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This study examines escalating concerns about out-migration from tea gardens, focusing on Kurti Tea Garden in Jalpaiguri, West Bengal, of India. Results from a comprehensive field study illuminate a complex scenario, with only 21.13 per cent of individuals employed and pervasive challenges in promotion prospects. High living expenses, limited livelihood options, and inadequate amenities propel households into debt, prompting migration. South India, notably Thiruvananthapuram, emerges as a preferred destination, especially for the younger demographic. The study provides insights into multifaceted reasons driving migration, stressing the need for holistic interventions, encompassing economic, socio-cultural, and labour-related aspects. It advocates for improved wages, enhanced living conditions, healthcare access, education, and measures to counter deceptive recruitment practices. The study reveals that comprehensive strategies are essential for addressing challenges related to migration-driven hardships in tea gardens. This can be achieved through collaborative efforts involving the government, management, and civil society. [ABSTRACT FROM AUTHOR]

Since the 2000s, hundreds of government-funded health insurance (GFHI) schemes were introduced in India. These schemes are meant to prevent poorer households from incurring catastrophic health expenditures. Through GFHIs, policy-makers want to mobilize the decision-making powers of private consumers in a liberalized healthcare market. Patients are called upon to act as 'co-creators' of healthcare value by optimizing supply through demand. Based on long-term ethnographic fieldwork with insurance users in South India, we argue that GFHIs fail because people experience the value of insurance in drastically different ways that only partly overlap with how the policy assumes they value insurance. In addition, the hollow promises of health coverage can be experienced as so frustrating that signing up for health insurance actually makes people feel devalued. [ABSTRACT FROM AUTHOR]

The study aimed to find out the association between self-care behaviors and glycemic control in older Type 2 diabetes mellitus patients in Multan, Pakistan. Data were collected from respondents registered in the Diabetic Clinic of Nishtar College and Hospital Multan from October 2018 to November 2018 through a self-administrative questionnaire. The simple random sample method was used, and a total of 154 Type 2 patients were selected randomly. The inclusion criteria were (a) respondents having Type 2 diabetes at least 6 months prior; (b) respondents being 60 years of age or above; (c) respondents registered in hospital diabetic clinic and (d) respondents belonging to low-income families having monthly income less than PKR 15000. The exclusion criteria were respondents having any physical disability and being dependent on others in physical movement and Type 1 diabetes mellitus patients. Descriptive and simple binary logistic regression was used to analyze the data through SPSS. The results of the study showed that mean glycemic control of respondents was (HbA1c, 8.47%), and only 48 (31.2%) respondents had better glycemic control. The respondent's level of education, Body Mass Index, hypertension, comorbidities, knowledge about diabetes and self-care behaviors (exercise, monitor glucose, medicine adherence, and diet plan) were significantly associated with glycemic level (P <.05). Bivariate logistic regression showed respondents, who performed self-care behaviors (to exercise daily 30 minutes, to monitor glucose two times in a week, regular medicine adherence, and to manage diet plan daily) had better glycemic control. The study concluded that few older Type 2 patients managed their better glycemic control in low economic status. The doctors and educationists must provide Type 2 self-care guidelines to older patients so that they may manage their glycemic control better and reduce the diabetes-related complications and treatment costs in Pakistan. [ABSTRACT FROM AUTHOR]

