different enterovirus types were identified. Two isolates with 71 and 74 % nucleotide sequence similarity to all other known enteroviruses were recognized as novel types. In this paper we report identification and complete genome sequence analysis of these two isolates classified as EV-A114 and EV-A121.

57Fe Mössbauer study of the chainpur meteorite

NASA Astrophysics Data System (ADS)

Elewa, Nancy N.; Cobas, R.; Cadogan, J. M.

2016-12-01

The Chainpur meteorite is one of 23 ordinary chondrites classified as LL3-type (low-Fe & low-metal). It was observed as a shower of stones falling on May 9, 1907 in Uttar Pradesh, India. We report here the characterization of the Fe-bearing phases in this chondrite using 57Fe Mössbauer spectroscopy carried out at 298 K, 120 K, 50 K and 13 K. The paramagnetic doublets of olivine and pyroxene dominate the room temperature spectrum, accounting for around 70 % of the spectral area. Moreover, a doublet present with a spectral area of 5 % and assigned to a superparamagnetic Fe 3+ phase is a consequence of terrestrial weathering. On the basis of the measured 57Fe electric quadrupole splitting of the olivine component at room temperature we estimate the mean Fe:Mg ratio in this meteoritic olivine to be around 35:65 % although there is clearly a wide range of composition. The effects of magnetic ordering of the major components olivine and pyroxene are observed at 13 K.

Forensic odontology as a victim identification tool in mass disasters: A feasibility study in the Indian scenario

PubMed Central

Sengupta, Shamindra; Sharma, Vandana; Gupta, Vineeta; Vij, Hitesh; Vij, Ruchieka; Prabhat, Kanika

2014-01-01

Aim: The aim of this study was to evaluate the awareness of practicing dentists about the subject of forensic odontology and to assess their willingness to maintain and share patient records. Materials and Methods: A blind questionnaire survey was carried out among 100 randomly selected practicing dentists in district Ghaziabad, Uttar Pradesh. Results: Most of the dentists interviewed were familiar with the subject of forensic odontology and its relation to dentistry, despite forensic dentistry having been newly introduced since 2007 into the undergraduate dental curriculum in India. However, dental records are maintained by only a few dentists, and only a very small percentage of them reported to have shared records, which may have helped in the identification of victims in a mass disaster. Conclusion: The result of our survey concluded that more awareness needs to be developed among practicing dentists regarding maintaining and sharing patient records for forensic odontology to succeed as a victim identification tool. PMID:24695834

What Characterises Women Vulnerable to Chronic Energy Deficiency?

ERIC Educational Resources Information Center

Kavi Kumar, K. S.; Ramachandran, Maithili; Viswanathan, Brinda

2009-01-01

Weight-for-squared height or body mass index (BMI) is often considered as an effective predictor of morbidity and mortality rates. This study uses BMI data from a sample of ever-married women in the age group of 15-49 years in the North Indian state of Uttar Pradesh for the year 1998-1999, to analyse the determinants of chronic energy deficiency…

Has the Janani Suraksha Yojana (a conditional maternity benefit transfer scheme) succeeded in reducing the economic burden of maternity in rural India? Evidence from the Varanasi district of Uttar Pradesh

PubMed Central

Mukherjee, Saradiya; Singh, Aditya

2018-01-01

Background One of the constraints in the utilisation of maternal healthcare in India is the out-of-pocket expenditure. To improve the utilisation and to reduce the out-of-pocket expenditure, India launched a cash incentive scheme, Janani Suraksha Yojana (JSY), which provides monetary incentive to the mothers delivering in public facility. However, no study has yet examined the extent to which the JSY payments reduce the maternal healthcare induced catastrophic out-of-pocket expenditure burden of the households. This paper therefore attempts to examine the extent to which the JSY reduces the catastrophic expenditure estimate household expenditure on maternity, i.e., all direct and indirect expenditure. Materials and methods The study used data on 396 mothers collected through a primary survey conducted in the rural areas of the Varanasi district of Uttar Pradesh state in 2013-2014. The degree and variation in the catastrophic impact of households’ maternity spending was computed as share of out-of-pocket payment in total household income in relation to specific thresholds, across socioeconomic categories. Logistic regression was used to understand the determinants of catastrophic expenditure and whether the JSY has any role in influencing the expenditure pattern. Results Results revealed that the JSY beneficiaries on an average spent about 8.3% of their Annual Household Consumption Expenditure on maternity care. The JSY reimbursement could reduce this share only by 2.1%. The study found that the expenditure on antenatal and postnatal care made up a significant part of the direct medical expenditure on maternity among the JSY beneficiaries. The indirect or non-medical expenditure was about four times higher than the direct expenditure on maternity services. The out-of-pocket expenditure across income quintiles was found to be regressive i.e. the poor paid a greater proportion of their income towards maternity care than the rich. Results also showed that the JSY reimbursement helped only about 8% households to escape from suffering catastrophic burden due to maternity payments. Conclusions It can be concluded that the JSY appeared to have achieved only a limited success in reducing the economic burden due to maternity. To reduce the catastrophic burden, policy makers should consider increasing the JSY reimbursement to cover not only antenatal and postnatal services but also non-medical expenditure due to maternity. The government should also take appropriate measures to curb non-medical or indirect expenditure in public health facilities. Significance for public healthImproving the well-being of mothers is an important public health goal for India. For improving maternal health, it is necessary that mothers utilize maternity services. However, maternity often becomes an economic burden, especially for disadvantaged and poorer groups of the society. To encourage mothers to utilize services, India launched a conditional maternity benefit transfer scheme back in 2005. This study explored whether the scheme has been able to help alleviate the burden of maternity expenditure or not. The study finds that the scheme has been successful only partially to reduce outof- pocket expenditure suggesting that maternity is a costly affair in rural India. Since the scheme is unable to save mothers from catastrophic expenditures, it is also unable to save mothers from a wide ranges of health illeffects caused by catastrophic expenditure. PMID:29780760

Improving Adherence to Essential Birth Practices Using the WHO Safe Childbirth Checklist With Peer Coaching: Experience From 60 Public Health Facilities in Uttar Pradesh, India

PubMed Central

Marx Delaney, Megan; Maji, Pinki; Kalita, Tapan; Kara, Nabihah; Rana, Darpan; Kumar, Krishan; Masoinneuve, Jenny; Cousens, Simon; Gawande, Atul A; Kumar, Vishwajeet; Kodkany, Bhala; Sharma, Narender; Saurastri, Rajiv; Pratap Singh, Vinay; Hirschhorn, Lisa R; Semrau, Katherine EA; Firestone, Rebecca

2017-01-01

Background: Adherence to evidence-based essential birth practices is critical for improving health outcomes for mothers and newborns. The WHO Safe Childbirth Checklist (SCC) incorporates these practices, which occur during 4 critical pause points: on admission, before pushing (or cesarean delivery), soon after birth, and before discharge. A peer-coaching strategy to support consistent use of the SCC may be an effective approach to increase birth attendants' adherence to these practices. Methods: We assessed data from 60 public health facilities in Uttar Pradesh, India, that received an 8-month staggered coaching intervention from December 2014 to September 2016 as part of the BetterBirth Trial, which is studying effectiveness of an SCC-centered intervention on maternal and neonatal harm. Nurse coaches recorded birth attendants' adherence to 39 essential birth practices. Practice adherence was calculated for each intervention month. After 2 months of coaching, a subsample of 15 facilities was selected for independent observation when the coach was not present. We compared adherence to the 18 practices recorded by both coaches and independent observers. Results: Coaches observed birth attendants' behavior during 5,971 deliveries. By the final month of the intervention, 35 of 39 essential birth practices had achieved >90% adherence in the presence of a coach, compared with only 7 of 39 practices during the first month. Key behaviors with the greatest improvement included explanation of danger signs, temperature measurement, assessment of fetal heart sounds, initiation of skin-to-skin contact, and breastfeeding. Without a coach present, birth attendants' average adherence to practices and checklist use was 24 percentage points lower than when a coach was present (range: −1% to 62%). Conclusion: Implementation of the WHO Safe Childbirth Checklist with coaching improved uptake of and adherence to essential birth practices. Coordination and communication among facility staff, as well as behaviors with an immediate, tangible benefit, showed the greatest improvement. Difficult-to-perform behaviors and those with delayed or theoretical benefits were less likely to be sustained without a coach present. Coaching may be an important component in implementing the Safe Childbirth Checklist at scale. (After publication of this article, the impact results of the BetterBirth intervention were published in the New England Journal of Medicine [volume 377, pages 2313-2324, doi: 10.1056/NEJMoa1701075]. The results showed that the intervention had no significant effect on maternal or perinatal mortality or maternal morbidity, despite having positive effects on essential birth practices.) PMID:28655800

Quick control of bubonic plague outbreak in Uttar Kashi, India.

PubMed

Mittal, Veena; Rana, U V S; Jain, S K; Kumar, Kaushal; Pal, I S; Arya, R C; Ichhpujani, R L; Lal, Shiv; Agarwal, S P

2004-12-01

A localized outbreak of bubonic plague occurred in village Dangud (population 332), district Uttar Kashi, Uttaranchal, India in the second week of October 2004. 8 cases were considered outbreak associated based on their clinical and epidemiological characteristics; 3 (27.3%) of them died within 48 hours of developing illness. All the 3 fatal cases and five surviving cases had enlargement of inguinal lymph nodes. None of them had pneumonia. The age of the cases ranged from 23-70 years and both sexes were affected. No such illness was reported from adjoining villages. The outbreak was fully contained within two weeks of its onset by supervised comprehensive chemoprophylaxis using tetracycline. A total of approximately 1250 persons were given chemoprophylaxis in three villages. There was no clear history of rat fall in the village. No flea was found on rodents or animals. 16 animal serum samples were found to be negative for antibodies against F-1 antigen of Y. pestis. However, Y. pestis was isolated from two rodents (Rattus rattus and Mus musculus) trapped in the village. One case and three animal sera showed borderline sero-positivity against rickettsial infection. The diagnosis of plague was confirmed by detection of four fold rise of antibody titre against F-1 antigen of Yersinia pestis in paired sera of three cases (one of the WHO approved criteria of diagnosis of confirmed plague). This outbreak and the occurrence of earlier outbreaks of plague in Surat (Gujarat) and Beed (Maharashtra) in 1994 and in district Shimla (Himachal Pradesh) in 2002 confirm that plague infection continue to exist in sylvatic foci in many parts of India which is transmitted to humans occasionally. Thus, there is a strong need for the States to monitor the plague activity in known sylvatic foci regularly and have a system of surveillance to facilitate prompt diagnosis and treatment of cases to control the disease. This investigation highlights that with high index of suspicion the disease can be diagnosed early and mounting of supervised comprehensive response can prevent the disease to proceed to pneumonic stage where man to man transmission gets established and outbreak assumes larger dimensions.

Role of the private sector in vaccination service delivery in India: evidence from private-sector vaccine sales data, 2009-12.

PubMed

Sharma, Abhishek; Kaplan, Warren A; Chokshi, Maulik; Zodpey, Sanjay P

2016-09-01

India's Universal Immunization Programme (UIP) provides basic vaccines free-of-cost in the public sector, yet national vaccination coverage is poor. The Government of India has urged an expanded role for the private sector to help achieve universal immunization coverage. We conducted a state-by-state analysis of the role of the private sector in vaccinating Indian children against each of the six primary childhood diseases covered under India's UIP. We analyzed IMS Health data on Indian private-sector vaccine sales, 2011 Indian Census data and national household surveys (DHS/NFHS 2005-06 and UNICEF CES 2009) to estimate the percentage of vaccinated children among the 2009-12 birth cohort who received a given vaccine in the private sector in 16 Indian states. We also analyzed the estimated private-sector vaccine shares as function of state-specific socio-economic status. Overall in 16 states, the private sector contributed 4.7% towards tuberculosis (Bacillus Calmette-Guérin (BCG)), 3.5% towards measles, 2.3% towards diphtheria-pertussis-tetanus (DPT3) and 7.6% towards polio (OPV3) overall (both public and private sectors) vaccination coverage. Certain low income states (Uttar Pradesh, Rajasthan, Madhya Pradesh, Orissa, Assam and Bihar) have low private as well as public sector vaccination coverage. The private sector's role has been limited primarily to the high income states as opposed to these low income states where the majority of Indian children live. Urban areas with good access to the private sector and the ability to pay increases the Indian population's willingness to access private-sector vaccination services. In India, the public sector offers vaccination services to the majority of the population but the private sector should not be neglected as it could potentially improve overall vaccination coverage. The government could train and incentivize a wider range of private-sector health professionals to help deliver the vaccines, especially in the low income states with the largest birth cohorts. We recommend future studies to identify strengths and limitations of the public and private health sectors in each Indian state. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparative cost-effectiveness of the components of a behavior change communication campaign on HIV/AIDS in North India.

PubMed

Sood, Suruchi; Nambiar, Devaki

2006-01-01

Numerous studies show that exposure to entertainment-education-based mass media campaigns is associated with reduction in risk behaviors. Concurrently, there is a growing interest in comparing the cost-effectiveness of HIV prevention interventions taking into account infrastructural and programmatic costs. In such analyses, though few in number, mass media campaigns have fared well. Using data from a mass media communication campaign in the low HIV prevalence states of Uttar Pradesh, Rajasthan, and Delhi in Northern India, in this article we examine the following: (1) factors that mediate behavior change in different components of the campaign, comprising a TV drama, reality show for youth audiences, and TV spots; (2) the relative impact of campaign components on the behavioral outcome: condom use; and (3) the cost-effectiveness calculations arising from this analysis. Results suggest that recall of the TV spots and the TV drama influences behavior change and is strongly associated with interpersonal communication and positive gender attitudes. The TV drama, in spite of being the costliest, emerges as the most cost-effective component when considering the behavioral outcome of interest. The analysis of the comparative cost-effectiveness of individual campaign components provides insights into the planning of resources for communication interventions globally.

Environmental risk of heavy metal pollution and contamination sources using multivariate analysis in the soils of Varanasi environs, India.

PubMed

Singh, Shubhra; Raju, N Janardhana; Nazneen, Sadaf

2015-06-01

This study assessed soil pollution in the Varanasi environs of Uttar Pradesh in India. Assessing the concentration of potentially harmful heavy metals in the soils is imperative in order to evaluate the potential risks to human. To identify the concentration and sources of heavy metals and assess the soil environmental quality, 23 samples were collected from different locations covering dumping, road and agricultural area. The average concentrations of the heavy metals were all below the permissible limits according to soil quality guidelines except Cu (copper) and Pb (lead) in dumping and road soils. Soil heavy metal contamination was assessed on the basis of geoaccumulation index (Igeo), pollution index (PI) and integrated pollution index (IPI). The IPI of the metals ranged from 0.59 to 9.94, with the highest IPI observed in the dumping and road soils. A very significant correlation was found between Pb and Cu. The result of principal component analysis suggested that PC1 was mainly affected by the use of agrochemicals, PC2 was affected by vehicular emission and PC3 was affected by dumping waste. Meanwhile, PC4 was mainly controlled by parent material along with anthropogenic activities. Appropriate measures should be taken to minimize the heavy metal levels in soils and thus protect human health.

Characterizing measles transmission in India: a dynamic modeling study using verbal autopsy data.

PubMed

Verguet, Stéphane; Jones, Edward O; Johri, Mira; Morris, Shaun K; Suraweera, Wilson; Gauvreau, Cindy L; Jha, Prabhat; Jit, Mark

2017-08-10

Decreasing trends in measles mortality have been reported in recent years. However, such estimates of measles mortality have depended heavily on assumed regional measles case fatality risks (CFRs) and made little use of mortality data from low- and middle-income countries in general and India, the country with the highest measles burden globally, in particular. We constructed a dynamic model of measles transmission in India with parameters that were empirically inferred using spectral analysis from a time series of measles mortality extracted from the Million Death Study, an ongoing longitudinal study recording deaths across 2.4 million Indian households and attributing causes of death using verbal autopsy. The model was then used to estimate the measles CFR, the number of measles deaths, and the impact of vaccination in 2000-2015 among under-five children in India and in the states of Bihar and Uttar Pradesh (UP), two states with large populations and the highest numbers of measles deaths in India. We obtained the following estimated CFRs among under-five children for the year 2005: 0.63% (95% confidence interval (CI): 0.40-1.00%) for India as a whole, 0.62% (0.38-1.00%) for Bihar, and 1.19% (0.80-1.75%) for UP. During 2000-2015, we estimated that 607,000 (95% CI: 383,000-958,000) under-five deaths attributed to measles occurred in India as a whole. If no routine vaccination or supplemental immunization activities had occurred from 2000 to 2015, an additional 1.6 (1.0-2.6) million deaths for under-five children would have occurred across India. We developed a data- and model-driven estimation of the historical measles dynamics, CFR, and vaccination impact in India, extracting the periodicity of epidemics using spectral and coherence analysis, which allowed us to infer key parameters driving measles transmission dynamics and mortality.

What husbands in northern India know about reproductive health: correlates of knowledge about pregnancy and maternal and sexual health.

PubMed

Bloom, S S; Tsui, A O; Plotkin, M; Bassett, S

2000-04-01

Women in India suffer from a high incidence of reproductive disease, disability and death. Very little work has been done on men, but a much higher incidence of sexual experience outside marriage and sexually transmitted diseases (STDs) among males than previously expected for this population is now being documented. In north India, women are dependent on their husbands and other family members for health-related decisions. Therefore, the behaviour, knowledge and attitudes of men are integral to the reproductive health status of couples there. This study explores knowledge about three distinct areas of reproductive health among 6549 married men in five districts of the northern state of Uttar Pradesh, India. Factors contributing to men's knowledge in the areas of fertility, maternal health and STDs were investigated. Results showed that very few men had basic knowledge in any of these areas. The likelihood of reporting knowledge was associated with a set of determinants that differed in their magnitude and effect across the areas of reproductive health explored. In particular, men's belief about the ability of an individual to prevent pregnancy demonstrated an independent association with men's knowledge. After controlling for factors such as age, parity and educational and economic status, men who believed it not possible to prevent a pregnancy were less likely to know when during the menstrual cycle women would become pregnant and certain facts about STDs, but they were more likely to be able to name two or more symptoms of serious maternal health conditions. Possible explanations for this trend are discussed.

Predictors and consequences of "Phubbing" among adolescents and youth in India: An impact evaluation study.

PubMed

Davey, Sanjeev; Davey, Anuradha; Raghav, Santosh K; Singh, Jai V; Singh, Nirankar; Blachnio, Agata; Przepiórkaa, Aneta

2018-01-01

"Phubbing" phenomenon, in the frequent use of a smartphone, describes the habit of snubbing someone in favor of a mobile phone. Its predictors and consequences are few in developed countries, but the literature lacks information on its actual occurrence and impact on adolescents and youth in a developing country such as India. This impact evaluation study was carried out as part of the Phubbing Project of the University of Poland for 6 months (November 15, 2016-May 15, 2017) on a sample of 400 adolescents and youth selected randomly from the five colleges in the district of Muzaffarnagar of Uttar Pradesh state in India. Data were collected through the Internet using e-questionnaires sent to all students. The phubbing predictors' and consequences' scales available in literature were used and data were analyzed by a mixed method to get the study findings. The prevalence of phubbing was 49.3%. The most important predictors associated with phubbers were Internet addiction ( p < 0.0001, Odds Ratio 2.26), smartphone addiction (OR 25.9), fear of missing out (OR 18.8), and the lack of self-control ( p < 0.0001, OR = 0.73-1.72). Phubbing also had significant consequences on their social health, relationship health, and self-flourishing, and was significantly related to depression and distress. Logistic regression analysis showed significant impact of phubbing predictors on phubbing consequences in phubbers, especially in depressed and distress status. Adolescents and youth of India need special guidance from government adolescent clinics or colleges or even families to control this habit in order to promote better physical, mental, and social health.

Investigation of the prevalence of antibody immunodeficiency in a polio endemic area in India.

PubMed

Mohanty, Madhu C; Deshpande, Jagadish M

2014-05-01

Protection against paralytic poliomyelitis is provided mainly by antibody mediated host defense. Despite intensive oral polio vaccine (OPV) immunization campaigns wild poliovirus transmission could not be stopped in Uttar Pradesh (UP) and Bihar states of India by the end of 2010. The objective of our study was to quantitate serum IgG and IgA in children of western UP, India, to determine the prevalence of antibody immunodeficiency. A cross-sectional survey for IgG and IgA concentrations in serum samples from healthy children and children with acute flaccid paralysis (AFP), up to the age of 5 years, was performed using sandwich ELISA. The overall mean IgG concentration for 1882 children of western UP, India, was 10.57 ± 4.53 (SD) g/L and mean IgA concentration for 979 children was 1.2 ± 0.818 g/L. Two 7-month-old female children had IgG levels below 2 g/L and there was an absence of neutralizing polio antibodies. The mean serum IgG level of children with AFP (n=979) was lower than levels observed in healthy children (n=903). The proportion of children with IgG levels below 2 g/L and IgA levels below 0.07 g/L was 0.7% in both healthy children and AFP cases. There was no abnormal prevalence of immunodeficiency in children in western UP which could have delayed achieving the eradication of polio in the state. The immunoglobulin levels reported here may be used as age-specific normal values for Indian children.

Partition and poliomyelitis: an investigation of the polio disparity affecting Muslims during India's eradication program.

PubMed

Hussain, Rashid S; McGarvey, Stephen T; Fruzzetti, Lina M

2015-01-01

Significant disparities in the incidence of polio existed during its eradication campaign in India. In 2006, Muslims, who comprise 16% of the population in affected states, comprised 70% of paralytic polio cases. This disparity was initially blamed on the Muslims and a rumor that the vaccination program was a plot to sterilize their children. Using the framework of structural violence, this paper describes how the socio-political and historical context of Muslim populations in India shaped the polio disparity. A qualitative study utilizing methods of rapid ethnography was conducted from May-August 2009 in Aligarh, Uttar Pradesh, India. Field methods included participant observation of vaccination teams, historical document research, and 107 interviews with both Global Polio Eradication Initiative (GPEI) stakeholders and families with vaccine-eligible children. Almost all respondents agreed that Aligarh was a highly segregated city, mostly due to riots after Partition and during the 1990s. Since the formation of segregated neighborhoods, most respondents described that "Muslim areas" had been underdeveloped compared to "Hindu areas," facilitating the physical transmission of poliovirus. Distrust of the government and resistance to vaccination were linked to this disparate development and fears of sterilization influenced by the "Family Planning Program" from 1976-1977. Ethnic violence and social marginalization since the Partition and during the rise of Hindu nationalism led to distrust of the government, the formation of segregated slums, and has made Muslims victims of structural violence. This led to the creation of disease-spreading physical environments, lowered vaccine efficacy, and disproportionately higher levels of resistance to vaccination. The causes of the polio disparity found in this study elucidate the nature of possible other health disparities affecting minorities in India. This study is limited by the manual coding of the transcribed data, size, and some dialectal difficulties in translation.

Pesticide residue in water--a challenging task in India.

PubMed

Agarwal, Akriti; Prajapati, Rajmani; Singh, Om Pal; Raza, S K; Thakur, L K

2015-02-01

Modern agriculture practices reveal an increase in use of pesticides to meet the food demand of increasing population which results in contamination of the environment. In India, crop production increased to 100 %, but the cropping area has increased marginally by 20 %. Pesticides have played a major role in achieving the maximum crop production but maximum usage and accumulation of pesticide residues is highly detrimental to aquatic and other ecosystem. Pesticide residues in drinking water have become a major challenge over the last few years. It has been monitored in public water supply resources in National capital territory, i.e., Delhi. Organochlorine pesticides (OCPs), mainly isomers of hexachlorohexane (HCH), dichloro-diphenyl-trichloroethane (DDT), endosulphan, endrin, aldrin, dieldrin, and heptachlore, were identified from potable water samples. Results suggested that continuous consumption of contaminated water can pose severe health threats to local residents of this area. Central Pollution Control Board (CPCB), Delhi, had found α and β isomers of endosulphan residues in the Yamuna river. High concentrations of γ-HCH (0.259 μg/l) and malathion (2.618 μg/l) were detected in the surface water samples collected from the river Ganga in Kanpur, Uttar Pradesh (UP). High concentration of methyl parathion, endosulfan, and DDT were observed in water samples collected from the river at Bhagalpur, Bihar. The Industrial Toxicology Research Centre (ITRC), Lucknow (UP) study also found 0.5671 ppb concentrations of endosulfan in the river at Allahabad, UP. Similar results were found in other water samples in India.

Gender inequality and the risk of HIV among married couples in North India

PubMed Central

Bloom, Shelah S.; Agrawal, Alpna; Singh, Kaushalendra K.; Suchindran, Chirayath M.

2014-01-01

This study investigated the distribution and determinants of HIV risks among married couples in North India. Gender inequality emerged as a potential driver of HIV risks in this region. Data collection took place in 2003 in a probability survey of 3,385 couples living in India’s most populous state – Uttar Pradesh – and Uttaranchal. Couples’ analyses utilizing generalized estimating equations showed that compared with husbands, wives were less knowledgeable about HIV (OR=0.31, 95% CI= 0.27–0.36), more likely to consider themselves at risk for infection (OR=6.86, 95% CI= 4.65–10.13), and less likely to feel that a wife had the right to refuse sex with her husband (OR=0.50, 95% CI= 0.44–0.58). The proportion of husbands reporting non-marital sex in the past year was 7.1% and transactional sex in the past year, 2.2%. Among their wives, 73.4% were unaware of their husbands’ non-marital sexual behaviors and only 28.9% of husbands reported condom use during their last non-marital sexual encounter. Logistic regression analyses showed that husbands’ alcohol use, husbands’ mobility, and urban residence were positively associated with husbands’ non-marital sexual behaviors adjusting for other covariates. The data demonstrate that HIV prevention programs among couples in North India should consider both sexual risks and gender inequalities which potentially fuel HIV spread in this region. PMID:25562412

Poliomyelitis surveillance: the model used in India for polio eradication.

PubMed Central

Banerjee, K.; Hlady, W. G.; Andrus, J. K.; Sarkar, S.; Fitzsimmons, J.; Abeykoon, P.

2000-01-01

Poliomyelitis surveillance in India previously involved the passive reporting of clinically suspected cases. The capacity for detecting the disease was limited because there was no surveillance of acute flaccid paralysis (AFP). In October 1997, 59 specially trained Surveillance Medical Officers were deployed throughout the country to establish active AFP surveillance; 11,533 units were created to report weekly on the occurrence of AFP cases at the district, state and national levels; timely case investigation and the collection of stool specimens from AFP cases was undertaken; linkages were made to support the polio laboratory network; and extensive training of government counterparts of the Surveillance Medical Officers was conducted. Data reported at the national level are analysed and distributed weekly. Annualized rates of non-polio AFP increased from 0.22 per 100,000 children aged under 15 years in 1997 to 1.39 per 100,000 in 1999. The proportion of cases with two adequate stools collected within two weeks of the onset of paralysis increased from 34% in 1997 to 68% in 1999. The number of polio cases associated with the isolation of wild poliovirus decreased from 211 in the first quarter of 1998 to 77 in the first quarter of 1999. Widespread transmission of wild poliovirus types 1 and 3 persists throughout the country; type 2 occurs only in Bihar and Uttar Pradesh. In order to achieve polio eradication in India during 2000, extra national immunization days and house-to-house mopping-up rounds should be organized. PMID:10812728

Health and economic benefits of scaling up a home-based neonatal care package in rural India: a modelling analysis.

PubMed

Nandi, Arindam; Colson, Abigail R; Verma, Amit; Megiddo, Itamar; Ashok, Ashvin; Laxminarayan, Ramanan

2016-06-01

Approximately 900 000 newborn children die every year in India, accounting for 28% of neonatal deaths globally. In 2011, India introduced a home-based newborn care (HBNC) package to be delivered by community health workers across rural areas. We estimate the disease and economic burden that could be averted by scaling up the HBNC in rural India using IndiaSim, an agent-based simulation model, to examine two interventions. In the first intervention, the existing community health worker network begins providing HBNC for rural households without access to home- or facility-based newborn care, as introduced by India's recent programme. In the second intervention, we consider increased coverage of HBNC across India so that total coverage of neonatal care (HBNC or otherwise) in the rural areas of each state reaches at least 90%. We find that compared with a baseline of no coverage, providing the care package through the existing network of community health workers could avert 48 [95% uncertainty range (UR) 34-63] incident cases of severe neonatal morbidity and 5 (95% UR 4-7) related deaths, save $4411 (95% UR $3088-$5735) in out-of-pocket treatment costs, and provide $285 (95% UR $200-$371) in value of insurance per 1000 live births in rural India. Increasing the coverage of HBNC to 90% will avert an additional 9 (95% UR 7-12) incident cases, 1 death (95% UR 0.72-1.33), and $613 (95% UR $430-$797) in out-of-pocket expenditures, and provide $55 (95% UR $39-$72) in incremental value of insurance per 1000 live births. Intervention benefits are greater for lower socioeconomic groups and in the poorer states of Chhattisgarh, Uttarakhand, Bihar, Assam and Uttar Pradesh. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Using Third-Party Inspectors in Building Energy Codes Enforcement in India

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, Sha; Evans, Meredydd; Kumar, Pradeep

India is experiencing fast income growth and urbanization, and this leads to unprecedented increases in demand for building energy services and resulting energy consumption. In response to rapid growth in building energy use, the Government of India issued the Energy Conservation Building Code (ECBC) in 2007, which is consistent with and based on the 2001 Energy Conservation Act. ECBC implementation has been voluntary since its enactment and a few states have started to make progress towards mandatory implementation. Rajasthan is the first state in India to adopt ECBC as a mandatory code. The State adopted ECBC with minor additions onmore » March 28, 2011 through a stakeholder process; it became mandatory in Rajasthan on September 28, 2011. Tamil Nadu, Gujarat, and Andhra Pradesh have started to draft an implementation roadmap and build capacity for its implementation. The Bureau of Energy Efficiency (BEE) plans to encourage more states to adopt ECBC in the near future, including Haryana, Uttar Pradesh, Karnataka, Maharashtra, West Bengal, and Delhi. Since its inception, India has applied the code on a voluntary basis, but the Government of India is developing a strategy to mandate compliance. Implementing ECBC requires coordination between the Ministry of Power and the Ministry of Urban Development at the national level as well as interdepartmental coordination at the state level. One challenge is that the Urban Local Bodies (ULBs), the enforcement entities of building by-laws, lack capacity to implement ECBC effectively. For example, ULBs in some states might find the building permitting procedures to be too complex; in other cases, lack of awareness and technical knowledge on ECBC slows down the amendment of local building by-laws as well as ECBC implementation. The intent of this white paper is to share with Indian decision-makers code enforcement approaches: through code officials, third-party inspectors, or a hybrid approach. Given the limited capacity and human resources available in the state and local governments, involving third-party inspectors could rapidly expand the capacity for plan reviews and broad implementation. However, the procedures of involving third-parties need to be carefully designed in order to guarantee a fair process. For example, there should be multiple checks and certification requirements for third-party inspectors, and the government should have the final approval when third-party inspectors are used in a project. This paper discusses different approaches of involving third-parties in ECBC enforcement; the Indian states may choose the approaches that work best in their given circumstances.« less

Status of women in India: a comparison by state.

PubMed

Devi, D R

1993-12-01

Reformers in India have worked since the late 19th century to abolish practices such as the patriarchal joint-family system, the structure of property ownership, early marriage, and the self-immolation of widows which have been detrimental to the development of women. As a result, independent India has taken steps to protect the rights and equality of women. In order to analyze the objective status of women, secondary data were used to make 1) interstate comparisons, 2) intrastate comparisons with the status of men, and 3) comparisons in relation to overall development. Data from the early 1980s were analyzed from the 14 states which had a population of 10 million or more. 7 variables describe educational status, 3 are employment indicators, 2 are health indicators, 3 are demographic indicators, and 13 represent various aspects of development. The taxonomic method designed by Polish mathematicians in 1952 was used to rank states on the basis of each of the indicators. This method allows the determination of homogeneous units in an n-dimensional space without using such statistical tools as regression, variance, and correlation. It was found that the status indicators resulted in similar rankings for males and females in many states, but that in some states (Orissa, Madhya Pradesh, Bihar, and Uttar Pradesh) the health, employment, and educational status of women is low. These states also show a low ranking in overall development status, thus highlighting the direct link between the status of women and the level of development. This study leads to the question of whether women's status can be studied at the macro level using macro-level data. If this is possible, then the lack of significant differences found in the present study either indicates that the indicators chosen did not reveal the differences or that, in fact, no differences exist. The observed direct link between ranks of development and status, however, indicates that what was read as status differences are simply differences in levels of development. In depth studies which focus on the self-perceptions of status of men and women as compared with macro-level analyses will be necessary to answer this question.

A Low-Cost Indigenous Intervention which has Revolutionized the Drilling Technology and Changed the Life of Millions of Farmers in the State of Uttar Pradesh, India

NASA Astrophysics Data System (ADS)

Chaurasia, Pratik Ranjan; Subhash

2018-06-01

An unknown indigenous driller combined the percussion and circulation drilling principles, resulting in the development of low cost, low weight manual boring set in the year 1990-1991/1991-1992, which revolutionized the shallow well drilling technology and made possible to drill about 4.5 million shallow bore wells in the State. This has changed the landscape of irrigated agriculture, changing the life of millions of small and marginal farmers and contributed a lot in increasing crop production and crop productivity. The developed drilling equipment locally known as "Pressure Boring Set" is manually operated, low cost and can be transported on bicycles. Drilling cost is also less. This low cost and simple technology made it possible to drill large number of shallow bore wells in comparatively short time span and less cost, consequently enhancing the rate of increase in irrigated area and in turn crop production and productivity. Cost of the boring set is also low, as compared to traditional sand pump hand boring set and suitable for alluvial areas.

Environmental status of groundwater affected by chromite ore processing residue (COPR) dumpsites during pre-monsoon and monsoon seasons.

PubMed

Matern, Katrin; Weigand, Harald; Singh, Abhas; Mansfeldt, Tim

2017-02-01

Chromite ore processing residue (COPR) is generated by the roasting of chromite ores for the extraction of chromium. Leaching of carcinogenic hexavalent chromium (Cr(VI)) from COPR dumpsites and contamination of groundwater is a key environmental risk. The objective of the study was to evaluate Cr(VI) contamination in groundwater in the vicinity of three COPR disposal sites in Uttar Pradesh, India, in the pre-monsoon and monsoon seasons. Groundwater samples (n = 57 pre-monsoon, n = 70 monsoon) were taken in 2014 and analyzed for Cr(VI) and relevant hydrochemical parameters. The site-specific ranges of Cr(VI) concentrations in groundwater were <0.005 to 34.8 mg L -1 (Rania), <0.005 to 115 mg L -1 (Chhiwali), and <0.005 to 2.0 mg L -1 (Godhrauli). Maximum levels of Cr(VI) were found close to the COPR dumpsites and significantly exceeded safe drinking water limits (0.05 mg L -1 ). No significant dependence of Cr(VI) concentration on monsoons was observed.

A Low-Cost Indigenous Intervention which has Revolutionized the Drilling Technology and Changed the Life of Millions of Farmers in the State of Uttar Pradesh, India

NASA Astrophysics Data System (ADS)

Chaurasia, Pratik Ranjan; Subhash

2018-02-01

An unknown indigenous driller combined the percussion and circulation drilling principles, resulting in the development of low cost, low weight manual boring set in the year 1990-1991/1991-1992, which revolutionized the shallow well drilling technology and made possible to drill about 4.5 million shallow bore wells in the State. This has changed the landscape of irrigated agriculture, changing the life of millions of small and marginal farmers and contributed a lot in increasing crop production and crop productivity. The developed drilling equipment locally known as "Pressure Boring Set" is manually operated, low cost and can be transported on bicycles. Drilling cost is also less. This low cost and simple technology made it possible to drill large number of shallow bore wells in comparatively short time span and less cost, consequently enhancing the rate of increase in irrigated area and in turn crop production and productivity. Cost of the boring set is also low, as compared to traditional sand pump hand boring set and suitable for alluvial areas.

Detection and isolation of Japanese encephalitis virus from blood clots collected during the acute phase of infection.

PubMed

Sapkal, Gajanan N; Wairagkar, Nitin S; Ayachit, Vijay M; Bondre, Vijay P; Gore, Milind M

2007-12-01

Clinical specimens from an encephalitis outbreak in the Lakhimpur area of Uttar Pradesh, India, were investigated for identification and characterization of the etiologic agent. IgM capture ELISA showed recent Japanese encephalitis virus (JEV) infection. JEV isolation was attempted from white blood cells (WBCs) separated from blood clots of 12 patients (9 IgM positive and 3 negative) by serial co-culturing with phytohemagglutinin P-stimulated peripheral blood mononuclear leukocytes (PBMCs) obtained from pre-screened JEV sero-negative healthy individuals. JEV was isolated from two IgM-positive blood clots. Isolate 014178 was detected in WBCs and in the first passage of PBMCs by ELISA and reverse transcriptase-polymerase chain reaction. Isolate 014173 was detectable only after a second passage in PBMC co-culture. Sequence analysis of 346 nt of the C-prM region showed homology with JEV strain GP78. This is the first report on isolation of JEV from patient blood clots. Our study shows that the co-cultures of PBMCs separated from patient blood clots provide an additional source for JEV isolation.

Assessment of community contribution to the ICDS scheme in district Agra: a case study.

PubMed

Nayar, D; Kapil, U; Nandan, D

1999-01-01

This study was conducted to assess community contribution to the Integrated Child Development Services (ICDS) program, which promotes mother and child health in the Agra district, Uttar Pradesh, India. Three rural ICDS projects in the district were selected, out of which a total of 74 Anganwadi centers (AWCs) were chosen for the study. The Anganwadi workers (AWWs) were interviewed through a semi-structured questionnaire to assess the community¿s contribution during the previous 6 months. Results revealed that about 68% of AWWs had been able to receive assistance in bringing the children to the AWC. 53.3% had received free accommodation for AWC, and 42.6% had obtained assistance in implementation of health activities. Only 4% and 12% of the AWWs reported community assistance in the preparation and distribution of nutritional supplements, respectively. There had been no contribution received in terms of raw food for supplementary nutrition and fuel for cooking. The study concludes that rural area free accommodation for the AWC and community assistance in bringing children to the AWC were the most common forms of community contribution to the ICDS program.

Poliovirus Laboratory Based Surveillance: An Overview.

PubMed

Zaidi, Syed Sohail Zahoor; Asghar, Humayun; Sharif, Salmaan; Alam, Muhammad Masroor

2016-01-01

World Health Assembly (WHA) in 1988 encouraged the member states to launch Global Polio Eradication Initiative (GPEI) (resolution WHA41.28) against "the Crippler" called poliovirus, through strong routine immunization program and intensified surveillance systems. Since its launch, global incidence of poliomyelitis has been reduced by more than 99 % and the disease squeezed to only three endemic countries (Afghanistan, Pakistan, and Nigeria) out of 125. Today, poliomyelitis is on the verge of eradication, and their etiological agents, the three poliovirus serotypes, are on the brink of extinction from the natural environment. The last case of poliomyelitis due to wild type 2 strain occurred in 1999 in Uttar Pradesh, India whereas the last paralytic case due to wild poliovirus type 3 (WPV3) was seen in November, 2012 in Yobe, Nigeria. Despite this progress, undetected circulation cannot fully rule out the eradication as most of the poliovirus infections are entirely subclinical; hence sophisticated environmental surveillance is needed to ensure the complete eradication of virus. Moreover, the vaccine virus in under-immunized communities can sometimes revert and attain wild type characteristics posing a big challenge to the program.

Knowledge and awareness of HIV/AIDS among students of a technical institution.

PubMed

Gupta, Prem Prakash; Verma, Rohit Kumar; Tripathi, Poonam; Gupta, Shruti; Pandey, Awanish Kumar

2015-08-01

Acquired immunodeficiency syndrome (AIDS) is a major health problem worldwide. The number of infected people is increasing daily. Knowledge and awareness toward prevention and control of the disease is necessary among both educated and illiterate people. This study is aimed at assessing the knowledge and awareness about human immunodeficiency virus (HIV)/AIDS among undergraduate students studying in a technical institute in Gorakhpur, Uttar Pradesh, India. A community-based cross-sectional study was conducted among youths aged 15-30 years studying in a technical institution in Gorakhpur. Data were collected using a semistructured questionnaire developed with the help of existing literature, from 250 participants (students). The main source of information was the television; knowledge about the difference between HIV/AIDS was satisfactory. The findings showed that the knowledge about modes of prevention (blood checkup, needle/syringe sterilization) was satisfactory. There were several misconceptions about the modes of transmission of the disease, such as through mosquito bites, eating/drinking, and kissing. The knowledge of the study population was satisfactory, and there is a need for innovation and comprehensive education to impart better knowledge and understanding about HIV/AIDS.

Health risks of employees working in pesticide retail shops: An exploratory study.

PubMed

Kesavachandran, C; Pathak, M K; Fareed, M; Bihari, V; Mathur, N; Srivastava, A K

2009-12-01

Shop keepers dealing with pesticides are exposed to multiple pesticides that include organophosphates, organochlorines, carbamates, pyrethroids. Hence an exploratory health study was conducted on shopkeepers selling pesticides in urban areas of Lucknow and Barabanki District, Uttar Pradesh, India. Detailed information regarding socio-economic status, family history, personal habits and work practices were recorded for 20 subjects and controls by the investigator on a pre-tested questionnaire. Clinical examination including neurological studies of the shopkeepers and control subjects was done. The study revealed significant slowing of motor nerve conduction velocity and low peak expiratory flow rate among shopkeepers as compared to control subjects. Prevalence of significantly higher gastro-intestinal problems was also observed among exposed subjects. Neurological, ocular, cardiovascular and musculo-skeletal symptoms were also found to be higher among shopkeepers. This was not statistically significant. Significantly higher relative risk for sickness related to systems viz., cardio-vasular, genito-urinary, respiratory, nervous and dermal was observed among exposed subjects compared to controls. These findings provide a prima facie evidence of clinical manifestations because of multiple exposures to pesticides and poor safety culture at work place.

JPRS Report, Near East & South Asia

DTIC Science & Technology

1989-05-04

maligned because of his insistence on making Raghunath Jha chairman of the Bihar Janata Dal. The Bihar political observers understand who is better...candidate] between Raghunath Jha and Ramsunder Das. So far as image is concerned, the end result was talk among the masses about VP Singh being more...Patel in Gujerat, Mulayam Singh Yadav in place of Rajmangal Pande in Uttar Pradesh, Raghunath Jha in place of Ramsunder Das in Bihar, V. C. Shukla

A qualitative study of factors impacting accessing of institutional delivery care in the context of India's cash incentive program.

PubMed

Vellakkal, Sukumar; Reddy, Hanimi; Gupta, Adyya; Chandran, Anil; Fledderjohann, Jasmine; Stuckler, David

2017-04-01

Not all eligible women use the available services under India's Janani Suraksha Yojana (JSY), which provides cash incentives to encourage pregnant women to use institutional care for childbirth; limited evidence exists on demand-side factors associated with low program uptake. This study explores the views of women and ASHAs (community health workers) on the use of the JSY and institutional delivery care facilities. In-depth qualitative interviews, carried out in September-November 2013, were completed in the local language by trained interviewers with 112 participants consisting of JSY users/non-users and ASHAs in Jharkhand, Madhya Pradesh and Uttar Pradesh. The interaction of impeding and enabling factors on the use of institutional care for delivery was explored. We found that ASHAs' support services (e.g., arrangement of transport, escort to and support at healthcare facilities) and awareness generation of the benefits of institutional healthcare emerged as major enabling factors. The JSY cash incentive played a lesser role as an enabling factor because of higher opportunity costs in the use of healthcare facilities versus home for childbirth. Trust in the skills of traditional birth-attendants and the notion of childbirth as a 'natural event' that requires no healthcare were the most prevalent impeding factors. The belief that a healthcare facility would be needed only in cases of birth complications was also highly prevalent. This often resulted in waiting until the last moments of childbirth to seek institutional healthcare, leading to delay/non-availability of transportation services and inability to reach a delivery facility in time. ASHAs opined that interpersonal communication for awareness generation has a greater influence on use of institutional healthcare, and complementary cash incentives further encourage use. Improving health workers' support services focused on marginalized populations along with better public healthcare facilities are likely to promote the uptake of institutional delivery care in resource-poor settings. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Three new species of the genus Kisaura Ross (1956) (Trichoptera: Philopotamidae) from Arunachal Pradesh, India.

PubMed

Pandher, Manpreet Singh; Kaur, Simarjit; Parey, Sajad H

2018-04-05

In this paper three new species of the genus Kisaura from Arunachal Pradesh, northeastern India, are described and illustrated. The newly described species are K. sainii sp. n. (from Lumla), K. dirangensis sp. n. and K. vikrami sp. n. (both from Dirang). With these additions the total number of species in the genus from India now stands at 27.

Globalisation of birth markets: a case study of assisted reproductive technologies in India

PubMed Central

2011-01-01

The escalation of Assisted Reproductive Technologies (ARTs) in India into a veritable fertility industry is the result of a multitude of reasons. This paper places the bio-genetic industry within the larger political economy framework of globalisation and privatisation, thus employing a framework that is often omitted from discussions on ARTs, but has direct and significant bearings on the ART industry in India. As markets for human organs, tissues and reproductive body parts experience unprecedented growth, the limits of what can or should be bought and sold continue to be pushed. As such, bodies have emerged as sale-worthy economic capital. Commercial flows of reproductive material create and deploy the division of the body into parts over which ownership is claimed, in the process following 'modern routes of capital' and raising issues of structural inequality. This paper presents a brief picture of India's fertility industry with specific focus on its ground-level operation, nature and growth. It aims to explore the industry dimensions of ARTs, by highlighting the macro picture of health care markets and medical tourism in India, the proliferation of the ART industry, market features such as the social imperative to mother, costs, promotion and marketing, unverified claims, inflated success rates, deals and offers, actors and collaborations in the field, and finally, the absence of standards. This paper presents findings from the research 'Constructing Conceptions: The Mapping of Assisted Reproductive Technologies in India', by Sama, a Delhi-based resource group working on gender, health and rights. This research was conducted from 2008 to 2010 in the three states of Uttar Pradesh, Orissa and Tamil Nadu in India, and is one of the first of its kind, highlighting unethical medical practices and making a case for the regulation of the ART industry. As such, it forms a significant part of Sama's ongoing work on women and technologies, particularly policy-level advocacy. PMID:21838866

Globalisation of birth markets: a case study of assisted reproductive technologies in India.

PubMed

Sarojini, Nadimpally; Marwah, Vrinda; Shenoi, Anjali

2011-08-12

The escalation of Assisted Reproductive Technologies (ARTs) in India into a veritable fertility industry is the result of a multitude of reasons. This paper places the bio-genetic industry within the larger political economy framework of globalisation and privatisation, thus employing a framework that is often omitted from discussions on ARTs, but has direct and significant bearings on the ART industry in India. As markets for human organs, tissues and reproductive body parts experience unprecedented growth, the limits of what can or should be bought and sold continue to be pushed. As such, bodies have emerged as sale-worthy economic capital. Commercial flows of reproductive material create and deploy the division of the body into parts over which ownership is claimed, in the process following 'modern routes of capital' and raising issues of structural inequality.This paper presents a brief picture of India's fertility industry with specific focus on its ground-level operation, nature and growth. It aims to explore the industry dimensions of ARTs, by highlighting the macro picture of health care markets and medical tourism in India, the proliferation of the ART industry, market features such as the social imperative to mother, costs, promotion and marketing, unverified claims, inflated success rates, deals and offers, actors and collaborations in the field, and finally, the absence of standards. This paper presents findings from the research 'Constructing Conceptions: The Mapping of Assisted Reproductive Technologies in India', by Sama, a Delhi-based resource group working on gender, health and rights. This research was conducted from 2008 to 2010 in the three states of Uttar Pradesh, Orissa and Tamil Nadu in India, and is one of the first of its kind, highlighting unethical medical practices and making a case for the regulation of the ART industry. As such, it forms a significant part of Sama's ongoing work on women and technologies, particularly policy-level advocacy.

Organizational Climate as Perceived by Veterinary Assistant Surgeons of Andhra Pradesh in India

ERIC Educational Resources Information Center

Ratnayake, Talata Chandrakanthi; Gupta, Jancy

2014-01-01

Purpose: To identify various organizational climatic factors responsible for role performances of veterinary officers in Andhra Pradesh, India. Design/methodology/approach: Study was conducted in 11 selected districts. Data were collected from 220 respondents through a pretested interview schedule and subjected to correlation and multiple…

Application of groundwater residence time tracers and broad screening for micro-organic contaminants in the Indo-Gangetic aquifer system

NASA Astrophysics Data System (ADS)

Lapworth, Dan; Das, Prerona; Mukherjee, Abhijit; Petersen, Jade; Gooddy, Daren; Krishan, Gopal

2017-04-01

Groundwater abstracted from aquifers underlying urban centres across India provide a vital source of domestic water. Abstraction from municipal and private supplies is considerable and growing rapidly with ever increasing demand for water from expanding urban populations. This trend is set to continue. The vulnerability of deeper aquifers (typically >100 m below ground) used for domestic water to contamination migration from often heavily contaminated shallow aquifer systems has not been studies in detail in India. This paper focusses on the occurrence of micro-organic contaminants within sedimentary aquifers beneath urban centres which are intensively pumped for drinking water and domestic use. New preliminary results from a detailed case study undertaken across Varanasi, a city with an estimated population of ca. 1.5 million in Uttar Pradesh. Micro -organic groundwater quality status and evolution with depth is investigated through selection of paired shallow and deep sites across the city. These results are considered within the context of paired groundwater residence time tracers within the top 150m within the sedimentary aquifer system. Groundwater emerging contaminant results are compared with surface water quality from the Ganges which is also used for drinking water supply. Broad screening for >800 micro-organic compounds was undertaken. Age dating tools were employed to constrain and inform a conceptual model of groundwater recharge and contaminant evolution within the sedimentary aquifer system.

Consumer perspectives on a pericoital contraceptive pill in India and Uganda.

PubMed

Cover, Jane K; Drake, Jennifer Kidwell; Kyamwanga, Imelda T; Turyakira, Eleanor; Dargan, Tanya; Kumakech, Edward; Harner-Jay, Claudia

2013-12-01

Studies suggest that women in some countries have adopted emergency contraceptive pills as a routine method of family planning. This practice indicates there may be latent demand for a pericoital contraceptive pill taken only when a woman has sexual intercourse, and labeled and marketed for use as a regular contraceptive method. To understand the appeal and potential market for a pericoital contraceptive pill, 39 focus groups and 23 in-depth interviews were conducted with women and men in Lucknow, Uttar Pradesh, India, and Kampala, Uganda. A total of 281 individuals participated in this qualitative study. In general, women embraced the idea of a female-controlled method that would be easier than taking a daily oral contraceptive pill and that could be taken either before or after sexual intercourse; in Uganda, especially, women approved of the fact that the method could be taken without a partner's knowledge. Although we do not yet know the extent of side effects for this method, women expressed some concerns about the level and nature of potential side effects. The results suggest that a pericoital contraceptive pill would be well-received by consumers in both country settings. If its efficacy and side effects are acceptable, a pericoital contraceptive pill could fill a gap for female-controlled, discreet, coitus-related contraception, particularly among women who do not have sex very frequently.

Dental myths, oral hygiene methods and nicotine habits in an ageing rural population: an Indian study.

PubMed

Singh, Saumyendra V; Akbar, Zafar; Tripathi, Arvind; Chandra, Suresh; Tripathi, Anurag

2013-01-01

Though, increased emphasis is being given on spreading dental care facilities and awareness in Indian villages, the target population is unfortunately less literate and is not financially equipped compared to their urban counterparts. The rural aged additionally may have to face problems like desertion by the educated youth to follow better opportunities in cities, disease, and lack of mobility. The present study strived to evaluate dental myths, oral hygiene methods, and tobacco habits awareness in a rural ageing population in the perspective of a changing India. The study area consisted of a group of ten villages, situated in district Lucknow, Uttar Pradesh, India. The subjects were questioned about dental myths, tobacco habits, and oral hygiene methods and then divided into groups on the basis of age, sex, and educational status. The number of sound teeth in each subject was also counted. Mean-values, standard deviation, Chi-square test and P values were used to make inter-group comparisons. Forty percent of the subjects considered oral hygiene unnecessary, 60.8% of the population was relying on simple mouth rinsing for maintaining oral hygiene, 48% had either the habit of smoking and chewing tobacco or both and 81% of the subjects had one dental myth or the other. We concluded that the rural aged is a deprived lot and a targeted program to infuse scientific dental practices in them is necessary.

'Drug adherence levels are falling down again': health worker perceptions of women's service utilization before and after integration of HIV/AIDS services into general care in India.

PubMed

Shukla, Shrivridhi; Muchomba, Felix M; McCoyd, Judith L M

2018-06-01

Integrated models of HIV/AIDS service delivery are believed to have advantages over stand-alone models of care from health planners' and providers' perspectives. Integration models differ, yet there is little information about the influence of differing models on workers' beliefs about models' efficacy. Here, we examine the effect of integration of HIV care into the general health system in India. In 2014, India replaced its stand-alone model of HIV service delivery-Community Care Centers (CCCs)-with a purported integrated model that delivers HIV medical services at general hospitals and HIV psychosocial services at nearby Care and Support Centers (CSCs). We examine 15 health workers' perceptions of how change from the earlier stand-alone model to the current model impacted women's care in a district in Uttar Pradesh, India. Results indicate that (1) Women's antiretroviral (ART) adherence and utilization of psychosocial support service for HIV/AIDS suffered when services were not provided at one site; (2) Provision of inpatient care in the CCC model offered women living in poverty personal safety in accessing HIV health services and promoted chances of competent ART usage and repeat service utilization; and (3) Although integration of HIV services with the general health system was perceived to improve patient anonymity and decrease chances of HIV-related stigma and discrimination, resource shortages continued to plague the integrated system while shifting costs of time and money to the patients. Findings suggest that integration efforts need to consider the context of service provision and the gendered nature of access to HIV care.

