Polycystic ovary syndrome (PCOS) in urban India

This thesis research focuses on urban women in India diagnosed with polycystic ovary syndrome (PCOS). PCOS is a complex metabolic, endocrine and reproductive disorder affecting approximately 5-10% of the female population in developed countries. The prevalence of PCOS is on the rise in developing nations like India, which are undergoing rapid nutritional transitions due to Westernized diets and lifestyle. However, less appreciated in the literature are the developmental psychosocial impacts for women diagnosed with PCOS, especially in developing countries. Thus, the goal of my thesis research was to contribute to the small but growing literature by investigating psychosocial dimensions of women with PCOS in the developing urban areas of Delhi, India. Using a mixed method case-control study design, I investigated gender identity, psychological general health and well being (PGWB), and body image. A total of 65 (33 PCOS, 32 control) urban Indian woman from Delhi NCR (National Capital Region) were recruited from a North Delhi gynecology clinic, and by word of mouth. All 65 women completed the survey, 5 of them (3 PCOS, 2 control) completed the semi-structured interview, and 4 of those 5 allowed me to complete participant observation with them. No statistical differences between PCOS and control groups were observed for the quantitative measures of the survey once body mass index, waist circumference and other covarying demographic variables were controlled for. However, the qualitative results suggest a more complex illustration of possible psychosocial differences between PCOS and control participants, especially in regard to body image. Despite intriguing qualitative results, more nuanced and in-depth quantitative and qualitative work is needed to verify whether urban Indian women with PCOS contend with discrete biopsychosocial trajectories of health and well-being. Future research is warranted on cross-cultural conceptualization of PCOS as well as the relevance of marital status, geographic location, socioeconomic status, diet, lifestyle and attitudes about health to the psychosocial experience of PCOS

Essays on hope and economic development

This thesis aims to introduce the economics of hope in an attempt to study the role of hope in economic development. It pertains to offering experimental evidence on the measurement, malleability and significance of hope in the process of improving academic achievement of primary school students in India. The thesis comprises of six chapters. Chapter 1 introduces the concept of hope in the context of aspirations, internal constraints and education. Chapter 2 is a broad literature review underlining the need for treatment interventions that foster hope. Chapter 3 and 4 focus on the experimental set-up. Starting with the relationship between hope, effort and achievement, chapter 3 provides a theory of change and a proposition in which, hope increases effort. It also includes an exhaustive research protocol deviced to explain the data collection plan in the field. After discussing the theoretical underpinnings, Chapter 4 describes the research design and the empirical strategy employed to make causal inferences. In the process, I elaborate the survey instruments used to capture information on the various outcome variables, whilst stating the main hypothesis. Chapter 5 presents the main results of the Randomised Controlled Trial (RCT). Along with the available heterogeneity in the findings, pre-meditated robustness checks are also incorporated in this chapter. The results from chapter 5, their cost-effectiveness and implications on developmental policies are discussed in detail in Chapter 6. Potential extensions and the avenues of future research are also included in this chapter. It concludes by revisiting the main findings of the RCT and its contribution towards future developmental policy-making

Socioeconomic Inequalities in Childhood Vaccination in India: Pathways and Interventions

India has the largest number of children aged under 5 years of any country in the world but also one of the lowest childhood immunization rates globally. Important health initiatives of the Indian government such as the Universal Immunization Program and the Reproductive and Child Health program have increased childhood vaccination rates and decreased socioeconomic inequalities. However, there is a paucity of national level studies that have utilized data collected after 2006 to examine these issues. In this dissertation, we examined time-trends in socioeconomic inequalities in childhood vaccination over an 11-year period between 2002 and 2013 using cross-sectional data collected during three distinct time-periods: 2002-2004, 2007-2008 and 2012-2013 in 29 Indian states. We assessed the role of availability and acceptability of health services as potential mediators in the association between socioeconomic status and childhood vaccination in 20 Indian states during 2007-2008 and 2012-2013. Finally, we examined the cost-effectiveness of the accredited social health activist (ASHA) program, a community health worker initiative introduced under National Rural Health Mission in 2005, in improving measles vaccination. We examined the associations between socioeconomic status (SES) and full childhood vaccination for three time-periods, stratifying our analyses by time-period and empowered action group (EAG) state status. Non-EAG states experienced decreased full vaccination rates in 2012-2013 compared to 2007-2008. We found that while SES based-inequalities in vaccination rate decreased in both EAG and non-EAG states, they were present to a greater degree in EAG states for all three time-periods; however, the gap in SES based-disparities between EAG and non-EAG states decreased during this 11-year time-period. To examine these inequalities further, we conducted mediation analyses to explore how availability and accessibility of vaccination services could mediate the association between SES and full childhood vaccination during 2007-2008 and 2012-2013. In our analyses, the indirect effect mediated by availability and acceptability of health services was positive and the direct effect of SES on full childhood vaccination was negative for both time-periods. The total direct effect of SES on full childhood was positive in 2007-2008 while negative in 2012-2013. Finally, we conducted a cost-effectiveness analysis of ASHAs with regards to childhood measles vaccination, obtaining parameter estimates for our cohort simulation model from 2012-2013 data and prior literature. ASHAs were highly cost-effective in our univariate sensitivity analyses and most of the bivariate and probabilistic sensitivity analyses. ASHAs remained cost-effective even when their financial incentive to perform measles vaccination related services was increased by 10 times. They remained cost-effective in long-term scenarios where the cohort size of a village decreased over time as more and more children were vaccinated. In view of these findings, the Indian government may want to focus its efforts on both EAG and non-EAG states to receive adequate funding and resources to ensure gains in vaccination are not lost. This study also demonstrates the possibility of vaccine hesitancy and lower full vaccination rates among children from richer households due to availing of vaccine services from private healthcare providers who tend to be less accountable than public healthcare providers in ensuring full vaccination of children. Finally, we quantitatively demonstrate the cost-effectiveness of ASHAs even when considering a single outcome among their myriad responsibilities and show that the financial compensation for ASHAs for services they render can be increased without compromising their cost-effectiveness.PHDEpidemiological ScienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/145903/1/bdeepti_1.pd

