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Summary This paper analyzes a unique data set that details the daily advertisements on Information, Education and Communication (IEC) material to avert heat stroke mortality in different media used by the state government of Odisha, India and the actual daily heat-wave mortalities in the state over a period of eight years. The paper then investigates the relative effectiveness of the different media in reducing mortality econometrically. The government adopted awareness generation as an adaptation strategy for heat waves in the year 2003 and intensified the use of public media from 2007 when multiple newspapers and radio and television channels were used for dissemination. I analyze the district-level daily death occurrences due to heat stroke using both linear and non-linear econometric models. Media used on the same day or on previous days are represented in the models by grouping them as either print, audio or video media. The data used is a daily panel data set consisting of only summer days (15th March–20th June) for the years 2005–12 for each of the 30 districts of the state. The estimated models account for the gap in data and the multidimensional nature of the panel (days, months, years). The results show the repeated use of video media to be the most effective in reducing deaths followed by newspapers and radio. The paper’s novel contribution is the use of secondary data to evaluate media and compare media effect of public health communication strategies in a developing country. [ABSTRACT FROM AUTHOR]

Recently, nutrition-sensitive agriculture programs have taken aim at malnutrition's multi-sectoral roots through re-diversifying agricultural production while integrating women's empowerment and nutrition behavior-change communication components. For these integrated nutrition-sensitive agricultural programs, women-led self-help groups have emerged as promising platforms for program delivery. Yet, while well-designed nutrition behavior-change communication has been successfully used in self-help groups, and is central to nutrition-sensitive agriculture, it can take many forms. These vary widely in their theoretical and ethical underpinnings, communication strategies, and theory of change. As nutrition-sensitive agriculture continues to proliferate, it is critical to better understand how women interact with different behavior-change messages and how to engage individuals in ethical, effective ways. This paper analyzes qualitative data collected from a nutrition-sensitive agricultural project in India that used participatory storytelling to generate knowledge and awareness about malnutrition among women. Drawing from data across two sites, the paper analyzes why certain messages generated more discussion among women then others. We find self-help group women were drawn to topics of early marriage and diet diversity because they emotionally connected to them, and felt they were relevant to their lives with high perceived pay-off and actionability. While other topics on gender and health also provoked emotional, lively discussions, the stories were less effective due to their complexity, which were difficult for volunteer facilitators to communicate. We conclude that there is unmet demand among women in rural India for structured spaces to discuss gendered aspects of health and diet, and nutrition-sensitive agricultural programs could benefit from focusing attention here. • Engages debates on health behavior change communication (BCC) ethics and efficacy. • Examines modified participatory learning and action (PLA) run in women's groups. • Finds women were drawn to simple, actionable messages they emotionally related to. • Insufficient investment in volunteers' PLA facilitation skills hampered impact. • There is need for more BCC focused on women as women, rather than mothers. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is an endocrine disorder linked to type II diabetes and the leading cause of female infertility worldwide. Despite being considered a “lifestyle” disease, PCOS has received scant attention in the social science literature. In India, media accounts citing prominent doctors have expressed concern that the syndrome affects a growing number of urban middle-class Indian women. The general public, doctors, and afflicted women all attribute the condition to stress, lifestyle changes, “Westernization,” modernization, and disrupted circadian rhythms. These factors are associated with changes in diets, gender roles, and aspirations since 1991, when the introduction of neoliberal reforms opened up the country to processes of globalization. Women with PCOS have come to be seen as living embodiments of the biosocial stresses associated with modern urban middle-class living, and discourse about PCOS serves as commentary indexing anxieties about social and political–economic shifts in the country. In this paper, based on ethnographic fieldwork in Mumbai, India, with 141 participants from 2012 to 2014, we point to local understanding of PCOS as corresponding to an ecosocial perspective that highlights the structural vulnerabilities of urban middle-class women. Whereas most research on structural vulnerabilities and health has centered on economically and otherwise disadvantaged groups, we use PCOS as a case study to draw attention to the rise of lifestyle disorders linked to the impact of globalization and the pressures of “modern” identities and aspirations among middle-class populations. [ABSTRACT FROM AUTHOR]

Hierarchies of power among healthcare professionals are well documented, nonetheless, power remains neglected, understudied and under-theorised in health systems analysis and policy discussions, especially in the domain of Traditional, Complementary and Alternative Medicine (TCAM). Sociological and public health scholarship has documented the persistence of medical dominance in the health system, theorised as the limitation, subordination, exclusion and incorporation of other professions. This paper explores how interprofessional power dynamics shape the integration of TCAM into Indian primary healthcare centres, as part of a nationwide policy of TCAM integration and medical pluralism implemented since 2005. We conducted interviews (n = 37) with health system administrators, nurses, pharmacists, TCAM and biomedicine doctors, and observed day-to-day activities of primary healthcare centres for six months in Odisha state, India. Thematic analysis enabled the identification of themes and exploration of sub-themes. The analysis revealed multilayered forms of medical dominance within the primary healthcare system and identified multiple sites where everyday power is mobilised. Biomedicine practitioners exercised authoritative power and restricted TCAM doctors' access to facility-level resources, i.e. financial and workforce support, which inhibited the integration policy implementation. Significantly, TCAM doctors were 'ordered' to practice biomedicine at primary healthcare centres, which was beyond the scope of the integration policy. However, TCAM doctors were also able to exercise countervailing power in their day-to-day activities in the primary healthcare centres and sought to assist patients' health behaviour change through their authoritative knowledge about 'how to live a healthy life'. The health system actors involved in policy implementation hold a range of forms of power specific to the circumstances, influencing the integration processes. We explain these dynamics in relation to existing theories of medical dominance and countervailing power, while introducing a previously unreported dimension of dominance: 'co-optation', which enrols TCAM practitioners in the practice of biomedicine. • Medical dominance in Indian primary health care centres (PHCs) is multi-layered. • AYUSH doctors working in PHCs experience subordination, exclusion and limitation. • A new form of medical dominance – co-optation – was also uncovered in this setting. • Co-optation here involved AYUSH doctors being ordered to undertake biomedical tasks. • Via countervailing power, AYUSH doctors retained autonomy in community-based work. [ABSTRACT FROM AUTHOR]