Principal Investigator: Dr. Peter Berman
Department: Global Health and Population
This is the “Strengthening Health Resource Tracking and Management (RTM) for Improved Delivery of Primary Care in India and Ethiopia” project. The goal of the RTM project is to develop better evidence and promote its use to increase the efficiency, effectiveness and equity of primary care delivery in Ethiopia and India. This will be accomplished through research and analysis on health RTM in each country, working with in-country partners in government and elsewhere. The project will also contribute to global learning on the effective use of resource tracking for improved primary care outcomes. RTM is conceptualized in the project framework as including resource mobilization, allocation, utilization, productivity, and targeting.
The 97 Project: Child Labour Trafficking
Principal Investigator: Dr. Jacqueline Bhabha
Department: Francois-Xavier Bagnoud Center for Health and Human Rights
The 97 Project is a study of 97 boys who were rescued in January 2014 from bangle manufacturing shops in Jaipur, Rajasthan, and returned back to their families in Bihar. Through the study, the FXB aims to collect data on the practice of labor trafficking, develop an evidence-based assessment of risk factors and indicators of child labor trafficking, assess the efficacy of rescue and return practices, and assess the capacity of the state and NGOs in preventing and intervening in child labor trafficking.
The Champions Project
Principal Investigator: Dr. Jacqueline Bhabha
Department: Francois-Xavier Bagnoud Center for Health and Human Rights
This is a mixed methods study whose aim is to determine how female college students– “champions”–from educationally and economically deprived families managed to achieve educational success despite the manifold economic social and cultural barriers to educational advancement. The project employs the “positive deviance” approach which deconstructs the uncommon behaviors of the successful minority to amplify efficacious strategies for the benefit of the disadvantaged majority. Having completed data collection with 1000 participants across the States of Maharashtra and Rajasthan, the project is being scaled to include 1000 more young women in Uttar Pradesh. Local partners include the Krantijyoti Savitribai Phule Women’s Studies Centre, University of Pune, Maharashtra, the Institute of Development Studies Jaipur, Rajasthan and Shiv Nadar University, Uttar Pradesh. The data support for the project has been provided by the National Commission for the Protection of Children’s Rights, the Passport Foundation and the Population Foundation of India.
The primary objective of LASI is to gather data on the physical, financial, and social well-being of India’s elderly population. In doing so, the study aims to contribute to the development of evidence-based policies that address the challenges of population aging.
Dr. Richard Cash, Department of Global Health and Population
- Public Health Foundation of India (PHFI) Delhi. Dr. Cash is a Visiting Professor at PHFI from November through August. In this capacity he teaches courses on ethical issues in global health research, infectious disease epidemiology and advises PHFI investigators on their ongoing research and implementation programs.
- Global Health and Population Winter Course. Dr. Cash leads Harvard School of Public Health course on Noncommunicable Diseases (NCDs) now run through PHFI in Delhi, India. Students are exposed to the health challenges faced by low and middle income countries in areas of cardiovascular diseases, diabetes, nutrition, mental health, accidents etc.
- Harvard School of Public Health, Department of Global Health and Population. During Fall I, Dr. Cash teaches the following courses: Introduction to the Practice of International Health (ID 262); The Political, Economic and Social Determinants of Infectious Diseases of Importance in Low and Middle Income Countries (GHP 539); and Ethical Issues in Global Health Research (GHP 265)
- Other international teaching/workshops of long standing.Dr. Cash has taught courses on infectious disease epidemiology at the Achutha Menon Centre for Health Science Studies in Trivandrum, Kerala, for the past 15 years; he has directed an ethics module at the Bangalore-Boston Nutrition Collaborative (BBNC) at St. John’s Medical College (four years).
- Nutrition and Global Health Program. A program to develop new curricula in nutrition at Harvard and in India, across disciplines and health problems. Undergraduate and graduate students from Harvard are paired with Indian counterparts and sponsored for research internships in India, Tanzania, and Brazil that utilize and enhance existing research platforms.
- Vitamin D and Maternal and Child Health. Observational studies, largely from developed countries, have suggested that poor vitamin D status during pregnancy is associated with markedly increased risk of intrauterine growth restriction and other poor pregnancy outcomes. We will assess vitamin D status during pregnancy among 2,500 women in Delhi and explore whether vitamin D deficiency heightens the risk of adverse pregnancy outcomes. The Translational Health Science and Technology Institute (THSTI), India, has received funding to begin a randomized trial exploring the effect of daily vitamin D supplementation during infancy on immune responses to vaccines.
