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Mahapatro M.,National Institute of Health and Family Welfare
Indian Journal of Medical Research | Year: 2015

Background & objectives: Inequity in the use of health care services is an important factor affecting the maternal and child survival. In southern Odisha, India, the health indicators remained below compared to the state and national average. This study identifies various equity issues at individual and community levels that influence women’s choice affecting the utilization of maternal health services in a district in southern Odisha. Methods: A qualitative study was carried out in Gajam district, rural region of south Odisha. Ten in-depth interviews were carried out till data saturation with women having less than one year child and 10 focus group discussions with the average eight women in each group having less than five year old child, community and health care providers separately. A total of 120 respondents were included in the study using in-depth interview and focus group discussions. Results: The important determinants in utilization of health care services by women emerging from the study were transportation and financial constraints. In addition, it was found that divergent aetiological concepts and low perceived hospital benefits of the women and community were equally important determinants. Further, community had different perceptions and interpretations of danger signs influencing the risk approach and health care seeking behaviour. Interpretation & conclusions: Our findings show that to increase the utilization of health care services, the grass root health workers should be made aware of specific social determinants of risk, perceptions and preferences. more attention should be given to the transportation system, and its operational feasibility. The husband of the women and the elders of the family should be considered as an important unit of interjection. A more individualized antenatal consultation could be provided by taking into account women’s perception of risk and their explanatory models. © 2015, Indian Council of Medical Research. All rights reserved. Source

Kumar V.,Jawaharlal Nehru University | Misro M.M.,National Institute of Health and Family Welfare | Datta K.,Jawaharlal Nehru University
Journal of Andrology | Year: 2012

In the experimentally cryptorchid rat, spermatogenic arrest is associated with the formation of multinuclear giant cells, leading to large-scale apoptosis and elimination of germ cells from the seminiferous epithelium. Using this model, the role of Hyaluronan Binding Protein 1 (HABP1), which expresses a stage specifically in post-meiotic cells during spermatogenesis, was examined. Cryptorchidism induced complete arrest of spermatogenesis by 2 days, and by 3-5 days many large and small multinucleated giant cells populated the affected tubules. Ultrastructure of the giant cells revealed both single and multiple chromatin aggregation, with some less compact and distorted, and others broken down into tiny fragments. These cells along with other germ cells were stained terminal deoxynucleotidyl transferase dUTP nick-end labeling positive, demonstrating strong expression of Bax and Heat Shock Protein 70. Simultaneously, there was an up-regulation of the proprotein form of HABP1 in these cells and a decrease in the mature form of protein. The above findings indicate a possible role for HABP1 proprotein in apoptosis induction of germ cells in the cryptorchid testes. © American Society of Andrology. Source

Mahapatro M.,National Institute of Health and Family Welfare | Gupta R.N.,Indian Council of Medical Research | Gupta V.,Health Related Information Dissemination Amongst Youth HRIDAY
Indian Journal of Community Medicine | Year: 2012

Background: It is over the last decade that research in this field of domestic violence has led to greater recognition of the issue as public health problem. The paper aims to study the prevalence of physical, psychological, and sexual violence and potential risk factors of the women confronting violence within the home in India. Materials and Methods: A multicentric study with analytical cross-sectional design was applied. It covers 18 states in India with 14,507 women respondents. Multistage sampling and probability proportion to size were done. Results: The result shows that overall 39 per cent of women were abused. Women who have a lower household income, illiterate, belonging to lower caste, and have a partner who drinks/bets, etc. found to be important risk factors and place women in India at a greater risk of experiencing domestic violence. Conclusion: As India has already passed a bill against domestic violence, the present results on robustness of the problem will be useful to sensitize the concerned agencies to strictly implement the law. This may lead to more constructive and sustainable response to domestic violence in India for improvement of women health and wellbeing. Source

Sundararaman T.,National Institute of Health and Family Welfare | Gupta G.,National Institute of Health and Family Welfare
Bulletin of the World Health Organization | Year: 2011

Problem The lack of skilled service providers in rural areas of India has emerged as the most important constraint in achieving universal health care. India has about 1.4 million medical practitioners, 74% of whom live in urban areas where they serve only 28% of the population, while the rural population remains largely underserved. Approach The National Rural Health Mission, launched by the Government of India in 2005, promoted various state and national initiatives to address this issue. Under India's federal constitution, the states are responsible for implementing the health system with financial support from the national government. Local setting The availability of doctors and nurses is limited by a lack of training colleges in states with the greatest need as well as the reluctance of professionals from urban areas to work in rural areas. Before 2005, the most common strategy was compulsory rural service bonds and mandatory rural service for preferential admission into post-graduate programmes. Relevant changes Initiatives under the National Rural Health Mission include an increase in sanctioned posts for public health facilities, incentives, workforce management policies, locality-specific recruitment and the creation of a new service cadre specifically for public sector employment. As a result, the National Rural Health Mission has added more than 82 343 skilled health workers to the public health workforce. Lessons learnt The problem of uneven distribution of skilled health workers can be solved. Educational strategies and community health worker programmes have shown promising results. Most of these strategies are too recent for outcome evaluation, although this would help optimize and develop an ideal mix of strategies for different contexts. Source

Bharti S.,National Institute of Health and Family Welfare | Bharti S.,University of Delhi | Misro M.M.,National Institute of Health and Family Welfare | Rai U.,University of Delhi
Molecular and Cellular Endocrinology | Year: 2014

Quercetin, as a flavonoid, has been recognized to possess dual properties of an oxidant and antioxidant as well. The role of quercetin (QC), as an antioxidant in countering estradiol-3-benzoate (EB) induced adverse effects and germ cell apoptosis in adult rat testis was presently investigated. Adult rats received EB (0.075. mg/rat/5th day) alone or EB. +. QC (15. mg/kg. bw/alternate day) simultaneously for 30. days. Revival of spermatogenesis following QC intervention was associated with a significant restoration in serum and intra-testicular levels of testosterone. Decline in lipid peroxidation and simultaneous improvement in the activities of superoxide dismutase, catalase and glutathione s-transferase were very much evident. Identically, total antioxidant capacity and glutathione demonstrated a marked improvement. QC augmented germ cell survival leading to a decrease in cell apoptosis. Expression of downstream apoptotic markers, caspase-3 and poly-ADP-ribose polymerase (PARP) presented a significant reduction. Down regulation with respect to upstream markers, caspase-8 and -9, Fas, FasL, Bax, and p53 was similarly observed. Taken together, the above findings indicate that with the dose presently used quercetin with its antioxidant and antiestrogenic properties restored testicular function leading to revival of spermatogenesis. It also augmented germ cell survival primarily mediated through downregulation in the expressions of upstream, downstream and other markers in the pathways of metazoan apoptosis. © 2013 Elsevier Ireland Ltd. Source

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