CFTBC Version 0.1 dt.31.7.

2013

Format for Application for AD-HOC Research Projects and Guidelines for Operation of Extramural Projects

Indian Council of Medical Research

V. Ramalingaswami Bhawan Ansari !agar P.Box !o. "#$$

!ew %elhi $$&&'#

CFTBC Version 0.1 dt.31.7.2013

(el. )'*+,,,#+ '*+,,#,& '*+,#1#" '*+,#22* Email) head5uarters6icmr.org.in
icmrh5ds6sansad.nic.in

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INDIAN COUNCIL OF MEDICAL RESEARCH

V. Ra alin!a"a i #ha"an$ Ansari Na!ar$ %os& #o' #o. ()** Ne" Delhi + **,,-) A%%LICA.ION FOR /RAN.+IN+AID OF AD+HOC RESEARCH %RO0EC. 7Please furnish $& copies and a CD8 Sec&ion A /ENERAL

$. (itle of the Research Project /ommunit9 %ri:en ;ealth committees < (heir Feasi=ilit9 and effecti:eness in addressing gender issues in pu=lic health with special reference to (B. '. !ame and %esignation of i8 Principal 0n:estigator > Email Email) ii8 /o40n:estigator7s8 > Email Email) 2. %uration of Research Project %r.E.(hiru:allu:an thiru:allu:ane6trcchennai.in %r.Beena E.(homas =eenathomas6trcchennai.in -( 1 on&hs on&hs

i8 Period which ma9 =e needed for collecting the data ii8 Period that ma9 =e re5uired for anal9?ing the data

". Please note that the font si?e of the content should =e at least ** 2& else the proposal will not =e e:aluated. +. Amount of grant4in4aid as@ed for 7details are to =e furnished in .ection B8 Total Rs. 37,81,130(Thjirty seven lakhs eighty one thousand ione hundred and thirty only) $st 9ear 'nd 9ear 2rd 9ear 13,64,000 13,88,000 0 .taff 0i /ontingencies Recurring 80,000 35000 !on4 recurring7E5uipment 8 48000 48000 (ra:el 89,130 0ii O:erhead charges 15,81,130 14,71,000 (otal +. 0nstitution responsi=le for the research project !ame Postal Address (elephone E4mail Fax No !ational 0nstitute for Research in (u=erculosis !o.$ -a9or .at9amoorth9 Road /hetput /hennai42$ &""4',2*#+&& thiru:allu:ane6trcchennai.in 044 -28362525, 28362528

CFTBC Version 0.1 dt.31.7.2013

2

*. 0nstitutional ethical clearance and Project appro:al 7!ecessar9 documents indicating institutional ethical clearance must =e enclosed for research in:ol:ing human su=jects as

also animal experiments8.

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1. 0s radio tagged material proposed to =e used in the project either for clinical trials or experimental purposesC 0f so clearance from !uclear -edicine /ommittee Bha=ha Atomic Research /entre -um=ai indicating should =e attached. - No ,. Projects in:ol:ing recom=inant %!ADGenetic engineering wor@ should =e examined and certificate =9 the 0nstitutional Biosafet9 /ommittee 70B./8 to =e enclosed. Guidelines for

constitution of 0B./ can =e o=tained from .ecretar9 %epartment of Biotechnolog9 /GO /omplex Eodhi Road !ew %elhi4$$&&&2. - Not a li!a"le #. Appro:al of the institutional ethics committee70E/8 should =e enclosed. Guidelines for IEC for animal experiments should follow /P/.EA re5uirements and for human studies should follow 0/-R guidelines. Su3 i&&ed for e'2edi&e a22ro4al $&. (he 0nstitution where the stud9 is =eing done should ensure that there is no financial conflict of interest =9 the in:estigators. No conflic& of in&eres&

CFTBC Version 0.1 dt.31.7.2013

DECLARA.ION AND A..ES.A.ION

i. 0DFe ha:e read the terms and conditions for 0/-R Research Grant. All necessar9 0nstitutional facilities will =e pro:ided if the research project is appro:ed for financial assistance. ii. 0DFe agree to su=mit within one month from the date of termination of the project the final report and a list of articles =oth expenda=le and non4 expenda=le left on the closure of the project. iii. 0DFe agree to su=mit audited statement of accounts dul9 audited =9 the auditors as stipulated =9 the 0/-R.
i:. 0t is certified that the e5uipment7s8 isDare not a:aila=le in the 0nstituteD%epartment or these are a:aila=le =ut cannot =e spared for the project
:. 0t is further certified that the e5uipment7s8 re5uired for the project ha:e not =een purchased from the funds pro:ided =9 0/-R for another project7s8 in the 0nstitute.

:i. 0DFe agree to su=mit 7online8 all the raw data 7along with descriptions8 generated from the project to the 0/-R %ata Repositor9 within one month from the date of completion Dtermination of the project. 0f an9 e5uipment alread9 exists with the %epartmentD0nstitute the in:estigator should justif9 purchase of the another e5uipment. .ignature of the) a8 Principal 0n:estigator BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB =8 /o40n:estigator7s8 BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB c8 ;ead of the %epartment BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB

.ignature of the ;ead of the 0nstitution with seal

%ate)

BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB

P... 0/-R should =e reminded if no ac@nowledgement is recei:ed within one month from the date of sending the application

CFTBC Version 0.1 dt.31.7.2013

Sec&ion + # DE.AILS OF .HE RESEARCH %RO0EC. Ade5uate information must =e furnished in a =rief =ut self4contained manner to ena=le the /ouncil to assess the project. $. (itle of the project.

Community driven health committees Their Feasibility and effectiveness in addressin ender issues in !ublic health "ith s!ecial reference to T#$
'. O=jecti:es 1.Feasibility and effectiveness of community based health committees in gender health lanning. !."o develo guidelines and tools to minimi#e gender dis arities in "$ rogrammes.
2. .ummar9 of the proposed research 7up to $+& words8 indicating o:erall aims of the research and importance of the research proposal. Application of the wor@ in the context of national priorities of medical research if an9 ma9 also =e mentioned.

%iterature revie& revealed that 'ender dis arity is visible across states, societies necessitating health lanners to devise alternate, effective and gender sensitive strategy to cater to the needs of &omen. "his study tries to understand constraints arising from social, cultural, economic, and environmental because of internal differences arising out of these factors largely influence health care utili#ation by the &omen. (econdly, this aims to include the rimary sta)eholders in the health care lanning and delivery rocess as ublic health systems have been lanned and managed by hysician &ho may not e* osed to gender sensitivities. First and foremost this study &ill e*amine the feasibility and effectiveness of &omen artici ation in health care lanning. "his study &ill e*amine &hether ublic health care system be made gender sensitive by health committees+ &omen,s artici ation in health care delivery considering local needs.

