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Narzary P.K.,Fakir Mohan University | Sharma S.M.,Institute of Health Management Research
Journal of Health, Population and Nutrition | Year: 2013

Although son preference in patrilineal society is an established fact, daughter preference in matrilineal society is not thoroughly examined. Very few studies have been carried out on the issue. This paper attempts to explore the daughter preference and contraceptive-use in matrilineal tribal societies in Meghalaya, India. Data from the National Family Health Survey 1998-1999 have been used in this study because, among the large-scale surveys, only this dataset allows identification of matrilineal sample. Mean, percentage, and standard deviation are computed in the present study. Further, the data have been cross-tabulated, and logistic regression has been run through SPSS (version 15). Among the ever-married matrilineal women, 17% desired more sons than daughters but 18.2% desired more daughters than sons. About 11% of ever-married women could achieve their desired sex composition of children. However, a very striking finding suggests that, even after achieving desired sex composition of children, as high as 61.8% of women were still not using contraception mainly because of programme factors while one-fourth were still depending on temporary methods. The rest 13.2% adopted terminal method of contraception, which calls for immediate attention of planners. With the increase in the number of sons but without daughter, contraceptive-use drastically decreased. The most desired sex composition of children seems to be two daughters and a son. Absence of daughter with increase in the total number of sons increased the desire for additional children. Every woman with two or more sons but without daughter wanted the next child to be a daughter. Thus, there are ample evidences to draw the conclusion that there is, in fact, a daughter preference in the matrilineal tribal societies in Meghalaya, India. Policy-makers may, thus, target the women who have achieved fertility and should ensure that daughter preference does not lead to the negligence to sons. © International Centre for Diarrhoeal Disease Research, Bangladesh.


Sengupta A.,Maastricht University | Sengupta A.,Institute of Health Management Research | Angeli F.,Maastricht University | Syamala T.S.,Institute for Social and Economic Change | And 2 more authors.
Social Science and Medicine | Year: 2015

Evidence from developing countries demonstrates a mixed relationship of overweight/obesity with socioeconomic status (SES) and place of residence. Theory of nutrition transition suggests that over the course of development, overweight first emerges among rich and urban people before spreading among rural and poor people. India is currently experiencing a rapid rise in the proportion of overweight and obese population especially among adult women. Under the backdrop of huge socio-economic heterogeneity across the states of India, the inter-state scenario of overweight and obesity differs considerably. Hence, this paper investigates the evolution over time of overweight and obesity among ever-married Indian women (15-49 years) from selected 'underweight states' (Bihar, Orissa and Madhya Pradesh, where underweight proportion is predominant) and 'overweight states' (Kerala, Delhi and Punjab, where overweight is the prime concern), in relation to a few selected socio-economic and demographic indicators. This study analysed National Family Health Surveys- NFHS-2 (1998-99) and NFHS-3 (2005-06) following Asian population specific BMI cut-offs for overweight and obesity. The results confirm that within India itself the relationship of overweight and obesity with place of residence and SES cannot be generalized. Results from 'overweight states' show that the overweight problem has started expanding from urban and well-off women to the poor and rural people, while the rural-urban and rich-poor difference has disappeared. On the other hand in 'underweight states' overweight and obesity have remained socially segregated and increasing strongly among urban and richer section of the population. The rate of rise of overweight and obesity has been higher in rural areas of 'OW states' and in urban areas of 'UW states'. Indian policymakers thus need to design state-specific approaches to arrest the rapid growth of overweight and its penetration especially towards under-privileged section of the society. © 2015 Elsevier Ltd.


Sodani P.R.,Institute of Health Management Research | Kumar R.K.,Institute of Health Management Research | Srivastava J.,Government of Rajasthan | Sharma L.,Institute of Health Management Research
Indian Journal of Community Medicine | Year: 2010

Objective: The main objective of the study is to measure the satisfaction of OPD (Outpatient Department) patients in public health facilities of Madhya Pradesh in India. Materials and Methods: Data were collected from OPD patients through pre-structured questionnaires at public health facilities in the sampled eight districts of Madhya Pradesh. The data were analyzed using SPSS. Settings: Outpatient Departments of district hospital, civil hospital, community health centre, and primary health centre of the eight selected districts of Madhya Pradesh. Results: A total of 561 OPD patients were included in the study to know their perceptions towards the public health facilities, choosing health facility, registration process, basic amenities, perception towards doctors and other staff, perception towards pharmacy and dressing room services. It was found that most of the respondents were youth and having low level of education. The major reason of choosing the public health facility was inexpensiveness, infrastructure, and proximity of health facility. Measuring patient satisfaction were more satisfied with the basic amenities at higher health facilities compared to lower level facilities. It was also observed that the patients were more satisfied with the behavior of doctors and staff at lower health facilities compared to higher level facilities.


