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In response to the global call to upscale mental health services in low--income countries, mental health non-governmental organisations (MHNGOs) have sprung up in Kerala to address mental health needs by partnering with pre-existing locally grown, bottom-up, community-led pain and palliative clinics (PPCs) to increase access to mental health care through task-shifting. The MHNGOs mandate filtering only patients with 'severe mental disorders' from low socioeconomic backgrounds for their free services. This eligibility criterion mandated by the MHNGO is ruffling feathers within the palliative clinics that oppose such -classifications. They believe that suffering cuts across all divisions and should not be discriminated against based on economic background and severity of illnesses. When chronicity and suffering are held universal by the MHNGO and palliative care, respectively, it brings to the fore the enactment of two perspectives of care. Drawing on observations of clinical interactions between patients, MHNGO staff and mental health professionals and interviews with community volunteers of palliative care clinics in Kerala, this paper demonstrates how chronicity narrative promoted by MHNGOs based on biopsychiatric model gains hegemony, whereas the community care model loses traction progressively. The state, caught between these two narratives, frontstages development by submitting its health machinery to the MHNGOs flouting basic medical safety laws in its services to marginalised people like the tribal population. This paper argues that the rising dominance of chronicity narrative in community mental health clinics as well as in popular media discourses evolves out of power relations between the MHNGOs and the palliative clinics. [ABSTRACT FROM AUTHOR]

Laparoscopic tubal ligation is the most prevalent method of contraception amongst India's rural and urban poor. Drawing on 18 months of ethnographic fieldwork in rural Rajasthan in 2012–2013, this paper investigates how rural women's perceptions of a biomedical instrument—the laparoscope—influence their perceptions of sterilization, a procedure often entrenched in coercive, target- and incentive-driven population control programme. By investigating how a laparoscope is entangled in global exchanges, national policies, institutional arrangements, and local moral worlds, this paper demonstrates that while wider biomedical discourses perpetuate the narrative of safety and convenience, people's everyday lives inform their understandings of technology that is widely known but rarely seen. [ABSTRACT FROM AUTHOR]

This paper points to an underexplored relationship of reinforcement between processes of quantification and digitisation in the construction of mental health as amenable to technological intervention, in India. Increasingly, technology is used to collect mental health data, to diagnose mental health problems, and as a route of mental health intervention and clinical management. At the same time, mental health has become recognised as a new public health priority in India, and within national and global public health agendas. We explore two sites of the technological problematisation of mental health in India: a large-scale survey calculating prevalence, and a smartphone app to manage stress. We show how digital technology is deployed both to frame a 'need' for, and to implement, mental health interventions. We then trace the epistemologies and colonial histories of 'psy' technologies, which question assumptions of digital empowerment and of top-down 'western' imposition. Our findings show that in India such technologies work both to discipline and liberate users. The paper aims to encourage global debate inclusive of those positioned inside and outside of the 'black box' of mental health technology and data production, and to contribute to shaping a future research agenda that analyses quantification and digitisation as key drivers in global advocacy to make mental health count. [ABSTRACT FROM AUTHOR]

Covid-induced lockdowns have increased the importance of technology in education. Though access to technology as well as availability of the internet remain a major concern for a lot of children in the global south, children with intellectual disabilities are disadvantaged even more as most of the e-content is developed keeping in mind the average learner. Unstructured interviews were conducted with children with intellectual disabilities studying in government schools in Haryana as well as their teachers and parents. Thematic analysis of the interviews was conducted to understand the use-patterns of mobile phones by children with intellectual disabilities. Findings suggest that these children are learning to use mobile phones on their own or with some support and are able to navigate the complexities of these smartphones quite well. They use these devices mostly for their entertainment. This paper then reflects on the need and strategies to develop these technologies in ways that they can be used as effective tools for teaching children with intellectual disabilities, especially in the inclusive education system in developing countries. The paper reflects on the need to develop technology and tools using flexible and exploratory designs to enhance the learning processes for children with intellectual disabilities from the lower income strata. This study highlights the importance of being able to use mobile phones by children with intellectual disabilities belonging to low income families. Following this, the article argues for designing of mobile phones suitable for use by children with intellectual disabilities using playfulness and explorations, and Building e-content keeping the elements of playfulness and exploration which can enhance the learnings of this group of students which is often ignored. [ABSTRACT FROM AUTHOR]

