Rural Indian Community Research Articles

Yoga to improve maternal mental health and immune function during the COVID-19 crisis (Yoga-M2 trial): study protocol for a pilot randomized controlled trial.

Background: Mental health of women is adversely affected during pregnancy. A huge proportion of pregnant women suffer from stress and depression which negatively impacts birthweight and neuro-cognitive development of the fetus. The current crisis due to the COVID-19 pandemic further adds to the stressful situation. Yoga practiced during pregnancy has beneficial effects on improving stress and depression and preliminary evidence suggests that yoga-based interventions can improve immunity. This study aims to examine the feasibility, acceptability, and preliminary efficacy of a Yoga-based intervention for maternal Mental health and iMmunity (Yoga-M2) in a rural community in India. Methods: The study design will be a single-blind individual randomized parallel group-controlled pilot trial with 1:1 allocation ratio. Adult pregnant women, with gestational age between 12–24 weeks will be randomly allocated to either the Yoga-M2 group or the Enhanced Usual Care (EUC) group. Participants in the Yoga-M2 arm will attend weekly group yoga sessions for 12 weeks and will be encouraged to practice yoga at home. In the EUC arm, participants will receive a single session of health education. Eligibility of the participants, recruitment, retention-in-care, and study completion rates will be estimated and feasibility of delivering Yoga-M2 and acceptability of this intervention by the participants will be assessed. Change in the scores of the Perceived Stress Scale (PSS), EuroQoL 5 Dimensions Score (EQ-5D-5L), Wisconsin Upper Respiratory Symptom Severity Scale (WURSS-21), and serum C-Reactive Protein at three-months post-randomization will be used to assess preliminary efficacy. Discussion: The key outputs of this trial will be a structured intervention manual and evidence about the feasibility, acceptability, and preliminary efficacy of the intervention, establishing the foundation to undertake an explanatory randomized controlled trial to assess efficacy and cost-effectiveness of Yoga-M2 intervention. Trial registration: CTRI/2022/01/039701. Prospectively registered with the Clinical Trials Registry of India on 25 January 2022.

A Single-Arm Pilot Study of Multicomponent Psychoeducational Intervention for Postpartum Depression and Anxiety in a Rural Community.

The prevalence of postpartum depression (PPD) and anxiety (PPA) is rising in India and efforts at generating local evidence for psychological intervention are scanty. We conducted a single-arm pilot study in an Indian rural community to test the impact of multicomponent psychoeducational intervention (MCPI) on women with PPD and PPA. Forty-three women with PPD/PPA/both received MCPI, which comprised three phases with in-person sessions held once weekly for a minimum of six and a maximum of ten weeks. Primary outcome variables were scores on depression and anxiety, assessed using the Edinburg postnatal depression scale and the state and trait anxiety inventory, along with evaluating the compliance rate to the intervention. The Mini-international neuropsychiatric interview (MINI) neuropsychiatric interview was used to confirm the diagnosis of depression and anxiety. Secondary outcome variables assessed were social support, functionality, parental stress, interpersonal violence, and marital satisfaction. We used Cohen's d effect size method for assessing the mean differences. MCPI resulted in the improvement of 72% women (95% CI = 56.3%-84.7%). The overall compliance rate to the intervention was 85.63%, which was higher for responders than nonresponders (92.9% vs. 69.8%; P < 0.001). MCPI resulted in statistically significant improvement in the mean score of depression (P = 0.001, d = 0.95) and anxiety (P = 0.001, d = 1.30). On secondary outcome variables, significant improvement was obtained in the overall present social support (P = 0.001; d = 4.65), present social support from partner (P = 0.027; d = 0.45) and parents (P = 0.001; d = 0.74), future social support from parents (P = 0.001; d = 0.81), the performance of household responsibility (P = 0.001; d = 0.97), lifestyle in the last two weeks (P = 0.001; d = 3.57), parental stress (P = 0.001; d = 1.04), and marital satisfaction (P = 0.014; d = 0.52). This pilot study shows that MCPI has a promising role in relieving depression and anxiety. It also improved the perception of social support from partner and parents, functionality, marital satisfaction, and reduced parental stress.

