South Indian Community Research Articles

What do consumers think about recycling human urine as fertiliser? Perceptions and attitudes of a university community in South India

Sanitation systems based on source separation and valorisation of human urine can improve the environmental sustainability of wastewater management. Yet, the social acceptability of such new, resource-oriented sanitation practices have not been assessed systematically. We attempt to address this research gap by reporting the findings of a survey conducted at a South Indian university that evaluated support for urine recycling among 1252 Indian consumers. We place our findings in the context of the Theory of Planned Behaviour, quantify consumer attitude to urine recycling through an exploratory numerical approach, and identify explanatory factors that shape consumer beliefs and perceptions. Overall, a moderately positive attitude was observed: 68% stated human urine should not be disposed but recycled, 55% considered it as fertiliser, but only 44% would consume food grown using it. While 65% believed using urine as crop fertiliser could pose a health risk, majority (80%) believed it could be treated so as to not pose a risk. The respondents' ‘willingness to consume’ urine-fertilised food was found to be strongly influenced by their willingness to pay. Consumer environmental attitudes, as evaluated using the New Ecological Paradigm scale, did not influence their attitude towards urine recycling behaviour. We thus believe that simply appealing to people's environmental sensitivities is not enough for introducing environmentally-friendly technologies like urine recycling, but that more targeted marketing messages are needed. We find sufficient support among our surveyed consumers for urine recycling but highlight that further research is needed to identify what information and agency will help translate positive attitudes into action and behaviour.

An exploration of understandings of major depressive disorder in a South African Indian Muslim female community

ABSTRACTDepression is a serious mental illness that has severe socio-economic costs. Studying the impact of various cultural beliefs on the understandings of depression is imperative as findings could assist with developing effective intervention strategies. This research aimed to explore the understandings South African Muslim females have of Major Depressive Disorder (MDD) with a focus on cultural and religious factors that may underlie these understandings. A mixed methods study was conducted using 12 semi-structured interviews and 62 questionnaires. Thematic analysis was used to analyse the qualitative data. Descriptive statistics were used to analyse the quantitative data. The results clustered around four main themes: participants’ understanding of MDD, perceptions around the etiology of MDD, treatment of MDD and the influence of culture on perceptions of MDD. It is evident that there is a better understanding of MDD in the sample in comparison to previous studies but there is still much misperception around MDD in the broader community.

Uncovering a politics of livelihoods: analysing displacement and contention in contemporary India

ABSTRACTIn this paper, we use livelihoods as an organizing concept which brings together questions of production, social reproduction, and the conditions for these, to describe and reflect upon three ‘moments’ of displacement and contention in India. Our first moment, a massive flash strike by workers in the export garments industry in Bangalore, is located in the present neo-liberal context of jobless growth, increasingly unregulated and precarious forms of employment, and market-based forms of service provision. Our second moment concerns popular struggles in defence of the commons in settled rural fishing communities in south India, and the third, the tenacious efforts of pavement dwellers in Bombay to make place, the political condition for production and social reproduction. The originary context for these last two moments was the state-led, technology-driven, capitalist modernization of agriculture and fisheries of the early post-‘independence’ decades, tied to projects of state-building, self-reliance, and sovereignty. The three moments chart the long history of processes of precarization under postcolonial capitalism but, equally, a constant politics of livelihood, grounded in claims to rights earned through labour, and addressing itself to both state and capital as complicit in structuring access to livelihoods under capitalism.

Development and communication in trade relations: new synergies in theory and practice

ABSTRACTThis article examines trade relations in alternative food networks as a space where communication practices can prove empowering for rural communities. Drawing on a theory of diverse economies, the article offers an alternative view of the global market, highlighting the social relations that underpin market transactions. These relations are then explored through a case study of a farming community in South India and their interactions with private enterprises in North America and Europe. The findings demonstrate how a dialogical communication process between the two groups can contribute to farmers’ well-being beyond economic growth, creating opportunities for more permanent social change.