CFTBC Version 0.1 dt.31.7.2013 This ex eri!ental st"d# $ill ado t %oth &1'pre-post test design,and &2' a ex eri!ent group and a control group. T$el(e health osts& six "r%an and six r"ral )enters' $ill %e identi*ied. Three in "r%an )l"ster and three in r"ral )l"ster $ill %e the ex eri!ental and the rest treated as )ontrolled "nits. +ata $ill %e o%tained *or! %oth ex eri!ental and )ontrolled "nits. ,n the ex eri!ent -ones, . #o$$unity %dvisory "oard - #o$$unity &oru$ &or T' !ontrol (#(T'#) $ill %e *or!ed. CFTBC $ill )o! rise o* one h#si)ian, health $or/er, one ele)ted re resentati(e &$ard !e!%er0)o"n)ilor0(illa1er an)ha#at resident', one o inion leader and 3 $o!en. -F"$- &ill meet once a month. .uring the meetings, -F"$- &ill discuss various issues ranging from infrastructure to health service delivery. /nce in three month 0eeting roceedings, follo&1u activities &ill be and assessed for effectiveness. $aseline information from each heath ost &ill be obtained before start of intervention. "here after data &ill be u dated from each health ost every month. 2re 3 ost evaluation using intervie& schedule and chec)list, health indicators including "$ case finding and case holding &ill be carried out. 2re 3 ost evaluation using intervie& schedule and chec)list &ill be carried out in control cluster too for com arative analysis. (econdary sources such as 415 .irectorate of 6conomics and (tatistics 4.6(5, 'overnment of "amilnadu and 4!5 7ational (am le (urvey /rgani#ation 47((/5, 'overnment of 8ndia &ill also be used for data collection.

.uration of this study &ill be !4 months. 8nvestigators &ish to come out &ith ra id and reliable alternate strategy in the face of fast develo ing communication channels. ". Present @nowledge and rele:ant =i=liograph9 including full titles of articles relating to the project. 1.,ntrod")tion2 "he gender dis arity, once &idely seen across the countries and religions has begun to change during the last fe& decades in some arts of the &orld. 9o&ever, in most ositions of o&er. traditional societies, the &omen &ere generally at a disadvantage. "heir education &as limited to learning domestic s)ills, and they had no access to 0arriage &as almost a necessity as a mean of su ort or rotection, and ressure &as

usually constant to roduce children, es ecially male heirs. :s such, a &oman had no

CFTBC Version 0.1 dt.31.7.2013 legal control over her erson, her o&n land and money, or her children 1. :ccording to a double standard of morality, res ectable &omen had to be chaste but res ectable men did not and &omen &ere seen mainly as baby1carriers and homema)ers!. "he &omen, articularly in 8ndia, are discriminated on &ide s ectrum of life &hich includes limited access to education, em loyment and artici ation in decisions ma)ing. (econdly, &omen across their lifes an, face different health roblems that are different from men and yet they receive less attention from health system. 'ender dis arity cou led &ith social and infra1structural difficulties ma)e health im rovements for &omen e*ceedingly difficult 'ender dis arity cou led &ith social and infra1structural difficulties ma)e health im rovements for &omen e*ceedingly difficult. "he 'lobal $urden of .isease estimates for !00! indicates that 68 out of the 1!6 health conditions and health ris) factors have at least a !0; difference bet&een &omen and men. "he ris) of a &oman in a develo ing country dying from a regnancy1related cause during her lifetime is about !5 times higher com ared to a &oman living in a develo ed country. 8n s ecific terms 0aternal mortality 1000 &omen die every day of the conse<uences of regnancy and child birth. /n an average a &oman in a high income country is e* ected to live !4 more years than a lo& income country. 2overty is the single most im ortant contributing factor in deciding the treatment. 8ne<uality based on income and dis arity bet&een oor and rich is &ell documented. =orld&ide, over a billion eo le live in absolute overty3, seventy er cent of these are &omen4 and three <uarters of the burden of ill1health among them is attributable to diseases of overty, of &hich infectious diseases are a ma>or art 5. health ris)s of overty is most visible in develo ing countries &here the magnitude of the "uberculosis is enormous. :bout a third of the &orld,s o ulation is infected &ith Mycobacterium tuberculosis. 8n 1998, about three1<uarters of a million &omen died of "$, and over three million contracted the disease, accounting for about 1? million disability ad>usted life years 4.:%@56 8n other &ords, gender dis arity is visible across countries, societies necessitating health lanners to devise alternate, effective and acce table strategy to

CFTBC Version 0.1 dt.31.7.2013 cater to the needs of &omen. %$&evie" of literature' "he term gender? refers to the socially constructed role, res onsibilities, identities and e* ectations assigned to men and &omen and thus contrasts &ith fundamental biological and hysiological differences bet&een men and &omen. 'ender also refers to the different social and cultural roles 8, e* ectations, and constraints laced u on men and &omen by virtue of their se*. =hen analy#ing the different e* eriences and im acts of health on men and &omen, differences relating to gender, in addition to biological se*, need to be considered. Aanet salt#man 9 ut for&ards t&o theoretical a roach to gender issues. First one is coercive as ect of gender system es ecially on &omen focus on men,s ability to maintain their advantage over &omen by dirt of su erior o&er resources, economic , olitical ideology and to much lesser e*tent hysical. /ther one being voluntaristic as ect of gender systems suggesting ho& &omen come to ma)e choice that inadvertently contribute to their o&n disadvantage and devaluation. -oercive a roach theory has a strong basis as the ine<uity of &omen is most countries seems to vary large e*tend from mass overty and the general bac)&ardness caused by underdevelo ment &hich is a roduct of im erialism, colonialism, neo B colonialism, a artheid, racism, racial discrimination and of un>ust international economic relations. "he unfavorable status of &omen is aggravated in many countries both develo ed and under develo ed by de facto discrimination on the grounds of se*. 'ender roles are by definition conte*t s ecific and sub>ect to change over time. (uch conte*t s ecific 'ender roles1 'ender constructs can have a far1reaching im act on diseased atterns and on the effectiveness of revention and control efforts. 9ence, 2olicies and rograms 10 that do not account for gender differences may have a detrimental im act on both men and &omen. 'iven the social conte*t of &omenCs lives, &omen are more li)ely to e* erience more significant detrimental conse<uences as a result of olicies that ignore otential gender im acts. "hus, gender differences in any society can influence both &omenCs and menCs health in number of &aysD For e*am le, 6* osure to ris) factorsE