Whose Development Counts? Adoption of Biogas in the Rural Communities of India- A Review

Whose Development Counts? Adoption of Biogas in the Rural Communities of India- A Review

The Community Developers' Role in the Development of an Inclusive Society

Aim/Purpose: The study looks at how community developers (CD) work in society. It also define their role to educate members to change their mindsets in order to bring social and economic change by eliminate dependency and become self-sufficient. Background: The role of community developers (CD) is to build an inclusive society where a cross-section of society benefits. It is an action to transform people’s socioeconomic situation by sustainable means, not just to develop individuals. Community development is a social learning process in general where community members are brought together to take collective action and generate solution to common problem in villages that provide food security and nourish local requirements and enable all people to participate in social, economic, cultural and political life on the basis of equality of rights, equity and dignity. Methodology: Exploratory research methodology has been used to explore the role of Social Worker or Community Developers to improve the life of communities in rural India. The paper is based on personal experience working in various Indian states to analyses the new wave of social/public service that is affecting the lives of India’s weaker sections. Findings: Overall, findings of this study suggest that: -Community workers serve as a vital link between families and village development activities. -Social workers empower both themselves and their communities. -Involvement in day-to-day activities empowers the members. -Community workers can help marginalized people to tackle their problems. Impact on Society: Community developers play an important role in society's growth by fostering the development of new leaders and encouraging transformational reforms through which entire community became stronger. CD's passion and commitment to the village's development efforts are critical to the project's success. As a result, the process entails working with individuals in groups, programs that focus on women's empowerment and that assist the most disadvantaged members of society in achieving economic and social gains. Community development entails learning from others rather than pushing one's own beliefs on the rest of society. Important steps can be taken if CD can create a vision for the development of the villages in which he or she is involved that is accepted and communicated to the masses and stems from a collective agreement and provides equal opportunity for all people; respect and tolerance for other opinions, ideas, and values; promotes people of all ages, genders, ethnicities, and religions to participate in local production; and continues to work on sustainable models. It is critical to foster a common purpose among all members of society, including involvement from all sectors. The program must be built on the village economy sustaining itself at a lower level of income, resulting in youth and women's employment, increased productivity, and a robust village economy.

SIGNIFICANCE OF RURAL CULTURE IN THE SHORT FICTION OF MANOJ DAS

A brief survey of Indian Short Fiction in English indicates that there is a wide scope for its study. Manoj Das has presented a serene and simple way of life of rural community in India in his fiction which is rapidly disappearing. He is one of the foremost short story writers in Post-Independent India and an outstanding bilingual writer both in English and Oriya at ease. He depicts very effectively and skillfully the way of life of people living in villages, their values, norms, beliefs, attitudes, traditions, customs, superstitions, religion, etc., in his stories. He is a keen observer of the changing socio-political and cultural scenario in the post independent India. The stories of Manoj Das are so subtle and suggestive that they have a concealed element of didacticism, a zeal for social reform as he is keenly interested in fostering and promoting the qualitative life of the rural people of India. Hence, in this paper I presented my views and opinions from Indian perspective keeping in mind the life of the rural people with all their day to day activities and problems as portrayed by Manoj Das. In spite of their penury, the cultural values and conventional ways are not given up. Thus, the author preserves the rich Indian cultural heritage in spite of his depicting the follies and foibles of human life.