The BetterBirth Program
Principal Investigator: Dr, Atul Gawande, Professor in the Department of Health Policy and Management; Co-Principal Investigator: Dr. Jonathan Spector, Research Associate in Health Policy and Management
Department: Department of Health Policy and Management
Sponsor(s): Bill and Melinda Gates Foundation
The BetterBirth Program, funded through a four-year grant from the Bill & Melinda Gates Foundation, is a partnership with the World Health Organization (WHO) and state and federal governments in India to test the effectiveness of a checklist-based childbirth safety program in reducing deaths and improving outcomes of mothers and infants in hospitals in Uttar Pradesh, India. The program was developed by the World Health Organization (WHO) and Ariadne Labs, a joint center for health system innovation at the Brigham and Women’s Hospital and HSPH. A link to the pilot results are published here, and the development of their intervention is published here. Dr. Gawande also wrote about this work as part of a New Yorker (July 28, 2013) article, entitled “Slow Ideas”.
Diabetes Risk Factors in India
Departments: Nutrition and Epidemiology
Dates of Research for Brown Rice Substitution Trial: March 2012-December 2013
This study evaluates the effect of substituting brown rice—a whole-grain—for white rice on diabetes risk in Chennai, India. India has the largest absolute number of people with diabetes in the world. The goal is to provide data for use in designing a global dietary intervention study aimed at reducing diabetes risk through simple, culturally appropriate, and sustainable dietary changes.
The work is part of the Global Nutrition and Epidemiologic Transition Group (GNET), which has projects in ten countries around the world. GNET is a collaborative initiative launched by researchers from the Departments of Epidemiology and Nutrition at HSPH, with the ultimate goal of helping to prevent the global diabetes epidemic by improving the carbohydrate quality of staple foods. Dr. Vasanti Malik is a member of the GNET Steering committee and an investigator involved with its projects in India (and other countries). Dr. Malik is a research associate based in the Nutrition Department at HSPH. GNET research in Chennai India began in 2009 and is ongoing.
A number of papers have come out of the work in Chennai so far:
Kumar S, Mohanraj R, Sudha V, Wedick NM, Malik V, Hu FB, Spiegelman D, Mohan V. Perceptions about varieties of brown rice: a qualitative study from Southern India. J Am Diet Assoc. 2011;111(10):1517-22
Vasudevan S, Spiegelman D, Hong B, Malik VS, Jones C, Hu FB, Willett WC, Bai MB, Ponnalagu MM, Arumugam K, Mohan V. Consumer Acceptance and Preference Study [CAPS] on brown and minimally polished rice varieties in Chennai, India. Am Coll Nutr. 2013;32(1):50-7
Mohan V, Spiegelman D, Sudha V, Gayathri R, Hong B, Praseena K, Anjana RM, Wedick NM, Arumugam K, Malik V, Ramachandran S, Bai MR, Henry JK, Hu FB, Willett WC, Krishnaswamy K. Effect of Brown Rice, White Rice, and Brown Rice with Legumes on Blood Glucose and Insulin Responses in Overweight Asian Indians: A Randomized Controlled Trial. Diabetes technology & therapeutics. 2014
Nutritional and sensory profile of two Indian rice varieties with different degrees of polishing. Shobana S, Malleshi NG, Sudha V, Spiegelman D, Hong B, Hu FB, Willett WC, Krishnaswamy K, Mohan V. Int J Food Sci Nutr. 2011 Dec;62(8):800-10
The trial, which was a 3-month cross-over study, tested the effects of substituting brown rice (rice, dosa and idly made from brown rice) for white rice (rice, dosa, idly) on markers of diabetes risk in overweight adults. The trial was done in batches and began in March 2012, with the last batch of participants completed in December 2013.
The Maternal Health Task Force
Principal Investigator: Dr. Ana Langer
Department: Department of Global Health and Population
Sponsor: Bill and Melinda Gates Foundation
Dates of Research: 2012-2015
Dr. Langer, professor of the Practice of Public Health and coordinator of the Dean’s Special Initiative on Women and Health will lead a Maternal Health Task Force (MHTF), part of an effort to significantly improve maternal health in developing countries.
