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Chronic Conditions and Public Policies

DEEP project to develop case studies around several Indian States

A paper on analysis of tobacco-related parliamentary questions accepted in the BMJ Global Health

The Deciphering Epidemic of Epic Proportions (DEEP) project at the Institute of Public Health (IPH) is currently developing the protocol for Phase-2 wherein the project team would be developing case studies around several Indian states. The project also engaged four interns who are helping to map select commodities (tobacco, alcohol, ultra-processed foods, automobiles) related to Commercial Determinants of Health in India.

A key achievement in this quarter is the paper on analysis of tobacco-related parliamentary questions in India, authored by Amiti Varma (former IPH colleague) Upendra Bhojani, and Latha Chilgod got accepted in the BMJ Global Health.

Dr. Upendra Bhojani’s teaching engagements: Lecture on smokeless tobacco (SARC-CCT. March 2021); Elective on Urban Health (Urban Fellows Programme, IIHS. Jan 2021); Lecture on “Health Systems and Health Systems Frameworks”, (India HPSR Fellowship program Jan 2021); and as a resource person in a couple of workshops on preventing tobacco industry interference in Manipur and Chattisgarh. Read a small note on the workshop: https://iphindia.org/workshop-on-preventing-tii-chhattisgarh-manipur/

Anushthana’s project study published in BMJ

The team participated in conferences to share about the project

In the first quarter of 2021, the team took stock of the objectives met so far and planned the activities for 2021. The team members participated in global conferences such as the Health Systems Research Symposium and the Realist 2021 conference to share about the Anushthana project and presented their learning from the conference in the public health seminars at IPH, Bengaluru. 

The project’s study protocol has been published in an international peer-reviewed journal BMJ Open available here https://bmjopen.bmj.com/content/11/5/e050859 

Dr. Pragati Hebbar work was spotlighted as part of the India Alliance fellow in spotlight https://www.indiaalliance.org/news/pragati-hebbar-fellow-spotlight 

Vivek Dsouza participated in a write-shop to help refine one of the upcoming scientific papers on media content analysis from the project

Undeterred support for Bengaluru UPHCs during COVID-19 second wave

COVID-19 relief team has distributed safety gear to 8 UPHCs and continues to provide support to BBMP Zone War Room

As part of the COVID-19 relief work in the Bengaluru district, AXA Business Services is supporting IPH for more than a year in relief activities that the team is taking up. Currently, the team has completed a year of continuous support for the eight selected Urban Primary Health Centres (UPHCs) by providing required essential safety equipment like PPE, masks, sanitisers etc., for frontline workers. The team also supported Health centres in creating awareness among the public on COVID-19 Appropriate Behaviour (CAB). 

As part of the project objective, the team is regularly participating in strategic meetings organised by Medical Officer-Health and also the Bruhat Bengaluru Mahanagara Palike (BBMP) East zone war room officials. Over the last quarter, the team has had meetings with Medical Officers of all the UPHCs to understand their further requirements and to plan the upcoming vaccination drives. Recently, another round of safety gear was distributed (5th and 6th round) to all the eight health centres. The team also participated in many community awareness sessions organised by various stakeholders.

The team is supporting these UPHCs with necessary personal protection equipment, strengthening the health system preparedness by facilitating and organizing training for health care workers, and the public by extending social support to the low-socioeconomic families with necessary grocery support and also to extend support in creating awareness on the importance of vaccination. In the month of March 2021, AXA business services have extended their support for another year to continue these relief activities.

Taking the anti-tobacco message to the rural youths

ToFY team involves grassroots stakeholders to keep youth away from tobacco and its related products

The Tobacco-Free Youth (ToFY) an initiative in Rural Karnataka is supported by ThoughtWorks under the Corporate Social Responsibility (CSR) initiative that focuses on creating a tobacco-free environment in education institutions. The focus is specifically on schools in the Tumakuru district with 75 education institutions being covered in the current project duration. The project has several phases of implementation starting from sensitization of key officials, stakeholders, training of officials to creating a tobacco-free school/education institution.

 
The team has completed around 80 percent of the project objective within the given timelines. With the completion of preliminary meetings, training, resource material finalization, distribution of signage to schools, etc., is completed and the project is right on schedule. As part of the project sensitisation sessions were held with district-level staff and educational institutions.

In the months of February and March, about six training sessions were conducted and one district-level training was conducted. In this, around 300 officials were trained and sensitized about the TOFEI campaign. Resource materials like the COTPA handbook, ToFY guidelines were printed and distributed to enforcing officials and school heads. Signages as per COTPA and ToFY guidelines were also printed and distributed to 36 schools. The team has so far conducted sensitization programs in 5 schools covering about 500 students.

Health Services Cluster

SPEAK team completed reports for four States

Study has been taken up to improve the health system’s response to Visceral leishmaniasis (VL) and sustaining VL elimination

The Setting Post Elimination Agenda for Kala Azar (SPEAK) health Systems team, comprising partner organization teams and IPH research team, developed and completed the draft reports for the four states: Uttar Pradesh, Bihar, West Bengal, and Jharkhand. These drafts were being refined to develop final reports. The reports include details of the health systems study’s findings and recommendations on improving the health system’s response to Visceral leishmaniasis (VL) and sustaining VL elimination once achieved in each state.

