IPH now a member of Transdisciplinary University research partnership ecosystem

IPH now a member of Transdisciplinary University research partnership ecosystem

On the 14th of June 2017, Institute of Public Health, Bengaluru signed a memorandum of understanding with the Transdisciplinary University to join a group of 10 other organizations as a member of the TDU research partnership ecosystem. Under this, we will be contributing to the public health and health systems component of learning in the PhD program.
Last date for application is 25th July, link to the call is here

 

Organization of Primary Health Care Services for Diabetes and Hypertension: A qualitative study of public and private, patient and provider perspectives in Rural India

Organization of Primary Health Care Services for Diabetes and Hypertension: A qualitative study of public and private, patient and provider perspectives in Rural India

Speaker

Dorothy Lall

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Affiliation

Institute of Public Health, Bengaluru

Date

9 June 2017

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Time

3:00 – 4:30 PM

Venue

Institute of Public health

#250, 2nd C Main, 2nd C Cross,

Girinagar Ist  Phase,

Bengaluru – 560085

Dorothy Lall will be presenting the findings of the first phase of research that is part of her PhD program. She is studying the organization of health care services for diabetes and hypertension at primary care level to identify ways to improve and strengthen services. These results are not published yet but the manuscript is being developed. In the next phase, we will be implementing and evaluating interventions that address the gaps identified in the first phase of the study.

Title: Organization of Primary Health Care Services for Diabetes and Hypertension; A qualitative study of public and private, patient and provider perspectives in Rural India

Abstract

Background: Diabetes and hypertension have emerged as major public health issues globally. Health systems in low to middle income countries are traditionally designed to deliver services for acute conditions but now are having to deal with chronic diseases like diabetes and hypertension. The Chronic Care Model (CCM) is one of many models that describe how services should be organized to achieve quality of care and good clinical outcomes. In this study, we used the CCM as a framework to understand the current organization of health care services for both diabetes and hypertension in both private and public health care sectors and studied both, patients and provider perspectives.

Methods: This study was designed as a qualitative study and data was collected from patients and providers through in depth interviews. The data was triangulated with findings from observations and facility level assessments. Findings were thematically analyzed using the elements of the chronic care as pre -specified themes.

Results: We found that both private and public health care delivery for diabetes and hypertension are lacking most of the elements of the CCM. The lack of a team approach where tasks are shared to improve quality was evident in both public and private sector. Also, the absence of clinical information systems that could be used to facilitate follow up and coordination of care across health care levels seems to result in patients dropping out of care.

Conclusion: Health care services for diabetes and hypertension are currently organized and delivered within an acute care model of service delivery. An urgent reorganization of health care services is required to respond to the demands of chronic conditions to improve social and clinical outcomes with regard to these conditions.

NCD’s in India: Using a vertical analysis tool to map out the problem

NCD’s in India: Using a vertical analysis tool to map out the problem

This will be an interactive group discussion session led by N Devadasan with the support of Dorothy Lall. We shall identify key issues about NCDs in India from a health systems perspective (not a bio medical perspective). The purpose of the discussion shall be to evolve a position paper on NCDs in India by IPH. Participants (from within IPH or outside) can join together to work on a literature review of current health systems understanding of NCDs and work together on a position paper on NCDs from a systems perspective. The position paper shall also guide future activities of IPH’s work on research and action on NCDs.

j

Affiliation

Institute of Public Health, Bengaluru

Date

12 May 2017

Time

2:30 pm – 4:00 pm

Venue

Institute of Public health

#250, 2nd C Main, 2nd C Cross,

Girinagar Ist  Phase,

Bengaluru – 560085

Law and NCD prevention: 3 case studies and discussion

Law and NCD prevention: 3 case studies and discussion

The talk will begin with an introduction to the Law and NCD Unit at University of Liverpool, followed by a discussion on the role of law in NCD prevention. Three case studies will be shared,

(1) Preventing childhood obesity by restricting unhealthy food marketing

(2) Supporting national laws through international human rights law and

(3) Trade and investment law. There will be discussion and questions.

Speaker

Nikhil Gokani

k

Affiliation

Law and Non-Communicable Diseases Unit Researcher, School of Law and Social Justice University of Liverpool

Date

14-April-2017

Time

3.00 pm – 4.30 pm

Venue

Institute of Public health
#250, 2nd C Main, 2nd C Cross,
Girinagar Ist  Phase,
Bengaluru – 560085

How Training as Community Health Workers Helped These 6 Women Fight Domestic Abuse and Neglect

How Training as Community Health Workers Helped These 6 Women Fight Domestic Abuse and Neglect

Health workers—who are they, and can anybody become health worker? During this World Health Workers Week (April 2 – 8, 2017), Thriveni S. Beerenahally shares some of her experiences, training wonderful women to be community health workers.

