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Publications

Filtering by Category: India

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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Using Theories of Change to inform implementation of health systems research and innovation: experiences of Future Health Systems consortium partners in Bangladesh, India and Uganda

Future Health Systems

Paina L, Wilkinson A, Tetui M, Ekirapa-Kiracho E, Barman D, Ahmed T, Mahmood SS, Bloom G, Knezovich J, George A and Bennett S (2017) Using Theories of Change to inform implementation of health systems research and innovation: experiences of Future Health Systems consortium partners in Bangladesh, India and Uganda, Health Research Policy and Systems, 15(Suppl 2):109, DOI: 10.1186/s12961-017-0272-y

The Theory of Change (ToC) is a management and evaluation tool supporting critical thinking in the design, implementation and evaluation of development programmes. We document the experience of Future Health Systems (FHS) Consortium research teams in Bangladesh, India and Uganda with using ToC. We seek to understand how and why ToCs were applied and to clarify how they facilitate the implementation of iterative intervention designs and stakeholder engagement in health systems research and strengthening.

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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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Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis project

Future Health Systems

Thow AM, Karn S, Devkota MD, Rasheed S, Roy SK, Suleman Y, Hazir T, Patel A, Gaidhane A, Puri S, Godakandage S, Senarath U and Dibley MJ (2017) Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis project, BMC Public Health, 17(Suppl 2):404 DOI: 10.1186/s12889-017-4336-2

South Asian countries experience some of the highest levels of child undernutrition in the world, strongly linked to poor infant and young child feeding (IYCF) practices. Strong and responsive policy support is essential for effective interventions to improve IYCF. This study aimed to identify opportunities for strengthening the policy environment in the region to better support appropriate infant and young child feeding.

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Analysis of stakeholders networks of infant and young child nutrition programmes in Sri Lanka, India, Nepal, Bangladesh and Pakistan

Future Health Systems

Uddin S, Mahmood H, Senarath U, Zahiruddin Q, Karn S, Rasheed S and Dibley M (2017) Analysis of stakeholders networks of infant and young child nutrition programmes in Sri Lanka, India, Nepal, Bangladesh and Pakistan, BMC Public Health, 17(Suppl 2):405, DOI: 10.1186/s12889-017-4337-1


Effective public policies are needed to support appropriate infant and young child feeding (IYCF) to ensure adequate child growth and development, especially in low and middle income countries. The aim of this study was to: (i) capture stakeholder networks in relation to funding and technical support for IYCF policy across five countries in South Asia (i.e. Sri Lanka, India, Nepal, Bangladesh and Pakistan); and (ii) understand how stakeholder networks differed between countries, and identify common actors and their patterns in network engagement across 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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What is the role of community capabilities for maternal health? An exploration of community capabilities as determinants to institutional deliveries in Bangladesh, India, and Uganda

Future Health Systems

Paina L, Vadrevu L, Hanifi SMMA, Akuze J, Rieder R, Chan KS and Peters DH (2016) What is the role of community capabilities for maternal health? An exploration of community capabilities as determinants to institutional deliveries in Bangladesh, India, and Uganda, BMC Health Services Research, 16:1861, DOI: 10.1186/s12913-016-1861-0

While community capabilities are recognized as important factors in developing resilient health systems and communities, appropriate metrics for these have not yet been developed. Furthermore, the role of community capabilities on access to maternal health services has been underexplored. In this paper, we summarize the development of a community capability score based on the Future Health System (FHS) project’s experience in Bangladesh, India, and Uganda, and, examine the role of community capabilities as determinants of institutional delivery in these three contexts.

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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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FHS Key Message Brief 3: Unlocking community capability: key to more responsive, resilient and equitable health systems

Future Health Systems

In Future Health Systems, we focused on communities as active service delivery participants across a wide variety of contexts. In this brief, we reflect on the process of unlocking community capabilities, the key actors involved, and the productive tensions within community partnerships forged to build more responsive, resilient and equitable health systems.

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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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Gender Differentials in the Impact of Multi-Morbidity on Self Rated Health in Rural West Bengal in India

Future Health Systems

Vadrevu L, Kumar V, Kanjilal B (2015) Gender Differentials in the Impact of Multi-Morbidity on Self Rated Health in Rural West Bengal in India. IOSR J Nurs Heal Sci 2015, 4:16–21. DOI: 10.9790/1959-04231621

Self Rated Health (SRH) has widely been used as an indicator of overall health in a population. Given the rising burden of chronic conditions even in the rural region of India, the present study explores the gender differentials in the impact of multi-morbidity on SRH in the Sundarbans of West Bengal.

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