Diabetes knowledge and self-efficacy among rural women in Gujarat, India.

PubMed

Mehta, Naaman V; Trivedi, Mayur; Maldonado, Luis E; Saxena, Deepak; Humphries, Debbie L

2016-01-01

Type II diabetes has risen dramatically among rural women in India, specifically in the states of Gujarat, Karnataka, Tamil Nadu and Uttar Pradesh. Recent studies suggest that rural Indian women's low level of self-efficacy, or confidence in their ability to carry out tasks, such as managing diabetes, is a key reason for this increase. Therefore, this study utilizes the Health Belief Model to analyze whether increased awareness of diabetes leads to a positive increase in levels of self-efficacy among diabetic women in two rural villages of Gujarat. A cross-sectional study of 126 known cases of women with diabetes was carried out in the villages of Rajpur and Valam in the Mehsana District in the state of Gujarat, India, to assess the relationship between diabetes knowledge and self-efficacy. The instrument was adapted from the Michigan Diabetes Research and Training Center's Diabetes Empowerment Scale-Short Form and Knowledge, Attitudes and Practices Assessment of the Indian Institute of Public Health Gandhinagar. Participants' mean knowledge score was 10.77±2.86 out of a possible 24 points, for a mean percentage of 45%. The median self-efficacy score for the women was 7 with an interquartile range of 3. The age-adjusted multiple regression analysis demonstrated a significant positive correlation between knowledge and self-efficacy (p<0.001). The observations of this study suggest a positive correlation between diabetes knowledge and self-efficacy. Future diabetes educational interventions in India should place a greater emphasis on increasing knowledge among rural women. Specifically, these interventions should emphasize the major gaps in knowledge regarding causes of diabetes, complications and treatment procedures. Educational interventions that are catered more towards rural women will be critical for improving their self-efficacy.

Predictors and consequences of “Phubbing” among adolescents and youth in India: An impact evaluation study

PubMed Central

Davey, Sanjeev; Davey, Anuradha; Raghav, Santosh K.; Singh, Jai V.; Singh, Nirankar; Blachnio, Agata; Przepiórkaa, Aneta

2018-01-01

BACKGROUND: “Phubbing” phenomenon, in the frequent use of a smartphone, describes the habit of snubbing someone in favor of a mobile phone. Its predictors and consequences are few in developed countries, but the literature lacks information on its actual occurrence and impact on adolescents and youth in a developing country such as India. MATERIALS AND METHODS: This impact evaluation study was carried out as part of the Phubbing Project of the University of Poland for 6 months (November 15, 2016–May 15, 2017) on a sample of 400 adolescents and youth selected randomly from the five colleges in the district of Muzaffarnagar of Uttar Pradesh state in India. Data were collected through the Internet using e-questionnaires sent to all students. The phubbing predictors’ and consequences’ scales available in literature were used and data were analyzed by a mixed method to get the study findings. RESULTS: The prevalence of phubbing was 49.3%. The most important predictors associated with phubbers were Internet addiction (p < 0.0001, Odds Ratio 2.26), smartphone addiction (OR 25.9), fear of missing out (OR 18.8), and the lack of self-control (p < 0.0001, OR = 0.73–1.72). Phubbing also had significant consequences on their social health, relationship health, and self-flourishing, and was significantly related to depression and distress. Logistic regression analysis showed significant impact of phubbing predictors on phubbing consequences in phubbers, especially in depressed and distress status. CONCLUSION: Adolescents and youth of India need special guidance from government adolescent clinics or colleges or even families to control this habit in order to promote better physical, mental, and social health. PMID:29386960

India's population--what is being done?

PubMed

Maloney, C

1986-01-01

Thus far, India's efforts to curtail population growth have consistently failed to meet official targets. The crude birthrate (per 1000 population per year) is highest in the belt of 6 Hindi-speaking states, which include Rajasthan (40), Madhya Pradesh (38.5), Uttar Pradesh (38.4), Bihar (37.2), and Haryana (35.9). The rates are slightly lower in the other large North Indian States. The rate is 33.6 for India as a whole according to 1983 data. 3 of the South Indian states have the lowest crude birthrates: Kamataka (28.7), Tamil Nadu (27.8), and Kerata (24.9). Each of India's successive Five Year Plans gave increasingly more emphasis to population control, but the key tactical features have stayed the same. Population control comes under the Ministry of Health and Family Welfare, with family planning services provided through the free health delivery system. The main strategy continues to be to persuade people on an individual basis to accept the small family norm by a wide range of advertising and educational efforts. As of 1986, the family planning establishment had grown to gigantic proportions, employing half a million people in the family planning and health services. The Five Year Plan initiated in July 1985 continues the same approach but with added features. "Green cards" are given to those who accept sterilization after 2 children, allowing them a wide range of benefits such as low interest housing loans, preference in getting housing plots and enterprise loans, and salary increases for government employees. Health workers and other government employees have quotas of persons to motivate for contraceptive acceptance. They receive a small monetary incentive, which they often give to the acceptors so they can maintain their quotas and keep their jobs. The 1986 Revised Strategy for Family Planning is essentially more of the same with family planning more integrated with the health delivery system. Foreign and international donor agencies frequently have placed contradictory pressures on the Indian government, according to their own ideological tendencies. The family planning program is essential despite its faults, which are: bypassing of the natural community; and excessive medicalization and linkage with the health delivery system. In India there is an increasing realization that the achievements of the rural development and family planning programs are marginal relative to the amount of resources committed to them. This is because of the bureaucratic, from-the-top-down bias in which the physical community is neglected.

An Inspector Calls: The Regulation of 'Budget' Private Schools in Hyderabad, Andhra Pradesh, India

ERIC Educational Resources Information Center

Tooley, J.; Dixon, P.

2005-01-01

Research explored the regulatory regime, both 'on paper' and 'in practice', for private unaided schools serving low-income families ('budget' private schools), in Hyderabad, Andhra Pradesh, India. Interviews were conducted with school managers, teachers, parents, and senior government officials and politicians. A Supreme Court Judgement rules out…

Factors of Role Conflict among Livestock Extension Professionals in Andhra Pradesh, India

ERIC Educational Resources Information Center

Sasidhar, P. V. K.; Rao, B. Sudhakar; Sreeramulu, Piedy

2008-01-01

To know the factors of role conflict among livestock extension professionals in Andhra Pradesh, India. Study was conducted following ex-post facto research design. Data were collected from 180 respondents through survey questionnaires. The data were subjected to multiple regression and path analyses to know the factors of role conflict.…

Increasing Choice or Inequality? Pathways through Early Education in Andhra Pradesh, India. Working Papers in Early Childhood Development, No. 58. Studies in Early Childhood Transitions

ERIC Educational Resources Information Center

Streuli, Natalia; Vennam, Uma; Woodhead, Martin

2011-01-01

This working paper is part of the Studies in Early Transitions series emerging from "Young Lives", a 15-year longitudinal study of childhood poverty in Ethiopia, India, Peru and Vietnam. It explores recent trends for children growing up in Andhra Pradesh, one of India's most populous states, based on Young Lives survey data collected for…

Decision-making for delivery location and quality of care among slum-dwellers: a qualitative study in Uttar Pradesh, India.

PubMed

Sudhinaraset, May; Beyeler, Naomi; Barge, Sandhya; Diamond-Smith, Nadia

2016-07-07

In 2013, the Government of India launched the National Urban Health Mission (NUHM) in order to better address the health needs of urban populations, including the nearly 100 million living in slums. Maternal and neonatal health indicators remain poor in India. The objective of this study is to highlight the experiences of women, their husbands, and mothers-in-law related to maternal health services and delivery experiences. In total, we conducted 80 in-depth interviews, including 40 with recent mothers, 20 with their husbands, and 20 with their mothers-in-law. Purposeful sampling was conducted in order to obtain differences across delivery experiences (facility vs. home), followed by their family members. Major factors that influence decision-making about where to seek care included household dynamics and joint-decision-making with families, financial barriers, and perceived quality of care. Women perceived that private facilities were higher quality compared to public facilities, but also more expensive. Disrespectful care, bribes in the facility, and payment challenges were common in this population. A number of programmatic and policy recommendations are highlighted from this study. Future endeavors should include a greater focus on health education and public programs, including educating women on how to access programs, who is eligible, and how to obtain public funds. Families need to be educated on their rights and expectations in facilities. Future programs should consider the role of husbands and mothers-in-law in reproductive decision-making and support during deliveries. Triangulating information from multiple sources is important for future research efforts.

Groundwater quality appraisal and its hydrochemical characterization in Ghaziabad (a region of indo-gangetic plain), Uttar Pradesh, India

NASA Astrophysics Data System (ADS)

Singh, Uday Veer; Abhishek, Amar; Singh, Kunwar P.; Dhakate, Ratnakar; Singh, Netra Pal

2014-06-01

India's growing population enhances great pressure on groundwater resources. The Ghaziabad region is located in the northern Indo-Gangetic alluvium plain of India. Increased population and industrial activities make it imperative to appraise the quality of groundwater system to ensure long-term sustainability of resources. A total number of 250 groundwater samples were collected in two different seasons, viz., pre-monsoon and post monsoon and analyzed for major physico-chemical parameters. Broad range and great standard deviation occurs for most parameters, indicating chemical composition of groundwater affected by process, including water-rock interaction and anthropogenic effect. Iron was found as predominant heavy metal in groundwater samples followed by copper and lead. An exceptional high concentration of Chromium was found in some locations. Industrial activities as chrome plating and wood preservative are the key source to metal pollution in Ghaziabad region. On the basis of classification the area water shows normal sulfate, chloride and bi-carbonate type, respectively. Base-exchange indices classified 76 % of the groundwater sources was the sodium-bicarbonate type. The meteoric genesis indices demonstrated that 80 % of groundwater sources belong to a shallow meteoric water percolation type. Chadha's diagram suggested that the hydro-chemical faces belong to the HCO3 - dominant Ca2+-Mg2+ type along with Cl--dominant Ca2+-Mg2+-type. There was no significant change in pollution parameters in the selected seasons. Comparison of groundwater quality with Indian standards proves that majority of water samples are suitable for irrigation purposes but not for drinking.

Interrupting wild poliovirus transmission using oral poliovirus vaccine: environmental surveillance in high-risks area of India.

PubMed

Chowdhary, Rashmi; Dhole, T N

2008-08-01

Global eradication of poliomyelitis has reached critical stage. Sabin Oral Poliovirus Vaccine (OPV) has been successful in three major regions of the world. In India eradication of poliomyelitis from states of Uttar Pradesh (UP) and Bihar has been difficult due to high population and low-socioeconomic standards of living. Acute flaccid paralysis (AFP) surveillance and intensive OPV rounds continues with the World Health Organization (WHO) operational strategies. Yet apparent lack of progress in reducing the number of wild cases has resulted in occasional impatience and frustration, even leading to questions about ultimate feasibility of global eradication using OPV. Lucknow in UP is in geographical area endemic for poliomyelitis and is surrounded by high-risk areas yet maintains a polio-free status since 2002. Environmental surveillance study was conducted (2004-2006) to authenticate the decline in the wild poliovirus (PV) cases in Lucknow. Sewage sample analyses were compared with stools of AFP patients and healthy children from same geographical area. Study reveals useful information on OPV circulation and proves important epidemiological tool to trust WHO's OPV immunization program. Genetic sequencing had detected silent wild PV-1 circulation of RCP1PGI (EU049849), RCP2PGI (EU049850), RCP3PGI (EU049851), and RCP4PGI (EU049852) in sewage waters. Properties of isolates from sewage reflected those of viruses excreted from human. This study provides valuable information and encouragement to AFP surveillance to maintain high levels of OPV immunization campaigns in the most difficult endemic region of India to interrupt the wild PV transmission.

Combining Work and School: The Dynamics of Girls' Involvement in Agricultural Work in Andhra Pradesh, India

ERIC Educational Resources Information Center

Morrow, Virginia; Vennam, Uma

2010-01-01

Child labour in India has long been the focus of research, policy concern and intervention. This article presents an analysis of children's involvement in agricultural work, particularly cottonseed production, drawing on evidence gathered for Young Lives in 2007 and 2008. In parts of Andhra Pradesh, children work in cotton fields for two or three…

India's population in transition.

PubMed

Visaria, L; Visaria, P

1995-10-01

This demographic profile of India addresses fertility, family planning, and economic issues. India is described as a country shifting from economic policies of self-reliance to active involvement in international trade. Wealth has increased, particularly at higher educational levels, yet 25% still live below the official poverty line and almost 66% of Indian women are illiterate. The government program in family planning, which was instituted during the early 1950s, did not change the rate of natural increase, which remained stable at 2.2% over the past 30 years. 1993 marked the first time the growth rate decline to under 2%. The growth rate in 1995 was 1.9%. The total population is expected double in 36 years. Only Nigeria, Pakistan, and Bangladesh had a higher growth rate and higher fertility in 1995. India is geographically diverse (with the northern Himalayan mountain zone, the central alluvial plains, the western desert region, and the southern peninsula with forest, mountains, and plains). There are regional differences in the fertility rates, which range from replacement level in Kerala and Goa to 5.5 children in Uttar Pradesh. Fertility is expected to decline throughout India due to the slower pace of childbearing among women over the age of 35 years, the increase in contraceptive use, and increases in marriage age. Increased educational levels in India and its state variations are related to lower fertility. Literacy campaigns are considered to be effective means of increasing the educational levels of women. Urbanization is not expected to markedly affect fertility levels. Urban population, which is concentrated in a few large cities, remains a small proportion of total population. Greater shifts are evident in the transition from agriculture to other wage labor. Fertility is expected to decline as women's share of labor force activity increases. The major determinant of fertility decline in India is use of family planning, which has improved in access and use during the 1980s. If India is to keep a stable population under 1.6 billion in the future, Indians may have to accept only one child per family.

Representing Farmer Irrigation Decisions in Northern India: Model Development from the Bottom Up.

NASA Astrophysics Data System (ADS)

O'Keeffe, J.; Buytaert, W.; Brozovic, N.; Mijic, A.

2017-12-01

The plains of northern India are among the most intensely populated and irrigated regions of the world. Sustaining water demand has been made possible by exploiting the vast and hugely productive aquifers underlying the Indo-Gangetic basin. However, an increasing demand from a growing population and highly variable socio-economic and environmental variables mean present resources may not be sustainable, resulting in water security becoming one of India's biggest challenges. Unless solutions which take into consideration the regions evolving anthropogenic and environmental conditions are found, the sustainability of India's water resources looks bleak. Understanding water user decisions and their potential outcome is important for development of suitable water resource management options. Computational models are commonly used to assist water use decision making, typically representing natural processes well. The inclusion of human decision making however, one of the dominant drivers of change, has lagged behind. Improved representation of irrigation water user behaviour within models provides more accurate, relevant information for irrigation management. This research conceptualizes and proceduralizes observed farmer irrigation practices, highlighting feedbacks between the environment and livelihood. It is developed using a bottom up approach, informed through field experience and stakeholder interaction in Uttar Pradesh, northern India. Real world insights are incorporated through collected information creating a realistic representation of field conditions, providing a useful tool for policy analysis and water management. The modelling framework is applied to four districts. Results suggest predicted future climate will have little direct impact on water resources, crop yields or farmer income. In addition, increased abstraction may be sustainable in some areas under carefully managed conditions. By simulating dynamic decision making, feedbacks and interactions between water users, irrigation officials, agricultural practices, and external influences such as energy pricing and farming subsidies, this work highlights the importance of directly including water user behaviour in policy making and operational tools, which will help achieve water and livelihood security.

Pathogenic and Genotypic Characterization of a Japanese Encephalitis Virus Isolate Associated with Reproductive Failure in an Indian Pig Herd

PubMed Central

Desingu, P. A.; Ray, Pradeep K.; Patel, B. H. M.; Singh, R.; Singh, R. K.; Saikumar, G

2016-01-01

Background India is endemic to Japanese encephalitis virus (JEV) and recurrent outbreaks occur mainly in rice growing areas. Pigs are considered to be the amplifying host for JEV and infection in gestating pigs results in reproductive failure. Most studies conducted on JEV infection in Indian pigs have been serological surveys and very little is known about JEV genotypes circulating in pigs. So the potential risk posed by pigs in JEV transmission and the genetic relationship between viruses circulating in pigs, mosquitoes and humans is poorly understood. Methodology/Principal Findings This study was conducted in pigs with a history of reproductive failure characterized by stillborn piglets with neuropathological lesions. Japanese encephalitis (JE) suspected brain specimens inoculated intracerebrally into mice and Vero cells resulted in successful isolation of JEV/SW/IVRI/395A/2014. Clinicopathological observations in infected mice, demonstration of JEV antigen in brain, and analysis of the envelope protein identified the swine isolate as being neurovirulent. Phylogenetic analysis based on prM and E gene sequences showed that it belonged to genotype III. This swine isolate was closely related to JEV associated with the 2005 outbreak in India and JaoArS982 from Japan. Phylogenetic analysis of JEV strains collected between 1956 and 2014 in India categorized the GIII viruses into different clades blurring their spatial distribution, which has been discernible in the previous century. Conclusions/Significance Isolation of JEV from stillborn piglets and its close genetic relationship with viruses detected at least three decades ago in humans and mosquitoes in Japan suggests that the virus may have been circulating among Indian pigs for several decades. The close similarity between the present swine isolate and those detected in humans affected in the 2005 outbreak in Uttar Pradesh, India, suggests the need for more intensive surveillance of pigs and implementation of suitable strategies to control JE in India. PMID:26895440

Eradicating poliomyelitis: India's journey from hyperendemic to polio-free status

PubMed Central

John, T. Jacob; Vashishtha, Vipin M.

2013-01-01

India's success in eliminating wild polioviruses (WPVs) has been acclaimed globally. Since the last case on January 13, 2011 success has been sustained for two years. By early 2014 India could be certified free of WPV transmission, if no indigenous transmission occurs, the chances of which is considered zero. Until early 1990s India was hyperendemic for polio, with an average of 500 to 1000 children getting paralysed daily. In spite of introducing trivalent oral poliovirus vaccine (tOPV) in the Expanded Programme on Immunization (EPI) in 1979, the burden of polio did not fall below that of the pre-EPI era for a decade. One of the main reasons was the low vaccine efficacy (VE) of tOPV against WPV types 1 and 3. The VE of tOPV was highest for type 2 and WPV type 2 was eliminated in 1999 itself as the average per-capita vaccine coverage reached 6. The VE against types 1 and 3 was the lowest in Uttar Pradesh and Bihar, where the force of transmission of WPVs was maximum on account of the highest infant-population density. Transmission was finally interrupted with sustained and extraordinary efforts. During the years since 2004 annual pulse polio vaccination campaigns were conducted 10 times each year, virtually every child was tracked and vaccinated - including in all transit points and transport vehicles, monovalent OPV types 1 and 3 were licensed and applied in titrated campaigns according to WPV epidemiology and bivalent OPV (bOPV, with both types 1 and 3) was developed and judiciously deployed. Elimination of WPVs with OPV is only phase 1 of polio eradication. India is poised to progress to phase 2, with introduction of inactivated poliovirus vaccine (IPV), switch from tOPV to bOPV and final elimination of all vaccine-related and vaccine-derived polioviruses. True polio eradication demands zero incidence of poliovirus infection, wild and vaccine. PMID:23760372

Eradicating poliomyelitis: India's journey from hyperendemic to polio-free status.

PubMed

John, T Jacob; Vashishtha, Vipin M

2013-05-01

India's success in eliminating wild polioviruses (WPVs) has been acclaimed globally. Since the last case on January 13, 2011 success has been sustained for two years. By early 2014 India could be certified free of WPV transmission, if no indigenous transmission occurs, the chances of which is considered zero. Until early 1990s India was hyperendemic for polio, with an average of 500 to 1000 children getting paralysed daily. In spite of introducing trivalent oral poliovirus vaccine (tOPV) in the Expanded Programme on Immunization (EPI) in 1979, the burden of polio did not fall below that of the pre-EPI era for a decade. One of the main reasons was the low vaccine efficacy (VE) of tOPV against WPV types 1 and 3. The VE of tOPV was highest for type 2 and WPV type 2 was eliminated in 1999 itself as the average per-capita vaccine coverage reached 6. The VE against types 1 and 3 was the lowest in Uttar Pradesh and Bihar, where the force of transmission of WPVs was maximum on account of the highest infant-population density. Transmission was finally interrupted with sustained and extraordinary efforts. During the years since 2004 annual pulse polio vaccination campaigns were conducted 10 times each year, virtually every child was tracked and vaccinated - including in all transit points and transport vehicles, monovalent OPV types 1 and 3 were licensed and applied in titrated campaigns according to WPV epidemiology and bivalent OPV (bOPV, with both types 1 and 3) was developed and judiciously deployed. Elimination of WPVs with OPV is only phase 1 of polio eradication. India is poised to progress to phase 2, with introduction of inactivated poliovirus vaccine (IPV), switch from tOPV to bOPV and final elimination of all vaccine-related and vaccine-derived polioviruses. True polio eradication demands zero incidence of poliovirus infection, wild and vaccine.

Partition and Poliomyelitis: An Investigation of the Polio Disparity Affecting Muslims during India's Eradication Program

PubMed Central

Hussain, Rashid S.; McGarvey, Stephen T.; Fruzzetti, Lina M.

2015-01-01

Background Significant disparities in the incidence of polio existed during its eradication campaign in India. In 2006, Muslims, who comprise 16% of the population in affected states, comprised 70% of paralytic polio cases. This disparity was initially blamed on the Muslims and a rumor that the vaccination program was a plot to sterilize their children. Using the framework of structural violence, this paper describes how the socio-political and historical context of Muslim populations in India shaped the polio disparity. Methods and Findings A qualitative study utilizing methods of rapid ethnography was conducted from May-August 2009 in Aligarh, Uttar Pradesh, India. Field methods included participant observation of vaccination teams, historical document research, and 107 interviews with both Global Polio Eradication Initiative (GPEI) stakeholders and families with vaccine-eligible children. Almost all respondents agreed that Aligarh was a highly segregated city, mostly due to riots after Partition and during the 1990s. Since the formation of segregated neighborhoods, most respondents described that "Muslim areas" had been underdeveloped compared to "Hindu areas," facilitating the physical transmission of poliovirus. Distrust of the government and resistance to vaccination were linked to this disparate development and fears of sterilization influenced by the "Family Planning Program" from 1976-1977. Conclusions Ethnic violence and social marginalization since the Partition and during the rise of Hindu nationalism led to distrust of the government, the formation of segregated slums, and has made Muslims victims of structural violence. This led to the creation of disease-spreading physical environments, lowered vaccine efficacy, and disproportionately higher levels of resistance to vaccination. The causes of the polio disparity found in this study elucidate the nature of possible other health disparities affecting minorities in India. Limitations This study is limited by the manual coding of the transcribed data, size, and some dialectal difficulties in translation. PMID:25742622

Detection of MEF-1 laboratory reference strain of poliovirus type 2 in children with poliomyelitis in India in 2002 & 2003.

PubMed

Deshpande, J M; Nadkarni, S S; Siddiqui, Z A

2003-12-01

Significant progress has been made towards eradication of poliomyelitis in India. Surveillance for acute flaccid paralysis (AFP) has reached high standards. Among the 3 types of polioviruses, type 2 had been eliminated in India and eradicated globally as of October 1999. However, we isolated wild poliovirus type 2 from a small number of polio cases in northern India in 2000 and again during December 2002 to February 2003. Using molecular tools the origin, of the wild type 2 poliovirus was investigated. Polioviruses isolated from stool samples collected from patients with AFP were differentiated as wild virus or Sabin vaccine-like by ELISA and probe hybridization assays. Complete VP1 gene nucleotide sequences of the wild type 2 poliovirus isolates were determined by reverse transcriptase polymerase chain reaction (RT-PCR), followed by cycle sequencing. VP1 nucleotide sequences were compared with those of wild type 2 polioviruses that were indigenous in India in the past as well as prototype/laboratory strains and the GenBank database. Wild poliovirus type 2 was detected in stool samples from 6 patients with AFP in western Uttar Pradesh and 1 in Gujarat. In addition, the virus was isolated from one healthy contact child and from environmental sewage sample in Moradabad where three of these patients were reported. These isolates were identified as genetically closely related to laboratory reference strain MEF-1. Molecular characterization of the isolates confirmed that there was no evidence of extensive person-to-person transmission of the virus in the community. Laboratory reference strain (MEF-1) of poliovirus type 2 caused paralytic poliomyelitis in 10 patients in September 2000 and November 2002 to February 2003. The origin of the virus was some laboratory as yet not identified. This episode highlights the urgent need for stringent containment of wild poliovirus containing materials in the laboratories across the country in order to prevent recurrence of such incidents.

Prevalence of mutation and phenotypic expression associated with sulfadoxine-pyrimethamine resistance in Plasmodium falciparum and Plasmodium vivax.

PubMed

Zakai, Haytham A; Khan, Wajihullah; Asma, Umme

2013-09-01

Therapeutic efficacy of sulfadoxine-pyrimethamine (SP), which is commonly used to treat falciparum malaria, was assessed in isolates of Plasmodium falciparum (Welch, 1897) and Plasmodium vivax (Grassi et Feletti, 1890) ofAligarh, Uttar Pradesh, North India and Taif, Saudi Arabia during 2011-2012. Both the species showed mutations in dihydrofolate reductase (DHFR) enzyme as they have common biochemical drug targets. Mutation rate for pfdhfr was higher compared to pvdhfr because the drug was mainly given to treat falciparum malaria. Since both the species coexist, P. vivax was also exposed to SP due to faulty species diagnosis or medication without specific diagnosis. Low level of mutations against SP in P. falciparum of Saudi isolates indicates that the SP combination is still effective for the treatment of falciparum malaria. Since SP is used as first-line of treatment because of high level of resistance against chloroquine (CQ), it may result in spread of higher level of mutations resulting in drug resistance and treatment failure in near future. Therefore, to avoid further higher mutations in the parasite, use of better treatment regimens such as artesunate combination therapy must be introduced against SP combination.

Peri-Urbanism in Globalizing India: A Study of Pollution, Health and Community Awareness

PubMed Central

Waldman, Linda; Bisht, Ramila; Saharia, Rajashree; Kapoor, Abhinav; Rizvi, Bushra; Hamid, Yasir; Arora, Meghana; Chopra, Ima; Priya, Ritu; Marshall, Fiona

2017-01-01

This paper examines the intersection between environmental pollution and people’s acknowledgements of, and responses to, health issues in Karhera, a former agricultural village situated between the rapidly expanding cities of New Delhi (India’s capital) and Ghaziabad (an industrial district in Uttar Pradesh). A relational place-based view is integrated with an interpretive approach, highlighting the significance of place, people’s emic experiences, and the creation of meaning through social interactions. Research included surveying 1788 households, in-depth interviews, participatory mapping exercises, and a review of media articles on environment, pollution, and health. Karhera experiences both domestic pollution, through the use of domestic waste water, or gandapani, for vegetable irrigation, and industrial pollution through factories’ emissions into both the air and water. The paper shows that there is no uniform articulation of any environment/health threats associated with gandapani. Some people take preventative actions to avoid exposure while others do not acknowledge health implications. By contrast, industrial pollution is widely noted and frequently commented upon, but little collective action addresses this. The paper explores how the characteristics of Karhera, its heterogeneous population, diverse forms of environmental pollution, and broader governance processes, limit the potential for citizen action against pollution. PMID:28867770

Knowledge, attitude and practice GAP in family planning usage: an analysis of selected cities of Uttar Pradesh.

PubMed

Singh, Anjali; Singh, K K; Verma, Prashant

2016-01-01

The GAP between the knowledge of contraception and its actual practice is well recognized in the literature of family welfare studies. The present study assessed the relation between the level of knowledge and practice of contraception among the women and sought to explore the reasons behind the Knowledge, Attitude, and Practice - GAP (KAP GAP) regarding contraceptive users in six cities of Uttar Pradesh. Present analysis based on 17,643 currently married women aged 15 to 49. A Bivariate analysis ( χ 2 test) and a multivariable logistic regression were performed for the study. The highest percentages of respondents (women) were in the age group 35-49 (40-45 %) in all the districts considered. Knowledge of contraceptives was almost universal; tubal ligation and pill were the commonly known methods. Information about the contraceptive methods was mostly obtained through the husband. In the present study, there was a highly significant association ( p  < 0.01) of age group, educational status of respondents, the number of living children, the wealth of the respondent, media exposure and husband's education with the variable KAP GAP for all six cities. Health concern issues in all the districts were the most prominent reason for not using contraception. There differences in the socioeconomic and demographic factors exist, which lead to KAP GAP in the family planning (FP) usages. Therefore, in designing effective family planning programme, there is a need to understand the various factors which influence the practice of contraception.

Catastrophic Health Expenditure and Impoverishment Effects of Out-of-pocket Expenses: A Comparative Study of Tannery and Non-tannery Workers of Kanpur, India.

PubMed

Kashyap, Gyan C; Singh, Shri K; Sharma, Santosh K

2018-01-01

Treatment-seeking behaviors and economic burden because of health expenditure are widely discussed issues in India, and more so in recent times. The aim of this study is to identify health problems of tannery workers and their treatment-seeking behavior and their health expenditure. The primary data used in this article were collected through a cross-sectional household survey of 284 male tannery workers in the Jajmau area of Kanpur city in the state of Uttar Pradesh, during January-June 2015. Findings of the study revealed that around 36% of the tannery workers and 42% of non-tannery workers received treatment as outpatients in government/municipal hospital in the first spell of treatment. The secondary source of treatment was pharmacy/drug stores for 30% of the tannery workers and 24% of the non-tannery workers, an indication that a substantial proportion takes treatment without consulting a qualified medical practitioner; it also highlights that almost one-third of the tannery and non-tannery workers visited private health facility despite poor economic condition. It is evident that a substantial proportion of tannery and non-tannery workers are visiting private/non-governmental organization/trust hospital despite their poor financial situation. There is an urgent need to reinstate people's faith in public health facilities by developing professionalism, integrity, and accountability among different levels of health functionaries and frontline workers with the support of credible, transparent, and responsible regulatory environment.

Locomotor problems among rural elderly population in a District of Aligarh, North India.

PubMed

Maroof, Mohd; Ahmad, Anees; Khalique, Najam; Ansari, M Athar

2017-01-01

Locomotor functions decline with the age along with other physiological changes. This results in deterioration of the quality of life with decreased social and economic role in the society, as well as increased dependency, for the health care and other basic services. The demographic transition resulting in increased proportion of elderly may pose a burden to the health system. To find the prevalence of locomotor problems among the elderly population, and related sociodemographic factors. The study was a community-based cross-sectional study done at field practice area of Rural Health Training Centre, JN Medical College, AMU, Aligarh, Uttar Pradesh, India. A sample of 225 was drawn from 1018 elderly population aged 60 years and above using systematic random sampling with probability proportionate to size. Sociodemographic characteristics were obtained using pretested and predesigned questionnaire. Locomotor problems were assessed using the criteria used by National Sample Survey Organization. Data were analyzed using SPSS version 20. Chi-square test was used to test relationship of locomotor problems with sociodemographic factors. P <0.05 was considered statistically significant. The prevalence of locomotor problems among the elderly population was 25.8%. Locomotor problems were significantly associated with age, gender, and working status whereas no significant association with literacy status and marital status was observed. The study concluded that approximately one-fourth of the elderly population suffered from locomotor problems. The sociodemographic factors related to locomotor problems needs to be addressed properly to help them lead an independent and economically productive life.

Trend of human brucellosis over a decade at tertiary care centre in North Karnataka.

PubMed

Patil, D P; Ajantha, G S; Shubhada, C; Jain, P A; Kalabhavi, A; Shetty, P C; Hosamani, M; Appannanavar, S; Kulkarni, R D

2016-01-01

Brucellosis is an important zoonotic disease. India having a major agrarian population is expected to have a higher prevalence. However, due to lack of laboratory facility or awareness among clinicians, the disease is largely underreported. The aim of this study was to know the prevalence and trend of human brucellosis over a decade, in patients attending a teaching hospital in North Karnataka, and to understand their geographical distribution. The study was conducted from January 2006 to December 2015 at a tertiary care teaching hospital in North Karnataka. A total of 3610 serum samples were evaluated from suspected cases of brucellosis. All serum samples were initially screened by Rose Bengal plate test, and positive samples were further analysed by Serum agglutination test (SAT) using standard Brucella abortus antigen from Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India. A titre above or equal to 1:80 IU/ml was considered as positive. Demographic data such as age, sex and native place of these patients were also analysed. We observed that human brucellosis is present in North Karnataka. The overall seropositivity of brucellosis in suspected cases was 5.1%. The positive titres ranged from 1:80 to 163,840 IU/ml. The majority of the patients were from Gadag, Koppal and Haveri districts of North Karnataka. Our study confirms the presence of human brucellosis in the northern part of Karnataka. Further studies to understand the prevalence of animal brucellosis in these areas will help in implementing prevention measures.

Liquefaction record of the great 1934 earthquake predecessors from the north Bihar alluvial plains of India

NASA Astrophysics Data System (ADS)

Rajendran, C. P.; John, Biju; Rajendran, Kusala; Sanwal, Jaishri

2016-07-01

The great 1934 Himalayan earthquake of moment magnitude (Mw) 8.1 generated a large zone of ground failure and liquefaction in north Bihar, India, in addition to the earthquakes of 1833 (Mw ~7.7) and 1988 (Mw 6.7) that have also impacted this region. Here, we present the results of paleoliquefaction investigations from four sites in the plains of north Bihar and one in eastern Uttar Pradesh. The liquefaction features generated by successive earthquakes were dated at AD 829-971, 886-1090, 907-1181, 1130-1376, 1112-1572, 1492-1672, 1733-1839, and 1814-1854. One of the liquefaction events dated at AD 829-971, 886-1090, and 907-1181 may correlate with the great earthquake of AD ~1100, recognized in an earlier study from the sections across the frontal thrust in central eastern Nepal. Two late medieval liquefaction episodes of AD 1130-1376 and 1492-1672 were also exposed in our sites. The sedimentary sections also revealed sandblows that can be attributed to the 1833 earthquake, a lesser magnitude event compared to the 1934. Liquefactions triggered by the 1934 and 1988 earthquakes were evident within the topmost level in some sections. The available data lead us to conjecture that a series of temporally close spaced earthquakes of both strong and large types, not including the infrequent great earthquakes like the 1934, have affected the Bihar Plains during the last 1500 years with a combined recurrence interval of 124 ± 63 years.

Progress toward interruption of wild poliovirus transmission - worldwide, 2009.

PubMed

2010-05-14

In 1988, an estimated 350,000 cases of poliomyelitis were occurring annually worldwide. By 2005, because of global vaccination efforts, indigenous transmission of wild poliovirus (WPV) types 1 and 3 (WPV1 and WPV3) had been eliminated from all but four countries (Afghanistan, India, Nigeria, and Pakistan). No cases of WPV type 2 have been reported since 1999. This report describes progress toward global WPV eradication during 2009 and updates previous reports. During 2009 a total of 1,606 cases of WPV infection were reported, compared with 1,651 in 2008. WPV3 incidence increased 67%, to 1,124 cases, compared with 675 in 2008. However, WPV1 incidence decreased 51%, to 482 cases in 2009, compared with 976 cases in 2008. In India, nearly all polio cases in 2009 were reported in high-risk districts in western Uttar Pradesh and central Bihar. In Afghanistan and Pakistan, WPV circulation in high-risk districts continued because of difficulties vaccinating children in conflict-affected areas and operational limitations in parts of Pakistan. In Nigeria, cases decreased by 51%, to 388 cases in 2009, compared with 798 in 2008. During 2009, outbreaks from importation of WPV affected 19 previously polio-free African countries. Two key steps are needed to make further progress in polio eradication: 1) addressing local barriers to interrupting transmission, and 2) using bivalent oral poliovirus vaccine (bOPV) broadly for WPV 1 and 3 in supplemental immunization activities (SIAs).

Cold chain monitoring of OPV at transit levels in India: correlation of VVM and potency status.

PubMed

Jain, R; Sahu, A K; Tewari, S; Malik, N; Singh, S; Khare, S; Bhatia, R

2003-12-01

We have conducted a study to analyze monitoring of the cold chain of 674 OPV field samples collected at four different levels of vaccine distribution viz., immunization clinics, district stores, hospitals and Primary Health Centers (PHC) from states of Uttar Pradesh, Madhya Pradesh, and Delhi. The study design included: collection and scoring of vaccine vial monitor (VVM) status of the samples and testing for total oral polio virus concentration (TOPV) by standard WHO protocol. Ten samples each were exposed to 25 degrees C and 37 degrees C, and 10 samples as controls were kept at -20 degrees C. VVM were scored daily till they attained grade 4 and each sample was subsequently subjected to potency testing for individual polio serotypes 1, 2 and 3, and TOPV. Of the 674 samples tested it was observed that: samples from immunization clinics and district stores had an acceptable VVM score of grade 1 and 2; however the probable risk that a sub potent vaccine could have been administered was 2.15%. In 2.5% samples received from district stores vaccine had a VVM score of grade 3 (i.e., discard point), although vaccine when tested was found to be potent (i.e., leading to the vaccine wastage). With exposure to higher temperatures, VVM changed score to grade 2 and 3 when the vaccine was kept at 25 degrees C/37 degrees C, and the titres of individual serotypes 1, 2 and 3 and TOPV were beyond the acceptable limits. Important observations at the different levels of vaccine distribution network and correlation of VVM and potency status of OPV are discussed in the paper which will be of help to the EPI program managers at different transit levels.

Public Report on Health: Development of a Nutritive Value Calculator for Indian Foods and Analysis of Food Logs and Nutrient Intake in six States

PubMed Central

Sathyamala, C; Kurian, NJ; DE, Anuradha; Saxena, KB; Priya, Ritu; Baru, Rama; Srivastava, Ravi; Mittal, Onkar; Noronha, Claire; Samson, Meera; Khalsa, Sneh; Puliyel, Ashish

2014-01-01

The Public Report on Health (PRoH) was initiated in 2005 to understand public health issues for people from diverse backgrounds living in different region specific contexts. States were selected purposively to capture a diversity of situations from better-performing states and not-so-well performing states. Based on these considerations, six states – the better-performing states of Tamil Nadu (TN), Maharashtra (MH) and Himachal Pradesh (HP) and the not-so-well performing states of Madhya Pradesh (MP), Uttar Pradesh (UP) and Orissa (OR) – were selected. This is a report of a study using food diaries to assess food intakes in sample households from six states of India. Method: Food diaries were maintained and all the raw food items that went into making the food in the household was measured using a measuring cup that converted volumes into dry weights for each item. The proportion consumed by individual adults was recorded. A nutrient calculator that computed the total nutrient in the food items consumed, using the ‘Nutritive Value of Indian Foods by Gopalan et al., was developed to analyze the data and this is now been made available as freeware (http://bit.ly/ncalculator). The total nutrients consumed by the adults, men and women was calculated. Results: Identifying details having been removed, the raw data is available, open access on the internet http://bit.ly/foodlogxls.The energy consumption in our study was 2379 kcal per capita per day. According to the Summary Report World Agriculture the per capita food consumption in 1997-99 was 2803 which is higher than that in the best state in India. The consumption for developing countries a decade ago was 2681 and in Sub-Saharan Africa it was 2195. Our data is compatible in 2005 with the South Asia consumption of 2403 Kcal per capita per day in 1997-99. For comparison, in industrialized countries it was 3380. In Tamil Nadu it was a mere 1817 kcal. Discussion: The nutrient consumption in this study suggests that food security in the villages studied is far from achieved. It is hoped that the new Food Security Ordinance will make a dent in the situation. The calculator for computing nutrients of foods consumed which we developed based on the ICMR defined nutrient values for Indian foods has been made available as freeware on the internet. This is with the hope that more such studies can be carried out at the household level. PMID:24995224

Public Report on Health: Development of a Nutritive Value Calculator for Indian Foods and Analysis of Food Logs and Nutrient Intake in six States.

PubMed

Sathyamala, C; Kurian, Nj; DE, Anuradha; Saxena, Kb; Priya, Ritu; Baru, Rama; Srivastava, Ravi; Mittal, Onkar; Noronha, Claire; Samson, Meera; Khalsa, Sneh; Puliyel, Ashish; Puliyel, Jacob

2014-05-01

The Public Report on Health (PRoH) was initiated in 2005 to understand public health issues for people from diverse backgrounds living in different region specific contexts. States were selected purposively to capture a diversity of situations from better-performing states and not-so-well performing states. Based on these considerations, six states - the better-performing states of Tamil Nadu (TN), Maharashtra (MH) and Himachal Pradesh (HP) and the not-so-well performing states of Madhya Pradesh (MP), Uttar Pradesh (UP) and Orissa (OR) - were selected. This is a report of a study using food diaries to assess food intakes in sample households from six states of India. Food diaries were maintained and all the raw food items that went into making the food in the household was measured using a measuring cup that converted volumes into dry weights for each item. The proportion consumed by individual adults was recorded. A nutrient calculator that computed the total nutrient in the food items consumed, using the 'Nutritive Value of Indian Foods by Gopalan et al., was developed to analyze the data and this is now been made available as freeware (http://bit.ly/ncalculator). The total nutrients consumed by the adults, men and women was calculated. Identifying details having been removed, the raw data is available, open access on the internet http://bit.ly/foodlogxls.The energy consumption in our study was 2379 kcal per capita per day. According to the Summary Report World Agriculture the per capita food consumption in 1997-99 was 2803 which is higher than that in the best state in India. The consumption for developing countries a decade ago was 2681 and in Sub-Saharan Africa it was 2195. Our data is compatible in 2005 with the South Asia consumption of 2403 Kcal per capita per day in 1997-99. For comparison, in industrialized countries it was 3380. In Tamil Nadu it was a mere 1817 kcal. The nutrient consumption in this study suggests that food security in the villages studied is far from achieved. It is hoped that the new Food Security Ordinance will make a dent in the situation. The calculator for computing nutrients of foods consumed which we developed based on the ICMR defined nutrient values for Indian foods has been made available as freeware on the internet. This is with the hope that more such studies can be carried out at the household level.

Impact of community-based health insurance in rural India on self-medication & financial protection of the insured.

PubMed

Dror, David M; Chakraborty, Arpita; Majumdar, Atanu; Panda, Pradeep; Koren, Ruth

2016-06-01

The evidence-base of the impact of community-based health insurance (CBHI) on access to healthcare and financial protection in India is weak. We investigated the impact of CBHI in rural Uttar Pradesh and Bihar s0 tates of India on insured households' self-medication and financial position. Data originated from (i) household surveys, and (ii) the Management Information System of each CBHI. Study design was "staggered implementation" cluster randomized controlled trial with enrollment of one-third of the treatment group in each of the years 2011, 2012 and 2013. Around 40-50 per cent of the households that were offered to enroll joined. The benefits-packages covered outpatient care in all three locations and in-patient care in two locations. To overcome self-selection enrollment bias, we constructed comparable control and treatment groups using Kernel Propensity Score Matching (K-PSM). To quantify impact, both difference-in-difference (DiD), and conditional-DiD (combined K-PSM with DiD) were used to assess robustness of results. Post-intervention (2013), self-medication was less practiced by insured HHs. Fewer insured households than uninsured households reported borrowing to finance care for non-hospitalization events. Being insured for two years also improved the HH's location along the income distribution, namely insured HHs were more likely to experience income quintile-upgrade in one location, and less likely to experience a quintile-downgrade in two locations. The realized benefits of insurance included better access to healthcare, reduced financial risks and improved economic mobility, suggesting that in our context health insurance creates welfare gains. These findings have implications for theoretical, ethical, policy and practice considerations.

Growth and obesity status of children from the middle socioeconomic group in Lucknow, northern India: A comparison with studies on children from the upper socioeconomic group.

PubMed

Gupta, Priyanka; Mittal, Nitya; Kulkarni, Abhishek; Meenakshi, J V; Bhatia, Vijayalakshmi

2015-01-01

Children from the upper socioeconomic group in India currently show a modest positive secular trend in height, accompanied by a high prevalence of obesity. We examined the anthropometric pattern among children from the middle socioeconomic group. A cross-sectional study of anthropometry in 3794 schoolchildren from the middle socioeconomic group in the city of Lucknow, Uttar Pradesh, India. A comparison with the data of a 20-year-old study of children from the upper socioeconomic group showed that the height of boys in our study was at par with or higher than that of boys of the same (Lucknow-Allahabad-Varanasi) region or national data, at all centiles. In contrast, girls in our study were shorter than national data at all centiles and shorter than girls of the same region at the 3rd centile. Children from the middle socioeconomic group did not show the large increase in weight centiles seen in the recent data of the upper socioeconomic group. The values of body mass index at the 85th and 95th percentile at 17 or 18 years of age in girls and boys were 23 and 25 kg/m2, respectively. Obesity was prevalent in 1% of children of the middle socioeconomic group and an additional 5.7% were overweight. Children from the middle socioeconomic group in Lucknow have grown taller than their 20-year-old counterparts from the upper socioeconomic group. Boys have fared better than girls. Children from the middle socioeconomic group in Lucknow are at present spared from the epidemic of obesity. Copyright 2015, NMJI.

Impact of community-based health insurance in rural India on self-medication & financial protection of the insured

PubMed Central

Dror, David M.; Chakraborty, Arpita; Majumdar, Atanu; Panda, Pradeep; Koren, Ruth

2016-01-01

Background & objectives: The evidence-base of the impact of community-based health insurance (CBHI) on access to healthcare and financial protection in India is weak. We investigated the impact of CBHI in rural Uttar Pradesh and Bihar States of India on insured households’ self-medication and financial position. Methods: Data originated from (i) household surveys, and (ii) the Management Information System of each CBHI. Study design was “staggered implementation” cluster randomized controlled trial with enrollment of one-third of the treatment group in each of the years 2011, 2012 and 2013. Around 40-50 per cent of the households that were offered to enroll joined. The benefits-packages covered outpatient care in all three locations and in-patient care in two locations. To overcome self-selection enrollment bias, we constructed comparable control and treatment groups using Kernel Propensity Score Matching (K-PSM). To quantify impact, both difference-in-difference (DiD), and conditional-DiD (combined K-PSM with DiD) were used to assess robustness of results. Results: Post-intervention (2013), self-medication was less practiced by insured HHs. Fewer insured households than uninsured households reported borrowing to finance care for non-hospitalization events. Being insured for two years also improved the HH's location along the income distribution, namely insured HHs were more likely to experience income quintile-upgrade in one location, and less likely to experience a quintile-downgrade in two locations. Interpretation & conclusions: The realized benefits of insurance included better access to healthcare, reduced financial risks and improved economic mobility, suggesting that in our context health insurance creates welfare gains. These findings have implications for theoretical, ethical, policy and practice considerations. PMID:27748307

Oral cancer awareness of the general public in Gorakhpur city, India.

PubMed

Agrawal, Mamta; Pandey, Sushma; Jain, Shikha; Maitin, Shipra

2012-01-01

Global cancer statistical data show that India has one of the highest incidence rates of oral cancer worldwide. Early detection is extremely important as it results in lower morbidity and death rates. The present study was undertaken to assess awareness of oral cancer and knowledge of its early signs and risk factors in the general public of the semi-urban Gorakhpur area of Uttar Pradesh (India). It was also intended to educate the same population for early detection by increasing their ability to recognize signs and risk factors. A questionnaire-based household survey was conducted over a period of one month in different parts of Gorakhpur district, a region where tobacco use is apparently very high. A total of 2,093 persons participated in the survey. The collected data were analyzed using SPSS software to assess and associate oral cancer awareness with the prevalence, and abstract risk factors, as well as other confounding variables. The general awareness, knowledge of signs and risk factors of oral cancer were found to be proportionate to the literacy level with the highest rate of awareness being among high school and graduates and lowest among illiterates. It was also observed that on most of these dimensions the younger age groups (<30 years) were significantly more knowledgeable. Overall, the awareness of oral cancer in the high-risk population of Gorakhpur was not satisfactory, pointing to a need for further dissemination of information on this issue and its associated risks. This is especially important for the youngsters, as this may possibly help them keep away from the deleterious habit of tobacco indulgence in any form. If necessary risk factor cessation counselling should be provided.

Acute myocardial infarction in very young adults: A clinical presentation, risk factors, hospital outcome index, and their angiographic characteristics in North India-AMIYA Study.

PubMed

Sinha, Santosh Kumar; Krishna, Vinay; Thakur, Ramesh; Kumar, Ashutosh; Mishra, Vikas; Jha, Mukesh Jitendra; Singh, Karandeep; Sachan, Mohit; Sinha, Rupesh; Asif, Mohammad; Afdaali, Nasar; Mohan Varma, Chandra

2017-03-01

India is currently in the fourth stage of epidemiological transitions where cardiovascular disease is the leading cause of mortality and morbidity. Purpose of the present study was to assess the risk factors, clinical presentation, angiographic profile including severity, and in-hospital outcome of very young adults (aged ≤ 30 years) with first acute myocardial infarction (AMI). Total of 1,116 consecutive patients with ST-segment elevation acute myocardial infarction (STEMI) were studied between March 2013 and February 2015 at LPS Institute of Cardiology, Kanpur, Uttar Pradesh, India. Mean age of the patients was 26.3 years. Risk factors were smoking (78.5%), family history of premature coronary artery disease (CAD) (46.8%), obesity (39.1%), physical inactivity (38.7%) and stressful life events (29.6%). The most common symptom and presentation was chest pain and anterior wall myocardial infarction (AWMI) in 94.8% and 58.8%, respectively. About 80.6% of patients had obstructive CAD with single vessel disease (57.6%), double-vessel disease (12.9%) and left main involvement (3.2%). Left anterior descending (LAD) was commonest culprit artery (58.1%) followed by right coronary artery in 28.2%. In-hospital mortality was 2.8%. Percutaneous coronary intervention was performed in 71.6% of patients. Median number and length of stent were 1.18 and 28 ± 16 mm, respectively. AMI in very young adult occurred most commonly in male. Smoking was the most common risk factor. AWMI owing to LAD artery involvement was the most common presentation. Mean time of presentation after symptom onset was 16.9 hours. In contrast to western population, it is characterised by earlier onset, delayed presentation, more severity, diffuse disease, and more morbidity but with favourable in-hospital mortality.

Can currently available advanced combustion biomass cook-stoves provide health relevant exposure reductions? Results from initial assessment of select commercial models in India.

PubMed

Sambandam, Sankar; Balakrishnan, Kalpana; Ghosh, Santu; Sadasivam, Arulselvan; Madhav, Satish; Ramasamy, Rengaraj; Samanta, Maitreya; Mukhopadhyay, Krishnendu; Rehman, Hafeez; Ramanathan, Veerabhadran

2015-03-01

Household air pollution from use of solid fuels is a major contributor to the national burden of disease in India. Currently available models of advanced combustion biomass cook-stoves (ACS) report significantly higher efficiencies and lower emissions in the laboratory when compared to traditional cook-stoves, but relatively little is known about household level exposure reductions, achieved under routine conditions of use. We report results from initial field assessments of six commercial ACS models from the states of Tamil Nadu and Uttar Pradesh in India. We monitored 72 households (divided into six arms to each receive an ACS model) for 24-h kitchen area concentrations of PM2.5 and CO before and (1-6 months) after installation of the new stove together with detailed information on fixed and time-varying household characteristics. Detailed surveys collected information on user perceptions regarding acceptability for routine use. While the median percent reductions in 24-h PM2.5 and CO concentrations ranged from 2 to 71% and 10-66%, respectively, concentrations consistently exceeded WHO air quality guideline values across all models raising questions regarding the health relevance of such reductions. Most models were perceived to be sub-optimally designed for routine use often resulting in inappropriate and inadequate levels of use. Household concentration reductions also run the risk of being compromised by high ambient backgrounds from community level solid-fuel use and contributions from surrounding fossil fuel sources. Results indicate that achieving health relevant exposure reductions in solid-fuel using households will require integration of emissions reductions with ease of use and adoption at community scale, in cook-stove technologies. Imminent efforts are also needed to accelerate the progress towards cleaner fuels.

Nutritional status of school-age children - A scenario of urban slums in India

PubMed Central

2012-01-01

Background One of the greatest problems for India is undernutrition among children. The country is still struggling with this problem. Malnutrition, the condition resulting from faulty nutrition, weakens the immune system and causes significant growth and cognitive delay. Growth assessment is the measurement that best defines the health and nutritional status of children, while also providing an indirect measurement of well-being for the entire population. Methods A cross-sectional study, in which we explored nutritional status in school-age slum children and analyze factors associated with malnutrition with the help of a pre-designed and pre-tested questionnaire, anthropometric measurements and clinical examination from December 2010 to April 2011 in urban slums of Bareilly, Uttar-Pradesh (UP), India. Result The mean height and weight of boys and girls in the study group was lower than the CDC 2000 (Centers for Disease Control and Prevention) standards in all age groups. Regarding nutritional status, prevalence of stunting and underweight was highest in age group 11 yrs to 13 yrs whereas prevalence of wasting was highest in age group 5 yrs to 7 yrs. Except refractive errors all illnesses are more common among girls, but this gender difference is statistically significant only for anemia and rickets. The risk of malnutrition was significantly higher among children living in joint families, children whose mother's education was [less than or equal to] 6th standard and children with working mothers. Conclusions Most of the school-age slum children in our study had a poor nutritional status. Interventions such as skills-based nutrition education, fortification of food items, effective infection control, training of public healthcare workers and delivery of integrated programs are recommended. PMID:22958757

Mobilizing community-based health insurance to enhance awareness & prevention of airborne, vector-borne & waterborne diseases in rural India.