Comparative burdens of atherosclerosis in rural and urban communities in South India: Insights from the Kovai Medical Center and Hospital-noncommunicable disease studies

Aim: The aim of this study was to describe the distribution and comparison of carotid intima thickness in two completely different demographics in South India. Materials and Methods: Data were obtained from 865 participants in rural Nallampatti and 1081 participants from urban Kalapatti in the state of Tamil Nadu. Local ethics committee approval and written and informed consent were obtained from all participants. Carotid intima thickness was measured on all participants using high-resolution B-mode ultrasound. Atherosclerosis was defined as a carotid intima-media thickness of ≥1 mm. Results: The prevalence of atherosclerosis was 10.3% in rural Nallampatti compared to 7.8% in urban Kalapatti. On binary logistic regression analysis, diabetes and hypertension were associated with atherosclerosis in rural areas, but this significance disappeared after adjustment for confounding factors. In urban areas, diabetes appeared to be significantly associated with atherosclerosis even after adjustment for confounding factors. Conclusion: Our data suggest a surprisingly increased prevalence of atherosclerosis in a rural farming population even though traditional risk factors for atherosclerosis such as diabetes and hypertension did not show a significant association after adjustment for confounding factors. If confirmed, this provides a rationale to do large-scale studies to explore the role of nontraditional risk factors in rural India that could have an impact on atherosclerosis and cardiovascular disease.

Alcohol use, harmful use of alcohol and probable dependence among residents of a selected fishermen community in South India: A community based cross-sectional analytical study

Background: Alcohol use is prevalent among fisherman community. In this regard, a community based survey was conducted among adults in the fisherman community of Puducherry a) to determine prevalence of alcohol use, harmful use and probable dependence b) to assess the factors associated with alcohol use and harmful use of alcohol. Methods: A community based cross-sectional analytical study was conducted in a selected coastal commune Panchayat of Puducherry, South India during April, 2016 to March, 2017. The named streets were selected as the clusters. In each of the selected street first seven houses on the right hand side were enrolled. A semi structured questionnaire was used to collect details regarding socio-demographic variables and WHO AUDIT tool was used to detect the harmful use and probable dependence. Data was entered in Microsoft Excel and analyzed using Stata 12 software. The association between the individual’s characteristics and alcohol use, harmful use of alcohol were assessed using generalized linear models with poisson distribution and log link function. Results: The prevalence of alcohol use was 152 (61.5%, 95% CI- 55.4%-67.5%), 63 (25.5%, 95% CI- 20.4%-31.2%) had harmful use of alcohol and 20 (8.1%, 95% CI- 5.2%-12.0%) had probable dependence to alcohol. The multivariate regression showed that age between 31 to 59 years and tobacco use (1.7 (95% CI- 1.4-2.0)) were independently associated with alcohol use. The multivariate regression showed that being illiterate (2.1 (95% CI- 1.2-3.6)), being graduate (3.2 (95% CI- 1.5-6.6)), currently married (2.2 (95% CI-1.1-5.0)), tobacco use (1.4 (95% CI- 1.1-1.9)) and family history (1.4 (95% CI- 1.1-1.9)) were independently associated with alcohol use. Conclusions: The present study showed very high prevalence of alcohol use and harmful use of alcohol in coastal villages. Stringent regulatory approaches and effective health education approaches were much needed for the control of alcohol use and harmful use of alcohol.

Prevalence of vitamin B12 deficiency among individuals with type 2 diabetes mellitus in a South Indian rural community

Background: To estimate the prevalence of vitamin B12 deficiency in a rural south Indian community and to evaluate the association between metformin use and prevalent vitamin B12 deficiency in people with T2DM stratified by oral vitamin B12 supplementation.Methods: Using a cross sectional study design, a random sample of people with T2DM (N=438) was recruited from a rural community. Vitamin B12 deficiency was defined as serum B12 ≤200pg/ml. Data on metformin dose, duration of use, oral vitamin B12 supplementation, and diet were collected. Laboratory measurements included complete blood count, tests for hepatic, renal, and thyroid function, as well as serum vitamin B12 levels and HbA1c.Results: The prevalence of vitamin B12 deficiency in people with T2DM was 11.2% (95% Confidence Interval (CI) 8.2%-14.1%). The odds of vitamin B12 deficiency in patients receiving a metformin dose of 2 grams/day were 4 times higher compared to those receiving ≤1 gram/day, after adjusting for oral B12 supplementation (odds ratio 4.2;95% CI 1.5-11.8). The odds of vitamin B12 deficiency in those taking metformin and receiving oral vitamin B12 supplementation were lower compared to those on metformin and not receiving vitamin B12 supplementation (adjusted odds ratio 0.20; 95% CI 0.06-0.70).Conclusions: Vitamin B12 deficiency affects 1 in 10 people with T2DM, is associated with higher dose metformin use, and oral vitamin B12 supplementation mitigates B12 deficiency in this group.