Drawing on critical theoretical perspectives and ethnographic field research related to HIV/AIDS in northern India, this paper argues for a cultured-centered approach to stigma reduction interventions and communication practices that are based on an assessment of larger social and structural processes on the one hand and the lived experiences and narratives of people living with HIV (PLWH) on the other. This paper suggests that while the complex nature of stigma, particularly as it relates to HIV/AIDS, makes it difficult to understand and respond to, this problem is further exacerbated by a largely individual and behavior-centered research that still dominates the field of Health Communication. Such research sees human cognition as the main source of stigma and underplays issues of power, structure, domination, and control. More specifically, and with concrete examples from the everyday lived experiences of PLWH – such as their experiences within family and health-care settings, this paper demonstrates how power and structure deeply impact their lives and remain central to their experience of (and resistance to) stigma, thus opening up space for alternative theorizing and practices in Health Communication. [ABSTRACT FROM AUTHOR]

The precarity of journalistic labour has received significant scholarly attention globally, leading to a plethora of studies that attempt to theorise changing journalistic roles, practices, and norms. Whereas precarity in newswork is formulated as the "new normal" in the Global North, the precarious situation of marginal(ised) newsworkers in the Global South has been simply normal. Based on ethnographic research in two small-town formations in South India, this article presents how stringers working in Indian-language newspapers have developed a complex professional identity and shared norms through journalistic and extra-journalistic practices to survive in the field. In doing so, we develop, in a novel way, Bourdieu's concept of illusio to understand the formation of a professional identity that spans adjacent fields. This paper's critical engagement with the difficult working lives of stringers and their invisible labour has learnings for analysis of precarity in journalism across the Global North and South. [ABSTRACT FROM AUTHOR]

Schoolchildren's embodied subjectivity has often been understood as a bio-political tool to 'clean up' and modernize poor and marginalized communities. In many post-colonial contexts, school uniforms frequently appear as visual symbols of a child's clean, schooled body and democratic access to education. Through ethnographic research with 10–14-year-old schoolchildren in urbanizing areas in northern Tamil Nadu, my paper asks how children inhabit and co-construct the school uniform code's cleanliness discourse in their everyday lives. Studying plural school uniforms through a spatial lens, I explore schoolchildren's embodied and relational work in negotiating with the equalizing school uniform codes within the schools and the circulation of multiple school uniforms in the community outside. Engaging with a shifting visual aesthetic of embodied cleanliness in a context of class segregated schooling. I argue that school uniforms are discursive sites where exclusions of class and gender, with undertones of caste and age, are simultaneously reinforced and negotiated. [ABSTRACT FROM AUTHOR]

Existing literature demonstrates agro-chemicals result in physical toxicity and damages human health, flora and fauna. However, little is known about how such ‘toxicity’ relates to mental well-being and social suffering. This paper aims to demonstrate how local, national and international vectors are interlinked to shape social distress among cotton farmers in India. Ethnographic interviews and focus group discussions were conducted in a cotton-growing village of the Warangal district, Telangana state, India. The results advance the concept of counter therapeutic spaces and hypothesise that toxic landscapes emerge through a dynamic interaction between dispersed agencies that interact and reconfigure agricultural spaces into socially toxic places. The paper argues that the disciplines of public health and agriculture suffer from a failure of imagination to forge vital interdisciplinary links that could address farmer suffering. Unpacking local ecologies of farmer suffering offer innovative ways for enhancing mental health policy and interventions in India. [ABSTRACT FROM AUTHOR]

Research and practice in the area of mental health has been conventionally predominated by the deficit-based approach, which attempts to improve lives by fixing symptoms. However, the growing impact of the positive psychology movement in the last two decades has resulted in incorporation of the strength-based approach into mental health work. The objective of this article is to (i) emphasize the efficacy of strength-based approach in the area of mental health (ii) identify shortcomings in the Indian Mental Health System (MHS) (iii) recognize micro-level initiatives in the MHS and (iv) provide recommendations for the future. These objectives are accomplished via reflections obtained from an ethnographic research with participants reporting mental health symptoms. Additionally, opinions gathered from mental health professionals, and government and non-government organizations working in the area were also considered. This work has shed light on the recent micro-level transformations in the system including contextualization of mental illness and treatment, valuing patient's input in the treatment process, and the creation and effective functioning of mental health task-forces. This paper concludes with a four-point recommendation that can help to incorporate the strength-based approach in MHSs for better outcomes. [ABSTRACT FROM AUTHOR]

