Public Health Education and Promotion Commons^™

Comparative Analysis Of The Water Crisis In Guam And New Delhi: Evaluating Causes And Potential Solutions, Jordina Marshall

Global Honors Theses

The core topic of this paper will be an examination of a comparative study of the water issue in India, with a particular emphasis on New Delhi, and the water crisis on the island of Guam, with a large amount of focus being placed on an assessment of the possible causes as well as potential remedies. Due to the impact the water problem has on the ecosystem, the welfare of the populace, and the security of their food supply, a solution must be found. There are rising concerns that endangers the health of both of these nations as well as …

Effects Of Covid-19 On Nutrition In Bihar, Unicef, Population Council Institute

Poverty, Gender, and Youth

An extended nationwide lockdown and stoppage of economic activities resulting from COVID-19 caused substantial loss of income for many families in Bihar, India. One of the significant implications is a food shortage in households and a reduction in food intake. This nutrition shock may hit females harder than males due to the deep-rooted gendered culture prevalent in India. This study's key objectives are to understand the extent of food shortage in households, any changes in food intake, and coverage of government nutrition schemes. Half of the households in Bihar reported food shortages in the past month, causing most to reduce …

Are More People Adopting Covid-19 Prevention Measures?, Unicef, Population Council Institute

Poverty, Gender, and Youth

Drawing on data from two rounds of COVID-19 knowledge, attitudes, and practices (KAP) telephone surveys conducted in Bihar, India, this research brief sheds light on the socioeconomic differentials and changes over time in the adoption of COVID-19 preventive measures. Though the adoption of preventive measures has increased, around two-fifths of males and one-quarter of females reported that they were currently practicing all four standard preventive measures. The better educated, wealthier, and those belonging to privileged castes were more likely than others to practice these measures, as were those who perceived moderate or high risk of COVID-19 in their neighborhood. Social …

Awareness Of And Receiving Social Protection Measures During Covid-19 Lockdown In Bihar, India, Unicef, Population Council Institute

Poverty, Gender, and Youth

Economic hardships caused by the nationwide lockdown to prevent the spread of COVID-19 have been reported across India. Social protection measures have been announced by the state and central governments to ease these hardships. The key objectives of this research brief are to examine the awareness and the social protection measures received during the COVID-19 lockdown in Bihar, and the socioeconomic differentials in receiving these measures. The majority of respondents (64%) reported a family member losing their job/income-earning opportunity and lacking resources to survive for long. Awareness of social protection schemes was high (88%). Among households, 68% reported having ration …

Effects Of Covid-19 On Livelihood, Employment, And Financial Resources, Unicef, Population Council Institute

Poverty, Gender, and Youth

COVID-19 and steps to break the chain of viral transmission led to certain economic challenges that triggered loss in livelihoods and income and constraints on financial resources in Bihar, India. Often, these effects were disproportionately experienced among the most marginalized. The key objective of this study is to assess the loss of income, livelihoods, and jobs among households in Bihar to help with program planning and implementation. Data were gathered May 13–22, 2020, from the existing study cohort of households under the UDAYA study. Interviews were conducted with a total of 794 participant households. About four-fifths of respondents said their …

Covid-19 Times: Study Protocol For Rapid Assessment Of The Situation Of Women And Children In Bihar, Unicef, Population Council Institute

Poverty, Gender, and Youth

India reported its first COVID-19 case on January 30, 2020, and numbers began to rise in late March 2020. The containment measures implemented by the national and state governments, particularly the nationwide lockdown, have helped keep the COVID-19 pandemic at a relatively low level in India. Bihar, being one of the poorest states in India, is at particularly high risk of adverse health and economic effects of COVID-19 and the lockdown. The Population Council Institute, in partnership with UNICEF Bihar, is conducting a rapid longitudinal study that aims to inform the design and development of locally relevant suitable response mechanisms …

Returning Home: Effects Of Covid-19 On Migrant Households In Bihar, Unicef, Population Council Institute