Model Health and Wellness Centre (HWC) project started in January 2021

In collaboration with Karuna, Trust IPH started the HWC project

The Model Health and Wellness Centre (HWC) project started in January 2021 in collaboration with Karuna Trust (KT). In the first quarter, the IPH Bengaluru team conducted several meetings with the implementation team from KT to understand the project implementation, develop Log frame analysis document and discuss a research plan to supplement the project implementation.

A theory of change for the project was developed in a workshop conducted with the implementation team. A research proposal was developed to undertake process evaluation, understand contextual factors affecting implementation and was submitted to the IPH IEC for approval.

Evaluation of Midwife-led Maternity Services, Telangana project entered the end-line phase

In the last quarter, the “publication plan” received approval from the UNICEF office.

Presentation to representatives from the Ministry of Health and Family Welfare (MOHFW), New Delhi
Scientific oral paper presentation at the 15th National Conference organised by "Society of Midwives, India"
The Evaluation of Midwife-led Maternity Services, Telangana project entered the end-line phase in January 2021. The findings from the project have been presented to representatives from the Ministry of Health and Family Welfare (MOHFW), New Delhi in the month of February 2021, and recommendations for scale-up have been made. All the suggestions from IPH were well received and the team is glad to be providing inputs on this important initiative in the country. 

A scientific oral paper presentation was made on the abstract titled: "The New frontiers in midwifery practice and education: Evaluation of a Midwife training program in Telangana, India” at the 15th National Conference organised by "Society of Midwives, India" on February 14, 2021. 

In the last quarter, the “publication plan” received approval from the UNICEF office. The final round of data collection of the project is planned to take place between April to June 2021.

INCARE team conducts 1,470 tribal household surveys

The team continues to work on NCDs in four tribal communities

INCARE team member taking the tribal household survey
In collaboration with Chamarajanagar district health authorities, Improving the Capacity of Health System and Community for Screening and Management of Some Non-Communicable Diseases among Scheduled Tribes: An Implementation Research in Chamarajanagar district, Karnataka (INCARE) research team completed 1,470 tribal household survey in four Primary health center coverage area on household demographics, prevalence and behavioral risk factors for hypertension, diabetes, and Chronic obstructive pulmonary disease (COPD), treatment-seeking behavior and out of the pocket expenditure.
 
The team continued its collaborative work on Non-communicable diseases in four tribal populations covering Primary Health centers (PHCs). In order to understand barriers and community perception on Diabetes, Hypertension, and COPD, team members underwent training on qualitative research methods.

NHSRC-ILC project team provides support for COVID-19 relief activity for four UPHCs

The quarter’s review meeting with the team puts a roadmap clear for the project

The team presented the progress report of the project to the NHSRC and NUHM teams, along with the support provided during the COVID-19. While this progress was appreciated, the team also took discussions pertaining to Phase 2 of the project.

The four Urban Primary Health Centers (UPHCs) in Bengaluru were supported with supplies of N95 masks and sanitizers from the funds raised by the COVID-19 relief team of IPH, Bangalore, and Karuna Trust.
In the last quarter, the ILC team members attended urban health courses from St John’s Research Institute, Bengaluru, the learnings from which were presented in public health seminars at IPH, Bangalore. Latha Chilgod delivered a session on migration for RGIPH students.
Research component on understanding the reasons behind implementation gaps continued in this quarter: Two interviews and a focus group discussion were conducted, and transcription was completed. The team took efforts in this quarter to strengthen the relationship building with the UPHCs through field visits, and with the state NUHM team. We visited the State Nodal Officer and submitted the Gap assessment report for the four UPHCs.

The last quarter had been instrumental in the project as the review with the NHSRC and the State NUHM team provided an opportunity to present the progress and challenges faced. This meeting also provided useful insights to be incorporated in the second year of the project. 

Health Equity Cluster

Strengthening tribal communities by starting libraries and wellness clubs

The tribal youths took part in number of community activities in the quarter

Under the ongoing Towards health equity and transformative action on Tribal health (THETA) THETA project, IPH researchers partnered with the Chamarajanagar district's Zilla Budakathu Girijana Abhivruddhi Sangha in a participatory action research program to examine the relationship between securing of forest rights and health through the rejuvenation of hamlet/podu-level forest rights committees in the Soliga hamlets. 

Research papers published: 

Raman V, Seshadri T, Joice S V., Srinivas, Prashanth N. Sickle cell disease in India: A scoping review from a health systems perspective to identify an agenda for research and action. BMJ Global Health. 2021 Feb 18 [cited 2021 Jun 2];6(2):4322. Available from: http://dx.doi.org/10.1136/bmjgh-2020-004322

Mahantesh Kamble, research officer at IPH Field station in BR Hills attended online training on ‘’Sports for Development'’. 