CFTBC Version 0.1 dt.31.7.2013 :ccess to and understanding of information about disease management, revention and controlE (ub>ective e* erience of illness and its social significanceE :ttitudes to&ards the maintenance of oneCs o&n health and that of other family membersE 4that there is a significant difference bet&een male and female out1of1 oc)et health e* enditure in urban 8ndia115 .ecision ma)ing illness 2atterns of health service useE 2erce tions of <uality of care. "here is gro&ing body of literature on the role and im ortance of gender in determining atterns of ill health, sub>ective e* eriences of illness and effectiveness of control efforts .9o&ever, much still remains to be done in terms of learning ho& to incor orate a gender sensitive ers ective into all as ects of health rogramme lanning and im lementation. 0ainly because, the distinct roles and behaviors of men and &omen in a given culture, dictated by that cultureCs gender norms and values, give rise to gender differences. 7ot all such differences bet&een men and &omen im ly ine<uity. 'ender norms and values, ho&ever, also give rise to gender ine<ualities 1! that is, differences bet&een men and &omen &hich systematically em o&er one grou to the detriment of the other. "he fact that, throughout the &orld, &omen on average have lo&er cash incomes than men is an e*am le of a gender ine<uality. $oth gender differences and gender ine<ualities can give rise to ine<ualities bet&een men and &omen in health status and access to health care. 8n addition, role of &omen as a care receiver and care rovider influence the e<uity in health service. 2rinci ally, because, &omen themselves, their families and health care roviders need to be aware of the e*istence of a health roblem. "hey may loo) u on health roblems as normal or natural as ects of &omen,s biology or everyday activities. For e*am le, certain ty es of health conditions, such as chronic treat them as normal states and ignore them13 . ain, de ression and re roductive tract infections, may be so &idely revalent that &omen and care roviders o&er related the recognition +labeling of and res onse to

CFTBC Version 0.1 dt.31.7.2013 (econdly, even though &omen are a&are of their health roblems, they may refuse to acknowledge the roblem by choosing to remain silent if they fear adverse reactions from the family, community and health care roviders. From my ersonal e* erience, adolescent girls in this region do not ublicly ac)no&ledge their health roblems, articularly "$ because it &ould lead to oorer chances for marriage. $oth unmarried men and &omen &ith se*ually transmitted infections may be highly stigmati#ed by the reaction from unsym athetic health care roviders, reventing them for see)ing care. :dolescent girls doubly victimi#ed by the misconce tion that ("8 can be cured by having se*ual intercourse &ith virgins. (ometimes families may also turn a blind eye to &omen,s health needs because of indifference, or lo& value attached to the lives or &ell1being of &omen. "his can affect all &omen but es ecially &omen &ho are infertile. %ac) of ac)no&ledgement may also affect the &ay in &hich health roviders ta)e action or not to romote health services for &omen, or deal &ith roblems such as maternal ris) or obstetric emergencies as &ell as other critical needs. "hird, even &hen &omen and their families acknowledge the need for treatment, social and financial barriers may be encountered before health care can be utili#ed14. "hese considerations may be influenced by gender biased normative structures that govern households. :lthough health services may be available, &omen and girls may be unable to access them due to discrimination &ithin the household, granting referential allocation of resources to male health needs or re<uiring consent from artners or other family members. 8n the 8ndian culture, girls are li)ely to receive less e* ensive and more home1based care than boys and are also more li)ely to suffer from outright neglect of their health needs than boys15. Festrictions on hysical mobility and the need for husband,s or other family member,s ermission to utili#e health service outside the household are im ortant gate&ays bet&een &omen and their access to health care. 8n 8ndian society this is the situation in both rich and oor households. 2hysical and economic barriers may also revent &omen from accessing health services, due to long distances to health facilities and lac) of trans ortation, lac) of rivate+ ublic insurance coverage. 0any studies have documented that, out1of oc)et e* enditures for ublic and rivate health care services

CFTBC Version 0.1 dt.31.7.2013 drive many families into overty, es ecially in develo ing countries 16. =omen are

dis ro ortionately affected as they have less access to household resources and re<uire more reventive re roductive health services1?. Feferring atients from the ublic service to their o&n rivate clinic, ma)ing atients ay for drugs and su lies that should be rovided free, recommending unnecessary interventions &hich they can charge for are e*am les of abusing users of services, sometimes contributing to medical overty and at times maternal deaths18. =omen are also reluctant to use health services because res ect, rivacy, confidentiality and information about treatment o tions are not ensured by the often over&or)ed, under aid and gender insensitive health care roviders. "here is gro&ing evidence that, at ublic healthcare centers, ho& &omen 4and men5 may be abused by care roviders hysically, verbally and economically. =hile religions li)e 8slam restricts social and hysical contact bet&een &omen atients and male care roviders, in other communities, &omen themselves are reluctant to consult male doctors. "he lac) of lady medical ersonnel B itself is a reflection of gender bias in health care services. :nother dimension to this &or)ers &ere not sufficiently trained and or roblem is available Female 9ealth ermitted to recogni#e and treat the

sym toms, and &omen could not access the services as easily. 6ven in the develo ed counties, <uality of health see)ing and resultant care received by &omen is roblematic. 8n 6ngland for e*am le com ared to men, &omen a ear to e* erience illness and re orting to health system more than men 19. 7athanson e*amined this relationshi bet&een illness and feminine role and offered three e* lanation of &omen,s higher levels of morbidity, des ite living longer. First, it is culturally acce table of the o inion that is &omen have a higher level of morbidityE second ,&omen,s fle*ible domestic timetables allo& them o ortunities to visit the 'eneral 2ractitionersE and third, it is &omen demanding social roles that ma)e them ill. (ome other studies confirmed this and sho&ed that married &omen e* erience more mental health roblems. : ty e of self1 rotective mechanism is one of the ma>or obstacles 1 sometimes the single most im ortant obstacle 1 standing bet&een men and &omen and the achievement of &ell1 being.

