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Publications

Filtering by Category: IIHMR

Children of an Uncertain Climate

Future Health Systems

The FHS India team have produced a new film titled Children of an Uncertain Climate, based on an FHS study titled ‘Decoding Child Health Impact under Climate Crisis.’ This short film identifies the pathways by which Climate Change is impacting the child health in Indian Sundarbans – a climatically vulnerable setting.

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Climate change: a threat to child food security in the Indian Sundarbans

Future Health Systems

The Sundarbans, the mangrove forest delta shared both by India and Bangladesh, is among the worst hit regions of climate change in the world. Even though food insecurities due to climate change are felt across the region, the distribution of vulnerabilities is largely uneven depending upon existing climatic and social intersections.

Within the context of socio-cultural and political dynamics, and rapid globalization, efforts to respond to, mitigate, or adapt to climate change needs to address issues of equity and social justice, posing both challenges and opportunities.

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In from the cold: Shifting the discourse on informal providers in Bangladesh and India

Future Health Systems

In Bangladesh and India, informal healthcare providers (IHPs) have long been part of the countries’ health systems. However, formal recognition of their existence is sensitive, partly due to resistance and concern from professional health bodies. Research by Future Health Systems (FHS) partners ICDDR,B and IIHMR has been instrumental in bringing the issues to discussion tables. Consequently, stakeholders have begun to recognize and work with IHPs – something previously unheard of.

Are Women of the Indian Sundarbans Living in the Dark?

Future Health Systems

World-wide, women experience a higher burden of visual impairments than men, and this increases with age. This short film from the FHS India team - based on research by IIHMR University, FHS and RinGs - highlights the gendered dimension of seeking eye health care in the Indian Sundarbans - a climatically vulnerable setting.

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Geo-climatically Vulnerable Sundarbans: A social network analysis of mother’s social ties and child care

Future Health Systems

Ghosh U, Bose S, Bramhachari R (2017) Geo-climatically Vulnerable Sundarbans: A social network analysis of mother’s social ties and child care, International Journal for Population, Development and Reproductive Health, Volume 1, Issue 1, pp. 27 - 41

Present paper explores mother's individual and system level social ties to support in taking care of children in resource scarce setting of the Indian Sundarbans. Climatic uncertainties resulted in male out-migration in search of alternative livelihoods leading towards female-headed households. Women now face triple burden of works – livelihood, household chores and childcare. Hence it is pertinent to know how and to what extent social ties support child care in female headed households in comparison to male headed households.

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Climate change: health effects and response in South Asia

Future Health Systems

Sen B, Dhimal M, Latheef AT and Ghosh U (2017) Climate change: health effects and response in South Asia, BMJ, 359, doi: 10.1136/bmj.j5117

The 2015 Lancet Commission on Health and Climate Change concluded that although climate change was the biggest public health threat of the 21st century, tackling it could be the greatest global health opportunity. All South Asian countries have ratified the Paris agreement, committing to monitor and reduce greenhouse gas emissions and develop systems to respond to the effects of climate change. However, climate change is not yet given priority in countries’ health agendas. The effect on the poorest and most vulnerable in society is also often neglected in the climate change discourse.

The authors examine the health effects of climate change in South Asian countries and current strategies to address these, and recommend an inclusive approach to climate change adaptation planning in the region.

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Measuring spatial equity and access to maternal health services using enhanced two step floating catchment area method (E2SFCA) – a case study of the Indian Sundarbans

Future Health Systems

Vadrevu L and Kanjilal B (2016) Measuring spatial equity and access to maternal health services using enhanced two step floating catchment area method (E2SFCA) – a case study of the Indian Sundarbans, International Journal for Equity in Health, 15: 87, doi:10.1186/s12939-016-0376-y

Inaccessibility due to terrain and lack of transport leaves mothers travelling for long hours before reaching a facility to deliver a child. In the present article we analyzed the issue of spatial inaccessibility and inequity of maternal health services in the Indian Sundarbans where complex topography and repeated climatic adversities make access to health services very difficult.