PubMed

Panda, Pradeep; Chakraborty, Arpita; Dror, David M

2015-08-01

Despite remarkable progress in airborne, vector-borne and waterborne diseases in India, the morbidity associated with these diseases is still high. Many of these diseases are controllable through awareness and preventive practice. This study was an attempt to evaluate the effectiveness of a preventive care awareness campaign in enhancing knowledge related with airborne, vector-borne and waterborne diseases, carried out in 2011 in three rural communities in India (Pratapgarh and Kanpur-Dehat in Uttar Pradesh and Vaishali in Bihar). Data for this analysis were collected from two surveys, one done before the campaign and the other after it, each of 300 randomly selected households drawn from a larger sample of Self-Help Groups (SHGs) members invited to join community-based health insurance (CBHI) schemes. The results showed a significant increase both in awareness (34%, p<0.001) and in preventive practices (48%, P=0.001), suggesting that the awareness campaign was effective. However, average practice scores (0.31) were substantially lower than average awareness scores (0.47), even in post-campaign. Awareness and preventive practices were less prevalent in vector-borne diseases than in airborne and waterborne diseases. Education was positively associated with both awareness and practice scores. The awareness scores were positive and significant determinants of the practice scores, both in the pre- and in the post-campaign results. Affiliation to CBHI had significant positive influence on awareness and on practice scores in the post-campaign period. The results suggest that well-crafted health educational campaigns can be effective in raising awareness and promoting health-enhancing practices in resource-poor settings. It also confirms that CBHI can serve as a platform to enhance awareness to risks of exposure to airborne, vector-borne and waterborne diseases, and encourage preventive practices.

Measuring communication competence and effectiveness of ASHAs (accredited social health activist) in their leadership role at rural settings of Uttar Pradesh (India).

PubMed

Shrivastava, Archana; Srivastava, Arun

2016-01-01

Purpose - This paper aims to find out accredited social health activists' (ASHA) communication competence and effectiveness while working as leaders with groups in the rural setting. ASHA, as the "first point of contact" for pregnant women in rural areas, plays a significant role in building awareness and disseminating key information at critical times (e.g. antenatal and post-natal period), promotes healthy maternal and newborn care practices and facilitates identification and referral of maternal and newborn complications. ASHA plays critical role of a leader in bridging the gap between health system and community. In the entire process, effective communication competency is the key to her effectiveness. Design/methodology/approach - The study adopts seven items from the farmers communication (FACOM) scale of communication measures developed by Udai Pareek and Y.P Singh. Preliminary editing of the items was done keeping certain points in mind such as the items should not be judgemental, should be acts of behaviour, should be observable and should be simple. This scale was adopted for the study, as it was designed to measure farmers' communication competence and suited the context. The evaluation criteria included the seven essential elements of communication identified in the FACOM scale. Findings - Results from the study identified a need to sensitise ASHAs on the critical role of effective communication and need for investing more in building her capacity for health communication. The trainings being imparted to ASHAs have to be strengthened in terms of communication skills. They should focus upon developing all three variables of communication skills equally and integrating them to get desired results. Research limitations/implications - The study was conducted in one state while the programme is running across the country. The sample size was small. Practical implications - The learning of the study will help in developing a better understanding of the beneficiaries' perspectives and their expectations regarding ASHAs communication process in the leadership role which she performs. Such understanding will not only be instructive but may also prove transformative for the benefit of both ASHAs and her community, whose support is critical to the success of the programme. This learning will feed into the policy planning and communication and capacity building strategy of the ASHA programme and may lead to better and more effective strategies and tools of communication. Originality/value - Research study is original. Keeping the observers' status in mind, questionnaire was translated in Hindi language. Twenty ASHAs were selected randomly from small villages of Uttar Pradesh, the largest state in India. The scale was presented to at least five observers (all females) for one ASHA. These observers/judges were the ones who knew ASHA well and with whom she had communicated at some point of time as part of her work.

Does Growth in Private Schooling Contribute to Education for All? Evidence from a Longitudinal, Two Cohort Study in Andhra Pradesh, India

ERIC Educational Resources Information Center

Woodhead, Martin; Frost, Melanie; James, Zoe

2013-01-01

This paper informs debates about the potential role for low-fee private schooling in achieving Education for All goals in India. It reports "Young Lives" longitudinal data for two cohorts (2906 children) in the state of Andhra Pradesh. Eight year olds uptake of private schooling increased from 24 per cent (children born in 1994-5) to 44…

Budget impact of polio immunization strategy for India: introduction of one dose of inactivated poliomyelitis vaccine and reductions in supplemental polio immunization.

PubMed

Khan, M M; Sharma, S; Tripathi, B; Alvarez, F P

2017-01-01

To conduct a budget impact analysis (BIA) of introducing the immunization recommendations of India Expert Advisory Group (IEAG) for the years 2015-2017. The recommendations include introduction of one inactivated poliomyelitis vaccine (IPV) dose in the regular child immunization programme along with reductions in oral polio vaccine (OPV) doses in supplemental programmes. This is a national level analysis of budget impact of new polio immunization recommendations. Since the states of India vary widely in terms of size, vaccine coverage and supplemental vaccine needs, the study estimated the budget impact for each of the states of India separately to derive the national level budget impact. Based on the recommendations of IEAG, the BIA assumes that all children in India will get an IPV dose at 14 weeks of age in addition to the OPV and DPT (or Pentavalent-3) doses. Cost of introducing the IPV dose was estimated by considering vaccine price and vaccine delivery and administration costs. The cost savings associated with the reduction in number of doses of OPV in supplemental immunization were also estimated. The analysis used India-specific or international cost parameters to estimate the budget impact. Introduction of one IPV dose will increase the cost of vaccines in the regular immunization programme from $20 million to $47 million. Since IEAG recommends lower intensity of supplemental OPV vaccination, polio vaccine cost of supplemental programme is expected to decline from $72 million to $53 million. Cost of administering polio vaccines will also decline from $124 million to $105 million mainly due to the significantly lower intensity of supplemental polio vaccination. The net effect of adopting IEAG's recommendations on polio immunization turns out to be cost saving for India, reducing total polio immunization cost by $6 million. Additional savings could be achieved if India adopts the new policy regarding the handling of multi-dose vials after opening. Introduction of three doses of IPV with the existing polio immunization schedule will increase the budget requirement by $102 million but replacing OPV doses with IPV will increase the budget by about $59 million. Discontinuation of supplemental OPV immunization with replacement of OPV by IPV will reduce the Government of India's (GOI) polio immunization budget by $99 million. Although the overall cost of polio programme will decline with the adoption of IEAG's recommendations, state-level costs will vary widely. In states like Kerala, Karnataka, Uttar Pradesh and Andhra Pradesh, cost of polio immunization will increase while in Punjab and Jharkhand the costs will remain more or less constant. Significant cost reductions will happen in states with high intensity of supplemental polio immunizations (Bihar, Haryana and Delhi). The cost of procuring polio vaccines will more than double from $20 million to about $47 million requiring allocation of additional foreign exchanges. In some states (like Bihar), the decline in polio-related employment will be very high requiring reallocation of personnel from polio to other programmes. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Knowledge and opinion about smoke-free laws and second-hand smoke among hospitality venue managers in Gujarat and Andhra Pradesh, India.

PubMed

Gupta, Vinay K; Arora, Monika; Sharma, Indrani; Nazar, Gaurang P; Modi, Bhavesh; Singh, Deepti; Millett, Christopher; Reddy, K Srinath

2013-01-01

India's Smoke-Free Law (SFL) was implemented in 2004 and reinforced on 2nd October 2008. This research attempts to understand the knowledge and opinion of hospitality venue (HV) managers about second-hand smoke (SHS) and SFL as well as self-reported compliance with SFL in two Indian states. A survey was conducted among 804 randomly sampled HVs from project STEPS (Strengthening of tobacco control efforts through innovative partnerships and strategies) in Gujarat and Andhra Pradesh, India. Four hundred and three HVs from two districts in Gujarat and 401 HVs from six districts in Andhra Pradesh were selected. The owner, manager or supervisor of each HV was interviewed using a pre-tested structured interview schedule. Association of opinion scales with respondents' background characteristics was assessed through the analysis of variance (ANOVA) method. Out of the 403 respondents in Gujarat and 401 in Andhra Pradesh, 56.1% and 84.3% had knowledge about SFL respectively. Compliance of HVs with SFL was 21.8% in Gujarat and 31.2% in Andhra Pradesh as reported by the managers. Knowledge about SHS was noted among 39.7% of respondents in Gujarat and 25.4% in Andhra Pradesh. Bivariate results indicated that more educated HV managers showed higher support for smoke-free public places (P < 0.001) and were more concerned about the health effects of SHS exposure (P = 0.002). Complete self-reported compliance with, and knowledge of SFL as well as SHS was not found in Gujarat and Andhra Pradesh. The education level of HV managers is an important determinant to ensure compliance with SFL in public places.

Modern and ancestral genotypes of Mycobacterium tuberculosis from Andhra Pradesh, India.

PubMed

Thomas, Shirly K; Iravatham, Chitra C; Moni, Bottu Heleena; Kumar, Ashutosh; Archana, Bandaru V; Majid, Mohammad; Priyadarshini, Yerra; Rani, Pittu Sandhya; Valluri, Vijayalakshmi; Hasnain, Seyed E; Ahmed, Niyaz

2011-01-01

Traditionally, the distribution of the Mycobacterium tuberculosis genotypes in India has been characterized by widespread prevalence of ancestral lineages (TbD1+ strains and variants) in the south and the modern forms (TbD1(-) CAS and variants) predominating in the north of India. The pattern was, however, not clearly known in the south-central region such as Hyderabad and the rest of the state of Andhra Pradesh where the prevalence of both tuberculosis (TB) and human immunodeficiency virus (HIV) infection is one of the highest in the country; this area has been the hotspot of TB vaccine trials. Spoligotyping of 101 clinical isolates obtained from Hyderabad and rural Andhra Pradesh confirmed the occurrence of major genogroups such as the ancestral (or the TbD1+ type or the East African Indian (EAI) type), the Central Asian (CAS) or Delhi type and the Beijing lineage in Andhra Pradesh. Sixty five different spoligotype patterns were observed for the isolates included in this study; these were further analyzed based on specific genetic signatures/mutations. It was found that the major genogroups, CAS and "ancestral," were almost equally prevalent in our collection but followed a north-south compartmentalization as was also reported previously. However, we observed a significant presence of MANU lineage in south Andhra Pradesh, which was earlier reported to be overwhelmingly present in Mumbai. This study portrays genotypic diversity of M. tuberculosis from the Indian state of Andhra Pradesh and provides a much needed snapshot of the strain diversity that will be helpful in devising effective TB control programs in this part of the world.

Evaluation of the Factors which Contribute to the Ocular Complaints in Computer Users.

PubMed

Agarwal, Smita; Goel, Dishanter; Sharma, Anshu

2013-02-01

Use of information technology hardware given new heights to professional success rate and saves time but on the other hand its harmful effect has introduced an array of health related complaints causing hazards for our human health. Increased use of computers has led to an increase in the number of patients with ocular complaints which are being grouped together as computer vision syndrome (CVS). In view of that, this study was undertaken to find out the ocular complaints and the factors contributing to occurrence of such problems in computer users. To evaluate the factors contributing to Ocular complaints in computer users in Teerthanker Mahaveer University, Moradabad, U.P. India. Community-based cross-sectional study of 150 subjects who work on computer for varying period of time in Teerthanker Mahaveer University, Moradabad, Uttar Pradesh. Two hundred computer operators working in different institutes offices and bank of were selected randomly in Teerthanker Mahaveer University, Moradabad, and Uttar Pradesh. 16 were non responders 18 did not come for assessment and 16 were excluded due to complaints prior to computer use making no response rate Twenty-one did not participate in the study, making the no response rate 25%. Rest of the subjects (n = 150) were asked to fill a pre-tested questionnaire, after obtaining their verbal consent Depending on the average hours of usage in a day, they were categorized into three categories viz. <2 hrs, 2-6 hrs, >6 hrs of usage. All the responders were asked to come to the Ophthalmic OPD for further interview and assessment. Simple proportions and Chi-square test. Among the 150 subjects studied major ocular complaint reported in descending order were eyestrain. (53%). Occurrence of eye strain, ( 53.8%), itching ( 47.6%) and burning (66.7%) in subjects using computer for more than 6 hours. distance from computer screen with respect to eyes, use of antiglare screen, taking frequent breaks, use of LCD monitor and adjustment of brightness of monitor screen bear a significant association with these ocular complaints in computer users. Eye strain is the most common ocular complaints among computer users working for more than 6 hours a day. We also found that maintaining ideal distance from screen, keeping level of eyes above the top of screen, taking frequent breaks, using LCD monitors and using antiglare screen and adjusting brightness levels according to workplace reduced these ocular complaints to a significant level.

Evaluation of the Factors which Contribute to the Ocular Complaints in Computer Users

PubMed Central

Agarwal, Smita; Goel, Dishanter; Sharma, Anshu

2013-01-01

Context: Use of information technology hardware given new heights to professional success rate and saves time but on the other hand its harmful effect has introduced an array of health related complaints causing hazards for our human health. Increased use of computers has led to an increase in the number of patients with ocular complaints which are being grouped together as computer vision syndrome (CVS). In view of that, this study was undertaken to find out the ocular complaints and the factors contributing to occurrence of such problems in computer users. Aims: To evaluate the factors contributing to Ocular complaints in computer users in Teerthanker Mahaveer University, Moradabad, U.P. India. Settings and Design: Community-based cross-sectional study of 150 subjects who work on computer for varying period of time in Teerthanker Mahaveer University, Moradabad, Uttar Pradesh. Materials and Methods: Two hundred computer operators working in different institutes offices and bank of were selected randomly in Teerthanker Mahaveer University, Moradabad, and Uttar Pradesh. 16 were non responders 18 did not come for assessment and 16 were excluded due to complaints prior to computer use making no response rate Twenty-one did not participate in the study, making the no response rate 25%. Rest of the subjects (n = 150) were asked to fill a pre-tested questionnaire, after obtaining their verbal consent Depending on the average hours of usage in a day, they were categorized into three categories viz. <2 hrs, 2-6 hrs, >6 hrs of usage. All the responders were asked to come to the Ophthalmic OPD for further interview and assessment. Statistical Analysis Used: Simple proportions and Chi-square test. Results: Among the 150 subjects studied major ocular complaint reported in descending order were eyestrain. (53%). Occurrence of eye strain, ( 53.8%), itching ( 47.6%) and burning (66.7%) in subjects using computer for more than 6 hours. distance from computer screen with respect to eyes, use of antiglare screen, taking frequent breaks, use of LCD monitor and adjustment of brightness of monitor screen bear a significant association with these ocular complaints in computer users. Conclusions: Eye strain is the most common ocular complaints among computer users working for more than 6 hours a day. We also found that maintaining ideal distance from screen, keeping level of eyes above the top of screen, taking frequent breaks, using LCD monitors and using antiglare screen and adjusting brightness levels according to workplace reduced these ocular complaints to a significant level. PMID:23543722

Selected risk factors associated with pulmonary tuberculosis among Saharia tribe of Madhya Pradesh, central India.

PubMed

Rao, Vikas G; Gopi, P G; Bhat, Jyothi; Yadav, Rajiv; Selvakumar, N; Wares, Douglas F

2012-04-01

Tuberculosis (TB) is a major public health problem among the Saharia, a marginalized tribal group in Madhya Pradesh state, central India. However, there is no information on the risk factors associated with the development of TB disease in this community. A cross-sectional TB prevalence survey was conducted among the Saharia residing in Sheopur district of Madhya Pradesh. Information on tobacco smoking and alcohol consumption was collected from all the individuals. Persons aged ≥45 years, males, smokers and alcohol consumers had higher risks of developing TB disease. There is an urgent need to develop and implement culturally appropriate awareness raising activities to target smoking and alcohol consumption to support the efforts to control TB in this community.

Increasing postpartum contraception in rural India: evaluation of a community-based behavior change communication intervention.

PubMed

Sebastian, Mary Philip; Khan, Mohammed Ejazduin; Kumari, Kaushal; Idnani, Rukma

2012-06-01

The Indian family planning program, though successful in increasing contraceptive use among couples who have achieved their desired family size, has not been equally successful in educating couples about the use of contraceptive methods for birth spacing. An evaluation was conducted of a behavior change communication intervention integrated into the existing government program to increase knowledge and use of the lactational amenorrhea method and postpartum contraception through counseling by community workers. The intervention, which ran between September 2006 and January 2007, was conducted among 959 pregnant women aged 15-24 who lived in Uttar Pradesh, India. The evaluation used logistic regression analyses to measure differences in knowledge and contraceptive use between baseline and the four- and nine-month postpartum follow-up surveys within and between the intervention and comparison groups. The follow-up data show increases in knowledge of the lactational amenorrhea method and spacing methods and in use of spacing methods. At four months postpartum, women in the intervention group were more likely to know the healthy spacing messages than those in the comparison group (odds ratio, 2.1). At nine months postpartum, women in the intervention group, those with higher knowledge of healthy spacing practices and those with correct knowledge of two or more spacing methods were more likely than others to be using a contraceptive method (1.5-3.5). Use of modern contraceptives for spacing at nine months postpartum was 57% in the intervention group versus 30% in the comparison group. Targeted behavior change communication using community workers is an effective and feasible strategy for promoting postpartum contraception.

Catastrophic Health Expenditure and Impoverishment Effects of Out-of-pocket Expenses: A Comparative Study of Tannery and Non-tannery Workers of Kanpur, India

PubMed Central

Kashyap, Gyan C.; Singh, Shri K.; Sharma, Santosh K.

2018-01-01

Purpose: Treatment-seeking behaviors and economic burden because of health expenditure are widely discussed issues in India, and more so in recent times. The aim of this study is to identify health problems of tannery workers and their treatment-seeking behavior and their health expenditure. Data and Methods: The primary data used in this article were collected through a cross-sectional household survey of 284 male tannery workers in the Jajmau area of Kanpur city in the state of Uttar Pradesh, during January–June 2015. Results: Findings of the study revealed that around 36% of the tannery workers and 42% of non-tannery workers received treatment as outpatients in government/municipal hospital in the first spell of treatment. The secondary source of treatment was pharmacy/drug stores for 30% of the tannery workers and 24% of the non-tannery workers, an indication that a substantial proportion takes treatment without consulting a qualified medical practitioner; it also highlights that almost one-third of the tannery and non-tannery workers visited private health facility despite poor economic condition. It is evident that a substantial proportion of tannery and non-tannery workers are visiting private/non-governmental organization/trust hospital despite their poor financial situation. Conclusion: There is an urgent need to reinstate people's faith in public health facilities by developing professionalism, integrity, and accountability among different levels of health functionaries and frontline workers with the support of credible, transparent, and responsible regulatory environment. PMID:29743781

Five-year measurements of ambient ammonia and its relationships with other trace gases at an urban site of Delhi, India

NASA Astrophysics Data System (ADS)

Saraswati; Sharma, S. K.; Mandal, T. K.

2018-04-01

In this study, we present the 5-year measurements of ambient ammonia (NH3), oxides of nitrogen (NO and NO2) and carbon monoxide (CO) along with the meteorological parameters at an urban site of Delhi, India from January 2011 to December 2015. The average mixing ratios of ambient NH3, NO, NO2 and CO over the entire period of observations were recorded as 19.3 ± 4.4 (ppb), 20.1 ± 5.9 (ppb), 18.6 ± 4.6 (ppb) and 1.8 ± 0.5 (ppm), respectively. The mixing ratios of NH3, NO, NO2 and CO were recorded highest during winter season, followed by summer and monsoon season. In the present case, a substantial seasonal variation of NH3 was observed during all the seasons except NO, NO2 and CO. The results emphasized that the traffic could be one of the significant sources of ambient NH3 at the urban site of Delhi as illustrated by positive correlations of NH3 with traffic related pollutants (NO x and CO). Surface wind as well as back trajectory analysis also supports the road side traffic and agricultural activities at the nearby area indicating possible major sources of ambient NH3 at observational site. Trajectory analysis, potential source contribution function and concentration weighted trajectory analysis indicated the surrounding nearby areas (NCR, Haryana, Punjab, Rajasthan and Uttar Pradesh) as a significant source region of ambient NH3 at the observational site of Delhi.

Hydrogeochemistry for the assessment of groundwater quality in Varanasi: a fast-urbanizing center in Uttar Pradesh, India.

PubMed

Janardhana Raju, Nandimandalam; Shukla, U K; Ram, Prahlad

2011-02-01

The hydrogeochemical parameters for groundwater samples of the Varanasi area, a fast-urbanizing region in India, were studied to evaluate the major ion chemistry, weathering and solute acquisition processes controlling water composition, and suitability of water quality for domestic and irrigation uses. Sixty-eight groundwater samples were collected randomly from dug wells and hand pumps in the urban Varanasi area and analyzed for various chemical parameters. Geologically, the study area comprises Quaternary alluvium made up of an alternating succession of clay, silty clay, and sand deposits. The Total dissolved solids classification reveals that except two locations, the groundwater samples are desirable for drinking, and all are useful for irrigation purposes. The cationic and anionic concentrations indicated that the majority of the groundwater samples belong to the order of Na>Ca>Mg>K and HCO3>Cl>SO4 types, respectively. Geochemical classification of groundwater based on the Chadha rectangular diagram shows that the majority (81%) of groundwater samples belong to the calcium-bicarbonate type. The HCO3/(HCO3+SO4) ratio (0.87) indicates mostly carbonic acid weathering process due to presence of kankar carbonate mixed with clay/fine sand. The high nitrate concentration (>45 mg/l) of about 18% of the groundwater samples may be due to the local domestic sewage, leakage of septic tanks, and improper management of sanitary landfills. In general, the calculated values of sodium adsorption ratio, percent sodium, residual sodium carbonate, and permeability index indicate good to permissible use of water for irrigation, and only a few locations demand remedial measures for better crop yields.

Groundwater arsenic contamination and its health effects in India

NASA Astrophysics Data System (ADS)

Chakraborti, Dipankar; Rahman, Mohammad Mahmudur; Das, Bhaskar; Chatterjee, Amit; Das, Dipankar; Nayak, Biswajit; Pal, Arup; Chowdhury, Uttam Kumar; Ahmed, Sad; Biswas, Bhajan Kumar; Sengupta, Mrinal Kumar; Hossain, Md. Amir; Samanta, Gautam; Roy, M. M.; Dutta, Rathindra Nath; Saha, Khitish Chandra; Mukherjee, Subhas Chandra; Pati, Shyamapada; Kar, Probir Bijoy; Mukherjee, Adreesh; Kumar, Manoj

2017-06-01

During a 28-year field survey in India (1988-2016), groundwater arsenic contamination and its health effects were registered in the states of West Bengal, Jharkhand, Bihar and Uttar Pradesh in the Ganga River flood plain, and the states of Assam and Manipur in the flood plain of Brahamaputra and Imphal rivers. Groundwater of Rajnandgaon village in Chhattisgarh state, which is not in a flood plain, is also arsenic contaminated. More than 170,000 tubewell water samples from the affected states were analyzed and half of the samples had arsenic >10 μg/L (maximum concentration 3,700 μg/L). Chronic exposure to arsenic through drinking water causes various health problems, like dermal, neurological, reproductive and pregnancy effects, cardiovascular effects, diabetes mellitus, diseases of the respiratory and gastrointestinal systems, and cancers, typically involving the skin, lungs, liver, bladder, etc. About 4.5% of the 8,000 children from arsenic-affected villages of affected states were registered with mild to moderate arsenical skin lesions. In the preliminary survey, more than 10,000 patients were registered with different types of arsenic-related signs and symptoms, out of more than 100,000 people screened from affected states. Elevated levels of arsenic were also found in biological samples (urine, hair, nails) of the people living in affected states. The study reveals that the population who had severe arsenical skin lesions may suffer from multiple Bowens/cancers in the long term. Some unusual symptoms, such as burning sensation, skin itching and watering of eyes in the presence of sun light, were also noticed in arsenicosis patients.

Integration of the Opportunity-Ability-Motivation behavior change framework into a coaching-based WHO Safe Childbirth Checklist program in India.

PubMed

Hirschhorn, Lisa R; Krasne, Margaret; Maisonneuve, Jenny; Kara, Nabihah; Kalita, Tapan; Henrich, Natalie; Rana, Darpan; Maji, Pinki; Delaney, Megan M; Firestone, Rebecca; Sharma, Narender; Kumar, Vishwajeet; Gawande, Atul A; Semrau, Katherine E A

2018-06-03

To evaluate whether integration of the Opportunity-Ability-Motivation plus Supplies (OAMS) framework into coaching improved the delivery of essential birth practices in a low-resource setting. This prospective mixed-methods study used routine coaching visit data obtained from the first eight intervention facilities of the BetterBirth trial in Uttar Pradesh, India, between December 19, 2014, and October 21, 2015. The 8-month intervention was peer coaching that integrated the OAMS framework to support uptake of the WHO Safe Childbirth Checklist. Descriptive statistics were used to measure nonadherence to essential birth practices. The frequency and accuracy of coaches' coding of barriers and the appropriateness of chosen resolution strategies to measure feasibility, acceptability, and fidelity of using OAMS, were assessed. Coaches observed 666 deliveries, including 12 602 practices. Overall, essential practice nonadherence decreased from 15.6% (262/1675 practices observed) to 4.5% (4/88 practices) (P<0.001). Of the 1048 barriers identified, opportunity (556 [53.1%]) and motivation (287 [27.4%]) were the most frequently reported categories; the frequency of both decreased over time (P=0.003 and P<0.001, respectively). The coaches appropriately categorized 930 (99.8%) of 932 barriers and provided an appropriate strategy for 800 (85.8%). The commonest reason for unaddressed barriers was lack of coaching opportunities. Successful integration of OAMS framework into delivery attendant coaching enabled coaches to rapidly diagnose barriers to practice adherence and develop responsive strategies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Medical Applications of Laser Induced Breakdown Spectroscopy

NASA Astrophysics Data System (ADS)

Pathak, A. K.; Rai, N. K.; Singh, Ankita; Rai, A. K.; Rai, Pradeep K.; Rai, Pramod K.

2014-11-01

Sedentary lifestyle of human beings has resulted in various diseases and in turn we require a potential tool that can be used to address various issues related to human health. Laser Induced Breakdown Spectroscopy (LIBS) is one such potential optical analytical tool that has become quite popular because of its distinctive features that include applicability to any type/phase of samples with almost no sample preparation. Several reports are available that discusses the capabilities of LIBS, suitable for various applications in different branches of science which cannot be addressed by traditional analytical methods but only few reports are available for the medical applications of LIBS. In the present work, LIBS has been implemented to understand the role of various elements in the formation of gallstones (formed under the empyema and mucocele state of gallbladder) samples along with patient history that were collected from Purvancal region of Uttar Pradesh, India. The occurrence statistics of gallstones under the present study reveal higher occurrence of gallstones in female patients. The gallstone occurrence was found more prevalent for those male patients who were having the habit of either tobacco chewing, smoking or drinking alcohols. This work further reports in-situ LIBS study of deciduous tooth and in-vivo LIBS study of human nail.

Investigation of malaria prevalence at National Thermal Power Corporation, Shaktinagar, Sonbhadra District (Uttar Pradesh), India.

PubMed

Dua, V K; Nanda, N; Gupta, N C; Kar, P K; Subbarao, S K; Sharma, V P

2000-12-01

Malaria in industrial complexes is promoted by extensive mosquitogenic potential generated by excavations and importation of parasite through migratory labor. The National Thermal Power Corporation (NTPC), Shaktinagar, Sonbhadra district was surveyed for malariogenic conditions from 1994 to 1996. The major mosquito breeding sites were drains, storm-water drains, lakes, outside tanks, overhead tanks, sluice-valve chambers, ornamental tanks, wells, pit wells and water reservoirs, etc. Anopheles culicifacies was the major vector of malaria in this area. Sibling species identification of An. culicifacies revealed that species C predominated during the transmission season and responsible to transmit malaria. Insecticide susceptibility tests against An. culicifacies sl showed that An.culicifacies population was 100% susceptible to malathion, fenitrothorn and deltamethrin while it was found 44% resistant to DDT. The malaria cases recorded in 1994, 1995 and 1996 were 847, 590 and 409 respectively. In vitro study on P. falciparum cases showed that 41, 70, 50% of the isolates tested were resistant to chloroquine in 1994, 1995 and 1996 respectively while an in vivo follow-up study showed 20-30% P. falciparum cases resistant to chloroquine. An integrated approach involving alternate vector control measures along with judicious use of insecticides has been suggested to bring down malaria in industrial complexes.

Activities of the Population Centre during 1979-80: a retrospect.

PubMed

Talwar, P P

1980-01-01

Activities of the Population Center in Lucknow are described. Studies designed to identify factors hindering the progress of the family welfare program are of 4 types. 1) Studies of operational and managerial aspects of the family welfare program service units include work on such topics as the determinants of effectiveness of subcenters in Uttar Pradesh, standardization of materials at rural service centers, factors affecting utilization and performance of primary health centers and subcenters, and effectiveness of auxiliary nurse midwives in delivering maternal and child health services. 2) Studies of effectiveness of program services include such topics as attitude toward vasectomy during the Emergency Period, collection of vital statistics by Community Health Volunteers, and comparisons of Lippes Loop insertions by doctors and paramedics. 3) Studies of education and communication activities include research into mass radio listening and newspaper reading habits and use of local first aid workers to motivate family planning acceptors. 4) Studies of involvement of different organizations in family welfare activities. Another group of studies conducted at the center was designed to evaluate the impact of the India Population Project and included surveys and analysis of secondary data. Population Center collaboration with other organizations and participation in professional meetings is also described, as is the proposed work for 1980-81.

"India Population Projects" in Karnataka.

PubMed

Reddy, P H; Badari, V S

1991-12-01

An overview, objectives, implementation, and research and evaluation studies of 2 India Population Projects in Karnataka are presented. The India Population Project I (IPP-I) was conducted in Karnataka and Uttar Pradesh. India Population Project III (IPP-III) took place between 1984-92 in 6 districts of Karnataka: Belgaum, Bijapur, Dharwad, Bidar, Gulbarga, and Raichur, and 4 districts in Kerala. The 6 districts in Karnataka accounted for 36% (13.2 million) of the total national population. The project cost was Rs. 713.1 million which was shared by the World Bank, and the Indian national and regional government. Due to poor past performance, these projects were undertaken to improve health and family welfare status. Specific project objectives are outlined. IPP-I included an urban component, and optimal Government of India program, and an intensive rural initiative. The urban program aimed to improved pre- and postnatal services and facilities, and the family planning (FP) in Bangalore city. The rural program was primarily to provide auxiliary nurse-midwives and hospitals and clinics, and also supplemental feeding program for pregnant and nursing mothers and children up to 2 years. The government program provided FP staff and facilities. IPP-I had 3 units to oversee building construction, to recruit staff and provide supplies and equipment, and to establish a Population Center. IPP-III was concerned with service delivery; information, education, and communication efforts (IEC) and population education; research and evaluation; and project management. Both projects contributed significantly to improving the infrastructure. A brief account of the types and kinds of studies undertaken is given. Studies were grouped into longitudinal studies of fertility, mortality, and FP; management information and evaluation systems for health and family welfare programs; experimental strategies; and other studies. Research and evaluation studies in IPP-III encompassed studies in gaps in knowledge, skills, and practice of health and FP personnel; baseline and endline surveys; and operational evaluation of the management information and evaluation system; factors affecting primary health care in Gulbarga district; evaluation of radio health lessons and the impact of the Kalyana Matha Program; and studies of vaccination and child survival and maternal mortality. Training programs were also undertaken.

First Report on the Ethnopharmacological Uses of Medicinal Plants by Monpa Tribe from the Zemithang Region of Arunachal Pradesh, Eastern Himalayas, India

PubMed Central

Chakraborty, Tamalika; Saha, Somidh; Bisht, Narendra S.

2017-01-01

The Himalayas are well known for high diversity and ethnobotanical uses of the region’s medicinal plants. However, not all areas of the Himalayan regions are well studied. Studies on ethnobotanical uses of plants from the Eastern Himalayas are still lacking for many tribes. Past studies have primarily focused on listing plants’ vernacular names and their traditional medicinal uses. However, studies on traditional ethnopharmacological practices on medicine preparation by mixing multiple plant products of different species has not yet been reported in published literature from the state of Arunachal Pradesh, India, Eastern Himalayas. In this study, we are reporting for the first time the ethnopharmacological uses of 24 medicines and their procedures of preparation, as well as listing 53 plant species used for these medicines by the Monpa tribe. Such documentations are done first time in Arunachal Pradesh region of India as per our knowledge. Our research emphasizes the urgent need to document traditional medicine preparation procedures from local healers before traditional knowledge of tribal people living in remote locations are forgotten in a rapidly transforming country like India. PMID:28257092

Mean Dietary Salt Intake in Urban and Rural Areas in India: A Population Survey of 1395 Persons.

PubMed

Johnson, Claire; Mohan, Sailesh; Rogers, Kris; Shivashankar, Roopa; Thout, Sudhir Raj; Gupta, Priti; He, Feng J; MacGregor, Graham A; Webster, Jacqui; Krishnan, Anand; Maulik, Pallab K; Reddy, K Srinath; Prabhakaran, Dorairaj; Neal, Bruce

2017-01-06

The scientific evidence base in support of population-wide salt reduction is strong, but current high-quality data about salt intake levels in India are mostly absent. This project sought to estimate daily salt consumption levels in selected communities of Delhi and Haryana in north India and Andhra Pradesh in south India. In this study, 24-hour urine samples were collected using an age- and sex-stratified sampling strategy in rural, urban, and slum areas. Salt intake estimates were made for the overall population of each region and for major subgroups by weighting the survey data for the populations of Delhi and Haryana, and Andhra Pradesh. Complete 24-hour urine samples were available for 637 participants from Delhi and Haryana and 758 from Andhra Pradesh (65% and 68% response rates, respectively). Weighted mean population 24-hour urine excretion of salt was 8.59 g/day (95% CI 7.68-9.51) in Delhi and Haryana and 9.46 g/day (95% CI 9.06-9.85) in Andhra Pradesh (P=0.097). Estimates inflated to account for the minimum likely nonurinary losses of sodium provided corresponding estimates of daily salt intake of 9.45 g/day (95% CI 8.45-10.46) and 10.41 g/day (95% CI 9.97-10.84), respectively. Salt consumption in India is high, with mean population intake well above the World Health Organization recommended maximum of 5 g/day. A national salt reduction program would likely avert much premature death and disability. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Communicative Language Teaching: Possibilities and Problems

ERIC Educational Resources Information Center

Sreehari, Pusuluri

2012-01-01

This paper investigates the teaching of English at undergraduate colleges in the state of Andhra Pradesh, India in the backdrop of Andhra Pradesh English Lecturers' Retraining Program. The program was jointly sponsored and conducted by the Directorate of Collegiate Education, Government of AP and the US State Department English Language Fellow…

Are learning strategies linked to academic performance among adolescents in two States in India? A tobit regression analysis.

PubMed

Areepattamannil, Shaljan

2014-01-01

The results of the fourth cycle of the Program for International Student Assessment (PISA) revealed that an unacceptably large number of adolescent students in two states in India-Himachal Pradesh and Tamil Nadu-have failed to acquire basic skills in reading, mathematics, and science (Walker, 2011). Drawing on data from the PISA 2009 database and employing multivariate left-censored to bit regression as a data analytic strategy, the present study, therefore, examined whether or not the learning strategies-memorization, elaboration, and control strategies-of adolescent students in Himachal Pradesh (N = 1,616; Mean age = 15.81 years) and Tamil Nadu (N = 3,210; Mean age = 15.64 years) were linked to their performance on the PISA 2009 reading, mathematics, and science assessments. Tobit regression analyses, after accounting for student demographic characteristics, revealed that the self-reported use of control strategies was significantly positively associated with reading, mathematical, and scientific literacy of adolescents in Himachal Pradesh and Tamil Nadu. While the self-reported use of elaboration strategies was not significantly associated with reading literacy among adolescents in Himachal Pradesh and Tamil Nadu, it was significantly positively associated with mathematical literacy among adolescents in Himachal Pradesh and Tamil Nadu. Moreover, the self-reported use of elaboration strategies was significantly and positively linked to scientific literacy among adolescents in Himachal Pradesh alone. The self-reported use of memorization strategies was significantly negatively associated with reading, mathematical, and scientific literacy in Tamil Nadu, while it was significantly negatively associated with mathematical and scientific literacy alone in Himachal Pradesh. Implications of these findings are discussed.

Population Health Metrics Research Consortium gold standard verbal autopsy validation study: design, implementation, and development of analysis datasets

PubMed Central

2011-01-01

Background Verbal autopsy methods are critically important for evaluating the leading causes of death in populations without adequate vital registration systems. With a myriad of analytical and data collection approaches, it is essential to create a high quality validation dataset from different populations to evaluate comparative method performance and make recommendations for future verbal autopsy implementation. This study was undertaken to compile a set of strictly defined gold standard deaths for which verbal autopsies were collected to validate the accuracy of different methods of verbal autopsy cause of death assignment. Methods Data collection was implemented in six sites in four countries: Andhra Pradesh, India; Bohol, Philippines; Dar es Salaam, Tanzania; Mexico City, Mexico; Pemba Island, Tanzania; and Uttar Pradesh, India. The Population Health Metrics Research Consortium (PHMRC) developed stringent diagnostic criteria including laboratory, pathology, and medical imaging findings to identify gold standard deaths in health facilities as well as an enhanced verbal autopsy instrument based on World Health Organization (WHO) standards. A cause list was constructed based on the WHO Global Burden of Disease estimates of the leading causes of death, potential to identify unique signs and symptoms, and the likely existence of sufficient medical technology to ascertain gold standard cases. Blinded verbal autopsies were collected on all gold standard deaths. Results Over 12,000 verbal autopsies on deaths with gold standard diagnoses were collected (7,836 adults, 2,075 children, 1,629 neonates, and 1,002 stillbirths). Difficulties in finding sufficient cases to meet gold standard criteria as well as problems with misclassification for certain causes meant that the target list of causes for analysis was reduced to 34 for adults, 21 for children, and 10 for neonates, excluding stillbirths. To ensure strict independence for the validation of methods and assessment of comparative performance, 500 test-train datasets were created from the universe of cases, covering a range of cause-specific compositions. Conclusions This unique, robust validation dataset will allow scholars to evaluate the performance of different verbal autopsy analytic methods as well as instrument design. This dataset can be used to inform the implementation of verbal autopsies to more reliably ascertain cause of death in national health information systems. PMID:21816095

Community Managed Services for Persons with Intellectual Disability: Andhra Pradesh Experience

ERIC Educational Resources Information Center

Narayan, Jayanthi; Pratapkumar, Raja; Reddy, Sudhakara P.

2017-01-01

In resource poor settings innovative and bottom-up approaches are required to provide services to people with with disabilities. In this context, the present paper explains a community-based model of manpower development and coordination of services for people with intellectual disabilities in unified state of Andhra Pradesh in India. Women with…

Complex routes into HIV care for migrant workers: a qualitative study from north India

PubMed Central

Rai, Tanvi; Lambert, Helen S.; Ward, Helen

2015-01-01

ABSTRACT Migrant workers are designated a bridge population in the spread of HIV and therefore if infected, should be diagnosed and treated early. This study examined pathways to HIV diagnosis and access to care for rural-to-urban circular migrant workers and partners of migrants in northern India, identifying structural, social and individual level factors that shaped their journeys into care. We conducted a qualitative study using in-depth interviews with HIV-positive men (n = 20) and women (n = 13) with a history of circular migration, recruited from an antiretroviral therapy centre in one district of Uttar Pradesh, north India. Migrants and partners of migrants faced a complex series of obstacles to accessing HIV testing and care. Employment insecurity, lack of entitlement to sick pay or subsidised healthcare at destination and the household's economic reliance on their migration-based livelihood led many men to continue working until they became incapacitated by HIV-related morbidity. During periods of deteriorating health they often exhausted their savings on private treatments focused on symptom management, and sought HIV testing and treatment at a public hospital only following a medical or financial emergency. Wives of migrants had generally been diagnosed following their husbands' diagnosis or death, with access to testing and treatment mediated via family members. For some, a delay in disclosure of husband's HIV status led to delays in their own testing. Diagnosing and treating HIV infection early is important in slowing down the spread of the epidemic and targeting those at greatest risk should be a priority. However, despite targeted campaigns, circumstances associated with migration may prevent migrant workers and their partners from accessing testing and treatment until they become sick. The insecurity of migrant work, the dominance of private healthcare and gender differences in health-seeking behaviour delay early diagnosis and treatment initiation. PMID:26608276

Complex routes into HIV care for migrant workers: a qualitative study from north India.

PubMed

Rai, Tanvi; Lambert, Helen S; Ward, Helen

2015-01-01

Migrant workers are designated a bridge population in the spread of HIV and therefore if infected, should be diagnosed and treated early. This study examined pathways to HIV diagnosis and access to care for rural-to-urban circular migrant workers and partners of migrants in northern India, identifying structural, social and individual level factors that shaped their journeys into care. We conducted a qualitative study using in-depth interviews with HIV-positive men (n = 20) and women (n = 13) with a history of circular migration, recruited from an antiretroviral therapy centre in one district of Uttar Pradesh, north India. Migrants and partners of migrants faced a complex series of obstacles to accessing HIV testing and care. Employment insecurity, lack of entitlement to sick pay or subsidised healthcare at destination and the household's economic reliance on their migration-based livelihood led many men to continue working until they became incapacitated by HIV-related morbidity. During periods of deteriorating health they often exhausted their savings on private treatments focused on symptom management, and sought HIV testing and treatment at a public hospital only following a medical or financial emergency. Wives of migrants had generally been diagnosed following their husbands' diagnosis or death, with access to testing and treatment mediated via family members. For some, a delay in disclosure of husband's HIV status led to delays in their own testing. Diagnosing and treating HIV infection early is important in slowing down the spread of the epidemic and targeting those at greatest risk should be a priority. However, despite targeted campaigns, circumstances associated with migration may prevent migrant workers and their partners from accessing testing and treatment until they become sick. The insecurity of migrant work, the dominance of private healthcare and gender differences in health-seeking behaviour delay early diagnosis and treatment initiation.

Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol.

PubMed

Prinja, Shankar; Nimesh, Ruby; Gupta, Aditi; Bahuguna, Pankaj; Thakur, Jarnail Singh; Gupta, Madhu; Singh, Tarundeep

2016-01-01

An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. A pre-post quasi-experimental design with a control group will be used to undertake difference in differences analysis for assessing the impact of intervention. The Annual Health Survey (2011) will provide pre-intervention data, and a household survey will be carried out to provide post-intervention data.Two community development blocks where the intervention was introduced will be treated as intervention blocks while two controls blocks are selected after matching with intervention blocks on three indicators: average number of antenatal care checkups, percentage of women receiving three or more antenatal checkups, and percentage of institutional deliveries. Two categories of beneficiaries will be interviewed in both areas: women with a child between 29 days and 6 months and women with a child between 12 and 23 months. Propensity score matched samples from intervention and control areas in pre-post periods will be analyzed using the difference in differences method to estimate the impact of intervention in utilization of key services.Bottom-up costing methods will be used to assess the cost of implementing intervention. A decision model will estimate long-term effects of improved health services utilization on mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per disability-adjusted life year averted and cost per unit increase in composite service coverage in intervention versus control groups. The study will generate significant evidence on impact of the m-health intervention for maternal, neonatal, and child services and on the cost of scaling up m-health technology for accredited social health activists in India.

Medical barriers to emergency contraception: a cross-sectional survey of doctors in North India.

PubMed

Khan, M E; Dixit, Anvita; Bhatnagar, Isha; Brady, Martha

2014-05-01

Some medical doctors in India have publicly expressed opposition to making emergency contraceptive pills (ECPs) easily accessible, even though ECPs are included in the method mix of the Ministry of Health and Family Welfare program and as an over-the-counter (OTC) product. Such opposition affects access to ECPs by influencing policy, procurement, and distribution, besides stigmatizing the ECP user. This study was conducted to assess ECP knowledge, attitudes, and practices of doctors in North India. A cross-sectional survey of 83 doctors who provide ECPs, randomly selected from 3 cities in the state of Uttar Pradesh, was conducted in 2011. The quantitative data were complemented by 19 in-depth interviews with purposively selected senior gynecologists and other opinion leaders. All surveyed physicians cited the correct dose and regimen for ECPs. However, the large majority of those surveyed believed that ECPs work by preventing implantation. (The best evidence currently indicates that ECPs do not work by preventing implantation.) Most doctors also believed incorrectly that ECPs have several contraindications and side effects. They also had strong reservations against OTC provision of ECPs by pharmacists and community health workers (CHWs) and negative attitudes toward ECP users, which serve as serious medical barriers to mainstreaming use of ECPs. Physicians and their professional associations exert a strong influence on the operationalization of national contraceptive policies. Evidence-based advocacy and educational campaigns targeting doctors are needed to address and resolve their reservations about ECPs, particularly about its provision as an OTC product and its distribution by CHWs. Partnerships with medical associations can help reduce doctors' negative attitudes and create a conducive environment for influencing clinical practices. Such changes are needed to increase the availability and use of ECPs as part of a package of a full range of contraceptive method options to prevent unwanted pregnancy among the most vulnerable populations.

District decision-making for health in low-income settings: a feasibility study of a data-informed platform for health in India, Nigeria and Ethiopia.

PubMed

Avan, Bilal Iqbal; Berhanu, Della; Umar, Nasir; Wickremasinghe, Deepthi; Schellenberg, Joanna

2016-09-01

Low-resource settings often have limited use of local data for health system planning and decision-making. To promote local data use for decision-making and priority setting, we propose an adapted framework: a data-informed platform for health (DIPH) aimed at guiding coordination, bringing together key data from the public and private sectors on inputs and processes. In working to transform this framework from a concept to a health systems initiative, we undertook a series of implementation research activities including background assessment, testing and scaling up of the intervention. This first paper of four reports the feasibility of the approach in a district health systems context in five districts of India, Nigeria and Ethiopia. We selected five districts using predefined criteria and in collaboration with governments. After scoping visits, an in-depth field visit included interviews with key health stakeholders, focus group discussions with service-delivery staff and record review. For analysis, we used five dimensions of feasibility research based on the TELOS framework: technology and systems, economic, legal and political, operational and scheduling feasibility. We found no standardized process for data-based district level decision-making, and substantial obstacles in all three countries. Compared with study areas in Ethiopia and Nigeria, the health system in Uttar Pradesh is relatively amenable to the DIPH, having relative strengths in infrastructure, technological and technical expertise, and financial resources, as well as a district-level stakeholder forum. However, a key challenge is the absence of an effective legal framework for engagement with India's extensive private health sector. While priority-setting may depend on factors beyond better use of local data, we conclude that a formative phase of intervention development and pilot-testing is warranted as a next step. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Mobilizing community-based health insurance to enhance awareness & prevention of airborne, vector-borne & waterborne diseases in rural India

PubMed Central

Panda, Pradeep; Chakraborty, Arpita; Dror, David M.

2015-01-01

Background & objectives: Despite remarkable progress in airborne, vector-borne and waterborne diseases in India, the morbidity associated with these diseases is still high. Many of these diseases are controllable through awareness and preventive practice. This study was an attempt to evaluate the effectiveness of a preventive care awareness campaign in enhancing knowledge related with airborne, vector-borne and waterborne diseases, carried out in 2011 in three rural communities in India (Pratapgarh and Kanpur-Dehat in Uttar Pradesh and Vaishali in Bihar). Methods: Data for this analysis were collected from two surveys, one done before the campaign and the other after it, each of 300 randomly selected households drawn from a larger sample of Self-Help Groups (SHGs) members invited to join community-based health insurance (CBHI) schemes. Results: The results showed a significant increase both in awareness (34%, p<0.001) and in preventive practices (48%, P=0.001), suggesting that the awareness campaign was effective. However, average practice scores (0.31) were substantially lower than average awareness scores (0.47), even in post-campaign. Awareness and preventive practices were less prevalent in vector-borne diseases than in airborne and waterborne diseases. Education was positively associated with both awareness and practice scores. The awareness scores were positive and significant determinants of the practice scores, both in the pre- and in the post-campaign results. Affiliation to CBHI had significant positive influence on awareness and on practice scores in the post-campaign period. Interpretation & conclusions: The results suggest that well-crafted health educational campaigns can be effective in raising awareness and promoting health-enhancing practices in resource-poor settings. It also confirms that CBHI can serve as a platform to enhance awareness to risks of exposure to airborne, vector-borne and waterborne diseases, and encourage preventive practices. PMID:26354212

Viability of Mycobacterium leprae in the environment and its role in leprosy dissemination.

PubMed

Mohanty, Partha Sarathi; Naaz, Farah; Katara, Dheeraj; Misba, Lama; Kumar, Dilip; Dwivedi, Deepak Kumar; Tiwari, Amit Kumar; Chauhan, Devendra Singh; Bansal, Avi Kumar; Tripathy, Srikanth Prasad; Katoch, Kiran

2016-01-01

Leprosy, a chronic disease caused by Mycobacterium leprae, is a public health concern in certain countries, including India. Although the prevalence of the disease has fallen drastically over time, new cases continue to occur at nearly the same rate in many regions. Several endemic pockets have been observed in India and elsewhere. The precise dynamics of leprosy transmission are still not clearly understood. Both live bacilli as well as M. leprae DNA have been detected in the soil and water of endemic areas; they possibly play an important role in disease transmission. To study the occurrence of viable M. leprae in environmental samples collected from areas of residence of patients with active leprosy. The study was conducted on 169 newly diagnosed leprosy patients in Ghatampur, Uttar Pradesh, India. Soil and water samples were collected from their areas of residence using a standardized protocol. An equal number of soil and water samples were also collected from non-patient areas of the same or adjoining villages. The environmental samples collected from the patients surroundings were subjected to 16S ribosomal RNA gene analysis after obtaining informed consent. About a quarter of the environmental samples collected from patient areas, (25.4% of soil samples and 24.2% of water samples) were found to be positive for specific 16S ribosomal RNA genes of M. leprae. Environmental samples collected from non-patient areas were all found negative for M. leprae 16S ribosomal RNA genes. The major limitation of the study was that the sample size was small. The study demonstrated the presence of viable strains of M. leprae in skin smear samples of paucibacillary patients and multibacillary patients, as well as in the environmental samples obtained from around their houses. This could play an important role in the continued transmission of leprosy.

Strategies to reduce infant mortality rate in India.

PubMed

Ghai, O P

1985-01-01

As a systems approach is needed to develop strategies to reduce the infant mortality rate (IMR), it is appropriate to analyze the present situation in India, reasons for low IMR in some Indian states vis-a-vis others, the status in some neighboring countries, and the cost effectiveness of various available technological interventions and their organizational constraints. A 1981 survey revealed 1) a low IMR for the state of Kerala, one which was comparable with Western nations, despite the fact that nearly half of the population in Kerala lived below the poverty line; 2) a very high IMR for the state of Uttar Pradesh, even though the number of people living below the poverty line was not significantly by different from the state of Kerala; and a moderate IMR reduction in the state of Punjab, even though only 15% of the population was below the poverty line. Favorable factors for low IMR appear to be a high female literacy rate, good medical and educational facilities close to the place of residence, and an excellent transportation and communication system. To significantly reduce IMR in a short period of time, it is necessary to adopt certain immediate measures. Nearly 55% of infant deaths occur in the 1st month of life, and these generally are not amenable to general measures and technological interventions. The problem is difficult, but a solution can be found by reaching a broad consensus among professionals and administrators. The major recommendations of a seminar on the Strategies for Reducing infant Mortality in India, held during January 1984, were: provide antenatal care to 100% of pregnant women; work for early registration of pregnancy and identification of high risk pregnancies; immunize 100% of pregnant women with tetanus toxoid; make available intrapartum care for all pregnant women; delineate anticipated job requirements, duties, and functions of village level health workers; make presterilized packaged delivery kits available to all female health workers; and implement secondary level perinatal care.

Danger signs of neonatal illnesses: perceptions of caregivers and health workers in northern India.

PubMed Central

Awasthi, Shally; Verma, Tuhina; Agarwal, Monica

2006-01-01

OBJECTIVE: To assess household practices that can affect neonatal health, from the perspective of caregivers and health workers; to identify signs in neonates leading either to recognition of illness or health-care seeking; and to ascertain the proportion of caregivers who recognize the individual items of the integrated management of neonatal and childhood illnesses (IMNCI) programme. METHODS: The study was carried out in a rural community in Sarojininagar Block, Uttar Pradesh, India, using qualitative and quantitative research designs. Study participants were mothers, grandmothers, grandfathers, fathers or "nannies" (other female relatives) caring for infants younger than 6 months of age and recognized health-care providers serving the area. Focus group discussions (n = 7), key informant interviews (n = 35) and structured interviews (n = 210) were conducted with these participants. FINDINGS: Many household practices were observed which could adversely affect maternal and neonatal health. Among 200 caregivers, 70.5% reported home deliveries conducted by local untrained nurses or relatives, and most mothers initiated breastfeeding only on day 3. More than half of the caregivers recognized fever, irritability, weakness, abdominal distension/vomiting, slow breathing and diarrhoea as danger signs in neonates. Seventy-nine (39.5%) of the caregivers had seen a sick neonate in the family in the past 2 years, with 30.38% in whom illness manifested as continuous crying. Health care was sought for 46 (23%) neonates. Traditional medicines were used for treatment of bulging fontanelle, chest in-drawing and rapid breathing. CONCLUSION: Because there is no universal recognition of danger signs in neonates, and potentially harmful antenatal and birthing practices are followed, there is a need to give priority to implementing IMNCI, and possible incorporation of continuous crying as an additional danger sign. PMID:17128362

The impact of recurrent disasters on mental health: a study on seasonal floods in northern India.