Leadership Behaviour in Initiating and Managing Organizational Change Evidence from Poultry Cooperatives, a Rural Enterprise of Jharkhand, India

The study was done to look into different organizational change models and leadership behaviours in the change process. The case of poultry cooperatives of Jharkhand India was studied to look into the aspects of initiating and managing the organizational change process. A mixed approach of literature review and mapping behavioural aspects through unstructured interviews with the group of leaders and managers was done. The exploratory study helped find the crucial behaviours and role play by the governing board members and managers of the case cooperatives in organizational change management. Further research is needed to establish the leader’s behavioural contribution in collective enterprises run by the rural community of India. The study provides ample opportunity to do a detailed study of the subject matter.

Community Health Workers for Prevention of Corneal Ulcers in South India: A Cluster-Randomized Trial

To determine whether a community health worker (CHW) program increases referrals to local eye care providers and ultimately reduces the incidence of corneal ulcers. Cluster-randomized trial performed from 2014 to 2017 in rural South India. This was a community-based study that included all inhabitants of 42 rural South Indian communities. CHWs were trained to diagnose corneal abrasions and assist participants in seeking care at a local vision center. Given the nature of the intervention, the trial was not masked. The main outcome measure was incident corneal ulcer, defined as an active infiltrate or evidence of a new opacity, as assessed by means of penlight examination during an annual door-to-door census. Twenty-one study clusters were randomized to the CHW intervention and 21 to no intervention. Vision centers diagnosed 195 corneal abrasions from the intervention clusters during the 2-year study (rate, 223 per 100,000 person-years; 95% CI, 28-1743) and 62 from the control clusters (rate, 62 per 100,000 person-years; 95% CI, 8-496; incidence rate ratio, 3.57; 95% CI, 2.01-6.35; P < .001). The estimated incidence of corneal ulceration during the study period was 60 per 100,000 person-years (95% CI, 25-141) in the intervention group and 32 per 100,000 person-years (95% CI, 13-80) in the control group (incidence rate ratio, 1.86; 95% CI, 0.5-6.4; P=.32). A CHW program resulted in 3.5 times more referrals to local eye care providers for corneal abrasions, but no difference could be detected in the incidence of corneal ulceration. CHW programs provide a mechanism for increasing referrals to eye hospitals. ClinicalTrials.gov ID: NCT02284698.

Treatment access for opioid use disorder in pregnancy among rural and American Indian communities

BackgroundOpioid use disorder (OUD) in pregnancy disproportionately impacts rural and American Indian (AI) communities. With limited data available about access to care for these populations, this study's objective was to assess clinic knowledge and new patient access for OUD treatment in three rural U.S. counties. Material and methodsThe research team used unannounced standardized patients (USPs) to request new patient appointments by phone for white and AI pregnant individuals with OUD at primary care and OB/GYN clinics that provide prenatal care in three rural Utah counties. We assessed a) clinic familiarity with buprenorphine for OUD; b) appointment availability for buprenorphine treatment; c) appointment wait times; d) referral provision when care was unavailable; and e) availability of OUD care at referral locations. We compared outcomes for AI and white USP profiles using descriptive statistics. ResultsThe USPs made 34 calls to 17 clinics, including 4 with publicly listed buprenorphine prescribers on the Substance Abuse and Mental Health Services Administration website. Among clinical staff answering calls, 16 (47%) were unfamiliar with buprenorphine. OUD treatment was offered when requested in 6 calls (17.6%), with a median appointment wait time of 2.5 days (IQR 1–5). Among clinics with a listed buprenorphine prescriber, 2 of 4 (50%) offered OUD treatment. Most clinics (n = 24/28, 85.7%) not offering OUD treatment provided a referral; however, a buprenorphine provider was unavailable/unreachable 67% of the time. The study observed no differences in appointment availability between AI and white individuals. ConclusionsRural-dwelling AI and white pregnant individuals with OUD experience significant barriers to accessing care. Improving OUD knowledge and referral practices among rural clinics may increase access to care for this high-risk population.

Can Social Enterprises Create Holistic Women Empowerment?

