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Does a legal change in women's inheritance rights have long-term effects on child health outcomes? This paper examines the effect of an improvement in women's inheritance rights on child nutritional health outcomes in India using a difference-in-differences estimation approach. We use the staggered implementation of the Hindu Succession (Amendment) Act, 2005 to investigate the impact of the reform on anthropometric indictors of child health: being underweight, stunted, and wasted. The findings of this study reveal that an improvement in women's inheritance rights has a positive impact on children's health and reduces the probability of nutritional deficiency in the child. We identify mechanisms such as increased educational levels, better marital outcomes, and improved intrahousehold bargaining power of women as potential pathways through which inheritance rights affect child nutritional health outcomes. The results of the paper lend credence to growing evidence that legal recognition of women's inheritance rights can have sustained and second-generation effects, in spite of poor enforcement mechanisms and persistence of deep-rooted societal bias against women holding property. [ABSTRACT FROM AUTHOR]

Entertainment-education has been touted as a potent delivery channel for health education campaigns. Yet, there is little evidence of its causal effects. This paper aims to fill the gap in the literature by using a field experiment in India to study two questions on the efficacy of health entertainment-education. First, can health entertainment-education, particularly through films that show role models and draw on emotions, lead to lasting, positive change in health knowledge and behavior? Second, can financial incentives for ex-post health literacy boost the effectiveness of health entertainment-education? The results show that health entertainment-education successfully increased health knowledge (e.g. knowledge about cleanliness and hygiene) by 16 percent. These gains persist almost one year later, although there were no observed impacts on health behaviors. Further, financial incentives do not appear to have any effects. These insights contribute to our knowledge of what works for health education in low-income settings, so that future education campaigns can be crafted with more meaningful impact. [ABSTRACT FROM AUTHOR]

The global rise of populism and concomitant polarizations across disenfranchised and marginalized groups has been magnified by so-called echo chambers, and a major public health crisis like the COVID-19 pandemic has only served to fuel these intergroup tensions. Media institutions disseminating information on ways to prevent the propagation of the virus have reactivated a specific discursive phenomenon previously observed in many epidemics: the construction of a defiled 'Other'. With anthropological lenses, discourse on defilement is an interesting path to understand the continuous emergence of pseudo-scientific forms of racism. In this paper, the authors focus on 'borderline racism', that is the use of an institutionally 'impartial' discourse to reaffirm the inferiority of another race. The authors employed inductive thematic analysis of 1200 social media comments reacting to articles and videos published by six media in three different countries (France, United States and India). Results delineate four major themes structuring defilement discourses: food (and the relationship to animals), religion, nationalism and gender. Media articles and videos portrayed Western and Eastern countries through contrasting images and elicited a range of reaction in readers and viewers. The discussion reflects on how borderline racism can be an appropriate concept to understand the appearance of hygienic othering of specific subgroups on social media. Theoretical implications and recommendations on a more culturally sensitive approach of media coverage of epidemics and pandemics are discussed. [ABSTRACT FROM AUTHOR]

Micronutrient deficiencies, majorly iron, iodine, vitamin-A, pose a serious threat to public health in many developing countries, including India. A surfeit of nutrition and health programs was developed to address micronutrient malnutrition in India, covering many aspects of lifecycle. The importance of nutrition education and communication is emphasized in public health nutrition policies. Concomitantly, there is a surge in various interventional studies with the integration of nutrition education and communication. However, there is a lack of clarity on the overall impact of community level nutrition education/communication interventions on micronutrient (mal)nutrition in India, which may be due to the lack of critical evaluation of the nutrition education/communication components in these studies. Given this background, this article reviews the studies conducted in the last two decades in India. This systematic review identified and analyzed the studies that aimed to use nutrition education and communication as intervention methods to promote micronutrients’ intake and status among various age groups. Using four online databases and systematic library search, research articles published from 1994 to 2016 were collected based on pre-defined inclusion/exclusion criteria. Data on general information, intervention, and key outcome measures were extracted. Inferences from findings of studies were drawn; factors that contributed to the success or failure of the interventions were analyzed by developing a framework. Systematic internet and library search resulted in 1250 published papers. After applying inclusion and exclusion criteria, 19 research papers (with five studies covering nutrition education + supplementation; one study with nutrition education + supplementation + psychosocial intervention and the rest only education/communication) were selected for the review. This paper discusses the contextual factors in the area of intervention, audience targeted, methods of communication used, messages delivered, and outcomes thereof. It suggests that integrated multiple strategies may work and a critical examination is needed to address macro and micro issues of micronutrient-related communication for developing sustainable communication interventions. [ABSTRACT FROM PUBLISHER]

There is an acute shortage of doctors in India, especially in rural areas. It does not even meet WHO's 2008 benchmark of a minimum requirement of 25 healthcare professionals per 10,000 population. The United Nations' Sustainable Development Goals (SDGs) set ambitious targets on maternal and child health and 'health for all' by 2030. The paper aims to critically examine the current and required capacities of training and distribution of doctors in the country to ensure meeting SDGs on maternal and child health and 'health for all' objective by 2030. The study used a simple regression model using the WHO data on 161 countries to estimate the coefficients of the density of physicians, nurses and mid-wives, pharmacists and the percent of child-births attended by skilled health personnel impacting maternal mortality, infant mortality and under-five mortality respectively. The estimated coefficients are used to conjecture the required densities of the above health workers for meeting the SDGs on maternal and child health in India. It is found that to achieve the desired SDG targets, India needs to double its densities of physicians and pharmacists and enhance the childbirths attended by skilled health workers to 100 percent from the current levels by 2030. It also suggests that India needs alternative allopathic practitioners, apart from doctors, mainly for rural areas to ensure 'health for all'. [ABSTRACT FROM AUTHOR]