The Maternal Health Task Force, funded by a three-year grant from the Bill & Melinda Gates Foundation, brings together major global and country-level maternal health organizations to improve maternal health in India and other countries by leading, coordinating, and promoting innovative and effective knowledge management, technical exchanges and consensus building activities; strengthening countries’ health care capacity through mentoring and training; and supporting strategic research on critical issues.
Dr. Glorian Sorensen, Social and Behavioral Sciences Department
Tobacco-free Teachers: Pilot study to assess program adoption in schools in India (2014-15). Drs. Sorensen, Viswanath, Nagler and the Healis-Sekhsaria Institute for Public Health are looking to disseminate the Tobacco-Free Teacher, Tobacco-Free Society program. This pilot study provides the foundation for the dissemination of an evidence-based tobacco use cessation intervention for school teachers, who are key opinion leaders in their communities. The objective of this one-year pilot study is to determine the facilitators and barriers associated with schools’ willingness to adopt a comprehensive tobacco control intervention. We will survey randomly selected school principals in two Indian states, and will conduct focus group interviews with a subsample of principals and teachers to determine needed changes in existing program materials.
Promoting Tobacco Cessation among Factory Workers (2010-2015). Drs. Sorensen, Viswanath, and Nagler, in collaboration with the Healis-Sekhsaria Institute for Public Health, are also undertaking a tobacco control research study in 20 manufacturing worksites in Mumbai. This five-year research study designs and tests an integrated tobacco control and occupational health (OH) intervention aimed at promoting tobacco use cessation among workers and supporting the adoption, implementation, and enforcement of tobacco control policies in manufacturing worksites in Mumbai, India. Through health education events at the worksites, blue-collar workers (who face dual health risks through their exposures to occupational hazards and their high rates of tobacco use) will gain the knowledge, skills, and social support needed to quit tobacco use. Simultaneously, management will receive OH and tobacco policy consultations to help build a healthy and safe work environment, where workers’ hazardous exposures are reduced.
Dr. Donna Spiegelman, Professor of Epidemiologic Methods, Departments of Epidemiology, Biostatistics, and Nutrition.
Consumer acceptance and preference study (CAPS) on brown and undermilled India rice varieties in Chennai, India.
Having found in previous studies that the intake of brown rice compared to white is associated with decreased risk of T2 diabetes, Dr. Spiegelman and other HSPH scientists collaborated with the Madras Diabetes Research Foundation (MDRF) to evaluate consumer awareness about the nutritional properties of, and preferences for, whole grains in an urban south Indian population. The study also aimed to explore the feasibility of introducing brown rice as a staple for several months in the south Indian diet as a substitute for fully polished rice.
See here for links to this and other GNET studies.
Dr. S.V. Subramanian, Department of Society, Human Development and Health
Maternal and Child Health. Dr. Subramanian’s research connects the health of parents to that of their children. Across India mothers (and often fathers) suffer from chronic levels of under-nutrition captured in measures such as weight and height with adverse consequences for the health of their offspring. Dr. Subramanian has conducted research examining the intergenerational cycle of growth failure in India. He is currently engaged in developing and designing a range of interventions focused on improving the health of adolescent girls and using mobile technologies to ensure timely visits to antenatal care services and immunizations.
Recent articles include:
Vollmer S, Harttgen K, Subramanyam MA, Finlay J, Klasen S, Subramanian SV. Association between economic growth and early childhood undernutrition: evidence from 121 Demographic and Health Surveys from 36 low-income and middle-income countries. Lancet Glob Health. 2014 Apr;2(4):e225-34. doi: 10.1016/S2214-109X(14)70025-7. Epub 2014 Mar 27.
Dr. K. “Vish” Viswanath, Department of Society, Human Development and Health
Dr. Viswanath has created the Viswanath Lab, which is dedicated to understanding health communication inequalities with the goal of addressing health disparities on the individual and population levels.
Also, he is collaborating with Salaam Bombay Foundation, Mumbai, to evaluate their tobacco control programs among children in Mumbai schools and tobacco cessation efforts in hospitals.
He co-founded the India Learning Network to provide a central mechanism for groups currently implementing effective approaches to reducing tobacco use to share their successes and challenges, and learn about best practices to improve health outcomes. To speed up progress, the Network will be guided by a growing multisectoral partnership of experts across public, private, nonprofit, medical and academic sectors.
Dr. Viswanath also is collaborating with Dr. Prakash Gupta of Healis Sekhsaria Institute on the role of media in tobacco use, including the impact of movies on tobacco uptake among adults.