CFTBC Version 0.1 dt.31.7.2013 (econdly, &omen as ma>or consumers of health, li)ely to be e* osed to male dominated health care rofession &hich includes the &ell established 79( &here 80; ercent of consultants!0 are men. 0edicalisation of health has lead to vie& &omen as a mere ob>ect rather than human erson. -hild birth for e*am le, has shifted a&ay from female to male controlled delivery in line &ith the changing status of mid&ifery. 2rior to the nineteenth century it &as usually managed by &omen &ho had learned their s)ills through oral tradition. 8n deed the term mid&ifery means G&ith &omenH. "hus the medicalisation of childbirth allo&ed the develo ing male medial rofession to consolidate its )no&ledge and status. in 6ngland, from 1?th century on&ards male mid&ifes restricted female mid&ives &or) differentiating bet&een normal and abnormal deliveries reserving for themselves those cases &here instruments. (uch as force s &ere deemed necessary!1. .evelo ment 9ormone re lacement thera y 49F"5 to address meno ause at later life though has lead to erceive a normal course of biological changes into sym tom to be relived and termed as a deficiency syndrome!!. 8n countries li)e 6ngland &here &omen and men, though, enter medical schools in almost e<ual numbers, &omen &ho <ualify, face hori#ontal and vertical occu ational segregation. For e*am le, in the year 199! &omen made u only !0 ercent of consultant even though they re resented 60; of doctors in the lo&er status s ecialism of ublic health medicine and 4?; of general ractitioners !3. 8n 8ndia 40; of doctors !4 &ere female in the 199!193 but their re resentation at decision ma)ing level &as une<ual to their number. :lthough ma>ority of the health they undervalued and unrecogni#ed, &or) force is female, and the contributions of &omen to formal and informal health care systems are significant, often artly due to vertical occu ational segregation. $ecause Female health workers in the health system are less li)ely to occu y ositions that involve decision ma)ing. 0any studies have sho&n that &omen are often e* ected to conform to male &or) models that ignore their s ecial needs, such as childcare or rotection from violence. :n :merican study revealed that more female doctors than male doctors are found in s eciali#ations &here ta)ing care of family res onsibilities are more acce ted!5. %o& &ages and salaries cou led &ith lac) of infrastructure and oor &or)ing conditions leads to migration of valuable and e* erienced human resources from

CFTBC Version 0.1 dt.31.7.2013 countries li)e 8ndia, 2a)istan to high income countries!6. : study in the IJ sho&s that 40; of the nurses &ere emigrants from resource oor settings.!? 8n other laces, community health &or)ers may be sub>ected to violence. For e*am le, in studies in 2a)istan!8 and in 8ndia!9 female community health &or)ers have re orted that they are often harassed &hen they are on their &ay to &or) or erforming &or). "he fear of being e* osed to hysical or se*ual violence ma)es them hesitant to attend to obstetric needs of atients at night. 8n each of these cases, mere re resentation of &omen in the health system rovide no great benefit to &omen as a &hole and are negatively affecting health. 2resently seventy er cent of over a billion eo le &ho live in absolute overty are &omen &orld&ide. 8n the health front three <uarters of the burden of ill1 health among them is attributable to diseases of overty, of &hich infectious diseases are a ma>or art. 9ealth ris)s of overty are most visible in develo ing countries &here the magnitude of the "uberculosis is enormous. :bout a third of the &orld,s o ulation is infected &ith 0ycobacterium tuberculosis. 8n 1998, about three B<uarters of a million contracted the disease, accounting for about 1? million disability ad>usted life years 4.:%@5. For &omen &ith "uberculosis in 8ndia and $angladesh concern about marriage ros ects &as a characteristic concern. : study underta)en to assess 'ender and socio1cultural determines of delay to diagnosis of "$ in $angladesh, 8ndia and 0ala&i re orts interval from sym tom onset to diagnosis &as longest36 in 8ndia. Further, this study suggest need for Further research distinguishing atient and rovider delay in order to ma)e health care gender sensitive. 8n 98K front $.6. "homas et observe 3? there are gender differences in se*ual behaviour atterns among men and &omen. Inderstanding these differences is im ortant to lan gender based intervention strategies in order to ensure that eo le living &ith 98K have a better <uality of life, addressing their se*ual concerns both &ithin and outside of marriage. 8nternational -ouncil of e* erience in 98K :8.( (ervice /rgani#ations 48-:(/5 from its e*tensive revention &or) suggest that community advocacy can bring

CFTBC Version 0.1 dt.31.7.2013 significant im acts on national olicies 4such as the rioriti#ation of )ey o ulation in 7(2s5 that, in turn, bring concrete rogrammatic benefits and resources. 'oing bac) to "$ related studies,
38

(udha 'ana athy et al, em hasis the need for gender s ecific

intervention strategies to enhance better access of "$ services. The literat"re re(ie$ de!onstrate that, 1ender dis arit# is (isi%le a)ross )o"ntries,states, so)ieties ne)essitatin1 health lanners to de(ise alternate, e**e)ti(e and 1ender sensiti(e strate1# to )ater to the needs o* $o!en. This 3lternati(e health ro!otion !odel0strate1# that ta/es into )onsideration o* the 1ro"nd realities. The alternati(e !odel sho"ld %e an inte1rated and in)l"si(e o* *i(e di**erent )o! onents. i.e.,

G G G G G

0edical $ehaviour change 6ducational 6m o&erment (ocial change :t least si* health romotion models can be found in the literature that

strives to bridge the ga

and reduce the health ine<ualities. "he different health

romotion models revie&ed areD 1.9olland 9ealth 2romotion 0odel30 !.$eattie 1 9ealth 2romotion 0ode31 3.'reen and Jreuter 12recede12roceed 0odel3! 4.(ocio1 economic 0odel4.ahlgren and =hite head 199133 5."annahill 9ealth 2romotion 0odel34 6."ones 9ealth romotion model 35 "he above models have both advantages and deficiencies as there is no one model that can e* lain the entire dimensions of human health and &ell being and fulfils the =9/ definition of health. 9o&ever, the most effective &omen centered health romotion &ould utili#e more than one ty e as &ell as forms of ractice &hich do not

CFTBC Version 0.1 dt.31.7.2013 easily land themselves to such categori#ation. :mong different socio1economic model of health is the most a ro riate one as it tries toE 1. "o identify the determinant at individual and societal level and attem ts to obtain the o inion at the grass root level, a sort of $ottom1u strategy !. 8t tries to understand constraints arising from social, cultural, economic and environmental factors because internal differences arising out of social, cultural, economic and environmental factors largely influence the health care utilisation of &omen. 3. (uggests a ro riate structural changes to enable &omen get an e<ual access to health &ithout any hardshi . "herefore, the researchers &ish to underta)e study a strategy in line &ith, (ocio1 economic model of health and ado ting -/00I78"@ :.K8(/F@ 'F/I2( 4-:'s5 2romoted by (outh :frican :ids Kaccine 8nitiative 39 and feasibility and effectiveness of 9ealth committees and artici ation of &omen in hel ing the health system to be gender sensitive &ill be studied in detail.

FeferencesD 1. ! J.%..atta,(avita (harma, Facet of 8ndia overty, -once t ublishing co. 7e& .elhi1 !00!. .3? J.%..atta,(avita (harma, Facet of 8ndia overty, -once t ublishing co. 7e& .elhi 1!00!. .31 2aolisso 0, %eslie A. 1995. 0eeting the changing health needs of &omen in Med 40415D 55165. =orld $an). 1990. develo ing countries. Soc Sci

4.