PubMed

Wind, Tim R; Joshi, Pooran C; Kleber, Rolf J; Komproe, Ivan H

2013-06-01

Very little is known on the impact of recurrent disasters on mental health. Aim The present study examines the immediate impact of a recurrent flood on mental health and functioning among an affected population in the rural district of Bahraich, Uttar Pradesh, India, compared with a population in the same region that is not affected by floods. The study compared 318 affected respondents with 308 individuals who were not affected by floods. Symptoms of anxiety and depression were assessed by the Hopkins Symptom Checklist-25 (HSCL-25). Psychological and physical functioning was assessed by using the Short Form-12 (SF-12). The affected group showed large to very large differences with the comparison group on symptoms of anxiety (D = .92) and depression (D = 1.22). The affected group scored significantly lower on psychological and physical functioning than the comparison group (respectively D = .33 and D = .80). However, hierarchical linear regressions showed no significant relationship between mental health and the domains of functioning in the affected group, whereas mental health and the domains of functioning were significantly related in the comparison group. This study found a large negative impact of the recurrent floods on mental health outcomes and psychological and physical functioning. However, in a context with recurrent floods, disaster mental health status is not a relevant predictor of functioning. The findings suggest that the observed mental health status and impaired functioning in this context are also outcomes of another mechanism: Both outcomes are likely to be related to the erosion of the social and environmental and material context. As such, the findings refer to a need to implement psychosocial context-oriented interventions to address the erosion of the context rather than specific mental health interventions.

A Comparative Evaluation of Public Health Centers with Private Health Training Centers on Primary Healthcare Parameters in India: a Study by Data Envelopment Analysis Technique

PubMed Central

Davey, Sanjeev; Raghav, Santosh Kumar; Singh, Jai Vir; Davey, Anuradha; Singh, Nirankar

2015-01-01

Background: The evaluation of primary healthcare services provided by health training centers of a private medical college has not been studied in comparison with government health facilities in Indian context. Data envelopment analysis (DEA) is one such technique of operations research, which can be used on health facilities for identifying efficient operating practices and strategies for relatively efficient or inefficient health centers by calculating their efficiency scores. Materials and Methods: This study was carried out by DEA technique by using basic radial models (constant ratio to scale (CRS)) in linear programming via DEAOS free online Software among four decision making units (DMUs; by comparing efficiency of two private health centers of a private medical college of India with two public health centers) in district Muzaffarnagar of state Uttar Pradesh. The input and output records of all these health facilities (two from private and two from Government); for 6 months duration from 1st Jan 2014 to 1st July 2014 was taken for deciding their efficiency scores. Results: The efficiency scores of primary healthcare services in presence of doctors (100 vs 30%) and presence of health staff (100 vs 92%) were significantly better from government health facilities as compared to private health facilities (P < 0.0001). Conclusions: The evaluation of primary healthcare services delivery by DEA technique reveals that the government health facilities group were more efficient in delivery of primary healthcare services as compared to private training health facilities group, which can be further clarified in by more in-depth studies in future. PMID:26435598

Assessment of underground water potential zones using modern geomatics technologies in Jhansi district, Uttar Pradesh, India.

NASA Astrophysics Data System (ADS)

Pandey, N. K.; Shukla, A. K.; Shukla, S.; Pandey, M.

2014-11-01

Ground water is a distinguished component of the hydrologic cycle. Surface water storage and ground water withdrawal are traditional engineering approaches which will continue to be followed in the future. The uncertainty about the occurrence, distribution and quality aspect of the ground water and the energy requirement for its withdrawal impose restriction on exploitation of ground water. The main objective of the study is assessment of underground water potential zones of Jhansi city and surrounding area, by preparing underground water potential zone map using Geographical Information System (GIS), remote sensing, and validation by underground water inventory mapping using GPS field survey done along the parts of National Highway 25 and 26 and some state highway passing through the study area. Study area covers an area of 1401 km2 and its perimeter is approximate 425 km. For this study Landsat TM (0.76-0.90 um) band data were acquired from GLCF website. Sensor spatial resolution is 30 m. Satellite image has become a standard tool aiding in the study of underground water. Extraction of different thematic layers like Land Use Land Cover (LULC), settlement, etc. can be done through unsupervised classification. The modern geometics technologies viz. remote sensing and GIS are used to produce the map that classifies the groundwater potential zone to a number of qualitative zone such as very high, high, moderate, low or very low. Thematic maps are prepared by visual interpretation of Survey of India topo-sheets and linearly enhanced Landsat TM satellite image on 1 : 50,000 scale using AutoCAD, ArcGIS 10.1 and ERDAS 11 software packages.

Analysing land and vegetation cover dynamics during last three decades in Katerniaghat wildlife sanctuary, India

NASA Astrophysics Data System (ADS)

Chitale, V. S.; Behera, M. D.

2014-10-01

The change in the tropical forests could be clearly linked to the expansion of the human population and economies. An understanding of the anthropogenic forcing plays an important role in analyzing the impacts of climate change and the fate of tropical forests in the present and future scenario. In the present study, we analyze the impact of natural and anthropogenic factors in forest dynamics in Katerniaghat wildlife sanctuary situated along the Indo-Nepal border in Uttar Pradesh state, India. The study site is under tremendous pressure due to anthropogenic factors from surrounding areas since last three decades. The vegetation cover of the sanctuary primarily comprised of Shorea robusta forests, Tectona grandis plantation, and mixed deciduous forest; while the land cover comprised of agriculture, barren land, and water bodies. The classification accuracy was 83.5%, 91.5%, and 95.2% with MSS, IKONOS, and Quickbird datasets, respectively. Shorea robusta forests showed an increase of 16 km2; while Tectona grandis increased by 63.01 km2 during 1975-2010. The spatial heterogeneity in these tropical vegetation classes surrounded by the human dominated agricultural lands could not be addressed using Landsat MSS data due to coarse spatial resolution; whereas the IKONOS and Quickbird satellite datasets proved to advantageous, thus being able to precisely address the variations within the vegetation classes as well as in the land cover classes and along the edge areas. Massive deforestation during 1970s along the adjoining international boundary with Nepal has led to destruction of the wildlife corridor and has exposed the wildlife sanctuary to human interference like grazing and poaching. Higher rates of forest dynamics during the 25-year period indicate the vulnerability of the ecosystem to the natural and anthropogenic disturbances in the proximity of the sanctuary.

Prevalence of hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus and hepatitis E virus as causes of acute viral hepatitis in North India: a hospital based study.

PubMed

Jain, P; Prakash, S; Gupta, S; Singh, K P; Shrivastava, S; Singh, D D; Singh, J; Jain, A

2013-01-01

Acute viral hepatitis (AVH) is a major public health problem and is an important cause of morbidity and mortality. The aim of the present study is to determine the prevalence of hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV) and hepatitis E virus (HEV) as causes of AVH in a tertiary care hospital of North India. Blood samples and clinical information was collected from cases of AVH referred to the Grade I viral diagnostic laboratory over a 1-year period. Samples were tested for hepatitis B surface antigen, anti-HCV total antibodies, anti-HAV immunoglobulin M (IgM) and anti-HEV IgM by the enzyme-linked immunosorbent assay. PCR for nucleic acid detection of HBV and HCV was also carried out. Those positive for HBV infection were tested for anti-HDV antibodies. Fisher's exact test was used and a P < 0.05 was considered to be statistically significant. Of the 267 viral hepatitis cases, 62 (23.22%) patients presented as acute hepatic failure. HAV (26.96%) was identified as the most common cause of acute hepatitis followed by HEV (17.97%), HBV (16.10%) and HCV (11.98%). Co-infections with more than one virus were present in 34 cases; HAV-HEV co-infection being the most common. HEV was the most important cause of acute hepatic failure followed by co-infection with HAV and HEV. An indication towards epidemiological shift of HAV infection from children to adults with a rise in HAV prevalence was seen. To the best of our knowledge, this is the first report indicating epidemiological shift of HAV in Uttar Pradesh.

Groundwater quality assessment in the village of Lutfullapur Nawada, Loni, District Ghaziabad, Uttar Pradesh, India.

PubMed

Singh, Vinod K; Bikundia, Devendra Singh; Sarswat, Ankur; Mohan, Dinesh

2012-07-01

The groundwater quality for drinking, domestic and irrigation in the village Lutfullapur Nawada, Loni, district Ghaziabad, U.P., India, has been assessed. Groundwater samples were collected, processed and analyzed for temperature, pH, conductivity, salinity, total alkalinity, carbonate alkalinity, bicarbonate alkalinity, total hardness, calcium hardness, magnesium hardness, total solids, total dissolved solids, total suspended solids, nitrate-nitrogen, chloride, fluoride, sulfate, phosphate, silica, sodium, potassium, calcium, magnesium, total chromium, cadmium, copper, iron, nickel, lead and zinc. A number of groundwater samples showed levels of electrical conductivity (EC), alkalinity, chloride, calcium, sodium, potassium and iron exceeding their permissible limits. Except iron, the other metals (Cr, Cd, Cu, Ni, Pb, and Zn) were analyzed below the permissible limits. The correlation matrices for 28 variables were performed. EC, salinity, TS and TDS had significant positive correlations among themselves and also with NO (3) (-) , Cl(-), alkalinity, Na(+), K(+), and Ca(2+). Fluoride was not significantly correlated with any of the parameters. NO (3) (-) was significantly positively correlated with Cl(-), alkalinity, Na(+), K(+) and Ca(2+). Chloride also correlated significantly with alkalinity, Na(+), K(+) and Ca(2+). Sodium showed a strong and positive correlation with K(+) and Ca(2+). pH was negatively correlated with most of the physicochemical parameters. This groundwater is classified as a normal sulfate and chloride type. Base-exchange indices classified 73% of the groundwater sources as the Na(+)-SO (4) (2-) type. The meteoric genesis indices demonstrated that 67% of groundwater sources belong to a deep meteoric water percolation type. Hydrochemical groundwater evaluations revealed that most of the groundwaters belong to the Na(+)-K(+)-Cl(-)-SO (4) (2-) type followed by Na(+)-K(+)-HCO (3) (-) type. Salinity, chlorinity and SAR indices indicated that majority of groundwater samples can be considered suitable for irrigation purposes.

Demand generation activities and modern contraceptive use in urban areas of four countries: a longitudinal evaluation

PubMed Central

Speizer, Ilene S; Corroon, Meghan; Calhoun, Lisa; Lance, Peter; Montana, Livia; Nanda, Priya; Guilkey, David

2014-01-01

ABSTRACT Family planning is crucial for preventing unintended pregnancies and for improving maternal and child health and well-being. In urban areas where there are large inequities in family planning use, particularly among the urban poor, programs are needed to increase access to and use of contraception among those most in need. This paper presents the midterm evaluation findings of the Urban Reproductive Health Initiative (Urban RH Initiative) programs, funded by the Bill & Melinda Gates Foundation, that are being implemented in 4 countries: India (Uttar Pradesh), Kenya, Nigeria, and Senegal. Between 2010 and 2013, the Measurement, Learning & Evaluation (MLE) project collected baseline and 2-year longitudinal follow-up data from women in target study cities to examine the role of demand generation activities undertaken as part of the Urban RH Initiative programs. Evaluation results demonstrate that, in each country where it was measured, outreach by community health or family planning workers as well as local radio programs were significantly associated with increased use of modern contraceptive methods. In addition, in India and Nigeria, television programs had a significant effect on modern contraceptive use, and in Kenya and Nigeria, the program slogans and materials that were blanketed across the cities (eg, leaflets/brochures distributed at health clinics and the program logo placed on all forms of materials, from market umbrellas to health facility signs and television programs) were also significantly associated with modern method use. Our results show that targeted, multilevel demand generation activities can make an important contribution to increasing modern contraceptive use in urban areas and could impact Millennium Development Goals for improved maternal and child health and access to reproductive health for all. PMID:25611476

A new monozoic tapeworm, Lobulovarium longiovatum n. g., n. sp. (Cestoda: Caryophyllidea), from barbs Puntius spp. (Teleostei: Cyprinidae) in the Indomalayan region.

PubMed

Oros, Mikuláš; Ash, Anirban; Brabec, Jan; Kar, Pradip Kumar; Scholz, Tomáš

2012-09-01

A new caryophyllidean cestode is described from barbs Puntius spp. (Cypriniformes: Cyprinidae), with P. sophore (Hamilton) as its type-host, in the Ganges and Brahmaputra river basins in India and Bangladesh, and a new genus, Lobulovarium n. g., is proposed to accommodate it. The genus belongs to the Lytocestidae because its vitelline follicles are situated in the cortex. It is typified by: (i) a peculiar ovary, which is roughly H-shaped, but with asymmetrical, irregular lobes on its ventral and dorsal sides; (ii) an extensive vitellarium formed by numerous vitelline follicles scattered throughout the cortex; (iii) a long, conical postovarian part of the body with numerous vitelline follicles; (iv) a broadly digitate scolex with a slightly protrusible central cone; (v) a single gonopore (male and female genital ducts open via a single pore and a common genital atrium is absent); and (vi) a small number of testes (< 60). Molecular data (partial sequences of the lsrDNA) indicate that Lobulovarium longiovatum n. sp. belongs among the most basal caryophyllidean cestodes, being unrelated to species from siluriform catfishes in the Indomalayan region. Paracaryophyllaeus osteobramensis (Gupta & Sinha, 1984) Hafeezullah, 1993 (syn. Pliovitellaria osteobramensis Gupta & Sinha, 1984) from another cyprinid fish, Osteobrama cotio (Hamilton), in Uttar Pradesh, India, is tentatively transferred to Lobulovarium as L. osteobramense (Gupta & Sinha, 1984) n. comb. It differs from L. longiovatum by having much smaller eggs (length <50 μm versus >90 μm in L. longiovatum), which are spherical (length/width ratio 1:1 versus 2.5-3:1 in the new species), and the presence of vitelline follicles alongside the ovarian lobes (almost completely absent in L. longiovatum).

Cross-sectional serologic assessment of immunity to poliovirus infection in high-risk areas of northern India.

PubMed

Bahl, Sunil; Estívariz, Concepción F; Sutter, Roland W; Sarkar, Bidyut K; Verma, Harish; Jain, Vibhor; Agrawal, Ashutosh; Rathee, Mandeep; Shukla, Hemant; Pathyarch, Surendra K; Sethi, Raman; Wannemuehler, Kathleen A; Jafari, Hamid; Deshpande, Jagadish M

2014-11-01

The objectives of this survey were to assess the seroprevalence of antibodies to poliovirus types 1 and 3 and the impact of bivalent (types 1 and 3) oral poliovirus vaccine (bOPV) use in immunization campaigns in northern India. In August 2010, a 2-stage stratified cluster sampling method identified infants aged 6-7 months in high-risk blocks for wild poliovirus infection. Vaccination history, weight and length, and serum were collected to test for neutralizing antibodies to poliovirus types 1, 2, and 3. Seroprevalences of antibodies to poliovirus types 1, 2, and 3 were 98% (95% confidence interval [CI], 97%-99%), 66% (95% CI, 62%-69%), and 77% (95% CI, 75%-79%), respectively, among 664 infants from Bihar and 616 infants from Uttar Pradesh. Infants had received a median of 3 bOPV doses and 2 monovalent type 1 OPV (mOPV1) doses through campaigns and 3 trivalent OPV (tOPV) doses through routine immunization. Among subjects with 0 tOPV doses, the seroprevalences of antibodies to type 3 were 50%, 77%, and 82% after 2, 3, and 4 bOPV doses, respectively. In multivariable analysis, malnutrition was associated with a lower seroprevalence of type 3 antibodies. This study confirmed that replacing mOPV1 with bOPV in campaigns was successful in maintaining very high population immunity to type 1 poliovirus and substantially decreasing the immunity gap to type 3 poliovirus. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

'The stars seem aligned': a qualitative study to understand the effects of context on scale-up of maternal and newborn health innovations in Ethiopia, India and Nigeria.

PubMed

Spicer, Neil; Berhanu, Della; Bhattacharya, Dipankar; Tilley-Gyado, Ritgak Dimka; Gautham, Meenakshi; Schellenberg, Joanna; Tamire-Woldemariam, Addis; Umar, Nasir; Wickremasinghe, Deepthi

2016-11-25

Donors commonly fund innovative interventions to improve health in the hope that governments of low and middle-income countries will scale-up those that are shown to be effective. Yet innovations can be slow to be adopted by country governments and implemented at scale. Our study explores this problem by identifying key contextual factors influencing scale-up of maternal and newborn health innovations in three low-income settings: Ethiopia, the six states of northeast Nigeria and Uttar Pradesh state in India. We conducted 150 semi-structured interviews in 2012/13 with stakeholders from government, development partner agencies, externally funded implementers including civil society organisations, academic institutions and professional associations to understand scale-up of innovations to improve the health of mothers and newborns these study settings. We analysed interview data with the aid of a common analytic framework to enable cross-country comparison, with Nvivo to code themes. We found that multiple contextual factors enabled and undermined attempts to catalyse scale-up of donor-funded maternal and newborn health innovations. Factors influencing government decisions to accept innovations at scale included: how health policy decisions are made; prioritising and funding maternal and newborn health; and development partner harmonisation. Factors influencing the implementation of innovations at scale included: health systems capacity in the three settings; and security in northeast Nigeria. Contextual factors influencing beneficiary communities' uptake of innovations at scale included: sociocultural contexts; and access to healthcare. We conclude that context is critical: externally funded implementers need to assess and adapt for contexts if they are to successfully position an innovation for scale-up.

Virus load in pigs affected with different clinical forms of classical swine fever.

PubMed

Rout, M; Saikumar, G

2012-04-01

Classical swine fever (CSF) is an endemic disease in India, but the real magnitude of the problem is not known as only outbreaks of acute CSF are reported and many cases of chronic and clinically inapparent forms of the disease, which manifest a confusing clinical picture, remain undiagnosed. The real status of classical swine fever virus (CSFV) infection can only be known by testing pigs with highly specific and sensitive diagnostic assays. To obtain the baseline prevalence of CSFV infection among pigs in an endemic region where no vaccination was being performed, a real-time PCR assay was used to detect viral genetic material in tissue samples collected from a slaughterhouse in the northern state of Uttar Pradesh in India. In total, 1120 slaughtered pigs were examined for the presence of CSF suggestive pathological lesions and tissues from suspected cases were tested for the presence of CSFV antigen and nucleic acids by indirect immuno-peroxidase test and real-time PCR, respectively. Based on the detection of viral genetic material in the tonsils, the prevalence of CSFV infection among slaughtered pigs was found to be 7.67%. Pigs detected positive for viral genome by quantitative real-time PCR assay when categorized into different forms of CSF, depending upon the pathological lesions observed, the viral load in the tonsils of some of the pigs with chronic or clinically inapparent form of the disease was similar to that detected in pigs with acute CSF. The results of the study suggested that the risk posed by pigs with chronic disease or those infected but showing no clinical disease may be relatively higher as they can transmit the virus to new susceptible hosts over a longer period of time. © 2011 Blackwell Verlag GmbH.

Can the management of blood sugar levels in gestational diabetes mellitus cases be an indicator of maternal and fetal outcomes? The results of a prospective cohort study from India

PubMed Central

Jain, Rajesh; Davey, Sanjeev; Davey, Anuradha; Raghav, Santosh K.; Singh, Jai V.

2016-01-01

Background: Gestational diabetes mellitus (GDM) is emerging as an important public health problem in India owing to its increasing prevalence since the last decade. The issue addressed in the study was whether the management of blood sugar levels in GDM cases can predict maternal and fetal outcomes. Materials and Methods: A prospective cohort study was done for 1 year from October 1, 2013, to September 31, 2014, at 652 diabetic screening units as a part of the Gestational Diabetes Prevention and Control Project approved by the Indian Government in the district of Kanpur, state of Uttar Pradesh. A total of 57,108 pregnant women were screened during their 24–28th weeks of pregnancy by impaired oral glucose test. All types of maternal and perinatal outcomes were followed up in both GDM and non-GDM categories in the 2nd year (2013–2014) after blood sugar levels were controlled. Results: It was seen that for all kinds of maternal and fetal outcomes, the differences between GDM cases and non-GDM cases were highly significant (P < 0.0001, relative risk >1 in every case). Moreover, perinatal mortality also increased significantly from 5.7% to 8.9% when blood sugar levels increased from 199 mg/dl and above. Perinatal and maternal outcomes in GDM cases were also significantly related to the control of blood sugar levels (P < 0.0001). Conclusion: Blood sugar levels can be an indicator of maternal and perinatal morbidity and mortality in GDM cases, provided unified diagnostic criteria are used by Indian laboratories. However, to get an accurate picture on this issue, all factors need further study. PMID:27186155

Climate drivers on malaria transmission in Arunachal Pradesh, India.

PubMed

Upadhyayula, Suryanaryana Murty; Mutheneni, Srinivasa Rao; Chenna, Sumana; Parasaram, Vaideesh; Kadiri, Madhusudhan Rao

2015-01-01

The present study was conducted during the years 2006 to 2012 and provides information on prevalence of malaria and its regulation with effect to various climatic factors in East Siang district of Arunachal Pradesh, India. Correlation analysis, Principal Component Analysis and Hotelling's T² statistics models are adopted to understand the effect of weather variables on malaria transmission. The epidemiological study shows that the prevalence of malaria is mostly caused by the parasite Plasmodium vivax followed by Plasmodium falciparum. It is noted that, the intensity of malaria cases declined gradually from the year 2006 to 2012. The transmission of malaria observed was more during the rainy season, as compared to summer and winter seasons. Further, the data analysis study with Principal Component Analysis and Hotelling's T² statistic has revealed that the climatic variables such as temperature and rainfall are the most influencing factors for the high rate of malaria transmission in East Siang district of Arunachal Pradesh.

78 FR 42505 - U.S. Healthcare Education Mission to New Delhi, Hyderabad, and Ahmedabad, India, January 27...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... study in the health professions fields, and 11.4% choose to study in the life sciences fields. India is... medical institutes in India is the All India Institute of Medical Sciences (AIIMS). The Institute has... Pradesh has 1,330 arts, science and commerce colleges, 847 engineering colleges and 53 medical colleges...

Prevalence and associated Risk Factors of Severe Early Childhood Caries in 12- to 36-month-old Children of Sirmaur District, Himachal Pradesh, India.

PubMed

G Mangla, Ritu; Kapur, Raman; Dhindsa, Abhishek; Madan, Manish

2017-01-01

To assess the prevalence, distribution, and associated risk factors of severe early childhood caries (S-ECC) among 12- to 36-month-old children of district Sirmaur, Himachal Pradesh, India. The present study was conducted on a random sample of 510 children, both boys and girls, between 12 and 36 months of age randomly selected from various government-sponsored day-care centers, private day-care centers, and vaccination centers. Caries was recorded using World Health Organization criteria. Statistical analysis was done by using chi-square test and Mann-Whitney test. A two-sided p value was calculated for each statistical test. Multiple logistic regressions were done to calculate the risk of S-ECC from independent variables. In the present study, S-ECC was found in 21% of 510, 12 to 36 months old children of Sirmaur district, Himachal Pradesh. The S-ECC was found to be significantly higher in 25 to 36 months old children's age group and was 27.8% in them as compared with 8% in 12 to 24 months old children. Providing anticipatory guidance and education to parents is essential for the promotion of optimal oral health of their children. There is a need for moving upstream to propose and implement policies and programs to improve the oral health of the very young, especially in a developing country like India, which lacks much data on S-ECC. Mangla RG, Kapur R, Dhindsa A, Madan M. Prevalence and associated Risk Factors of Severe Early Childhood Caries in 12- to 36-month-old Children of Sirmaur District, Himachal Pradesh, India. Int J Clin Pediatr Dent 2017;10(2):183-187.

Distribution of Major and trace elements in Koppunuru area, Guntur district, Andhra Pradesh, India.

PubMed

Arumugam, K; Srinivasalu, S; Purvaja, R; Ramesh, R

2018-06-01

From koppunuru study area totally 58 samples were collected in 7 different boreholes, minimum depth of 28 m and Maximum depth of 157.7 m. The borehole samples geochemical analysis (major and trace elements) was carried out at Atomic Minerals Directorate for Exploration & Research (AMD), Hyderabad, India. Major and trace element studies have been conducted on the Neoproterozoic Palnad sub-basin Andhra Pradesh, South India, to determine their Geochemistry, Uranium mineralization and provenance characteristics. Geochemically, this sedimentary basin has a different litho - unit like as gritty quartzite, conglomerate, and Shale. This study area mainly dominated by Uranium deposited and radioactive elements are predominately deposit. Strong positive correlation between Uranium and Lead ( r = 0.887) suggested radiogenic nature of this system.

Scanning electron microscopic studies and growth response of the plants of Helianthus annuus L. grown on tannery sludge amended soil.

PubMed

Singh, Shraddha; Sinha, Sarita

2004-05-01

The plants of Helianthus annuus L. var. modern were grown in the soil amended with different amounts of tannery sludge (10%, 25%, 35%, 50%, 75% and 100%), collected from Wastewater Treatment Plant Jajmau, Kanpur (Uttar Pradesh, India) under field conditions. The effect of tannery sludge amendments was studied on the growth performance of the plant, i.e. root length, shoot length, leaf area and number of leaves after 30, 60 and 90 days of exposures. The root length of the plant increased up to 35% tannery sludge followed by significant (p<0.01) decrease at higher amendments, whereas the shoot length of the plant increased with increase in sludge amendment ratio at all the exposure periods, compared to their respective controls. The number of leaves and leaf area in the plants of H. annuus increased at all the amendments of tannery sludge at initial exposure periods (30 and 60 days); however, it decreased at higher sludge amendments at highest exposure period (90 days) as compared to their respective controls. The analysis of scanning electron micrographs of the leaf surface of H. annuus grown on 50% and 100% tannery sludge after 90 days showed an increase in the frequency of stomata and trichomes, closure of stomata and degeneration of certain cells in the sludge grown plants.

Trichoderma species mediated differential tolerance against biotic stress of phytopathogens in Cicer arietinum L.

PubMed

Saxena, Amrita; Raghuwanshi, Richa; Singh, Harikesh Bahadur

2015-02-01

Trichoderma spp. have been reported to aid in imparting biotic as well as abiotic tolerance to plants. However, there are only few reports unfolding the differential ability of separate species of Trichoderma genera generally exploited for their biocontrol potential in this framework. A study was undertaken to evaluate the biocontrol potential of different Trichoderma species namely T. harzianum, T. asperellum, T. koningiopsis, T. longibrachiatum, and T. aureoviride as identified in the group of indigenous isolates from the agricultural soils of Eastern Uttar Pradesh, India. Their biocontrol potential against three major soilborne phytopathogens, i.e., Sclerotium rolfsii, Sclerotinia sclerotiorum, and Colletotrichum capsici was confirmed by dual culture plate technique. Efficient mycoparasitic ability was further assessed in all the isolates in relation to chitinase, β-1,3 glucanase, pectinase, lipase, amylase, and cellulase production while equally consistent results were obtained for their probable phosphate solubilization and indole acetic acid (IAA) production abilities. The selected isolates were further subjected to test their ability to promote plant growth, to reduce disease incidence and to tolerate biotic stress in terms of lignification pattern against S. rolfsii in chickpea plants. Among the identified Trichoderma species, excellent results were observed for T. harzianum and T. koningiopsis indicating better biocontrol potential of these species in the group and thus exhibiting perspective for their commercial exploitation. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Human touch vs. axillary digital thermometry for detection of neonatal hypothermia at community level.

PubMed

Agarwal, Siddharth; Sethi, Vani; Pandey, Ravindra Mohan; Kondal, Dimple

2008-06-01

We examined the diagnostic accuracy of human touch (HT) method in assessing hypothermia against axillary digital thermometry (ADT) by a trained non-medical field investigator (who supervised activities of community health volunteers) in seven villages of Agra district, Uttar Pradesh, India. Body temperature of 148 newborns born between March and August 2005 was measured at four points in time for each enrolled newborn (within 48 h and on days 7, 30 and 60) by the field investigator under the axilla using a digital thermometer and by HT method using standard methodology. Total observations were 533. Hypothermia assessed by HT was in agreement with that assessed by ADT (<36.5 degrees C) in 498 observations. Hypothermia assessed by HT showed a high diagnostic accuracy when compared against ADT (kappa 0.65-0.81; sensitivity 74%; specificity 96.7%; positive predictive value 22; negative predictive value 0.26). HT is a simple, quick, inexpensive and programmatically important method. However, being a subjective assessment, its reliability depends on the investigator being adequately trained and competent in making consistently accurate assessments. There is also a need to assess whether with training and supervision even the less literate mothers, traditional birth attendants and community health volunteers can accurately assess mild and moderate hypothermia before promoting HT for early identification of neonatal risk in community-based programs.

Renewing membership in three community-based health insurance schemes in rural India.

PubMed

Panda, Pradeep; Chakraborty, Arpita; Raza, Wameq; Bedi, Arjun S

2016-12-01

Low renewal rate is a key challenge facing the sustainability of community-based health insurance (CBHI) schemes. While there is a large literature on initial enrolment into such schemes, there is limited evidence on the factors that impede renewal. This article uses longitudinal data to analyse what determines renewal, both 1 year and 2 years after the introduction of three CBHI schemes, which have been operating in rural Bihar and Uttar Pradesh since 2011. We find that initial scheme uptake is ∼23-24% and that 2 years after scheme operation, only ∼20% of the initial enrolees maintain their membership. A household's socio-economic status does not seem to play a large role in impeding renewal. In some instances, a greater understanding of the scheme boosts renewal. The link between health status and use of health care in maintaining renewal is mixed. The clearest effect is that individuals living in households that have received benefits from the scheme are substantially more likely to renew their contracts. We conclude that the low retention rates may be attributed to limited benefit packages, slow claims processing times and the gap between the amounts claimed and amounts paid out by insurance. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Environmental consequences of Pollution and its Impact on earth's surface climate Using Geospatial Technology

NASA Astrophysics Data System (ADS)

Kumar, Amit

2016-07-01

Modern transportation is an indispensable ingredient for development, allowing the pressure group of labor, supplies and goods, and enabling general public to access key resources and services. Climate change is a most important threat to sustainable development in any developing or developed country. Urban air pollution is on the rise, due to rapid economic and inhabitants growth and an increase in motorization. Modern transport is fundamental for improvement, allowing the movement of goods and enabling general public to access key resources and services. Travel today is relatively faster and people across the world are travelling more than ever before. Its stipulate regarding forecast is an indispensable part of transportation development in order to evaluate future needs of an urban area. Over increasing traffic concentration posed continued threat to ambient air quality and responsible for producing agents of physical condition hazards. Geospatial technology provides the smartest approach to resolve these inconvenience as it can cover a large area in a fraction of time. The research work focuses on the recognition of traffic intensities with increasing of SO2, NO2 and noise level considered at particular traffic sites in the Varanasi, Uttar Pradesh, India. SO2, NO2 and Noise levels recorded in the city, are much higher than the permissible level and are likely to causes associated health and psychological illnesses to nearby inhabitant.

Environmental consequences of Pollution and its Impact on climate Using Geospatial Technology

NASA Astrophysics Data System (ADS)

Kumar, Amit; Vandana, Vandana

2016-07-01

Modern transportation is an indispensable ingredient for development, allowing the pressure group of labor, supplies and goods, and enabling general public to access key resources and services. Climate change is a most important threat to sustainable development in any developing or developed country. Urban air pollution is on the rise, due to rapid economic and inhabitants growth and an increase in motorization. Modern transport is fundamental for improvement, allowing the movement of goods and enabling general public to access key resources and services. Travel today is relatively faster and people across the world are travelling more than ever before. Its stipulate regarding forecast is an indispensable part of transportation development in order to evaluate future needs of an urban area. Over increasing traffic concentration posed continued threat to ambient air quality and responsible for producing agents of physical condition hazards. Geospatial technology provides the smartest approach to resolve these inconvenience as it can cover a large area in a fraction of time. The research work focuses on the recognition of traffic intensities with increasing of SO2, NO2 and noise level considered at particular traffic sites in the Varanasi, Uttar Pradesh, India. SO2, NO2 and Noise levels recorded in the city, are much higher than the permissible level and are likely to causes associated health and psychological illnesses to nearby inhabitant. Keywords: Population growth; Traffic; Transportation

Genetic affinities between endogamous and inbreeding populations of Uttar Pradesh.

PubMed

Khan, Faisal; Pandey, Atul Kumar; Tripathi, Manorma; Talwar, Sudha; Bisen, Prakash S; Borkar, Minal; Agrawal, Suraksha

2007-04-07

India has experienced several waves of migration since the Middle Paleolithic. It is believed that the initial demic movement into India was from Africa along the southern coastal route, approximately 60,000-85,000 years before present (ybp). It has also been reported that there were two other major colonization which included eastward diffusion of Neolithic farmers (Elamo Dravidians) from Middle East sometime between 10,000 and 7,000 ybp and a southern dispersal of Indo Europeans from Central Asia 3,000 ybp. Mongol entry during the thirteenth century A.D. as well as some possible minor incursions from South China 50,000 to 60,000 ybp may have also contributed to cultural, linguistic and genetic diversity in India. Therefore, the genetic affinity and relationship of Indians with other world populations and also within India are often contested. In the present study, we have attempted to offer a fresh and immaculate interpretation on the genetic relationships of different North Indian populations with other Indian and world populations. We have first genotyped 20 tetra-nucleotide STR markers among 1800 north Indian samples of nine endogamous populations belonging to three different socio-cultural strata. Genetic distances (Nei's DA and Reynold's Fst) were calculated among the nine studied populations, Caucasians and East Asians. This analysis was based upon the allelic profile of 20 STR markers to assess the genetic similarity and differences of the north Indian populations. North Indians showed a stronger genetic relationship with the Europeans (DA 0.0341 and Fst 0.0119) as compared to the Asians (DA 0.1694 and Fst - 0.0718). The upper caste Brahmins and Muslims were closest to Caucasians while middle caste populations were closer to Asians. Finally, three phylogenetic assessments based on two different NJ and ML phylogenetic methods and PC plot analysis were carried out using the same panel of 20 STR markers and 20 geo-ethnic populations. The three phylogenetic assessments revealed that north Indians are clustering with Caucasians. The genetic affinities of Indians and that of different caste groups towards Caucasians or East Asians is distributed in a cline where geographically north Indians and both upper caste and Muslim populations are genetically closer to the Caucasians.

Declining Groundwater Levels in North India: Understanding Sources of Irrigation Inefficiency

NASA Astrophysics Data System (ADS)

O'Keeffe, J.; Buytaert, W.; Mijic, A.; Brozovic, N.

2014-12-01

Over the last half century, the green revolution has transformed India from a famine-prone, drought-susceptible country, into the world's third largest grain producer and one of the most intensely irrigated regions on the planet. This is in no small part due to the country's vast water resources along with an increase in tubewells and more advanced abstraction methods. While agricultural intensification has had undeniable benefits, it has, and continues to have a significant impact on water resources. Unless solutions which take into consideration the ever evolving socio-economic, hydrological and climatic conditions are found, India's agricultural future looks bleak.This research examines the irrigation behaviour of farmers, using data collected during field work in the State of Uttar Pradesh within the Ganges Basin of North India. Significant differences in farmer behaviour and irrigation practices are highlighted, not only between State districts but between individual farmers. This includes the volume of irrigation water applied and the price paid, as well as differences in the yields of crops produced. Analyses of results suggest that this is due to a number of factors, particularly the source of irrigation water. Study areas which had access to cheaper, but crucially less reliable, canal water were found to invest in more efficient water saving technologies in order to reduce the overall cost of irrigation during periods where less expensive canal water is not available. As a result, overall water use and irrigation cost is lower and yields are higher despite very similar climatic conditions. While cheap canal water is not an option for all farmers, the results show that the introduction of more efficient water saving technologies, despite the significant capital expenditure is a viable option for many farmers and costs can be recovered in a relatively short space of time. In addition, the reduction of declining water levels mean that water is abstracted from a shallower depths, resulting in an extra cost saving. The impacts and practicalities of introducing more water efficient technologies are discussed and their potential impact on water resources and farmer livelihoods, pointing the way to a realistic and more sustainable balance between agriculture and sustainable water resources in the future.

Haplotype diversity and linkage disequilibrium at DRD2 locus--a study on four population groups of Andhra Pradesh, India.

PubMed

Saraswathy, Kallur Nava; Mukhopadhyay, Rupak; Shukla, Deepti; Kaur, Harpreet; Sachdeva, Mohinder Pal; Rao, A P; Saksena, Deepti; Kalla, Aloke Kumar

2009-02-01

Dopamine receptor D2 (DRD2) is expressed in the central nervous system and has a high affinity for many antipsychotic drugs. Besides several epidemiological investigations on association of DRD2 locus polymorphism(s) with neuropsychiatric problems and addictive behavior, a few polymorphisms in this locus have also been used to understand genomic diversity and population migratory histories globally. The present study attempts to understand the genomic diversity/affinity among four endogamous groups of Andhra Pradesh (India) against the backdrop of diversity studies from other parts of India and the rest of the world, with special reference to DRD2 locus. The four population groups from Adilabad District of Andhra Pradesh, namely, Brahmin (n=50), Nayakpod (n=49), Thoti (n=52), and Kolam (n=53), were included in the study. The DRD2 markers typed for the present study are three biallelic restriction fragments, that is, TaqI A (rs1800497), TaqI B (rs1079597), and TaqI D (rs1800498). Scoring of DRD2 haplotypes with respect to the three TaqI sites shows that five out of eight possible haplotypes are shared by the four populations. Ancestral haplotype B2D2A1 is most frequent among Thotis (0.359). The results of the present study indicate a differential gene flow into South India followed by certain important demographic events resulting in diversified peopling of India.

Genetic structure of Rajaka caste and affinities with other caste populations of Andhra Pradesh, India.

PubMed

Parvatheesam, C; Babu, B V; Babu, M C

1997-01-01

The present study gives an account of the genetic structure in terms of distribution of a few genetic markers, viz., A1A2B0, Rh(D), G6PD deficiency and haemoglobin among the Rajaka caste population of Andhra Pradesh, India. The genetic relationships of the Rajaka caste with other Andhra caste populations were investigated in terms of genetic distance, i.e., Sq B (mn) of Balakrishnan and Sanghvi. Relatively lesser distance was established between the Rajaka and two Panchama castes. Also, the pattern of genetic distance corroborates the hierarchical order of the Hindu varna system.

Awareness of glaucoma in the rural population of Southern India.

PubMed

Krishnaiah, Sannapaneni; Kovai, Vilas; Srinivas, Marmamula; Shamanna, Bindiganavale R; Rao, Gullapalli N; Thomas, Ravi

2005-09-01

To explore the awareness of glaucoma amongst the rural population of Andhra Pradesh, India. A total of 7775 subjects of all ages, representative of the rural population of Andhra Pradesh, participated in the Andhra Pradesh Eye Disease Study. The responses of subjects older than 15 years (n=5573) who completed a structured questionnaire regarding awareness (heard of glaucoma) and knowledge (understanding of disease) of glaucoma formed the basis of this study. Awareness of glaucoma (n=18; 0.32%) was very poor in this rural population, and females were significantly less aware (p=0.007). Awareness of glaucoma was also significantly less among illiterate persons (p<0.0001), and socially backward population (p<0.0001). Majority of the respondents who were aware of glaucoma (n=10; 55.6%) did not know if visual loss due to glaucoma was permanent or reversible. The major source of awareness of glaucoma in this population was TV/magazines and other media followed by information from a relative or acquaintance suffering from the disease. Awareness of glaucoma is very poor in the rural areas of southern India. The data suggest the need for community-based health education programmes to increase the level of awareness and knowledge about glaucoma.

Local Economic Development and Hydropower Along the Brahmaputra River Basin in Northeast India

NASA Astrophysics Data System (ADS)

Mock, A.

2014-12-01

Large dams have long been controversial. They offer benefits, such as reduced greenhouse gas emissions, energy security, and local development, yet produce negative social and ecological impact, such as wildlife habitat destruction, human displacement, and the disruption of downstream fishing or agricultural industries. In the past decade, the Indian government has signed Memoranda of Understanding with hydroelectric power companies for the building of over 130 large dams on the Brahmaputra River in the state of Arunachal Pradesh in Northeast India. These dams can generate 43% of India's assessed hydropower potential to sustain India's growing economy. In addition, the Indian government claims that these dams will bring local development with needed jobs. However, local Arunachali people have protested and temporarily halted hydropower projects because of the impact of dams on their existing livelihoods. Using the North Eastern Electric Power Corporation's (NEEPCO) Ranganadi Hydroelectric Project as a case study, our project examined whether dams in Northeast India provide jobs for local people, and whether distance from the dam or work colony to a worker's hometown affects the type of job the worker received. Survey data from residents at NEEPCO's work colony in Doimukh, Arunachal Pradesh, was analyzed using SPSS (n = 18). Our research found that 100% of workers at the dam originally resided in Northeast India, with 33% from Arunachal Pradesh, and 67% from the nearby states of Assam, and Tripura. Further, our analysis revealed no statistically significant relationship between the distance to a worker's hometown and job type (p = .609). Where workers come from did not affect the type of job they received. More research using a larger sample size and additional hydroelectric project case studies is needed to further explore the relationship between worker home location and their job types.

Characterization of a potyvirus associated with yellow mosaic disease of jasmine (Jasminum sambac L.) in Andhra Pradesh, India.

PubMed

Sudheera, Y; Vishnu Vardhan, G P; Hema, M; Krishna Reddy, M; Sreenivasulu, P

2014-01-01

A virus isolate associated with yellow mosaic disease was purified from commercially cultivated jasmine (Jasminum sambac) from Andhra Pradesh, India and it contained flexuous filamentous particles of ~720 × 13 nm. The denatured purified virus had single major polypeptide of molecular weight 32 kDa. Complementary DNA representing 1678 nucleotides (nt) of the 3' terminus of viral RNA was cloned and sequenced. Comparisons of complete coat protein (CP) gene nucleotide and amino acid sequences of the present virus isolate with certain reported potyviruses revealed 86.1 and 92.7 % identity, respectively with jasmine potyvirus T (JaVT) reported from Taiwan and less than 70 % with other potyviruses. Based on the phylogenetic analysis of 3' UTR and CP gene, the present virus isolate was identified as an isolate of JaVT that belongs to the genus Potyvirus and the name Jasmine yellow mosaic virus-Andhra Pradesh (JaYMV-AP) is proposed.

Two Blades of Grass: A Summary of Two Studies on Agricultural Innovation in India.

ERIC Educational Resources Information Center

Roy, Prodipto; And Others

Under contract with the United States Agency for International Development and Michigan State University, a study was made comparing diffusion of innovations in Brazil, Nigeria, and India. In India, the study was in two phases: a survey of 108 villages in Andhra Pradesh, Maharashtra, and West Bengal; and a study of adoption behavior among 680…

Biogeochemical study of termite mounds: a case study from Tummalapalle area of Andhra Pradesh, India.

PubMed

Arveti, Nagaraju; Reginald, S; Kumar, K Sunil; Harinath, V; Sreedhar, Y

2012-04-01

Termite mounds are abundant components of Tummalapalle area of uranium mineralization of Cuddapah District of Andhra Pradesh, India. The systematic research has been carried out on the application of termite mound sampling to mineral exploration in this region. The distribution of chemical elements Cu, Pb, Zn, Ni, Co, Cr, Li, Rb, Sr, Ba, and U were studied both in termite soils and adjacent surface soils. Uranium accumulations were noticed in seven termite mounds ranging from 10 to 36 ppm. A biogeochemical parameter called "Biological Absorption Coefficient" of the termite mounds indicated the termite affected soils contained huge amounts of chemical elements than the adjacent soils.

Level of literacy and dementia: A secondary post-hoc analysis from North-West India.

PubMed

Raina, Sunil Kumar; Chander, Vishav; Kumar, Dinesh; Raina, Sujeet; Bhardwaj, Ashok

2014-10-01

A relation between literacy and dementia has been studied in past and an association has been documented. This is in spite of some studies pointing to the contrary. The current study was aimed at investigating the influence of level of literacy on dementia in a sample stratified by geography (Migrant, Urban, Rural and Tribal areas of sub-Himalayan state of Himachal Pradesh, India). The study was based on post-hoc analysis of data obtained from a study conducted on elderly population (60 years and above) from selected geographical areas (Migrant, Urban, Rural and Tribal) of Himachal Pradesh state in North-west India. Analysis of variance revealed an effect of education on cognitive scores [F = 2.823, P =0.01], however, post-hoc Tukey's HSD test did not reveal any significant pairwise comparisons. The possibility that education effects dementia needs further evaluation, more so in Indian context.

Rhizopalmoxylon nypoides - a new palm root from the Deccan Intertrappean beds of Sagar, Madhya Pradesh, India

NASA Astrophysics Data System (ADS)

Kathal, P. K.; Srivastava, Rashmi; Mehrotra, R. C.; Alexander, P. O.

2017-04-01

A new species of fossil palm rhizome having root-mat under the organ genus Rhizopalamoxylon ( Rhizopalmoxylon nypoides sp. nov.) is reported. The specimen shows the closest resemblance with the modern monotypic genus Nypa Wurmb of the Arecaceae. The specimen was collected from the late Maastrichtian-early Danian sediments of Deccan Intertrappean beds, Mothi, Sagar district, Madhya Pradesh, India. Nypa is a mangrove palm naturally found in estuaries and swamps of the tropical region and represents one of the oldest records of the genus from the Deccan Intertrappean beds of central India. The abundance of palms, including Nypa and previously recorded coastal and mangrove elements such as Acrostichum, Barringtonia, Cocos, Sonneratia and marine algae ( Distichoplax and Peyssonellia) from the Deccan Intertrappean beds indicate marine influence and existence of tropical rainforest ecosystem in the vicinity of fossil locality in contrast to the deciduous forests occurring there at present.

Barriers of mistrust: public and private health sectors' perceptions of each other in Madhya Pradesh, India.

PubMed

De Costa, Ayesha; Johansson, Eva; Diwan, Vinod K

2008-06-01

India has one of the most highly privatized health care systems in the world. The dominant private health sector functions alongside a traditional tiered public health sector. There has been an overall lack of collaboration between the two sectors despite international policy recommendations and local initiatives. It has been postulated that "conflicting perceptions" might contribute to the uncooperative attitude between the two sectors. But there has been little empirical exploration of the existing perceptions that the private and public health sectors have of each other. We explored these perceptions among key stakeholders (who influence the direction of health policy) in the public and private health sectors in the province of Madhya Pradesh, India. The barriers of mistrust, which hinder true dialogue, are complex, and have social, moral, and economic bases. They can be best addressed by necessary structural change before any significant long-term partnership between the two sectors is possible.

Stochastic Analysis of Wind Energy for Wind Pump Irrigation in Coastal Andhra Pradesh, India

NASA Astrophysics Data System (ADS)

Raju, M. M.; Kumar, A.; Bisht, D.; Rao, D. B.

2014-09-01

The rapid escalation in the prices of oil and gas as well as increasing demand for energy has attracted the attention of scientists and researchers to explore the possibility of generating and utilizing the alternative and renewable sources of wind energy in the long coastal belt of India with considerable wind energy resources. A detailed analysis of wind potential is a prerequisite to harvest the wind energy resources efficiently. Keeping this in view, the present study was undertaken to analyze the wind energy potential to assess feasibility of the wind-pump operated irrigation system in the coastal region of Andhra Pradesh, India, where high ground water table conditions are available. The stochastic analysis of wind speed data were tested to fit a probability distribution, which describes the wind energy potential in the region. The normal and Weibull probability distributions were tested; and on the basis of Chi square test, the Weibull distribution gave better results. Hence, it was concluded that the Weibull probability distribution may be used to stochastically describe the annual wind speed data of coastal Andhra Pradesh with better accuracy. The size as well as the complete irrigation system with mass curve analysis was determined to satisfy various daily irrigation demands at different risk levels.

Medicinal Plant-Lore of Sugali Tribe of Anantapur District, Andhra Pradesh, India.

PubMed Central

Reddy, M. Hamambara; Reddy, K. Eshwara; Venkataraju, R.R

2000-01-01

The preliminary investigations of crude during resources of sugali tribes of Anantapur district, Andhra Pradesh with their recipes, preparation of drugs, administration, usage form several centuries. Fifty plant crude drugs (species) belong to twenty nine families were collected based on folk-lore knowledge. Botanical name, family name, part used, mode of preparation and administration and purpose, for which it as been used were enumerated. PMID:22556937

Evaluation of telemedicine centres in Madhya Pradesh, Central India.

PubMed

Bali, Surya; Gupta, Arti; Khan, Asif; Pakhare, Abhijit

2016-04-01

In a developing country such as India, there is substantial inequality in health care distribution. Telemedicine facilities were established in Madhya Pradesh in 2007-2008. The purpose of this study was to evaluate the infrastructure, equipment, manpower, and functional status of Indian Space and Research Organisation (ISRO) telemedicine nodes in Madhya Pradesh. All district hospitals and medical colleges with nodes were visited by a team of three members. The study was conducted from December 2013-January 2014. The team recorded the structural facility situation and physical conditions on a predesigned pro forma. The team also conducted interviews with the nodal officers, data entry operator and other relevant people at these centres. Of the six specialist nodes, four were functional and two were non-functional. Of 10 patient nodes, two nodes were functional, four were semi-functional and four were non-functional. Most of the centres were not working due to a problem with their satellite modem. The overall condition of ISRO run telemedicine centres in Madhya Pradesh was found to be poor. Most of these centres failed to provide telemedicine consultations. We recommend replacing this system with another cost effective system available in the state wide area network (SWAN). We suggest the concept of the virtual out-patient department. © The Author(s) 2015.

Teacher Education in Northeast India--Status, Weaknesses and Alternatives

ERIC Educational Resources Information Center

Bhattacharjee, D. S.

2011-01-01

Northeast India comprises of a cluster of eight states--Arunachal Pradesh, Assam, Meghalaya, Manipur, Mizoram, Nagaland, Sikkim and Tripura. The region is usually stereotyped as underdeveloped. Geographically, the region is surrounded by international border with part of Nepal, Bhutan, China, Myanmar and Bangladesh. Prevalence of insurgency and…

76 FR 77485 - Certain Frozen Fish Fillets From the Socialist Republic of Vietnam: Preliminary Results of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

... Pangasius, Pangasianodon- Hypophthalmus Farming in Andhra Pradesh, India (``Pangasius Study''), on the... industry when undertaking its analysis. First, we note that the Pangasius Study regarding India is a ``first attempt'' \\22\\ study undertaken by a professor with estimated production quantities. When compared...

Mining Induced Displacement and Mental Health: A Call for Action

ERIC Educational Resources Information Center

Goessling, Kristen P.

2010-01-01

India is a country of unparalleled diversity within both the cultural and ecological spheres of life. This paper examines the author's experience exploring and inquiring into the mental health implications of mining and mining induced displacement within several Adivasi (tribal) communities in Andhra Pradesh, India. Through collaboration with…

Portrait of a Science Teacher as a Bricoleur: A Case Study from India

ERIC Educational Resources Information Center

Sharma, Ajay

2008-01-01

This paper presents a case study of science teaching in an eighth grade school classroom in India. It comes out of a larger ethnographic study done in 2005 that looked at how science was taught and learned in a rural government run middle school in the state of Madhya Pradesh in India. Subscribing to a sociocultural perspective, the paper presents…

Incidence of cleft Lip and palate in the state of Andhra Pradesh, South India

PubMed Central

Reddy, Srinivas Gosla; Reddy, Rajgopal R.; Bronkhorst, Ewald M.; Prasad, Rajendra; Ettema, Anke M.; Sailer, Hermann F.; Bergé, Stefaan J.

2010-01-01

Objective: To assess the incidence of cleft lip and palate defects in the state of Andhra Pradesh, India. Design Setting: The study was conducted in 2001 in the state of Andhra Pradesh, India. The state has a population of 76 million. Three districts, Cuddapah, Medak and Krishna, were identified for this study owing to their diversity. They were urban, semi-urban and rural, respectively. Literacy rates and consanguinity of the parents was elicited and was compared to national averages to find correlations to cleft births. Type and side of cleft were recorded to compare with other studies around the world and other parts of India. Results: The birth rate of clefts was found to be 1.09 for every 1000 live births. This study found that 65% of the children born with clefts were males. The distribution of the type of cleft showed 33% had CL, 64% had CLP, 2% had CP and 1% had rare craniofacial clefts. Unilateral cleft lips were found in 79% of the patients. Of the unilateral cleft lips 64% were left sided. There was a significant correlation of children with clefts being born to parents who shared a consanguineous relationship and those who were illiterate with the odds ratio between 5.25 and 7.21 for consanguinity and between 1.55 and 5.85 for illiteracy, respectively. Conclusion: The birth rate of clefts was found to be comparable with other Asian studies, but lower than found in other studies in Caucasian populations and higher than in African populations. The incidence was found to be similar to other studies done in other parts of India. The distribution over the various types of cleft was comparable to that found in other studies. PMID:21217978

Awareness assessment of harmful effects of mercury in a health care set-up in India: A survey-based study.

