M-Health Based Neonatal and Child Infectious Disease Syndromic Surveillance and Monitoring at ChildCare Centres (Anganwadis and Kindergartens) in Hyderabad

Funding agency: Department of Health Research

Team: Dr. Anandhi Ramachandran, Prof Sairam Challa (AIMSR), Mr Anand Sengupta

Anganwadi centers that take care of pre-school children are at high risk for transmission of infectious diseases as they have the population that is vulnerable to infections in a group. IDSP that addresses the issues related to infectious diseases gets the surveillance data from PHC through the field visits of the ANMs and ASHAs. Since timeliness is critical in surveillance, our study proposes to test the feasibility of having a mobile-based Neonatal and Child Infectious Disease Syndromic Surveillance system that can provide timely alerts, promote preventive measures and risk profiling of disease outbreaks among Under 5 population. The system will monitor the parameters according to the ‘S’ form of IDSP and track the children using Geospatial Mapping.

Since private kindergartens/nursery schools (KGs) that are out of reach of IDSP network are higher than AWCs especially in the urban areas, they are also included as reporting units.   GIS Mapping of the location of the reporting center (AWC and schools) and providing unique identification for the children will help in maintaining the electronic health record of the child for easy tracking and monitoring. 

The study has completed two phases where the system has been designed and developed based on inputs from the field. In the next phase, the system will be implemented and evaluated for its applicability and efficiency. 

Healthcare seeking behavior for Malaria – An ethnographic study of health service seekers and healthcare providers in a tribal dominated district of Chhattisgarh

Funding Agency: ICMR                                                   

Team: Vinay Tripathi, Preetha GS, Satish Kumar and Sanjiv Kumar

Malaria related morbidity and mortality is relatively higher in tribal-dominated states of India, including Chhattisgarh, the State which has not been covered under the Intensified Malaria Control Project. Chhattisgarh accounted for 17 percent of all malaria cases in 2017, second only to Orissa. Malaria was the main cause of deaths among children aged 1 – 15 years as well as among those who are in above 50-years of age groups and one among the six major causes of rural deaths reported in the State. Healthcare seeking behavior among the tribal group is complex and cannot be understood from a single lens. Tribals have a pluralistic perspective of any disease and malaria is no exception. Accordingly, the two year study attempts to capture the pluralistic view of tribal regarding malaria and how it influences their health-seeking behavior with the broader aim of designing a targeted intervention while taking into account the health system perspective in the state of Chhattisgarh.

Lifestyle Intervention to reduce the risk and prevalence of hypertension among Urban Poor of Delhi: Quasi-experimental study

Funding agency: ICMR

Team: Dr B. S. Singh, Dr Pankaj Telraja and Dr Anandhi Ramachandran 

Hypertension is a common but dangerous condition. High blood pressure increases the risk of heart disease, stroke, kidney disease, cancer, osteoporosis, and dementia. As per National Family Health Survey-4, 2015-16, prevalence of hypertension for men and women are 14.8% and 11% respectively. However, many who are affected by high blood pressure are unaware that they have it because there are no warning signs, which is why it’s called the “silent killer”. Thirty-seven years of scientific evidence conducted by Dean Ornish, M.D. and his colleagues in collaboration with the UC San Francisco and other leading academic institutions shows that changes in diet and lifestyle can make a powerful difference in your heart function and overall well-being. 

In our study which is of 2 years duration, an attempt is made to assess whether environmental or lifestyle (smoking, excess alcohol, urban living, psychological stress, reduced physical activity, unhealthy diet, excess salt intake, overweight and obesity etc) factors are associated with high blood pressure in urban poor living. Objective is to assess the effect of lifestyle intervention on hypertension, which will be achieved through lifestyle interventions, providing information on hypertension to community through technology and promoting the use of public health facilities existing nearby and coordination with other department/program/ stakeholders working in the area, such as NGOs, etc. Expected outcomes are reduction in raised blood pressure through changes in lifestyle and with use of technology, awareness of high blood pressure education program on the primary prevention of hypertension and increase in utilization of the public health facility by urban poor in a year. In Delhi, since UPHCs provides services under National Programme for Prevention and control of Cancer, Diabetes, Cardiovascular diseases & Stroke (NPCDCS) as per NHM guidelines at facility and in the community (i.e slum) through ASHAs i.e community health workers so the study is being conducted in collaboration with urban primary health centre (UPHC) covered under National Urban Health Mission.

An intervention area, covered by 4 ASHAs (approximately 2000 households and 500 households per ASHAs) under Urban primary health centre is being identified.

Planning and piloting an integrated disease control campaign in Uttar Pradesh

Team: Preetha GS, Sutapa B Neogi, Nikita Sabherwal, Jaswinder Kaur, Aanchal Singhal, Shivani Sharma

Integrated health campaigns combining two or more campaigns have been seen to leverage the strengths of compatible programs and avoid geographic and temporal duplications in efforts. The most common reported benefits for integrated campaigns are that they enhance population coverage and are cost effective, client-oriented, equitable and locally owned. The project attempts to explore ways to develop a collaborative plan for an integrated health campaign and pilot the plan in the districts of Gorakhpur and Deoria in Uttar Pradesh. The activities will involve a local landscaping for implementing integrated campaigns, developing a collaborative plan for an integrated campaign, demonstrating the plan on a limited scale in both the districts and documenting the experiences. Currently data collection is ongoing.

Implementation research to situational analysis and recommend an improved program model to improve adherence to IFA and calcium in selected areas of selected states in India

Funding agency: Nutrition International

Team: Sutapa B Neogi, Vinay Tripathi, and Sumesh Kumar

Iron-deficiency, which is one of the most prevalent nutrient deficiencies in the world, is one of the most common causes of anemia particularly affecting young children, pregnant and postpartum women. The iron-deficiency anemia and maternal under-nutrition account for at least twenty percent of global maternal deaths. India contributes to eighty percent of the maternal deaths in South Asia. Despite India witnessing a declining trend in anaemia during 2006 – 2016, anaemia remained highly prevalent in children and pregnant women with a very little improvement among non-pregnant women. The Government of India (GoI) has been implementing two focused programs, namely, Anemia Mukt Bharat (AMB) and Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) to address the need of comprehensive maternal nutrition and reducing anaemia. Along with this, the GoI has also initiated a calcium supplementation program. However, the coverage and compliance of both these programs for pregnant and postpartum women remain suboptimum and possess several operational challenges. The 2 year study aims to systematically investigate, through Implementation Research (IR), the factors that facilitates/ enables or hinders the program pertaining to maternal nutrition, come up with mitigation strategies, and inform scale up. This two-year long IR, which is divided into three phases of formative research, designing, and implementation phase, will evaluate an Improved Model of Implementation, in two states of India, namely, Madhya Pradesh and Gujarat. The study has just started, and necessary preparatory activities have been completed for data collection.