CFTBC Version 0.1 dt.31.7.2013 World Development Report: overty. /*ford Iniversity 2ress, 7e& @or). 5 6. Inited 7ations .evelo ment 2rogramme. 1995. !uman Development Report. I7.2, 7e& @or). 0u)und I le)ar ,(heela Fangan ,Aessica /gden 'ender and "uberculosis -ontrolD "o&ards a (trategy for Fesearch and :ction =orld 9ealth /rgani#ation, 'eneva, (&it#erland ,(ecember 1))) =9/ 'ender, htt D++&&&.&ho.int+to ics+gender+en+..ate accessed !5+8+!009 =omenCs 9ealth Kictoria =omenCs 9ealth 8ne<uitiesE htt D++&&&.&hv.org.au+&hat1 &e1do+&omen1s1health1ine<uities, date.!5 February !009 Fa>a)umar. =omen 2roblems :geing =omenE (ome 8ssuesE :nmol 2ublication, 7e& .elhi !000.2.31 =omenCs 9ealth Kictoria htt D++&&&.&hv.org.au+healthL olicy+ gender.htm -ontent 2ublication .ateD11th 7ovember !00!, :ccessed on !9+1+!009 =omen and health develo ment1 'ender htt D++&&&.&ho.int+gender+en+ date accessed !9+1+!009 9imanshu (e)har, Fout :rchive 'ender 8ne<uality in 9ousehold 9ealth 6* enditureD "he -ase of Irban /rissaE .r. (FJ 'overnment :rts -ollege, @anam, 8ndia !006 /nline at htt D++m ra.ub.uni1 muenchen.de+6544+ 02F: 2a er 7o. 6544, osted 03. Aanuary !008 + 03D36 8yer, :. 'ender, -aste, -lass, and 9ealth -are :ccessD 6* eriences of Fural 9ouseholds in Jo al .istrict, Jarnata)aE "rivandrum, :chutha 0enon -entre for 9ealth (cience (tudies, (ree -hitra "irunal 8nstitute for 0edical (ciences and "echnology. 4!0055 8bid. .16 :hmed, (. 0., :dams, :. 0., -ho&dhury, 0. 3 $huiya, :. 6nder, (ocioeconomic .evelo ment and 9ealth (ee)ing $ehaviour in $angladeshE Soc Sci Med" 51, 3611 ?1. !000 Jrishna, :., Ja ila, 0. 3 2atha), (. Falling into overty in villages of :ndhra 2radeshD =hy overty avoidance olicies are neededE #conomic and olitical Weekly" 1?, 3!4?13!56. !004 9anson, J. 0easuring u D 'ender, $urden of .isease, and 2riority (etting. 87 (67 ', '. :.,

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CFTBC Version 0.1 dt.31.7.2013 M("%87 2 46d.5 6ngendering 8nternational 9ealthD "he challenge of e<uity. -ambridge, 08" 2ress. !00! 18 'eorge, :. "he /utrageous as /rdinaryD 2rimary 9ealth -are =or)ersC 2ers ectives on :ccountability in Jo al .istrict, Jarnata)a (tate 8ndiaE $nstitute o% Development Studies. $righton (usse* Iniversity !00? Aenny 9oc)ey. =omen and 9ealth 1 8ntroducing =omen,s (tudiesE 6dited by Kictoria Fobinson, .iane Fichardson, 2algrave, 7e& @or)1199? 8bid .!93 199? Aenny 9oc)ey, =omen and 9ealth B 8ntroducing &omen,s studies16dited by Kictoria Fobinson and .iane Fichardson, 2algrave, 7e& @or) 199? 1 .!89. 199? 8bid .!91 8bid. .!95 :sha 'eorge 9uman Fesource for 9ealth B: 'ender analysis, =omen and 'ender 6<uityE Jno&ledge 7et&or) B =9/ -ommission on (ocial .eterminants of health. Aune !00?. 2.1? .e Joninc), 0., $ergeron, 2. 3 $ourbonnais, F. =omen hysicians in NuebecE Soc Sci Med" 44, 18!513!. 199? =9/, (ocio16conomic =elfare, =9/.!006 $uchan, A., Aoban utra, F., 'ough, 2. 3 9utt, F. 8nternationally recruited nurses in %ondonD : (urvey of -areer 2aths and 2lansE !um Resour !ealth" 4, 14. !006 0umta#, O., (al&ay, (., =aseem, 0. 3 Imer, 7. 'ender1based barriers to rimary health care rovision in 2a)istanD the e* erience of female rovidersE !ealth olicy lan" 18, !6119. !003 'eorge, :. "he /utrageous as /rdinaryD 2rimary 9ealth -are =or)ersC 2ers ectives on :ccountability in Jo al .istrict, Jarnata)a (tate, 8ndiaE $nstitute o% Development Studies. $righton (usse* Iniversity. !00? 'abe A, -alnan 0, $ury 0 -a lan F "est case for social olicy and social theory. 8nD "he sociology of the 9ealth (ervice. Foutledge, %ondon. 1991

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CFTBC Version 0.1 dt.31.7.2013 31 9olland F Fethin)ing 9ealth 6ducation "heory. 9ealth 6ducation Aournal, Kol. 49, 7o. 1, 101 1! 419905 $eattie, : Jno&ledge and -ontrol in 9ealth 2romotionD : "est -ase for (ocial 2olicy and (ocial "heory, in 'abe, A -alnan, 0 $ury, 0 46ds5 "he sociology of the health service Foutledge, %ondon, 1991. 'reen, %= and Jreuter, 0=., 9ealth 2romotion 2lanningD :n 6ducational and 6cological : roach 4 th edn. 7e& @or), 0c'ra& 9ill.!005 .ahlgren, ' and =hitehead.0, 2olicies and (trategies to 2romote (ocial 6<uity in 9ealth, 8nstitute of Futures (tudies. (toc)holm 1991 .o&nie F (, "annahill -, "annahill.:, 9ealth 2romotion: Models and Kalues 4!nd ed.5, /*ford Iniversity 2ress 4&''(5. Fenaud F $oulanger, (te hanie (eidel, 6rica %essem, %ee 2yne10ercier, (haron . =illiams, %aia Fui# 0ingote, -herise (cott, :licia @ -hou,Aames K %avery, 6ngaging communities in tuberculosis research &&&.thelancet.com+infection 2ublished online 0arch !4, !013 $.6. "homas, (. -handra, J.A.:. (elvi, .. (uriyanarayanan, (oumya (&aminathan 'ender differences in se*ual behaviour among eo le living &ith 98K in -hennai, 8ndia 8ndian A 0ed Fes 1!9, Aune !009, 6901694 (udha 'ana athy, $eena 6 "homas, 0.(. Aa&ahar, J. Aose hine :roc)ia (elvi, (ivasubramaniam and 0itchell =eiss 2erce tions /f 'ender :nd "uberculosis 8n : (outh 8ndian Irban -ommunity 8ndian A 0ed Fes 1!9, Aune !009, 6901694 (outh :frican :ids Kaccine 8nitiative 'uidelines For -ommunity :dvisory 'rou s 4-:'s5 1 Auly, !00?