PubMed

Halder, Nabanita; Peshin, Sharda Shah; Pandey, Ravindra Mohan; Gupta, Yogendra Kumar

2015-12-01

Mercury, one of the most toxic heavy metals, is ubiquitous in environment. The adverse health impact of mercury on living organisms is well known. The health care facilities are one of the important sources of mercury release into the atmosphere as mercury items are extensively used in hospitals. To assess the awareness about mercury toxicity and the knowledge of proper handling and disposal of mercury-containing items in health care set-up, a questionnaire-based survey was carried out amongst doctors (n = 835), nurses (n = 610) and technicians (n = 393) in government hospitals, corporate hospitals and primary health care centres in the Indian states of Delhi, Uttar Pradesh and Haryana. The study was conducted using a tool-containing pretested structured multiple-choice questionnaire. Analysis of the results using STATA 11.1 software highlighted that overall awareness was more in corporate sector. However, percentage range of knowledge of respondents irrespective of health care sector was only between 20 and 40%. Despite the commitment of various hospitals to be mercury free, mercury containing-thermometer/sphygmomanometer are still preferred by health professionals. The likely reasons are availability, affordability, accuracy and convenience in use. There is an urgent need for source reduction, recycling and waste minimization. Emphasis must be laid on mercury alternative products, education and training of health personnel and public at large, about correct handling and proper clean up of spills. © The Author(s) 2013.

The influence of organophosphate and carbamate on sperm chromatin and reproductive hormones among pesticide sprayers.

PubMed

Jamal, Farrukh; Haque, Quazi S; Singh, Sangram; Rastogi, S K

2016-08-01

This study is aimed at evaluating the association between occupational exposure to organophosphate (OP) and carbamate (CB) pesticides and semen quality as well as levels of reproductive and thyroid hormones of pesticide sprayers in Malihabad, Lucknow, Uttar Pradesh, India. Thirty-five healthy men (unexposed group) and 64 male pesticide sprayers (exposed group) were recruited for clinical evaluation of fertility status. Fresh semen samples were evaluated for sperm quality and analyzed for DNA fragmentation index (DFI) by flow cytometry. Pesticide exposure was assessed by measuring erythrocyte acetylcholinesterase and plasma butyrylcholinesterase (BuChE) with a Test-mate ChE field kit. Serum levels of total testosterone (Tt), prolactin (PRL), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and free thyroxine (FT4) were analyzed using enzyme immunoassay kits. Evidence of pesticide exposure was found in 88.5% of sprayers and significant increments were observed in sperm DFI with significant decrease in some semen parameters. DFI was negatively correlated with BuChE, sperm concentration, morphology, and vitality in these pesticide sprayers. The levels of Tt, PRL, FT4, and TSH appeared to be normal; however, there was a tendency for increased LH and FSH levels in exposed workers. The results confirm the potential impact of chronic occupational exposure to OP and CB pesticides on male reproductive function, which may cause damage to sperm chromatin, decrease semen quality, and produce alterations in reproductive hormones, leading to adverse reproductive health outcomes. © The Author(s) 2015.

Incidence and pattern of mandibular fractures in Rohilkhand region, Uttar Pradesh state, India: A retrospective study

PubMed Central

Giri, Kolli Yada; Singh, Aishwarya Pratap; Dandriyal, Ramakant; Indra, Niranjanaprasad; Rastogi, Sanjay; Mall, Sunil Kumar; Chowdhury, Shouvik; Singh, Himanshu Pratap

2015-01-01

Aims To understand and evaluate the significance of various aetiological factors in determining the incidence and dictating the patterns of mandibular fractures in Rohilkhand region. Methods The patient records and radiographs for 144 patients treated for mandibular fractures were reviewed between the time periods from January 2012 to December 2013. Data on age, gender, aetiology, use of intoxicants, head injury, associated injuries, days of the week, anatomic site and multiple fractures within the mandible were recorded and assessed. Results Maximum incidence of fractures was observed among the individuals in 3rd decade (35.4%) followed by 2nd and 4th decades, which exhibited 32 and 30 cases (22.2% and 20.8%), respectively. Male to female ratio was biased (4:1) portraying a male predominance. Road traffic accidents (RTAs) were observed to be the predominant aetiological factor responsible accounting for 79.2% of the total injuries followed by assaults (11.8%) and falls (9%). Parasymphysis exhibited the highest incidence (32.63%) amongst the anatomic sites, followed by body (18.75%), angle (16.66%), condyle (15.27%), symphysis (12.50%), ramus (2.77%) and coronoid (1.38%). Conclusion The study reveals that majority of affected patients were in the 2nd and 3rd decades. A definitive relationship existed between RTA and the incidence of mandibular fractures. The frequency further increased with consumption of social intoxicants. The most commonly fractured site was parasymphysis either isolated or associated with other fractures in the mandible. PMID:26587379

State health insurance and out-of-pocket health expenditures in Andhra Pradesh, India.

PubMed

Fan, Victoria Y; Karan, Anup; Mahal, Ajay

2012-09-01

In 2007 the state of Andhra Pradesh in southern India began rolling out Aarogyasri health insurance to reduce catastrophic health expenditures in households 'below the poverty line'. We exploit variation in program roll-out over time and districts to evaluate the impacts of the scheme using difference-in-differences. Our results suggest that within the first nine months of implementation Phase I of Aarogyasri significantly reduced out-of-pocket inpatient expenditures and, to a lesser extent, outpatient expenditures. These results are robust to checks using quantile regression and matching methods. No clear effects on catastrophic health expenditures or medical impoverishment are seen. Aarogyasri is not benefiting scheduled caste and scheduled tribe households as much as the rest of the population.

Confidentiality, Privacy, and Respect: Experiences of Female Sex Workers Participating in HIV Research in Andhra Pradesh, India

PubMed Central

Reed, Elizabeth; Khoshnood, Kaveh; Blankenship, Kim M.; Fisher, Celia B.

2014-01-01

Female sex workers (FSW) from Andhra Pradesh, India who had participated in HIV research were interviewed to examine participant perspectives on research ethics. Content analysis indicated that aspects of the consent process, staff gender and demeanor, study environment, survey content, time requirements for study participation, and perceived FSW community support for research were key factors influencing whether FSW perceived their confidentiality and privacy had been maintained, and whether they felt the study was conducted respectfully. Findings suggest that partnership with community-based organizations and investigation of participant’s experiences in HIV prevention research can provide critical information to best inform research ethics protocols, a particular priority among research studies with highly stigmatized populations, such as FSW. PMID:24572080

Consanguinity and its relationship to differential fertility and mortality in the Kotia: a tribal population of Andhra Pradesh, India.

PubMed

Yasim; Naidu, J M; Mascie-Taylor, C G

1997-04-01

Data on patterns of marriage, differential fertility and mortality were collected from 211 Kotia women residing in Visakhapatnam district of Andhra Pradesh, India. Consanguineous marriages made up just over a quarter of the total, and of these, father's sister's daughter (FSD) were more common than mother's brother's daughter (MBD). The mean inbreeding coefficient for the sample (F) was 0.0172. Women in consanguineous marriages had a lower mean number of total conceptions, live births and living offspring (net fertility) than women in non-consanguineous marriages. Significant heterogeneity was found in the means of living offspring for FSD, MBD and non-consanguineous couples, but not for conceptions and live births.

Prevalence of Periodontal Disease in the General Population of India-A Systematic Review.

PubMed

Shewale, Akhilesh H; Gattani, Deepti R; Bhatia, Nidhi; Mahajan, Rupali; Saravanan, S P

2016-06-01

Periodontal disease is a chronic inflammatory disease resulting in destruction of tissues and structures surrounding the teeth thus, if left untreated causes loss of teeth and ultimately results in edentulism, posing a great negative impact on individuals' quality of life. Hence the global epidemiological data suggests periodontal disease to be one of a major burden on oral diseases. To reduce this burden it is necessary to know the true prevalence of the disease according to which proper initiatives can be formulated. India being home to nearly 1.2 billion people and one amongst the rapidly developing country, its population requires being systemically as well as orally healthy to lead a good quality of life. However due to large heterogenecity amongst its residing population in terms of geographical area, culture, education, socioeconomic status, a variety of oral diseases like periodontal diseases are prevalent here. Even though the early studies suggested that the population is highly susceptible to the disease, the true prevalence of periodontal disease has not been found yet due to paucity in literature available. To systematically review the available literature taken from various parts of India and find the prevalence rate of periodontal disease amongst the general population of India. A literature search was performed using PUB MED, COCHRANE and EMBASE databases on August 6, 2015. Following full text assessment a thorough references search was made and potential studies were included. A Quality assessment of retrieved articles from 2(nd) round was done using a self designed questionnaire and only field survey studies were included in the systematic review. The literature search yielded six studies which had performed field surveys to find the prevalence of periodontal disease in their respective areas. These studies have observed different sets of age groups and the same has been accomplished by using Community Periodontal Index (CPI) or Community Periodontal Index of Treatment Needs (CPITN). It was also found that no prevalence studies have been carried out in few North and North Eastern states and Union Territories of India. Due to non-availability of same age groups in selected studies an overall prevalence rate could not be obtained. However, it was observed that few areas of states like West Bengal, Uttar Pradesh and Assam have reported a prevalence rate of periodontal disease of more than 85% in their general population. The data from the present systematic review calls for a combined initiative from the Government of India and Dental council of India to have a nationwide multicentric prevalence studies to obtain the true prevalence rate of periodontal disease in India and interventions should be provided for the same to maintain the oral health and quality of life of the affected population.

India - 103 Agricultural Extension. Madhya Pradesh Hindi Language.

ERIC Educational Resources Information Center

Papazian, Elaine; Ray, S. B.

This guide is designed for Hindi language training of Peace Corps workers in agriculture in India and reflects daily communication needs in that context. It consists of notes on Hindi phonology and pronunciation and a series of lessons on description, common phrases, and grammatical constructions. The 41 lessons are presented in four sections,…

76 FR 55872 - Certain Frozen Fish Fillets From the Socialist Republic of Vietnam: Preliminary Results and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-09

...- Hypophthalmus Farming in Andhra Pradesh, India (``Pangasius Study''), on the record.\\35\\ \\35\\ See VASEP's First... when undertaking its analysis. First, we note that the Pangasius Study regarding India is a ``first attempt'' \\36\\ study undertaken by a professor with estimated production quantities. When compared to the...

Increasing Full Child Immunization Rates by Government Using an Innovative Computerized Immunization Due List in Rural India

PubMed Central

Gupta, Rahul; Reddy, R. Purushotham; Balasubramanian, K.; Reddy, P. S.

2018-01-01

Increasing child vaccination coverage to 85% or more in rural India from the current level of 50% holds great promise for reducing infant and child mortality and improving health of children. We have tested a novel strategy called Rural Effective Affordable Comprehensive Health Care (REACH) in a rural population of more than 300 000 in Rajasthan and succeeded in achieving full immunization coverage of 88.7% among children aged 12 to 23 months in a short span of less than 2 years. The REACH strategy was first developed and successfully implemented in a demonstration project by SHARE INDIA in Medchal region of Andhra Pradesh, and was then replicated in Rajgarh block of Rajasthan in cooperation with Bhoruka Charitable Trust (private partners of Integrated Child Development Services and National Rural Health Mission health workers in Rajgarh). The success of the REACH strategy in both Andhra Pradesh and Rajasthan suggests that it could be successfully adopted as a model to enhance vaccination coverage dramatically in other areas of rural India. PMID:29359630

Variation in cost and performance of routine immunisation service delivery in India

PubMed Central

Chatterjee, Susmita; Das, Palash; Nigam, Aditi; Nandi, Arindam; Brenzel, Logan; Ray, Arindam; Haldar, Pradeep; Aggarwal, Mahesh Kumar; Laxminarayan, Ramanan

2018-01-01

A comprehensive understanding of the costs of routine vaccine delivery is essential for planning, budgeting and sustaining India’s Universal Immunisation Programme. India currently allocates approximately US$25 per child for vaccines and operational costs. This budget is prepared based on historical expenditure data as information on cost is not available. This study estimated the cost of routine immunisation services based on a stratified, random sample of 255 public health facilities from 24 districts across seven states—Bihar, Gujarat, Kerala, Meghalaya, Punjab, Uttar Pradesh and West Bengal. The economic cost for the fiscal year 2013–2014 was measured by adapting an internationally accepted approach for the Indian context. Programme costs included the value of personnel, vaccines, transport, maintenance, training, cold chain equipment, building and other recurrent costs. The weighted average national level cost per dose delivered was US$2.29 including vaccine costs, and the cost per child vaccinated with the third dose of diphtheria–pertussis–tetanus (DPT) vaccine (a proxy for full immunisation) was US$31.67 (at 2017 prices). There was wide variation in the weighted average state-level cost per dose delivered inclusive of vaccine costs (US$1.38 to US$2.93) and, for the cost per DTP3 vaccinated child (US$20.08 to US$34.81). Lower costs were incurred by facilities and districts that provided the largest number of doses of vaccine. Out of the total cost, the highest amount (57%) was spent on personnel. This costing study, the most comprehensive conducted to date in India, provides evidence, which should help improve planning and budgeting for the national programme. The budget generally considers financial costs, while this study focused on economic costs. For using this study’s results for planning and budgeting, the collected data can be used to extract the relevant financial costs. Variation in cost per dose and doses administered across facilities, districts and states need to be further investigated to understand the drivers of cost and measure the efficiency of service delivery. PMID:29946488

Informing resource-poor populations and the delivery of entitled health and social services in rural India: a cluster randomized controlled trial.

PubMed

Pandey, Priyanka; Sehgal, Ashwini R; Riboud, Michelle; Levine, David; Goyal, Madhav

2007-10-24

A lack of awareness about entitled health and social services may contribute to poor delivery of such services in developing countries, especially among individuals of low socioeconomic status. To determine the impact of informing resource-poor rural populations about entitled services. Community-based, cluster randomized controlled trial conducted from May 2004 to May 2005 in 105 randomly selected village clusters in Uttar Pradesh state in India. Households (548 intervention and 497 control) were selected by a systematic sampling design, including both low-caste and mid- to high-caste households. Four to 6 public meetings were held in each intervention village cluster to disseminate information on entitled health services, entitled education services, and village governance requirements. No intervention took place in control village clusters. Visits by nurse midwife; prenatal examinations, tetanus vaccinations, and prenatal supplements received by pregnant women; vaccinations received by infants; excess school fees charged; occurrence of village council meetings; and development work in villages. At baseline, there were no significant differences in self-reported delivery of health and social services. After 1 year, intervention villagers reported better delivery of several services compared with control villagers: in a multivariate analysis, 30% more prenatal examinations (95% confidence interval [CI], 17%-43%; P < .001), 27% more tetanus vaccinations (95% CI, 12%-41%; P < .001), 24% more prenatal supplements (95% CI, 8%-39%; P = .003), 25% more infant vaccinations (95% CI, 8%-42%; P = .004), and decreased excess school fees of 8 rupees (95% CI, 4-13 rupees; P < .001). In a difference-in-differences analysis, 21% more village council meetings were reported (95% CI, 5%-36%; P = .01). There were no improvements in visits by a nurse midwife or in development work in the villages. Both low-caste and mid- to high-caste intervention households reported significant improvements in service delivery. Informing resource-poor rural populations in India about entitled services enhanced the delivery of health and social services among both low- and mid- to high-caste households. Interventions that emphasize educating resource-poor populations about entitled services may improve the delivery of such services. clinicaltrials.gov Identifier: NCT00421291.

Improving polio vaccination during supplementary campaigns at areas of mass transit in India

PubMed Central

2010-01-01

Background In India, children who are traveling during mass immunization campaigns for polio represent a substantial component of the total target population. These children are not easily accessible to health workers and may thus not receive vaccine. Vaccination activities at mass transit sites (such as major intersections, bus depots and train stations), can increase the proportion of children vaccinated but the effectiveness of these activities, and factors associated with their success, have not been rigorously evaluated. Methods We assessed data from polio vaccination activities in Jyotiba Phule Nagar district, Uttar Pradesh, India, conducted in June 2006. We used trends in the vaccination results from the June activities to plan the timing, locations, and human resource requirements for transit vaccination activities in two out of the seven blocks in the district for the July 2006 supplementary immunization activity (SIA). In July, similar data was collected and for the first time vaccination teams also recorded the proportion of children encountered each day who were vaccinated (a new monitoring system). Results In June, out of the 360,937 total children vaccinated, 34,643 (9.6%) received vaccinations at mass transit sites. In the July SIA, after implementation of a number of changes based on the June monitoring data, 36,475 children were vaccinated at transit sites (a 5.3% increase). Transit site vaccinations in July increased in the two intervention blocks from 18,194 to 21,588 (18.7%) and decreased from 16,449 to 14,887 (9.5%) in the five other blocks. The new monitoring system showed the proportion of unvaccinated children at street intersection transit sites in the July campaign decreased from 24% (1,784/7,405) at the start of the campaign to 3% (143/5,057) by the end of the SIA, consistent with findings from the more labor-intensive post-vaccination coverage surveys routinely performed by the program. Conclusions Analysis of vaccination data from transit sites can inform program management changes leading to improved outcomes in polio immunization campaigns. The number of vaccinated children encountered should be routinely recorded by transit teams and may provide a useful, inexpensive alternative mechanism to assess program coverage. PMID:20459824

HIV in India: the Jogini culture

PubMed Central

Borick, Joseph

2014-01-01

Jogini is the name for a female sexually exploited temple attendant and is used interchangeably with Devadasi in the state of Andhra Pradesh, India. Jogini are twice more likely than other women who are used for sexual intercourse in India to be HIV positive, and their rate of mortality from HIV is 10 times the total mortality rate for all women in India. The four states in India with the most Jogini also have the highest prevalence of HIV. The following case is unfortunately typical of the Jogini and sheds light on a potentially disastrous public health problem in rural South India. PMID:25015167

Longitudinal Andhra Pradesh Eye Disease Study: rationale, study design and research methodology.

PubMed

Khanna, Rohit C; Murthy, Gudlavalleti Vs; Marmamula, Srinivas; Mettla, Asha Latha; Giridhar, Pyda; Banerjee, Seema; Shekhar, Konegari; Chakrabarti, Subhabrata; Gilbert, Clare; Rao, Gullapalli N

2016-03-01

The rationale, objectives, study design and procedures for the longitudinal Andhra Pradesh Eye Disease Study are described. A longitudinal cohort study was carried out. Participants include surviving cohort from the rural component of Andhra Pradesh Eye Disease Study. During 1996-2000, Andhra Pradesh Eye Disease Survey was conducted in three rural (n = 7771) and one urban (n = 2522) areas (now called Andhra Pradesh Eye Disease Study 1). In 2009-2010, a feasibility exercise (Andhra Pradesh Eye Disease Study 2) for a longitudinal study (Andhra Pradesh Eye Disease Study 3) was undertaken in the rural clusters only, as urban clusters no longer existed. In Andhra Pradesh Eye Disease Study 3, a detailed interview will be carried out to collect data on sociodemographic factors, ocular and systemic history, risk factors, visual function, knowledge of eye diseases and barriers to accessing services. All participants will also undergo a comprehensive eye examination including photography of lens, optic disc and retina, Optic Coherence Tomography of the posterior segment, anthropometry, blood pressure and frailty measures. Measures include estimates of the incidence of visual impairment and age-related eye disease (lens opacities, glaucoma and age-related macular degeneration) and the progression of eye disease (lens opacities and myopia) and associated risk factors. Of the 7771 respondents examined in rural areas in Andhra Pradesh Eye Disease Study 1, 5447 (70.1%) participants were traced in Andhra Pradesh Eye Disease Study 2. These participants will be re-examined. Andhra Pradesh Eye Disease Study 3 will provide data on the incidence and progression of visual impairment and major eye diseases and their associated risk factors in India. The study will provide further evidence to aid planning eye care services. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

Epidemiology, Clinico-Haematological Profile and Management of Aplastic Anaemia: AIIMS Experience.

PubMed

Mahapatra, M; Singh, P K; Agarwal, M; Prabhu, M; Mishra, P; Seth, T; Tyagi, S; Patil, H P; Saxena, R

2015-03-01

The incidence of aplastic anaemia (AA) is higher in Asia than in the West. The precise incidence of AA in India is not known due to lack of epidemiological study. 20-40% of pancytopenic patients in referral centres are of aplastic anaemia. This was an analysis of 1501 patients diagnosed with aplastic anaemia over a period of seven and half years (January 2007- June 2014) attending the Aplastic clinic of department of haematology of All India Institute of Medical Sciences, New Delhi. The details regarding medical history, physical examination, complete blood count, bone marrow aspirate and biopsy, treatment received, were retrieved. Inherited bone marrow failure was screened in patients below 35 years. Treatment response was analysed for various treatment modalities. 1501 patients of AA from 20 different states of India were analysed. The bulk of patients were from Uttar Pradesh (28.7%), Bihar (23.6%), Delhi/NCR (20%) and Haryana (7%).The average number of new aplastic anaemia patients enrolled per year 214 (range: 101 -263). The median age at presentation was 25 years (range 2-83),with M;F - 2.3:1. Severity of AA revealed: severe (SAA): 75%, very severe (VSAA): 15%, non-severe (NSAA): 10%. Inherited bone marrow failure syndromes constituted 5% (75 patients) of all aplastic anaemia patients. The most common clinical presentations were pallor (97%), bleeding manifestations (69.6%) and fever (54%). The haematological parameters showed: median level of haemoglobin level: 5.9 gm/dL, WBC: 2700/mm3, ANC: 380/mm3, platelet: 1 0000/mm3. PNH clone was present in 13.5% of patients. 107 patients (7%) were lost to follow up or expired before any treatment was initiated. Only 69 patients (4.5%) received treatment with HLA-matched sibling stem cell transplantation and another 232 (15.5%) patients received ATG plus cyclosporine as immunosuppressive therapy. Seven hundred thirteenpatients (47.5%) received cyclosporine. The overall response to various treatment modalities was: HLA matched sibling haematopoietic stem cell transplant: 75.3%, Anti-thymocyte globulin plus cyclosporine: 58.7%, cyclosporine plus androgen: 45.6%, cyclosporine alone: 32.2%. Management of AA is a real challenge in developing countries.This is one of the largest case series from a single centre from India. It is our endeavour to reduce the detrimental outcome by increasing awareness among patients and referring physicians to reduce the delay between diagnosis and treatment.

Relevance of Indian Summer Monsoon and its Tropical Indo-Pacific Climate Drivers for the Kharif Crop Production

NASA Astrophysics Data System (ADS)

Amat, Hemadri Bhusan; Karumuri, Ashok

2017-12-01

While the Indian agriculture has earlier been dependent on the Indian summer monsoon rainfall (ISMR), a multifold increase in irrigation and storage facilities raise a question whether the ISMR is still as relevant. We revisit this question using the latest observational climate datasets as well as the crop production data and find that the ISMR is still relevant for the Kharif crop production (KCP). In addition, in the recent changes in the tropical Indo-Pacific driver evolutions and frequency, particularly more frequent occurrence of the ENSO Modokis in place of the canonical ENSOs, we carry out a correlation analysis to estimate the impact of the various Indo-Pacific climate drivers on the rainfall of individual Indian states for the period 1998-2013, for which crop production data for the most productive Indian states, namely West Bengal, Odisha, United Andhra Pradesh (UAP), Haryana, Punjab, Karnataka, Kerala, Madhya Pradesh, Bihar and Uttar Pradesh are available. The results suggest that the KCP of the respective states are significantly correlated with the summer monsoon rainfall at the 95-99% confidence levels. Importantly, we find that the NINO 3.4 and ENSO Modoki indices have a statistically significant correlation with the KCP of most of the Indian states, particularly in states such as UAP and Karnataka, through induction of anomalous local convergence/divergence, well beyond the equatorial Indian Ocean. The KCP of districts in UAP also has a significant response to all the climate drivers, having implication for prediction of local crop yield.

Finger ridge count correlations among four tribes of Andhra Pradesh, India.

PubMed

Kusuma, Y S; Babu, B V; Naidu, J M

2002-06-01

The present paper reports the distribution of finger ridge count correlations among four tribal populations from Andhra Pradesh, India viz., Dulia, Kotia, Manne Dora and Manzai Mali, and examines the intra and inter population variation. Higher correlations are recorded in left hands compared to right hands, but they are not significant. The homologous fingers exhibit a stronger correlation. In all the tribes, the correlations between right hand fingers are relatively higher among women when compared to men. Regarding inter population variation Dulia men differ significantly from the men of Manne Dora and the Manzai Mali tribes, and Kotia women also differ from the women of the Manne Dora significantly. The average correlation coefficient of the present populations is similar to other Indian populations reported earlier but lower than African and European populations.

The ICT Laboratory: An Analysis of Computers in Public High Schools in Rural India

ERIC Educational Resources Information Center

Arora, Payal

2007-01-01

There has been a strong push towards e-literacy in India, particularly in the distribution and usage of information and communication technologies (ICT) in schools for economic and social growth. As a result, the Vidhya Vahini scheme was launched in Kuppam, a marginalized village constituency in Andhra Pradesh. This scheme strived to disseminate…

Constraints and Suggestions in Adopting Seasonal Climate Forecasts by Farmers in South India

ERIC Educational Resources Information Center

Shankar, K. Ravi; Nagasree, K.; Venkateswarlu, B.; Maraty, Pochaiah

2011-01-01

The main objective of this study was to determine constraints and suggestions of farmers towards adopting seasonal climate forecasts. It addresses the question: Which forms of providing forecasts will be helpful to farmers in agricultural decision making? For the study, farmers were selected from Andhra Pradesh state of South India. One hundred…

Impact of m-health application used by community health volunteers on improving utilisation of maternal, new-born and child health care services in a rural area of Uttar Pradesh, India.

PubMed

Prinja, Shankar; Nimesh, Ruby; Gupta, Aditi; Bahuguna, Pankaj; Gupta, Madhu; Thakur, Jarnail Singh

2017-07-01

To raise the quality of counselling by community health volunteers resulting in improved uptake of maternal, neonatal and child health services (MNCH), an m-health application was introduced under a project named 'Reducing Maternal and Newborn Deaths (ReMiND)' in district Kaushambi in India. We report the impact of this project on coverage of key MNCH services. A pre- and post-quasi-experimental design was undertaken to assess the impact of intervention. This project was introduced in two community development blocks in Kaushambi district in 2012. Two other blocks from the same district were selected as controls after matching for coverage of two indicators at baseline - antenatal care and institutional deliveries. The Annual Health Survey conducted by the Ministry of Health and Family Welfare in 2011 served as pre-intervention data, whereas a household survey in four blocks of Kaushambi district in 2015 provided post-intervention coverage of key services. Propensity score matched samples from intervention and control areas in pre-intervention and post-intervention periods were analysed using difference-in-difference method to estimate the impact of ReMiND project. We found a statistically significant increase in coverage of iron-folic acid supplementation (12.58%), self-reporting of complication during pregnancy (13.11%) and after delivery (19.6%) in the intervention area. The coverage of three or more antenatal care visits, tetanus toxoid vaccination, full antenatal care and ambulance usage increased in intervention area by 10.3%, 4.28%, 1.1% and 2.06%, respectively; however, the changes were statistically insignificant. Three of eight services which were targeted for improvement under ReMiND project registered a significant improvement as result of m-health intervention. © 2017 John Wiley & Sons Ltd.

Emission estimates of particulate matter (PM) and trace gases (SO2, NO and NO2) from biomass fuels used in rural sector of Indo-Gangetic Plain, India

NASA Astrophysics Data System (ADS)

Saud, T.; Mandal, T. K.; Gadi, Ranu; Singh, D. P.; Sharma, S. K.; Saxena, M.; Mukherjee, A.

2011-10-01

In this paper, we present the experimentally determined emission factors and emission estimates of particulate matter (PM), SO2, NO and NO2 emitted from biomass fuels used as energy in rural area of Indo-Gangetic Plain (IGP), India. Biomass fuel samples were collected at district level from this region. The burning of the collected biomass fuels is performed by using the modified dilution sampler based on studies done by Venkataraman et al. (2005). In this study, the emission factor represents the total period of burning including pyrolysis, flaming and smoldering. The average emission factor of PM from dung cake, fuel-wood and crop residue over Delhi, Uttar Pradesh, Punjab, Haryana, Uttarakhand and Bihar are estimated as 16.26 ± 2.29 g kg-1, 4.34 ± 1.06 g kg-1 and 7.54 ± 4.17 g kg-1 respectively. Similarly, the average emission factor of SO2, NO and NO2 from dung cake, fuel-wood and crop residue over this region are also determined (SO2: 0.28 ± 0.09 g kg-1, 0.26 ± 0.10 g kg-1 and 0.27 ± 0.11 g kg-1, NO: 0.27 ± 0.21 g kg-1, 0.41 ± 0.25 g kg-1 and 0.54 ± 0.50 g kg-1 and NO2: 0.31 ± 0.23 g kg-1, 0.35 ± 0.28 g kg-1 and 0.54 ± 0.47 g kg-1 respectively). The emission of PM, SO2, NO and NO2 from biomass fuels used as energy in rural household over, IGP are also estimated in this paper. The result shows the regional emission inventory from Indian scenario with spatial variability.

Prevalence of scrub typhus in pyrexia of unknown origin and assessment of interleukin-8, tumor necrosis factor-alpha, and interferon-gamma levels in scrub typhus-positive patients.

PubMed

Rizvi, Meher; Sultan, Asfia; Chowdhry, Madhav; Azam, Mohd; Khan, Fatima; Shukla, Indu; Khan, Haris M

2018-01-01

Scrub typhus is lesser known cause of fever of unknown origin in India. Even if there have been reports documenting the prevalence of scrub typhus in different parts of India, it is still an unknown entity, and clinicians usually do not consider it as differential diagnosis. The present study was performed to document the prevalence of scrub typhus among febrile patients in western part of Uttar Pradesh and to assess the clinical profile of infected patients on the one hand and knowledge, attitude, and practices among clinicians on the other. A total of 357 adult patients with fever of more than 5-day duration were recruited. All patients underwent complete physical examination, and detailed clinical history was elicited as per predesigned pro forma. After primary screening to rule out malaria, enteric fever, and leptospirosis infection, secondary screening for scrub typhus was done by rapid screen test and IgM ELISA. Scrub typhus infection was positive in 91 (25.5%) cases. The most common symptoms among the patients were fever (100%), pain in abdomen (79.1%), pedal edema 56 (61.5%), rash 44 (48.3%), headache 44 (48.3%), vomiting 42 (46.1%), constipation 33 (36.2%), cough 28 (30.7%), and lymphadenopathy 20 (21.9%). The median values of interleukin-8, interferon-gamma, and tumor necrosis factor-alpha in healthy controls were 15.54 pg/ml, 7.77 pg/ml, and 54.1 pg/ml, respectively, while the median values of these cytokines in scrub typhus-positive patients were 21.04 pg/ml, 8.74 pg/ml, and 73.8 pg/ml, respectively. Our results highlight that scrub typhus infection is an important cause of pyrexia of unknown origin, and active surveillance is necessary to assess the exact magnitude and distribution of the disease.

The expanding host tree species spectrum of Cryptococcus gattii and Cryptococcus neoformans and their isolations from surrounding soil in India.

PubMed

Randhawa, H S; Kowshik, T; Chowdhary, Anuradha; Preeti Sinha, K; Khan, Z U; Sun, Sheng; Xu, Jianping

2008-12-01

This study reports the widespread prevalence of Cryptococcus neoformans and Cryptococcus gattii in decayed wood inside trunk hollows of 14 species representing 12 families of trees and from soil near the base of various host trees from Delhi and several places in the Indian states of Uttar Pradesh, Haryana, Tamil Nadu and Chandigarh Union Territory. Of the 311 trees from which samples were obtained, 64 (20.5%) were found to contain strains of the C. neoformans species complex. The number of trees positive for C. neoformans var grubii (serotypeA) was 51 (16.3%), for C. gattii (serotype B) 24 (7.7%) and for both C. neoformans and C. gattii 11 (3.5%). The overall prevalence of C. neoformans species complex in decayed wood samples was 19.9% (111/556). There was no obvious correlation between the prevalence of these two yeast species and the species of host trees. The data on prevalence of C. gattii (24%) and C. neoformans (26%) in soil around the base of some host trees indicated that soil is another important ecologic niche for these two Cryptococcus species in India. Among our sampled tree species, eight and six were recorded for the first time as hosts for C. neoformans var grubii and C. gattii, respectively. A longitudinal surveillance of 8 host tree species over 0.7 to 2.5 years indicated long term colonization of Polyalthia longifolia, Mimusops elengi and Manilkara hexandra trees by C. gattii and/or C. neoformans. The mating type was determined for 153 of the isolates, including 98 strains of serotype A and 55 of serotype B and all proved to be mating type alpha (MAT alpha). Our observations document the rapidly expanding spectrum of host tree species for C. gattii and C. neoformans and indicate that decayed woods of many tree species are potentially suitable ecological niches for both pathogens.

Impact of an integrated nutrition and health programme on neonatal mortality in rural northern India.

PubMed

Baqui, Abdullahh; Williams, Emma K; Rosecrans, Amanda M; Agrawal, Praween K; Ahmed, Saifuddin; Darmstadt, Gary L; Kumar, Vishwajeet; Kiran, Usha; Panwar, Dharmendra; Ahuja, Ramesh C; Srivastava, Vinod K; Black, Robert E; Santosham, Manthuram

2008-10-01

To assess the impact of the newborn health component of a large-scale community-based integrated nutrition and health programme. Using a quasi-experimental design, we evaluated a programme facilitated by a nongovernmental organization that was implemented by the Indian government within existing infrastructure in two rural districts of Uttar Pradesh, northern India. Mothers who had given birth in the 2 years preceding the surveys were interviewed during the baseline (n = 14 952) and endline (n = 13 826) surveys. The primary outcome measure was reduction of neonatal mortality. In the intervention district, the frequency of home visits by community-based workers increased during both antenatal (from 16% to 56%) and postnatal (from 3% to 39%) periods, as did frequency of maternal and newborn care practices. In the comparison district, no improvement in home visits was observed and the only notable behaviour change was that women had saved money for emergency medical treatment. Neonatal mortality rates remained unchanged in both districts when only an antenatal visit was received. However, neonates who received a postnatal home visit within 28 days of birth had 34% lower neonatal mortality (35.7 deaths per 1000 live births, 95% confidence interval, CI: 29.2-42.1) than those who received no postnatal visit (53.8 deaths per 1000 live births, 95% CI: 48.9-58.8), after adjusting for sociodemographic variables. Three-quarters of the mortality reduction was seen in those who were visited within the first 3 days after birth. The effect on mortality remained statistically significant when excluding babies who died on the day of birth. The limited programme coverage did not enable an effect on neonatal mortality to be observed at the population level. A reduction in neonatal mortality rates in those receiving postnatal home visits shows potential for the programme to have an effect on neonatal deaths.

District decision-making for health in low-income settings: a feasibility study of a data-informed platform for health in India, Nigeria and Ethiopia

PubMed Central

Avan, Bilal Iqbal; Berhanu, Della; Umar, Nasir; Wickremasinghe, Deepthi; Schellenberg, Joanna

2016-01-01

Low-resource settings often have limited use of local data for health system planning and decision-making. To promote local data use for decision-making and priority setting, we propose an adapted framework: a data-informed platform for health (DIPH) aimed at guiding coordination, bringing together key data from the public and private sectors on inputs and processes. In working to transform this framework from a concept to a health systems initiative, we undertook a series of implementation research activities including background assessment, testing and scaling up of the intervention. This first paper of four reports the feasibility of the approach in a district health systems context in five districts of India, Nigeria and Ethiopia. We selected five districts using predefined criteria and in collaboration with governments. After scoping visits, an in-depth field visit included interviews with key health stakeholders, focus group discussions with service-delivery staff and record review. For analysis, we used five dimensions of feasibility research based on the TELOS framework: technology and systems, economic, legal and political, operational and scheduling feasibility. We found no standardized process for data-based district level decision-making, and substantial obstacles in all three countries. Compared with study areas in Ethiopia and Nigeria, the health system in Uttar Pradesh is relatively amenable to the DIPH, having relative strengths in infrastructure, technological and technical expertise, and financial resources, as well as a district-level stakeholder forum. However, a key challenge is the absence of an effective legal framework for engagement with India’s extensive private health sector. While priority-setting may depend on factors beyond better use of local data, we conclude that a formative phase of intervention development and pilot-testing is warranted as a next step. PMID:27591204

Rakshasutra movement: a women's campaign to save Uttarakhand forests.

PubMed

Bhai, S

1999-01-01

Villagers, particularly the women, have once again come forward to launch another novel movement to save Uttarakhand forests and the environment. Established in July 1995, the Rakshasutra (Safety thread) movement struggled to stop the operations of Uttar Pradesh Forest Corporation (UPFC). Through the help of the Himalayan Environmental Education Society volunteers, women consolidated and unite to protest against illegal felling and selling of trees in the region. Moreover, the National Commission for Women also voiced their concerns regarding this issue and supported women in this movement to save the forests. In Tehri, a group of environmentalists, social workers, and women activists initiated an action program to investigate the increasing tree felling activities of UPFC. Their campaign, and the strong public opinion it generated, forced UPFC to put an end to its illegal business.

The Summer Monsoon of 1987.

NASA Astrophysics Data System (ADS)

Krishnamurti, T. N.; Bedi, H. S.; Subramaniam, M.

1989-04-01

In this paper we have examined the evolution of a number of parameters we believe were important for our understanding of the drought over India during the summer of 1987. The list of parameters includes monthly means or anomalies of the following fields: sea surface temperatures, divergent circulations, outgoing longwave radiation, streamfunction of the lower and upper troposphere, and monthly precipitation (expressed as a percentage departure from a long-term mean). The El Niño related warm sea surface temperature anomaly and a weaker warm sea surface temperature anomaly over the equatorial Indian Ocean provide sustained convection, as reflected by the negative values of the outgoing longwave radiation. With the seasonal heating, a pronounced planetary-scale divergent circulation evolved with a center along the western Pacific Ocean. The monsoonal divergent circulation merged with that related to the El Niño, maintaining most of the heavy rainfall activity between the equatorial Pacific Ocean and east Asia. Persistent convective activity continued south of India during the entire monsoon season. Strong Hadley type overturnings with rising motions over these warm SST anomaly regions and descent roughly near 20° to 25°S was evident as early as April 1987. The subtropical high pressure areas near 20° to 25°S showed stronger than normal circulations. This was revealed by the presence of a counterclockwise streamfunction anomaly at 850 mb during April 1987. With the seasonal heating, this anomaly moved northwards and was located over the Arabian Sea and India. This countermonsoon circulation anomaly at the low levels was associated with a weaker than normal Somali jet and Arabian Sea circulation throughout this summer. The monsoon remained active along northeast India, Bangladesh, northern lndochina, and central China during the summer monsoon season. This was related to the eastward shift of the divergent circulation. An eastward shift of the upper tropospheric anticyclone bell near 25° to 30°N resulted in the continued presence of a westerly wind anomaly north of India. The westerly winds brought in very dry air over the tropical upper troposphere. The dry air penetrated eastwards to central Uttar Pradesh and this seemed to have a major role in inhibiting organized deep convection over most of central, northern and western parts of the Indian subcontinent. The westward extension of the planetary-scale divergent circulation over North and South Africa and the continued drought over the regions are also briefly addressed.

Changing trends in the prevalence of blindness and visual impairment in a rural district of India: Systematic observations over a decade

PubMed Central

Khanna, Rohit C; Marmamula, Srinivas; Krishnaiah, Sannapaneni; Giridhar, Pyda; Chakrabarti, Subhabrata; Rao, Gullapalli N

2012-01-01

Context: Globally, limited data are available on changing trends of blindness from a single region. Aims: To report the changing trends in the prevalence of blindness, visual impairment (VI), and visual outcomes of cataract surgery in a rural district of Andhra Pradesh, India, over period of one decade. Settings and Design: Rural setting; cross-sectional study. Materials and Methods: Using a validated Rapid Assessment of Cataract Surgical Services (RACSS) method, population-based, cross-sectional survey was done in a rural district in the state of Andhra Pradesh, India. Two-stage sampling procedure was used to select participants ≥50 years of age. Further, a comparative analysis was done with participants ≥50 years from the previously concluded Andhra Pradesh Eye Disease Study (APEDS) study, who belonged to the same district. Statistical Analysis: Done using 11th version of Stata. Results: Using RACSS, 2160/2300 (93.9%) participants were examined as compared with the APEDS dataset (n=521). Age and sex adjusted prevalence of blindness in RACSS and APEDS was 8% (95% CI, 6.9–9.1%) and 11% (95% CI, 8.3–13.7%), while that of VI was 13.6% (95% CI, 12.2–15.1%) and 40.3% (95% CI, 36.1–44.5%), respectively. Cataract was the major cause of blindness in both the studies. There was a significant reduction in blindness following cataract surgery as observed through RACSS (17.3%; 95% CI, 13.5–21.8%) compared with APEDS (34%; 95% CI, 20.9–49.3%). Conclusion: There was a significant reduction in prevalence of blindness and VI in this rural district of India over a decade. PMID:22944766

Changing trends in the prevalence of blindness and visual impairment in a rural district of India: systematic observations over a decade.

PubMed

Khanna, Rohit C; Marmamula, Srinivas; Krishnaiah, Sannapaneni; Giridhar, Pyda; Chakrabarti, Subhabrata; Rao, Gullapalli N

2012-01-01

Context : Globally, limited data are available on changing trends of blindness from a single region. Aims : To report the changing trends in the prevalence of blindness, visual impairment (VI), and visual outcomes of cataract surgery in a rural district of Andhra Pradesh, India, over period of one decade. Settings and Design : Rural setting; cross-sectional study. Materials and Methods : Using a validated Rapid Assessment of Cataract Surgical Services (RACSS) method, population-based, cross-sectional survey was done in a rural district in the state of Andhra Pradesh, India. Two-stage sampling procedure was used to select participants ≥50 years of age. Further, a comparative analysis was done with participants ≥50 years from the previously concluded Andhra Pradesh Eye Disease Study (APEDS) study, who belonged to the same district. Statistical Analysis : Done using 11 th version of Stata. Results : Using RACSS, 2160/2300 (93.9%) participants were examined as compared with the APEDS dataset (n=521). Age and sex adjusted prevalence of blindness in RACSS and APEDS was 8% (95% CI, 6.9-9.1%) and 11% (95% CI, 8.3-13.7%), while that of VI was 13.6% (95% CI, 12.2-15.1%) and 40.3% (95% CI, 36.1-44.5%), respectively. Cataract was the major cause of blindness in both the studies. There was a significant reduction in blindness following cataract surgery as observed through RACSS (17.3%; 95% CI, 13.5-21.8%) compared with APEDS (34%; 95% CI, 20.9-49.3%). Conclusion : There was a significant reduction in prevalence of blindness and VI in this rural district of India over a decade.

Choosing and Changing Schools in India's Private and Government Sectors: Young Lives Evidence from Andhra Pradesh

ERIC Educational Resources Information Center

James, Zoe; Woodhead, Martin

2014-01-01

The growth and increasing popularity of 'low-fee' private schooling across many parts of India has attracted much research and policy attention. This paper broadens the discussion by drawing attention to the increasing heterogeneity of the educational landscape in many communities. Our specific focus is on the consequences for school choices made…

Extending Access to Low-Cost Private Schools through Vouchers: An Alternative Interpretation of a Two-Stage "School Choice" Experiment in India

ERIC Educational Resources Information Center

Tooley, James

2016-01-01

Muralidharan and Sundararaman report a randomised controlled trial of a school voucher experiment in Andhra Pradesh, India. The headline findings are that there are no significant academic differences between voucher winners and losers in Telugu, mathematics, English, and science/social studies, although because the private schools appear to use…

Greening the Grid: Pathways to Integrate 175 Gigawatts of Renewable Energy into India's Electric Grid, Regional Study: Andhra Pradesh

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cochran, Jaquelin M; Palchak, Joseph D; Ehlen, Annaliese K

This chapter on Andhra Pradesh is one of six state chapters included in Appendix C of 'Greening the Grid: Pathways to Integrate 175 Gigawatts of Renewable Energy into India's Electric Grid, Vol. II - Regional Study' (the Regional Study). The objective of the state chapters is to provide modeling assumptions, results, and next steps to use and improve the model specific to each state. The model has inherent uncertainties, particularly in how the intrastate transmission network and RE generation projects will develop (e.g., locations, capacities). The model also does not include information on contracts or must-run status of particular plantsmore » for reliability purposes. By providing details on the higher spatial resolution model of 'Greening the Grid: Pathways to Integrate 175 Gigawatts of Renewable Energy into India's Electric Grid, Vol. II - Regional Study' (the Regional Study), which better represents the impact of congestion on least-cost scheduling and dispatch, provides a deeper understanding of the relationship among renewable energy (RE) location, transmission, and system flexibility with regard to RE integration, compared to 'Greening the Grid: Pathways to Integrate 175 Gigawatts of Renewable Energy into India's Electric Grid, Vol. I - National Study.'« less

Pathways and consequences of unsafe abortion: a comparison among women with complications after induced and spontaneous abortions in Madhya Pradesh, India.

PubMed

Banerjee, Sushanta K; Andersen, Kathryn L; Warvadekar, Janardan

2012-09-01

This study aimed to understand women's pathways of seeking care for postabortion complications in Madhya Pradesh, India. The study recruited 786 women between July and November 2007. Data were collected on service provision, abortion-related complications, care-seeking behavior, knowledge about abortion legality and availability, methods used, symptoms, referral source, and out-of-pocket costs. Women seeking care for complications from induced abortion followed more complex pathways to treatment than women with complications of spontaneous abortion. More complex pathways were associated with higher out-of-pocket costs. Improving community awareness on legal aspects, safe abortion methods, and trained providers are necessary to reduce morbidity associated with unsafe abortion. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Predominance of unusual rotavirus G1P[6] strain in North India: An evidence from hospitalized children and adult diarrheal patients.

PubMed

Jain, Swapnil; Thakur, Nutan; Vashistt, Jitendraa; Grover, Neelam; Krishnan, Triveni; Changotra, Harish

2016-12-01

Group A Rotavirus remains the leading cause of gastroenteritis in children and accounts for 0.2 million fatalities each year; out of which, approximately 47,100 deaths occur in India. In adults also, rotavirus is reported to be responsible for diarrhea severe enough to require hospitalizations. India has recently introduced rotavirus vaccine in the Universal Immunization Programme and Himachal Pradesh became the first Indian state to implement this project. This study is an attempt to provide the pre-vaccination data on rotavirus gastroenteritis burden and circulating genotypes in Himachal Pradesh, India. A total of 607 faecal specimens (247 children ≤5years, 50 older children and 310 adults) from hospitalized diarrheal patients from Himachal Pradesh, India were screened for rotavirus using ELISA and RT-PCR. The positive samples were further G/P genotyped using semi-nested PCR. Rotavirus was detected in 25.2% and 28.3% of samples with ELISA and RT-PCR, respectively. In children, rotavirus frequency was significantly high with positivity in 49.0% cases whereas 14.0% adult samples have rotavirus in them. Genotyping of the positive samples revealed predominance of G1 (66.0%) and P[6] (66.7%) genotypes. The most common G and P combination was G1P[6] (62.8%) followed by G1P[8] (16.5%), G9P[6] (7.4%) and G12P[6] (5.0%). Molecular analysis reveals the belonging of P[6] strains in Lineage 1a. This pre-vaccination data on rotavirus prevalence and diversity would be helpful for assessing the affect of vaccination on the disease burden and its comparison with post-vaccination data of circulating genotypes would help in studying the effect on diversity of rotavirus strains possibly due to vaccine selection pressure. Copyright © 2016 Elsevier B.V. All rights reserved.

A Study on Consciousness of Adolescent Girls About Their Body Image

PubMed Central

Dixit, Swati; Agarwal, GG; Singh, JV; Kant, Surya; Singh, Neelam

2011-01-01

Background: Perceived body image is an important potential predictor of nutritional status. Body image misconception during adolescence is unexplored field in Indian girls. Objectives: To study the consciousness of adolescent girls about their body image. Materials and Methods: This multistage observational study was conducted on 586 adolescent girls of age 10–19 years in Lucknow district (151 from rural, 150 from slum, and 286 from urban area) of Uttar Pradesh, India. Information on desired and actual body size was collected with the help of predesigned questionnaire. Results: 20.5% of studied girls show aspiration to become thin, who already perceived their body image as too thin. 73.4% adolescent girls were satisfied with their body image, while 26.6% were dissatisfied. The dissatisfaction was higher among girls of urban (30.2%) and slum (40.0%) areas in comparison to rural (22.5%) area. Percentage of satisfied girls was less in the 13–15 years (69.9%) age groups in comparison to 10–12 years (76.5%) and 16–19 years (76.4%). Among girls satisfied with their body image, 32.8% girls were found underweight, and 38.4% were stunted. Underweight girls (42.1%) and stunted girls (64.9%) were higher in number within satisfied girls of slum area. Among all of these adolescent girls, 32.8% of girls had overestimated their weight, while only 4.9% of girls had underestimated their weight. Conclusions: This study concludes that desire to become thin is higher in adolescent girls, even in those who already perceived their body image as too thin. PMID:22090673

The use of semi-structured interviews for the characterisation of farmer irrigation practices

NASA Astrophysics Data System (ADS)

O'Keeffe, Jimmy; Buytaert, Wouter; Mijic, Ana; Brozović, Nicholas; Sinha, Rajiv

2016-05-01

For the development of sustainable and realistic water security, generating information on the behaviours, characteristics, and drivers of users, as well as on the resource itself, is essential. In this paper we present a methodology for collecting qualitative and quantitative data on water use practices through semi-structured interviews. This approach facilitates the collection of detailed information on actors' decisions in a convenient and cost-effective manner. Semi-structured interviews are organised around a topic guide, which helps lead the conversation in a standardised way while allowing sufficient opportunity for relevant issues to emerge. In addition, they can be used to obtain certain types of quantitative data. While not as accurate as direct measurements, they can provide useful information on local practices and users' insights. We present an application of the methodology on farmer water use in two districts in the state of Uttar Pradesh in northern India. By means of 100 farmer interviews, information was collected on various aspects of irrigation practices, including irrigation water volumes, irrigation cost, water source, and their spatial variability. Statistical analyses of the information, along with data visualisation, are also presented, indicating a significant variation in irrigation practices both within and between districts. Our application shows that semi-structured interviews are an effective and efficient method of collecting both qualitative and quantitative information for the assessment of drivers, behaviours, and their outcomes in a data-scarce region. The collection of this type of data could significantly improve insights on water resources, leading to more realistic management options and increased water security in the future.

The use of semi-structured interviews for the characterisation of farmer irrigation practices

NASA Astrophysics Data System (ADS)

O'Keeffe, J.; Buytaert, W.; Mijic, A.; Brozovic, N.; Sinha, R.

2015-08-01

Generating information on the behaviours, characteristics and drivers of users, as well on the resource itself, is vital in developing sustainable and realistic water security options. In this paper we present a methodology for collecting qualitative and quantitative data on water use practices through semi-structured interviews. This approach facilitates the collection of detailed information on actors' decisions in a convenient and cost-effective manner. The interview is organised around a topic guide, which helps lead the conversation in a standardised way while allowing sufficient opportunity to identify relevant issues previously unknown to the researcher. In addition, semi-structured interviews can be used to obtain certain types of quantitative data. While not as accurate as direct measurements, it can provide useful information on local practices and farmers' insights. We present an application of the methodology on two districts in the State of Uttar Pradesh in North India. By means of 100 farmer interviews, information was collected on various aspects of irrigation practices, including irrigation water volumes, irrigation cost, water source and their spatial variability. A statistical analysis of the information, along with some data visualisation is also presented, which highlights a significant variation in irrigation practices both within and between the districts. Our application shows that semi-structured interviews are an effective and efficient method of collecting both qualitative and quantitative information for the assessment of drivers, behaviours and their outcomes in a data scarce region. The collection of this type of data could significantly improve insight on water resources, leading to more realistic management options and increased water security in the future.

Challenging cultural constraints: a personal testimony.

PubMed

Clayton, L

1995-02-01

DISHA is one of the oldest Oxfam project partners in Uttar Pradesh, India. DISHA works with rural women and rope-makers; it encourages village-level women's organizations to fight against obstacles to women's empowerment and to institute income-producing activities; and it provides legal, educational, and health care services. In this article, a Muslim woman tells the story of her involvement with DISHA and how that involvement gave her the courage to reject the restrictions of purdah and of the wearing of the bourkha. This woman was married at age 13. She suffered ill treatment at the house of her in-laws and returned to her father's home with her 3 daughters. Her husband eventually joined her at her father's house. She was approached by a coordinator of DISHA and asked to apply for a job. She was offered the job, which she accepted. When she started going into the villages, she felt that the restrictive dress of the bourkha interfered with her ability to work. With the permission of her father and her husband, she set aside the bourkha. She had to endure criticism and censure for this action, but eventually people have been won over to her position as they have seen the positive results of her work on behalf of society. After having 5 daughters, she finally had a son. Now she is determined that her daughters will never wear the bourkha, even if they must remain single as a result of this resolve. She feels that DISHA has given her the power to overcome oppression in her own life, in the life of her family, and in society.

Bacterial diversity and real-time PCR based assessment of linA and linB gene distribution at hexachlorocyclohexane contaminated sites.