The objective of the paper is to assess the usefulness of conceptions of different modes of governance for understanding policy outcomes by studying the experience with hierarchical and non-hierarchical governance modes in the health care sector in China, India, and Thailand. The paper shows their experience with non-hierarchical modes to have been largely disappointing and that all three, but especially Thailand, are in the process of reverting to a more hierarchical mode of service delivery. The conclusion from this study is that non-hierarchical governance is not a substitute for or an improvement upon hierarchical governance in health care due to the many market and government failures that afflict the sector and affect the ability of different governance modes to function effectively. The hierarchical mode of government is also imperfect but less so than the alternatives in delivering health care. [ABSTRACT FROM AUTHOR]

This paper examines the relationship of empowerment to women's self-reported general health status and women's self-reported health during pregnancy in low-income communities in Mumbai. The data on which this paper is based were collected in three study communities located in a marginalised area of Mumbai. We draw on two data sources: in-depth qualitative interviews conducted with 66 married women and a survey sample of 260 married women. Our analysis shows that empowerment functions differently in relation to women's reproductive status. Non-pregnant women with higher levels of empowerment experience greater general health problems, while pregnant women with higher levels of empowerment are less likely to experience pregnancy-related health problems. We explain this non-intuitive finding and suggest that a globally defined empowerment measure for women may be less useful that one that is contextually and situationally defined. [ABSTRACT FROM AUTHOR]

This paper examines the wellness effects of yoga retreats on Indian guru-led new religious movements' (NRMs) fellowship. The two-year repeated-measures study included 3658 active followers and 3658 peripheral associates as the comparison group. Two measures assessed wellness: the Flourishing Scale (FS) and the Comprehensive Inventory of Thriving (CIT). Phase 1 scores of both groups were not significantly different. Active followers who attended yoga retreats scored higher at phase 2 on the FS and the CIT than the peripheral associates. Within the active followers' cohort, women, upper class, Hindus and never married/widowed had higher phase 2 FS and CIT scores. Active followers who attended retreats for meditation and reflection, practiced yoga, prayer and personal study during retreats, and regularly maintained the spiritual routine after retreats, acquired several psychological resources and strengths. Hence, active and serious followers of the Indian guru-led NRMs psychologically gain as a result of experiencing yoga retreats. [ABSTRACT FROM AUTHOR]

Abortion laws in India, like other laws, are premised on the 1861 British Penal Code. The Medical Termination of Pregnancy Act was passed in 1971 to circumvent the criminality clause around abortion. Yet the law continues to render invisible women's right to choose. Legal procedures have often hindered in permitting abortion, resulting in the death of a mother or the foetus. Despite the latest techno-medical advances, the laws have remained stagnant or rather restrictive, complicated further by selective female foetus abortions. Legal resistance to abortion-seeking after 20 weeks gestation adversely affects women, depriving them of autonomy of choice. In this paper, raising important gender, health and ethical issues are illustrated through a recent legal case in India. Feminist campaigns against the legal mindset in India are emerging. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including role of philosophical and spiritual values, group drumming as a therapy for young female commercial sex workers in India, and development of a tool to measure music in health promotion.

Three hypotheses dominate the literature on fertility and religion, viz., “particular theological hypothesis” which argues that religious doctrines and ideologies influence contraceptive use and fertility behaviour of different religious groups; “characteristics hypothesis” which argues that differentials in fertility and contraceptive use between majority and minority religious groups are due to socio-economic and demographic factors; and “minority hypothesis” which asserts that minority-group status exerts an independent influence on fertility behaviour. These hypotheses are the subject of discussion in this paper as to how pervasive general explanation can be a limiting factor to contextual studies or local studies and what are the gaps or missing elements in these theories? In this paper, I would like to attempt to show how generalization can be applicable to any religious group in a pluralistic society and propose a “cultural hypothesis” which postulates that religious group differentials in reproductive behaviour may be due to differences in norms, values, and attitudes towards fertility among different religious groups. An empirical part of this paper attempts to explore the role of culture in the reproductive behaviour of Muslim women in Delhi, India. [ABSTRACT FROM PUBLISHER]

The branding of ayurveda as a market strategy for the health consumer has become an important factor in the creation of 'New Age orientalist desire'. Using Vedic Village as a case, this paper shows how new age orientalism has been spread in modern India to middle class professionals, entrepreneurs and overseas health tourists. With this representation, ayurveda has become a wellness therapy instead of a means to restore health, and affluent people can now buy a package of 'ayurvedic healthy life' without changing their lifestyles. In addition to Euro-American health tourists, emerging middle class professionals and entrepreneurs in modern India have also become an integral part of the process of 'new age orientalization'. This paper concludes that the commodijied version of ayurveda, which has been developed in the West as part of 'wellness and spa culture', has become popular among the affluent middle class in India and abroad today, and through this the West has claimed and justifies authority over Eastern medicine. [ABSTRACT FROM AUTHOR]

Evidence on the association between widowhood and health is widely available in the literature. However, there is a dearth of analysis on the mechanism through which widowhood affects the health status of an individual, particularly in old age, specifically whether widowhood among the elderly affects their health through their economic conditions. This paper purports to establish both the direct and indirect effects of widowhood on self-reported health status among aged Indians. We examine the mediating effect of economic factors such as income, labor force participation, extent of economic independence and other economic factors in the relationship between widowhood and health status. Structural Equation Modeling (SEM) is employed to test specific hypotheses. We use unit level 60th round data for the year 2004 surveyed by the National Sample Survey Organization (NSSO). The results confirm that poor economic conditions have a mediating effect on the relationship between widowhood and health and, therefore, any policy to reduce the effect of widowhood on health must be based on economic factors. [ABSTRACT FROM PUBLISHER]

This study conducted a scientometric review on beta thalassemia research using HistCite, BibExcel, and VOS viewer from 2000 to 2019. A total of 10,002 articles were downloaded from the Web of Science core collection database. The study used several quantitative scientometric indicators to measure the performance of the global beta thalassemia research output. The purpose of this review study is to analyze and visualize the state-of-the-art on beta thalassemia in a systematic way. The research findings include research areas, types of documents, authors, journals, institutions, and countries, and how these are linked within the existing body of literature on beta thalassemia. The result reveals that organizations such as Mahidol University and the University of Athens have published numerous articles encouraged by specific R&D funding schemes and made a significant contribution to the development of beta thalassemia research. [ABSTRACT FROM AUTHOR]