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+. Preliminar9 wor@ alread9 done =9 the 0n:estigator on this pro=lem e.g. selection of su=jects standardi?ation of methods with results if an9. 2reliminary &or) underta)en during the data collection &or) for one of investigator,s 2h. &or) to ascertain the demand from &omen. 9o&ever, other activities li)e selection of sub>ects and obtaining ermission from .irector 2ublic

CFTBC Version 0.1 dt.31.7.2013 9ealth &ill be initiated on a roval from the council. *. Ein@s with other 0/-R projects 7ad4hoc tas@ force or colla=orati:e8. 7ecessary efforts &ill be made to lin) other 8-0F ro>ects. 8t &ill be lin)ed &ith model ./"( rogramme of 7ational 8nstitute foer Fesearch in "uberculosis, -hennai. 1. Eist of important pu=lications of last + 9ears of the all the in:estigators in the rele:ant fields 7enclose reprints if a:aila=le 1. Beena 4 Tho!as, 5"neet 6. +e$an, 7o hia Vi8a#, 3le#a!!a Tho!as 9 7 Cha"han, Chandrase/aranV, 5reetish Vaid#anathan, 7o"!#a 7$a!inathan,. 5er)e tion o* T"%er)"losis atients on ro(ider-initiated :,V testin1 and Co"nselin1- 3 st"d# *ro! 7o"th ,ndia, 5los ;ne +e)e!%er 200<, Vol"!e 4, ,ss"e 12 , e838< 2. Beena Tho!as, =atthe$ >. =i!ia1a, 6enneth :. =a#er,, 7"nil =enon, V. Chandrase/aran, 5. ="r"1esan, 7o"!#a 7$a!inathan, ? 7te(en 3. 7a*ren. @:,V 5re(ention ,nter(entions in Chennai, ,ndia2 3re =7= Bein1 Aea)hedBC 23,+7 atients )are and 7T+sVol"!e 23 N"!%er 11,200< 3. Beena 4. Tho!as, Chandra 7, >ose hine 6, 7"ri#anara#anan + and 7o"!#a 7$a!inathan @Dender di**eren)es in !arria1e and sex"al %eha(ior a!on1 eo le li(in1 $ith :,V in Chennai, ,ndiaC ,ndian >o"rnal o* =edi)al Aesear)h 12<&6', >"ne 200<, 625-724 4. Do/ila Vani.D, Thir"(all"(an.4 7hen%a1a(alli ,n*l"en)e o* stress on )o in1 and E"alit# o* li*e a!on1 $o!en li(in1 $ith :,V in*e)tion 6a/ati#a >o"nral o* Fo!enGs 7t"dies. Vol.1. No.1 =ar)h 2007 5. Thir"(all"(an.4 =asterGs dissertation on @7o)ial and 4thi)al ,ss"es o* 7ex 7ele)tionC 6H 9e"(en, Bel1i"!, 2008
,. %etailed research plan. 7gi:e here the design of stud9 indicating the total num=er of casesDsamplesDanimals to =e studied the mode of selection of su=jects speciall9 in experiments in:ol:ing human =eings e5uipments and other materials to =e used methodolog9Dtechni5ues to =e emplo9ed for e:aluating the results including statistical methods an9 potential to o=tain patents etc.8

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CFTBC Version 0.1 dt.31.7.2013 "he study &ill be carried out in the state of "amilnadu 8ndia. "&elve health osts4 si* urban and si* rural centers5 &ill be identified. "hree in urban cluster and three in rural cluster &ill be the e* erimental and the rest be treated as controlled units. %$(ata' .ata &ill be obtained form both e* erimental and controlled units. 8n the e* eriment #ones, .#o$$unity &oru$ &or formed. -F"$T' !ontrol) (#(T'#) &ill be anchayat resident5, one &ill com rise of one hysician, health &or)er, one elected

re resentative 4 &ard member+councilor+villager o inion leader and 3 &omen.

-F"$- &ill meet once a month. .uring the meetings, -F"$- &ill discuss various issues ranging from infrastructure to health service delivery. /nce in three month 0eeting roceedings, follo&1u activities &ill be and assessed for effectiveness. $aseline information from each heath ost &ill be obtained before start of intervention. "here after data &ill be u dated from each health ost every month. 2re 3 ost evaluation using intervie& schedule and chec)list, health indicators including "$ case finding and case holding &ill be carried out. 2re 3 ost evaluation using intervie& schedule and chec)list &ill be carried out in control cluster too for com arative analysis. (econdary sources such as 415 .irectorate of 6conomics and (tatistics 4.6(5, 'overnment of "amilnadu and 4!5 7ational (am le (urvey /rgani#ation 47((/5, 'overnment of 8ndia &ill also be used for data collection.. Private Sector 1).Organizational profile /rgani#ational rofiling &ill assesses the both 29- and -F"$- origins and develo ment, <uality of membershi 4in terms of &hy eo le >oin, and e*clusivity of the organi#ation5, institutional ca acity and institutional lin)ages 4in terms of

CFTBC Version 0.1 dt.31.7.2013 levels of collective actions, information e*change, and levels of efficacy among governmental and non1governmental agencies5. 0ean atient registration, mean time ga for various rocedures and e* ense related to receiving of health care etc., o tions made available to &omen members from oorer sections of society &ill be collected from the 29- management. Further, o inion concerning modalities in &or)ing &ith government system and their social commitment to address social determinants of oor &ill be e* lored. %+,ndividual survey: "hrough a series of semi1structured intervie&s &ith organi#ational leadershi , community leaders, &omen leaders, membershi committees, 7'/s, data &ill be collected. -.!ected benefits' 1 2revailing social sector commitment of rivate health sector &ill be documented. 1 7eed and roblems &ill be identified on com letion of this study, and 1 Felevant+need based strategies can be suggested for health olicy ma)ers. #. Facilities in terms of e5uipment etc a:aila=le at the sponsoring institution for the proposed in:estigation. 7ational 8nstitute for Fesearch in "uberculosis is one of the im ortant centres under 8-0F and has e*cellent managerial and infrastructure facilities. $&.Budget re5uirements 7with detailed =rea@4up and full justification8) and non1members in health