PubMed

Lal, Devi; Jindal, Swati; Kumari, Hansi; Jit, Simran; Nigam, Aeshna; Sharma, Pooja; Kumari, Kirti; Lal, Rup

2015-03-01

The disposal of hexachlorocyclohexane (HCH) muck has created large number of HCH dumpsites all over the world from where the harmful HCH isomers are leaking into the environment. Bacteria have evolved at such contaminated sites that have the ability to degrade HCH. Degradation of various HCH isomers in bacterial strains is mediated primarily by two genes: linA and linB which encode dehydrochlorinase and haloalkane dehalogenase respectively. In this study we explored one such highly contaminated HCH dumpsite located in Lucknow, Uttar Pradesh, India. To assess the biostimulation potential of the contaminated site, microbial diversity study and real-time PCR based quantification of lin genes was carried out. The soil samples from dumpsite and surrounding areas were found to be highly contaminated with HCH residue levels as high as 1.8 × 10(5)  mg kg(-1). The residues were detected in areas upto 13 km from the dumpsite. Sphingomonads, Chromohalobacter, and Marinobacter were the dominant genera present at the dump-site. Role of Sphingomonads in HCH degradation has been well documented. The highest copy numbers of linA and linB genes as determined using real-time PCR were 6.2 × 10(4) and 5.3 × 10(5), respectively, were found in sample from the dump site. The presence of Sphingomonads, linA, and linB genes from HCH contaminated soil indicates the presence of indigenous bacterial communities capable of HCH degradation. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Exploitation of agro-climatic environment for selection of 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase producing salt tolerant indigenous plant growth promoting rhizobacteria.

PubMed

Misra, Sankalp; Dixit, Vijay Kant; Khan, Mohammad Haneef; Kumar Mishra, Shashank; Dviwedi, Gyanendra; Yadav, Sumit; Lehri, Alok; Singh Chauhan, Puneet

2017-12-01

A comprehensive survey for 09 agro-climatic zones of Uttar Pradesh, India was conducted to isolate and characterize salt tolerant 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase possessing plant growth promoting (PGP) rhizobacteria for salt stress amelioration in rice. Here, we have isolated 1125 bacteria having the ability to tolerate 1M NaCl and out of those, 560 were screened for utilizing ACC as sole nitrogen source. 560 isolates were subjected for bacteria coated seed germination assay under 100mM salt (NaCl) stress resulting to 77 isolates which were further evaluated for seed germination assay, PGP and abiotic stress tolerance ability in vitro. This evaluation revealed 15 potent rhizobacteria representing each agro-climatic zone and salt stress mitigation in vitro. In particular, the biomass obtained for bacteria coated rice seedlings were corroborated with the performance of isolates exhibiting maximum average indole acetic acid (IAA) production respective to the agro-climatic zone. Surprisingly based on 16S rRNA, much of the propitious isolates belonged to same specific epithet exhibited variedly in their characteristics. Overall, Bacillus spp. was explored as dominant genera in toto with highest distribution in Western Plain zone followed by Central zone. Therefore, this study provides a counter-intuitive perspective of selection of native microflora for their multifarious PGP and abiotic stress tolerance abilities based on the agro-climatic zones to empower the establishment and development of more suitable inoculants for their application in agriculture under local stress environments. Copyright © 2017 Elsevier GmbH. All rights reserved.

Social determinants and polio 'endgame': a qualitative study in high risk districts of India.

PubMed

Dasgupta, Rajib; Chaturvedi, Sanjay; Adhish, S Vivek; Ganguly, Kalyan K; Rai, Sanjay; Sushant, Leena; Arora, N K

2008-05-01

To understand the perceptions and likely determinants that facilitate or act as barriers in implementing additional strategies for polio eradication: (a) accelerated delivery of mOPV1 (monovalent polio vaccine type 1); (b) use of IPV (inactivated polio vaccine); and (c) provision of incentives. QUALITATIVE. Rapid appraisal procedures (RAP) were adopted to derive the reality by synthesizing multiple sources of information; search for opinions, motivations, behaviors and attitudes of key stakeholders within their organizational and socio-cultural matrix. Two districts of Uttar Pradesh - Moradabad and J P Nagar. Total 244 interactions were conducted; 33 interviews and 4 focussed group discussions (FGD) conducted with providers; 33 mothers (<5 years) and 10 leaders were interviewed; 8 FGD were conducted with mothers of under-fives. Informal interactions (156) were also conducted with village pradhans, religious leaders, parents, businessmen, journalists (Hindi and Urdu media), mobilizers, vaccinators and supervisors. Providers expressed reservation regarding accelerated rounds of OPV; scientific rationale of accelerated rounds is not clear to parents and leaders. Although technical advantages of introducing IPV exist, issues of logistical difficulties and injection safety emerged strongly. Providers and communities indicated a clear 'no' to the cash incentives but argued for developmental issues. Resistance to the program has declined over time but still the program is perceived as the "government's need, not ours". The polio eradication program is critically poised, an opportunity to intensify efforts for reducing inequities in health services and improve access of all children to the PHC services. Ongoing dialogue with local communities and strong political commitment would be essential to translate the technological innovations into a sustainable program.

Evaluation of WRF PBL parameterization schemes against direct observations during a dry event over the Ganges valley

NASA Astrophysics Data System (ADS)

Sathyanadh, Anusha; Prabha, Thara V.; Balaji, B.; Resmi, E. A.; Karipot, Anandakumar

2017-09-01

Accurate representations of the planetary boundary layer (PBL) are important in all weather forecast systems, especially in simulations of turbulence, wind and air quality in the lower atmosphere. In the present study, detailed observations from the Cloud Aerosol Interaction and Precipitation Enhancement Experiment - Integrated Ground based Observational Campaign (CAIPEEX-IGOC) 2014 comprising of the complete surface energy budget and detailed boundary layer observations are used to validate Advanced Research Weather Research and Forecasting (WRF) model simulations over a diverse terrain over the Ganges valley region, Uttar Pradesh, India. A drying event in June 2014 associated with a heat wave is selected for validation.Six local and nonlocal PBL schemes from WRF at 1 km resolution are compared with hourly observations during the diurnal cycle. Near-surface observations of weather parameters, radiation components and eddy covariance fluxes from micrometeorological tower, and profiles of variables from microwave radiometer, and radiosonde observations are used for model evaluations. Models produce a warmer, drier surface layer with higher wind speed, sensible heat flux and temperature than observations. Layered boundary layer dynamics, including the residual layer structure as illustrated in the observations over the Ganges valley are missed in the model, which lead to deeper mixed layers and excessive drying.Although it is difficult to identify any single scheme as the best, the qualitative and quantitative analyses for the entire study period and overall reproducibility of the observations indicate that the MYNN2 simulations describe lower errors and more realistic simulation of spatio-temporal variations in the boundary layer height.

Readability of Distance Education Course Material.

ERIC Educational Resources Information Center

Mouli, C. Raja; Ramakrishna, C. Pushpa

1991-01-01

Flesch Reading Ease scores were calculated for 48 books used in distance education courses at Andhra Pradesh Open University (India). Scores ranged from 32 (public administration) to 46 (geology). Scores correlated positively with pass percentages. (SK)

'Whatever She May Study, She Can't Escape from Washing Dishes': Gender Inequity in Secondary Education--Evidence from a Longitudinal Study in India

ERIC Educational Resources Information Center

Singh, Renu; Mukherjee, Protap

2018-01-01

Using unique panel data from Young Lives study conducted in undivided Andhra Pradesh, India, this mixed-method paper analyses gender differentials in completion of secondary education. Results show biased secondary school completion rates in favor of boys. Probit regression results highlight certain variables such as mothers' education, wealth,…

Reading the Water Table: The Interaction between Literacy Practices and Groundwater Management Training in Preparing Farmers for Climate Change in South India

ERIC Educational Resources Information Center

Chavva, Konda Reddy; Smith, Cristine A.

2012-01-01

This article focuses on farmers' use of literacy for individual decision-making on crop-water management and crop choices and investigates how farmer participants perceive the usefulness of Farmer Water School (FWS) training. It draws upon a study conducted with farmers of Kurnool district of Andhra Pradesh, India. This study has demonstrated that…

Tuberculosis management practices by private practitioners in Andhra Pradesh, India.

PubMed

Achanta, Shanta; Jaju, Jyoti; Kumar, Ajay M V; Nagaraja, Sharath Burugina; Shamrao, Srinivas Rao Motta; Bandi, Sasidhar Kumar; Kumar, Ashok; Satyanarayana, Srinath; Harries, Anthony David; Nair, Sreenivas Achutan; Dewan, Puneet K

2013-01-01

Private medical practitioners in Visakhapatnam district, Andhra Pradesh, India. To evaluate self-reported TB diagnostic and treatment practices amongst private medical practitioners against benchmark practices articulated in the International Standards of Tuberculosis Care (ISTC), and factors associated with compliance with ISTC. Cross- sectional survey using semi-structured interviews. Of 296 randomly selected private practitioners, 201 (68%) were assessed for compliance to ISTC diagnostic and treatment standards in TB management. Only 11 (6%) followed a combination of 6 diagnostic standards together and only 1 followed a combination of all seven treatment standards together. There were 28 (14%) private practitioners who complied with a combination of three core ISTC (cough for tuberculosis suspects, sputum smear examination and use of standardized treatment). Higher ISTC compliance was associated with caring for more than 20 TB patients annually, prior sensitization to TB control guidelines, and practice of alternate systems of medicine. Few private practitioners in Visakhapatnam, India reported TB diagnostic and treatment practices that met ISTC. Better engagement of the private sector is urgently required to improve TB management practices and to prevent diagnostic delay and drug resistance.

NOMENCLATURE OF ANUKTA DRAVYA

PubMed Central

Kusuma, Ganji; Joshi, V. K

2010-01-01

Field survey was conducted in rural areas of Varanasi district of Uttar Pradesh including Ramnagar, Manduadih and surrounding areas to identify and collect information on undocumented medicinal plants (Anukta Dravya) by direct interaction with folklore people through field survey and indirect means by means of comprehensive survey of available literature. Local names of undocumented medicinal plants along with other relevant information were collected, after recording local names of medicinal plants, their botanical identification was done by comprehensive survey of literature, and the plants were identified according to Bentham & Hooker's system of classification using local floristic works. Expert opinion of plant taxonomists was also sought for cross checking and confirmation on identity. The freshly collected specimens were photographed for visual identification of the species. After identification, nomenclature of 10 Anukta Dravya was done as per the criteria of nomenclature mentioned in Nighantus. PMID:22557363

Urinary fluoride as a monitoring tool for assessing successful intervention in the provision of safe drinking water supply in five fluoride-affected villages in Dhar district, Madhya Pradesh, India.

PubMed

Srikanth, R; Gautam, Anil; Jaiswal, Suresh Chandra; Singh, Pavitra

2013-03-01

Endemic fluorosis was detected in 31 villages in the Dhar district of Madhya Pradesh, Central India. Out of the 109 drinking water sources that were analyzed, about 67 % were found to contain high concentration of fluoride above the permissible level of 1.0 mg/l. Dental fluorosis among the primary school children in the age between 8 and 15 served as primary indicator for fluoride intoxication among the children. Urinary fluoride levels among the adults were found to be correlated with drinking water fluoride in 10 villages affected by fluoride. Intervention in the form of alternate safe water supply in five villages showed significant reduction in the urinary fluoride concentration when compared to the control village. Urinary fluoride serves as an excellent marker for assessing the effectiveness of intervention program in the fluoride-affected villages.

Supplementary Role of Health Metrics for Reducing Total Fertility Rate in a North-Indian State

PubMed Central

Ganguly, Enakshi

2014-01-01

Reducing Total Fertility Rate (TFR) amongst rural Indian couples from the current level is a significant challenge to the population control policies relying solely on the Government efforts. REACH strategy, based on health metrics, succeeded in lowering the TFR below replacement levels in a rural population of more than 300,000 in Rajasthan. The REACH strategy was first developed and demonstrated success in decreasing TFR in a pilot project by SHARE India in Medchal region of Andhra Pradesh utilizing designated workers, and was replicated in Rajgarh District of Rajasthan in cooperation with Bhoruka Charitable Trust (supervisor of ICDS and NRHM health workers in Rajgarh) using Government health workers. The success of the REACH strategy in both Rajasthan and previously in Andhra Pradesh holds promise as a tool to reduce TFR in other areas of rural India. PMID:25620855

Dual Infection with Bluetongue Virus Serotypes and First-Time Isolation of Serotype 5 in India.

PubMed

Hemadri, D; Maan, S; Chanda, M M; Rao, P P; Putty, K; Krishnajyothi, Y; Reddy, G H; Kumar, V; Batra, K; Reddy, Y V; Maan, N S; Reddy, Y N; Singh, K P; Shivachandra, S B; Hegde, N R; Rahman, H; Mertens, P P C

2017-12-01

Bluetongue is endemic in India and has been reported from most Indian states. Of late, the clinical disease is most frequently seen in the states of Andhra Pradesh, Telangana (erstwhile Andhra Pradesh state), Tamil Nadu and Karnataka. Our analysis of diagnostic samples from bluetongue outbreaks during 2010-2011 from the state of Karnataka identified bluetongue virus (BTV) serotype 5 (BTV-5) for the first time in India. One of the diagnostic samples (CH1) and subsequent virus isolate (IND2010/02) contained both BTV-2 and BTV-5. Segment 2 (seg-2) sequence data (400 bp: nucleotides 2538-2921) for IND2010/02-BTV5, showed 94.3% nucleotide identity to BTV-5 from South Africa (Accession no. AJ585126), confirming the virus serotype and also indicating that Seg-2 was derived from a Western topotype, which is in contrast to serotype 2, that belongs to an Eastern topotype. BTV-5 has been recently reported from Africa, China, French islands and the Americas. Although the exact source of the Indian BTV-5 isolate is still to be confirmed, recent identification of additional exotic serotypes in India is of real concern and might add to the severity of the disease seen in these outbreaks. © 2016 Blackwell Verlag GmbH.

Dental caries prevalence and treatment needs among 12- and 15- Year old schoolchildren in Shimla city, Himachal Pradesh, India.

PubMed

Shailee, Fotedar; Sogi, G M; Sharma, K R; Nidhi, Pruthi

2012-01-01

Dental caries is one of the commonest oral diseases in children. Despite this fact, not many studies have been done on this issue among school children in Shimla. To assess the prevalence of dental caries and treatment needs among schoolchildren aged 12 years and 15 years in Shimla city, Himachal Pradesh, India. With this study we also aimed to establish reliable baseline data. Cross-sectional study. This study was conducted among 12 - and 15 - year old schoolchildren in Shimla city, Himachal Pradesh-India. A sample of 1011 schoolchildren was selected by a two-stage cluster sampling method. Clinical recording of dental caries, was done according to WHO diagnostic criteria (1997). The statistical tests used were the t- test, and the Chi-square test. The prevalence of dental caries was 32.6% and 42.2% at 12 years and 15 years respectively. At 12 years of age, the mean Decayed Missing Filled Teeth was 0.62 ± 1.42 and it was 1.06 ± 2.93 at 15 years of age. Females had higher level of caries than males at both the ages. Dental caries was higher in children from government schools as compared to those from private schools. The 'decayed' component was the biggest contributor to the DMFT index. The highest treatment need at both ages was one surface restoration. The caries experience of 12- and 15- year-old children was low compared to WHO - 'recommended' values. Effective oral health promotion strategies need to be implemented to further improve the dental health of school children in Shimla city.

Seven Programs for Seven Countries

ERIC Educational Resources Information Center

Otte, Max R.

1975-01-01

Programs from abroad represented at the January, 1975 Multinational Workshop on Adult Education (Washington, D. C.) included: Rural Reconstruction Movement (Philippines); Nonformal Education for Rural Women (Andhra Pradesh, India); Accion Cultural Popular (Colombia); Village Polytechnic Centers (Kenya); CONCORDE (Honduras); National Adult…

Male migration and risky sexual behavior in rural India: is the place of origin critical for HIV prevention programs?

PubMed

Saggurti, Niranjan; Mahapatra, Bidhubhusan; Swain, Suvakanta N; Jain, Anrudh K

2011-12-29

Recent studies of male migrants in India indicate that those who are infected with HIV are spreading the epidemic from high risk populations in high prevalence areas to populations in low prevalence areas. In this context, migrant men are believed to initiate and have risky sexual behaviors in places of destination and not in places of origin. The paucity of information on men's risky sexual behaviors in places of origin limits the decision to initiate HIV prevention interventions among populations in high out-migration areas in India. A cross-sectional behavioral survey was conducted among non-migrants, returned migrants (with a history of migration), and active (current) migrants in rural areas across two districts with high levels of male out-migration: Prakasam district in Andhra Pradesh and Azamgarh district in Uttar Pradesh. Surveys assessed participant demographics, migration status, migration history, and sexual behavior along the migration routes, place of initiation of sex. District-stratified regression models were used to understand the associations between migration and risky sexual behaviors (number of partners, condom use at last sex) and descriptive analyses of migrants' place of sexual initiation and continuation along migration routes. The average age at migration of our study sample was 19 years. Adjusted regression analyses revealed that active migrants were more likely to engage in sex with sex workers in the past 12 months (Prakasam: 15 percent vs. 8 percent; adjusted odds ratio (aOR)=2.1, 95% CI 1.2-3.4; Azamgarh: 19 percent vs.7 percent; aOR=4.0, 95% CI 2.4-6.6) as well as have multiple (3+) sex partners (Prakasam: 18 percent vs. 9 percent; aOR=2.0, 95% CI 1.3-3.2; Azamgarh: 28 percent vs. 21 percent; aOR=1.9, 95% CI 1.2-3.0) than non-migrants. Contrary to popular belief, a high proportion of active and returned migrants (almost 75 percent of those who had sex) initiated sex at the place of origin before migrating, which is equivalent to the proportion of non-migrants who engaged in sex with sex workers as well as with casual unpaid partners. Moreover, non-migrants were more likely than migrants to engage in unprotected sex. Findings of this study document that returned migrants and active migrants have higher sexual risk behaviors than the non-migrants. Most migrants initiate non-marital sex in the place of origin and many continue these behaviors in places of destination. Migrants' destination area behaviors are linked to sex with sex workers and they continue to practice such behaviors in the place of origin as well. Unprotected sex in places of destination with high HIV prevalence settings poses a risk of transmission from high risk population groups to migrants, and in turn to their married and other sexual partners in places of origin. These findings suggest the need for controlling the spread of HIV among both men and women resulting from unsafe sex in places of origin that have high vulnerability due to the frequent migratory nature of populations.

Male migration and risky sexual behavior in rural India: is the place of origin critical for HIV prevention programs?

PubMed Central

2011-01-01

Background Recent studies of male migrants in India indicate that those who are infected with HIV are spreading the epidemic from high risk populations in high prevalence areas to populations in low prevalence areas. In this context, migrant men are believed to initiate and have risky sexual behaviors in places of destination and not in places of origin. The paucity of information on men's risky sexual behaviors in places of origin limits the decision to initiate HIV prevention interventions among populations in high out-migration areas in India. Methods A cross-sectional behavioral survey was conducted among non-migrants, returned migrants (with a history of migration), and active (current) migrants in rural areas across two districts with high levels of male out-migration: Prakasam district in Andhra Pradesh and Azamgarh district in Uttar Pradesh. Surveys assessed participant demographics, migration status, migration history, and sexual behavior along the migration routes, place of initiation of sex. District-stratified regression models were used to understand the associations between migration and risky sexual behaviors (number of partners, condom use at last sex) and descriptive analyses of migrants' place of sexual initiation and continuation along migration routes. Results The average age at migration of our study sample was 19 years. Adjusted regression analyses revealed that active migrants were more likely to engage in sex with sex workers in the past 12 months (Prakasam: 15 percent vs. 8 percent; adjusted odds ratio (aOR)=2.1, 95% CI 1.2-3.4; Azamgarh: 19 percent vs.7 percent; aOR=4.0, 95% CI 2.4-6.6) as well as have multiple (3+) sex partners (Prakasam: 18 percent vs. 9 percent; aOR=2.0, 95% CI 1.3-3.2; Azamgarh: 28 percent vs. 21 percent; aOR=1.9, 95% CI 1.2-3.0) than non-migrants. Contrary to popular belief, a high proportion of active and returned migrants (almost 75 percent of those who had sex) initiated sex at the place of origin before migrating, which is equivalent to the proportion of non-migrants who engaged in sex with sex workers as well as with casual unpaid partners. Moreover, non-migrants were more likely than migrants to engage in unprotected sex. Conclusion Findings of this study document that returned migrants and active migrants have higher sexual risk behaviors than the non-migrants. Most migrants initiate non-marital sex in the place of origin and many continue these behaviors in places of destination. Migrants’ destination area behaviors are linked to sex with sex workers and they continue to practice such behaviors in the place of origin as well. Unprotected sex in places of destination with high HIV prevalence settings poses a risk of transmission from high risk population groups to migrants, and in turn to their married and other sexual partners in places of origin. These findings suggest the need for controlling the spread of HIV among both men and women resulting from unsafe sex in places of origin that have high vulnerability due to the frequent migratory nature of populations. PMID:22375813

Mapping of risk prone areas of kala-azar (Visceral leishmaniasis) in parts of Bihar State, India: an RS and GIS approach.

PubMed

Sudhakar, S; Srinivas, T; Palit, A; Kar, S K; Battacharya, S K

2006-09-01

The kala-azar fever (Visceral leishmaniasis) is continuing unabated in India for over a century, now being largely confined to the eastern part of India mainly in Bihar state and to some extent in its bordering states like West Bengal and Uttar Pradesh. Two study sites namely Patepur block in Vaishali district with high endemicity in northern part and Lohardagga block in Lohardagga district with absolute non-endemicity in southern part of Bihar were selected for the study with the following objectives : (i) to study the macro-ecosystem in relation to distribution of vector -Phlebotomus argentipes; (ii) to identify/map the risk prone areas or villages in a block for quick remedial measures; and (iii) to make use of satellite remote sensing and GIS to demonstrate the utility for rapid assessment of landuse/landcover and their relation with the incidence of kalaazar leading to the mapping of risk prone areas. Indian Remote Sensing (IRS)-1D LISS III satellite data for the periods of March and November 2000 were analysed in Silicon graphic image processing system using ERDAS software. False color composites (FCC) were generated and landuse/landcover was assessed using Maximum likelihood supervised classification techniques based on ground truth training sets. During the study the GIS functions are used to quantify the remotely sensed landscape proportions of 5 km2 buffer surrounding each known group of villages of high occurrence of sandflies in endemic and nonendemic study sites. Instead of traditional ground based survey methods to vector surveillance, the present study used a combination of remote sensing (RS) and geographical information system (GIS) approach to develop landscape predictors of sandfly abundance-an indicator of human vector contact and as a measure of risk prone areas. Statistical analysis using the remotely sensed landscape variables showed that rural villages surrounded by higher proportion of transitional swamps with soft stemmed edible plants and banana, sugarcane plantations had higher sandfly abundance and would, therefore, be at higher risk prone areas for man-vector contact. The present study clearly brought out the usefulness of satellite remote sensing technology in generating the crucial information on spatial distribution of landuse/landcover classes with special emphasis on indicator landcover classes thereby helping in prioritising the area to identify risk prone areas of kala-azar through GIS application tools.

Regional variability of farmer decision making and irrigation water use: insights from a data-scarce region of North India

NASA Astrophysics Data System (ADS)

O'Keeffe, Jimmy; Buytaert, Wouter; Brozović, Nick; Mijic, Ana

2014-05-01

Over the last fifty years, changes in agriculture brought about by the Green Revolution have transformed India from a famine-prone, drought-susceptible country into the worlds' third largest grain producer and one of the most intensively irrigated parts of the globe. Regionally, cheap energy, subsidised seeds and fertilisers, and in some areas Government purchase guarantees for grain promote the intensification of farming. While this allows farmers to survive, it also aggravates the drain agriculture is having on resources, particularly energy and water. Analysis at a regional scale, however, masks the considerable spatial variability that exists on a more localised level and must be taken into consideration to understand correctly aggregate system response to policy, hydrologic, and climatic change. In this study we present and analyse the results from over 100 farmer interviews conducted in the data-scarce districts of Jalaun and Sitapur on the Gangetic Plains of Uttar Pradesh during the post monsoon period of 2013. Variables such as the volumes and timing of irrigation water applied, sources of water, methods of abstraction and irrigation, and costs incurred are mapped, using qualitative data analysis and GIS. Large differences between the districts emerge, for instance in the region of Jalaun where cheaper canal water is available in addition to groundwater. This has enabled farmers to afford more water efficient technologies such as sprinklers, a practice not found in Sitapur which depends almost exclusively on more expensive diesel pumps. Results are used to delineate the spatial variability in water use practices, along with farmer behaviour and decision making. The primary data are compared with socio-economic information taken from regionally produced statistical abstracts. The combined data are used to identify the main drivers that influence farmer decision-making, which is in turn leading to groundwater overdraught in many parts of North India. Finally, the importance of understanding and modelling farmer behaviour for policy development, and the significance of this in the face of growing population, changes in socio-economic conditions, and climate change are discussed. Taking these variables into account is necessary in creating a transparent, socially acceptable and economically viable balance between sustainable water resources and farmer livelihoods.

An integrated nutrition and health program package on IYCN improves breastfeeding but not complementary feeding and nutritional status in rural northern India: A quasi-experimental randomized longitudinal study.

PubMed

Singh, Veena; Ahmed, Saifuddin; Dreyfuss, Michele L; Kiran, Usha; Chaudhery, Deepika N; Srivastava, Vinod K; Ahuja, Ramesh C; Baqui, Abdullah H; Darmstadt, Gary L; Santosham, Mathuram; West, Keith P

2017-01-01

Undernutrition below two years of age remains a major public health problem in India. We conducted an evaluation of an integrated nutrition and health program that aimed to improve nutritional status of young children by improving breast and complementary feeding practices over that offered by the Government of India's standard nutrition and health care program. In Uttar Pradesh state, through multi-stage cluster random sampling, 81 villages in an intervention district and 84 villages in a comparison district were selected. A cohort of 957 third trimester pregnant women identified during house-to-house surveys was enrolled and, following childbirth, mother-child dyads were followed every three months from birth to 18 months of age. The primary outcomes were improvements in weight-for-age and length-for-age z scores, with improved breastfeeding and complementary feeding practices as intermediate outcomes. Optimal breastfeeding practices were higher among women in intervention than comparison areas, including initiating breastfeeding within one hour of delivery (17.4% vs. 2.7%, p<0.001), feeding colostrum (34.7% vs. 8.4%, p<0.001), avoiding pre-lacteals (19.6% vs. 2.1%, p<0.001) and exclusively breastfeeding up to 6 months (24.1% vs. 15.3%, p = 0.001). However, differences were few and mixed between study arms with respect to complementary feeding practices. The mean weight-for-age z-score was higher at 9 months (-2.1 vs. -2.4, p = 0.0026) and the prevalence of underweight status was lower at 12 months (58.5% vs. 69.3%, p = 0.047) among intervention children. The prevalence of stunting was similar between study arms at all ages. Coefficients to show the differences between the intervention and comparison districts (0.13 cm/mo) suggested significant faster linear growth among intervention district infants at earlier ages (0-5 months). Mothers participating in the intervention district were more likely to follow optimal breast, although not complementary feeding practices. The program modestly improved linear growth in earlier age and weight gain in late infancy. Comprehensive nutrition and health interventions are complex; the implementation strategies need careful examination to improve feeding practices and thus impact growth. The trial was registered with ClinicalTrials.gov, NCT00198835.

Real-time Extremely Heavy Rainfall Forecast and Warning over Rajasthan During the Monsoon Season (2016)

NASA Astrophysics Data System (ADS)

Srivastava, Kuldeep; Pradhan, D.

2018-01-01

Two events of extremely heavy rainfall occurred over Rajasthan during 7-9 August 2016 and 19-21 August 2016. Due to these events, flooding occurred over east Rajasthan and affected the normal life of people. A low-pressure area lying over northwest Madhya Pradesh on 7 August 2016 moved north-westward and lay near east Rajasthan and adjoining northwest Madhya Pradesh on 8 and 9 August 2016. Under the influence of this low-pressure system, Chittorgarh district and adjoining areas of Rajasthan received extremely heavy rainfall of 23 cm till 0300 UTC of 8 August 2016 and 34 cm on 0300 UTC of 9 August 2016. A deep depression lying over extreme south Uttar Pradesh and adjoining northeast Madhya Pradesh on 19 August 2016 moved westward and gradually weakened into a depression on 20 August 2016. It further weakened into a low-pressure area and lay over east Rajasthan on 21 and 22 August 2016. Under the influence of this deep depression, Jhalawar received 31 cm and Baran received 25 cm on 19 August. On 20 August 2016, extremely heavy rainfall (EHR) occurred over Banswara (23.5 cm), Pratapgarh (23.2 cm) and Chittorgarh (22.7 cm) districts. In this paper, the performance of the National Centers for Environmental Prediction (NCEP) global forecast system (GFS) model for real-time forecast and warning of heavy to very heavy/EHR that occurred over Rajasthan during 7-9 August 2016 and 19-21 August 2016 has been examined. The NCEP GFS forecast rainfall (Day 1, Day 2 and Day 3) was compared with the corresponding observed gridded rainfall. Based on the predictions given by the NCEP GFS model for heavy rainfall and with their application in real-time rainfall forecast and warnings issued by the Regional Weather Forecasting Center in New Delhi, it is concluded that the model has predicted the wind pattern and EHR event associated with the low-pressure system very accurately on day 1 and day 2 forecasts and with small errors in intensity and space for day 3.

Molecular characterization of Orientia tsutsugamushi serotypes causing scrub typhus outbreak in southern region of Andhra Pradesh, India.

PubMed

Usha, K; Kumar, E; Kalawat, Usha; Kumar, B Siddhartha; Chaudhury, A; Gopal, D V R Sai

2016-10-01

Scrub typhus is a vector-borne zoonotic infection caused by Orientiatsutsugamushi. Local epidemiology of the circulating serotypes of scrub typhus is not available from most parts of India. We conducted this study for the diagnosis of scrub typhus using IgM ELISA and to detect O. tsutsugamushi serotypes circulating in southern Andhra Pradesh, India. Samples were collected from patients clinically suspected to have scrub typhus and were subjected to IgM ELISA to measure IgM antibodies against O. tsutsugamushi. Nested polymerase chain reaction (PCR) was performed targeting strain-specific regions in ELISA-positive samples. Of a total of 663 samples, 258 (38.91%) were found to be positive by IgM ELISA. Serotypes could be detected in 230 (34.69%) samples only. Only two serotypes, Karp and Kawasaki, were found in the serum samples, with the former being predominant. The dual infection of Karp and Kawasaki serotypes was found in seven patients. Other serotypes such as Gilliam, Kuroki and Kato were not detected in the samples. The nested PCR products proved useful in presumptively identifying the endemic O. tsutsugamushi serotypes. The present study could be significant in understanding scrub typhus epidemiology in this region.

Filaria monitoring visualization system: a geographical information system-based application to manage lymphatic filariasis in Andhra Pradesh, India.

PubMed

Upadhyayula, Suryanaryana Murty; Mutheneni, Srinivasa Rao; Kumaraswamy, Sriram; Kadiri, Madhusudhan Rao; Pabbisetty, Sampath Kumar; Yellepeddi, Venkata Suryanarayana Murthy

2012-05-01

Among various public health diseases, filariasis constitutes a major public health problem in India, wherein an estimated 553.7 million people are at risk of infection. The aim of this article is to present a spatial mapping and analysis of filariasis data over a 3-year period (2004-2007) from Karimnagar, Chittoor, East and West Godavari districts of Andhra Pradesh, India. The data include epidemiological and entomological studies (i.e., infection rate, infectivity rate, mosquito per man hour, and microfilaria rate). These parameters were customized on Geographical Information System (GIS) platform and developed filaria monitoring visualization system (FMVS) for identifying the endemic/risk areas of filariasis among these four districts. GIS map for filariasis transmission from the study areas was created and stratified into different spatial entities like low, medium, and high risk zones. On the basis of the data and FMVS maps, it was demonstrated that filariasis remained unevenly distributed within the districts. Balancing the intervention coverage in different villages with overall mass drug administration and continued promotion of the proper use of control measures are necessary for further reduction of filarial cases in these districts.

Police-related experiences and HIV risk among female sex workers in Andhra Pradesh, India.

PubMed

Erausquin, Jennifer Toller; Reed, Elizabeth; Blankenship, Kim M

2011-12-01

Research suggests experiences with police are related to human immunodeficiency virus (HIV) sexual risk among women working as sex workers. However, little is known about the links between specific police-related behaviors and HIV vulnerability. We examine whether 5 police-related experiences are associated with measures of HIV risk and violence among a sample of female sex workers (FSWs) in Andhra Pradesh, India, and consider the implications for HIV prevention. FSWs at least 18 years of age (n = 835) were recruited through respondent-driven sampling for a cross-sectional survey conducted as part of Avahan, the India AIDS Initiative. Using logistic regression models adjusted for age, age at start of sex work, and sex work venue, we assessed police-related experiences reported by FSWs in relation to HIV risk behaviors and violence. Results showed having sex with police to avoid trouble, giving gifts to police to avoid trouble, having police take condoms away, experiencing a workplace raid, and being arrested were associated with sexually transmitted infection symptoms, inconsistent condom use, acceptance of more money for sex without a condom, and experience of client violence. These findings suggest a need for interventions targeting police-FSW interactions to reduce HIV vulnerability among FSWs.

Tuberculosis Management Practices by Private Practitioners in Andhra Pradesh, India

PubMed Central

Achanta, Shanta; Jaju, Jyoti; Kumar, Ajay M. V.; Nagaraja, Sharath Burugina; Shamrao, Srinivas Rao Motta; Bandi, Sasidhar Kumar; Kumar, Ashok; Satyanarayana, Srinath; Harries, Anthony David; Nair, Sreenivas Achutan; Dewan, Puneet K.

2013-01-01

Setting Private medical practitioners in Visakhapatnam district, Andhra Pradesh, India. Objectives To evaluate self-reported TB diagnostic and treatment practices amongst private medical practitioners against benchmark practices articulated in the International Standards of Tuberculosis Care (ISTC), and factors associated with compliance with ISTC. Design Cross- sectional survey using semi-structured interviews. Results Of 296 randomly selected private practitioners, 201 (68%) were assessed for compliance to ISTC diagnostic and treatment standards in TB management. Only 11 (6%) followed a combination of 6 diagnostic standards together and only 1 followed a combination of all seven treatment standards together. There were 28 (14%) private practitioners who complied with a combination of three core ISTC (cough for tuberculosis suspects, sputum smear examination and use of standardized treatment). Higher ISTC compliance was associated with caring for more than 20 TB patients annually, prior sensitization to TB control guidelines, and practice of alternate systems of medicine. Conclusion Few private practitioners in Visakhapatnam, India reported TB diagnostic and treatment practices that met ISTC. Better engagement of the private sector is urgently required to improve TB management practices and to prevent diagnostic delay and drug resistance. PMID:23967158

An exploration of the socio-economic profile of women and costs of receiving abortion services at public health facilities of Madhya Pradesh, India.

PubMed

Banerjee, Sushanta K; Kumar, Rakesh; Warvadekar, Janardan; Manning, Vinoj; Andersen, Kathryn Louise

2017-03-21

Maternal mortality, which primarily burdens developing countries, reflects the greatest health divide between rich and poor. This is especially pronounced for access to safe abortion services which alone avert 1 of every 10 maternal deaths in India. Primarily due to confidentiality concerns, poor women in India prefer private services which are often offered by untrained providers and may be expensive. In 2006 the state government of Madhya Pradesh (population 73 million) began a concerted effort to ensure access to safe abortion services at public health facilities to both rural and urban poor women. This study aims to understand the socio-economic profile of women seeking abortion services in public health facilities across this state and out of pocket cost accessing abortion services. In particular, we examine the level of access that poor women have to safe abortion services in Madhya Pradesh. This study consisted of a cross-sectional client follow-up design. A total of 19 facilities were selected using two-stage random sampling and 1036 women presenting to chosen facilities with abortion and post-abortion complications were interviewed between May and December 2014. A structured data collection tool was developed. A composite wealth index computed using principal component analysis derived weights from consumer durables and asset holding and classified women into three categories, poor, moderate, and rich. Findings highlight that overall 57% of women who received abortion care at public health facilities were poor, followed by 21% moderate and 22% rich. More poor women sought care at primary level facilities (58%) than secondary level facilities and among women presenting for postabortion complications (67%) than induced abortion. Women reported spending no money to access abortion services as abortion services are free of cost at public facilities. However, poor women spend INR 64 (1 USD) while visiting primary level facilities and INR 256 (USD 4) while visiting urban hospitals, primarily for transportation and food. Improved availability of safe abortion services at the primary level in Madhya Pradesh has helped meeting the need of safe abortion services among poor, which eventually will help reducing the maternal mortality and morbidity due to unsafe abortion.

The emergence of maternal health as a political priority in Madhya Pradesh, India: a qualitative study.

PubMed

Jat, Tej Ram; Deo, Prakash Ramchandra; Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel

2013-09-30

Politics plays a critical role in agenda setting in health affairs; therefore, understanding the priorities of the political agenda in health is very important. The political priority for safe motherhood has been investigated at the national level in different countries. The objective of this study was to explore why and how maternal health became a political priority at sub-national level in the state of Madhya Pradesh in India. This study followed a qualitative design. Data were collected by carrying out interviews and review of documents. Semi-structured interviews were carried out with twenty respondents from four stakeholder groups: government officials, development partners, civil society and academics. Data analysis was performed using thematic analysis. The analysis was guided by Kingdon's multiple streams model. The emergence of maternal health as a political priority in Madhya Pradesh was the result of convergence in the developments in different streams: the development of problem definition, policy generation and political change. The factors which influenced this process were: emerging evidence of the high magnitude of maternal mortality, civil society's positioning of maternal mortality as a human rights violation, increasing media coverage, supportive policy environment and launch of the National Rural Health Mission (NRHM), the availability of effective policy solutions, India's aspiration of global leadership, international influence, maternal mortality becoming a hot debate topic and political transition at the national and state levels. Most of these factors first became important at national level which then cascaded to the state level. Currently, there is a supportive policy environment in the state for maternal health backed by greater political will and increased resources. However, malnutrition and population stabilization are the competing priorities which may push maternal health off the agenda. The influence of the events and factors evolving from international and national levels significantly contributed to the development of maternal health as a priority in Madhya Pradesh. This led to several opportunities in terms of policies, guidelines and programmes for improving maternal health. These efforts were successful to some extent in improving maternal health in the state but several implementation challenges still require special attention.

Assessment of groundwater quality of Ballia district, Uttar Pradesh, India, with reference to arsenic contamination using multivariate statistical analysis

NASA Astrophysics Data System (ADS)

Singh, Asha Lata; Singh, Vipin Kumar

2018-06-01

A total of 22 water quality parameters were selected for the analysis of groundwater samples with reference to arsenic contamination. Samples were collected in the pre-monsoon and monsoon seasons of the year 2013. The maximum arsenic concentration in both the pre-monsoon and monsoon seasons was approximately the same, i.e., the maximum arsenic concentration being 75.60 and 74.46 µg/L in pre-monsoon and monsoon, respectively. Out of 72 collected samples, three were below the WHO guideline value of 10 µg/L for arsenic concentration. In 95.83% of the groundwater samples, the arsenic concentration was above the permissible limit. Nickel, manganese, and chromium concentrations were above the permissible limits in nearly all samples except for chromium concentration in a few pre-monsoon samples. However, the total iron concentrations in 23 samples (31.94%) were above the permissible limit. A total of six and seven principal components (PCs) were extracted using principal component analysis during the pre-monsoon and monsoon seasons, respectively, accounting for 76.25 and 78.52% of the total variation during two consecutive seasons. Correlation statistics revealed that the arsenic concentration was positively correlated with phosphate, iron, ammonium, bicarbonate, and manganese concentrations but negatively correlated with oxidation reduction potential (ORP), sulfate concentration, electrical conductivity, and total dissolved solids concentration. The negative correlation of arsenic with ORP suggested reducing conditions prevailing in the groundwater. The trilinear Piper diagram revealed calcium and magnesium enrichment of groundwater with an abundance of chloride ions but no predominance of bicarbonate ions. Thus, the groundwater fell into Ca2+ - Mg2+ - Cl- - SO4 2- category.

Norplant campaign in India.

PubMed

1992-01-01

The Indian government's plan to introduce the new long-acting contraceptive Norplant in the National Family Planning Program under pressure from the US government is opposed because Norplant has not been adequately tested. The government has reduced the funding for the national program for eradication of malaria and tuberculosis, but it is proposing to finance a Norplant based population project for the State of Uttar Pradesh. The powers that can turn a deaf ear to the possible hazards of Norplant. Implanted in the arm of a woman, the chemical is released into the bloodstream providing contraception for 5 years. Severe adverse reactions include depression, heart disease thromboembolism, high blood pressure, and ovarian cysts. Many such long-acting contraceptives are being developed including injectables, vaccines, nasal sprays, and vaginal rings with potential permanent impairment to fertility. One of the major objectives of the Family Planning Program is the improvement of the health status of women, but the introduction of Norplant would harm healthy young women. Therefore, the group Saheli and others in the campaign demand: 1) that plans for introduction of Norplant in the Family Planning Program be halted immediately; 2) that the introduction of any other long acting invasive contraceptive such as Net-En, vaginal ring, nasal spray, and anti-fertility vaccine be banned, both on the grounds of inadequacy of the health services and loss of user controls; 3) that information on the safety aspects of Norplant and the basis on which the Drugs Controller has granted his approval be made public; 4) that each and every one of the hundreds of women who still have the implant should be located, and the implant removed; and 5) that all hormonal contraceptive preparations be banned in the social marketing program as their use involves extensive monitoring.

The use of semi-structured interviews for collection of qualitative and quantitative data in hydrological studies

NASA Astrophysics Data System (ADS)

O'Keeffe, Jimmy; Buytaert, Wouter; Mijic, Ana; Brozovic, Nicholas

2015-04-01

To build an accurate, robust understanding of the environment, it is important to not only collect information describing its physical characteristics, but also the drivers which influence it. As environmental change, from increasing CO2 levels to decreasing water levels, is often heavily influenced by human activity, gathering information on anthropogenic as well as environmental variables is extremely important. This can mean collecting qualitative, as well as quantitative information. In reality studies are often bound by financial and time constraints, limiting the depth and detail of the research. It is up to the researcher to determine what the best methodology to answer the research questions is likely to be. Here we present a methodology of collecting qualitative and quantitative information in tandem for hydrological studies through the use of semi-structured interviews. This is applied to a case study in two districts of Uttar Pradesh, North India, one of the most intensely irrigated areas of the world. Here, decreasing water levels exacerbated by unchecked water abstraction, an expanding population and government subsidies, have put the long term resilience of the farming population in doubt. Through random selection of study locations, combined with convenience sampling of the participants therein, we show how the data collected can provide valuable insight into the drivers which have led to the current water scenario. We also show how reliable quantitative information can, using the same methodology, be effectively and efficiently extracted for modelling purposes, which along with developing an understanding of the characteristics of the environment is vital in coming up with realistic and sustainable solutions for water resource management in the future.

Groundwater arsenic contamination from parts of the Ghaghara Basin, India: influence of fluvial geomorphology and Quaternary morphostratigraphy

NASA Astrophysics Data System (ADS)

Shah, Babar Ali

2017-09-01

A groundwater arsenic (As) distribution in Faizabad, Gonda, and Basti districts of Uttar Pradesh is shown in the entrenched channels and floodplains of the Ghaghara River. Tubewell water samples were analysed for As through flow injection hydride generation atomic absorption spectrometry (FI-HG-AAS) system. About 38, 61, and 42 % of tubewells in Faizabad, Gonda, and Basti districts, respectively, have As >10 µg/l (WHO guideline). Moreover, 15, 45, and 26 % of tubewells in Faizabad, Gonda, and Basti districts, respectively, have As above 50 µg/l. About 86, 69, and 35 % of tubewells in Faizabad, Gonda, and Basti districts, respectively, are from shallow depth (21-45 m), and it is worth noticing that 47 % As-contaminated (As >10 µg/l) tubewells in these three districts are located within the depth of 10-35 m in Holocene Newer Alluvium aquifers. The high content of As (7.11 mg/kg) is measured in suspended river sediments of the Ghaghara River. Most of the As-contaminated villages in the Ghaghara Basin are located close to abandoned or present meander channels and floodplains of the Ghaghara River. In contrast, tubewells in Faizabad, Ayodhya, and Nawabganj towns are As-safe because of their positions on the Pleistocene Older Alluvium upland surfaces. Quaternary geomorphology plays an important role in groundwater arsenic contamination in the Ghaghara Basin. The sources of groundwater arsenic are geogenic and perennial mountainous rivers in the Ghaghara Basin supplied high sediment loads. The arsenic in groundwater of Ghaghara Basin is getting released from associated sediments which were likely deposited from the Himalayas. The process of release of groundwater arsenic is reductive dissolution of iron hydroxides.

Epidemiology & preventive aspects of railway suicides and fatalities related to trespassing accidents.

PubMed

Kumar, Sachil; Verma, Anoop K; Bhattacharya, Sandeep; Singh, Uma Shankar

2013-11-01

Suicide and trespass are major contributors to risk on the railway, resulting in around 170-180 fatalities per year in Lucknow region, as well as associated major disruption to the rail network. Lucknow is the capital city of the state of Uttar Pradesh in India. The analysis included train-pedestrian fatalities during 2007-2012. The data for 2007-2012 were collected from the autopsy reports of the university, case sheets from the hospital, the general prosecutor's investigations report and the inquest reports from police. The results show that the majority of victims were males. Half of the suicide victims were 20-39 years old. Accidents happened most frequently in situations when a person was walking on the tracks/in front of train (22.7%) or were crossing the tracks illegally (20.9%). Among all train-pedestrian fatalities, about half of the victims (42.8%) were intoxicated by alcohol. Female suicide victims suffered from mental health problems more frequently (55.8%) than male suicide victims. Overall, there is no reason to believe that train-pedestrian fatalities are unavoidable. By contrast, the effective prevention of railway suicides and accidents should be based on a systems approach involving effective measures introduces by several organisations such as government, railway organisations, various authorities (such as public health, education, enforcement, urban planning) and communities. Same measures can often be used to prevent both trespassing and suicides, even though their effectiveness may depend on the target group. In addition, there are measures specifically targeted to prevent either trespassing or suicides. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Levels of select organophosphates in human colostrum and mature milk samples in rural region of Faizabad district, Uttar Pradesh, India.

PubMed

Srivastava, S; Narvi, S S; Prasad, S C

2011-10-01

Human colostrum and mature milk samples from rural mothers were separately screened for organophosphate pesticides (OPPs). The samples were assessed for the pollution load they are transmitting to the nursing infant to determine potential toxicity. The role of colostrum for toxicity monitoring was assessed in comparison to mature milk as it is the very first infant food. The pesticides were quantified using a Gas Chromatograph equipped with Electron Capture Detector (GC-ECD) and the results were further validated on GC linked with Mass Spectrophotometer (GC-MS) and Fourier transform infrared (FTIR). A total of 33 samples were analyzed out of 40 samples collected. These samples were from 33 mothers. Out of these, 25 were colostrum samples and 8 were mature milk samples. Frequency percentage (N%) of organophosphates analyzed was highest for ethion (23.1% or 6/26) in colostrum and chlorpyrifos (50% or 4/8) in mature milk samples. Frequency percentage in colostrum was 19.2% (5/26) for chlorpyrifos and 3.8% (1/26) for dimethoate; 25.0% (2/8) mature milk samples carried dimethoate and 12.5% (1/8) carried ethion. Mean OPPs in colostrum: dimethoate (85.888 ng/g fat) > ethion (48.000 ng/g fat) > chlorpyrifos (4.003 ng/g fat); and mature milk: ethion (744.925 ng/g fat) > chlorpyrifos (37.274 ng/g fat) > dimethoate (26.752 ng/g fat). MS data revealed the presence of methyl parathion, which was not quantitated. None of the samples exceeded acceptable daily intake standards set by Joint Meeting on Pesticide Residues (JMPR). The study will pave way for further analysis on pesticide toxicology.

Gender, family, and the nutritional status of children in three culturally contrasting states of India.

PubMed

Griffiths, Paula; Matthews, Zoë; Hinde, Andrew

2002-09-01

This paper has three main aims: to measure the clustering of children with low weight for age z-scores within families, to establish whether significant differences exist by gender in weight for age z-scores, and to demonstrate whether the presence of a mother-in-law in the household has any significant impact on the nutritional status of young children. Regression modelling is used to examine the weight for age z-scores of children under the age of four years in Maharashtra, Tamil Nadu and Uttar Pradesh using the 1992-93 Indian National Family Health Survey data. Random effects models measure the clustering of children with low weight for age z-scores in families, controlling for a number of other family factors. Our findings do not reveal significant gender differences in weight for age z-scores. Although little variation was found between family structures in the nutritional status of children, there were significant differences between families after controlling for family type. This suggests that there are differences between families that cannot be explained by a cross-sectional demographic survey. The evidence from this work suggests that nutrition programs need to adopt community nutrition interventions that aim resources at young children from families where children with low weight for age z-scores are found to cluster. However, there is a need for further inter-disciplinary research to collect data from families on behavioural factors and resource allocation in order that we might better understand why some families are more prone to having children with low weight for age z-scores. The diversity in the significant covariates between the three states in the models has shown the need for Indian nutrition programs to adopt state-specific approaches to tackling malnutrition.

Hydrogeochemical analysis and evaluation of surface water quality of Pratapgarh district, Uttar Pradesh, India

NASA Astrophysics Data System (ADS)

Tiwari, Ashwani Kumar; Singh, Abhay Kumar; Singh, Amit Kumar; Singh, M. P.

2017-07-01

The hydrogeochemical study of surface water in Pratapgarh district has been carried out to assess the major ion chemistry and water quality for drinking and domestic purposes. For this purpose, twenty-five surface water samples were collected from river, ponds and canals and analysed for pH, electrical conductivity, total dissolved solids (TDS), turbidity, hardness, major cations (Ca2+, Mg2+, Na+ and K+), major anions (HCO3 -, F-, Cl-, NO3 -, SO4 2-) and dissolved silica concentration. The analytical results show mildly acidic to alkaline nature of surface water resources of Pratapgarh district. HCO3 - and Cl- are the dominant anions, while cation chemistry is dominated by Na+ and Ca2+. The statistical analysis and data plotted on the Piper diagram reveals that the surface water chemistry is mainly controlled by rock weathering with secondary contributions from agriculture and anthropogenic sources. Ca2+-Mg2+-HCO3 -, Ca2+-Mg2+-Cl- and Na+-HCO3 --Cl- are the dominant hydrogeochemical facies in the surface water of the area. For quality assessment, values of analysed parameters were compared with Indian and WHO water quality standards, which shows that the concentrations of TDS, F-, NO3 -, Na+, Mg2+ and total hardness are exceeding the desirable limits in some water samples. Water Quality Index (WQI) is one of the most effective tools to communicate information on the quality of any water body. The computed WQI values of Pratapgarh district surface water range from 28 to 198 with an average value of 82, and more than half of the study area is under excellent to good category.

Behavior change for newborn survival in resource-poor community settings: bridging the gap between evidence and impact.

PubMed

Kumar, Vishwajeet; Kumar, Aarti; Darmstadt, Gary L

2010-12-01

Despite an established evidence base of simple, affordable, and low-cost interventions to avert neonatal deaths, global progress in reducing neonatal mortality has stagnated in recent years. Under-recognition of the critical role played by behavior change in ensuring adoption and dissemination of innovations is a major reason for this gap between evidence and impact. A general lack of understanding of the mechanisms underlying behavior change at a population level coupled with an under-appreciation of the sociocultural context of newborn care behaviors has underscored ill-informed approaches towards behavior change that have met with limited success. This article draws upon available evidence from prevention-oriented, community-based newborn survival trials to derive insights into the role of behavior change in neonatal mortality reduction. We propose a simple model, the intervention-causation pathway, to explain the pathway through which behavior change interventions may lead to reductions in mortality. Further, we explore the unique nature of newborn care behaviors and their underlying sociocultural context, along with state-of-the-art advances in social, behavioral, and management sciences. These principles form the basis of the behavior change management framework that has successfully guided intervention design and implementation, leading to high impact on neonatal mortality reduction, in Uttar Pradesh, India. We describe how the behavior change management framework can be applied to inform the design of theoretically and empirically sound behavior change interventions with greater precision, predictability and pace towards reduction in neonatal mortality. We finally touch upon key overarching principles that should guide intervention execution for maximal impact. Copyright © 2010 Elsevier Inc. All rights reserved.

'Scaling-up is a craft not a science': Catalysing scale-up of health innovations in Ethiopia, India and Nigeria.

PubMed

Spicer, Neil; Bhattacharya, Dipankar; Dimka, Ritgak; Fanta, Feleke; Mangham-Jefferies, Lindsay; Schellenberg, Joanna; Tamire-Woldemariam, Addis; Walt, Gill; Wickremasinghe, Deepthi

2014-11-01

Donors and other development partners commonly introduce innovative practices and technologies to improve health in low and middle income countries. Yet many innovations that are effective in improving health and survival are slow to be translated into policy and implemented at scale. Understanding the factors influencing scale-up is important. We conducted a qualitative study involving 150 semi-structured interviews with government, development partners, civil society organisations and externally funded implementers, professional associations and academic institutions in 2012/13 to explore scale-up of innovative interventions targeting mothers and newborns in Ethiopia, the Indian state of Uttar Pradesh and the six states of northeast Nigeria, which are settings with high burdens of maternal and neonatal mortality. Interviews were analysed using a common analytic framework developed for cross-country comparison and themes were coded using Nvivo. We found that programme implementers across the three settings require multiple steps to catalyse scale-up. Advocating for government to adopt and finance health innovations requires: designing scalable innovations; embedding scale-up in programme design and allocating time and resources; building implementer capacity to catalyse scale-up; adopting effective approaches to advocacy; presenting strong evidence to support government decision making; involving government in programme design; invoking policy champions and networks; strengthening harmonisation among external programmes; aligning innovations with health systems and priorities. Other steps include: supporting government to develop policies and programmes and strengthening health systems and staff; promoting community uptake by involving media, community leaders, mobilisation teams and role models. We conclude that scale-up has no magic bullet solution - implementers must embrace multiple activities, and require substantial support from donors and governments in doing so. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effects of water level changes and wading bird abundance on the foraging behaviour of blacknecked storks Ephippiorhynchus asiaticus in Dudwa National Park, India.

