Previously Completed Projects

Gender-Based Violence and HIV/AIDS (China, India, Thailand, Vietnam)
Principal Investigator: Sofia Gruskin
Department: Global Health and Population
Sponsor: Ford Foundation

Dates of Research:
August 1, 2004 — May 31, 2007

In 2004, the Program on International Health and Human Rights (PIHHR) developed a pilot project with the aim of using a human rights framework to facilitate programming, advocacy efforts and research amongst those working on issues of HIV, GBV, and sexuality. The program supports translation of the growing theoretical and policy discussion about the links between HIV and GBV into enhanced programming. In its initial stage, the project collaborated with partners in China, India, Thailand, and Vietnam to bring together two organizations in each country, one working primarily on HIV and one working primarily on GBV, to collaborate and work together. In India the program collaborates with Swasthya and Action India.

Study of Lead Exposure and Outcomes Amongst Children in Chennai, India
Principal Investigator: Howard Hu
Department: Environmental Health
Sponsor(s): NIH/FIC

This project studied 750 children aged 4-6 years attending specific public schools in Chennai, India. These schools were chosen to represent areas of the city that are high-high, high-low, low-high, and low-low with respect to traffic and industry. The study measured levels of lead in blood and shed primary teeth, assess IQ, visuospatial function, visuomotor function, and behavior for each child. With this information, the study explored lead exposure and exposure dose relationships, tested specific hypotheses on the relationship of lead dose to neurobehavioral outcomes, and explored other relationships of interest.

Howard Hu is now heading the Dalla Lana School of Public Health at University of Toronto

Assessing the Public Health Consequences of Sex Trafficking in India, Nepal and Bangladesh
Principal Investigator: Jay Silverman
Department: Society, Human Development, and Health
Sponsor: Department of State-BINL

Dates of Research:
November 30, 2006 — November 30, 2008

Trafficking in persons for prostitution (TIP/P) is a significant global public health issue. An estimated 600,000-800,000 people are trafficked globally each year, approximately 80% of whom are women and children trafficked for prostitution. A significant percentage of these victims are trafficked for prostitution across India, Nepal and Bangladesh. To date, there is no adequate estimate of the global or South Asian regional public health impact of TIP/P. This project assesses and documents the public Health impact of TIP/P across India, Nepal and Bangladesh.

Promoting Tobacco Cessation among School Teachers (2008-2012).

Conducted with the full support of the Bihar Department of Education, Drs. Sorensen, Viswanath and Nagler collaborated with the Healis-Sekhsaria Institute for Public Health on a five-year research study funded by the U.S. National Institutes of Health to promote tobacco use cessation among teachers in 72 schools in the state of Bihar. Teachers are the focus of the study because as role models for youth and key opinion leaders in society, they represent an important group for tobacco control. Using a randomized controlled design, this study assessed the effectiveness of a school-based tobacco use cessation program, the Tobacco-Free Teachers, Tobacco-Free Society program, which combined school policy initiatives and tobacco use cessation assistance for teachers through discussion groups, cessation support, and educational materials.

The program was found to be effective at increasing tobacco use quit rates in school personnel. Immediately after the program was completed, the percentage of school personnel reporting they quit tobacco within the last 30 days was 50% in intervention schools compared to 15% in control schools. Nine months after the program ended, 19% of school personnel in intervention schools reported quitting tobacco within the past 6 months, compared to 7% in the control schools. When compared only among school personnel employed in the school for the entire time the intervention was implemented, the number of teachers quitting within the past 6 months was 20% in intervention schools and 5% in control schools.

For more information on these results, please refer to this publication:

Sorensen G, Pednekar M, Sinha DN, Stoddard AM, Nagler EM, Aghi M, Lando HA, Viswanath K, Pawar P, Gupta PC. Effects of a tobacco control intervention for teachers in India: Results of the Bihar School Teachers Study. Am J Public Health. 2013 Nov;103(11):2035-40. doi: 10.2105/AJPH.2013.301303. Epub 2013 Sep 12. PMCID 3828698.

The psychological toll of slum living in Mumbai, India: A mixed methods study

Principal Investigator(s): Drs. Ramnath Subbaraman, David E. Bloom, & Anita Patil-Deshmukh.

In India, “non-notified” slums are not officially recognized by city governments; they suffer from insecure tenure and poorer access to basic services than “notified” (government-recognized) slums. Subbaraman et al. conducted a study in a non-notified slum of about 12,000 people in Mumbai to determine the prevalence of individuals at high risk for having a common mental disorder (i.e., depression and anxiety), to ascertain the impact of mental health on the burden of functional impairment, and to assess the influence of the slum environment on mental health.

The PUKAR team lobbied the Mumbai government to start health camps and bring water into the community. Kaula Bandar residents trained by the PUKAR team through these programs are using their compensation from the research work for school bills, and may themselves pursue careers in public health.

 The social ecology of water in a Mumbai slum: failures in water quality, quantity, and reliability

Principal Investigator(s): Drs. Ramnath Subbaraman, David E. Bloom, and Anita Patil-Deshmukh.

The findings revealed severe deficiencies in water-related health and social equity indicators. All bacterial contamination of drinking water occurred due to post-source contamination during storage in the household, except during the monsoon season, when there was some point-of-source water contamination. This suggests that safe storage and household water treatment interventions may improve water quality in slums. Problems of exorbitant expense, inadequate quantity, and poor point-of-source quality can only be remedied by providing unrecognized slums with equitable access to municipal water supplies.

 Off the map: the health and social implications of being a non-notified slum in India

Principal Investigator(s): Drs. Ramnath Subbaraman, David E. Bloom, and Anita Patil-Deshmukh.

Approximately half of all slums in India are not recognized by the government. Lack of government recognition, also referred to as “non-notified status” in the Indian context, may create entrenched barriers to legal rights and basic services such as water, sanitation, and security of tenure. This paper shows the relationship between non-notified status and health outcomes in Kaula Bandar (KB), a slum in Mumbai, India. This relationship is illuminated using the findings of a four-year series of studies in the community.