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Expressing collective voices on children’s health: photovoice exploration with mothers of young children from the Indian Sundarbans

Future Health Systems

Ghosh U, Bose S, Bramhachari R and Mandal S (2016) Expressing collective voices on children’s health: photovoice exploration with mothers of young children from the Indian Sundarbans, BMC Health Services Research, 16:1866, DOI: 10.1186/s12913-016-1866-8

The Indian Sundarbans is marked by inhospitable terrain and frequent climatic shocks which jointly hinder access to health care. Community members, and women in particular, have few means to communicate their concerns to local decision makers. Photovoice is one way in which communities can raise their local health challenges with decision makers. This study unlocks mothers’ voices on the determinants of their children’s health to inform local level decision-making on child health issues in the Indian Sundarbans.

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How is perceived community cohesion and membership in community groups associated with children’s dietary adequacy in disadvantaged communities? A case of the Indian Sundarbans

Future Health Systems

Barman D and Vadrevu L (2016) How is perceived community cohesion and membership in community groups associated with children’s dietary adequacy in disadvantaged communities? A case of the Indian Sundarbans, BMC Health Services Research, 16:1862, DOI: 10.1186/s12913-016-1862-z

Membership in community groups and a sense of community cohesion may facilitate collective action in mobilizing resources towards better health outcomes. This paper explores the relationship of these factors, along with individual level socio-economic variables, to dietary adequacy among children below 6 years of age, a proximate determinant of child malnutrition.

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Unlocking community capabilities across health systems in low- and middle-income countries: lessons learned from research and reflective practice

Future Health Systems

George AS, Scott K, Sarriot E, Kanjilal B and Peters DH (2016) Unlocking community capabilities across health systems in low- and middle-income countries: lessons learned from research and reflective practice, BMC Health Services Research, 16:1859, DOI: 10.1186/s12913-016-1859-7

The right and responsibility of communities to participate in health service delivery was enshrined in the 1978 Alma Ata declaration and continues to feature centrally in health systems debates today. Communities are a vital part of people-centred health systems and their engagement is critical to realizing the diverse health targets prioritised by the Sustainable Development Goals and the commitments made to Universal Health Coverage. Community members’ intimate knowledge of local needs and adaptive capacities are essential in constructively harnessing global transformations related to epidemiological and demographic transitions, urbanization, migration, technological innovation and climate change. Effective community partnerships and governance processes that underpin community capability also strengthen local resilience, enabling communities to better manage shocks, sustain gains, and advocate for their needs through linkages to authorities and services. This is particularly important given how power relations mark broader contexts of resource scarcity and concentration, struggles related to social liberties and other types of ongoing conflicts.

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Through the lens: empowering women in vulnerable communities to voice their concerns

Future Health Systems

Participatory Action Research (PAR) methodologies can help empower marginalised groups to capture and articulate their experiences and concerns to decision-makers. Future Health Systems (FHS) has worked with women in the Sundarbans of West Bengal to use Photovoice – a PAR method using photographs and narrative – to raise awareness of the challenges the women face to access health care. The initiative has led local policymakers and health workers to prioritise, and take steps to address, the issues.

FHS India Research Brief 9 - Voices from the ground: Photovoice research on children’s health in the Indian Sundarbans

Future Health Systems

The objective of this brief is to introduce the Photovoice method, highlight how it helped capture the voices of mothers in the Sundarbans, and demonstrate how the method can bridge the gap between communities and local decision-makers. 

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Measuring spatial equity and access to maternal health services using enhanced two step floating catchment area method (E2SFCA) – a case study of the Indian Sundarbans

Future Health Systems

Vadrevu L and Kanjilal B (2016) Measuring spatial equity and access to maternal health services using enhanced two step floating catchment area method (E2SFCA) – a case study of the Indian Sundarbans, International Journal for Equity in Health, 15:87, DOI: 10.1186/s12939-016-0376-y

Inaccessibility due to terrain and lack of transport leaves mothers travelling for long hours before reaching a facility to deliver a child. This article analyzes the issue of spatial inaccessibility and inequity of maternal health services in the Indian Sundarbans where complex topography and repeated climatic adversities make access to health services very difficult. 