PubMed

Maheswaran, G; Rahmani, A R

2001-09-01

The effect of water level changes and wading birds' abundance on the foraging behaviour of the blacknecked stork (BNS) Ephippiorhynchus asiaticus was studied from January 1995 to June 1997 in Dudwa National Park, Uttar Pradesh. Our observations indicate that BNS territoriality increased as food levels became depleted, resulting in increased rates of aggression towards intruders. Chasing or aggression was more intense during the early period (February and March) than the late period (April, May and June). Most of (> 50%) the aggressive encounters were observed between 0600 and 1000 h of the day. Seventeen species (including BNS) were observed interacting with BNS, throughout the study period. Most interactions were with the spoonbill, Platalea leucorodia (67.4%), followed by the whitenecked stork, Ciconia episcopus (16.6%). The distance (while foraging) between BNS and other wading birds varied significantly (P < 0.001) between years indicating that BNS and other water birds foraged at different water depths and thereby explored the wetlands fully. Spoonbills were chased often; the number varied from 1 to 43 birds. BNS occasionally accepted the presence of other wading birds, including spoonbills and started foraging amidst them. This led to successful foraging of BNS (solitary feeder). Other fish-eating bird species and their numbers also limited the food consumption of foraging BNS as they had to spend time chasing away the intruders. Availability of the preferred prey fish species, Heteropnestus fossilis, forced BNS to stay throughout the year in their respective territories. High (> 60 cm) water levels were not suitable for BNS even though the patch had high prey abundance.

WHO Multidrug Therapy for Leprosy: Epidemiology of Default in Treatment in Agra District, Uttar Pradesh, India

PubMed Central

Kumar, Anil; Girdhar, Anita; Chakma, Joy Kumar; Girdhar, Bhuwneswar Kumar

2015-01-01

Aim. To study the magnitude of default, time of default, its causes, and final clinical outcome. Methods. Data collected in active surveys in Agra is analyzed. Patients were given treatment after medical confirmation and were followed up. The treatment default and other clinical outcomes were recorded. Results. Patients who defaulted have comparable demographic characteristics. However, among defaulters more women (62.7% in PB, 42.6% in MB) were seen than those in treatment completers (PB 52.7% and MB 35.9%). Nerve involvement was high in treatment completers: 45.7% in PB and 91.3% in MB leprosy. Overall default rate was lower (14.8%) in ROM than (28.8%) in standard MDT for PB leprosy (χ 1 2 = 11.6, P = 0.001) and also for MB leprosy: 9.1% in ROM compared to 34.5% in MDT (χ 1 2 = 6.0, P = 0.015). Default rate was not different (28.8% versus 34.5%, P > 0.05) in both types of leprosy given MDT. Most patients defaulted at early stage of treatment and mainly due to manageable side effects. Conclusion. The default in standard MDT both for PB and MB leprosy was observed to be significantly higher than in ROM treatment. Most defaults occurred at early stage of treatment and major contribution of default is due to side effects like drowsiness, weakness, vomiting, diarrhea, and so forth, related to poor general health. Although about half of the defaulters were observed to be cured 2.2% in PB-MDT and 10.9% of MB-MDT developed disability. This is an issue due to default. Attempts are needed to increase treatment compliance. The use of specially designed disease related health education along with easily administered drug regimens may help to reduce default. PMID:25705679

Impact assessment of treated/untreated wastewater toxicants discharged by sewage treatment plants on health, agricultural, and environmental quality in the wastewater disposal area.

PubMed

Singh, Kunwar P; Mohan, Dinesh; Sinha, Sarita; Dalwani, R

2004-04-01

Studies were undertaken to assess the impact of wastewater/sludge disposal (metals and pesticides) from sewage treatment plants (STPs) in Jajmau, Kanpur (5 MLD) and Dinapur, Varanasi (80 MLD), on health, agriculture and environmental quality in the receiving/application areas around Kanpur and Varanasi in Uttar Pradesh, India. The raw, treated and mixed treated urban wastewater samples were collected from the inlet and outlet points of the plants during peak (morning and evening) and non-peak (noon) hours. The impact of the treated wastewater toxicants (metals and pesticides) on the environmental quality of the disposal area was assessed in terms of their levels in different media samples viz., water, soil, crops, vegetation, and food grains. The data generated show elevated levels of metals and pesticides in all the environmental media, suggesting a definite adverse impact on the environmental quality of the disposal area. The critical levels of the heavy metals in the soil for agricultural crops are found to be much higher than those observed in the study areas receiving no effluents. The sludge from the STPs has both positive and negative impacts on agriculture as it is loaded with high levels of toxic heavy metals and pesticides, but also enriched with several useful ingredients such as N, P, and K providing fertilizer values. The sludge studied had cadmium, chromium and nickel levels above tolerable levels as prescribed for agricultural and lands application. Bio-monitoring of the metals and pesticides levels in the human blood and urine of the different population groups under study areas was undertaken. All the different approaches indicated a considerable risk and impact of heavy metals and pesticides on human health in the exposed areas receiving the wastewater from the STPs.

Fighting malaria in Madhya Pradesh (Central India): Are we loosing the battle?

PubMed Central

Singh, Neeru; Dash, Aditya P; Thimasarn, Krongthong

2009-01-01

Malaria control in Madhya Pradesh is complex because of vast tracts of forest with tribal settlement. Fifty four million individuals of various ethnic origins, accounting for 8% of the total population of India, contributed 30% of total malaria cases, 60% of total falciparum cases and 50% of malaria deaths in the country. Ambitious goals to control tribal malaria by launching "Enhanced Malaria Control Project" (EMCP) by the National Vector Borne Disease Control Programme (NVBDCP), with the World Bank assistance, became effective in September 1997 in eight north Indian states. Under EMCP, the programme used a broader mix of new interventions, i.e. insecticide-treated bed nets, spraying houses with effective residual insecticides, use of larvivorous fishes, rapid diagnostic tests for prompt diagnosis, treatment of the sick with effective radical treatment and increased public awareness and IEC. However, the challenge is to scale up these services. A retrospective analysis of data on malaria morbidity and associated mortality reported under the existing surveillance system of the Madhya Pradesh (Central India) for the years 1996–2007 was carried out to determine the impact of EMCP on malaria morbidity and associated mortality. Analysis revealed that despite the availability of effective intervention tools for the prevention and control of malaria, falciparum malaria remains uncontrolled and deaths due to malaria have increased. Precisely, the aim of this epidemiological analysis is to draw lessons applicable to all international aid efforts, bureaucracy, policy makers and programme managers in assessing its project performance as a new Global Malaria Action Plan is launched with ambitious goal of reducing malaria and its elimination by scaling up the use of existing tools. PMID:19419588

Disjunctive Grade Variation from Greenschist to Granulite Facies, Siyom Valley, Eastern Arunachal Pradesh, India

NASA Astrophysics Data System (ADS)

Clarke, G. L.; Bhowmik, S. K.; Aitchison, J. C.; Ireland, T. R.

2014-12-01

The Siyom Valley section in eastern Arunachal Pradesh exposes an inverted metamorphic succession (Nandini & Thakur, 2011), metapelitic assemblages increasing in grade northwards from chlorite, through biotite, garnet-staurolite and kyanite-bearing schist to kyanite-sillimanite migmatite. Grade changes are mostly controlled by shallowly north, and northwest-dipping fault structures. Two textural stages of garnet growth can be identified in the ilmenite-bearing amphibolite facies rocks, staurolite having formed late in, or after, deformation responsible for the main penetrative foliation (S2). Kyanite and rutile inclusions in garnet indicate that their growth in migmatite preceded that of matrix sillimanite, ilmenite and cordierite, though unrecrystallized kyanite is also common in the feldspathic matrix. Preliminary data indicate the pronounced tectonic thinning of metasedimentary protoliths during exhumation, and the probability of a pronounced step in grade in the middle part of the river section. Similarities with sections in the Sikkim (Dasgupta et al., 2004) and western Arunachal Pradesh (Goswami et al., 2009) Himalaya reflect the lateral continuity of the south-vergent thrusts that controlled the exhumation of the high-grade rocks, with debate concerning the location and significance of the Main Central Thrust zone begging protolith and metamorphic age data. Dasgupta, S.,Ganguly, J. & Neogi, S., 2004. Inverted metamorphic sequence in the Sikkim Himalayas: crystallization history, P-T gradient and implications. Journal of Metamorphic Geology, 22, 395-412. Goswami, S., Bhowmik, S.K. & Dasgupta, S., 2009. Petrology of a non-classical Barrovian inverted metamorphic sequence from the western Arunachal Himalaya, India. Journal of Asian Earth Sciences, 36, 390-406. Nandini, P. & Thakur, S.S., 2011. Metamorphic evolution of the Lesser Himalayan Crystalline Sequence, Siyom Valley, NE Himalaya, India. Journal of Asian Earth Sciences, 40, 1089-1100

Draft Genome Sequence of Thermus sp. Strain RL, Isolated from a Hot Water Spring Located atop the Himalayan Ranges at Manikaran, India

PubMed Central

Dwivedi, Vatsala; Sangwan, Naseer; Nigam, Aeshna; Garg, Nidhi; Niharika, Neha; Khurana, Paramjit; Khurana, Jitendra P.

2012-01-01

Thermus sp. strain RL was isolated from a hot water spring (90°C to 98°C) at Manikaran, Himachal Pradesh, India. Here we report the draft genome sequence (20,36,600 bp) of this strain. The draft genome sequence consists of 17 contigs and 1,986 protein-coding sequences and has an average G+C content of 68.77%. PMID:22689228

Aircraft Observations of Soil Hydrological Influence on the Atmosphere in Northern India

NASA Astrophysics Data System (ADS)

Taylor, Christopher M.; Barton, Emma J.; Belusic, Danijel; Böing, Steven J.; Hunt, Kieran M. R.; Mitra, Ashis K.; Parker, Douglas J.; Turner, Andrew G.

2017-04-01

India is considered to be a region of the world where the influence of land surface fluxes of sensible and latent heat play an important role in regional weather and climate. Indian rainfall simulations in GCMs are known to be particularly sensitive to soil moisture. However, in a monsoon region where seasonal convective rainfall dominates, it is a big challenge for GCMs to capture, on the one hand, a realistic depiction of surface fluxes during wetting up and drying down at seasonal and sub-seasonal scales, and on the other, the sensitivity of convective rainfall and regional circulations to space-time fluctuations in land surface fluxes. On top of this, most GCMs and operational atmospheric forecast models don't explicitly consider irrigation. In the Indo-Gangetic plains of the Indian sub-continent, irrigated agriculture has become the dominant land use. Irrigation suppresses temporal flux variability for much of the year, and at the same time enhances spatial heterogeneity. One of the key objectives of the Anglo-Indian Interaction of Convective Organization and Monsoon Precipitation, Atmosphere, Surface and Sea (INCOMPASS) collaborative project is to better understand the coupling between the land surface and the Indian summer monsoon, and build this understanding into improved prediction of rainfall on multiple time and space scales. During June and July 2016, a series of research flights was performed across the sub-continent using the NERC/Met Office BAe146 aircraft. Here we will present results for a case study from a flight on 30th June which sampled the Planetary Boundary Layer (PBL) on a 700 km low level transect, from the semi-arid region of Rajasthan eastwards into the extensively irrigated state of Uttar Pradesh. As well as crossing different land uses, the flight also sampled mesoscale regions with contrasting recent rainfall conditions. Here we will show how variations in surface hydrology, driven by both irrigation and rainfall, influence the temperature, humidity and winds in the PBL. These unique observations will provide a powerful tool for understanding the dominant land-atmosphere coupling mechanisms operating on a range of multiple length scales, and which help to shape the Indian monsoon.

Demand generation activities and modern contraceptive use in urban areas of four countries: a longitudinal evaluation.

PubMed

Speizer, Ilene S; Corroon, Meghan; Calhoun, Lisa; Lance, Peter; Montana, Livia; Nanda, Priya; Guilkey, David

2014-11-06

Family planning is crucial for preventing unintended pregnancies and for improving maternal and child health and well-being. In urban areas where there are large inequities in family planning use, particularly among the urban poor, programs are needed to increase access to and use of contraception among those most in need. This paper presents the midterm evaluation findings of the Urban Reproductive Health Initiative (Urban RH Initiative) programs, funded by the Bill & Melinda Gates Foundation, that are being implemented in 4 countries: India (Uttar Pradesh), Kenya, Nigeria, and Senegal. Between 2010 and 2013, the Measurement, Learning & Evaluation (MLE) project collected baseline and 2-year longitudinal follow-up data from women in target study cities to examine the role of demand generation activities undertaken as part of the Urban RH Initiative programs. Evaluation results demonstrate that, in each country where it was measured, outreach by community health or family planning workers as well as local radio programs were significantly associated with increased use of modern contraceptive methods. In addition, in India and Nigeria, television programs had a significant effect on modern contraceptive use, and in Kenya and Nigeria, the program slogans and materials that were blanketed across the cities (eg, leaflets/brochures distributed at health clinics and the program logo placed on all forms of materials, from market umbrellas to health facility signs and television programs) were also significantly associated with modern method use. Our results show that targeted, multilevel demand generation activities can make an important contribution to increasing modern contraceptive use in urban areas and could impact Millennium Development Goals for improved maternal and child health and access to reproductive health for all. © Speizer et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/. When linking to this article, please use the following permanent link: http://dx.doi.org/10.9745/GHSP-D-14-00109.

Stated Choice design comparison in a developing country: recall and attribute nonattendance

PubMed Central

2014-01-01

Background Experimental designs constitute a vital component of all Stated Choice (aka discrete choice experiment) studies. However, there exists limited empirical evaluation of the statistical benefits of Stated Choice (SC) experimental designs that employ non-zero prior estimates in constructing non-orthogonal constrained designs. This paper statistically compares the performance of contrasting SC experimental designs. In so doing, the effect of respondent literacy on patterns of Attribute non-Attendance (ANA) across fractional factorial orthogonal and efficient designs is also evaluated. The study uses a ‘real’ SC design to model consumer choice of primary health care providers in rural north India. A total of 623 respondents were sampled across four villages in Uttar Pradesh, India. Methods Comparison of orthogonal and efficient SC experimental designs is based on several measures. Appropriate comparison of each design’s respective efficiency measure is made using D-error results. Standardised Akaike Information Criteria are compared between designs and across recall periods. Comparisons control for stated and inferred ANA. Coefficient and standard error estimates are also compared. Results The added complexity of the efficient SC design, theorised elsewhere, is reflected in higher estimated amounts of ANA among illiterate respondents. However, controlling for ANA using stated and inferred methods consistently shows that the efficient design performs statistically better. Modelling SC data from the orthogonal and efficient design shows that model-fit of the efficient design outperform the orthogonal design when using a 14-day recall period. The performance of the orthogonal design, with respect to standardised AIC model-fit, is better when longer recall periods of 30-days, 6-months and 12-months are used. Conclusions The effect of the efficient design’s cognitive demand is apparent among literate and illiterate respondents, although, more pronounced among illiterate respondents. This study empirically confirms that relaxing the orthogonality constraint of SC experimental designs increases the information collected in choice tasks, subject to the accuracy of the non-zero priors in the design and the correct specification of a ‘real’ SC recall period. PMID:25386388

Prevalence study of oral mucosal lesions, mucosal variants, and treatment required for patients reporting to a dental school in North India: In accordance with WHO guidelines

PubMed Central

Bhatnagar, Puneet; Rai, Shalu; Bhatnagar, Gunjan; Kaur, Mandeep; Goel, Sumit; Prabhat, Mukul

2013-01-01

The aim of the study was to evaluate the prevalence of oral mucosal lesions (OML) in adult patients reporting to the dental outpatient department at the Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India. The purpose was to determine the priorities in oral health education, preventive measures, and identify the group in urgent need of treatment. Materials and Methods: The study was conducted over a period of 6 months in 2010, when 8866 subjects were offered structured interviews and standardized extraoral and intraoral examinations according to the World Health Organization (WHO) guidelines. Result: Overall prevalence of OML was 1736 (16.8%), the most prevalent being smoker's palate (10.44%) followed by leukoplakia (2.83%), oral submucous fibrosis (1.97%), oral candidiasis (1.61%), recurrent aphthous stomatitis (1.53%), oral lichen planus (0.8%) and others (0.78%). The highest prevalence of the tobacco habit in both forms was recorded in the group aged 40–44 yearsand those aged between 60 and 64 years who wore dentures. Lesions were most prevalent in those aged 40–44 years with a significant predominance of males at 3:1 (M = 12.6% and F = 4.3%). Patients who consumed tobacco in any form or wore dentures had a significantly higher prevalence of OML (P < 0.001). The highest number of lesions were on the palate (59.7%) followed by buccal mucosa (19.9%). Various normal mucosal variants were recorded. Fordyce's granules (0.13%), fissured tongue (3.3%), leukoedema (1.47%), and lingual varices (2.73%) were also recorded. The tongue showed the highest number of variants (64.4%). Patients were grouped according to the treatment needed under the WHO criteria. One hundred and ninety-seven patients were given oral hygiene instructions only, whereas 1422 patients were advised on change of habit and a follow-up and 674 patients needed definitive treatment. Conclusion: This study thus highlights diagnostic criteria, multifactorial risk factors to make standard measurements of OML a basis for planning and evaluating oral health programs for data collection. PMID:23723730

Outbreak of influenza-like illness investigated during August 2013 near Indo-China border of Arunachal Pradesh, Northeast India.

PubMed

Biswas, Dipankar; Buragohain, Manika; Yadav, Kaushal; Dutta, Mousumi; Sarmah, Kimmi; Baruah, Pranjal Jyoti; Borkakoty, Biswajyoti

2016-11-01

During August 2013, an outbreak of influenza-like illnesses (ILI) was investigated in Monigong area, near Indo-China border of Arunachal Pradesh, Northeast India. Influenza type A/H3N2 was detected by RT-PCR in 33.3% (8/24) of ILI cases. Sequence analysis of HA and NA genes revealed eight and five amino acid substitutions, respectively in Monigong H3N2 (Mo/H3N2) strains as compared to vaccine strain A/Victoria/361/2011. Four non-synonymous substitutions, three localizing at antigenic sites T144A, A; R158G, B; L173S, D, and one H9Y in close proximity to a potential glycosylation site aa8 in HA1 domain along with the substitution T329N in NA are likely to influence the antigenicity/virulence of Mo/H3N2 viruses. J. Med. Virol. 88:1999-2003, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Correlation of HIV/AIDS prevalence with social, economic and demographic measures in Andhra Pradesh, India.

PubMed

Kandwal, R; Garg, P K; Garg, R D

2012-09-01

In this study, the spatial distribution of HIV/AIDS is investigated with several socioeconomic variables. Results of exploratory analysis of correlations have been reported between the prevalence of HIV/AIDS as it is the dependent variable against a range of socioeconomic and demographic measures in Andhra Pradesh, India. The state ranks among the top six states for HIV prevalence in the country. This study offers an insight to the distribution of HIV prevalence and the potential impacts of the epidemic on the high-, medium- and low-risk groups determined through cluster analyses of population and cumulative HIV infections. The impacts have been addressed through selective social and economic measures as HIV/AIDS is considered more of a social epidemic. These results help in identifying factors that are contributing more towards the spread of HIV and so guide policies to counteract dominant factors in order to control the disease. Future investigations are necessary to elucidate characterization of the rates of infection according to gender, age groups and regions.

Molecular characterization of chikungunya virus from Andhra Pradesh, India & phylogenetic relationship with Central African isolates.

PubMed

M Naresh Kumar, C V; Anthony Johnson, A M; R Sai Gopal, D V

2007-12-01

Chikungunya virus has caused numerous large outbreaks in India. Suspected blood samples from the epidemic were collected and characterized for the identification of the responsible causative from Rayalaseema region of Andhra Pradesh. RT-PCR was used for screening of suspected blood samples. Primers were designed to amplify partial E1 gene and the amplified fragment was cloned and sequenced. The sequence was analyzed and compared with other geographical isolates to find the phylogenetic relationship. The sequence was submitted to the Gen bank DNA database (accession DQ888620). Comparative nucleotide homology analysis of the AP Ra-CTR isolate with the other isolates revealed 94.7+/-3.6 per cent of homology of CHIKAPRa-CTR with other isolates of Chikungunya virus at nucleotide level and 96.8+/-3.2 per cent of homology at amino acid level. The current epidemic was caused by the Central African genotype of CHIKV, grouped in Central Africa cluster in phylogenetic trees generated based on nucleotide and amino acid sequences.

Where on Earth...? MISR Mystery Image Quiz #8:Yarlung Tsangpo River, China

NASA Image and Video Library

2002-05-15

The mighty river featured in this image is called the Yarlung Tsangpo in China, and is then known as the Dikrong during its passage through India state of Arunachal Pradesh. This image from NASA Terra satellite is MISR Mystery Image Quiz #8.

India-Japan Strategic Cooperation and Implications for U.S. Strategy in the Indo-Asia-Pacific Region

DTIC Science & Technology

2017-03-01

Pradesh, Maharashtra, and West Bengal. In a 2015 ex post facto evaluation of Japan’s ODA Rural Electrification Project, project evaluator Keishi...rights are observed and extended. Implicit in the rebalance was a hedge against a China acting to challenge the existing post –World War II rules-based...during the last 45 years of the 20th century. In the immediate post –World War II era, India provided urgent supplies of food and other equipment to

Draft Genome Sequence of a Cellulase-Producing Psychrotrophic Paenibacillus Strain, IHB B 3415, Isolated from the Cold Environment of the Western Himalayas, India.

PubMed

Dhar, Hena; Swarnkar, Mohit Kumar; Gulati, Arvind; Singh, Anil Kumar; Kasana, Ramesh Chand

2015-02-19

Paenibacillus sp. strain IHB B 3415 is a cellulase-producing psychrotrophic bacterium isolated from a soil sample from the cold deserts of Himachal Pradesh, India. Here, we report an 8.44-Mb assembly of its genome sequence with a G+C content of 50.77%. The data presented here will provide insights into the mechanisms of cellulose degradation at low temperature. Copyright © 2015 Dhar et al.

Climate change and threat of vector-borne diseases in India: are we prepared?

PubMed

Dhiman, Ramesh C; Pahwa, Sharmila; Dhillon, G P S; Dash, Aditya P

2010-03-01

It is unequivocal that climate change is happening and is likely to expand the geographical distribution of several vector-borne diseases, including malaria and dengue etc. to higher altitudes and latitudes. India is endemic for six major vector-borne diseases (VBD) namely malaria, dengue, chikungunya, filariasis, Japanese encephalitis and visceral leishmaniasis. Over the years, there has been reduction in the incidence of almost all the diseases except chikungunya which has re-emerged since 2005. The upcoming issue of climate change has surfaced as a new threat and challenge for ongoing efforts to contain vector-borne diseases. There is greater awareness about the potential impacts of climate change on VBDs in India and research institutions and national authorities have initiated actions to assess the impacts. Studies undertaken in India on malaria in the context of climate change impact reveal that transmission windows in Punjab, Haryana, Jammu and Kashmir and north-eastern states are likely to extend temporally by 2-3 months and in Orissa, Andhra Pradesh and Tamil Nadu there may be reduction in transmission windows. Using PRECIS model (driven by HadRM2) at the resolution of 50 x 50 Km for daily temperature and relative humidity for year 2050, it was found that Orissa, West Bengal and southern parts of Assam will still remain malarious and transmission windows will open up in Himachal Pradesh and north-eastern states etc. Impact of climate change on dengue also reveals increase in transmission with 2 C rise in temperature in northern India. Re-emergence of kala-azar in northern parts of India and reappearance of chikungunya mainly in southern states of India has also been discussed. The possible need to address the threat and efforts made in India have also been highlighted. The paper concludes with a positive lead that with better preparedness threat of climate change on vector-borne diseases may be negated.

A microsatellite guided insight into the genetic status of adi, an isolated hunting-gathering tribe of northeast India.

PubMed

Krithika, S; Maji, Suvendu; Vasulu, T S

2008-07-02

Tibeto-Burman populations of India provide an insight into the peopling of India and aid in understanding their genetic relationship with populations of East, South and Southeast Asia. The study investigates the genetic status of one such Tibeto-Burman group, Adi of Arunachal Pradesh based on 15 autosomal microsatellite markers. Further the study examines, based on 9 common microsatellite loci, the genetic relationship of Adi with 16 other Tibeto-Burman speakers of India and 28 neighboring populations of East and Southeast Asia. Overall, the results support the recent formation of the Adi sub-tribes from a putative ancestral group and reveal that geographic contiguity is a major influencing factor of the genetic affinity among the Tibeto-Burman populations of India.

A Microsatellite Guided Insight into the Genetic Status of Adi, an Isolated Hunting-Gathering Tribe of Northeast India

PubMed Central

Krithika, S.; Maji, Suvendu; Vasulu, T. S.

2008-01-01

Tibeto-Burman populations of India provide an insight into the peopling of India and aid in understanding their genetic relationship with populations of East, South and Southeast Asia. The study investigates the genetic status of one such Tibeto-Burman group, Adi of Arunachal Pradesh based on 15 autosomal microsatellite markers. Further the study examines, based on 9 common microsatellite loci, the genetic relationship of Adi with 16 other Tibeto-Burman speakers of India and 28 neighboring populations of East and Southeast Asia. Overall, the results support the recent formation of the Adi sub-tribes from a putative ancestral group and reveal that geographic contiguity is a major influencing factor of the genetic affinity among the Tibeto-Burman populations of India. PMID:18596928

Quest for Teaching Experimental Skills

ERIC Educational Resources Information Center

Lakshmi, B. Samrajya; Rao, B. Venkateswara

2013-01-01

In Andhra Pradesh, India, chemical experimenting in under graduate college labs by students is neglected because most of the intermediate (10+1 and 10+2) students concentrate on writing competitive exams like EAMCET (Engineering and Medical Common Entrance Test), IIT JEE (Indian Institute of Technology Joint Entrance Test), AIEEE (All India…

A Model for the Correlates of Students' Creative Thinking

ERIC Educational Resources Information Center

Sarsani, Mahender Reddy

2007-01-01

The present study was aimed to explore the relationships between orgainsational or school variables, students' personal background variables, and cognitive and motivational variables. The sample for the survey included 373 students drawn from nine Government schools in Andhra Pradesh, India. Students' creative thinking abilities were measured by…

Personality Adjustment and Job Satisfaction among the Lecturers Working in Junior Colleges

ERIC Educational Resources Information Center

Raju, T. J. M. S.

2011-01-01

The present study focused on the relationship between personality adjustment and job satisfaction among junior college Lecturers in Vizianagaram District of Andhra Pradesh, India. The successfulness of any educational program basically depends on the right performance and acceptance of teacher community. This mainly depends on their satisfaction…

Police-Related Experiences and HIV Risk Among Female Sex Workers in Andhra Pradesh, India

PubMed Central

Reed, Elizabeth; Blankenship, Kim M.

2011-01-01

Research suggests experiences with police are related to human immunodeficiency virus (HIV) sexual risk among women working as sex workers. However, little is known about the links between specific police-related behaviors and HIV vulnerability. We examine whether 5 police-related experiences are associated with measures of HIV risk and violence among a sample of female sex workers (FSWs) in Andhra Pradesh, India, and consider the implications for HIV prevention. FSWs at least 18 years of age (n = 835) were recruited through respondent-driven sampling for a cross-sectional survey conducted as part of Avahan, the India AIDS Initiative. Using logistic regression models adjusted for age, age at start of sex work, and sex work venue, we assessed police-related experiences reported by FSWs in relation to HIV risk behaviors and violence. Results showed having sex with police to avoid trouble, giving gifts to police to avoid trouble, having police take condoms away, experiencing a workplace raid, and being arrested were associated with sexually transmitted infection symptoms, inconsistent condom use, acceptance of more money for sex without a condom, and experience of client violence. These findings suggest a need for interventions targeting police–FSW interactions to reduce HIV vulnerability among FSWs. PMID:22043036

Portfolio of Outpatients Attending Centre for Urban Health, Madhya Pradesh, Central India.

PubMed

Gupta, Arti; Reddy, B Venkatashiva; Nagar, Mukesh Kumar; Chandel, Ajeet; Bali, Surya

2015-01-01

Knowledge on distribution and burden of diseases in a community is essential for planning of public health services. In the absence of information on morbidity profile through community-based surveys, facility-based data provide a good alternative. The aim of this study was to describe the morbidity profile of patients attending the Centre for Urban Health All India Institute of Medical Sciences (AIIMS) Bhopal (CUHA). A record-based descriptive study was carried out in the CUHA Bhopal, Madhya Pradesh, Central India. Information on age, gender, residence, new case, and principal diagnosis were extracted from the outpatient registers for the period between January 2014 and December 2014. Only newly registered patients for the study year (2014) were included. Descriptive analysis was done. A total of 6685 new episodes of illnesses were treated. Adults (>15 years) constituted about 85.0%. Overall, the respiratory disorders were the most common (27.2%) followed by the digestive disorders (10.9%), circulatory disorders (9.9%), musculoskeletal disorders (8.8%), and infectious and parasitic disorders (7.4%). This study gives a brief description of the morbidity profile of patients attending a primary health care center over a period of 1 year. This knowledge would help in planning health services to meet the patients' needs and help in training health staff.

Comprehensive dental health care program at an orphanage in Nellore district of Andhra Pradesh.

PubMed

Muralidharan, Dhanya; Fareed, Nusrath; Shanthi, M

2012-01-01

Provision of oral health care in India, especially for the underprivileged is limited due to inadequate finances and manpower. Resources of dental colleges in such a scenario can be utilized to provide prevention oriented oral health care. To improve the oral health status of children at an institute in Nellore district of Andhra Pradesh, India, through prevention based comprehensive dental health care program (CDHP). A longitudinal institution based interventional study conducted among the primary grade children (n=162). Baseline data collection included (i) basic demographic data (ii) body mass index (BMI) (iii) assessment of the dentition status and treatment needs according to WHO 1997 criteria. The CDHP included group based dental health education, professional oral prophylaxis, weekly (0.2%) sodium fluoride mouth rinse program, biannual application of topical fluoride (1.23% APF), pit and fissure sealants for all first permanent molars and provision of all necessary curative services. Mean treatment requirements per child decreased at 18 months. New caries lesions developed among four children. BMI of children with decay was seen to improve significantly after instituting the CDHP. CDHP is effective in overall improvement of general and oral health. In resource limited countries like India, such programs organized by dental schools can improve oral health.

Estimating population salt intake in India using spot urine samples.

PubMed

Petersen, Kristina S; Johnson, Claire; Mohan, Sailesh; Rogers, Kris; Shivashankar, Roopa; Thout, Sudhir Raj; Gupta, Priti; He, Feng J; MacGregor, Graham A; Webster, Jacqui; Santos, Joseph Alvin; Krishnan, Anand; Maulik, Pallab K; Reddy, K Srinath; Gupta, Ruby; Prabhakaran, Dorairaj; Neal, Bruce

2017-11-01

To compare estimates of mean population salt intake in North and South India derived from spot urine samples versus 24-h urine collections. In a cross-sectional survey, participants were sampled from slum, urban and rural communities in North and in South India. Participants provided 24-h urine collections, and random morning spot urine samples. Salt intake was estimated from the spot urine samples using a series of established estimating equations. Salt intake data from the 24-h urine collections and spot urine equations were weighted to provide estimates of salt intake for Delhi and Haryana, and Andhra Pradesh. A total of 957 individuals provided a complete 24-h urine collection and a spot urine sample. Weighted mean salt intake based on the 24-h urine collection, was 8.59 (95% confidence interval 7.73-9.45) and 9.46 g/day (8.95-9.96) in Delhi and Haryana, and Andhra Pradesh, respectively. Corresponding estimates based on the Tanaka equation [9.04 (8.63-9.45) and 9.79 g/day (9.62-9.96) for Delhi and Haryana, and Andhra Pradesh, respectively], the Mage equation [8.80 (7.67-9.94) and 10.19 g/day (95% CI 9.59-10.79)], the INTERSALT equation [7.99 (7.61-8.37) and 8.64 g/day (8.04-9.23)] and the INTERSALT equation with potassium [8.13 (7.74-8.52) and 8.81 g/day (8.16-9.46)] were all within 1 g/day of the estimate based upon 24-h collections. For the Toft equation, estimates were 1-2 g/day higher [9.94 (9.24-10.64) and 10.69 g/day (9.44-11.93)] and for the Kawasaki equation they were 3-4 g/day higher [12.14 (11.30-12.97) and 13.64 g/day (13.15-14.12)]. In urban and rural areas in North and South India, most spot urine-based equations provided reasonable estimates of mean population salt intake. Equations that did not provide good estimates may have failed because specimen collection was not aligned with the original method.

What influences the decision to undergo institutional delivery by skilled birth attendants? A cohort study in rural Andhra Pradesh, India.

PubMed

Nair, M; Ariana, P; Webster, P

2012-01-01

Despite continuing efforts to promote skilled institutional delivery, eight women die every hour in India due to causes related to pregnancy and child birth. The objectives of this study were to assess the prevalence and the determinants of institutional delivery by skilled birth attendants in a rural population in Andhra Pradesh, India. This cross-sectional study used data from 'Young Lives', a longitudinal study on childhood poverty, and the study population was a cohort of 1419 rural, economically deprived women (from the Young Lives study) in Andhra Pradesh, India. The data are from round-1 of Young Lives younger cohort recruited in 2002 and followed until 2015. The participation rate of households was 99.5%. Prevalence of skilled institutional delivery was 36.8%. Women's education (odds ratio [OR] for secondary education 2.06; 95% confidence interval [95%CI] 1.33-3.19), desire to be pregnant (OR 1.89; 95% CI 1.12-3.22) and adequate prenatal care (OR 1.69; 95% CI 1.30-2.21) were found to be the positive determinants of skilled institutional delivery. High birth order (OR for second birth 0.44; 95% CI 0.32-0.60, OR for third birth 0.47; 95% CI 0.30-0.72 and OR for ≥fourth 0.47; 95% CI 0.27-0.81), schedule caste/schedule tribe social background (OR 0.70; 95% CI 0.53-0.93) and poor economic status of the household (OR for the poorest households 0.67; 95% CI 0.46-0.99) were negatively associated with skilled institutional delivery. Despite existence of supporting schemes, the utilisation of skilled institutional delivery services was low in the study population. Educated women and women with adequate prenatal care who have a desired pregnancy were more likely to utilise health institutions and skilled delivery care. There is a need for integrated approaches through maternal health, family planning and education programs, and a focus on uneducated, poor women belonging to disadvantaged social groups.

Patent Pooling for Promoting Access to Antiretroviral Drugs (ARVs) – A Strategic Option for India

PubMed Central

Satyanarayana, Kanikaram; Srivastava, Sadhana

2010-01-01

The current HIV/AIDS scenario in India is quite grim with an estimated 2.4 million people living with HIV/AIDS (PLHA) in 2008, just behind South Africa and Nigeria. The anti-retroviral drugs (ARVs) remain the main stay of global HIV/AIDS treatment. Over 30 ARVs (single and FDCs) available under six categories viz., NRTIs (nucleoside reverse transcriptase inhibitors), NNRTIs (non-nucleoside reverse transcriptase inhibitors), Protease inhibitors, the new Fusion inhibitors, Entry inhibitors-CCR5 co-receptor antagonists and HIV integrase strand transfer inhibitors. The major originator companies for these ARVs are: Abbott, Boehringer Ingelheim (BI), Bristol-Myers Squibb (BMS), Gilead, GlaxoSmithKline (GSK), Merck, Pfizer, Roche, and Tibotec. Beginning with zidovidine in 1987, all the drugs are available in the developed countries. In India, about 30 ARVs are available as generics manufactured by Aurobindo, Hyderabad, Andhra Pradesh; Cipla Limited, Goa; Emcure Pharmaceuticals, Pune, Maharashtra; Hetero Drugs, Hyderabad, Andhra Pradesh; Macleods Pharmaceuticals, Daman; Matrix Laboratories, Nashik, Maharashtra; Ranbaxy, Sirmour, Himachal Pradesh; and Strides Arcolab, Bangalore, Karnataka. The National AIDS Control Organization (NACO) set up in 1992 by the Govt. of India provides free ARVs to HIV positive patients in India since 2004. The drugs available in India include both single drugs and FDCs covering both first line and second line ARVs. Even while there are claims of stabilization of the disease load, there is still huge gap of those who require ARVs as only about 150,000 PLHA receive the ARVs from the Govt. and other sources. Access to ARVs therefore is still a cause of serious concern ever since India became fully Trade Related Aspects of Intellectual Property Rights (TRIPS)-complaint in 2005. Therefore, the Indian pharmaceutical companies cannot make generics for those for drugs introduced post-2005 due to product patent regime. Other concerns include heat stable, other better formulations and second line ARVs for adults and more drugs and formulations for paediatric groups, that are still to be widely available in India and other developing countries. To examine whether strong intellectual property (IP) protection systems are to be considered important barriers for the limited or lack of access to ARVs, we studied the patent profile of the ARVs of the originator companies within and outside India. We could record 93 patents in the United States Patent & Trademark Office (USPTO). The originator companies have been also aggressively filing and enforcing patents in India. There have been a few efforts by companies like Gilead and GSK to grant licenses to generic manufacturers in developing countries, ostensibly to promote access to ARVs through lower (two-tier) pricing. These steps are considered as too little and too late. There is an urgent need to look for alternative strategies to promote access to ARVs both linked to and independent of IPRs. Patent pooling as a viable strategy mooted by the UNITAID should be seriously explored to promote access to ARVs. India is ideally suited for trying out the patent pool strategy as most of the global requirement of affordable ARV drugs for HIV/AIDS treatment is sourced from Indian generic companies. PMID:20148091

Patent Pooling for Promoting Access to Antiretroviral Drugs (ARVs) - A Strategic Option for India.

PubMed

Satyanarayana, Kanikaram; Srivastava, Sadhana

2010-01-19

The current HIV/AIDS scenario in India is quite grim with an estimated 2.4 million people living with HIV/AIDS (PLHA) in 2008, just behind South Africa and Nigeria. The anti-retroviral drugs (ARVs) remain the main stay of global HIV/AIDS treatment. Over 30 ARVs (single and FDCs) available under six categories viz., NRTIs (nucleoside reverse transcriptase inhibitors), NNRTIs (non-nucleoside reverse transcriptase inhibitors), Protease inhibitors, the new Fusion inhibitors, Entry inhibitors-CCR5 co-receptor antagonists and HIV integrase strand transfer inhibitors. The major originator companies for these ARVs are: Abbott, Boehringer Ingelheim (BI), Bristol-Myers Squibb (BMS), Gilead, GlaxoSmithKline (GSK), Merck, Pfizer, Roche, and Tibotec. Beginning with zidovidine in 1987, all the drugs are available in the developed countries. In India, about 30 ARVs are available as generics manufactured by Aurobindo, Hyderabad, Andhra Pradesh; Cipla Limited, Goa; Emcure Pharmaceuticals, Pune, Maharashtra; Hetero Drugs, Hyderabad, Andhra Pradesh; Macleods Pharmaceuticals, Daman; Matrix Laboratories, Nashik, Maharashtra; Ranbaxy, Sirmour, Himachal Pradesh; and Strides Arcolab, Bangalore, Karnataka. The National AIDS Control Organization (NACO) set up in 1992 by the Govt. of India provides free ARVs to HIV positive patients in India since 2004. The drugs available in India include both single drugs and FDCs covering both first line and second line ARVs. Even while there are claims of stabilization of the disease load, there is still huge gap of those who require ARVs as only about 150,000 PLHA receive the ARVs from the Govt. and other sources. Access to ARVs therefore is still a cause of serious concern ever since India became fully Trade Related Aspects of Intellectual Property Rights (TRIPS)-complaint in 2005. Therefore, the Indian pharmaceutical companies cannot make generics for those for drugs introduced post-2005 due to product patent regime. Other concerns include heat stable, other better formulations and second line ARVs for adults and more drugs and formulations for paediatric groups, that are still to be widely available in India and other developing countries. To examine whether strong intellectual property (IP) protection systems are to be considered important barriers for the limited or lack of access to ARVs, we studied the patent profile of the ARVs of the originator companies within and outside India. We could record 93 patents in the United States Patent & Trademark Office (USPTO). The originator companies have been also aggressively filing and enforcing patents in India. There have been a few efforts by companies like Gilead and GSK to grant licenses to generic manufacturers in developing countries, ostensibly to promote access to ARVs through lower (two-tier) pricing. These steps are considered as too little and too late. There is an urgent need to look for alternative strategies to promote access to ARVs both linked to and independent of IPRs. Patent pooling as a viable strategy mooted by the UNITAID should be seriously explored to promote access to ARVs. India is ideally suited for trying out the patent pool strategy as most of the global requirement of affordable ARV drugs for HIV/AIDS treatment is sourced from Indian generic companies.

Suicide deaths in rural Andhra Pradesh--a cause for global health action.

PubMed

Joshi, Rohina; Guggilla, Rama; Praveen, Devarsetty; Maulik, Pallab K

2015-02-01

To determine the proportion of deaths attributable to suicides in rural Andhra Pradesh, India over a 4-year period using a verbal autopsy method. Deaths occurring in 45 villages (population 185,629) were documented over a 4-year period from 2003 to 2007 by non-physician healthcare workers trained in the use of a verbal autopsy tool. Causes of death were assigned by physicians trained in the International Classification of Diseases, version 10. All data were entered and processed electronically using a secure study website. Verbal autopsies were completed for 98.2% (5786) of the deaths (5895) recorded. The crude death rate was 8.0/1000. 4.8% (95% CI 4.3-5.4) of all deaths were suicides, giving a suicide rate of 37.5/100,000 population. Forty-three percent of suicides occurred in the age group 15-29 years, and 62% were in men. In the younger age groups (10-29 years), suicides by women (56%) were more common than by men (44%). Poisoning (40%) was the most common method of self-harm followed by hanging (12%). The suicide rate in this part of rural Andhra Pradesh is three times higher than the national average of 11.2/100,000, but is in line with that reported in the Million Death Study. There is an urgent need to develop strategies targeted at young individuals to prevent deaths by suicide in India. © 2014 John Wiley & Sons Ltd.

New evidence for paleobiogeographic intercontinental Gondwana relationships based on Late Cretaceous-earliest Paleocene coastal faunas from peninsular India

NASA Astrophysics Data System (ADS)

Sahni, Ashok; Rana, R. S.; Prasad, G. V. R.

A number of localities for freshwater microvertebrate assemblages of Late Cretaceous-early Paleocene age fringing the Deccan Basalt outcrops of Peninsular India have been studied during the last 4 years. The diversified vertebrate assemblages recovered by bulk wet screening at the localities of Rahioli (Gujarat), Jabalpur (Madhya Pradesh), Nagpur, Umrer, Pisdura (Maharashtra), and Asifabad (Andhra Pradesh) clearly suggest lack of faunal endemism for the drifting Indian island subcontinent. On the contrary, at the generic level, the fauna from the peninsular Indian localities is cosmopolitan in nature. The presence of a number of Laurasiatic elements, such as pelobatid frogs, suggests that a dispersal corridor was maintained with Laurasia throughout the drifting phase of India. The coastal plain faunas contain a mixed assemblage of freshwater and marine forms represented by 62 genera and 79 species. There is a striking similarity at the generic level between the fish and turtle faunas of the Upper Cretaceous of Peninsular India and those of Niger. Similarly, the few data now available from south central Bolivia, South America, also suggest interesting similarities to the corresponding faunas of Peninsular India. The lack of faunal endemism in India during the temporal span of India's northward drift as an island subcontinent can be attributed to a land contact maintained with Madagascar and the east African region by such aseismic elements as the Mascarene plateau and the Chagos-Laccadive Ridge. A more northerly contact with Laurasia may have been established by an island arc system represented at present by the Dras volcanics of Kashmir. The proximity of the Iran-Afghan plate to the drifting Indian landmass may have further contributed as a corridor for the dispersal of Laurasiatic elements into the subcontinent. By the middle Eocene, with the establishment of a firm dispersal corridor with central and east Asia, faunal affinities changed from Gondwanic to Holarctic, a condition which still persists today.

Glacier fluctuation using Satellite Data in Beas basin, 1972-2006, Himachal Pradesh, India

NASA Astrophysics Data System (ADS)

Dutta, Shruti; Ramanathan, A. L.; Linda, Anurag

2012-10-01

Glaciers are widely recognized as sensitive indicators for regional climate change. Very few studies have been conducted to investigate the long term deglaciation status in the Himalaya. In the present study, glaciers in the Beas basin, Himachal Pradesh, India were mapped by interpretation of various glacio-morphological features using the Landsat and IRS images. The mapping of 224 glaciers during the period 1972-2006 reveals that the glacier cover reduced from 419 to 371 km2, witnessing approximately 11.6% deglaciation in the Beas basin. A higher rate of retreat of the glaciers was observed during 1989-2006 as compared to the retreat during 1972-1989. Also, the loss has been more prominent in the glaciers with an areal extent of 2-5 km2. The number of glaciers increased from 224 to 236 due to fragmentation in this period. The average elevation of the ablation zone basin showed an upward shift from 3898 m (1972) to 4171 m (2006) which may be a consequence of a shift in Equilibrium Line Altitude (ELA) reflecting imbalance.

Correlates of health care utilization under targeted interventions: The case of female sex workers in Andhra Pradesh, India.

PubMed

Sharma, Varun; Suryawanshi, Dipak; Saggurti, Niranjan; Bharat, Shalini

2017-11-01

Accessibility and frequency of use of health care services among female sex workers (FSWs) are constrained by various factors. In this analysis, we examined the correlates of frequency of using health care services under targeted interventions among FSWs. A sample of FSWs (N = 1,973) was obtained from a second round (2012) of Behavioral Tracking Survey, conducted in five districts of Andhra Pradesh, a high-HIV-prevalence state in southern India. We used negative binomial regression models to analyze frequency of utilization of health care services among FSWs. Based on our analysis, we suggest that various predisposing and enabling factors were found to be significantly associated with the visit to NGO clinics for treatment of any health problem, any sexually transmitted infection symptom, and the number of condoms received from the peer worker or condom depot. We suggest the need for further research with respect to various correlates of frequency of using health care among FSWs to develop effective intervention strategies in countries that have high HIV prevalence among FSWs and targeted interventions need more diligent implementation to reach the unreached.

Ethnomedicinal botany of the Apatani in the Eastern Himalayan region of India

PubMed Central

Kala, Chandra Prakash

2005-01-01

This paper investigates the wealth of medicinal plants used by the Apatani tribe of Arunachal Pradesh. Apatani have traditionally settled in seven villages in the Ziro valley of Lower Subansiri district of Arunachal Pradesh in the Eastern Himalayan region of India. The present study has resulted in the documentation of 158 medicinal plant species used by the Apatani group of villages. These medicinal plant species were distributed across 73 families and 124 genera. Asteraceae was the most dominant family (19 species, 11 genera) of medicinal plants, followed by Zingiberaceae, Solanaceae, Lamiaceae and Araceae. For curing ailments, the use of aboveground plant parts was higher (80%) than the belowground plant parts in the Apatani group of villages. Of the aboveground plant parts, leaf was used in the majority of cases (56 species), followed by fruit. Different belowground plant forms such as root, tuber, rhizome, bulb and pseudo-bulb were used by Apatani as a medicine. About 52 types of ailments were cured by using these 158 medicinal plant species. The results of this study are further discussed in the changing socio-economic contexts. PMID:16288657

Contributions of an intensive HIV prevention programme in increasing HIV testing among men who have sex with men in Andhra Pradesh, India.

PubMed

Ramesh, Sowmya; Mehrotra, Purnima; Saggurti, Niranjan

2015-01-01

The objective of this study was to identify the factors associated with uptake of HIV testing and to assess their relative contributions in increasing HIV testing. Data are drawn from two rounds of cross-sectional Integrated Behavioural and Biological Assessment (IBBA) surveys of self-identified men who have sex with men (MSM) from Andhra Pradesh, India, recruited through probability-based sampling in 2005-2006 and 2009-2010 (IBBA1, n = 1621; IBBA2, n = 1608, respectively). Logistic regression model was used to assess the relationship between socio-demographic characteristics, sexual behaviours, programme exposure and HIV testing. Significant factors were further parsed using decomposition analysis to examine the contribution of different components of that factor towards the change in HIV testing. There was a significant increase in the proportion of MSM reporting HIV testing from IBBA1 to IBBA2. Higher literacy levels, being 25-34 years old, being a kothi (predominantly receptive), engaging in both commercial and non-commercial sexual relationships and intervention programme exposure contributed the most to the increase in HIV testing.

Fossil wood flora from the Siwalik Group of Arunachal Pradesh, India and its climatic and phytogeographic significance

NASA Astrophysics Data System (ADS)

Srivastava, Gaurav; Mehrotra, R. C.; Srikarni, C.

2018-02-01

The plant fossil records from the Siwalik Group of Arunachal Pradesh, India are far from satisfactory due to remoteness and dense vegetation of the area. We report seven fossil woods of which three belong to the Middle Siwalik (Subansiri Formation), while the rest are from the Upper Siwalik (Kimin Formation). The modern analogues of the fossils from the Middle Siwalik are Lophopetalum littorale (Celastraceae), Afzelia-Intsia and Sindora siamensis (Fabaceae) and from the Upper Siwalik are Miliusa velutina (Annonaceae), Calophyllum tomentosum and Kayea (Calophyllaceae) and Diospyros melanoxylon (Ebenaceae). The dominance of diffuse porosity in the fossil woods indicates a tropical climate with low seasonality (little variation) in temperature, while a high proportion of large vessels and simple perforation plates in the assemblage infer high precipitation during the deposition of the sediments. The aforesaid inference is in strong agreement with the previous quantitative reconstruction based on fossil leaves. Several modern analogues of the fossil taxa are now growing in low latitudes possibly due to an increase in seasonality (increased variation) in temperature caused by the rising Himalaya.

Delivering Medical Abortion at Scale: A Study of the Retail Market for Medical Abortion in Madhya Pradesh, India

PubMed Central

Powell-Jackson, Timothy; Acharya, Rajib; Filippi, Veronique; Ronsmans, Carine

2015-01-01

Background Medical abortion (mifepristone and misoprostol) has the potential to contribute to reduced maternal mortality but little is known about the provision or quality of advice for medical abortion through the private retail sector. We examined the availability of medical abortion and the practices of pharmacists in India, where abortion has been legal since 1972. Methods We interviewed 591 pharmacists in 60 local markets in city, town and rural areas of Madhya Pradesh. One month later, we returned to 359 pharmacists with undercover patients who presented themselves unannounced as genuine customers seeking a medical abortion. Results Medical abortion was offered to undercover patients by 256 (71.3%) pharmacists and 24 different brands were identified. Two thirds (68.5%) of pharmacists stated that abortion was illegal in India. Only 106 (38.5%) pharmacists asked clients the timing of the last menstrual period and 38 (13.8%) requested to see a doctor’s prescription – a legal requirement in India. Only 59 (21.5%) pharmacists correctly advised patients on the gestational limit for medical abortion, 97 (35.3%) provided correct information on how many and when to take the tablets in a combination pack, and 78 (28.4%) gave accurate advice on where to seek care in case of complications. Advice on post-abortion family planning was almost nonexistent. Conclusions The retail market for medical abortion is extensive, but the quality of advice given to patients is poor. Although the contribution of medical abortion to women’s health in India is poorly understood, there is an urgent need to improve the practices of pharmacists selling medical abortion. PMID:25822656

Diarrhea no more: does zinc help the poor? Evidence on the effectiveness of programmatic efforts to reach poorest in delivering zinc and ORS at scale in UP and Gujarat, India.

PubMed

LeFevre, Amnesty E; Mohan, Diwakar; Mazumder, Sarmila; Lamberti, Laura L; Taneja, Sunita; Black, Robert E; Fischer-Walker, Christa L

2016-12-01

India has the greatest burden of diarrhea in children under 5 years globally. The Diarrhea Alleviation through zinc and oral rehydration salts (ORS) Therapy program (2010-2014) sought to improve access to and utilization of zinc and ORS among children 2-59 months in Gujarat and Uttar Pradesh (UP), India, through public and private sector delivery channels. In this analysis, we present findings on program's effect in reducing child-health inequities. Data from cross-sectional baseline and endline surveys were used to assess disparities in key outcomes across six dimensions: socioeconomic strata, gender, caregiver education, ethnicity and geography. Careseeking outside the home for children under 5 years with diarrhea did not increase significantly in UP or Gujarat across socioeconomic strata. Declines in private sector careseeking were observed in both sites along with concurrent increases in public sector careseeking. Zinc, ORS, zinc+ORS use did not increase significantly in UP across socioeconomic strata. In Gujarat, increases in zinc use (20% overall; 33% in the Quintile 5 (Q5) strata) and zinc+ORS (18% overall; 30% in the Q5 strata) were disproportionately observed in the high income strata, among members of the most advantaged caste, and among children whose mothers had ≥1 year of schooling. ORS use increased significantly across all socioeconomic strata for children in Gujarat with diarrhea (23% overall; 33% in Q5 strata) and those with dehydration + diarrhea (33% overall; 38% in Q5 strata). The magnitude of increase in ORS receipt from the public sector was nearly twice that observed in the private sector. In Gujarat, while out of pocket spending for diarrhea was significantly higher for male children, overall costs to users declined by a mean of US$ 2; largely due to significant reductions in wages lost (-US$ 0.79; P  < 0.003), and transportation costs (-US$ 0.44; P  < 0.00). While significant improvements in diarrhea treatment were achieved in Gujarat, new strategies are needed in UP, particularly in the private sector. If national-level reductions in diarrheal disease burden are to be realized, improved understanding is needed of how to optimally increase coverage of zinc and ORS and decrease contraindicated treatments amongst the most disadvantaged across geographic areas and axes of gender, ethnicity, education and socioeconomic status.