Muralikrishnan K.,Stanley Medical College | Balakrishnan B.,Isha Institute of Inner science and Research | Balasubramanian K.,Stanley Medical College | Visnegarawla F.,Institute of Health Management Research
Journal of Ayurveda and Integrative Medicine | Year: 2012

Background: Beneficial effects of Yoga have been postulated to be due to modulation of the autonomic nervous system. Objective: To assess the effect of Isha Yoga practices on cardiovascular autonomic nervous system through short-term heart rate variability (HRV). Design of the Study: Short-term HRV of long-term regular healthy 14 (12 males and 2 females) Isha Yoga practitioners was compared with that of age- and gender-matched 14 (12 males and 2 females) non-Yoga practitioners. Methods and Materials: ECG Lead II and respiratory movements were recorded in both groups using Polyrite during supine rest for 5 min and controlled deep breathing for 1 minute. Frequency domain analysis [RR interval is the mean of distance between subsequent R wave peaks in ECG], low frequency (LF) power, high frequency (HF) power, LF normalized units (nu), HF nu, LF/HF ratio] and time domain analysis [Standard Deviation of normal to normal interval (SDNN), square of mean squared difference of successive normal to normal intervals (RMSSD), normal to normal intervals which are differing by 50 ms (NN50), and percentage of NN50 (pNN50)] of HRV variables were analyzed for supine rest. Time domain analysis was recorded for deep breathing. Results: Results showed statistically significant differences between Isha Yoga practitioners and controls in both frequency and time domain analyses of HRV indices, with no difference in resting heart rate between the groups. Conclusions: Practitioners of Isha Yoga showed well-balanced beneficial activity of vagal efferents, an overall increased HRV, and sympathovagal balance, compared to non-Yoga practitioners during supine rest and deep breathing.


Lal V.,Institute of Health Management Research
Indian journal of public health | Year: 2010

OBJECTIVES : To describe the pattern of adherence to Highly Active Antiretroviral therapy (HAART) and ascertain the factor(s) associated with nonadherence. This was a cross-sectional, two-site, hospital-based study. The study was undertaken in 2005; as a result of phased roll out of free HAART as part of National AIDS Control Program, patients at Lok Nayak Jai Prakash (LNJP) hospital were receiving free HAART, while patients at All India Institute of Medical Sciences (AIIMS) had to bear out-of-pocket expenses for HAART. Adherence was defined as not having missed even a single pill over the previous 4-day period on self-reporting. Adherence at AIIMS was 47%, whereas it was 90% at LNJP. The difference was statistically significant. Multivariate analysis showed that nonadherence was associated with not having been told about the importance of HAART, having to pay out-of-pocket for HAART and reported continued risk behavior post HAART. With the provision of free HAART, adherence is likely to be high. Emphasis should be given on simultaneous recruitment of counselors, and physicians should be made aware about the need to inquire and counsel patients against continued risk behavior.


Sodani P.R.,Institute of Health Management Research
Indian journal of public health | Year: 2011

The main objective of the study is to identify the availability of infrastructure facility, human resources, investigative services, and facility based newborn care services with respect to Indian Public Health Standards (IPHS) at community health centers (CHC) of Bharatpur District of Rajasthan State. Data were collected from service providers at CHC through well structured questionnaire at thirteen CHCs situated at Bharatpur District of Rajasthan State. It was found that infrastructure facilities were available in almost all the CHCs, but shortage of manpower especially specialists was observed. Availability of investigative services was found quite satisfactory except ECG. It was also observed that none of the CHCs have fully equipped facility based newborn care services (including newborn corner and newborn care stabilization unit). As per IPHS suggested in the revised draft (2010) important deficiencies were revealed in the studied CHCs of Bharatpur district and by additional inputs such as recruiting staff, improving infrastructure facilities, CHCs can be upgraded.