Internally displaced women are underserved by health schemes and policies, even as they may face greater risk of violence and unplanned pregnancies, among other burdens. There are an estimated 450,000 internally displaced persons in India, but they are not formally recognised as a group. Displacement has been a common feature in India's northeast region. This paper examines reproductive and maternal health (RMH) care-seeking among Bru displaced women in India. The study employed qualitative methodology: four focus group discussions (FGDs) were held with 49 displaced Bru women aged 18–45 between June and July 2018; three follow-up interviews with FGD participants and five in-depth interviews with community health workers (Accredited Social Health Activists – ASHAs) in camps for Bru displaced people in the Indian state of Tripura. All interviewees gave written or verbal informed consent; discussions were conducted in the local dialect, recorded, and transcribed. Data were indexed deductively from a dataset coded using grounded approaches. Most women were unaware of many of the RMH services provided by health facilities; very few accessed such care. ASHAs had helped increase institutional deliveries over the years. Women were aware of temporary contraceptive methods as well as medical abortion, but lacked awareness of the full range of contraceptive options. Challenges in accessing RMH services included distance of facilities from camps, and multiple costs (for transport, medicines, and informal payments to facility staff). The study highlighted a need for comprehensive intervention to improve RMH knowledge, attitudes, and practices among displaced women and to reduce access barriers. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a research study in Thane District, Maharashtra, India, on access to sexual and reproductive health and rights (SRHR) for women and girls of Nomadic and Denotified Tribes (NT-DNT). NT-DNT communities face stigma and violence due to their historically criminalised status and nomadic lifestyle. Their precarious legal, social, and economic status has a negative impact on women's SRHR. Existing literature on this subject is sparse, and studies by researchers from within the community, which could bring about organic and community-led change, are almost non-existent. This study, carried out by a woman from a Nomadic Tribe, presents an insider's perspective on the experiences of and factors underlying the violation of the SRHR of girls and women of NT-DNT communities. The study used a human rights-based participatory methodology with qualitative methods including three focus group discussions with 21 women and 10 in-depth interviews with women and key informants from NT-DNT communities. The findings describe the gender, community, and health system barriers which hinder women's and girls' access to SRHR. Issues such as language barriers between the women and medical fraternity, criminalisation by the police, and extreme deprivation – more intense than faced by the general poor – are unique to women of these communities. The NT-DNT communities face extreme deprivation of basic resources such as identity documents, shelter, sanitation, education support, workplace safety, and transportation, which further deny women their sexual and reproductive rights. The paper aims to amplify these women's voices to advocate for better SRHR services for women and girls of NT-DNT communities. [ABSTRACT FROM AUTHOR]

In India, the "feminization of aging" is one of the areas in which prejudice most frequently occurs. Noticeably, poverty, isolation, changes in residential care, and weak institutional support push women into several vulnerabilities. This study demonstrates that elderly women are often denied basic rights and are compelled to reside in old-age homes; the situation is worse for elderly widowed women. We examine the claims that the lives of elderly women are more precarious due to their lower literacy, limited social exposure, and monetary dependence. Being women, old, and widowed, they are affected by triple vulnerabilities that require concrete policy implications. [ABSTRACT FROM AUTHOR]

A significant number of “marginalized” population groups are denied their health rights, healthcare access, benefits of government health programs, and other health-related social security benefits. These population groups, particularly the rickshaw pullers of India, are vulnerable because of their poor social and economic status, migration history, lack of permanent settlements, lack of social capital, and so on. These reasons, coupled with other social-political reasons, lead to no or limited access to health services and poor health conditions. This study intends to explore and understand the context and health seeking behavior of rickshaw pullers in Ranchi, the capital city of Jharkhand state in India, with special reference to wider social determinants of health such as, access, affordability, and delivery of health services. The data was collected from 1,000 rickshaw pullers from 40 “rickshaw garages” in Ranchi. The findings of the study show that rickshaw pullers can't afford to “attach” much importance to their health due to various reasons and suffer from a variety of occupational and other illnesses. The health conditions of the rickshaw pullers are affected by poverty, negligence, illiteracy, lack of awareness and unavailability of affordable, quality health services. These are only a symptom of the larger structural issues affecting health. The study suggests that rickshaw pullers, being a marginalized and excluded population group, require special health and social security programs that include safe, affordable, and accessible services along with a special focus on health education, behavior change, and promotion of appropriate health-seeking behavior. [ABSTRACT FROM PUBLISHER]

This article describes the efforts made by some centers in India and other low- and middle-income countries to provide comprehensive care to persons with schizophrenia and their families despite limited resources. In India these efforts include leveraging existing but unutilized resources in the community (such as community-level lay workers), supporting and empowering families as the primary and major caregivers, and using telepsychiatry to reach untreated persons in remote and rural areas. Innovations of this kind have added value to the process of professional care for those with schizophrenia. They may be useful strategies for other developing countries to adopt. [ABSTRACT FROM AUTHOR]

Background: Millennium Development Goal (MDG) 5 is focused on reducing maternal mortality and achieving universal access to reproductive health care. India has made extensive efforts to achieve MDG 5 and in some regions much progress has been achieved. Progress has been uneven and inequitable however, and many women still lack access to maternal and reproductive health care. Objective: In this review, a framework developed by the Commission on Social Determinants of Health (CSDH) is used to categorize and explain determinants of inequity in maternal and reproductive health in India. Design: A review of peer-reviewed, published literature was conducted using the electronic databases PubMed and Popline. The search was performed using a carefully developed list of search terms designed to capture published papers from India on: 1) maternal and reproductive health, and 2) equity, including disadvantaged populations. A matrix was developed to sort the relevant information, which was extracted and categorized based on the CSDH framework. In this way, the main sources of inequity in maternal and reproductive health in India and their inter-relationships were determined. Results: Five main structural determinants emerged from the analysis as important in understanding equity in India: economic status, gender, education, social status (registered caste or tribe), and age (adolescents). These five determinants were found to be closely interrelated, a feature which was reflected in the literature. Conclusion: In India, economic status, gender, and social status are all closely interrelated when influencing use of and access to maternal and reproductive health care. Appropriate attention should be given to how these social determinants interplay in generating and sustaining inequity when designing policies and programs to reach equitable progress toward improved maternal and reproductive health. [ABSTRACT FROM AUTHOR]