World leaders across the globe are focusing on issues of women empowerment through the creation of equal opportunities in education, work, and society. The Indian artisans are being exposed to several interventions that aim at creating empowerment for these women from the rural underprivileged social strata. Social entrepreneurship has been considered as a driver of women's empowerment; hence it also becomes important to assess its potential to empower women in Indian rural artisan communities. The study was conducted in rural villages of one of the most underdeveloped states of India. Woman empowerment was measured on indices proposes by OXFAM. 130 women engaged with a social enterprise, and 127 women who were part of an NGO were compared with a base group of 130 women untouched by any intervention. We found that both social entrepreneurship and non-governmental organizations had the potential to influence women's empowerment, but social enterprises performed better on most of the indexes. The women working with the social enterprise have stronger financial independence that may be attributing to better self-confidence, autonomy, individual capability, opinion towards women’s economic role, greater control over household decisions and assets. While the environmental level indicators are slightly improved for NGO-based women, most probably due to their unity and psychological effect of being in a group. Social enterprises provided these women with hassle-free earnings and were accepted by the patriarchal social structure.

Removal and risk assessment of pharmaceuticals and personal care products in a decentralized greywater treatment system serving an Indian rural community

A widespread occurrence of pharmaceuticals and personal care products (PPCPs) is reported in all the environmental matrices. Thus, the present study investigated the prevalence of these emerging contaminants in the wastewater from Vichoor village, Tamil Nadu, India. Among the 14 investigated PPCPs, caffeine (CAF), triclosan (TCS), bisphenol A (BPA), and diethyl phthalate (DEP) were the most frequently detected compounds in the concentration range of 5 ng/L to 250.14 µg/L. A seasonal variation (p < 0.05) in the concentration of selected PPCPs was observed, except for BPA, DEP, and carbamazepine (CBZ), due to the difference in the consumption pattern among the households of the community. The fate of selected pollutants was investigated in each component of vertical flow constructed wetland (VFCW). The overall removal efficiencies of COD, ammonia, phosphate, and pathogens were more than 93.34 ± 1.94%, 85.25 ± 1.51, 79.81 ± 1.15%, and 99.9 ± 0.81%, respectively. Also, VFCW exhibited substantial removal of the selected pollutants in the range of 81–97.7%. Microbial degradation (74.9–93.8%) followed by sorption over the substrate materials (0.54–12.56%) seem to be the predominant mechanism for the removal of target PPCPs. The environmental risk assessment witnessed that PPCPs concentration in the treated effluent contributed lower risk to human and aquatic organisms.

Trends, relationships and case attribution of antibiotic resistance between children and environmental sources in rural India

Bacterial antibiotic resistance is an important global health threat and the interfaces of antibiotic resistance between humans, animals and the environment are complex. We aimed to determine the associations and overtime trends of antibiotic resistance between humans, animals and water sources from the same area and time and estimate attribution of the other sources to cases of human antibiotic resistance. A total of 125 children (aged 1–3 years old) had stool samples analysed for antibiotic-resistant bacteria at seven time points over two years, with simultaneous collection of samples of animal stools and water sources in a rural Indian community. Newey–West regression models were used to calculate temporal associations, the source with the most statistically significant relationships was household drinking water. This is supported by use of SourceR attribution modelling, that estimated the mean attribution of cases of antibiotic resistance in the children from animals, household drinking water and wastewater, at each time point and location, to be 12.6% (95% CI 4.4–20.9%), 12.1% (CI 3.4–20.7%) and 10.3% (CI 3.2–17.3%) respectively. This underlines the importance of the ‘one health’ concept and requires further research. Also, most of the significant trends over time were negative, suggesting a possible generalised improvement locally.

Burden of Vitamin D, Vitamin B12 and Folic Acid Deficiencies in an Aging, Rural Indian Community.