This paper explores the effectiveness of religious healing by focusing on one important factor that has been much neglected – the stay within the shrine. Drawing on qualitative research in Mahanubhav temples in India, this paper emphasises that the central part of religious healing is the process of being in the temple and becoming familiar with shrine culture. At the same time, I argue that the social space of the shrine is important not only for the benefits of a soothing environment or support system. It is argued that temporary residence within the shrine enables individuals to develop long-term associations with the religious community and sect. Through discussion of indicative cases, this paper elaborates on the process of “becoming a Mahanubhav pilgrim” that is at the heart of temple healing practices in India. [ABSTRACT FROM AUTHOR]

This paper is a disruptive ethnography of Indians in Tanzania (Tanzanian-Indians). It uses narratives of individuals to challenge the popular ethnographic categories within which the individuals are usually subsumed. This paper analyses three critical questions concerning Category, Homeland and Community. Is the category Mhindi (‘Indian’ in Kiswahili) exhaustive as a cultural identity? What is the relationship of Tanzanian-Indians to their ‘homeland’ India? Does a community-based approach map on to the realities of everyday lives of Tanzanian-Indians? The focus will be on Zanzibar and Dar es Salaam. Both these neighbouring places have significant Indian presence and through ethnographic research using conversations, semi-structured interviews and the self-presentation of individuals through temples, mosques and clubs, we highlight the diversity of experience that lies behind the specific identity category of Mhindi. [ABSTRACT FROM PUBLISHER]

This paper examines the grid of sentiment that structures medical travel to India. In contrast to studies that render emotion as ancillary, the paper argues that affect is fundamental to medical travel's ability to ease the linked somatic, emotional, financial, and political injuries of being ill 'back home'. The ethnographic approach follows the scenes of medical travel within the Indian corporate hospital room, based on observations and interviews among foreign patients, caregivers, and hospital staff in Mumbai, New Delhi, Chennai, and Bangalore. Foreign patients conveyed diverse sentiments about their journey to India ranging from betrayal to gratitude, and their expressions of risk, healthcare costs, and cultural difference help sustain India's popularity as a medical travel destination. However, although the affective dimensions of medical travel promise a remedy for foreign patients, they also reveal the fault lines of market medicine in India. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this paper was to highlight the importance of cultural infl uence in understanding hearing-help seeking and hearing-aid uptake. Design: Information on audiological services in different countries and ' theories related to cross-culture ' is presented, followed by a general discussion. Study sample: Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. Results: Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the infl uence of cross-cultural factors in this area calls for an immediate need for research. Conclusions: This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed. [ABSTRACT FROM AUTHOR]

India is not known as a country to be in for a bisexual person. Homosexual acts even within wedlock are a punishable offence in India. Legal battles over provisions in the Indian Penal Code which criminalizes any sexual act “against the order of nature” are rife. Even though Kerala has been hailed as a paradox inside India (mainly due to its human development parameters), the social, cultural and legal environment in the state is hostile to individuals who question hetero-normativity. Non-judgemental and unbiased scientific therapy or counselling are seldom available to sexual minorities. This paper is an attempt to map the experiences of a female who is openly bisexual, and is living in Kerala. An ethnographic interview was conducted where the experiences of the participant are explored, from the relationship dynamics as seen by her, to sexual experiences and difficulties in relationships. A reference is also made to the personal and social support systems that are in place for the Lesbian, Gay, Bisexual, Transgender (LGBT) community in Kerala and their role in initiating discourses regarding the topic. A few pointers for future studies in the topic, especially within the context of Kerala are also put forward. [ABSTRACT FROM PUBLISHER]

The public works program (PWP), the Mahatma Gandhi National Rural Employment Guarantee Act (MNREGA) in India, opened a new chapter in rural governance, signifying transformative potential for enhancing economic and social security. Despite the aim of this social protection scheme to enhance the "livelihood security of the household", provide employment to landless labourers, and encourage sustainable development, young men still opt to be migrant labourers in Bombay, many of whom become infected with AIDS and subsequently die. Often economic returns outweigh social risks and the new channels of disempowerment it reopens for women and children who are dependent on the income of these migrant men. We draw on ethnographic research conducted in Udaisarai (Gram Panchayat), Bhitaura block in Fatehpur District (Uttar Pradesh), to uncover rural-to-urban migration to Bombay, for better employment opportunities, and AIDS as one of the fallouts of the poor implementation of MNREGA. These pressing concerns need to be critically evaluated. [ABSTRACT FROM AUTHOR]

