Reproductive health of women with and without disabilities in South India, the SIDE study (South India Disability Evidence) study: a case control study.

BACKGROUND: Evidence shows that women with disability have adverse pregnancy outcomes compared to those without a disability. There is a lack of published data on reproductive health of women with disability in India till date. The objective of the South India Disability Evidence (SIDE) Study was to compare reproductive health parameters including pregnancy experience, health access during pregnancy and type of delivery among women with disability compared to women with no disability. METHODS: The study was conducted in one district each in two States (Andhra Pradesh and Karnataka) in 2012. A case-control design was used to identify appropriate age and sex-matched controls for women with disability identified through a population-based survey. Trained key informants first listed women with disabilities who were then examined by a medical team to confirm the diagnosis. Trained research investigators administered questionnaire schedules to both groups of women to collect information on reproductive health and outcomes of any pregnancy experienced in the past two years. RESULTS: A total of 247 women with disability and 324 age-matched controls aged 15-45 years were recruited for the study. 87% of the women with disability had a physical disability. The mean age of women with disability was 29.86 against 29.71 years among women without a disability. A significantly lower proportion of women with disability experienced pregnancy (36.8%) compared to women without a disability (X (2) -16.02 P <0.001). The odds ratio for suffering from diabetes among women with disability compared to women without a disability was 19.3(95% CI: 1.2- 313.9), while it was 9.5 (95% CI: 2.2-40.8) for depression. A higher proportion of women without a disability (7.7%) compared to women with a disability (5.3%) reported a successful pregnancy in the past two years. There were no statistically significant differences between women with and without a disability with regard to utilization of antenatal care and pregnancy outcomes. CONCLUSIONS: The study provides evidence on some reproductive health parameters of women with disability in India for the first time ever. The findings will help in formulating policy and to develop specific interventions to improve pregnancy outcomes for women with disability in India

Livelihood opportunities amongst adults with and without disabilities in Cameroon and India: A case control study.

Proven links between disability and poverty suggest that development programmes and policies that are not disability-inclusive will leave persons with disabilities behind. Despite this, there is limited quantitative evidence on livelihood opportunities amongst adults with disabilities in Low and Middle Income Countries. This study adds to the limited evidence base, contributing data from one African and one Asian Setting. We undertook a population-based case-control study of adults (18+) with and without disabilities in North-West Cameroon and in Telangana State, India. We found that adults with disabilities were five times less likely to be working compared to age-sex matched controls in both settings. Amongst adults with disabilities, current age, marital status and disability type were key predictors of working. Inclusive programmes are therefore needed to provide adequate opportunities to participate in livelihood prospects for adults with disabilities in Cameroon and India, on an equal basis as others. These findings are of crucial importance at this stage of the Sustainable Development Agenda, to ensure that the mandate of inclusive development is achieved

Effectiveness of a novel mobile health (Peek) and education intervention on spectacle wear amongst children in India: Results from a randomized superiority trial in India.