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Rising challenge of multiple morbidities among the rural poor in India—a case of the Sundarbans in West Bengal

Future Health Systems

Vadrevu L, Kumar V and Kanjilal B (2016) Rising challenge multi morbidity in the Indian Sundarbans, Indian Journal of Medical Research 5(2): 343-350  doi: 10.5455/ijmsph.2016.25082015129

Multimorbidity or multiple chronic conditions increase with age and imply complicated clinical management and lower quality of life that is compounded by poverty. Yet, there is a serious dearth of evidence on this issue. This article aims to explore the burden and predictors of multiple morbidities in the Sundarbans of West Bengal.

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Reflections of Child Health Rights: Perspectives from Healthcare Stakeholders in North India

Future Health Systems

Bhati, D. K. (2015) Reflections of Child Health Rights: Perspectives from Healthcare Stakeholders in North India, European Scientific Journal, Vol 11, No 18, pp 143-15

In health-care settings, stakeholder’s knowledge, attitudes and perspectives influence their perception towards children, including children’s rights and right to health. The knowledge and attitudes generally present a culture of how children’s right are perceived and treated. This study explored the knowledge, attitudes and perspectives of 35 Indian health care stakeholders regarding children’s rights and right to health and their perspectives on realization of the selected domains of rights in reality. 

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FHS India Research Brief 8: Early Childhood Development in the Sundarbans Neglect in the face of risks and adversity

Future Health Systems

Risks and adversities during early childhood majorly hamper this neurological development. They are also irreversible with long standing impact on the eventual productivity in life. Given the huge impact that deficits in the early years have in terms of human productivity and sustainable development, early childhood development needs serious attention. This research brief provides formative evidence on the gaps in the care practices needed for Early Childhood Development in the Sundarbans. It will begin by first gauging the status of child development, the gaps and challenges in key practices needed for it and it will conclude with key recommendations.

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FHS India Research Brief 7: Open defecation and childhood undernutrition in the Indian Sundarbans: A case study from rural West Bengal

Future Health Systems

Among the several determinants of child malnutrition – ranging from individual factors to societal ones – recent evidence indicates open defecation as an important determinant responsible for child malnutrition. This research brief explores the association between underweight children (0-6 years) and open defecation in the context of Indian Sundarbans, where low body weight is considered as an indicator of childhood malnutrition.

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Ex Ante Inequality and Under-Nutrition Vulnerability Dynamics: Case Study of the Sundarbans Delta Region, West Bengal, India

Future Health Systems

In this paper ex ante inequality measure is used to estimate inequality in childhood chronic under-nutrition among different vulnerable subgroups. Results found that vulnerability to consumption poverty aggravated chronic under-nutrition among less vulnerable groups mainly among those who perceived that unqualified providers provided quality service and were very effective during crisis.The paper finally suggests several policy suggestions for different vulnerable segments.

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সুন্দরবনের শিশুদের স্বাস্থ্য: বাংলা সংস্করণ - ২০১৪

Future Health Systems

এফ.এইচ.এস.- ইন্ডিয়া ২০০৯ সাল থেকেই সুন্দরবনের মানুষের স্বাস্থ্যের ওপর গবেষণার কাজ চালাচ্ছে। বর্তমানে  (২০১০ সাল থেকে) এফ.এইচ.এস. শিশু স্বাস্থ্যের ওপর বেশি গুরুত্ব দিয়ে কাজ করছে। সম্প্রতি সুন্দরবনের পাথরপ্রতিমা ব্লকে শিশু -স্বাস্থ্যের ওপর একটি সমীক্ষা করা হয়েছে। বর্তমান রিপোর্টটিতে এলাকার শিশু স্বাস্থ্যের বিভিন্ন দিক ও তার বর্তমান অবস্থা, স্বাস্থ্য পরিষেবার ক্ষেত্রে ফাঁকফোকর গুলি ও সম্ভাব্য সমাধানসূত্র তুলে ধরার চেষ্টা করা হয়েছে। এফ.এইচ.এস.- ইন্ডিয়ার এই গবেষণাটি আরও বেশি করে সুন্দরবনের মানুষের মাঝে পৌঁছে দেওয়ার জন্য এই বাংলা সংস্করণটি প্রকাশিত হল।

 

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