Auroville as an intentional spiritual community and the practice of Integral yoga

This paper discusses Auroville as an intentional spiritual community in South India and the way facets of Integral yoga are manifested. The existential thinking, aspirations, existential anxieties,...

Alcohol, harmful use and dependence: Assessment using the WHO Alcohol Use Disorder Identification Test tool in a South Indian fishermen community.

Background:Fishermen have a high burden of alcohol-related morbidity. The Alcohol Use Disorder Identification Test (AUDIT) is used to classify individual to have harmful use of alcohol and probable alcohol dependence. Hence, this study was conducted among fishermen in a selected fishermen community in Puducherry, South India, to (a) assess the proportion of harmful alcohol use and probable dependence to alcohol among alcohol users using AUDIT tool and (b) find the sociodemographic factors associated with harmful alcohol use and probable dependence among alcohol users.Materials and Methods:A community-based cross-sectional study was carried out among the fishermen above 18 years of age in a selected “fishing hamlet.” A house-to-house survey was conducted to identify the fishermen. A semi-structured questionnaire was used to obtain sociodemographic details. AUDIT tool was administered by interviewer to those fishermen who used alcohol in the past 1 year. Data were entered and analyzed using EpiData software. The proportion of harmful use of alcohol and probable dependence among alcohol users was expressed as percentage. Chi-square test was used to find association between sociodemographic factors with harmful use of alcohol and probable dependence.Results:Of 304 fishermen included in the study, 241 (79%) reported alcohol use in the past 1 year. Of 241 alcohol users, four-fifths (82%) had some formal education and two-thirds (67%) had monthly income <3000 INR. “Harmful use” of alcohol was noted in 76.8% (95% confidence interval [CI]: 71.1%–81.7%) and probable alcohol dependence in 12.4% (95% CI: 8.9%–17.2%). None of the individual characteristics of alcohol users were associated with either harmful use of alcohol or probable dependence.Conclusion:Among fishermen who use alcohol, eight out of ten have harmful use of alcohol. There is a need to screen for alcohol-related disorders among fisherman and adopt brief intervention strategies to counter problems of harmful use of alcohol.

Size matters! The scalability of modern hunter-gatherer animism

Cultural anthropology has for decades been committed to the tenet that all cultures deserve equal scholarly consideration, regardless of population or community size. In this article, I argue that the minuscule size of hunter-gatherer communities, as well as how they scale and imagine their worlds, are critical factors that should not be glossed over in their study. To illustrate my point, I examine the distortive effect of scale-blind research on a long-studied topic currently drawing renewed interest: indigenous animism. I demonstrate how uncritical use of key terms in analyzing animism, without regard for scale, inadvertently leads to serious disfiguring of hunter-gatherer worlds. I then factor scale into reanalysis of a South Indian forager community known as Nayaka that I started studying in the late 1970s. I argue that the Nayaka animistic cosmos is best understood in terms of a plurispecies community of local beings who are present in each other's lives, rather than in terms of human and nonhuman “persons” and “societies.”

Gender differentiated impacts from weather extremes: Insight from rural communities in South India

Several studies focus on the effects of climate variability on female and male gender relations as perceived through various biophysical and socio-economic aspects. More emphasis is given on the impacts of extreme weather events on rural communities of less developed regions. The results are often interpreted in a qualitative manner through policy measures that may reduce gender inequalities. However, the interpretation of the qualitative results to more crisp and measurable outputs is often not attained while the validation of the findings is rarely ensured. The current study suggests a gender-differentiated impact framework based on qualitative and quantitative components for the assessment of climate variability effects on rural communities in South India. Fifteen villages mostly practicing rice farming in Andhra Pradesh and Telangana states were selected as representative drought-prone case studies. The study results advocate that the qualitative outcomes were validated from the quantitative approach but for a few cases which could be attributed to methodological and case-specific differentiations. Policy recommendations are made on common gender trainings in water-resistant crops and livestock activities for the alleviation of drought impact and abatement of gender inequalities. Also, entrepreneurship workshops for women could enhance gender balance and diverse family income from the current sole dependence on farming revenues. Regional climate adaptation programs could be better implemented when the specific features and capacities of local communities are taken into consideration.