CFTBC Version 0.1 dt.31.7.2013 1 (taff 1$/ro0ect coordinator1*&F+ &s$18,000 . % . %4 &s 8,24,000 "&o (FFs &ill coordinate the activities of K9's./ne coordinator &ill be res onsible for 3 K9's ,3 e* erimental sites and 3 control sites. -oordinators &ill identify the -:$ members, facilitate interaction bet&een -F"$- and 29-, organi#e sensiti#ation sessions to -F"$- members, organi#e meeting etc., %$3illa e 4ealth 5uides &s$1%000 . 2 .%4 months &s$17,%8,000 K9's &ill be res onsible for day1to1day activities of -F"$- and re are the -F"$members &ith s)ills of need4community5 identification and strategy building . 3$(ata entry o!erator &s$8000 . 1 . %1 months &s$ 1,28,000 .ata entry o erator &ill be recruited at 3rd month from the initiation of study and entrusted &ith documentation of res onsibilities related to the study. %7,20,000 ! -ontingencies 1.Fecurring !.7on1recurring 4e<ui ment5 1..ata collection tools rinting !.8nvestigators +2ro>ect staff meeting and Fe ort discussion 3.Fe ort &riting 4..issemination &or)sho s 5.-om uter &ith rinter Fs.4000 46 #ones5 * !4 months

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1. Research speciali?ation 7-ajor scientific fields of interest8 Ps9cho social issues Gender issues ;0VDA0%. (u=erculosis ,. 0mportant recent pu=lications 7last + 9ears with titles and References8 including papers 0n press 1. =ohanarani 7"hade(, *r 'eena + Tho$as, ="r"1esan, Nir" arani Charles, +r.Chandrase/aran V, +"r1a, 3"xilia, +r 3le#e!!a Tho!as and +r Fraser Fares. Screening for Alcohol Use Disorders (AUD) among Tuberculosis patientsattending Chennai Corporation Health Centers, Tamilnadu, 59o7 ;N4 , =a# 2011 , Vol"!e 6 ,,ss"e 5 2. = > =i!ia1a , ' Tho$as , 6 : =a#er , 7 9 Aeisner , 7 =enon , 7 7$a!inathan , = 5eri#asa!# , C V >ohnson and 7 3 7a*ren Alcohol use and HIV se ual ris! among "S" in Chennai, India, ,nt > 7T+ 3,+7 2011L222121-125 3. =ohanarani 7"hade(,Hda#a =ahade(an, =eenalo)hani +ili ,, +e(ara8 7"r#anara#anan, Aa8ase/aran 7i/ha!ani,and 'eena Tho$as #$ercentages,$rocess and $atterns of HIV Disclosure among the spouses of HIV infected men in South India%, >o"rnal o* the ,nternational 3sso)iation o* 5h#si)ians in 3,+7 Care, 2011,10&1' 26-2< &' 6 >a11ara8a!!a , 'eena Tho$as . Challenges in dealing (ith the problem of Tuberculosis)* periences from Tuberculosis +esearch Centre (IC"+), Chennai, India, 5ro)eedin1s o* 2010 ,nternational Con*eren)e on :"!anities, :istori)al and 7o)ial s)ien)es &C::772010' ,7BN2 <78-184626-025-4L 474-477 5. =ohanarani 7"hade(, Hda#a =ahade(an, 'eena + Tho$as ? 7o"!#a 7$a!inathan -omen as carers. /urden of the (i0es of HIV infected men in South India. 5ro)eedin1s o* 2010 ,nternational Con*eren)e on :"!anities, :istori)al and 7o)ial s)ien)es &C::772010' ,7BN2 <78-1-84626-025-4L 454458

CFTBC Version 0.1 dt.31.7.2013 6. Nir" arani Charles, 'eena Tho$as, Basilea Fatson, Aa8a 7a/thi(el =., Chandrase/eran V, Fraser Fares, Care See!ing /eha0ior of Chest S1mptomatics. A Communit1 /ased Stud1 Done in South India after the Implementation of the +2TC$, 59o7 ;N4 7e te!%er 2010, Vol"!e 5 , ,ss"e < , e1237< 7. C.5ad!a ri#adarsini, 7.7$a!inathan, => 6arthi ri#a, D N3rendran, 5redee 3ra(indan =enon, 'eena + Tho$as, "orpholog1 and bod1 composition changes are Different in "en and (omen on generic combination Antiretro0iral Therap1 3 An 4bser0ational Stud1, >35,, >"ne 2010 Vol 58&375377' 8. 7te(en 3. 7a*ren Beena Tho!as, =atthe$ >. =i!ia1a, 6enneth :. =a#er,, 7"nil =enon, V. Chandrase/aran, 5. ="r"1esan, 7o"!#a 7$a!inathan, #Depressi0e s1mptoms and HIV ris! among "S" in Chennai, India% 5s#)holo1#, :ealth ? =edi)ine Vol. 14, No. 6, +e)e!%er 200< 705-715 <. 'eena + Tho$as, 5"neet 6. +e$an, 7o hia Vi8a#, 3le#a!!a Tho!as 9 7 Cha"han, Chandrase/aranV, 5reetish Vaid#anathan, 7o"!#a 7$a!inathan,. $erception of Tuberculosis patients on pro0ider)initiated HIV testing and Counseling) A stud1 from South India, 5los ;ne +e)e!%er 200<, Vol"!e 4, ,ss"e 12 , e838< 10. 'eena Tho$as, =atthe$ >. =i!ia1a, 6enneth :. =a#er,, 7"nil =enon, V. Chandrase/aran, 5. ="r"1esan, 7o"!#a 7$a!inathan, ? 7te(en 3. 7a*ren' #HIV $re0ention Inter0entions in Chennai, India. Are "S" /eing +eached5% 23,+7 atients )are and 7T+sVol"!e 23 N"!%er 11,200< 11. 7o hia Vi8a#, 7o"!#a 7$a!inathan, 5reethish Vaid#anathan,3le#a!!a Tho!as, 9.7.Cha"han,5rahlad 6"!ar, 7onali Chiddar$ar, 'eena Tho$as, 5"neet 6.+e$an 6easibilit1 of $ro0ider) Initiated HIV Testing and Counselling of Tuberculosis $atients Under the T/ Control $rogram in T(o District of South India No( 200<,Vol 4, ,ss"e 11,e78<< 12. 'eena Tho$as, 7o"!#a 7$a!inathan, 3deline N#a!athi. #Impact of HIV7AIDSon "others in Southern India. A 8ualitati0e Stud1% J 3,+7 Beha(&200<'132<8<-<<6 13. Beena Tho!as, =atthe$ >. =i!ia1a, 7"nil =enon, V. Chandrase/aran, 5. ="r"1esan, 7o"!#a 7$a!inathan, 6enneth :. =a#er, 7te(en 3. 7a*ren. #Unseen and Unheard. $redictors of se ual ris! beha0iour and HIV infection among men (ho ha0e se (ith men ("S") in Chennai, India% J 3,+7 4d")ation and 5re(ention, 24&4', 372-383, 200<, s"%!itted in >3,+7 J 4 ide!iolo1#.