Poverty, Gender, and Youth

Many migrants from metropolitan cities in India began to return to their native homes with the rise in COVID-19 cases in the cities and the extension of the lockdown. With relaxation of travel restrictions, Bihar started receiving migrants who were returning home. The government made arrangements for them to be quarantined before they traveled to their villages and homes. The key objectives of this study are to understand the extent of return migration, the impact of lockdown on migrant household livelihoods, and the opportunities for household economic revival through social protection schemes. Among migrant households, about half may experience return …

Demand For And Access To Family Planning Services Among Young Married Women During Covid-19 Crisis, Unicef, Population Council Institute

Poverty, Gender, and Youth

In Bihar, India, as a result of the COVID-19 lockdown and men returning home in large numbers and spending more time at home in high stress conditions, the need for contraceptive services could get greater. March to May are considered the “lean season” when demand is typically low for family planning (FP) programs in states like Bihar. However, higher demand caused by the lockdown and lack of access to health facilities has created a gap between demand and uptake. This could have negative consequences such as high numbers of unintended pregnancies, unsafe abortions, and maternal mortality. Current use of modern …

Self-Help Groups: A Potential Pivot Of Bihar's Response To Covid-19, Unicef, Population Council Institute

Poverty, Gender, and Youth

More than 10 million women in Bihar, India, are members of women’s self-help groups (SHGs), run by the Bihar Rural Livelihoods Promotion Society, Government of Bihar. The SHGs play a crucial role in the community by providing livelihood support and income-generating activities to their members. The key objectives of this study are to document SHG leaders’ engagement in community awareness and infection-prevention activities and the extent of support they give to their members through different funds and loans for livelihoods and income generation during the COVID-19 pandemic. About half of the SHG leaders were engaged in COVID-19–related community-awareness and prevention …

Migration And Covid-19: Uttar Pradesh And Bihar, Population Council Institute

Poverty, Gender, and Youth

To control the spread of COVID-19 in India and to aid the efforts of the Ministry of Health and Family Welfare, the Population Council and other nongovernmental organizations are conducting research to assess residents’ ability to follow sanitation and social distancing precautions under a countrywide lockdown. The Population Council COVID-19 study team is implementing rapid phone-based surveys to collect information on knowledge, attitudes, and practices, as well as needs, among 1,237 young people. As noted in this brief, Uttar Pradesh (UP) and Bihar are two of the highest out-migration states in India. Migration is mostly to metropolitan areas in Delhi, …

Low Perceived Risk: A Challenge To Adoption Of Preventive Behaviors For Covid-19?, Population Council Institute

Poverty, Gender, and Youth

India, with 13,387 cases reported as of April 17, currently accounts for just 0.6% of the COVID-19 cases worldwide. The nationwide lockdown may have helped contain the initial COVID-19 outbreak. However, until testing rates improve, the size of the outbreak remains unclear, and the risk of spread remains. It is critical to ensure ongoing adherence to current social distancing and handwashing behaviours to protect the population from a larger outbreak. An ongoing COVID-19 knowledge, attitudes and practices study implemented by the Population Council Institute in Bihar and Uttar Pradesh sought to assess the extent to which study participants felt personally …

Cultural Factors Associated With Utilization Of Antenatal Care Services In Rural India, Anjali Om

Undergraduate Research Posters

Despite vast economic growth in developing countries in the past few years, infant mortality continues to plague underdeveloped regions, particularly rural regions of India. Many of these deaths are caused by a lack of education and motivation in regard to utilization of antenatal and neonatal care services to prevent and treat consequences of unhygienic umbilical cord care.

For years, high incidences of neonatal tetanus have plagued rural areas of India as a result of cultural practices that encourage topical applications of cow dung to cut umbilical stumps either directly or by using ghee heated with cow dung to warm umbilical …

Why Are There Delays In Seeking Treatment For Childhood Diarrhoea In India?, Nisha Malhotra

Nisha Malhotra

Abstract Aim To examine the barriers and facilitating factors for seeking treatment for childhood diarrhoea and to determine the main causes for delay in seeking treatment.