BACKGROUND: Uncorrected refractive errors can be corrected by spectacles which improve visual functioning, academic performance and quality of life. However, spectacle wear can be low due to teasing/bullying, parental disapproval and no perceived benefit.Hypothesis: higher proportion of children with uncorrected refractive errors in the schools allocated to the intervention will wear their spectacles 3-4 months after they are dispensed. METHODS: A superiority, cluster-randomised controlled trial was undertaken in 50 government schools in Hyderabad, India using a superiority margin of 20%. Schools were the unit of randomization. Schools were randomized to intervention or a standard school programme. The same clinical procedures were followed in both arms and free spectacles were delivered to schools. Children 11-15 years with a presenting Snellen visual acuity of <6/9.5 in one or both eyes whose binocular acuity improved by ≥2 lines were recruited.In the intervention arm, classroom health education was delivered before vision screening using printed images which mimic the visual blur of uncorrected refractive error (PeekSim). Children requiring spectacles selected one image to give their parents who were also sent automated voice messages in the local language through Peek. The primary outcome was spectacle wear at 3-4 months, assessed by masked field workers at unannounced school visits. www.controlled-trials.com ISRCTN78134921 Registered on 29 June 2016. FINDINGS: 701 children were prescribed spectacles (intervention arm: 376, control arm: 325). 535/701 (80%) were assessed at 3-4 months: intervention arm: 291/352 (82.7%); standard arm: 244/314 (77.7%). Spectacle wear was 156/291 (53.6%) in the intervention arm and 129/244 (52.9%) in the standard arm, a difference of 0.7% (95% confidence interval (CI), -0.08, 0.09). amongst the 291 (78%) parents contacted, only 13.9% had received the child delivered PeekSim image, 70.3% received the voice messages and 97.2% understood them. INTERPRETATION: Spectacle wear was similar in both arms of the trial, one explanation being that health education for parents was not fully received. Health education messages to create behaviour change need to be targeted at the recipient and influencers in an appropriate, acceptable and accessible medium. FUNDING: USAID (Childhood Blindness Programme), Seeing is Believing Innovation Fund and the Vision Impact Institute

Access to health care and employment status of people with disabilities in South India, the SIDE (South India Disability Evidence) study.

BACKGROUND: Data shows that people with disability are more disadvantaged in accessing health, education and employment opportunities compared to people without a disability. There is a lack of credible documented evidence on health care access and barriers to access from India. The South India Disability Evidence (SIDE) Study was undertaken to understand the health needs of people with disabilities, and barriers to accessing health services. METHODS: The study was conducted in one district each in two States (Andhra Pradesh and Karnataka) in 2012. Appropriate age and sex-matched people without a disability were recruited to compare with people with disability who were identified through a population-based survey and available government disability records by trained key informants. These people were then examined by a medical team to confirm the diagnosis. Investigators administered questionnaire schedules to people with and without a disability to harness information on employment and health service access, utilization and barriers. RESULTS: A total of 839 people with disabilities and 1153 age and sex matched people without a disability, aged 18 years or more were included. People with disability had significantly lower employment rates. On univariate analysis, people with disability (18.4%) needed to visit a hospital significantly more often in the preceding year compared to people without a disability (8.8%) (X2- 40.0562; P < =0.001). However adjusted odds ratios did not show a statistically significant difference. Significant differences were also observed with respect to past hospitalization. People with disabilities had 4.6 times higher risk of suffering from diabetes and 5.8 times higher risk of suffering from depression compared to people without a disability and the risk was significantly higher in males compared to females with disability. People with disability faced significantly more barriers to accessing health services compared to people without a disability. Barriers included ignorance regarding availability of services, costs of services and transportation. CONCLUSIONS: This study highlights the challenges that people with disability face in accessing health-care and employment opportunities. The study findings have public health implications and should be used for planning need-based appropriate strategies to improve health care access for people with disabilities

Efficient Generation of Standard Customer Reports for Airbag Simulation Results

Passive safety systems like airbags have significantly improved road safety. These occupant safety systems help in reducing the severity of injuries, and save lives in the event of a road accident. The airbag systems must be configured correctly to minimize the impact of collision and protect the occupants. To configure the airbag, test crashes are performed and data is recorded. This data is simulated to find out appropriate parameters for the airbag deployment. The airbag simulation results are stored into databases. Airbag application tools are used to handle the data stored in databases. The airbag simulation results must be extracted efficiently and required computations needs to be performed. This data is then stored to reports. RSDBnext is an airbag application tool, it stands for Result Database next generation. This tool is used for extraction of data from the database. The RSDBnext tool should be adapted to generate Standard Customer Reports. These reports are to be generated based on customer requirements. The existing methodology to generate Standard Customer Reports used Excel macros, which took a lot of time to generate the reports. This method was complex and unstable. Hence, a new methodology was proposed without using macros. In the proposed method, an XML file and XSLT StyleSheet were used to generate the report in Excel using C# with Visual Studio. This approach reduces report generation time, and overcomes the drawbacks of the previous approach. From the results, this methodology to generate reports is faster, easier, and more reliable