Introduction: The important role of micronutrient deficiencies in aging-related disorders including dementia is becoming increasingly evident. However, information on their burden in India is scarce, especially, among aging and rural communities.Methods: Prevalence of vitamin D, B12 and folic acid deficiency was measured in an ongoing, aging cohort, from rural India–Srinivaspura Aging Neurosenescence and COGnition (SANSCOG) study cohort. Serum level estimation of vitamin D, B12 and folic acid, using chemiluminescence immunoassay, was performed on 1648 subjects (872 males, 776 females).Results: Mean vitamin D, B12 and folic acid levels were 23.4 ± 10.6 ng/ml, 277.4 ± 194.4 pg/ml and 6 ± 3.5 ng/ml), respectively. Prevalence of low vitamin D (<30 ng/ml), vitamin D deficiency (<20 ng/ml), B12 deficiency (<200 pg/ml) and folic acid deficiency (<3 ng/ml) were 75.7, 39.1, 42.3, and 11.1%, respectively. Significantly more women had vitamin D deficiency, whereas more men had folic acid deficiency. Women belonging to the oldest age group (≥75 years) had the maximum burden of low vitamin D (94.3%) and folic acid deficiency (21.8%).Discussion: Older, rural-dwelling Indians have high burden of vitamin D and B12 deficiencies, which is concerning given the potentially negative consequences on cognition, immunity and frailty in the aging population. Urgent public health strategies are needed to address this issue and prevent or mitigate adverse consequences.

Participatory design approach to address water crisis in the village of Karkatta, Jharkhand, India

Several Indian rural communities are marginalized due to the multi-dimensional sustainability challenges prevalent in their communities. The interrelationships between these challenges are also very complex. Previous remedial measures were unable to address the intricacies of the interconnected challenges. This study reveals how water scarcity during the summer months, experienced by a community residing in an Indian village named Karkatta, obligates the community to abandon agricultural practices during summer, culminating in significant risk of poverty. Students and faculty of the Live-in-Labs® program undertook diverse approaches to experience and engage in solving the challenges of this community. This work proposed a Human-Centered Design approach to analyze the water scarcity problem and elucidate potential solutions. The participatory methods, including co-design, were marshalled to get a handle of the multidimensional challenges from the stakeholder perspective, and develop the design requirements for the recommended solution. Meteorology, hydrology, geology, agriculture and mechanical engineering disciplines were unified in the derivation of a solution to ensure multi-dimensional sustainability of water, agriculture, and livelihood in Karkatta. The proffered design exploits advanced knowledge from these multiple domains towards combining rainwater harvesting, irrigation strategies, and less water-intensive crop-based agricultural choices while converting a water-scarce region to one of a water surplus.

Technology-enabled knowledge management for community healthcare workers: The effects of knowledge sharing and knowledge hiding

The objective of this study is to explore different facet (dark and bright sides) of technology-enabled knowledge management (KM) for rural lay healthcare workers who belong to the bottom of pyramid (BoP) population in India. Data were collected through multiple rounds of engagements and semi-structured interviews with 37 Accredited Social Health Activists (ASHAs). Findings indicate the existence of spirals of value that are shaped by KM practices in such settings. Technology-enabled KM through knowledge-sharing is supporting an upward spiral of value creation at three different levels, i.e., the micro-level in the form of empowerment of ASHAs, the meso-level in the form of better healthcare for the rural Indian population, and the macro-level in the form of an effective public health policy outcome as envisioned by the government. Contrary to the technology-enabled KM through knowledge-sharing, technology-enabled KM through knowledge-hiding is eroding value resulting in failed attempts to use technology and reduced self-efficacy of ASHAs at the micro level. Technology-enabled KM through knowledge-hiding at the macro level is promoting stratification and marginalization within rural communities in India. Study leaves key implications for healthcare researchers, policymakers and businesses.

Effectiveness of Yoga Lifestyle on Lipid Metabolism in a Vulnerable Population-A Community Based Multicenter Randomized Controlled Trial.