Methods Data from Indian Demographic and Health survey 2005–06 (NFHS-III) was used. Mothers were asked if their children (<5-years) had suffered from diarrhoea during the two weeks preceding the survey. Data were collected on the time of seeking treatment after start of the illness, and days waited to seek treatment after the diarrhoea started. Multivariate logistic regression analysis was performed to find the determinants of seeking treatment at the health facility and the factors responsible for the “delay” in seeking advice/treatment.

Results Out of a sample of 41,287 children, 3890 (9.4%) reportedly had diarrhoea. Sixty percent of children with diarrhoea were taken to a health facility. Mother's education till higher secondary and above (OR 1.65; 95% CI, 1.08 – 2.54), richest (OR 1.76; 95% CI, 1.24 – 2.48) wealth index, mother's lack of knowledge of oral …

Providers' Attitudes And Practices Regarding Emergency Contraception In India: Key Findings, M.E. Khan, Isha Bhatnagar, Deepthi S. Varma, Anvita Dixit

Reproductive Health

This policy brief reports key findings of a study in India that explored providers’ knowledge of how emergency contraception (ECP) works and its safety and effectiveness, their perceptions of the frequency of repeat use, their provision of ECP, and their attitudes toward women who seek it. Many of the findings of this study are encouraging. Most providers believed that ECP is an effective and safe method to prevent pregnancy and that it cannot induce abortion, and half supported the over-the-counter provision of ECP. Nevertheless, the study revealed many biases and gaps in knowledge. Recommendations include a number of ways to …

Increasing Access To Family Planning And Reproductive Health Services Through Community Work: A Case Study Of A Dual Cadre Model In India, Jaleel Ahmad, Isha Bhatnagar, M.E. Khan

Reproductive Health

Before the introduction of Accredited Social Health Activists (ASHAs) in India, mid-level auxiliary nurse midwives (ANMs) were responsible for community health education and services such as antenatal care, delivery, IUCD insertion, and sterilization referrals. The Population Council studied how community extension work and some primary care responsibilities have been shifted to ASHAs, who are tasked with identifying pregnant women; facilitating ANC check-ups; motivating women for institutional deliveries during ANC checkups; and organizing child immunization. Establishing dual worker cadres in India by shifting community extension tasks from ANMs to local ASHAs has been well conceived. Task shifting has allowed ANMs, as …

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In India: Final Survey Report, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady

Reproductive Health

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECPs) among providers in public and private facilities and pharmacies in India. This study’s objectives were: 1) to assess providers’ knowledge of ECP’s biological mechanism; 2) to understand providers’ knowledge and attitudes about ECP’s safety, effectiveness, and availability as an over-the-counter drug; and 3) to identify providers’ definitions of “repeated use” and profiling of women who are “repeated users” of ECP. The study recommends intervention programs and advocacy strategies to increase knowledge and access to ECP.

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Concerning Emergency Contraception: A Multicountry Study In India, Nigeria, And Senegal, Martha Brady, M.E. Khan, Babatunde A.O. Ahonsi, Babacar Mane, Ian Askew, Saumya Ramarao

Reproductive Health

The Population Council conducted a cross-sectional, descriptive, multicountry study in India, Nigeria, and Senegal aimed at understanding the attitudes, beliefs, and practices of providers and key opinion leaders (KOLs) regarding the provision and use of emergency contraception (ECP). The overarching goal of this study was to investigate and document providers’ attitudes, beliefs, and practices regarding ECP, and to capture the opinions and insights of providers and KOLs on a range of policy and program issues. Findings indicate that many provider-related barriers can be overcome through implementation of targeted interventions such as training and values clarification, whereas other barriers will require …

Key Opinion Leaders' Views Regarding Emergency Contraception In India, M.E. Khan, Isha Bhatnagar, Deepthi S. Varma, Anvita Dixit

