Suchergebnisse

Intro -- Acknowledgments -- Contents -- About the Editors and Contributors -- Editors -- Contributors -- Abbreviations -- List of Figures -- List of Tables -- List of Boxes -- Chapter 1: Adolescents and Youth: Setting the Context -- 1.1 Introduction -- 1.2 Adolescence: The Phase of Growth and Transition -- 1.3 Youth: The Phase of Intimacy and Identity -- 1.4 The Need to Focus on Adolescents and Youth in India -- 1.4.1 Demographic Significance -- 1.4.2 Demographic Dividend -- 1.4.3 Domain of Health and Fitness -- 1.4.4 Diversity and Heterogeneity -- 1.5 Adolescence and Young Adults: The Present Scenario and the Gaps -- 1.5.1 Rural-Urban Gap -- 1.5.2 Education/Training Gap -- 1.5.3 Gender Gap -- 1.6 Investing in Young People -- 1.6.1 Benefits of Investing in Young People -- 1.6.2 The Importance of Laws and Policies -- References -- Chapter 2: Adolescent and Youth Nutrition in India -- 2.1 Introduction -- 2.2 Prevalence -- 2.2.1 The Prevalence of Underweight Among Adolescents and Youth in India -- 2.2.2 Prevalence of Overweight and Obesity Among Adolescents and Youth -- 2.2.3 Prevalence of Micronutrient Deficiencies -- 2.2.3.1 Vitamin A Deficiency (VAD) -- 2.2.3.2 Iron Deficiency -- 2.2.3.3 Zinc Deficiency -- 2.2.3.4 Vitamin D and Calcium Deficiency -- 2.2.4 Prevalence of Multiple Micronutrient Deficiencies -- 2.2.5 Prevalence of Physical Activity -- 2.2.6 Gaps in Research and Data -- 2.3 Government Policies and Programmes -- 2.3.1 National Nutrition Policy -- 2.3.2 The Integrated Child Development Scheme (ICDS) -- 2.3.3 Midday Meal (MDM) Scheme -- 2.3.4 Public Distribution System -- 2.3.5 Rashtriya Kishor Swasthya Karyakram (RKSK): National Adolescent Health Programme -- 2.4 Programmes to Address Micronutrient Deficiencies -- 2.4.1 Iron Deficiency/Anaemia -- 2.4.2 Iodine Deficiency -- 2.4.3 Other Micronutrients -- 2.4.4 Gaps in Research and Data.

Careful perusal of the family literature in India dispels the belief that the Indian family was basically joint, and that following industrialisation and urbanisation, the nuclear family replaced it. On the contrary, the literature demonstrates that family plurality has been an essential feature of Indian society and that joint, nuclear, single parent, dual earner and adoptive families have always coexisted. The evolution of family research, characterised by distinct phases, each with specific questions, resulted in biases in the research process that hindered the early cognisance of this reality. This paper discusses the multiplicity of family forms simultaneously present in the country. The authors have adopted the chronological phases of family research in India as the mode of presentation in order that an appreciation of the development of family studies in the country, the biases of family researchers and the process of according recognition to family plurality in India emerges.

Mobility among Female Sex Workers (FSWs) interrupts their demand for, and utilization of, health services under any intervention. Various strategic interventions are meant to provide access to care and reduce the incidence of HIV and other STIs among FSWs. This paper applies a bivariate probit regression analysis to explain the probability of mobile FSWs being reached by the system and being exposed to interventions jointly with a wide variety of characteristics of mobile FSWs in India. The data used are based on a cross-section survey among 5,498 mobile FSWs in 22 districts of four high HIV prevalence states in southern India. A majority of mobile FSWs (59%) were street-based and about 70 percent of them were members of SW organization and nearly half (46%) were highly mobile. The majority of them (90%) had been contacted by outreach workers from any system in the last two years in their current location and 94 percent were exposed to interventions in terms of getting free or subsidized condoms. Bivariate probit analysis revealed that comprehensive interventions are able to reach more vulnerable mobile FSWs effectively, e.g. new entrants, highly mobile, reported STIs, tested for HIV ever and serving a high volume of clients. The results complement the efforts of government and other agencies in response to HIV. However, the results highlight that specific issues related to various subgroups of this highly vulnerable population remain unaddressed calling for tailoring the response to the specific needs of the sub-groups.