In this study the author analyzes the relationship between the individual body and the body politic in a region of the north Indian state of Uttarakhand, in connection with social changes occurring at the local and trans-local level, which are impacting the status of the different healing systems. By investigating these issues, this paper aims to shed light on some of the complex ways in which practitioners and patients who take part in a local method of healing, in this case ritual healing through possession, respond to the expansion of biomedicine. [ABSTRACT FROM AUTHOR]

In India, nurses and midwives are key to the provision of public sexual and reproductive health services. Research on impediments to their performance has primarily focused on their individual capability and systemic resource constraints. Despite emerging evidence on gender-based discrimination and low professional acceptance faced by these cadres, little has been done to link these constraints to power asymmetries within the health system. We analysed data from an ethnography conducted in two primary healthcare facilities in an eastern state in India, using Veneklasen and Miller's expressions of power framework, to explore how power and gender asymmetries constrain performance and quality of care provided by Auxiliary Nurse Midwives (ANMs). We find that ANMs' low position within the official hierarchy allows managers and doctors to exercise "power over" them, severely curtailing their expression of all other forms of power. Disempowerment of ANMs occurs at multiple levels in interlinked and interdependent ways. Our findings contribute to the empirical evidence, advancing the understanding of gender as a structurally embedded dimension of power. We illustrate how the weak positioning of ANMs reflects their lack of representation in policymaking positions, a virtual absence of gender-sensitive policies, and ultimately organisational power structures embedded in patriarchy. By deepening the understanding of empowerment, the paper suggests implementable pathways to empower ANMs for improved performance. This requires addressing entrenched gender inequities through structural and organisational changes that realign power relations, facilitate more collaborative ways of exercising power, and create the antecedents to individual empowerment. [ABSTRACT FROM AUTHOR]

This paper explores how an array of HIV epidemic responders became embroiled in producing quantitative evidence for HIV interventions in India. Based upon extensive ethnographic fieldwork in Karnataka State, I examine the life history of the Gates-funded AIDS initiative in India known as Avahan as a case study to consider the social and political implications of large-scale, standardizing knowledge regimes enacted in the era of global health. Specifically, I analyze a sample of the key material artifacts that are implicated in the production of standardized knowledge in an attempt to illuminate the workings of what I refer to as ‘evidentiary sovereignty’. I argue that documents, forms, and other paperwork used to generate evidence in global health interventions neither merely reflect expert knowledge nor convey information about scientific standards but, rather,are integral to the re-instantiation of sovereignty.The effects of evidentiary sovereignty not only narrow the aperture of global health interventions to overlook the on-the-ground realities that shape health problems, but they also transform the very ground upon which communities responding to HIV epidemics conceive of and enact politics. As highly HIV-affected communities struggle with the bureaucratic demands of intensive form-filling and query agreed upon standards and systems of classification, a form of politicization of knowledge unfurls that pertains to the documents themselves. [ABSTRACT FROM PUBLISHER]

Under the umbrella of the Bill and Melinda Gates-funded HIV initiative in India, the Mysore-based sex workers’ (SWs) collective Ashodaya Samithi focused on improving its members’ living and working conditions through community-led structural interventions, including community mobilisation, advocacy, peer-led support, and health promotional activities. Based on four months of ethnographic fieldwork, this article examines the care and support activities of one of its sub-wings, Ashraya, which specifically focuses on people living with HIV and AIDS (PLHIV). We first discuss the stigma-related perceptions and experiences of participants in relation to health-care settings and work environment, families and communities, and within varied HIV support networks. We then explore how Ashraya's community-led interventions attempt to challenge the structural forces feeding on and creating stigma. We argue that the current policy focus on the involvement of SWs’ collectives in sexually transmitted infection (STI) prevention in India is rather limited and should be expanded along the continuum of care and support offered to PLHIV. As suggested in this paper, SWs’ organisations may have greater potential to contribute to more than STI prevention work, both within and outside their communities, than currently recognised. [ABSTRACT FROM PUBLISHER]