Treatment Discontinuation in Schizophrenia: A Qualitative Exploration from a Rural South Indian Community.

Background:Medication discontinuation remains a big hurdle for retaining persons with schizophrenia under the treatment AMBIT. It is imperative to understand reasons for the same to effectively tackle it.Methods:The study was carried out in Turuvekere, a rural South Indian taluk (an administrative block). Qualitative interviews were conducted with consenting consecutive nineteen patients (along with their family members) who had discontinued medications. All interviews were transcribed. Enlisted reasons were then color coded to synthesize different factors. From the 16th patient onward, no new reason emerged. Three more interviews were done to ensure that there was no additional reason.Results:The following factors (average 4.26 factors per patient) led to medication discontinuation: (1) lack of support/supervision from family/well-wishers (n = 14/19 [73.68%]); (2) lack of insight and cooperation from the patient (n = 11; [57.89%]); (3) lack of awareness about the illness (8 [42.10%]); (4) adverse effects of medications (n = 8; [42.10%]); (5) financial factors (n = 8; [42.10%]); (6) distance/transport (n = 8; [42.10%]); (7) lack of knowledge about treatment process (n = 7; [36.84%]); (8) perceived lack of beneficial effects of treatment (n = 5; [26.32%]); (9) treatment center-related issues (n = 4; [21.05%]); and others.Conclusions:Medication discontinuation is driven by a diverse set of interrelated factors among community-living persons with schizophrenia. Professionals need to be aware of this complexity to effectively manage the problem.

Reproductive tract infections: Attitude and barriers among marginalized fisher women in Kerala, South India

ABSTRACTReproductive tract infections (RTIs) are the cause of severe gynecological and maternal morbidity in India. In marginalized communities, women persevere quietly when faced with a culturally sensitive health issue such as an RTI. To hypothesize on the differential health behavior and low levels of reported incidents among women living in marginalized communities, we undertake an exploratory study in a coastal fishermen community in South India. We identify barriers influencing decisions to seek curative and preventive medical care. Public health practitioners and social workers may find our recommendations relevant for addressing health issues in marginalized communities.

High rates of latent TB infection in contacts and the wider community in South India.

We aimed to compare TB transmission rates between case and community households in Vellore, South India. 359 household contacts (HHC) and 363 community contacts (CC) were assessed with tuberculin skin test (TST) and QuantiFERON TB Gold In-Tube test (QFT) between August 2010 and September 2011. Concordance test and multivariate risk factor assessment were conducted using logistic regression adjusted for clustering. Latent TB infection (LTBI) positivity was similar between the two groups using both tests, with only moderate concordance observed between QFT and TST. Children of HHC (<15 years) were at a higher risk for LTBI (odds of 2.37 [1.15-4.89] and 3.02 [1.22-7.45] for TST and QFT respectively). Among adults, both age in decades (odds of 1.33 [1.14-1.15] and 1.16 [1.02-1.32] for TST and QFT, respectively) and the interaction of male gender, smoking and alcohol consumption (odds of 4.06 [1.38-11.93] and 2.59 [1.19-5.64] for TST and QFT, respectively), were associated with increased risk of LTBI. This study provides estimates of TB infection rates accounting for both community and household exposure that contribute to understanding of TB transmission in this setting. We suggest that assessment of risk factors for infection need increased examination as prophylactic treatment of LTBI are being considered.