Background: Dyslipidemia poses a high risk for cardiovascular disease and stroke in Type 2 diabetes (T2DM). There are no studies on the impact of a validated integrated yoga lifestyle protocol on lipid profiles in a high-risk diabetes population. Methods: Here, we report the results of lipid profile values of 11,254 (yoga 5932 and control 5322) adults (20–70 years) of both genders with high risk (≥60 on Indian diabetes risk score) for diabetes from a nationwide rural and urban community-based two group (yoga and conventional management) cluster randomized controlled trial. The yoga group practiced a validated integrated yoga lifestyle protocol (DYP) in nine day camps followed by daily one-hour practice. Biochemical profiling included glycated hemoglobin and lipid profiles before and after three months. Results: There was a significant difference between groups (p < 0.001 ANCOVA) with improved serum total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein in the yoga group compared to the control group. Further, the regulatory effect of yoga was noted with a significant decrease or increase in those with high or low values of lipids, respectively, with marginal or no change in those within the normal range. Conclusion: Yoga lifestyle improves and regulates (lowered if high, increased if low) the blood lipid levels in both genders of prediabetic and diabetic individuals in both rural and urban Indian communities.

Detecting the Cause of Depression using BECK Depression Scale among Patients

Background: The onset of Depression is a cause of concern. And various factors have been found to spark off this psychological set back among different groups of people. &#x0D; Aim: This investigation aims to identify various trigger factors causing depression. BECK Depression scale will be the reference to gauge the intensity of depression among psychiatric patients at selected Health care institutions.&#x0D; Objectives: Identifying and determining the type of trigger factors of depression.&#x0D; Materials and Methods: Research design: Descriptive and evaluator approximation. Data Collection would be based on ‘BECK’ depression scale, translated in the vernacular language (Marathi) for its utility.&#x0D; Sampling Technique: Purposive, of the size: 100 participants attending psychiatric OPD primarily diagnosed with depression. &#x0D; Results: Cause factors of depression include: 1) Family history of mental illness, 2) emotional setback: Death or job lay-off, 3) discriminatory and sexual harassment at work place, 4) Chronic medical challenges and 5) Prolonged drug abuse in the view of physical infirmity. Most of the victims evaluated revealed stress in the background, developed pessimistic approach and un-convivial relationship among family members.&#x0D; Conclusion: Chronic infirmity requiring, prolonged medical attention, lack of facilities, cost of the treatment, negligence, are the significant factors affecting the Indian rural community.

Comparative study of bio-chemicals and antioxidant activities of two wild edible mushrooms Russula gnathangensis and Ramaria thindii from Sikkim Himalayas, India

Wild edible mushrooms are utilized by ethnic people in rural communities of India as food and medicinal purposes. The aim of the present study was to estimate biochemical constituents and antioxidant activities of two wild edible mushrooms viz. Russula gnathangensis and Ramaria thindii isolated from Sikkim Himalaya. Methanolic extract of oven dried mushroom powders were used for the estimation of polyphenol, flavonoid, tannin, lycopene and ­β-carotene contents and determination of antioxidant activities though protein and carbohydrate contents were estimated using aqueous extracts. All the chemical constituents were measured on dry wt. basis. Protein contents of R. thindii and R. gnathangensis were 185.8 μg/mg and 164.7 μg/mg, respectively. R. thindii showed 191.7 μg/mg carbohydrate content whereas R. gnathangensis showed 140.5 μg/mg. Polyphenol and flavonoid contents of R. thindii were 7.9 μg/mg and 1.0 μg/mg, respectively whereas R. gnathangensis showed 4.25 μg/mg polyphenol and 0.75 μg/mg flavonoid contents. Tannin contents of R. thindii and R. gnathangensis were 2.35 and 1.46 μg/mg, respectively. R. thindii showed better lycopene content but both the species showed similar amount of ­β-carotene. Both the species showed high amount of antioxidant activities. These wild mushrooms may fulfill the nutritional requirement of the local ethnic people if properly conserved.