As our globalized world entails meetings between health care givers and patients from diverse cultures, cultural factors must be considered in physiotherapy practice. Yet there is insufficient research regarding physiotherapists’ experiences when meeting different cultures. This paper aims to describe my experiences and reactions when meeting a different physiotherapy culture than my own. An autoethnographic study was conducted in India at four different physiotherapy clinical settings during seven weeks. Participant observation and field notes were used to document experiences. The data were analyzed with a qualitative content analysis to find recurring categories and themes. The analysis of field notes resulted in a overreaching category ‘From curiosity to appreciating and re-evaluating cultural diversity in physiotherapy’, divided into three different subcategories and themes: reflecting on hierarchies and the working structure in the context of physiotherapy practice, on the Indian physiotherapy students’ knowledgebase compared with my earlier experiences from Sweden and on the emotions emerging from being a student in the field with minor experience and knowledge in a different context. This reflective process over my experiences has taught me that my own culture is something I can only understand and re-evaluate when I have met a different one, and has helped me to start appreciate and develop further insight of the importance and the complexity of cultural diversity in physiotherapy. [ABSTRACT FROM PUBLISHER]

A way forward in the emerging societal structures is to engage in cross-cultural research for enhanced understanding of multi-ethnic sites in national and international contexts. (Shah, 2004, p. 549) In the course of a small-scale research project with an expatriate Indian community two Western researchers at a British university have reflected on the international dimensions of their work. This paper presents the experience and the thoughts of the researchers about their work on this project, reflecting some of the challenges of working globally in higher education. The researchers comment upon how the work reported might impact their future practice as teachers and researchers in higher education, working in an increasingly international context. Reflecting on the impact of engagement with the project, implications for teaching and learning in higher education are discussed. [ABSTRACT FROM PUBLISHER]

Following the recognition that 'culture matters' in designing effective public health programs, this paper focuses on one refraction of culture within the so-called 'homosexual' community in India, to highlight how attention to local knowledge and its socio-economic underpinnings can impact the politics of health care. Drawing primarily on ethnographic fieldwork conducted from 1995-1997 and 2003 in the South Indian city of Hyderabad among hijras (the so-called third sex of India) as well as the wider community of MSM or 'men who have sex with men', the paper argues that public health framings of homosexuality often fail to pay attention to differential understandings of stigma and their socio-economic underpinnings, a failure that accounts in some measure for the ineffectiveness of prevention programs targeted at 'high risk' communities such as hijras and MSM. Focusing on the local moral economy of respect and shame as one pathway of stigma and contagion, and in particular on the differences in constructions of respect and shame between hijras and the wider community of MSM, this paper points at one small way in which understanding how culture matters can ultimately address the ineffectiveness of prevention programs and redress the inequalities in health outcomes between the various margins and centers of power. [ABSTRACT FROM AUTHOR]

An emerging body of literature examines multiple connections between water insecurity and mental health, with particular focus on women's vulnerabilities. Women can display greatly elevated emotional distress with increased household water insecurity, because it's them who are primarily responsible for managing household water and uniquely interact with wider water environments. Here we test an extension of this proposition, identifying how notions of dignity and other gendered norms related to managing menstruation might complicate and amplify this vulnerability. Our analysis is based on systematic coding for themes in detailed semi-structured interviews conducted with twenty reproductive-age women living in two water insecure communities in New Delhi, India in 2021. The following themes, emerging from our analysis, unfold the pathways through which women's dignity and mental health is implicated by inadequate water: ideals of womanhood and cleanliness; personal dignity during menstruation; hierarchy of needs and menstruation management amidst water scarcity; loss of dignity and the humiliation; expressed stress, frustration and anger. These pathways are amplified by women's expected roles as household water managers. This creates a confluence of gendered negative emotions – frustration and anger – which in turn helps to explain the connection of living with water insecurity to women's relatively worse mental health. [ABSTRACT FROM AUTHOR]

Though coercion and rape have cast a persistent shadow over prospects of sexual health and consent in contemporary India, other narratives, agency and tools are quietly emerging to transform collective claims of power and bodily dignity. In these narratives from collectives, NGOs, on social media and among friends, dialogues about consent and pleasure feature prominently. This paper analyses statements in the news made by highly visible political and public figures regarding the subject of rape in the context of themes emerging from ethnography and semi-structured interviews with middle class people in Delhi. Using the device of social frameworks, contested framings of rape and consent are examined in order to interrogate essentialist gender norms, compare putative “causes” of rape, and highlight local efforts promoting sexual consent, health and well-being. [ABSTRACT FROM AUTHOR]