An epidemiological study of prevalence of hypertension and its risk factors in a rural community of South India

Background: Chronic non-communicable diseases are important among adult population all over the world. Hypertension (HTN) is the most common cardiovascular disorder accounting for 20-50% of all cardiovascular deaths. The prevalence of HTN is increasing in both rural and urban communities. Objective: The objective of this study was to determine the prevalence of HTN and its associated risk factors in a rural population. Materials and Methods: A community-based cross-sectional study was conducted at rural areas of South India. The sociodemographic variables and risk factors were obtained by interviewing the participants in a predesigned semi-structured questionnaire. The sample size was calculated by the prevalence of HTN in previous studies and 650 participants were included. The blood pressure was assessed and classified according to the Joint National Committee VII classification. Statistical analysis was done using descriptive statistics and Chi-square test of significance. Results: Out of the 650 adults surveyed, 92 individuals (14.1%) were found to be suffering from HTN. Among males, 58 (16.2%) had HTN and 92 (25.7%) were prehypertensives, and among females, 34 (11.6%) had HTN and 71 (24.2%) were prehypertensives. The prevalence rate of HTN shows an upward trend as age advances. The prevalence rate was high among males, higher socioeconomic class, and among the highly educated groups. The risk factors such as tobacco usage, alcohol consumption, additional salt intake, family history of HTN, obesity, high waist-hip ratio, and diabetes mellitus were found to have statistically significant association with HTN. Conclusions: There is an increase in the prevalence of HTN in the rural communities of South India. Population-based prevention strategies and evidence-based clinical strategies should focus on early detection and appropriate treatment.

A cross sectional study to assess the socio-economic impact of falls in an urban community in South India

Background: Epidemiological transition have resulted the injuries to emerge as a global public health problem. Falls are one of the leading causes of injuries and has been predicted that it will be top 20 leading cause of death by 2030. Very few studies have been conducted about falls in all age groups. Hence the present study focussed on the prevalence of falls in an urban area, Bangalore and its social and economic impact on the individual and their family. Materials and Methods: Cross sectional study was conducted covering 3003 population by house-house survey. Pre-tested, semi-structured questionnaire was used. Among injured by falls further details was obtained. Results: Prevalence of falls was 23/1000 population; 95% CI (18-29). High prevalence was seen among extremes of age group and among males. Home was the common place of falls. Lower limb was common injury site and fracture was seen in 16.4% cases. Even after one month of injury, disability persisted in 31.5% cases. Hospital charges were high for elderly people (P=0.04). Total cost incurred following falls was high among 15-59 year age group (P=0.005). Conclusions: Prevalence of falls was 23/1000 population; 95% CI (18-29). Social impact in terms of disability lasting even after one month following falls was present in 31.5%, most common being limping. Though the prevalence of falls was high among extremes of age group, overall economic impact following falls was high among 15-60 year age group.

Prevalence of autism spectrum disorders in a semiurban community in south India

This study aimed to investigate the characteristics of children diagnosed with ASD in China and to estimate ASD treatment patterns in 2020. This study used data from the 2020 Survey on Family Circumstance and Demand Support and Resources among Autistic Children in China. The study sample included 4,557 children diagnosed with ASD aged 2–16 years old. Data were collected through questionnaires completed by parents. Of the 4,557 children with ASD, there was a male-to-female ratio of 5.75:1, and the average age when ASD risk symptoms were first reported was 27.97(SD=10.83) months. Higher proportions of families with highly educated parents (college and above; around 58%) and advanced parental age at childbirth (≥35 years; over 50%) were found among autistic children. Additionally, about 41.05% of autistic children had an immediate family member diagnosed with mental/intellectual disorders. In terms of the treatment patterns for autistic children, 84.82% had received behavioral and developmental treatments and 77.74% had received therapy-based treatments, whereas 3% children had not received any treatment. Higher odds of non-treatment were found among children who were male (OR=1.69, 95% CI: 1.01,3.03) and had ASD diagnosed later on (OR= 1.02, 95% CI:1.01,1.03), as compared to their counterparts. Future studies will need to explore the etiology of the disparities of ASD, and policy efforts are critically needed to understand and address the barriers for children with ASD to receive appropriate treatments.

