Exploring Inclusive MedTech Innovations for Resource-Constrained Healthcare in India

The potential of inclusive medical technological innovations to create access to affordable and appropriate products and services for local healthcare systems in developing countries has emerged as a critical area of academic and policy debates. This research contributes to these debates by studying the key factors, actors and their interactions influencing the development and adoption of three innovative diagnostic devices to resolve the healthcare needs of the local population in the Indian healthcare systems. It highlights the critical role of the state in influencing the development and adoption of inclusive MedTech innovations in resource-constraint settings. It further reveals that the availability of finance facilitated the early-stage development of innovations. At the same time, collaborative arrangements with a diverse set of stakeholders contributed to late-stage development and adoption of innovations in the local healthcare systems. This research also expands on the conceptualization of inclusivity in the MedTech sector by providing a holistic interpretation of affordability as reducing healthcare costs over a longer period through access to early diagnostics rather than the purchase cost of a product. These research findings have significant implications for innovation and healthcare policies that can help to resolve the challenges of accessible healthcare in developing countries

Formation of partnerships among young women and men in Pune district, Maharashtra

Young people in India face traditional age- and sex-stratified norms that espouse gender double standards. Premarital partnerships are taboo and anecdotal evidence suggests that in many settings in India, the hint of a romantic relationship or even social interaction between young girls and boys is sufficient to damage a family\u27s reputation and/or result in accelerated arranged marriage, particularly for the girl. While there is a prevailing perception at the community level that in these circumstances, premarital partnerships are rare, there is a small body of literature that suggests that such partnerships are indeed formed and sexual relations experienced, among, typically, fewer than 10 percent of young women and 15–30 percent of young men. At the same time, little is known about the lives of young people and the contexts in which they form romantic, marital, and other partnerships. This report describes the situation of young unmarried and married women and men aged 15–24 in rural and urban slum settings in India, namely Pune district, Maharashtra

Caste, Kinship, and Life Course: Rethinking Women's Work and Agency in Rural South India

This paper reexamines the linkages between women's work, agency, and well-being based on a household survey and in-depth interviews conducted in rural Tamil Nadu in 2009 and questions the prioritization of workforce participation as a path to gender equality. It emphasizes the need to unpack the nature of work performed by and available to women and its social valuation, as well as women's agency, particularly its implications for decision making around financial and nonfinancial household resources in contexts of socioeconomic change. The effects of work participation on agency are mediated by factors like age and stage in the life cycle, reproductive success, and social location – especially of caste – from which women enter the workforce

HIV in rural India: context and healthcare needs

Primary research on HIV/AIDS in India has predominantly focused on known risk groups such as sex workers, STI clinic attendees and long-distance truck drivers, and has largely been undertaken in urban areas. There is evidence of HIV spreading to rural areas but very little is known about the context of the infection or about issues relating to health and social impact on people living with HIV/AIDS. In-depth interviews with nineteen men and women infected with HIV who live in rural areas were used to collect experiences of testing and treatment, the social impacts of living with HIV and differential impacts on women and men. Eight focus group discussions with groups drawn from the general population in the four villages were used to provide an analysis of community level views about HIV/AIDS. While men reported contracting HIV from sex workers in the cities, women considered their husbands to be the source of their infection. Correct knowledge about HIV transmission co-existed with misconceptions. Men and women tested for HIV reported inadequate counselling and sought treatment from traditional healers as well as professionals. Owing to the general pattern of husbands being the first to contract HIV women faced a substantial burden, with few resources remaining for their own or their children’s care after meeting the needs of sick husbands. Stigma and social isolation following widowhood were common, with an enforced return to the natal home. Implications for potential educational and service interventions are discussed within the context of gender and social relations

Correlates of premarital relationships among unmarried youth in Pune District, Maharashtra, India

Context: Although premarital partnerships - whether or not they involve sex - are widely discouraged in India, some youth do form such partnerships. It is important to know more about the nature of and the factors associated with these relationships. Methods: Data are drawn from a community-based study of 15-24-year-olds in urban slum and rural settings in Pune District, Maharashtra. Multivariate analyses were conducted to identify associations between youths\u27 individual, peer and family factors and their experience of romantic relationships and physical intimacy, including intercourse. Results: Among young men, 17-24% had had a romantic relationship, 20-26% had engaged in some form of physical intimacy and 16-18% had had sex; the proportions among young women were 5-8%,4-6% and 1-2%, respectively. Exposure to alcohol, drugs or pornographic films and having more frequent interaction with peers were positively associated with romantic and sexual relationships for both young women and young men. Educational attainment was negatively associated with both types of relationships for young women, but only with sexual relationships for young men. Closeness to parents was negatively associated with relationships only for young women. Young women whose father beat their mother were more likely than other young women to form romantic partnerships, and those beaten by their family had an elevated risk of entering romantic and sexual partnerships. Youth who reported strict parental supervision were no less likely than others to enter relationships. Conclusions: Program interventions should ensure that youth are fully informed and equipped to make safe choices and negotiate wanted outcomes, while positively influencing their peer networks; encourage closer interaction between parents and children; and be tailored to the different circumstances and experiences of young women and men

Measuring agency among unmarried young women and men

In order to draw out and measure dimensions of agency (the capacity to make choices through the acquisition of a sense of self and a sense of personal competence) among unmarried young women and men, a survey was undertaken among young people in rural and urban slum settings in Pune. It looked at three key dimensions - mobility, decision-making and sense of self-worth. The findings show that agency was clearly constrained among youth inthis setting, irrespective of gender and the rural-urban divide. Second, young women had significantly lower levels of agency than young men on mobility and decision-making, but appeared to have a significantly higher sense of self-worth. Third, the rural-urban differences were negligible and considerably narrower than gender differences. Fourth, older respondents were progressively more likely to report agency on all three dimensions. Age and education were consistently and positively associated with almost every measure of agency for both young women and men

Romance and sex: Pre-marital partnership formation among young women and men, Pune District, India

Using qualitative and survey data in a rural and an urban slum setting in Pune district, India, this paper describes patterns of pre-marital romantic partnerships among young people aged 15-24, in spite of norms that discourage opposite-sex interaction before marriage. 25-40% of young men and 14-17% of young women reported opposite-sex friends. Most young people devised strategies to interact with others, largely from the same neighbourhood. There were wide gender differences with regard to making or receiving romantic proposals, having a romantic partner and experiencing hand-holding, kissing and sexual relations. For those who engaged in sexual relations, the time from the onset of the partnership to having sexual relations was short. Sex most often took place without protection or communication, and for a disturbing minority of young women only after persuasion or without consent. Among those who were unmarried, a large percentage had expected to marry their romantic partner, but for a third of young women and half of young men the relationship had been discontinued. Partnership formation often leads to physical intimacy, but intimacy should be wanted, informed and safe. Findings call for programmes that inform youth in non-threatening, non-judgmental and confidential ways, respect their sexual rights and equip them to make safe choices and negotiate wanted outcomes