 

 

Our work in Kadugondanahalli (KG Halli), Bengaluru started in 2009 with the census of the area. KG Halli is one of the 198 administrative units in the Bengaluru Municipal Corporation area, with a population of over 50,000 living in 0.7 sq. km. of area.

Six married women joined our Urban Health Action Research Project team for data collection. They came with no prior experience, but training helped to learn about data collection. They lacked confidence, and hardly spoke with the researchers in the team.

Later, we considered enrolling them to train as health workers with the project team. The education of the six women varied from Class VI to Class XII. They could speak and write in at least one language. Training these women was challenging, due to the multiple languages (Kannada, Hindi, Tamil) they understood. But the mutual co-operation between themselves helped with cross-translation, to make sure all of them understood what was taught. Training was structured with less classroom teaching and more hands-on training in the field.

Over the years, they got trained by health professionals to become community health workers (CHWs).

As the training progressed, and home visits with the team’s doctors increased, there was a sense of satisfaction for the CHWs on learning new things about health. More than that, there was a sense of pride that they were accompanying doctors during home visits, and were respected equally by the families.

Popular training topics for the CHWs included enhancing soft skills like team building, communication skills, and how to handle challenges while working in the community. There was constant effort during training to bring in the need of the community, and how to be sympathetic and empathetic while interacting with people throughout the training session. As the months progressed, it was evident that the confidence of the women was increasing.

It was visible that they were getting empowered even to tackle their own personal issues.

As the bonding between the CHWs and research team grew, they started sharing their personal problems. That’s when I realized that these women could relate very well with issues in the community, because they came from the same socio-economic background and had similar problems. More than half of the women had the burden of managing the house and kids while their husbands were either unemployed or non-supportive

I also realized some of them were the victims of domestic abuse, and had accepted it as a norm. No word of encouragement, information about their rights and law, or support from researchers helped empower these women to fight against domestic abuse. A famous saying commonly heard in the economically backward strata in India is “Husband is god”, which the victim also believed and thought it was her fate to bear with it.

 

Every time they reported domestic abuse, I used to get frustrated with a sense of helplessness and failure.

However, one incident brought the CHWs together to fight domestic abuse. One lady in the team was beaten up by her husband so badly that she risked losing her vision. That moment was a tipping point for all the women. They came together and stood with her and encouraged her to report to the police, as by then, many attempts by her family had failed to stop the abuse.

That lady’s decision was so courageous, because there was a chance that her family could have disowned her. But she had the confidence to lead life without her husband’s support, which came from her training and the financial stability of her job. This helped her take that step without worrying too much about the consequences of her decision. Sadly, for months, like many Indian women do, she felt guilty of taking her husband to the police station, a stigma in society.

But constant support from the team helped her face the consequences and fight domestic abuse.

When I look back at the journey of the CHWs over the last seven years, I see remarkable change in their personalities, the way they look at the world, and their capacity to deal with personal and professional problems independently. They have a sense of responsibility for the community, and are very sympathetic towards people without judging who they are. They are the last link in the chain reaching the end-users of all health policies. More than anything else, I sense pride, confidence, motivation to bring change, and self-respect in their conduct. This change did not happen overnight. It took many years, and the road was bumpy, but the result was fruitful.

As a researcher, it was great to understand that bringing in change, especially empowering women, is a long and tedious process, and requires dedication and belief. Girls always have a list of things to do or not to do, since their childhoods. According to me, notions like girls as a kid should only play with dolls, kitchen sets, etc., are an indication that when you grow up it’s your responsibility to raise children and manage the kitchen!

When boys play with a kitchen set in Indian families, one can often hear, “You don’t have to learn cooking, and when you grow up, your wife will cook for you!” It takes lot of energy and patience to change the way women look at life, themselves, and the way the community looks at them.

Unlearning what they have heard from childhood is a difficult task.

It’s a proud moment for us to say that now, these women can “empower” other women in the community. Personal experience is always rich and enriching for researchers, and witnessing their journey was great learning for the whole team. Proper training, support, encouragement, and economic independence helped bring in change in these women’s lives. This World Health Worker’s Week, let us celebrate such inspiring people who are an integral part of the healthcare system, and whose efforts often go unnoticed and unappreciated, yet without whom, there would be a large gap between communities and the healthcare system.

(The author is the Director of Sarvagna Health Care Institute, and Adjunct Faculty at the Institute of Public Health, Bengaluru. The blog is about a project by the Institute of Public Health Bangalore in collaboration with local actors.)

Help IPH strengthen Indian health systems by contributing to research, training, and policy support initiatives here.

Disclaimer: This post originally appeared in the Better India on April 12, 2017.