Barriers to higher education:Commonalities and contrasts in the experiences of Hindu and Muslim young women in urban Bengaluru

Gender inequalities in educational attainment have attracted considerable attention and this article aims to contribute to our understanding of young women’s access to higher education. The article is based on our in-depth interviews with 26 Hindu and Muslim young women attending colleges in urban Bengaluru (formerly Bangalore), south India, and explores the barriers they confronted in fulfilling their aspirations. We highlight the similarities amongst the young women, as well as the distinctive experiences of the Hindu and Muslim interviewees. Financial constraints, lack of safety for women in public space, and gender bias, gossip and social control within the family and the local community affected Hindu and Muslim interviewees in substantially similar ways. For the Muslim interviewees, however, gender disadvantage was compounded by their minority status. This both underlines the importance of incorporating communal politics into our analysis and undermines popular discourses that stereotype Muslims in India as averse to girls’ and young women’s education

Educational films for improving screening and self-management of gestational diabetes in India and Uganda (GUIDES): study protocol for a cluster-randomised controlled trial.

BACKGROUND: The prevalence of gestational diabetes mellitus (GDM) is rising rapidly in many low- and middle-income countries (LMICs). Most women with GDM in LMICs are undiagnosed and/or inadequately managed due to a lack of knowledge and skills about GDM on the part of both providers and patients. Following contextual analysis, we developed an educational/behavioural intervention for GDM delivered through a package of culturally tailored films. This trial aims to evaluate whether the intervention can improve the timely detection and management of GDM in two LMIC settings. METHODS: Two independent cluster randomised controlled trials, one each to be conducted in Uganda and India. Thirty maternity facilities in each country have been recruited to the study and randomised in a 1:1 ratio to the intervention and control arms. The intervention comprises of three interconnected sets of films with the following aims: to improve knowledge of GDM guidelines and skills of health providers, to raise awareness of GDM screening among pregnant women and their families, and to improve confidence and skills in self-management among those diagnosed with GDM. In facilities randomised to the intervention arm, a GDM awareness-raising film will be shown in antenatal care waiting rooms, and four films for pregnant women with GDM will be shown in group settings and made available for viewing on mobile devices. Short films for doctors and nurses will be presented at professional development meetings. Data will be collected on approximately 10,000 pregnant women receiving care at participating facilities, with follow-up at 32 weeks gestational age and 6 weeks postnatally. Women who self-report a GDM diagnosis will be invited for a clinic visit at 34 weeks. Primary outcomes are (a) the proportion of women who report a GDM diagnosis by 32 weeks of pregnancy and (b) glycaemic control (fasting glucose and HbA1C) in women with GDM at ~34 weeks of pregnancy. The secondary outcome is a composite measure of GDM-related adverse perinatal-neonatal outcome. DISCUSSION: Screening and management of GDM are suboptimal in most LMICs. We hypothesise that a scalable film-based intervention has the potential to improve the timely detection and management of GDM in varied LMIC settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT03937050 , registered on 3 May 2019. Clinical Trials Registry India CTRI/2020/02/023605 , registered on 26 February 2020

Health care professionals' perspectives on screening and management of gestational diabetes mellitus in public hospitals of South India - a qualitative study.

BACKGROUND: Women developing Gestational Diabetes Mellitus (GDM) are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM are essential in preventing progression to type 2 diabetes mellitus. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM. METHODS: We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India's major city (Bengaluru). The interviews were conducted in the preferred language of the participants (Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using the grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model. RESULTS: Health care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to their natal homes during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol. CONCLUSION: There is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India

'Lived Islam' in India and Bangladesh

This paper seeks to answer the question of how Muslim women interpret and negotiate religion in order to realise their reproductive aspirations. A close reading of lived experiences of 32 Muslim women from a varied educational background yields a wider perspective of the different interpretations of reproductive norms employed by adherents of the same religion (Islam), situated in two countries (India/Bangladesh) and group (majority/minority) contexts. Further, this comparative study yields a deeper understanding of agency that is employed by Muslim participants in each country. Muslim women both in India and Bangladesh are not passive followers of religious norms, but have agency to bring change in their own life and take an active role in planning their family, thereby transgressing religious norms in reproductive matters. Muslim women in India exercise their agency by adopting sterilisation - a method proscribed by Islam - without the knowledge of their significant others. Muslim women in Bangladesh use their agency by making a flexible interpretation of Islam in reproductive matters. A lesson learned from this comparative study is the need to remove barriers that prevent the adoption of contraceptives by Muslim minorities in India and to design family planning programmes that takes into account their religious needs

'Lived Islam' in India and Bangladesh:negotiating religion to realise reproductive aspirations

This paper seeks to answer the question of how Muslim women interpret and negotiate religion in order to realise their reproductive aspirations. A close reading of lived experiences of 32 Muslim women from a varied educational background yields a wider perspective of the different interpretations of reproductive norms employed by adherents of the same religion (Islam), situated in two countries (India/Bangladesh) and group (majority/minority) contexts. Further, this comparative study yields a deeper understanding of agency that is employed by Muslim participants in each country. Muslim women both in India and Bangladesh are not passive followers of religious norms, but have agency to bring change in their own life and take an active role in planning their family, thereby transgressing religious norms in reproductive matters. Muslim women in India exercise their agency by adopting sterilisation - a method proscribed by Islam - without the knowledge of their significant others. Muslim women in Bangladesh use their agency by making a flexible interpretation of Islam in reproductive matters. A lesson learned from this comparative study is the need to remove barriers that prevent the adoption of contraceptives by Muslim minorities in India and to design family planning programmes that takes into account their religious needs