Reproductive Health

This policy brief explores the views of key opinion leaders (KOLs) in the field of reproductive health and family welfare on provision of emergency contraception (ECPs). The study’s objective was to gain a better understanding of how the attitudes and beliefs of KOLs might influence policy and program implementation, either encouraging or opposing ECP promotion and service delivery. Results suggest strong support by the majority of KOLs to continue the sale of ECP as an over-the-counter drug. KOLs also emphasized the importance of comprehending and addressing the main barriers to ECP provision and use: poor knowledge, lack of training, moral …

Attitudes, Beliefs, And Practices Of Providers And Key Opinion Leaders On Emergency Contraception In India, M.E. Khan, Deepthi S. Varma, Isha Bhatnagar, Anvita Dixit, Martha Brady

Reproductive Health

The Population Council undertook this study to assess the knowledge, attitudes, and practices regarding emergency contraception (ECP) among providers in public and private facilities and pharmacies in India. The objectives of the study were to: assess providers' knowledge of ECP's biological mechanism; understand providers' knowledge and attitudes about ECP's safety, effectiveness, and availability as an OTC drug; and identify providers' definitions of “repeated use” and profiling women who are “repeated users” of ECP. This study's findings show that most providers, including doctors and some KOLs, were incorrectly informed about ECP's mechanism of action. Service guidelines are necessary for accurate and …

Situation Analysis Of Behavior Change Communication Activities In Bihar: A Step Towards Developing A Comprehensive Bcc Strategy, M.E. Khan, Isha Bhatnagar, Avishek Hazra, Mukesh Kumar

Reproductive Health

A situation analysis undertaken by the Population Council in Bihar, India assessed a number of contributing factors to a behavior change communication (BCC) strategy. Social norms and practices can be changed if appropriate messages are delivered through a combination of communication channels including mass, mid-, and other media, coupled with improved interactions between frontline healthcare workers and target populations at family and community levels. The analysis notes that effective BCC strategy should be measured in terms of actual behavior change. Impact of BCC activities can be measured by immediate outputs and intermediate and final outcomes depending on implementation duration. The …

Increasing Access To Safe Abortion In Rural Maharashtra: Outcomes Of A Comprehensive Abortion Care Model, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Shveta Kalyanwala

Reproductive Health

This assessment of a Comprehensive Abortion Care (CAC) model was conducted by the Population Council on behalf of the Consortium for Safe Abortions in India. The goal of the Consortium is to increase access to legal, safe, and comprehensive abortion services, including post-abortion family planning, in the public health system, and especially among the rural poor. This report describes the CAC model implemented in Aurangabad district, Maharashtra, and examines the extent to which the model improved (a) the availability and quality of abortion services in public sector facilities, and (b) women’s awareness and experiences with regard to abortion services. It …

Shaping Demand And Practices To Improve Family Health Outcomes In Northern India: A Framework For Behavior Change Communication, Population Council

Reproductive Health

An initiative from the Population Council could help in developing a comprehensive communication strategy to improve reproductive, maternal, newborn, and child health, and nutrition outcomes in Uttar Pradesh and other northern states of India. The identification of key barriers to and facilitating factors for selected target behaviors that have a direct bearing on maternal and child health could go a long way in packaging specific messages for different stakeholders, such as women, husbands, elder family members, opinion makers in the community, and frontline health workers. One of the key deliverables of this publication is to fill an important knowledge gap …

Increasing Access To Safe Abortion In Rural Rajasthan: Outcomes Of A Comprehensive Abortion Care Model, Shireen J. Jejeebhoy, A.J. Francis Zavier, Rajib Acharya, Shveta Kalyanwala

Reproductive Health

This report describes an assessment by the Population Council of the Comprehensive Abortion Care (CAC) model implemented in Tonk district, Rajasthan. Findings highlight that at the time of the baseline survey, the availability of abortion services was limited; also evident was the poor quality of abortion-related care. Given this context, and given the short duration of implementation, the changes achieved by the intervention are promising. The district-level CAC model succeeded in strengthening facilities, training providers, and increasing women’s access to safe abortion services at the Primary Health Centre level. Community-level activities were less successful, attributable to a considerable extent to …