Bhatnagar S.,Institute of Health Management Research
Indian journal of public health | Year: 2012

To develop a prediction model for dengue fever/dengue haemorrhagic fever (DF/DHF) using time series data over the past decade in Rajasthan and to forecast monthly DF/DHF incidence for 2011. Seasonal autoregressive integrated moving average (SARIMA) model was used for statistical modeling. During January 2001 to December 2010, the reported DF/DHF cases showed a cyclical pattern with seasonal variation. SARIMA (0,0,1) (0,1,1) 12 model had the lowest normalized Bayesian information criteria (BIC) of 9.426 and mean absolute percentage error (MAPE) of 263.361 and appeared to be the best model. The proportion of variance explained by the model was 54.3%. Adequacy of the model was established through Ljung-Box test (Q statistic 4.910 and P-value 0.996), which showed no significant correlation between residuals at different lag times. The forecast for the year 2011 showed a seasonal peak in the month of October with an estimated 546 cases. Application of SARIMA model may be useful for forecast of cases and impending outbreaks of DF/DHF and other infectious diseases, which exhibit seasonal pattern.


Mehta S.,Institute of Health Management Research
Journal of Health Management | Year: 2011

Satisfaction has been shown to predict important health-related behaviour, such as adhering to treatment recommendations and maintaining continuity of care. The study resulted in two self-designed standardised questionnaires which were used to evaluate service quality and patient satisfaction. The study has yielded three factors of service quality namely promptness, medical aid and patient interest for service quality and amenities, clinical services and physical services. The study explains that service quality and patient satisfaction are more strongly associated with adherence and continuity of visit; when service quality and patient satisfaction were placed in the regression model, they are positively associated. The findings suggest that service quality and satisfaction level of the patients will be important for improving the outcomes in health care settings. © 2011 Indian Institute of Health Management Research SAGE Publications.


Purohit N.,Institute of Health Management Research | Luna S.,Institute of Health Management Research
The National medical journal of India | Year: 2015

BACKGROUND: The Government of India has been conducting multiskills training programmes to address the shortage of specialized human resources in gynaecology and anaesthesia for maternal and child healthcare. There has been little evaluation of the operation of these programmes, though several years have passed since their introduction.METHODS: We did a cross-sectional study to assess some aspects of the multiskills training programmes in gynaecology and anaesthesia, and the utilization of human resources trained under this scheme in Rajasthan. The analysis was primarily based on a review of records of postings of doctors obtained from the Department of Health and Family Welfare, Government of Rajasthan. Information was also obtained through qualitative interviews with 122 doctors from 14 districts of the state, irrespective of their training status.RESULTS: In 2012, a total of 302 anaesthetists and 480 gynaecologists were posted in various public health facilities in Rajasthan. Of these, 128 (42%) anaesthetists and 69 (14.4%) gynaecologists had received multiskills training. However, only 57% of trained doctors were posted at health facilities for which they were trained. The acceptance of multiskills training among doctors was found to be low.CONCLUSION: Posting and deployment of personnel who had received multiskills training was often inappropriate, leading to suboptimal utilization of the skills acquired during such training and suboptimal delivery of public health services. Accreditation of the multiskills training programmes by regulatory bodies such as the Medical Council of India may improve the acceptance of such training among MBBS doctors and their colleagues. There is a need to review multiskills training programmes. Copyright 2015, NMJI.


PubMed | Institute of Health Management Research
Type: Journal Article | Journal: The National medical journal of India | Year: 2015

The Government of India has been conducting multiskills training programmes to address the shortage of specialized human resources in gynaecology and anaesthesia for maternal and child healthcare. There has been little evaluation of the operation of these programmes, though several years have passed since their introduction.We did a cross-sectional study to assess some aspects of the multiskills training programmes in gynaecology and anaesthesia, and the utilization of human resources trained under this scheme in Rajasthan. The analysis was primarily based on a review of records of postings of doctors obtained from the Department of Health and Family Welfare, Government of Rajasthan. Information was also obtained through qualitative interviews with 122 doctors from 14 districts of the state, irrespective of their training status.In 2012, a total of 302 anaesthetists and 480 gynaecologists were posted in various public health facilities in Rajasthan. Of these, 128 (42%) anaesthetists and 69 (14.4%) gynaecologists had received multiskills training. However, only 57% of trained doctors were posted at health facilities for which they were trained. The acceptance of multiskills training among doctors was found to be low.Posting and deployment of personnel who had received multiskills training was often inappropriate, leading to suboptimal utilization of the skills acquired during such training and suboptimal delivery of public health services. Accreditation of the multiskills training programmes by regulatory bodies such as the Medical Council of India may improve the acceptance of such training among MBBS doctors and their colleagues. There is a need to review multiskills training programmes.

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