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Limited literature exists in India on WhatsApp use for health communication among frontline health workers like Auxiliary Nurse Midwives (ANM). We conducted this study to assess the adoption of WhatsApp among ANMs and identify factors influencing its adoption. In addition, the study explored the perceptions of ANMs on WhatsApp use for sharing health information. We employed a mixed-method sequential explanatory design. We surveyed 259 ANMs, followed by in-depth interviews with 19 purposively sampled ANMs. We conducted multinomial logistic regression to identify factors associated with WhatsApp adoption and employed thematic analysis to analyze interviews. 257 ANMs responded to the survey questionnaire, of which 18.3%, 48.2%, and 33.5% had low, mid, and high levels of WhatsApp adoption, respectively. Education (AOR = 2.87 [95% CI = 1.20–6.85]), motivation (AOR = 6.31 [95% CI = 1.43–27.80]), and technical awareness (AOR = 2.91 [95% CI = 1.11–7.62]) were significantly associated with WhatsApp adoption. Thematic analysis of the interviews resulted in six themes describing perceptions and experiences of ANMs on WhatsApp use. They are: (i) a way of instant communication, (ii) provision for multimedia messaging, (iii) a quick fix tool for queries and concerns, (iv) make attendance and reporting easy (v) a way of reaching higher officials, and (vi) a cost-saving mechanism. WhatsApp facilitated ANMs' communication and service delivery at the grassroots level. Measures to improve motivation, technical awareness, and digital education will likely improve WhatsApp adoption among health workers. [ABSTRACT FROM AUTHOR]

This paper analyses the relationships between economic development, women's social and economic empowerment and reproductive health in rural India using both state- and micro-level data. While previous studies have examined the separate effects of economic development on women's empowerment and reproductive health, and the interrelationships between empowerment and reproductive health indicators, to our knowledge ours is the first to examine the interrelationships among all four variables. Multiple regression analysis of data from 28 states from India's National Family Health Survey (NFHS-3), 2005–2006, shows that both social and economic empowerment are key intervening factors between economic development and reproductive health. Data from 494 women in the micro study from rural Maharashtra in 2007–2008 confirm several of these associations, and demonstrate the added value of women's economic empowerment over social empowerment and broad economic development. Economic empowerment is therefore critical for inducing positive changes in reproductive health for rural Indian women. [ABSTRACT FROM AUTHOR]

An important issue for health policy and planning is the way in which multiple sources of disadvantage, such as class, gender, caste, race, ethnicity, and so forth, work together to influence health. Although 'intersectionality' is a topic for which there is growing interest and evidence, several questions as yet remain unanswered. These gaps partly reflect limitations in the quantitative methods used to study intersectionality in health, even though the techniques used to analyse health inequalities as separable processes can be sophisticated. In this paper, we discuss a method we developed to analyse the intersections between different social inequalities, including a technique to test for differences along the entire span of the social spectrum, not just between the extremes. We show how this method can be applied to the analysis of intersectionality in access to healthcare, using cross-sectional data in Koppal, one of the poorest districts in Karnataka, India. [ABSTRACT FROM AUTHOR]

In Mysore city, the leafy vegetables which grow by the use of sewage water like Spinacia oleracea (Spinach), Trigonella foenum (Fenugreek), Apium graveolens (Cerery), Mentha silvertrisviridis, Coriander sativum (Coriander) and Amaranths viridi are subjected to the analysis of heavy metals like cadmium, chromium, cobalt, copper, lead, nickel and zinc. Among the six vegetables Mentha silvertrisviridis shows more absorption of heavy metals from sewage water followed by Apium graveolens (Cerery), Spinacia oleracea (Spinach), Trigonella foenum (Fenugreek), Amaranths viridi and Coriander sativum (Coriander) in northerns area of the city,where these heavy metals affect both plants and human beings. The details are discussed in this paper. [ABSTRACT FROM AUTHOR]

Resettlement poses several risks to vulnerable urban populations such as slum dwellers in cities like Mumbai in the Third World. The causes for involuntary resettlement in the urban context, such as the expansion of airports, widening roads, or building of commercial complexes, are often unconnected to the lives of those living in slums. Resettlement is associated with economic hardships, disruption of the social fabric, and a feeling of uprootment, alienation and psychological trauma. This paper is based on the findings of an action-research study conducted in a resettled slum community in Mumbai, India that aimed to understand the implications of involuntary resettlement from a human rights perspective. It focuses on the impact of involuntary resettlement on issues concerning women's health. It discusses gender differentials in morbidity patterns and the access to healthcare. It argues that there is a need for integrated planning to ensure an improvement in overall living conditions, which also include provision and access to health services apart from just the mere allocation of alternate housing. [ABSTRACT FROM AUTHOR]

This article is a keynote speech delivered at the 15th International Conference on Social Development at the Hong Kong Polytechnic University in 2007.2 The author points out that one of the misgivings in development today is that many countries consider a higher GDP as the only worthwhile achievement one should go after. However, this economic indicator alone does not and cannot reflect accurately the real improvement of the standard of living of people. In this paper, the author suggests a better measurement for social development and improvement of livelihood should include public health, education, mortality and basic social security. There is no doubt economic development and wealth accumulation can bring certain improvements in daily lives, they should not be elevated to become the ultimate objective for human kind; rather, they are only means to improving life situations. What is more significant should be the pursuit of freedom for humanity. We have witnessed a continuous rise in the indicators measuring development in the developing world, but these increases have not brought commensurate reduction in poverty or advancement in livelihoods in real terms. Furthermore, by using the cases of China and India, the author has illustrated that there is no real connection between economic and social development. Instead better social policies can play a bigger role in advancing social and human development. [ABSTRACT FROM AUTHOR]