Delhi's Education Revolution

In 2015, the Aam Aadmi Party (AAP) was elected to govern Delhi promising to improve public services, including education through government schools that would be the equal of private-school provision. Media reports, along with the party’s re-election in 2020, suggest strong public confidence that AAP are delivering on that promise. But is this success reflected by experience in schools? Delhi’s Education Revolution offers a critical evaluation of the AAP’s education reforms by exploring policy and practice through the eyes of one key group: the government-school teachers tasked with making the AAP’s pledge a reality. Drawing on 110 research interviews conducted via Zoom during the Covid pandemic in the summer of 2020, teachers explain how the reforms have changed their profession and practice, and whether education really has improved for children of all backgrounds. Analysis of views about critical issues such as inclusion and the pressure of achievement targets in classrooms that often contain more than 50 students, informs their observations about the reform programme itself. The study paints a more qualified picture of success than suggested elsewhere and makes a valuable contribution to the understanding of education reforms in India, and most especially, in Delhi

Delhi's Education Revolution: Teachers, agency & inclusion

In 2015, the Aam Aadmi Party (AAP) was elected to govern Delhi promising to improve public services, including education through government schools that would be the equal of private-school provision. Media reports, along with the party’s re-election in 2020, suggest strong public confidence that AAP are delivering on that promise. But is this success reflected by experience in schools? Delhi’s Education Revolution offers a critical evaluation of the AAP’s education reforms by exploring policy and practice through the eyes of one key group: the government-school teachers tasked with making the AAP’s pledge a reality. Drawing on 110 research interviews conducted via Zoom during the Covid pandemic in the summer of 2020, teachers explain how the reforms have changed their profession and practice, and whether education really has improved for children of all backgrounds. Analysis of views about critical issues such as inclusion and the pressure of achievement targets in classrooms that often contain more than 50 students, informs their observations about the reform programme itself. The study paints a more qualified picture of success than suggested elsewhere and makes a valuable contribution to the understanding of education reforms in India, and most especially, in Delhi

Modern religious movements in India.

http://www.archive.org/details/modernreligiousm025064mbpSTATE CENTRAL LIBRARY, HYD

Modern religious movements in India.

http://www.archive.org/details/modernreligiousm025064mbpSTATE CENTRAL LIBRARY, HYD

Documentation of HIV prevention research and programmatic learnings from India—Selected peer-reviewed journal publications from the Knowledge Network Project (Volume 1)

Over the past decade (2000–11), India has achieved dramatic successes in reversing the HIV epidemic. These successes are largely due to the implementation of upscaled HIV-prevention interventions by the National AIDS Control Organization, two other donors, and nongovernmental organizations, under the National AIDS Control Program III. As the epidemic in India is concentrated in vulnerable subpopulations, these interventions were focused on high-risk groups. It is important to understand the lessons learned from the implementation of HIV-prevention programs and the vulnerabilities that need to be addressed to reach the goal of zero new infections. To support this understanding, the Population Council and its Knowledge Network Project partners have been documenting and disseminating evidence-based lessons from upscaled HIV-prevention programs in India. As part of this initiative, selected peer-reviewed journal publications from the Knowledge Network Project have been compiled into “Documentation of HIV Prevention Research and Programmatic Learnings from India,” Volume 1. This reference tool can help guide policymakers, program managers, and field teams in different states of India in the design and implementation of HIV-prevention programs

Identifying Good Practice in a Community-based Postvention Support Service: Findings from a Mixed Methods Evaluation study in the UK

Background: This paper reports on a two-year evaluation of a community-based postvention support service in the UK. Aims: To identify factors that help to improve service delivery (1); to understand the needs of those affected following a suicide and the impact of the support service on their lives (2). Method: Mixed methods. Using descriptive statistics, we examined utilisation rates over time: sources of referrals; age; gender; relationship to deceased of those referred for support. In-depth interviews with volunteer supporters, service-users, and key stakeholders were undertaken to understand various perspectives on the perceived effectiveness of the service and delivery. Results: A wide variety of ages and relationships were represented. The majority were female and most were in the deceased’s immediate family. Elements of good practice identified included: effective multi-agency partnership working; the use of real-time surveillance in providing timely referrals; volunteer-led support; pro-active persistent contact; continuous unlimited support.Conclusion: The evaluation identified new recommendations for service development and delivery which will be of significant value for future community-based postvention services. Consistent with findings from previous research was the need to engage more men and friends. Pro-active strategic use of social media might be one way to engage those under-represented groups