International Institute of Health Management Research
Campus of Indian Institute of Health Management Research, Jaipur

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

Funding Agency: ICMR-ICSSR                                               

Team: Preetha G S and BS Singh     

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

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

Funding Agency: DST                                                         

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

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

Motivational factors for acceptance and continuation of PPIUCD and barriers for non-acceptance and discontinuation of PPIUCD: A cross sectional study

Funding Agency: ICMR-ICSSR

Team: BS Singh and Dhananjay Srivastava

With increasing numbers of women electing to give birth in health institutions, the Government of India decided to strengthen PPFP and to introduce PPIUCD services in a phased manner. In spite of all efforts regarding intensification of PPIUCD coverage we still are far away from satisfactory coverage. We planned in our study to find out why most of the population avoids PPIUCD and motivational factors for acceptance of PPIUCD. We will also explore that why female not continuing the PPIUCD for appropriate period to achieve proper spacing i.e. 2 years between delivery and pregnancy. Our study design is cross sectional and participants will be both beneficiaries i.e. female delivered at institution and service providers i.e. doctors, nursing staff and ASHAs as well. Country-level evidence on the post-insertion outcomes will strengthen the effectiveness of IUCD & PPIUCD programs, ultimately contributing to improved health outcomes for women and babies.

The study is proposed to be undertaken at district hospitals, Block primary health centres (PHC), sub health centres (SC), villages and urban wards in nine selected districts of Bihar state i.e Patna, Muzaffarpur, Chhapra, Darbhanga, Saharsa, Purnia, Bhagalpur, Munger and Gaya.

Health Impact of Metro 

Funding Agency: Delhi Metro Rail Corporation

Team: Nitish Dogra, Preetha GS, Pradeep Panda, Vinay Tripathi, Sumant Swain & Sanjiv Kumar (Adviser)

The Metro project has three main objectives. It aims to assess the change in health status for new Metro resulting from physical activity, air quality in transit and health economics metrics. The study is designed as a 6-month before-after study. It aims to study 100 new metro commuters with respect to the above parameters. A screening questionnaire is planned at one metro station to assess the universe of the study. 100 study subjects meeting the inclusion criteria will be drawn by purposive sampling. Further assessment of physical activity and air quality will be done by simulation of the path involving research assistants. Results will be then be modelled for health economics and extrapolated for entire metro system. Results will be validated through additional assessment of physical activity and air quality at selected sites.

Impact of Traffic on Asthma amongst School Children in Delhi

Funding Agency: Central Pollution Control Board

Team: Nitish Dogra and Anandhi Ramachandran

Numerous studies from around the world have established that exposure to traffic causes adverse health effects particularly in children. However, there is limited evidence in the Indian context. This is particularly relevant in Delhi where the problem is compounded by high exposure and multiple sources, traffic being one of them. Thus from scientific, programmatic and policy perspective it is essential to have a large-scale definite study on this subject. The present study involves 6000 schoolchildren in Sarita Vihar ward of South Delhi involving heavy, medium and light traffic sites with schools and residence of children near main road contrasted with schools and residence of children away from main road. Health outcomes of asthma, infections and other allergies will be considered. Assessment will be clinical and physiological with pulmonary function tests. The study will also involve geographic information systems (GIS) in order to systematically delineate exposures and model for impacts at the ward level.

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

Funding Agency:   IIPS, Mumbai

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

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