Background : Growth parameters are widely used in the assessment of health, nutrition and physical characteristics of a population; however, there still exist uncertainties regarding ethnic variation and the influence of physical activity on growth. Due to the paucity of longitudinal data, the dynamics of the adolescent growth spurt have not been satisfactorily examined in most populations. Aim : The main purpose of this longitudinal study is to present the secular trends in the dynamics of height growth over four decades. In the process, this paper also aims to establish current norms for some biological parameters of growth and to address issues concerning ethnic variation and the effect of childhood physical activity on growth. Methodology : Three hundred and one boys and 235 girls of Indian origin who had been enrolled in the Sri Aurobindo International Centre of Education (SAICE) by age 6 and remained for at least 3 uninterrupted years were divided into four birth cohort periods. Cross-sectional and longitudinal analyses were carried out to derive distance, velocity and acceleration curves. Results : No significant differences were found between ethnic groups in any of the growth parameters. Over the 40-year span of this study, SAICE children prove to be taller than their Indian peers. A significant positive secular trend was seen in the height attained at all velocity turning points over the first two decades. Most pre-pubertal growth parameters in these children resemble those from developed nations. Conclusions : Children from most parts of India have similar genetic growth potential. After a significant positive secular trend in height attained over the first 20 years, the adult height has now plateaued. The significant difference in post-pubertal stature between the current generation and those of European origin indicates a genetic difference. Regular and graded physical activities have a salutary effect on growth. The data provide norms for healthy, active Indian child growing up in a satisfactory environment. [ABSTRACT FROM AUTHOR]

The article discusses the use of social media hashtags by activists in India protesting the proposed taxation of sanitary pads of luxury products. Topics include social and medical consequences of unhygienic menstrual practices in India, the social influence of the activist campaign, and elitist aspects of political campaigning using social media.

This study examined the effect of public spending on education and health sectors on human development in India. Data for the period 1990–2018, obtained from UNDP and World Bank databases, were used. The ARDL model technique was used for data analysis. In the long run, the findings showed that public expenditure on health and education has positive and negative significant effects, respectively, on human development in India. In the short run, results indicated that the public expenditure on health and education has positive and negative respectively insignificant impacts on human development in India. In addition, GDP per capita has been found to have positive but insignificant impact on human development for both long run and short run. The findings of this article suggest that government of India should rise funding for health and education with proper targeting. [ABSTRACT FROM AUTHOR]

Communication about menstrual health continues to be influenced by institutional and social practices which deem it to be unclean and impure. In a country such as India, several customs and traditions reinforce secrecy and shame about menstruation. As such, scholars advocate the need to generate knowledge that can open opportunities to converse on the topic of menstruation and understand issues related to bodily changes. Using a culture-centered approach, this study examined how college-going adult women from two cities in Northern India made sense of menstrual health. Data collection included 20 focus groups with 180 college-going women and interviews with 16 female family members. Participants discussed communication patterns surrounding menstrual health and how they uphold, challenge, and change social practices. Specifically, participants reflected on how they were communicated to about their menstrual health with underpinnings of secrecy and shame and how the influence of current opportunities for openness encourage them to anticipate positive change. Theoretical and practical implications for studying communication around menstruation in diverse cultural contexts are discussed. [ABSTRACT FROM AUTHOR]

We identify individuals who set daily intake budgets and examine if an intervention making people estimate their calorie intake up to a certain point in the day helps those setting daily budgets to regulate their calorie intake for the remainder of the day, after high prior consumption. We conducted an online experiment in five countries: Australia, China, Germany, India, and the UK (n = 3,032) using a 2 (setting calorie budget: yes vs. no, measured) x 2 (intervention: intake reminder vs. control, manipulated) between-subjects design, with the amount of prior consumption measured. Participants were contacted in the afternoon. Those in the intervention condition were asked to estimate their prior calorie intake on that day. We measured the individual characteristics of those who set daily calorie budgets and the intended calorie intake for the remainder of the day. Among people who set daily calorie budgets, the intervention reduced intended calorie intake for the remainder of the day by 176 calories if they had already consumed a high amount of calories that day. A timely intervention to estimate one's calorie intake can lower additional intended calorie intake among those who set daily calorie budget. [ABSTRACT FROM AUTHOR]

We integrate John Rawls' concept of primary goods with self-determination theory, to examine the links between people's perceptions of primary goods (i.e., views of society as providing access to the necessities of a meaningful life), basic psychological needs, and well-being. In Study 1 (N = 762, countries = Australia, the United States, South Africa, India, and the Philippines) and Study 2 (N = 1479, groups = ethnic minority, sexual minority, political group, religious group), we used partial least squares structural equation modelling to assess associations between primary goods' perceptions and wellness, and the intermediary role of basic psychological needs. Across groups, primary goods' perceptions linked positively to well-being (average effect size = 0.48), and negatively to ill-being (average effect size = −0.46), mediated strongly by basic psychological needs (average percentage mediated: 53% Study 1, 68% Study 2). Results signify the importance of primary goods' perceptions to individuals' wellness. [ABSTRACT FROM AUTHOR]

Child malnutrition is remarkably high in India. The problem of food insecurity is also extremely alarming in the country. From a policy perspective, a question of paramount importance in this context is: are these two problems inter-related? Answering this question based on existing literature is difficult. This is because literature examining specifically the effect of food insecurity on child / adolescent malnutrition in India is scarce. Besides, the small number of studies that do examine this question empirically find mixed evidence. In light of this, here we reexamine the effect of food insecurity on child malnutrition using data from the Young Lives survey. Employing several contemporary econometric approaches, we not only estimate the mean effect but also the distributional effects of food insecurity on child malnutrition. We find evidence of sizeable negative average effects of food insecurity on children's anthropometric indices for nutrition surveillance including weight-for-age z score (WAZ) and height-for-age z-score (HAZ). Further, we document important heterogeneity in the effect of food insecurity on children's WAZ and HAZ across the outcome-distributions. Our results suggest that expansion of policies that could effectively reduce household food insecurity is vital to address the problem of malnutrition among Indian children. [ABSTRACT FROM AUTHOR]