A Study of Risk Factors in Recidivistic Criminals

PubMed Central

Tiwari, S.C.; Gupta, S. C.; Shukla, Seema; Srivastava, Shipra; Pandey, Mamta; Maurya, Amit; Kumar, Aditya

2004-01-01

A study was carried out under the aegis of Indian Council of Medical Research, New Delhi with objectives to identify psychosocial, physical, psychiatric, anthropometric and psychometric risk factors in recidivistic criminals, which could predict a future recidivistic criminal. The paper presents study observations on 250 experimental, 250 control-1 and 250 control-2 subjects. Experimental and control-1 subjects were recruited from district jails of Uttar Pradesh and control-2 from the community. Pretested Semi-structured proformae, Verghese and Beig Symptoms Checklist, International Personality Disorder Examination module, Hostility and Direction of Hostility Questionnaire, Rorschach Ink Blot Test and Standard Anthropometric instruments were used to collect data on study probands. All the three groups were compared using Analysis of Variance and Chi-Square Test. The results highlight a number of psycho-social, psychiatric, psychometric and anthropometric factors which were found to have significant association with recidivistic criminal behaviour. The findings would not only help in identifying future recidivistic criminals but can also be used for legal, judicial, interventional and corrective purposes. PMID:21408043

Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India

PubMed Central

2010-01-01

Background Information on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India. Methods Based on data from a representative sample of 128 public-funded HIV prevention programs of 14 types in Andhra Pradesh, we have recently reported the number of HIV infections averted by each type of HIV prevention intervention and their cost. Using estimates of the age of onset of HIV infection, we used standard methods to calculate the cost per Disability Adjusted Life Year (DALY) saved as a measure of cost-effectiveness of each type of HIV prevention intervention. Results The point estimates of the cost per DALY saved were less than US $50 for blood banks, men who have sex with men programmes, voluntary counselling and testing centres, prevention of parent to child transmission clinics, sexually transmitted infection clinics, and women sex worker programmes; between US $50 and 100 for truckers and migrant labourer programmes; more than US $100 and up to US $410 for composite, street children, condom promotion, prisoners and workplace programmes and mass media campaign for the general public. The uncertainty range around these estimates was very wide for several interventions, with the ratio of the high to the low estimates infinite for five interventions. Conclusions The point estimates for the cost per DALY saved from the averted HIV infections for all interventions was much lower than the per capita gross domestic product in this Indian state. While these indicative cost-effectiveness estimates can inform HIV control planning currently, the wide uncertainty range around estimates for several interventions suggest the need for more firm data for estimating cost-effectiveness of HIV prevention interventions in India. PMID:20459755

Low tuberculosis knowledge among HIV-infected patients in a high HIV prevalence region within southeast India.

PubMed

Arora, Nick; Vadrevu, Ravi; Chandrasekhar, Aditya; Gupta, Amita

2013-01-01

A private multispecialty hospital in Kakinada, Andhra Pradesh, India. A survey of knowledge, attitudes, and perceptions adapted from a pretested questionnaire was administered to 128 HIV-infected adults, from July to August 2008. A total of 31% had not heard of tuberculosis (TB), with 15 (38%) currently receiving anti-TB therapy or had received it in the past. Of those familiar with TB, 70% could not list a method by which it was spread. Low education attainment, female sex, and less frequent television exposure were associated with low TB literacy. HIV-infected patients in southeast India have poor knowledge of TB and the methods by which it is spread. Scale-up of patient-directed educational programs is necessary to help control TB in India.

Emergence of Arctic-like Rabies Lineage in India

PubMed Central

Turner, Geoff; Paul, Joel P. V.; Madhusudana, Shampur N.; Wandeler, Alexander I.

2007-01-01

A collection of 37 rabies-infected samples, 10 human saliva and 27 animal brain, were recovered during 2001–2004 from the cities of Bangalore and Hyderabad in southern India and from Kasauli, a mountainous region in Himachal Pradesh, northern India. Phylogenetic analysis of partial N gene nucleotide sequences of these 37 specimens and 1 archival specimen identified 2 groups, divided according to their geographic (north or south) origins. Comparison of selected Indian viruses with representative rabies viruses recovered worldwide showed a close association of all Indian isolates with the circumpolar Arctic rabies lineage distributed throughout northern latitudes of North America and Europe and other viruses recovered from several Asian countries. PMID:17370523

Behavioral surveillance of premarital sex among never married young adults in a high HIV prevalence district in India.

PubMed

Kumar, G Anil; Dandona, Rakhi; Kumar, S G Prem; Dandona, Lalit

2011-01-01

In a population-based representative sample of 2,475 never married persons aged 15-24 years from Guntur district of Andhra Pradesh state in India, 21.7% (95% CI 18.7-24.7) males and 4.6% (95% CI 2.2-7.0) females reported having had sex. Only 22.3% males and 6.3% females reported consistent condom use for premarital sex in the last 6 months. The strongest associations with premarital sex for males were current use of alcohol and tobacco, and for females were not living with parents currently and being an income earner. These findings can inform HIV prevention efforts among young adults in India.

Violence in contract work among female sex workers in Andhra Pradesh, India.

PubMed

George, Annie; Sabarwal, Shagun; Martin, P

2011-12-01

Female sex workers (FSWs) are vulnerable to physical and sexual violence at work. This article examines the prevalence of recent physical and sexual violence victimization and associations of type of sex work among a large sample of young FSWs. We used data from a cross-sectional survey on sex trafficking and sex work in southern India that included 1138 FSWs aged 18-25 years residing in 3 districts of Andhra Pradesh state. The independent variable was organization of sex work. FSWs on contract at sex work establishments outside their home district were classified as contract workers, as compared with women who worked autonomously within their home district. Using logistic regression models adjusted for sociodemographic factors, we assessed the relation between contract/ non-contract sex work and various forms of violence experienced by FSWs. Results indicate a high prevalence of work-related physical and sexual violence; 50% FSWs reported physical violence, and 77% reported sexual violence. FSWs performing contract work were at increased risk of physical and sexual violence at work, compared with women engaged in sex work in their home districts. The findings that contract work outside the home district increases the vulnerabilities faced by FSWs in India suggest that violence and disease prevention services aimed at FSWs would be more effective if organization of sex work--as contract or noncontract--is taken into account.

Cultural characteristics, morphology, and variation within Claviceps africana and C. sorghi from India.

PubMed

Muthusubramanian, Venkateshwaran; Bandyopadhyay, Ranajit; Rajaram Reddy, Daram; Tooley, Paul W

2006-04-01

Sorghum ergot in India is caused by Claviceps africana and C. sorghi. The distributions of these two species in India is not known. Eighty-nine sorghum ergot isolates were cultured from young sphacelia obtained from male sterile sorghum plants artificially inoculated using inoculum collected in the field. Based on cultural characteristics, the isolates were separated into two groups which differed distinctly in the morphology of their sphacelia, conidia, and sclerotia. Marked differences also were observed in rates of secondary conidial production and disease spread between the groups. In combination with molecular evidence, our results confirm that the isolates placed in Group I represent C. africana and Group II isolates represent C. sorghi. C. africana was found to be widely distributed in all sorghum growing areas of India. The species first described as occuring in India, C. sorghi, appears to be restricted to a few locations in the states of Maharashtra, Andhra Pradesh, and Karnataka.

Availability and distribution of safe abortion services in rural areas: a facility assessment study in Madhya Pradesh, India

PubMed Central

Chaturvedi, Sarika; Ali, Sayyed; Randive, Bharat; Sabde, Yogesh; Diwan, Vishal; De Costa, Ayesha

2015-01-01

Background Unsafe abortion contributes to a significant portion of maternal mortality in India. Access to safe abortion care is known to reduce maternal mortality. Availability and distribution of abortion care facilities can influence women's access to these services, especially in rural areas. Objectives To assess the availability and distribution of abortion care at facilities providing childbirth care in three districts of Madhya Pradesh (MP) province of India. Design Three socio demographically heterogeneous districts of MP were selected for this study. Facilities conducting at least 10 deliveries a month were surveyed to assess availability and provision of abortion services using UN signal functions for emergency obstetric care. Geographical Information System was used for visualisation of the distribution of facilities. Results The three districts had 99 facilities that conducted >10 deliveries a month: 74 in public and 25 in private sector. Overall, 48% of facilities reported an ability to provide safe surgical abortion service. Of public centres, 32% reported the ability compared to 100% among private centres while 18% of public centres and 77% of private centres had performed an abortion in the last 3 months. The availability of abortion services was higher at higher facility levels with better equipped and skilled personnel availability, in urban areas and in private sector facilities. Conclusions Findings showed that availability of safe abortion care is limited especially in rural areas. More emphasis on providing safe abortion services, particularly at primary care level, is important to more significantly dent maternal mortality in India. PMID:25797220

Identifying Children with Intellectual Disabilities in the Tribal Population of Barwani District in State of Madhya Pradesh, India

ERIC Educational Resources Information Center

Lakhan, Ram; Mawson, Anthony R.

2016-01-01

Background: Low-and middle-income countries (LAMI) lack an integrated and systematic approach to identify people with intellectual disabilities. Screening surveys are considered resource-intensive; therefore, alternative approaches are needed. This study attempted to identify children up to age 18 years with intellectual disabilities through a…

Awareness of eye donation in the rural population of India.

PubMed

Krishnaiah, Sannapaneni; Kovai, Vilas; Nutheti, Rishita; Shamanna, Bindiganavale R; Thomas, Ravi; Rao, Gullapalli N

2004-03-01

To determine the "awareness of eye donation" and "willingness to pledge eyes for donation" in the rural population of Andhra Pradesh, southern India. A total of 7,775 subjects of all ages, representative of the rural population of Andhra Pradesh, participated in the Andhra Pradesh Eye Disease Study (APEDS). Subjects older than 15 years were interviewed regarding awareness of eye donation and willingness to pledge eyes for donation. Age-gender adjusted prevalence of awareness of eye donation in this population was 30.7% (95% CI: 29.5-31.9) but only 0.1% (age-gender adjusted prevalence) (95% CI: 0.05-0.25) had pledged eyes. On multivariate analysis the awareness of eye donation was significantly less in those subjects > or = 70 years old (OR 0.7; 95% CI: 0.6-0.8), illiterates (OR 0.2; 95% CI: 0.1-0.2), females (OR 0.8; 95% CI: 0.7-0.9), lower socioeconomic status group (OR 0.4; 95% CI: 0.4-0.5) and Christians (OR 0.2; 95% CI: 0.1-0.6). Media comprised the major source of information about eye donation. Of those aware of eye donation, 32.9% were willing to pledge eyes, and 50.6% needed more information to decide whether or not to pledge their eyes. There needs to be more transfer of knowledge if more eyes are to be pledged. One-third of those aware of eye donation have not pledged their eyes, and an additional 50.6% needed more information to decide. This means only about one-fifth of those aware of eye donations have pledged their eyes.

Building nurse education capacity in India: insights from a faculty development programme in Andhra Pradesh

PubMed Central

2013-01-01

Background India faces an acute shortage of nurses. Strategies to tackle the human resource crisis depend upon scaling up nursing education provision in a context where the social status and working conditions of nurses are highly variable. Several national and regional situation assessments have revealed significant concerns about educational governance, institutional and educator capacity, quality and standards. Improving educational capacity through nursing faculty development has been proposed as one of several strategies to address a complex health human resource situation. This paper describes and critically reflects upon the experience of one such faculty development programme in the state of Andhra Pradesh. Discussion The faculty development programme involved a 2 year partnership between a UK university and 7 universities in Andhra Pradesh. It adopted a participatory approach and covered training and support in 4 areas: teaching, research/scholarship, leadership/management and clinical education. Senior hospital nurses were also invited to participate. Summary The programme was evaluated positively and some changes to educational practice were reported. However, several obstacles to wider change were identified. At the programme level, there was a need for more intensive individual and institutional mentorship as well as involvement of Indian Centres of Excellence in Nursing to provide local (as well as international) expertise. At the organisational level, the participating Colleges reported heavy workloads, lack of control over working conditions, lack of control over the curriculum and poor infra-structure/resources as ongoing challenges. In the absence of wider educational reform in nursing and government commitment to the profession, faculty development programmes alone will have limited impact. PMID:23537273

An integrated nutrition and health program package on IYCN improves breastfeeding but not complementary feeding and nutritional status in rural northern India: A quasi-experimental randomized longitudinal study

PubMed Central

Ahmed, Saifuddin; Dreyfuss, Michele L.; Srivastava, Vinod K.; Ahuja, Ramesh C.; Baqui, Abdullah H.; Darmstadt, Gary L.; Santosham, Mathuram; West, Keith P.

2017-01-01

Background Undernutrition below two years of age remains a major public health problem in India. We conducted an evaluation of an integrated nutrition and health program that aimed to improve nutritional status of young children by improving breast and complementary feeding practices over that offered by the Government of India’s standard nutrition and health care program. Methods In Uttar Pradesh state, through multi-stage cluster random sampling, 81 villages in an intervention district and 84 villages in a comparison district were selected. A cohort of 957 third trimester pregnant women identified during house-to-house surveys was enrolled and, following childbirth, mother-child dyads were followed every three months from birth to 18 months of age. The primary outcomes were improvements in weight-for-age and length-for-age z scores, with improved breastfeeding and complementary feeding practices as intermediate outcomes. Findings Optimal breastfeeding practices were higher among women in intervention than comparison areas, including initiating breastfeeding within one hour of delivery (17.4% vs. 2.7%, p<0.001), feeding colostrum (34.7% vs. 8.4%, p<0.001), avoiding pre-lacteals (19.6% vs. 2.1%, p<0.001) and exclusively breastfeeding up to 6 months (24.1% vs. 15.3%, p = 0.001). However, differences were few and mixed between study arms with respect to complementary feeding practices. The mean weight-for-age z-score was higher at 9 months (-2.1 vs. -2.4, p = 0.0026) and the prevalence of underweight status was lower at 12 months (58.5% vs. 69.3%, p = 0.047) among intervention children. The prevalence of stunting was similar between study arms at all ages. Coefficients to show the differences between the intervention and comparison districts (0.13 cm/mo) suggested significant faster linear growth among intervention district infants at earlier ages (0–5 months). Interpretation Mothers participating in the intervention district were more likely to follow optimal breast, although not complementary feeding practices. The program modestly improved linear growth in earlier age and weight gain in late infancy. Comprehensive nutrition and health interventions are complex; the implementation strategies need careful examination to improve feeding practices and thus impact growth. Trial registration The trial was registered with ClinicalTrials.gov, NCT00198835. PMID:28931088

Improving Student Learning via Mobile Phone Video Content: Evidence from the BridgeIT India Project

ERIC Educational Resources Information Center

Wennersten, Matthew; Quraishy, Zubeeda Banu; Velamuri, Malathi

2015-01-01

Past efforts invested in computer-based education technology interventions have generated little evidence of affordable success at scale. This paper presents the results of a mobile phone-based intervention conducted in the Indian states of Andhra Pradesh and Tamil Nadu in 2012-13. The BridgeIT project provided a pool of audio-visual learning…

Troubling Transitions? Young People's Experiences of Growing up in Poverty in Rural Andhra Pradesh, India

ERIC Educational Resources Information Center

Morrow, Virginia

2013-01-01

Global policy attention has begun to focus on young people in developing countries and much of the discourse is framed around notions of "transition to adulthood" based on the idea that individuals develop in linear ways, separate from family and community. This idea has already been widely critiqued in western contexts. This article…

Assessment of Quality of Higher Education in Hostile Environment: An Analysis on Provincialised Colleges under Assam University Silchar

ERIC Educational Resources Information Center

Das, Prasun; Mukherjee, Srabanti; Roy, Suprabir Dutta

2016-01-01

Historically low average pass rate has been a perennial challenge for the universities and provincialised colleges in the North-Eastern states of India (Assam, Meghalaya, Mizoram, Nagaland, Tripura, Manipur and Arunachal Pradesh). Pass rate refers to the proportion of students promoted from one semester to the next and also the proportion of…

Whose Values? Young People's Aspirations and Experiences of Schooling in Andhra Pradesh, India

ERIC Educational Resources Information Center

Morrow, Virginia

2013-01-01

Increasing rates of school enrolment have changed childhoods in the global South, so that it is now the norm for children to attend at least some years of primary school. This paper explores the extent to which valuing of children as educational projects and outcomes may be displacing previous valuations of children as contributors to the domestic…

The Impact of Education on the Economy among the Baiga Tribe in Madhya Pradesh, India: A Brief Note

ERIC Educational Resources Information Center

Jain, A. K.; Sharma, A. N.

2009-01-01

Literacy is a powerful instrument to boost the economy in the form of providing positive attitudes and perceptions that can contribute to an improved daily life. Further, it plays an important role in determining the ecological condition, use and uptake of health-care facilities, awareness of different aspects of socio-religious and taboo…

Assessment of Nutritional Status of Boys and Girls in Government School Children in Rompicherla Mandal Andhra Pradesh, India

ERIC Educational Resources Information Center

Sasikala, P.

2016-01-01

Nutrition is the intake of food to meet the body's dietary needs through different sources namely vegetarian and non-vegetarian foods. Good nutrition and well balanced diet with regular physical activities is acceptable. Poor nutrition leads to reduction in immunity of an individual, on the other hand increased levels of nutrition leads…

Negotiating between Family, Peers and School: Understanding the World of Government School and Private School Students

ERIC Educational Resources Information Center

Sucharita, V.

2014-01-01

The present paper, based on an ethnographic study of a government school and a low-cost private school in Andhra Pradesh, India, argues that the students of a government school and a private school have two different worlds and are socialised differently. As children progress from childhood to adolescence, the transition is accompanied by…

Emergence of swine flu in Andhra Pradesh: Facts and future.

PubMed

Venkataramana, Musturi; Vindal, Vaibhav; Kondapi, Anand K

2009-12-01

Swine flu is a common term representing the respiratory viral infections caused by influenza A virus strain H1N1. This disease was noticed for the first time in Mexico during early 2009, spread worldwide very soon and took nearly 4000 lives. It is observed that this infection is due to an evolved virulent version of previously existing H1N1. The first report of this infection was noticed in a traveler from USA to India at the Hyderabad international airport. Later, because of its highly contagious and fast-spreading nature through air, many people reported to have the infection throughout the country. In Andhra Pradesh, there were 735 officially confirmed cases of which 44 died. These cases were not only from Hyderabad which is the state capital having frequent travelers from abroad but are also reported from different parts of the state. The incidence and mortality rate is less in Andhra Pradesh compared to some of the other Indian states. This raises a question whether the type of the strain is different or genetic features of the population is playing the role in reducing the severity of the disease. In this review we have discussed about the occurrence, spread and mortality of the current H1N1 pandemic. We have also discussed about the current status of research on H1N1 and efforts in the state of Andhra Pradesh.

Seroprevalence of viral and bacterial diseases among the bovines in Himachal Pradesh, India

PubMed Central

Katoch, Shailja; Dohru, Shweta; Sharma, Mandeep; Vashist, Vikram; Chahota, Rajesh; Dhar, Prasenjit; Thakur, Aneesh; Verma, Subhash

2017-01-01

Aim: The study was designed to measure the seroprevalence of viral and bacterial diseases: Infectious bovine rhinotracheitis, bovine viral diarrhea, bovine leukemia, bovine parainfluenza, bovine respiratory syncytial disease, brucellosis, and paratuberculosis among bovine of Himachal Pradesh during the year 2013-2015. Materials and Methods: The serum samples were collected from seven districts of state, namely, Bilaspur, Kangra, Kinnaur, Lahul and Spiti, Mandi, Sirmour, and Solan. The samples were screened using indirect ELISA kits to measure the seroprevalence of viral and bacterial diseases. Results: The overall seroprevalence of infectious bovine rhinotracheitis was 24.24%, bovine viral diarrhea 1.52%, bovine leukemia 9.09%, bovine parainfluenza 57.58%, bovine respiratory syncytial disease 50%, brucellosis 19.69%, and paratuberculosis 9.09% in Himachal Pradesh. The seroprevalence of bovine rhinotracheitis, bovine leukemia, bovine parainfluenza, bovine respiratory syncytial disease, and paratuberculosis in the state varied significantly (p<0.01) while was insignificant for bovine viral diarrhea and brucellosis (p>0.01). Multiple seropositivity has been observed in this study. Bovine parainfluenza virus 3 was observed commonly in mixed infection with almost all viruses and bacteria under study. Conclusion: The viral and bacterial diseases are prevalent in the seven districts of Himachal Pradesh investigated in the study. Therefore, appropriate management practices and routine vaccination programs should be adopted to reduce the prevalence of these diseases. PMID:29391682

Qualitative stability assessment of cut slopes along the National Highway-05 around Jhakri area, Himachal Pradesh, India

NASA Astrophysics Data System (ADS)

Kundu, Jagadish; Sarkar, Kripamoy; Tripathy, Ashutosh; Singh, T. N.

2017-12-01

Several deformation phases in tectonically active Himalayas have rendered the rock masses very complex in terms of structure, lithology and degree of metamorphism. Again, anthropogenic activities such as roads, tunnels and other civil engineering constructions have led to a state of disequilibrium which in many cases, results in failure of rock masses. National Highway-05 around Jhakri area in India is a major connecting route to the China border in the hilly terrains of the state Himachal Pradesh. It cuts through the Himalayan rocks and has a hazardous history of landslides destroying human lives and interrupting communication very frequently. As a contribution towards the mitigation process, a study has been carried out along the highway to analyse kinematic stability and qualitative estimation of rock mass condition through rock mass classification systems. The kinematic analysis shows that the rock slopes are prone to planar and wedge failure. Rock mass rating for most of the locations lies between 7 and 34, representing a poor rock mass quality (Class IV), whereas slope mass rating is more disperse and ranges from 11 to 52 for most of the slopes (Class III, IV and V).

Poverty and development in a marginal community: case study of a settlement of the Sugali Tribe in Andhra Pradesh, India.

PubMed

Kasi, Eswarappa

2011-01-01

The concepts of poverty and development have many meanings in contemporary globalized societies. Development by definition implies desired changes in terms of livelihood, improved quality of life and better access to assets and services, etc. However in reality development programmes sometimes have negative consequences, perhaps unintended, multiplying the acute scarcity of resources and opportunities, or reproducing poverty. Also, the consequences of developmental programmes often appear to be out of focus, and seen at the ground level, there seems to be a gap between what is intended and what is actualized. In this framework, this paper presents a case study of the social, cultural and economic correlates of the development processes in Adadakulapalle, a settlement of Sugali peoples, once a semi-nomadic tribe, in Anantapur District of Andhra Pradesh, South India. The paper shows how factionalism and faction politics affect the implementation of development interventions. It also looks at the poverty in the settlement and focuses on the types of change that people have experienced with the implementation of different schemes by both government and other agencies. The type of change is discussed in the present study through the macro and micro analysis of development programmes.

Limnology and cyanobacterial diversity of high altitude lakes of Lahaul-Spiti in Himachal Pradesh, India.

PubMed

Singh, Y; Khattar, Jis; Singh, D P; Rahi, P; Gulati, A

2014-09-01

Limnological data of four high altitude lakes from the cold desert region of Himachal Pradesh, India, has been correlated with cyanobacterial diversity. Physico-chemical characteristics and nutrient contents of the studied lakes revealed that Sissu Lake is mesotrophic while Chandra Tal, Suraj Tal and Deepak Tal are ultra-oligotrophic. Based on morphology and 16S rRNA gene sequence, a total of 20 cyanobacterial species belonging to 11 genera were identified. Canonical correspondence analysis distinguished three groups of species with respect to their occurrence and nutrient/physical environment demand. The first group, which included Nostoc linckia, N. punctiforme, Nodularia sphaerocarpa, Geitlerinema acutissimum, Limnothrix redekii, Planktothrix agardhii and Plank. clathrata, was characteristic of water with high nutrient content and high temperature. The second group, including Gloeocapsopsis pleurocapsoides, Leptolyngbya antarctica, L. frigida, Pseudanabaena frigida and N. spongiaeforme, occurred in oligotrophic water with high pH and low temperature. The distribution of third group of Cyanobium parvum, Synechocystis pevalekii, L. benthonica, L. foveolarum, L. lurida, L. valderiana, Phormidium autumnale and P. chalybeum could not be associated with a particular environmental condition because of their presence in all sampling sites.

Environmental isotope investigation for the identification of source of springs observed in the hillock on the left flank of Gollaleru Earthen Dam, Andhra Pradesh, India

NASA Astrophysics Data System (ADS)

Noble, J.; Arzoo Ansari, MD

2017-07-01

A hydrometric, hydrochemical and environmental isotopic study was conducted to identify the source and origin of observed springs on the foot of the hillock abutting the left flank of the Gollaleru earthen dam, Nandyal, Andhra Pradesh, India. Water samples (springs, reservoir water and groundwater) in and around the dam area were collected and analyzed for environmental isotopes (δ^{18}!O, δ2H and 3H) and hydrochemistry. Reservoir level, spring discharges and physico-chemical parameters (temperature, electrical conductivity, pH, etc.) were monitored in-situ. Isotopic results indicated that the source of springs is from the Owk reservoir and groundwater contribution to the springs is insignificant. Based on hydrometric observations, it is inferred that the springs might be originated from the reservoir level of 209 m amsl. It is found that the lower spring discharges were derived from diffuse sources (seepage) which could be a mixture of reservoir water and the groundwater, while the relatively higher spring discharges were resulted from concentrated sources (leakage) from the reservoir. Thus, the study portraits the usefulness of isotope techniques in understanding the dam seepage/leakage related problems.

Consumption of junk foods by school-aged children in rural Himachal Pradesh, India.

PubMed

Gupta, Aakriti; Kapil, Umesh; Singh, Gajendra

2018-01-01

There has been an increase in the consumption of junk food (JF) among school-aged children (SAC) possibly leading to obesity and diet-related diseases among them. We do not have evidence on consumption of JF in rural areas; hence, we conducted a study to assess the consumption of JF by SAC in rural, Himachal Pradesh. A total of 425 children in the age group of 12-18 years studying in 30 government schools (clusters) were included. The clusters were selected using population proportionate to size sampling methodology. We found high prevalence (36%) of consumption of JF among SAC during the last 24 h. Efforts should be taken to reduce the consumption of JF by promotion of healthy dietary habits and educating children about the ill effects of JF.

Acidovorax kalamii sp. nov., isolated from a water sample of the river Ganges.

PubMed

Pal, Deepika; Kaur, Navjot; Sudan, Sarabjeet Kour; Bisht, Bhawana; Krishnamurthi, Srinivasan; Mayilraj, Shanmugam

2018-05-01

A Gram-stain-negative, rod-shaped, aerobic, straw yellow, motile strain, designated KNDSW-TSA6 T , belonging to the genus Acidovorax, was isolated from a water sample of the river Ganges, downstream of the city of Kanpur, Uttar Pradesh, India. Cells were aerobic, non-endospore-forming and motile with single polar flagella. It differed from its phylogenetically related strains by phenotypic characteristics such as hydrolysis of urea, gelatin, casein and DNA, and the catalase reaction. The major fatty acids were C16 : 1ω7c/C16 : 1ω6c, C16 : 0 and C18 : 1ω7c/C18 : 1ω6c. Phylogenetic analysis based on 16S rRNA and housekeeping genes (gyrb, recA and rpoB gene sequences), confirmed its placement within the genus Acidovorax as a novel species. Strain KNDSW-TSA6 T showed highest 16S rRNA sequence similarity to Acidovorax soli BL21 T (98.9 %), Acidovorax delafieldii ATCC 17505 T (98.8 %), Acidovorax temperans CCUG 11779 T (98.2 %), Acidovorax caeni R-24608 T (97.9 %) and Acidovorax radicis N35 T (97.6 %). The digital DNA-DNA hybridization and average nucleotide identity values calculated from whole genome sequences between strain KNDSW-TSA6 T and the two most closely related strains A. soli BL21 T and A. delafieldii ATCC 17505 T were below the threshold values of 70 and 95 % respectively. Thus, the data from the polyphasic taxonomic analysis clearly indicates that strain KNDSW-TSA6 T represents a novel species, for which the name Acidovorax kalamii sp. nov. is proposed. The type strain is Acidovorax kalamii (=MTCC 12652 T =KCTC 52819 T =VTCC-B-910010 T ).

Interventions to increase immunisation coverage among children 12–23 months of age in India through participatory learning and community engagement: pilot study for a cluster randomised trial

PubMed Central

Johri, Mira; Chandra, Dinesh; Koné, Georges K; Dudeja, Sakshi; Sylvestre, Marie-Pierre; Sharma, Jitendar K; Pahwa, Smriti

2015-01-01

Objective With the aim of conducting a future cluster randomised trial to assess intervention impact on child vaccination coverage, we designed a pilot study to assess feasibility and aid in refining methods for the larger study. Trial design Cluster-randomised design with a 1:1 allocation ratio. Methods Clusters were 12 villages in rural Uttar Pradesh. All women residing in a selected village who were mothers of a child 0–23 months of age were eligible; participants were chosen at random. Over 4 months, intervention group (IG) villages received: (1) home visits by volunteers; (2) community mobilisation events to promote immunisation. Control group (CG) villages received community mobilisation to promote nutrition. A toll-free number for immunisation was offered to all IG and CG village residents. Primary outcomes were ex-ante criteria for feasibility of the main study related to processes for recruitment and randomisation (50% of villages would agree to participate and accept randomisation; 30 women could be recruited in 70% of villages), and retention of participants (50% of women retained from baseline to endline). Clusters were assigned to IG or CG using a computer-generated randomisation schedule. Neither participants nor those delivering interventions were blinded, but those assessing outcomes were blinded to group assignment. Results All villages contacted agreed to participate and accepted randomisation. 36 women were recruited per village; 432 participants were randomised (IG n=216; CG n=216). No clusters were lost to follow-up. The main analysis included 86% (373/432) of participants, 90% (195/216) from the IG and 82% (178/216) from the CG. Conclusions Criteria related to feasibility were satisfied, giving us confidence that we can successfully conduct a larger cluster randomised trial. Methodological lessons will inform design of the main study. Trial registration number ISRCTN16703097 PMID:26384721

Assessment of eco-environmental geochemistry of heavy metals pollution of the river Gandak, a major tributary of the river Ganga in Northern India

NASA Astrophysics Data System (ADS)

Singh, Harendra; Kushwaha, Alok; Shukla, D. N.

2018-04-01

This study includes a seasonal analysis of sediment contamination of the River Gandak by heavy metals. It passes through the many small, medium and big cities of Uttar Pradesh and Bihar in Indian Territory. To explore the geochemical condition of the streambed sediment of the river, seven heavy metals, namely Co, Cu, Cr, Ni, Cd, Zn and Pb were analyzed. The newly deposited river bed sediment tests gathered on a seasonal basis from five stations for the years 2013-14 and 2014-15. Level of heavy metals in the sediments of the river was measured in the range between 10.54-16.78mg/kg for Co, 6.78-23.97mg/kg for Cu, 16.56-23.17mg/kg forCr, 9.71-18.11mg/kg for Ni, 0.364-1.068mg/kg forCd), 30.54-51.09mg/kg for Zn, 12.21-17.01mg/kg for Pb. Anthropogenic addition of heavy metals into the stream was controlled by utilizing metal Contamination Factor. Geo-accumulation values were found between (0-1) which indicates that sediment was uncontaminated to moderately contaminated, and can adversely influence the freshwater ecosystem of the river. A Good correlation was noted between Co, Zn, Pb, Ni, and Cu. Cluster analysis demonstrated three cluster groups of sites, which indicate that the metals originate from the same source mainly due to natural weathering of rocks, atmospheric deposition, human settlement and agriculture activity and is additionally confirmed by correlation analysis. However, on the basis of contamination indicators, it was found that the stream bed sediment is slightly contaminated with toxic metals. The conditions may harmful in the future because of the fast population growth in the river basin which might bring about irreparable biological harm in the long haul.

Phylogeny of imported and reestablished wild polioviruses in theDemocratic Republic of the Congo from 2006 to 2011.

PubMed

Gumede, Nicksy; Jorba, Jaume; Deshpande, Jagadish; Pallansch, Mark; Yogolelo, Riziki; Muyembe-Tamfum, Jean Jacques; Kew, Olen; Venter, Marietjie; Burns, Cara C

2014-11-01

The last case of polio associated with wild poliovirus (WPV) indigenous to the Democratic Republic of the Congo (DRC) was reported in 2001, marking a major milestone toward polio eradication in Africa. However, during 2006-2011, outbreaks associated with WPV type 1 (WPV1) were widespread in the DRC, with >250 reported cases. WPV1 isolates obtained from patients with acute flaccid paralysis (AFP) were compared by nucleotide sequencing of the VP1 capsid region (906 nucleotides). VP1 sequence relationships among isolates from the DRC and other countries were visualized in phylogenetic trees, and isolates representing distinct lineage groups were mapped. Phylogenetic analysis indicated that WPV1 was imported twice in 2004-2005 and once in approximately 2006 from Uttar Pradesh, India (a major reservoir of endemicity for WPV1 and WPV3 until 2010-2011), into Angola. WPV1 from the first importation spread to the DRC in 2006, sparking a series of outbreaks that continued into 2011. WPV1 from the second importation was widely disseminated in the DRC and spread to the Congo in 2010-2011. VP1 sequence relationships revealed frequent transmission of WPV1 across the borders of Angola, the DRC, and the Congo. Long branches on the phylogenetic tree signaled prolonged gaps in AFP surveillance and a likely underreporting of polio cases. The reestablishment of widespread and protracted WPV1 transmission in the DRC and Angola following long-range importations highlights the continuing risks of WPV spread until global eradication is achieved, and it further underscores the need for all countries to maintain high levels of poliovirus vaccine coverage and sensitive surveillance to protect their polio-free status. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Sickle cell disease in Madhya Pradesh, Central India: A comparison of clinical profile of sickle cell homozygote vs. sickle-beta thalassaemia individuals.

PubMed

Yadav, Rajiv; Lazarus, Monica; Ghanghoria, Pawan; Singh, Mpss; Gupta, Rasik Behari; Kumar, Surendra; Sharma, Ravendra K; Shanmugam, Rajasubramaniam

2016-10-01

The clinical manifestation in sickle cell disease (SCD) patients varies from one individual to another due to factors like the presence of alpha-thalassaemia mutation, foetal haemoglobin, and β-globin gene haplotype. The present study enumerates the clinical profile of sickle cell anaemia patients from Central India. Seven hundred seventy-six SCD patients from Jabalpur and surrounding districts (Madhya Pradesh) in central India were registered with the sickle cell clinic of NIRTH, Jabalpur. The present study reveals recorded signs and symptoms of genetically confirmed sickle cell anaemia (404) and sickle beta thalassaemia (92) patients. Majority of the patients were from scheduled caste communities (47.9%) and Gond tribal community (13.8%). Splenomegaly was the most common clinical manifestation observed (71.4%). Overall, 63.5% patients had a history of blood transfusion. The most frequent signs and symptoms observed were Pallor, Icterus, Joint pain, Fever, and Fatigue. Majority of the patients revealed onset of disease prior to attaining the age of 3 years (sickle cell anaemia 44.3% and sickle beta thalassaemia 35.9%). Mean haemoglobin levels among SCA individuals were marginally higher than SBT patients. On the other hand, mean foetal haemoglobin levels among SBT individuals showed the reverse trend. Notably, the present study reports the first incidence of priapism recorded in Central India. The study revealed a high prevalence of SCD among scheduled caste, backward caste, and tribal communities. Dissemination of study findings, screening, pre-marriage counselling, and pre-natal diagnosis are fundamental to preventing or lowering of birth of sickle cell anaemia children in the affected populations.

Practical observations from an epidemiological investigation of a measles outbreak in a district of India.

PubMed

Mishra, Ashok; Mishra, Subodh; Lahariya, Chandrakant; Jain, Pankaj; Bhadoriya, Rahul S; Shrivastav, Dhiraj; Marathe, Neera

2009-04-01

Measles is a major cause of childhood morbidity and mortality, accounting for nearly half of the morbidity associated with global vaccine preventable diseases. Regular outbreaks of Measles are reported in India, of which only a few are investigated. This study was conducted in the Shivpuri District of Madhya Pradesh (India) to investigate and asses various epidemiological factors associated with measles outbreak. A cross-sectional study was carried out in 30 randomly selected sub-centers in 8 blocks of the Shivpuri District of Madhya Pradesh, covering 212 villages, selected by cluster sampling. The villages, which had reported measles cases, were extensively investigated by the field teams through extensive house-to-house surveys during 12-19 May 2004. A total of 1204 cases with 14 deaths were reported with an attack rate of 6.2% and a case fatality rate of 1.2%. In this study, 17.7% of the cases reported post-measles complications with diarrhea as the most common post measles complication. The routine measles vaccine and Vitamin A supplementation in the area was also less than 30%. The majority of the cases had occurred in the unvaccinated children and in under 5 year old population. There are repeated outbreaks and a long delay in reporting of the cases. The occurrence of cases, in a reasonable proportion of the vaccinated population, points toward the fact that there is a possibility of a vaccine failure in older children. This study calls for an improved surveillance system, an improvement in the cold chain, and enhancements for measles vaccination if India is to achieve the goal of measles elimination.

Reasons for seeking HIV-test: evidence from a private hospital in rural Andhra Pradesh, India.

PubMed

Sivaram, Sudha; Saluja, Gurcharan Singh; Das, Manik; Reddy, P Sudhakar; Yeldandi, Vijay

2008-12-01

This study sought to describe the development of HIV counselling and testing services in a rural private hospital and to explore the factors associated with reasons for seeking HIV testing and sexual behaviours among adults seeking testing in the rural hospital. Data for this study were drawn from a voluntary counselling and testing clinic in a private hospital in rural Andhra Pradesh state in southern India. In total, 5,601 rural residents sought HIV counselling and testing and took part in a behavioural risk-assessment survey during October 2003-June 2005. The prevalence of HIV was 1.1%. Among the two reported reasons for test-seeking--based on past sexual behaviour and based on being sick at the time of testing--men, individuals reporting risk behaviours, such as those having multiple pre- and postmarital sexual partners, individuals whose recent partner was a sex worker, and those who reported using alcohol before sex, were more likely to seek testing based on their past sexual behaviour. Men also were more likely to seek testing because they were sick. The findings from this large sample in rural India suggest that providing HIV-prevention and care services as part of an ongoing system of healthcare-delivery may benefit rural residents who otherwise may not have access to these services. The implications of involving the private sector in HIV-related service-delivery and in conducting research in rural areas are discussed. It is argued that services that are gaining prominence in urban areas, such as addressing male heterosexual behaviours and assessing the role of alcohol-use, are equally relevant areas of intervention in rural India.

Genetic affinity among five different population groups in India reflecting a Y-chromosome gene flow.

PubMed

Saha, Anjana; Sharma, Swarkar; Bhat, Audesh; Pandit, Awadesh; Bamezai, Ramesh

2005-01-01

Four binary polymorphisms and four multiallelic short tandem repeat (STR) loci from the nonrecombining region of the human Y-chromosome were typed in different Indian population groups from Uttar Pradeh (UP), Bihar (BI), Punjab (PUNJ), and Bengal (WB) speaking the Indo-Aryan dialects and from South India (SI) with the root in the Dravidian language. We identified four major haplogroups [(P) 1+, (C and F) 2+, (R1a) 3, (K) 26+] and 114 combinations of Y-STR haplotypes. Analyses of the haplogroups indicated no single origin from any lineage but a result of a conglomeration of different lineages from time to time. The phylogenetic analyses indicate a high degree of population admixture and a greater genetic proximity for the studied population groups when compared with other world populations.

Genetic variation in South Indian castes: evidence from Y-chromosome, mitochondrial, and autosomal polymorphisms

PubMed Central

Watkins, WS; Thara, R; Mowry, BJ; Zhang, Y; Witherspoon, DJ; Tolpinrud, W; Bamshad, MJ; Tirupati, S; Padmavati, R; Smith, H; Nancarrow, D; Filippich, C; Jorde, LB

2008-01-01

Background Major population movements, social structure, and caste endogamy have influenced the genetic structure of Indian populations. An understanding of these influences is increasingly important as gene mapping and case-control studies are initiated in South Indian populations. Results We report new data on 155 individuals from four Tamil caste populations of South India and perform comparative analyses with caste populations from the neighboring state of Andhra Pradesh. Genetic differentiation among Tamil castes is low (RST = 0.96% for 45 autosomal short tandem repeat (STR) markers), reflecting a largely common origin. Nonetheless, caste- and continent-specific patterns are evident. For 32 lineage-defining Y-chromosome SNPs, Tamil castes show higher affinity to Europeans than to eastern Asians, and genetic distance estimates to the Europeans are ordered by caste rank. For 32 lineage-defining mitochondrial SNPs and hypervariable sequence (HVS) 1, Tamil castes have higher affinity to eastern Asians than to Europeans. For 45 autosomal STRs, upper and middle rank castes show higher affinity to Europeans than do lower rank castes from either Tamil Nadu or Andhra Pradesh. Local between-caste variation (Tamil Nadu RST = 0.96%, Andhra Pradesh RST = 0.77%) exceeds the estimate of variation between these geographically separated groups (RST = 0.12%). Low, but statistically significant, correlations between caste rank distance and genetic distance are demonstrated for Tamil castes using Y-chromosome, mtDNA, and autosomal data. Conclusion Genetic data from Y-chromosome, mtDNA, and autosomal STRs are in accord with historical accounts of northwest to southeast population movements in India. The influence of ancient and historical population movements and caste social structure can be detected and replicated in South Indian caste populations from two different geographic regions. PMID:19077280

Dental prosthetic status and prosthetic needs of institutionalised elderly population in oldage homes of jabalpur city, madhya pradesh, India.

PubMed

Deogade, Suryakant C; Vinay, S; Naidu, Sonal

2013-12-01

Oral disorders are cumulative throughout life and hence unfavourable outcomes are likely to be greatest among the elderly. A descriptive cross-sectional study was conducted among institutionalized geriatric population in old-age homes of Jabalpur city, Madhya Pradesh, to assess their prosthetic status and prosthetic needs. A cross-sectional survey was conducted in all the four old-age homes of Jabalpur city, Madhya Pradesh state, India. All residents aged 60 years and above formed the study population. The recording of prosthetic status and prosthetic needs was carried out according to the World Health Organisation (WHO) Oral Health Assessment Form (1997). A total of 224 individuals were included in the study of which 123 were females and 101 were males. Seventy five percent of the females and 55 % of the males had no prostheses in their upper arch and 61 % of the females and 76 % of the males had no prostheses in their lower arch. More number of males presented with 'Bridges' in their upper arch when compared to females (P value = 0.006). Highest prosthetic need in males was multi-unit prosthesis (42 % in upper arch and 41 % in lower arch) whereas, females' required full prosthesis (39 % in both the upper arch and lower arches). Ageing presents some formidable challenges, particularly with the institutionalised. This study clearly demonstrates a high insufficiency of prosthetic care among the institutionalized elderly population. Any preparation towards the provision of oral health care should not be limited to treatment alone but, more importantly focus on empowering this elderly community with information and education programmes.

Mobilising community collectivisation among female sex workers to promote STI service utilisation from the government healthcare system in Andhra Pradesh, India.

PubMed

Parimi, Prabhakar; Mishra, Ram Manohar; Tucker, Saroj; Saggurti, Niranjan

2012-10-01

To assess the association between female sex workers' (FSWs) degree of community collectivisation and self-efficacy, utilisation of sexually transmitted infection (STI) services from government-run health centres in Andhra Pradesh, India. Cross-sectional analyses of 1986 FSWs recruited using a probability-based sampling from five districts of Andhra Pradesh during 2010-2011. Multiple logistic regression models were constructed to assess associations. The independent variables included-collective efficacy, collective agency and collective action-measured using a series of items that assessed the grouping of the community on issues that concern most sex workers. An additional independent variable included FSWs belonging to an area where there was a project partnership with government health centres to provide STI treatment services to FSWs. The outcome indicators included self-efficacy for service utilisation from government health facilities and the treatment for STIs from government health facilities at least once in the past year experience of STI symptoms. Of the 1986 FSWs, nearly two-fifths (39.5%) reported a high level of overall collectivisation (collective efficacy: 89%, collective agency: 50.7%; collective action: 12.7%). Sex workers with a high degree compared with low degree of overall collectivisation were significantly more likely to report high self-efficacy to use government health facilities (75.0% vs 57.3%, adjusted OR 2.5, 95% CI 2.0 to 3.1) and to use government health centres for STI treatment in past 1 year (78.1% vs 63.2%, adjusted OR 2.1, 95% CI 1.6 to 2.8), irrespective of project partnership with government centres. The current research findings reinforce the need for stronger community mobilisation for better utilisation of government health facilities for STI and HIV prevention interventions.

Relationship Between Drinking Water Fluoride Levels, Dental Fluorosis, Dental Caries and Associated Risk Factors in 9-12 Years Old School Children of Nelakondapally Mandal of Khammam District, Andhra Pradesh, India: A Cross-sectional Survey

PubMed Central

Shanthi, M; Reddy, B Vishnuvardhan; Venkataramana, V; Gowrisankar, S; Reddy, B V Thimma; Chennupati, Sireesha

2014-01-01

Background: The present study was conducted to assess the relationship between drinking water fluoride (F) levels, dental fluorosis and dental caries among 9-12 years old school children of Nelakondapally Mandal, Khammam district, Andhra Pradesh. Materials and Methods: A cross-sectional analytical study was conducted on 1500 school children aged 9-12 years, selected by stratified random sampling from different areas with different levels of naturally occurring F in drinking water. The children were assessed for dental fluorosis according to WHO basic survey guidelines. The overall oral health status of the child was assessed by decayed missing filled teeth (DMFT)/dmft index. Statistical analysis was done using mean, standard deviation, standard error, Z-test, ANOVA test, and Chi-square test. Results: The results of the present study revealed that the prevalence of fluorosis was 74.9%. Number of children having dental fluorosis was highest in children who consume water from bore wells. Caries prevalence in the study population was about 56.5%. Caries prevalence and mean DMFT/dmft scores were least in children with optimal F areas and highest in children with below optimal F areas. Conclusion: There was moderate prevalence of fluorosis in Nelakondapally Mandal of Khammam district, and caries prevalence is high in areas below optimal F areas. How to cite the article: Shanthi M, Reddy BV, Venkataramana V, Gowrisankar S, Reddy BV, Chennupati S. Relationship between drinking water fluoride levels, dental fluorosis, dental caries and associated risk factors in 9-12 year old school children of Nelakondapally Mandal of Khammam district, Andhra Pradesh, India: A cross-sectional survey. J Int Oral Health 2014;6(3):106-10. PMID:25083044

Risk factors for diabetic retinopathy: Findings from The Andhra Pradesh Eye Disease Study

PubMed Central

Krishnaiah, Sannapaneni; Das, Taraprasad; Nirmalan, Praveen K; Shamanna, Bindiganavale R; Nutheti, Rishita; Rao, Gullapalli N; Thomas, Ravi

2007-01-01

Objective: To assess prevalence, potential risk factors and population attributable risk percentage (PAR%) for diabetic retinopathy (DR) in the Indian state of Andhra Pradesh. Methods: A population-based study, using a stratified, random, cluster, systematic sampling strategy, was conducted in the state of Andhra Pradesh in India during 1996 and 2000. Participants from 94 clusters in one urban and three rural areas representative of the population of Andhra Pradesh, underwent a detailed interview and a comprehensive dilated ocular evaluation by trained professionals. DR was defined according to the international classification and grading system. For subjects more than or equal to 30 years of age, we explored associations of DR with potential risk factors using bivariable and multivariable analyses. Population attributable risk percent was calculated using Levin’s formula. Results: Diabetic retinopathy was present in 39 of 5586 subjects, an age-gender-area-adjusted prevalence of 0.72% (95% confidence interval (CI): 0.49%–0.93%) among subjects aged ≥ 30 years old, and 0.27% (95% CI: 0.17%–0.37%) for all ages. Most of the DR was either mild (51.3%) or moderate (35.9%) non-proliferative type; one subject (2.6%) had proliferative retinopathy. Multivariable analysis showed that increasing age, adjusted odds ratio (OR); 4.04 (95% CI: 1.88–8.68), middle and upper socioeconomic status group (OR); 2.34 (95% CI: 1.16–4.73), hypertension (OR); 3.48 (95% CI: 1.50–8.11) and duration of diabetes ≥ 15 years (OR); 8.62 (95% CI: 2.63–28.29) were significantly associated with increasing risk of DR. The PAR % for hypertension was 50%; it was 10% for cigarette smokers. Conclusions: Extrapolating the prevalence of diabetic retinopathy in our sample to the Indian population suggests that there may be an estimated 2.77 million people with DR, approximately 0.07 million people with severe DR. As the population demographics change towards aging, this number is likely to increase further. Health care programs in India need to examine strategies to prevent diabetes and DR, as well as create the infrastructure required to manage this condition. PMID:19668525

Risk factors for age-related macular degeneration: findings from the Andhra Pradesh eye disease study in South India.

PubMed

Krishnaiah, Sannapaneni; Das, Taraprasad; Nirmalan, Praveen K; Nutheti, Rishita; Shamanna, Bindiganavale R; Rao, Gullapalli N; Thomas, Ravi

2005-12-01

To assess prevalence, potential risk factors, and population attributable risk percentage (PAR%) for age-related macular degeneration (AMD) in the Indian state of Andhra Pradesh. A population-based study, using a stratified, random, cluster, systematic sampling strategy, was conducted in the state of Andhra Pradesh in India from 1996 to 2000. Participants from 94 clusters in one urban and three rural areas representative of the population of Andhra Pradesh underwent a detailed interview and a detailed dilated ocular evaluation by trained professionals. In this report, the authors present the prevalence estimates of AMD and examine the association of AMD with potential risk factors in persons aged 40 to 102 years (n = 3723). AMD was defined according to the international classification and grading system. Standard bivariate and multivariate analyses were performed to identify the potential risk factors for AMD. PAR% was calculated by Levin's formula. AMD was present in 71 subjects--an age-gender-area-adjusted prevalence of 1.82% (95% confidence interval [CI], 1.39%-2.25%). Risk factors that were significant in bivariate analyses were considered for multivariate logistic regression analysis. Multivariate analysis showed that the adjusted prevalence of AMD was significantly higher in those 60 years of age or older (odds ratio [OR], 3.55; 95% CI, 1.61-7.82) and history of prior cigar smoking (OR, 3.29; 95%CI, 1.42-7.57). Presence of cortical cataract and prior cataract surgery were significantly associated with increased prevalence of AMD (adjusted OR, 2.87; 95% CI, 1.57-5.26 and 3.79; 95% CI, 2.1-6.78), respectively. The prevalence of AMD was significantly lower in light alcohol drinkers (adjusted OR, 0.38; 95% CI, 0.19-0.76) compared with nondrinkers. The PAR% for hypertension and heavy cigar smoking was 10% and 14%, respectively, in this population. The prevalence of AMD in this south Indian population is similar to those reported in other developed countries. Abstinence from smoking may reduce the risk of AMD in this population.

Risk factors for diabetic retinopathy: Findings from The Andhra Pradesh Eye Disease Study.

PubMed

Krishnaiah, Sannapaneni; Das, Taraprasad; Nirmalan, Praveen K; Shamanna, Bindiganavale R; Nutheti, Rishita; Rao, Gullapalli N; Thomas, Ravi

2007-12-01

To assess prevalence, potential risk factors and population attributable risk percentage (PAR%) for diabetic retinopathy (DR) in the Indian state of Andhra Pradesh. A population-based study, using a stratified, random, cluster, systematic sampling strategy, was conducted in the state of Andhra Pradesh in India during 1996 and 2000. Participants from 94 clusters in one urban and three rural areas representative of the population of Andhra Pradesh, underwent a detailed interview and a comprehensive dilated ocular evaluation by trained professionals. DR was defined according to the international classification and grading system. For subjects more than or equal to 30 years of age, we explored associations of DR with potential risk factors using bivariable and multivariable analyses. Population attributable risk percent was calculated using Levin's formula. Diabetic retinopathy was present in 39 of 5586 subjects, an age-gender-area-adjusted prevalence of 0.72% (95% confidence interval (CI): 0.49%-0.93%) among subjects aged >/= 30 years old, and 0.27% (95% CI: 0.17%-0.37%) for all ages. Most of the DR was either mild (51.3%) or moderate (35.9%) non-proliferative type; one subject (2.6%) had proliferative retinopathy. Multivariable analysis showed that increasing age, adjusted odds ratio (OR); 4.04 (95% CI: 1.88-8.68), middle and upper socioeconomic status group (OR); 2.34 (95% CI: 1.16-4.73), hypertension (OR); 3.48 (95% CI: 1.50-8.11) and duration of diabetes >/= 15 years (OR); 8.62 (95% CI: 2.63-28.29) were significantly associated with increasing risk of DR. The PAR % for hypertension was 50%; it was 10% for cigarette smokers. Extrapolating the prevalence of diabetic retinopathy in our sample to the Indian population suggests that there may be an estimated 2.77 million people with DR, approximately 0.07 million people with severe DR. As the population demographics change towards aging, this number is likely to increase further. Health care programs in India need to examine strategies to prevent diabetes and DR, as well as create the infrastructure required to manage this condition.