Bargaining over local public good provision in nested social dilemmas: A comparative study of variation from South India

ABSTRACTIn rural India, decentralized government schemes and assembly constituency development programs represent major channels through which local public good provision is realized. This polycentric governance structure confronts local leaders with a distributional conflict, which is nested in a social dilemma situation. Based on a controlled case study approach, we investigate the provision of small-scale infrastructure in three South Indian communities. Apart from roads and drinking water facilities that directly appeal to the residents of a community, local leaders bargain over infrastructure contracts, which serve as patronage resources in interactions with politicians from higher government levels. A comparative game-theoretic analysis of the results suggests that coordination through political party identities has translated into alternative bargaining strategies and hence varying distributional outcomes regarding contracts and local public goods in the communities under review. The study concludes with recommendations for polycentric institutional design.

Utilization of maternal health care services and their determinants in Karnataka State, India.

BackgroundKarnataka State continues to have the highest rates of maternal mortality in south India at 144/100,000 live births, but lower than the national estimates of 190–220/100,000 live births. Various barriers exist to timely and appropriate utilization of services during pregnancy, childbirth and postpartum. This study aimed to describe the patterns and determinants of routine and emergency maternal health care utilization in rural Karnataka State, India.MethodsThis study was conducted in Karnataka in 2012–2013. Purposive sampling was used to convene twenty three focus groups and twelve individual interviews with community and health system representatives: Auxiliary Nurse Midwives and Staff Nurses, Accredited Social Health Activists, community leaders, male decision-makers, female decision-makers, women of reproductive age, medical officers, private health care providers, senior health administrators, District health officers, and obstetricians. Local researchers familiar with the setting and language conducted all focus groups and interviews, these researchers were not known to community participants. All discussions were audio recorded, transcribed, and translated to English for analysis. A thematic analysis approach was taken utilizing an a priori thematic framework as well as inductive identification of themes.ResultsMost women in the focus groups reported regular antenatal care attendance, for an average of four visits, and more often for high-risk pregnancies. Antenatal care was typically delivered at the periphery by non-specialised providers. Participants reported that sought was care women experienced danger signs of complications. Postpartum care was reportedly rare, and mainly sought for the purpose of neonatal care. Factors that influenced women’s care-seeking included their limited autonomy, poor access to and funding for transport for non-emergent conditions, perceived poor quality of health care facilities, and the costs of care.ConclusionsRural south Indian communities reported regular use of health care services during pregnancy and for delivery. Uptake of maternity care services was attributed to new government programmes and increased availability of maternity services; nevertheless, some women delayed disclosure of pregnancy and first antenatal visit. Community-based initiatives should be enhanced to encourage early disclosure of pregnancies and to provide the community information regarding the importance of facility-based care. Health facility infrastructure in rural Karnataka should also be enhanced to ensure a consistent power supply and improved cleanliness on the wards.Trial registrationNCT01911494Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-016-0138-8) contains supplementary material, which is available to authorized users.

Standardized Mortality Ratio in Patients with Schizophrenia - Findings from Thirthahalli: A Rural South Indian Community.

Background:Schizophrenia is associated with excess mortality experience than the general population. Though this is one of the important outcome measures, it has not been adequately explored especially in rural community dwelling patients in India. We describe the standardized mortality ratio (SMR) of a cohort of schizophrenia patients of Thirthahalli, one such rural taluk of South India.Materials and Methods:SMRs for the years 2009-2011 were calculated. A number of patients in the cohort were 301, 317, and 325 for those consecutive years, respectively. Observed deaths among the patients were noted for these years separately. Crude death rates (CDRs) of the general population of Shimoga district were obtained from the Statistics Department of the Government of Karnataka. CDR (per 1000) was multiplied by the number of patients in each year to get the expected deaths. Then, observed deaths were divided by the expected deaths to get the SMR.Results:There were totally 12 deaths among the patients in these 3 years. SMRs for the years 2009, 2010, and 2011 were respectively 1.4, 1.8, and 2.2. Six had died out of natural (medical) causes. Four had committed suicide, and one died from an accident. Cause from one death remained unknown. There was no statistically significant difference between the alive and deceased patients in any of the demographic or clinical variables.Conclusions:Mortality among schizophrenia patients in this rural cohort is considerably lower than patients from developed countries. Nevertheless, nearly two-fold excess mortality in schizophrenia calls for attention to their medical and psychosocial needs.