Estimation of multi-dimensional welfare measures are gaining popularity. Health is multi-dimensional and efforts to estimate multi-dimensional health inequality are fairly nascent. I estimate inequality in health using a normative index and decompose it into component parts. Inequality increases as health attributes become complementary. Inequalities at the state level as well as by caste and gender, are negatively associated with the level of social and economic development. [ABSTRACT FROM AUTHOR]

India is experiencing a nutrition transition, with sales of packaged and processed foods rapidly increasing in recent years. This study sought to understand the views and experiences of self-help groups about highly processed, packaged food in Visakhapatnam, India, using the Photovoice method. Participants were able to record, reflect on and critique their environments through participatory analysis, identifying key themes, and offering a critical lens on their food environment and experiences. On an average eight and 14 members participated in the Photovoice workshops held in urban and rural Visakhapatnam respectively. The key themes emerging from the photos and text data are that participants experienced highly processed packaged foods as being: 1) democratic (easily available and consumed by all, affordable and accessible; 2) convenient (easy to prepare) and 3) unhealthy (for human consumption and for environmental sustainability). These data demonstrate the challenges facing public health nutritionists in wishing to shift dietary behaviors to healthy habits: on the surface participants acknowledged their unhealthy characteristics, however these products may now be embedded in dietary culture. Traditional methods for changing dietary habits may not be able to capture the complexity and systems approach is required to explore the most effective entry points for affecting change. [ABSTRACT FROM AUTHOR]

India allows abortion up to 20 weeks of pregnancy but places restrictions on abortion facilities and providers. Abortion services are especially deficient in rural areas. Although vacuum aspiration is safer, sharp curettage continues to be used by providers as they lack relevant training. This paper describes the provision of first trimester abortion services using manual vacuum aspiration (MVA) in a rural clinic in the state of Rajasthan over a four-year period. Non-use of anaesthesia increased safety and allowed women to return early to a normal routine. Of 534 women, none suffered major complications; 16 required repeat evacuation and the procedure failed in two. We recommend that models based on MVA and including medical methods be piloted in rural areas of a number of states of the country, to establish the feasibility of delivering first trimester abortion as a primary health service. Ways to increase access to second trimester procedures are also required. Current requirements for certification of private facilities are excessive and the process of obtaining certification is arduous. The law in India does not extend these norms to government facilities, which remain under-equipped and lack trained providers. We recommend that certification of facilities be liberalised and applied equally to government and private institutions. There is also a need to rapidly increase training capacity across the country. L'Inde applique une politique libérale qui permet d'avorter jusqu'à 20 semaines de grossesse. Néanmoins, les services sont particulièrement déficients dans les zones rurales. Bien que l'aspiration manuelle soit plus sûre, le curetage continue d'être utilisé par des prestataires insuffisamment formés. Cet article décrit les services d'avortement par aspiration manuelle pendant le premier trimestre dans un dispensaire rural de l'Etat du Rajasthan sur une période de 4 ans. Le non-recours à l'anesthésie augmentait la sécurité et permettait aux patientes de reprendre rapidement leurs occupations. Sur 534 femmes, on a enregistré peu de complications et aucune complication grave; 18 avaient eu besoin d'une nouvelle évacuation, 16 pour avortement incomplet et 2 pour échec de l'avortement. Nous recommandons que les modèles basés sur l'aspiration manuelle assortis de méthodes médicales fassent l'objet d'une étude pilote dans les zones rurales de plusieurs Etats, pour décider s'il est possible de réaliser des avortements sûrs pendant le premier trimestre dans le cadre des services de santé primaires. Il faut également trouver des moyens d'accroı̂tre l'accès aux procédures pendant le deuxième trimestre. Nous avons constaté que les exigences actuelles pour l'agrément d'équipements privés sont excessives et le processus de demande est complexe. La Loi sur l'interruption médicale de grossesse n'étend pas ces normes aux institutions gouvernementales, qui demeurent sous-équipées et manquent de prestataires formés. Nous recommandons que l'agrément des installations soit libéralisé et s'applique aux institutions publiques et privées. Il faut également rendre obligatoire la formation à l'avortement par aspiration manuelle et électrique et à l'avortement médical pour tous les prestataires concernés dans les instituts de formation. En la India se permite el aborto por diversas razones hasta 20 semanas del embarazo. Sin embargo, los servicios de aborto son especialmente deficientes en las áreas rurales. Aunque la aspiración endouterina es más segura, los proveedores continúan practicando el curetaje por falta de otro tipo de capacitación. Este artı́culo describe la provisión de servicios de aborto en el primer trimestre usando la aspiración manual endouterina (AMEU) en una clı́nica rural en el estado de Rajastan durante un periodo de 4 años. Al eliminar la anestesia, se disminuyeron los riesgos y las mujeres pudieron volver pronto a una rutina normal. De 534 casos, se presentaron pocas complicaciones y ninguna complicación mayor; en 18 casos hubo que repetir la evacuación, 16 por aborto incompleto y 2 por falla del aborto. Se recomienda realizar modelos pilotos basados en AMEU incluyendo métodos médicos en áreas rurales de varios estados a través del paı́s, con el fin de establecer la factibilidad de proveer servicios de aborto sin riesgos en el primer trimestre como un servicio de salud primaria. Habrı́a que buscar además la forma de ampliar el acceso a intervenciones durante el segundo trimestre. Determinamos que los requisitos de certificación vigentes para los establecimientos privados son excesivos y que el trámite es arduo. El Acta MTP no extiende estas normas a las instituciones públicas, las cuales carecen de equipos y de proveedores capacitados. Recomendamos por lo tanto la liberalización de los requisitos de certificación y que estos se apliquen igualmente a instituciones públicas y privadas. Se precisa además exigir que todos los proveedores indicados reciban capacitación en la provisión de la aspiración endouterina tanto eléctrica como manual. [ABSTRACT FROM AUTHOR]

Investigates the factors that contributed to the need for Indian women with sexually transmitted diseases to utilize social networks to cope with their conditions. Link between health and social status; Use of Q-analysis in studying the health-seeking behavior of women.