This is an ethnographic study that examines the experiences of peer counsellors in the Thinking Healthy Programme Peer-delivered (THPP), a randomized controlled trial of a psychological intervention for perinatal depression in Goa, India. Based on nine months of fieldwork from 2015 to 2017 and through caregiving theories posited by one of us, we examine how caregiving is experienced by peer counsellors in a randomized controlled trial, a context in which care is given for a finite period and is removed at the study's end. Analysis of our data generated three themes: caregiving as a reciprocated process that impacts peer counsellor and participant; memories of care, with attention to the space that caregiving occupies in the memories and subjectivities of peer counsellors; and the end of the trial as experienced as a removal of care in the community of the counsellors. We posit that the moral aspects of caregiving are particularly important for peer counsellors, and that the context of randomized controlled trials is central to these moral experiences, particularly at the trial's end, when peer counsellors are asked to end care that, in many cases, remains expressed as needed. [ABSTRACT FROM AUTHOR]

Poverty-alleviation programmes aimed to improved mental well-being among persons living with HIV (PLWH) in low and middle income countries have underscored the importance of understanding how and why such programmes work. We present findings from a six-month ethnographic process evaluation of Kiran, an economic livelihood programme locally designed to improve mental well-being among women affected by HIV in Delhi, India. In addition to benefits of improved economic standing, we found that supportive relationships cultivated among participants (n = 9) and with providers (n = 3) provided respite from worry about their illness and reframed what was relationally and practically possible in the context of living with HIV. In acquiring marketable craft skills with peers, participants challenged internalized scripts of being socially devalued and regained agency about their abilities to contribute to their community and support their children's immediate and future needs. We found that the benefits of Kiran weighed less on the direct alleviation of mental distress and more on the instillation of hope for their children. Our findings exemplify the importance of re-visiting a priori theories that inform interventions for PLWH and highlight the methodological merits of ethnographic approaches that underscore how theory and intervention praxis are bidirectionally informed. [ABSTRACT FROM AUTHOR]

Studies of power in health care settings in low- and middle-income countries largely describe providers' exercise of discretionary power in frontline roles, leaving under-specified the macro-institutions and mechanisms of power that drive health care outcomes. In this study I conceptualise providers' actions not in terms of discretionary power but as obligatory responses to 'authority' over them. Authority denotes an actor's rightfully held social power over others, who accept to follow that actor's directives. Explaining authority's workings entails studying how it operates from its subjects' perspectives. I analyse in particular the authority of popular opinion—which derives from citizens' claims to state services—over primary care doctors in municipal health facilities in Pune, India. Through year-long ethnographic fieldwork, I examine doctors' experience of popular opinion, social relations between doctors and communities, and the institutional history of state-provided urban primary care. Findings show that doctors routinely confront popular disregard for their services. But under conditions of long-standing neglect of municipal services, tenuous state-society relations, and an avid, widely preferred private sector, doctors appear unable and wary to deliver more than minimum clinical care. Their circumscribed response reflects mechanisms by which the power of popular opinion, under policy neglect, impels them to maintain a deficient status quo. [ABSTRACT FROM AUTHOR]

Drawing upon ethnographic research conducted in urban locations in India, I consider the relationship between stigma and contagion in the context of deaf peoples' desires for and practices of communication in Indian Sign Language. If sign language can be considered or represented as a virus-and if it spreads between and among deaf people upon exposure-what might cure differentially look like, in a time when cochlear implantation and oral-based early intervention is increasingly becoming normalized? Considering the impact of stigma on multiple forms of relationality, I argue that sign language's viral potentiality lies in its ability to transform and create new relationships and worlds. [ABSTRACT FROM AUTHOR]

The article assesses the daily violence in Garo Hills, India through enacted cultural critique. Topics discussed include the issues of ethnic violence and exclusions against nontribal minorities in the region and the Indian government response, the enacted cultural critique project composed of interviews, group discussions and the Voices youth participatory action research (PAR) project, and the viability of the youth PAR in addressing issues linked to ethnic violence and discrimination.