Development of an unannounced standardized patient protocol to evaluate opioid use disorder treatment in pregnancy for American Indian and rural communities

BackgroundOpioid use disorder (OUD) disproportionately impacts rural and American Indian communities and has quadrupled among pregnant individuals nationwide in the past two decades. Yet, limited data are available about access and quality of care available to pregnant individuals in rural areas, particularly among American Indians (AIs). Unannounced standardized patients (USPs), or “secret shoppers” with standardized characteristics, have been used to assess healthcare access and quality when outcomes cannot be measured by conventional methods or when differences may exist between actual versus reported care. While the USP approach has shown benefit in evaluating primary care and select specialties, its use to date for OUD and pregnancy is very limited.MethodsWe used literature review, current practice guidelines for perinatal OUD management, and stakeholder engagement to design a novel USP protocol to assess healthcare access and quality for OUD in pregnancy. We developed two USP profiles—one white and one AI—to reflect our target study area consisting of three rural, predominantly white and AI US counties. We partnered with a local community health center network providing care to a large AI population to define six priority outcomes for evaluation: (1) OUD treatment knowledge among clinical staff answering telephones; (2) primary care clinic facilitation and provision of prenatal care and buprenorphine treatment; (3) appropriate completion of evidence-based screening, symptom assessment, and initial steps in management; (4) appropriate completion of risk factor screening/probing about individual circumstances that may affect care; (5) patient-directed tone, stigma, and professionalism by clinic staff; and (6) disparities in care between whites and American Indians.DiscussionThe development of this USP protocol tailored to a specific environment and high-risk patient population establishes an innovative approach to evaluate healthcare access and quality for pregnant individuals with OUD. It is intended to serve as a roadmap for our own study and for future related work within the context of substance use disorders and pregnancy.

Responsible Leadership and the Reflective CEO: Resolving Stakeholder Conflict by Imagining What Could be done

In light of grand societal challenges, most recently the global Covid-19 pandemic, there is a call for research on responsible leadership. While significant advances have been made in recent years towards a better understanding of the concept, a gap exists in the understanding of responsible leadership in emerging countries, specifically how leaders resolve prevalent moral dilemmas. Following Werhane (1999), we use moral imagination as an analytical approach to analyze a dilemmatic stakeholder conflict (between indigenous communities in rural India and an emerging market multinational enterprise headquartered in the same country) through the lense of different responsible leadership mindsets and in light of different ethical principles and moral background theories. Based on this analysis, we arrive at a tentative moral judgement, concluding that the instrumental approach is morally inferior and recommending the integrative approach as the morally superior choice. In the subsequent discussion—focussed on what “could” (instead of “should”) be done, we apply the integrative script and use moral imagination as a pathway for generating morally justifiable solutions. Through this analysis, we provide novel insights on how to apply an integrative responsible leadership approach to a stakeholder conflict situation, using the single case study to expand the responsible leadership discussion to emerging markets.

Case Article—Route Planning at an Animal Husbandry Department

The case provides an opportunity for undergraduate, graduate, and doctoral students to demonstrate a practical application of supply chain modeling in the area of livestock management for a group of rural communities in India. An animal husbandry department needs to ensure timely replenishment of liquid nitrogen to several livestock locations to preserve semen straws, which are frozen for artificial insemination. The department wishes to explore a possible route redesign for cost reduction. The description in the case, as well as the presented data, is based on a real project undertaken by the authors. The case enables students to conceptualize and design sample routes manually to meet the cost objective. However, the main objective is to make students understand and implement solution heuristics for large-scale vehicle routing problems. It also allows students to compare various designs trying not only possible vehicle capacities but also three solution heuristics. Nevertheless, students can also realize the importance of the spreadsheet as a decision support tool for evaluating several options by integrating the chosen heuristic. An important milestone of the case project was the implementation of our recommendations by the animal husbandry department.