As per the Paris Accord, India committed to reduce carbon emissions' intensity by 33–35 percent of its economy by 2030 compared to 2005 levels. A variety of sectors emit different intensities of Greenhouse Gases and air pollutants and it is not clear whether Greenhouse Gas reductions may automatically lead to reduced air pollution or the other way round. There are huge health hazards associated with air pollution. In India with its vast population base, it is more important to curb air pollution than to focus more on Greenhouse Gas emissions policies. In our study, we model the impact of the reduction of Greenhouse Gases based on Paris Accord commitments as well as air pollutants in India. From this analysis, we infer the economic mechanisms that determine the potential complementarities and conflicts involved in reducing Greenhouse Gases and air pollutants, and thereby arrive at nuanced policy implications for the environment in India. [ABSTRACT FROM AUTHOR]

Previous research has documented intergenerational transmission of human capital from children to parents. Less is known, however, about heterogeneity in this 'upward transmission' in low-resource settings. We examine whether co-resident adult children's education is associated with improved health among older parents in India, using nationally representative data from the 2014 Indian National Sample Survey. Parents of children with tertiary education had a lower probability of reporting poor health than parents of children with less than primary education. The benefits of children's education persisted after controlling for economic factors, suggesting that non-pecuniary pathways—such as health knowledge or skills—may play an important role. The association was more pronounced among economically dependent parents and those living in the North and West regions. Taken together, our results point to a strong positive association between children's education and parental health, the role of non-pecuniary pathways, and the importance of subnational heterogeneity in India. [ABSTRACT FROM AUTHOR]

Dengue's re-emerging epidemiology poses a major global health threat. India contributes significantly to the global communicable disease burden has been declared highly dengue-endemic, exposing public health authorities to severe challenges. Our study aims to provide a deeper understanding of India's urban dengue surveillance policies as well as to explore the organisation, functioning and integration of existing disease control pillars. We conducted a qualitative regional case study, consisting of semi-structured expert interviews and observational data, covering the urban region of Hyderabad in South India. Our findings indicate that Hyderabad's dengue surveillance system predominantly relies on public reporting units, neglecting India's large private health sector. The surveillance system requires further strengthening and additional efforts to efficiently integrate existing governmental initiatives at all geographical levels and administrative boundaries. We concluded with recommendations for improved consistency, accuracy, efficiency and reduction of system fragmentation to enhance the integration of dengue surveillance and improved health information in urban India. Finally, our study underlines India's overall need to increase investment in public health and health infrastructures. That requires coordinated and multi-level action targeting the development of a competent, effective and motivated public health cadre, as well as truly integrated surveillance and epidemic response infrastructure, for dengue and beyond. [ABSTRACT FROM AUTHOR]

Objectives: To explore ethnic and generational differences in six physical health outcomes and whether these differences can be explained by health-related behaviors and socio-economic status. Design: Multivariate analyses using nationally representative data in 2010–2011 on self-assessed general health, activity-limiting illness, doctor-diagnosed diabetes, doctor-diagnosed high blood pressure, doctor-diagnosed asthma and body mass index from 21,651 White British, 997 Pakistanis, 695 Bangladeshis, 1,126 Indians, 573 Black Caribbeans and 873 Black Africans, adjusted for age, gender, health-related behaviors and socio-economic status. Results: While ethnicity is of great importance in patterning health differences, we find that ethnic differences in activity-limiting illness, diabetes, asthma and body mass index vary across generations. Health-related behaviors and socio-economic status are shown to partly explain ethnic and generational differences in some health outcomes. Conclusions: This study enables a better understanding of more nuanced patterns of ethnic and generational differences in health, highlighting the need to understand ethnicity as a fluid and changing characteristic, and the importance of socio-economic status and health-related behaviors in shaping ethnic differences in certain health outcomes. [ABSTRACT FROM AUTHOR]

We investigate whether there is excess morbidity among daughters of Indian or Chinese immigrants in the US by studying the prevalence of disability among children. We use data from the 2012–14 American Community Surveys on approximately 20,000 US-born children of Indian and Chinese immigrants. Children of US natives are used as a comparison group to account for innate differences in disability between the sexes. Results indicate that there is excess disability among daughters compared with sons among children of Chinese immigrants and children of immigrants from northern or western Indian states; this excess disability declines with younger age at arrival or longer exposure to the host country. Analysis using children of Filipino immigrants as an alternative comparison group yields similar excess disability rates for females. Supplementary material is available for this article at: [ABSTRACT FROM AUTHOR]

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For many years, the concept of gratitude was not considered worthy of investigation by psychologists since research goals were strongly dominated by the deficit-based approach and gratitude concepts were believed to be derived from common sense, and thus not warranting scientific query. This study, in attempting to understand gratitude themes, explores various events that elicit gratitude among engineering students in India. Thirty-two final year engineering students were introduced to gratitude research, administered gratitude exercises, and asked to provide feedback about the exercises. Nested questions, in the form of three-blessings and benefit finding exercises, were used to identify experiences of students leading to gratitude. Content analysis was applied to identify underlying themes and report them systematically. Four major themes and five minor themes were uncovered. Among these, positive emotions was the most prevalent theme and finance was the least encountered theme. Strategies to improve intervention studies, including restricting the area of investigation to one domain and making exercises interesting, have been suggested. Implications of the research within the socio-cultural context have been discussed with special reference to the complexities in separating the sense of duty and gratitude. Further research will provide us with more insights into the topic, specifically from an Indian socio-cultural perspective. [ABSTRACT FROM PUBLISHER]