Anika Juneja, a PhD student associated with the cluster was selected for India Health Policy & Systems Research  Fellowships Programme

Yogish C B, research officer in THETA project participated in a writeshop to help finalise one of his upcoming paper on Risk factors for Hypertension in tribal and non-tribal communities in four states (Karnataka, Arunachal Pradesh, Kerala, and Madhya Pradesh). 

Under THETA project, a community library and a collective platform, the Doddasampige Adivasi Granthalaya, and eight sports and wellness clubs for adolescents and young adults from the Solega community are ongoing. The aim is to create platforms to discuss health and wellness and bring the focus on tobacco and alcohol use. In collaboration with sports and wellness clubs, two Volleyball tournaments were conducted to bring all sports & wellness clubs together and to discuss Podu health and wellness activity. 

THETA team completed survey data collection in all the five sites  (southern Karnataka, northern Kerala, southern Madhya Pradesh, and western Arunachal Pradesh) on Maternal and child health, Non-communicable diseases, and biomedical surveys in the Karnataka site. Along with collaborators, THETA team is working on survey data analysis. 

Activities conducted by THETA team
Podu swachhata program at B R Hills.

Podu swachhata program at B R Hills with the support of Grampanchayat members and local boys and girls from Hospodu, Yarakangadde, and Bangali podu. Around 25 people participated in collecting roadside plastics and other waste from Yarakangadde to Hospodu, a distance of around 2km.
Doddasampige Volleyball Tournament 

Soliga youth health and well-being by sports engagements conducted to keep them away from bad habits. The second edition of the Doddasampige Volleyball tournament was organized and about 8 Soliga youth sports clubs were joined on both days at BR Hills. 

International Women’s Day Celebration at IPH Field station 

Gram Panchayat President Rangamma Launched the International Women’s day of Soliga Adivasi Women in Collaboration with Grampanchayat Biligirirangana Betta, Jilla Budakattu  Girijana Abhivrudhi Sangha, Institute of Public Health Bangalore, Vivekanand Girijana Kalyana Kendra.

Training and Introduction of Rugby Game for Tribal Youths at BR Hills 

The Karnataka Rugby Federation Team conducted two days of rugby game training for tribal youths in the BR hills under the sports and wellness club, and more than 50 youths participated and were trained.

Two Day Leadership Workshop.

A two-day leadership workshop was organised for Adivasi Soliga young people from Mysore and Kodagu districts by Rajya Soliga Abhivrudhi Sangha, Taluka, Jilha Budakattu Girijana Abhivrudhi Sangha, Institute of Public Health Bengaluru and Vivekanand Girijana Kalyan Kendra.

Rajya Soliga Abhivrudhi Sangha Function at Rani Gate

Attended district level sports and cultural activities 2020-21

Education

The HPSR Fellowship program completes three online modules this quarter

The fellows had a series of interactions with HPSR experts like Dr. Upendra Bhojani, Professor Barbara McPake, and  Professor Ajay Mahal.

The IPH, in collaboration with several leading public health research organisations,  financially supported by Sir Ratan Tata Trusts and ACCESS Health International has set up a unique HPSR capacity-building initiative - India HPSR Fellowships Programme, that will build a community of Indian HPSR professionals.
 
The HPSR Fellowship has completed three online modules from January to March where fellows navigated through lectures, discussion forums, peer-based learning, hangout sessions with experts, and other activities. The programme began with ‘Introduction to health systems’ where fellows were exposed to how to describe a health system using a range of appropriate frameworks, to demonstrate the complex nature of health systems and the consequences for research in and of health systems.

In “Introduction to Health Policy and the Policy Process”, fellows were familiarized with understanding what a policy is and the policy-making processes as well as being able to analyze both the content and the processes keeping in mind the power of the various stakeholders.

The preceding modules set the stage for “Introduction to HPSR and framing HPSR questions", where fellows developed a broad overview of the field of HPSR and fellows were able to frame research questions based on a health policy and systems problem and further refined the research question using systems thinking, complexity, ethics, and equity as lenses. 

During these 3 months, the fellows had the opportunity to learn from HPSR experts such as Dr. Upendra Bhojani, Professor Barbara McPake, and  Professor Ajay Mahal.
 
Follow the India HPSR Fellowships Programme updates on Twitter handle: @hpsrindia

Contact Information:
Website: https://indiahpsrfellowships.org/  |info@indiahpsrfellowships.org | tutor@indiahpsrfellowships.org

The education team at IPH in a learning session with Carlos Kiyan on cardinal elements of impactful e-learning programs - designing, evaluation, and delivery.

If we look at the overview of the education cluster of IPH, in the last quarter, two interns were recruited - one under the Health Equity Cluster and the other under Chronic Conditions and Policy Cluster.  Currently, there are five internal PhD students registered with the following Universities viz, Maastricht University and The University of Trans-Disciplinary Health Sciences and Technology (TDU), Bengaluru, respectively for their Doctoral programs.  There are ongoing discussions on the launch of the eIR course.

The Education team at IPH has been routinely engaging with Carlos Kiyan, Instructional Designer- Academic Programs, ITM, for augmenting the skills in education designing and planning.

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