The limited autonomy and agency of women in developing countries is recognized as a key barrier to improving their reproductive health. Using an existing perinatal cohort in urban South India, we interviewed 36 women who had recently been through childbirth, and we carried out observations of family life and clinic encounters. Critical domains involved in women's agency and autonomy were women's participation in employment and group action and their mobility. Household decision making was considered a joint rather than individual responsibility. We call for a more nuanced understanding of these domains and their relationship to women's reproductive health, particularly for urban populations. [ABSTRACT FROM AUTHOR]

The percentage of India's national budget allocated to the health sector remains one of the lowest in the world, and healthcare expenditures are largely out-of-pocket (OOP). Currently, efforts are being made to expand health insurance coverage as one means of addressing health disparity and reducing catastrophic health costs. In this review, we document reasons for rising interest in health insurance and summarize the country's history of insurance projects to date. We note that most of these projects focus on in-patient hospital costs, not the larger burden of out-patient costs. We briefly highlight some of the more popular forms that government, private, and community-based insurance schemes have taken and the results of quantitative research conducted to assess their reach and cost-effectiveness. We argue that ethnographic case studies could add much to existing health service and policy research, and provide a better understanding of the life cycle and impact of insurance programs on both insurance holders and healthcare providers. Drawing on preliminary fieldwork in South India and recognizing the need for a broad-based implementation science perspective (studying up, down and sideways), we identify six key topics demanding more in-depth research, among others: (1) public awareness and understanding of insurance; (2) misunderstanding of insurance and how this influences health care utilization; (3) differences in behavior patterns in cash and cashless insurance systems; (4) impact of insurance on quality of care and doctor-patient relations; (5) (mis)trust in health insurance schemes; and (6) health insurance coverage of chronic illnesses, rehabilitation and OOP expenses. [ABSTRACT FROM AUTHOR]

We utilised a comparative ethnographic approach to study the implementation of a community mobilisation intervention addressing HIV risk among female sex workers (FSWs) in India, as implemented first by an non-governmental organisation and after oversight of the intervention was transitioned to the government. We demonstrate that the work of peer outreach workers changed from Social Change Agents within a community-led structural intervention (CLSI) to Peer Educators within a targeted intervention (TI). In the CLSI approach, built on the assumption that FSW risk for HIV is rooted in power inequality and structural vulnerability, peer outreach workers mobilised their peers through community-based organisations to address underlying conditions of inequality and vulnerability. In contrast, the TI approach, which views FSW risk as a function of limited knowledge and barriers to services, addressed peers' access to information and health services. Analysis of changes in the function of peer outreach workers reveals critical differences of which we discuss four: assumptions about conditions that produce HIV risk; degree of emphasis placed on collective mobilising and building collective power; extent to which community mobilisation and HIV prevention goals are linked; and the intervention's use of peer input. We discuss the implications of these findings for HIV prevention programming. [ABSTRACT FROM AUTHOR]

A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011–2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive ‘teamwork’ and ‘building trust with the community’ (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology – which the health workers espouse – is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration. [ABSTRACT FROM AUTHOR]

Earlier studies showed that the presence of a son in the family consistently decreases the likelihood of marital instability. We investigated the determinants of a perceived sad married life and high marital instability by analyzing data from an in-depth interview of 329 women in an ethnographic survey conducted in five villages of Haryana state of India during the year 2003. Our study provides empirical evidence of an association between children's gender and women's perception of their married life as sad in rural India. [ABSTRACT FROM AUTHOR]

The childhood experience of women is an important aspect of study in order to promote a change in women's fertility behavior and individual perpetration of gender discrimination. We looked into different dimensions and correlates of childhood experiences by exploring data of 329 women in an ethnographic survey conducted in five villages of Haryana, India. We found women's childhood experiences in rural Haryana were relatively worse; a significant proportion of women had faced food discrimination during their childhood and also were abused/cursed by the family because of their gender. Almost none of the women were asked for their opinion before arranging their marriage and in most cases their marriage was considered a burden. We conclude that a life cycle approach should be taken to examine the situation of girls in rural India starting from early childhood into adolescence and womanhood in order to solve the problem of high gender discrimination within the society. [ABSTRACT FROM AUTHOR]

This pioneering research in the field of human trafficking from South Asia is an important study as the subject population has not been studied in social work literature. Victims of trafficking who were working as exotic dancers in South Asian bars in the United States were studied qualitatively. The method of recruiting, transporting, putting to work, and maintaining victims within the trafficking system is explored through interaction and observation revealing victims' personal accounts. Data analysis was conducted using NVivo and experts' analysis. The study results support a dynamic theoretical framework in which social exchanges and choice of migration networks increase South Asian women's vulnerability to trafficking. [ABSTRACT FROM AUTHOR]