The contamination of inorganic elements in soil is a serious environmental problem,. The aim of the present study is to investigate concentrations of 19 elements in order to access the extent of their contaminations in the surface soil of hydroelectric catchments, Uttarakhand, India. For analysis, 168 soil samples were divided into eight groups according to altitudes. In soil samples, the concentration levels of Cr and Cu were found more than their background and threshold limit. Moreover, the evaluation of geochemical index (Igeo), enrichment factor (EF), and contamination factor (CF) suggests that soil samples were reasonably contaminated and highly enriched in Rb. The pollution load index (PLI) and degree of contamination (Cd) revealed that the presence of contaminations (PLI: 1.44; Cd: 44.94) in the study site might be a possible health risk for local residents. However, the calculation pollution ecological risk index (PERI) suggests low ecological risk (PERI: 77.61) of these elements. The clustering of sampling groups contained two clusters: the first cluster comprised F1 and F4 while the second cluster consists of the rest of the sampling group. Multivariate statistical analysis revealed that the variation in concentrations of the elements might be a result of agricultural activities and pedological processes. [ABSTRACT FROM PUBLISHER]

Objectives. Our objective is to contribute to the literature regarding the association between immigrant children's health, their ethnicity and their living in neighbourhoods with a high ethnic concentration of one's own ethnicity. Using data from families from five ethnic groups who all immigrated to Vancouver metropolitan region in Canada, our research question asks: How ethnicity, ethnic concentration and living in a neighbourhood with others of the same ethnic background contribute to the health of immigrant children? Design. Two data sets are integrated in our study. The first is the New Canadian Children and Youth Study, which collected original data from five ethnic groups who immigrated to metropolitan Vancouver. The second data set, from which we derived neighbourhood data, is the Canadian census. The dependent variable is health status as reported by the parent. Independent variables are at both the individual and neighbourhood levels, including ethnicity, sex and the percentage of people living in the neighbourhood of the same ethnic background. Analysis was completed using hierarchical linear modelling. Results. Children (n = 759) from 24 neighbourhoods were included in the analyses. Health status varied by ethnicity and ethnic concentration, indicating the heterogeneity of immigrant populations. Conclusion. With the lack of research on the health of immigrant children and youth living in ethnic concentrations, our findings make an important contribution to understanding the influences on the well-being of immigrant populations. [ABSTRACT FROM PUBLISHER]

UNAIDS set an ambitious target of "90-90-90" by 2020. The first 90 being 90% of those HIV-infected will be diagnosed; the second 90 being 90% of those diagnosed will be linked to medical care and on antiretroviral therapy (ART). While there has been dramatic improvement in HIV testing and ART use, substantial losses continue to occur at linkage-to-care following HIV diagnosis. Data on linkage among men who have sex with men (MSM) and people who inject drugs (PWID) are sparse, despite a greater burden of HIV in these populations. This cross-sectional study was conducted in 27 sites across India. Participants were recruited using respondent-driven sampling and had to be ⩾18 years and self-identify as male and report sex with a man in the prior year (MSM) or injection drug use in the prior 2 years (PWID). Analyses were restricted to HIV-infected persons aware of their status. Linkage was defined as ever visiting a doctor for management of HIV after diagnosis. We explored factors that discriminated between those linked and not linked to care using multi-level logistic regression and area under the receiver operating curves (AUC), focusing on modifiable factors. Of 1726 HIV-infected persons aware of their status, 80% were linked to care. Modifiable factors around the time of diagnosis that best discriminated linkage included receiving assistance with HIV medical care (odds ratio [OR]: 10.0, 95% confidence interval [CI]): 5.6-18.2), disclosure of HIV-positive status (OR: 2.8; 95% CI: 2.4-6.1) and receiving information and counseling on management of HIV (OR: 2.3; 95% CI: 1.1-4.6). The AUC for these three factors together was 0.85, higher than other combinations of factors. We identified three simple modifiable factors around the time of diagnosis that could facilitate linkage to care among MSM and PWID in low- and middle-income countries to achieve UNAIDS targets. [ABSTRACT FROM AUTHOR]

Aim: To analyze the profile, etiology, complications, medical and surgical management, and visual outcome among pediatric uveitis patients seen at a referral uveitis clinic in India.Design: Retrospective cohort study, tertiary hospital setting.Methods: Records between January 2007 and April 2010 were reviewed for patients with uveitis who were 0-18 years of age. Uveitis diagnosis was based on SUN criteria; complications, medical and surgical management, and visual outcome were evaluated.Results: Among 190 children with uveitis, 64.2% were boys and 112 had unilateral disease. The median age at presentation was 11 years. Ninety-nine (52%) had anterior, 49 (26%) intermediate, 27 (14%) posterior, and 15 (7.9%) panuveitis. Infectious uveitis was present in 44 patients, of which 21 cases (48%) were posterior uveitis. Parasitic, tuberculous, and viral infectious uveitis was encountered. A total of 174 patients were followed over 315.5 person-years (median = 1.35 years). Seventy-seven (40.5%) children had complications related to uveitis. Forty-six out of 77 complications noted were complicated cataracts. Surgical procedures were done in 46.9% (15%/100 person-years). The visual acuity improved by two Snellen lines in the uveitic eyes, following therapy in 120 children, was stable in 40 children, and worsened in 14 children. Follow-up visual acuity was missing for 16 children.Conclusion: A large proportion of pediatric uveitis cases experienced complications of uveitis, mostly prior to presentation for subspecialty management. These often required surgical management, most commonly to clear the visual axis of cataract for visual rehabilitation and to prevent amblyopia. In most cases, tertiary management was associated with visual improvement. The results suggest that subspecialty management can result in improvement of the clinical course of pediatric uveitis. [ABSTRACT FROM AUTHOR]

Long-distance truck drivers (truckers) in India have been identified as a “high-risk” group for the HIV/AIDS epidemic, and are consequently the targets of prevention and education-based interventions. While such interventions have addressed risk at the level of individual behavior, little attention has been paid to the structural barriers to health for truckers. Research among truckers in India has ignored the economic, social, and cultural context of health. In this article, I employ the culture-centered approach (CCA) to health communication in documenting truckers’ narratives of health, which are innately connected to social and institutional structures around their lives. The data included 36 narrative interviews that I conducted as part of my fieldwork with Indian truckers, in addition to field notes and a reflexive journal. Through a reflexive analysis of these narratives, I present three themes: (a) the everyday violence of trucking, (b) health as sacrifice, and (c) migration and HIV/AIDS. I discuss how communication interventions can attend to the relationship between trucker health and the structural barriers they encounter. [ABSTRACT FROM PUBLISHER]

