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Mukherjee S.,Florida International University | Pierre-Victor D.,Florida International University | Bahelah R.,Florida International University | Madhivanan P.,Florida International University | Madhivanan P.,Public Health Research Institute of India
Women and Health | Year: 2014

Incarceration-induced stress makes pregnant women in correctional facilities a high-risk group for mental health problems, resulting in adverse maternal and fetal outcomes. A systematic review was conducted to examine the prevalence and correlates of mental health issues among pregnant inmates. Databases searched included PubMed, Medline, CINAHL Plus, PsycINFO, National Criminal Justice Reference System, Social Work Abstracts, Cochrane and Campbell libraries, which were searched for studies published in English from 1950 till July 2013. Eleven studies were included of pregnant women in correctional facilities and addressed at least one mental illness. Quality score was assigned to these eligible articles. Due to heterogeneity, a narrative review was performed. All of the studies were conducted in the United States, with quality scores ranging from 7 to 10 out of 10. Only one of these studies used mixed methods, the rest were quantitative. Tobacco use among pregnant inmates exceeded 50%, with some studies reporting as high as 84%. Alcohol use was common; 36% of the inmates used illicit drugs in one study. Depression and anxiety levels were high—some studies reported depression among 80% of inmates. Findings suggest that mental health among pregnant prisoners is a huge concern that has not been adequately addressed. ©, Taylor & Francis Group, LLC.

Madhivanan P.,Florida International University | Madhivanan P.,Public Health Research Institute of India | Krupp K.,Public Health Research Institute of India | Reingold A.,University of California at Berkeley
Asia-Pacific Journal of Public Health | Year: 2014

Few studies have examined intimate partner physical violence (IPPV) in south India. This article examines the frequency and correlates of IPPV among 898 young married women from urban, rural, and periurban areas of Mysore, India. Most (69.2%) of the participants were Hindus and 28.7% were Muslims. Overall, 50% of participants reported some type of IPPV. Factors that were independently associated with IPPV included being younger than 18 years at the time of marriage, contributing some household income, having anal sex, reporting sexual violence, and having a sex partner who drinks alcohol and smokes cigarettes. Women with skilled occupation were at reduced odds of experiencing IPPV compared with women who did not work. These findings suggest that IPPV is highly prevalent in this setting and that additional interventions are needed to reduce morbidity particularly among young women. These data also suggest that more studies are needed among men who perpetrate IPPV in south India. © 2011 APJPH.

Adamson P.C.,University of California at San Francisco | Krupp K.,Public Health Research Institute of India | Niranjankumar B.,Public Health Research Institute of India | Freeman A.H.,George Washington University | And 3 more authors.
BMC Public Health | Year: 2012

Background: While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations. Methods. A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery. Results: Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. While increasing numbers of women were accessing antenatal care and delivering in hospitals, large disparities were found in uptake of these services among different castes. Mothers belonging to general castes were almost twice as likely to have an institutional birth as compared to scheduled castes and tribes. Mothers belonging to other backward caste or general castes had 1.8 times higher odds (95% CI: 1.21, 2.89) of having an institutional delivery as compared to scheduled castes and tribes. In multivariable analysis, which adjusted for inter- and intra-village variance, Below Poverty Line status, caste, and receiving antenatal care were all associated with institutional delivery. Conclusion: The results of the study suggest that while the Indian Government has made significant progress in increasing antenatal care and institutional deliveries among rural populations, further success in lowering maternal mortality will likely hinge on the success of NRHM programs focused on serving marginalized groups. Health interventions which target SC/ST may also have to address both perceived and actual stigma and discrimination, in addition to providing needed services. Strategies for overcoming these barriers may include sensitization of healthcare workers, targeted health education and outreach, and culturally appropriate community-level interventions. Addressing the needs of these communities will be critical to achieving Millennium Development Goal Five by 2015. © 2012 Adamson et al; licensee BioMed Central Ltd.

Rathod S.D.,University of California at Berkeley | Krupp K.,Public Health Research Institute of India | Klausner J.D.,University of California at San Francisco | Arun A.,Public Health Research Institute of India | And 2 more authors.
Sexually Transmitted Diseases | Year: 2011

Background: Bacterial vaginosis (BV) and Trichomonas vaginalis (TV) have been estimated to affect one-quarter to one-third of sexually active women worldwide, and are often found concurrently. Few studies have examined this relationship longitudinally to better understand the direction and temporality of this association. Methods: Between 2005 and 2006, a cohort of 853 young, sexually active women was followed in Mysore, India; participants were interviewed and tested for BV and TV at baseline, and at 3- and 6-month visit. Generalized estimating equations were used to estimate how changes in vaginal flora between consecutive visits-as defined by Nugent diagnostic criteria for BV-were related to the risk of TV infection at the latter visit, adjusted for sociodemographic and behavioral covariates. Treatment was offered to women with TV and/or symptomatic BV. Results: After adjustment for covariates, participants with abnormal vaginal flora at 2 consecutive visits had 9 times higher risk of TV (95% CI: 4.1, 20.0) at the latter visit, relative to those with persistently normal flora. An increased risk of TV was also observed for participants whose flora status changed from normal to abnormal (adjusted risk ratio: 7.11, 95% CI: 2.8, 18.2) and from abnormal to normal (adjusted risk ratio: 4.50, 95% CI: 1.7, 11.8). Conclusions: Women experiencing abnormal flora during a 3-month span appear to have significantly increased risk of acquiring TV infection. Women of reproductive age in low-resource settings found to have abnormal vaginal flora should be assessed for TV. Copyright © 2011 American Sexually Transmitted Diseases Association. All rights reserved.

Madhivanan P.,Florida International University | Madhivanan P.,Public Health Research Institute of India | Li T.,Florida International University | Srinivas V.,Public Health Research Institute of India | And 4 more authors.
Preventive Medicine | Year: 2014

Objective: Worldwide, 530,000 women are diagnosed with cervical cancer and 275,000 die annually. India bears the greatest burden of the disease with 132,000 cases and 74,000 deaths yearly. Widespread uptake of human papillomavirus (HPV) vaccine could reduce incidence and mortality by two-thirds. This study explored obstacles and facilitators of parental acceptability of HPV vaccine. Methods: In 2010, questionnaires were sent home with a random sample of 800 girls attending 12 schools in Mysore city to be completed by a parent. Data were analyzed using multivariable logistic regression with generalized estimating equation to account for potential clustering by school. Results: Of the 797 completed surveys; 71% reported willingness to accept HPV vaccine for their daughters. The adjusted odds of acceptance was higher among participants who received recommendation from their parents, perceived cervical cancer as a serious disease, believed that HPV vaccine was safe, or felt that vaccination was a good way to protect against cervical cancer. Parents who had concerns about vaccine side-effects or thought that it would cause pain had lower odds of acceptance. Conclusion: Future promotion of vaccine should emphasize safety of immunization and involve promotion to the extended family, so that they actively recommend immunization of young adolescent girls. © 2014 .

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