Objectives. The Rose Angina Questionnaire (RAQ) is an important measure of coronary heart disease prevalence. It has been shown to perform inconsistently across some ethnic groups in Britain. This study investigates whether the best available versions of the RAQ in Punjabi and Cantonese were linguistically equivalent to the English version. Design. Interviews were carried out with lay people from the Pakistani, Chinese and European-origin communities in Scotland to assess the versions of the RAQ used in the Newcastle Heart Project (the best available versions). For each questionnaire item, participants were asked to elaborate on their understanding of the question and the meaning of keywords or phrases. Results. Problems were discovered with the Punjabi and Cantonese translations of the RAQ. For example, the translation for ‘chest’ was interpreted by some Pakistani and Chinese women to mean ‘breasts’. ‘Walking uphill’ was translated in Chinese as ‘walking the hill’, without stipulation of the direction, so that some Cantonese speakers interpreted the question as pertaining to walking downhill. Many Chinese interpreted RAQ items to be referring to breathlessness rather than chest pain due to ambiguous wording. Conclusion. Existing versions of the RAQ are unlikely to be yielding data that are cross-culturally valid or comparable. For robust health survey research in languages other than that in which the questionnaire was developed, lay assessment of questionnaires prior to and after translation is a necessity rather than a luxury. [ABSTRACT FROM PUBLISHER]

The past decade has witnessed a tremendous growth in the scale and policy influence of civil society in global health governance. The AIDS ‘industry’ in particular opens up spaces for active mobilisation and participation of non-state actors, which further crystallise with an ever-increasing dominance of global health initiatives. While country evaluations of global initiatives call for a greater participation of ‘civil society’, the evidence base examining the organisation, nature and operation of ‘civil society’ and its claims to legitimacy is very thin. Drawing on the case of one of the most visible players in the global response to HIV epidemic, the Global Fund to Fight AIDS, Tuberculosis and Malaria, this article seeks to highlight the complex micropolitics of its interactions with civil society. It examines the nature of civil society actors involved in the Fund projects and the processes through which they gain credibility. We argue that the imposition of global structures and principles facilitates a reconfiguration of actors around newer forms of expertise and power centres. In this context, the notion of ‘civil society’ underplays differences and power dynamics between various institutions and conceals the agency of outsiders under the guise of autonomy of the state and people. [ABSTRACT FROM PUBLISHER]

Background: A strong son preference has been the norm in most of Asian countries. Modern sex-selection1 technology (although illegal in India) along with traditional methods have led to a skewed sex ratio. Methods: This study attempts to explore slum-dwelling women’s perception regarding the use of sex-selection techniques, both traditional and modern. Forty-two women from three different groups (adolescent, adult and elderly) participated in seven focus group discussions. Thematic analysis using interpretive framework identified five themes; that is, ‘Preference for male child’, ‘Acceptance of female foeticide’, ‘Awareness and impact of declining sex ratio’, ‘Awareness of methods of sex detection and selection’ and ‘Awareness of the law’ related to sex selection. Results: One-third of the participants expressed a preference for sons compared to daughters and only half perceived female foeticide as undesirable. The majority were aware of one or more method for sex detection and selection; however, less than half of the participants were aware that sex detection and selection is illegal. Five adolescent girls admitted to sex selection in their families. Conclusion: There is a continued use of sex selection and detection methods including the use of traditional medicines in slums. [ABSTRACT FROM PUBLISHER]

The connection between identity and health communication has been amply documented in communication research. How an individual frames oneself with respect to and in conjunction with one's interpersonal relationships and material and communicative structures shapes one's identity. This in turn shapes how one enacts the self, given the relationships and available contexts one is embedded in, all of which have a significant influence on how one communicates about and negotiates health and illness. This study reports the results of an ethnographic field study conducted during two periods-June and August 2007 and July and August 2009, which examined, chiefly through interviews of 46 participants, how members of a community of sex workers in Kalighat, in the city of Kolkata in India, communicatively constructed their selves with respect to their prevalent cultural indices and available structures, and how enunciations and enactments of sex worker selves as 'mothers first' influenced localized patterns of HIV/AIDS communication and related work practices. Sex worker narratives suggested that mainstream assumptions and identity labels that depict sex workers as incapable mothers and the concurrent HIV/AIDS practices sex workers are asked to adopt need to be questioned and transformed to effect positive changes in health and HIV/AIDS negotiation practices among members of this marginalized community. [ABSTRACT FROM AUTHOR]