In India, health inequality, rooted in structural elements of the public healthcare system, is a topic of much concern and discussion in research literature. However, very few articles have approached this persistent problem from a theoretical standpoint. This article addresses this gap by employing the social justice framework of the Health Capability Paradigm (HCP). After critically analyzing some features of the Indian healthcare system, the article argues that some public healthcare system features not only cause health inequalities, but more specifically cause inequities in central health capabilities to avoid escapable diseases and premature death. To address such inequities, the article argues from an HCP perspective that the Indian healthcare system should (a) revise the national health policy's underlying vision of health, (b) reshape its three-tiered public healthcare system to deliver healthcare services to all, and (c) focus on core HCP concepts such as shared health governance and shortfall inequality as guiding principles to provide universal health coverage to all. [ABSTRACT FROM PUBLISHER]

The objective is to examine when patients should switch to second-line antiretroviral therapy (ART) under health uncertainty and in the absence of viral load monitoring. We formalize and solve the therapeutic dilemma about whether or not, and when, to switch a therapy. The model's main value-added consists in the concrete application to patients with HIV in India. In our dynamic stochastic model, health level volatility can be understood as the variation in CD4 count and the trend of health level as increases in CD4 count and, thus, decreases in the incidence of opportunistic infections and mortality. The results of the empirical application suggest that the theoretical model can explain ART treatment switch. Treatment switch depends negatively on the volatility of patients' health, and on trend of health, i.e., the greater the variation in CD4 count and the more CD4 count increase, the fewer treatment switches one expects to occur. Treatment switch also depends negatively on the degree of irreversibility. Under irreversibility, low-risk patients must begin the second-line treatment as soon as possible, which is precisely when the second-line treatment is least valuable. The existence of an option value means that ART first-line regimen may be the better choice when considering lifetime welfare. Conversely, treatment switch depends positively on the discount rate and on the correlation between the patient's health under first- and second-line treatments. This means that treatment switch is likelier to succeed in second-line treatments that are similar to the first-line treatments, implying that a decision-maker should not rely on treatment switch as a risk diversification tool. [ABSTRACT FROM AUTHOR]

Objective To examine the relationships between climate (season, temperature, humidity), lifestyle, health, mood and beliefs and experience of hot flushes and night sweats amongst mid-aged women living in eight urban Indian centers. Methods A total of 717 peri- and postmenopausal women, aged 45-55 years, from urban centers in different regions of India were included. Data were collected during both summer and winter months. Participants completed questionnaires eliciting information about sociodemographics, hot flushes (prevalence, frequency and problem-rating), health and lifestyle (body mass index, diet, exercise, alcohol use), mood (Women's Health Questionnaire) and attributions and beliefs (Menopause Representations Questionnaire). Results The prevalence of vasomotor symptoms was low, with 34% of the sample reporting hot flushes and/or night sweats. Seasonal variation in temperature was not associated with hot flush prevalence, frequency or problem rating. Hot flush prevalence was mainly associated with higher anxiety and intake of spicy foods, frequency with (older) age and (more) frequent exercise, while hot flushes were more problematic for women who reported poorer general health and more negative beliefs about menopause. Conclusions In this study of Indian women, seasonal temperature variation did not appear to influence hot flush reporting. Health, mood, beliefs and lifestyle factors appear to explain some, but not all, of the variance in experience of menopausal symptoms. [ABSTRACT FROM AUTHOR]

Growth hormone (GH) deficiency in children manifests as short stature but is also associated with metabolic disturbances. Paucity of GH is also likely to be associated with increased intima media thickness. Data on body composition (BC) and carotid intima media thickness (cIMT) in children with growth hormone deficiency (GHD) from developing countries are very scarce. Therefore, objectives of present study were to assess effect of 1 year of rhGH therapy on (i) BC and lipid profile (LP) in a cohort of Indian GHD children and (ii) effect on atherosclerotic markers - cIMT in subsample. Anthropometry, BC [% body fat (BF), % lean body mass (LBM), bone mineral content (BMC)] (DXA) and LP were measured in 49 pre-pubertal GHD-children (9.3 ± 3.1 years) at baseline and after 1 year of rhGH therapy. On subset of 20 children, cIMT of right common carotid artery was also measured. Baseline BC parameters were compared with age-gender matched healthy controls ( n = 49). At baseline % BF was 23 ± 9 %, LBM was 9 ± 3 kg and BMC was 0.306 ± 0.15 kg in GHD- children; BF was comparable, while lean and bone were less than controls ( p < 0.05). Post therapy, significant reduction in fat (15%), and cIMT (7%) and increase in LBM and BMC by 40% and 44%, respectively ( p < 0.05) was seen. Our cohort of untreated GHD children had abnormal BC and cIMT as compared to controls. rhGH therapy for 1 year had beneficial effect on BC and cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

The article focuses on the measures that the Indian Ministry of Education undertook in order to adapt and educate the 5000 Tibetan children who in 1950s were exiled in India. The author discusses the problems of these children, including language, poor adaptation to the climate and their overall poor physical and mental condition. Details about the courses at Tibetan schools and educational methods are also provided.

The Calcutta Improvement Trust was set up in 1911 well after the plague scare of 1896, which indicated that there were many overlapping concerns that could not be immediately resolved. The autonomous nature of the Trust indicated that the colonial government distrusted Indians in the elected municipality. But state intervention also brought into focus the question of funding improvements pitching imperial and local governments against each other. The theme of the unhygienic Indian body was prominent among the non-official Europeans in the city and built a consensus for authoritarian reform linking the regulation of spaces to the regulation of bodies in the discourse about Calcutta's planning. [ABSTRACT FROM PUBLISHER]