Expanding Access To Safe Abortion And Post-Abortion Care: Recommendations Of A South Asia Regional Consultation, Population Council

Reproductive Health

A South Asia Regional Consultation, organized by the Population Council with representation from governments and key stakeholders of Bangladesh, India, Nepal, and Pakistan, was held in New Delhi, to discuss ways of expanding women’s access to safe abortion services. The Consultation deliberated on ways of expanding the provider base for safe induced abortion so as to overcome inadequate and inequitable access to safe abortion. They also looked to expand access to services for the management of incomplete abortion and complications of unsafe abortion that persist in the region and, thereby, to reduce morbidity and mortality resulting from unsafe abortion. In …

Migration And Hiv In India: Study Of Select Districts, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Alka Narang, Umesh Chawla

HIV and AIDS

Report of a study assessing the important role of migration in the spread of HIV in districts with high out-migration in India. The study suggests a considerable spread of HIV linked to migrants’ extramarital sexual behaviors, and subsequent delay in treatment for infected spouses. In order to control the spread of HIV, the study provides programmatic recommendations made by the study participants and the counselors from ICTCs and ART centers. These suggestions include village-level mapping of at-risk persons, mainstreaming HIV prevention interventions within current health resources, improving various village level HIV prevention programs, and involving women left behind by migrant …

Hiv Transmission Among Married Men And Women In Districts With High Out-Migration In India: Study Brief, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Umesh Chawla, Alka Narang

HIV and AIDS

This brief describes a study examining the links between male out-migration and HIV transmission among married men and women and other mechanisms by which HIV is transmitted within marital relationships in districts with high out-migration.

Increasing Institutional Delivery And Access To Emergency Obstetric Care Services In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative in rural Uttar Pradesh (UP), India to determine the impact of the Janani Suraksha Yojana (JSY) scheme on the current status of institutional delivery in the region, to understand the facilitating factors and barriers in delivering in a health facility, and to identify programmatic and behavior change communication (BCC) initiatives that could accelerate the adoption of institutional delivery. JSY was launched as an intervention to address the barriers to institutional delivery, through the introduction of community-based women volunteers. The study shows that with the introduction of the JSY the rate of institutional delivery jumped …

Future Demands For Services From Public Health Facilities In Uttar Pradesh, Population Council

Reproductive Health

A Population Council-led consortium in India conducted a study to assess (a) the expected workload of public health facilities, and (b) the extent to which the demand for contraception could be met by the existing health facilities in Uttar Pradesh, following the implementation of behavior change communication (BCC) activities. This policy brief recommends that BCC efforts create demand for services and address perceptions that it is “not necessary” to access health care services. BCC must play a greater role in motivating women to move to facilities not just for institutional delivery but for other services as well. BCC can also …

Increasing Early And Exclusive Breastfeeding In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to determine the current status of early and exclusive breastfeeding, understand the facilitating factors and barriers in adopting the desired breastfeeding practices, and identify programmatic and behavior change communication (BCC) initiatives to promote the practice. Findings indicate that efforts by Primary Health Centre staff to counsel and encourage women to breastfeed early could significantly increase adoption of this practice. The policy brief identifies barriers that reflect a lack of knowledge and misperceptions about breastfeeding, but finds that education, supportive family members, and knowledgeable health workers can facilitate breastfeeding. …

Increasing Complete Immunization In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to determine the current rate of compliance for recommended schedules of child immunization, identify the barriers and factors facilitating the uptake of full immunization, and identify behavior change communication (BCC) initiatives that could accelerate adoption of this practice. This policy brief identifies a number of barriers to immunization: low risk perception, lack of faith in vaccines, lack of knowledge about vaccines, fear of side effects, lack of family support, and lack of knowledge about location and type of services available. The brief also identifies several facilitating factors and …