Since 2005, the Government of India has initiated several interventions to address the issue of maternal mortality, including efforts to improve maternity services and train community health workers, and to give cash incentives to poor women if they deliver in a health facility. Following local protests against a high number of maternal deaths in 2010 in Barwani district in Madhya Pradesh, central India, we undertook a fact-finding visit in January 2011 to investigate the 27 maternal deaths reported in the district from April to November 2010. We found an absence of antenatal care despite high levels of anaemia, absence of skilled birth attendants, failure to carry out emergency obstetric care in obvious cases of need, and referrals that never resulted in treatment. We present two case histories as examples. We took our findings to district and state health officials and called for proven means of preventing maternal deaths to be implemented. We question the policy of giving cash to pregnant women to deliver in poor quality facilities without first ensuring quality of care and strengthening the facilities to cope with the increased patient loads. We documented lack of accountability, discrimination against and negligence of poor women, particularly tribal women, and a close link between poverty and maternal death. Depuis 2005, le Gouvernement indien applique plusieurs interventions en matière de mortalité maternelle, notamment pour améliorer les services de maternité, former les agents de santé communautaires et verser une allocation aux femmes pauvres si elles accouchent dans un centre de santé. Après des manifestations locales contre le nombre élevé de décès maternels en 2010 dans le district Barwani au Madhya Pradesh, en Inde centrale, nous avons mené une mission d'enquête en janvier 2011 sur les 27 décès maternels signalés dans le district d'avril à novembre 2010. Nous avons constaté une absence de soins prénatals, en dépit de niveaux élevés d'anémie, un manque d'accoucheurs qualifiés, l'incapacité à dispenser des soins obstétricaux d'urgence dans des cas évidents de besoin et des aiguillages de patientes n'ayant jamais abouti à un traitement. Nous présentons deux cas à titre d'exemple. Nous avons transmis nos conclusions aux autorités de santé du district et de l'État, et demandé l'application de mesures éprouvées de prévention des décès maternels. Nous remettons en question la politique d'encouragement financier pour inciter les femmes à accoucher dans des centres de mauvaise qualité sans d'abord garantir la qualité des soins et renforcer les installations pour leur donner les moyens de traiter le nombre accru de patientes. Nous avons mis en évidence le manque de responsabilisation, la discrimination et l'indifférence à l'égard des femmes pauvres, en particulier des femmes tribales, et un lien étroit entre pauvreté et mortalité maternelle. Desde el año 2005, el Gobierno de India ha iniciado varias intervenciones para tratar el problema de mortalidad materna,incluso esfuerzos para mejorar los servicios de maternidad y capacitar a trabajadores comunitarios de la salud, y dar incentivos de dinero en efectivo a las mujeres pobres que dan a luz en una unidad de salud. En el año 2010, tras protestas contra el alto índice de muertes maternas en el distrito de Barwani en Madhya Pradesh, en India central, realizamos una visita en enero de 2011 para investigar las 27 muertes maternas reportadas en el distrito desde abril hasta noviembre de 2010. Encontramos una ausencia de servicios de atención antenatal a pesar de los altos niveles de anemia, ausencia de asistentes de parto calificadas, incumplimiento de los cuidados obstétricos de emergencia en casos obvios de necesidad, y referencias que nunca produjeron tratamiento. Presentamos dos historias de casos como ejemplos. Llevamos nuestros hallazgos a funcionarios de salud distritales y estatales e instamos a que se implementen medios comprobados para la prevención de muertes maternas. Cuestionamos la política de dar dinero en efectivo a mujeres embarazadas para que den a luz en unidades de calidad deficiente sin antes garantizar la calidad de la atención y fortalecer las unidades para que puedan manejar el número cada vez mayor de pacientes. Documentamos la falta de responsabilidad, discriminación y descuido de las mujeres pobres, en particular las mujeres tribales, y una estrecha asociación entre la pobreza y la muerte materna. [ABSTRACT FROM AUTHOR]

The article presents editor's note on the programme that focuses on the innovative approaches to improve the nutrition for women and children in India. It mentions that in situ, pregnant and lactating women are included in the programme. It mentions that poverty has an adverse affect on the growth and development of children.