Mobility among Female Sex Workers (FSWs) interrupts their demand for, and utilization of, health services under any intervention. Various strategic interventions are meant to provide access to care and reduce the incidence of HIV and other STIs among FSWs. This paper applies a bivariate probit regression analysis to explain the probability of mobile FSWs being reached by the system and being exposed to interventions jointly with a wide variety of characteristics of mobile FSWs in India. The data used are based on a cross-section survey among 5,498 mobile FSWs in 22 districts of four high HIV prevalence states in southern India. A majority of mobile FSWs (59%) were street-based and about 70 percent of them were members of SW organization and nearly half (46%) were highly mobile. The majority of them (90%) had been contacted by outreach workers from any system in the last two years in their current location and 94 percent were exposed to interventions in terms of getting free or subsidized condoms. Bivariate probit analysis revealed that comprehensive interventions are able to reach more vulnerable mobile FSWs effectively, e.g. new entrants, highly mobile, reported STIs, tested for HIV ever and serving a high volume of clients. The results complement the efforts of government and other agencies in response to HIV. However, the results highlight that specific issues related to various subgroups of this highly vulnerable population remain unaddressed calling for tailoring the response to the specific needs of the sub-groups.

SummaryFemale sex workers (FSWs) are vulnerable to HIV infection. Their socioeconomic and behavioural vulnerabilities are crucial push factors for movement for sex work. This paper assesses the factors associated with the likelihood of movement of sex workers from their current place of work. Data were derived from a cross-sectional survey conducted among 5498 mobile FSWs in 22 districts of high in-migration across four states in southern India. A multinomial logit model was constructed to predict the likelihood of FSWs moving from their current place of work. Ten per cent of the sampled mobile FSWs were planning to move from their current place of sex work. Educational attainment, marital status, income at current place of work, debt, sexual coercion, experience of violence and having tested for HIV and collected the results were found to be significant predictors of the likelihood of movement from the current place of work. Consistent condom use with different clients was significantly low among those planning to move. Likewise, the likelihood of movement was significantly higher among those who had any STI symptom in the last six months and those who had a high self-perceived risk of HIV. The findings highlight the need to address factors associated with movement among mobile FSWs as part of HIV prevention and access to care interventions.

SummaryThis study examined the association of gender-based attitudes, HIV misconceptions and community feelings for marginalized groups with stigmatizing responses towards people with HIV/AIDS in Mumbai, India. Participants included 546 men and women sampled in hospital settings during 2007–2008. Structured measures were used to assess avoidance intentions and denial of rights of people with HIV/AIDS. Mean age of participants was 32 years; 42% had less than 10 years of education. Higher HIV transmission misconceptions (β=0.47; p<0.001), more traditional gender attitudes (β=0.11; p<0.01) and more negative feelings towards HIV-positive people (β=0.23; p<0.001) were related to higher avoidance intentions. Endorsement of denial of rights was also significantly associated with higher transmission misconceptions (β=0.20; p<0.001), more traditional gender attitudes (β=0.33; p<0.001) and greater negative feelings towards HIV-positive people (β=0.12; p<0.05), as well as with a lower education level (β=−0.10; p<0.05). The feelings respondents had towards people with HIV/AIDS were more strongly correlated with their feelings towards those with other diseases (tuberculosis, leprosy) than with feelings they had towards those associated with 'immoral' behaviour (e.g. sex workers). Eliminating HIV transmission misconceptions and addressing traditional gender attitudes are critical for reducing HIV stigma in Indian society.

IntroductionHIV stigma inflicts hardship and suffering on people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. Health professionals are often named by PLHIV as an important source of stigma. This study was designed to examine rates and drivers of stigma and discrimination among doctors, nurses and ward staff in different urban healthcare settings in high HIV prevalence states in India.MethodsThis cross‐sectional study enrolled 305 doctors, 369 nurses and 346 ward staff in both governmental and non‐governmental healthcare settings in Mumbai and Bengaluru, India. The approximately one‐hour long interviews focused on knowledge related to HIV transmission, personal and professional experiences with PLHIV, instrumental and symbolic stigma, endorsement of coercive policies, and intent to discriminate in professional and personal situations that involve high and low risk of fluid exposure.ResultsHigh levels of stigma were reported by all groups. This included a willingness to prohibit female PLHIV from having children (55 to 80%), endorsement of mandatory testing for female sex workers (94 to 97%) and surgery patients (90 to 99%), and stating that people who acquired HIV through sex or drugs "got what they deserved" (50 to 83%). In addition, 89% of doctors, 88% of nurses and 73% of ward staff stated that they would discriminate against PLHIV in professional situations that involved high likelihood of fluid exposure, and 57% doctors, 40% nurses and 71% ward staff stated that they would do so in low‐risk situations as well. Significant and modifiable drivers of stigma and discrimination included having less frequent contact with PLHIV, and a greater number of transmission misconceptions, blame, instrumental and symbolic stigma. Participants in all three groups reported high rates of endorsement of coercive measures and intent to discriminate against PLHIV. Stigma and discrimination were associated with multiple modifiable drivers, which are consistent with previous research, and which need to be targeted in future interventions.ConclusionsStigma reduction intervention programmes targeting healthcare providers in urban India need to address fear of transmission, improve universal precaution skills, and involve PLHIV at all stages of the intervention to reduce symbolic stigma and ensure that relevant patient interaction skills are taught.