Efficient Generation of Standard Customer Reports for Airbag Simulation Results

Passive safety systems like airbags have significantly improved road safety. These occupant safety systems help in reducing the severity of injuries, and save lives in the event of a road accident. The airbag systems must be configured correctly to minimize the impact of collision and protect the occupants. To configure the airbag, test crashes are performed and data is recorded. This data is simulated to find out appropriate parameters for the airbag deployment. The airbag simulation results are stored into databases. Airbag application tools are used to handle the data stored in databases. The airbag simulation results must be extracted efficiently and required computations needs to be performed. This data is then stored to reports. RSDBnext is an airbag application tool, it stands for Result Database next generation. This tool is used for extraction of data from the database. The RSDBnext tool should be adapted to generate Standard Customer Reports. These reports are to be generated based on customer requirements. The existing methodology to generate Standard Customer Reports used Excel macros, which took a lot of time to generate the reports. This method was complex and unstable. Hence, a new methodology was proposed without using macros. In the proposed method, an XML file and XSLT StyleSheet were used to generate the report in Excel using C# with Visual Studio. This approach reduces report generation time, and overcomes the drawbacks of the previous approach. From the results, this methodology to generate reports is faster, easier, and more reliable

Efficient Generation of Standard Customer Reports for Airbag Simulation Results

Passive safety systems like airbags have significantly improved road safety. These occupant safety systems help in reducing the severity of injuries, and save lives in the event of a road accident. The airbag systems must be configured correctly to minimize the impact of collision and protect the occupants. To configure the airbag, test crashes are performed and data is recorded. This data is simulated to find out appropriate parameters for the airbag deployment. The airbag simulation results are stored into databases. Airbag application tools are used to handle the data stored in databases. The airbag simulation results must be extracted efficiently and required computations needs to be performed. This data is then stored to reports. RSDBnext is an airbag application tool, it stands for Result Database next generation. This tool is used for extraction of data from the database. The RSDBnext tool should be adapted to generate Standard Customer Reports. These reports are to be generated based on customer requirements. The existing methodology to generate Standard Customer Reports used Excel macros, which took a lot of time to generate the reports. This method was complex and unstable. Hence, a new methodology was proposed without using macros. In the proposed method, an XML file and XSLT StyleSheet were used to generate the report in Excel using C# with Visual Studio. This approach reduces report generation time, and overcomes the drawbacks of the previous approach. From the results, this methodology to generate reports is faster, easier, and more reliable

Assessing health and rehabilitation needs of people with disabilities in Cameroon and India.

PURPOSE: To assess the association between disability and serious health problems, and the access and uptake of health and rehabilitation services in Cameroon and India. METHODS: We undertook a population-based case-control study, nested within a survey in Fundong Health District, North West Cameroon (August-October 2013) and in Mahbubnagar District, Telangana State, India (February-April 2014). Disability was defined as the presence of self-reported difficulties in functioning or clinical impairments. One control without disability was selected per case, matched by age, gender and cluster. Information was collected using structured questionnaires on: socioeconomic status, health, access to health services and rehabilitation. RESULTS: Cases with disability were significantly more likely to report a serious health problem in the last year compared to controls in both India (OR = 3.2, 95% CI 2.1-4.8) and Cameroon (OR = 1.9, 1.4-2.7). The vast majority of people sought care when seriously ill, and this did not vary between cases and controls. Awareness and use of rehabilitation services was extremely low in both Cameroon and India. CONCLUSIONS: Further focus is needed to improve awareness of rehabilitation services among people with disabilities in India and Cameroon to ensure that their rights are fulfilled and to achieve the goal of Universal Health Coverage. Implications for Rehabilitation People with and without disabilities equally seek health care in India and Cameroon. However, people with disabilities experience more frequent serious health problems than people without. Extremely few people with disabilities were aware of rehabilitation services despite their existence in the study settings