CFTBC Version 0.1 dt.31.7.2013 14. 'eena +. Tho$as, Chandra 7, >ose hine 6, 7"ri#anara#anan + and 7o"!#a 7$a!inathan #9ender differences in marriage and se ual beha0ior among people li0ing (ith HIV in Chennai, India% ,ndian >o"rnal o* =edi)al Aesear)h 12<&6', >"ne 200<, 625-724 15. 3deline N#a!athi, 'eena Tho$as, Bar%ara Dreen1old and 7o"!#a 7$a!inathan, $erceptions and health care needs of HIV )positi0e mothers in India,$rogress in Communit1 Health $artnerships, The >ohns :o /ins Hni(ersit# 5ress 200< Vol 3.2, <<-10< 16. 6. >a11ara8a!!a, A. Bala!%al, =. ="ni#andi, =. Vasantha, 'eena Tho$as, C.Nir" a, D. 7"dha, V. Chandrase/aran and Fraser Fares, $erceptions of Tuberculosis $atients about $ri0ate $ro0iders /efore and After Implementation of +e0ised 2ational Tuberculosis Control $rogramme, ,ndian > T"%er) 200<L 562185-1<0 17. Thila/a(athi 7, =ohan +. D, Aa!esh 7, 5aran8a e, Dinnela N.V.B, 9a/sh!i A,Aa8atash"(ra 3, Boo athi 6, Tho$as, '. +., et. al. #HIV, se uall1 transmitted infections and se ual beha0iour of male clients of female se (or!ers in Andhra $radesh, Tamil 2adu and "aharashtra, India. results of a crosssectional sur0e1C 3,+7 2008, 22 &7" l'2 76< J 7<. :;' +. 7o!!a, '. +. Tho$as, F. 6ari!, >. 6e! , N. 3rias, C. 3"er, et. al, #9ender and Socio)cultural determinants of T/)related stigma in /angladesh, India, "ala(i and Colombia% ,nt > T"%er) 9"n1 +is 2008 12&7'2 856 J 66 1<. 7o"!#a 7$a!inathan, C. 5ad!a ri#adarsini, B. 7"/"!ar, 7hei/ ,lia#as, 7. Aa!esh 6"!ar, C. Tri(eni, 5. Do!ath#, 'eena Tho$as, =innie =athe$, 5. A. Nara#anan #2utritional Status of $ersons (ith HIV Infection, $ersons (ith HIV Infection and Tuberculosis, and HIV)2egati0e Indi0iduals from Southern India% C,+ 2008L 462 <46-<. 20. 7"dha Dana ath#, 'eena +. Tho$as, =.7. >a$ahar, >ose hine 3ro)/ia 7el(i, 6.7i(as"%ra!ania!, =it)hell Feiss #$erceptions of gender and Tuberculosis in a South Indian urban communit1% ,ndian > T"%er), 2008L 552 <-14. #. IFinancial support recei:ed $. From 0/-R Past IPresent IPending '. From other sources Past IPresent IPending
I (his information must =e gi:en otherwise the application will =e returned. 0n case no financial
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B7) &A+7' =7F &=aster o* 7o)ial $or/' =aster o* Bio-ethi)s

3r"l 3nandar )olle1e T,77,="!%ai

A"ral +e(elo !ent st"dies 1<87 =edi)al ? 5s#)hiatri) 7o)ial $or/ Bio-ethi)s Dender :ealth 1<8< 2008 2013

Catholi) "ni(ersit# 9e"(en,Bel1i"! 5h + &Fo!enGs st"dies' 3la1a a Hni(ersit# 6arai/"di *. ResearchD(raining Experience
%uration 0nstitution

BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB

Particulars of wor@ done

23 #ears

N,AT,Chennai

7o)io-Beha(ioral as e)ts o* atients $ith TB,:,V03,+7

1.Research speciali?ation 7-ajor scientific fields of interest8 Ps9cho social issues Gender issues ;0VDA0%. (u=erculosis

CFTBC Version 0.1 dt.31.7.2013 ,.0mportant recent pu=lications 7last + 9ears with titles and References8 including papers 0n press 1.,n*l"en)e o* 7ha!e and 7ti1!a in :,V s)reenin1 a!on1 $o!en in prostitution Thir"(all"(an, 4.L 7hen%a1a(alli, A.L =ohana, =. 733AC >o"rnal o* T"%er)"losis, Lung Disease and HIV/AIDS; 2008 2.5re(alen)e o* :,V a!on1 T"%er)"losis ;"t 5atient 3ttendees Thir"(all"(an 4, 7hen%a1a(alli A, =ohana =
733AC >.THB4A. 9HND +,7.:,V03,+7 200< V, &1' 16-24

3.Do/ila Vani.D, Thir"(all"(an.4 7hen%a1a(alli ,n*l"en)e o* stress on )o in1 and E"alit# o* li*e a!on1 $o!en li(in1 $ith :,V in*e)tion 6a/ati#a >o"nral o* Fo!enGs 7t"dies. Vol.1. No.1 =ar)h 2007 4.Thir"(all"(an.4 =asterGs dissertation on @7o)ial and 4thi)al ,ss"es o* 7ex 7ele)tionC 6H 9e"(en, Bel1i"!, 2008 #.IFinancial support recei:ed $.From 0/-R Past IPresent IPending '.From other sources Past IPresent IPending
I (his information must =e gi:en otherwise the application will =e returned. 0n case no financial assistance has =een recei:ed nil should =e stated. 0ndicate titles of the projects and reference num=er if a:aila=le for 0/-R grants.

CFTBC Version 0.1 dt.31.7.2013

#,--.N/T0 %*1/2,R0 ',%R* Community forum for T# control 1CFT#C+

CFTBC Version 0.1 dt.31.7.2013 -ommunity forum for "$ control 4-F"$-5 &ill ado t the model of -ommunity :dvisory 'rou s4-:'5 romoted by 4(::K85 (outh :frican :8.( Kaccine 8nitiative. /reamble' Fecogni#e the devastating im act of the "$+0.F "$ e idemic on the eo le of 8ndia, &omen in articular and the urgent need for evolving safe, affordable, effective and locally relevant "$ case finding and case holding Fecogni#e the need for community involvement in ublic health care delivery to also include the ro er functioning of -F"$- as an integral com onent of the ublic health system. 1$ (efinition "he term QCommunity forum for T# control 1CFT#C+ , refers to grou of community re resentatives artici ation in lanning health care delivery relevant to local need. %$ 6ission CFT#C rovide an o ortunity for affected communities, es ecially &omen "$ atients to 1 i increase understanding of the "$ sym toms, screening and treatment rocessE ii voice concerns about the develo ment, im lementation and outcomes of &omen s ecific "$ treatment servicesE iii give advice on accrual and retention of &omen "$ atientsE iv advocate for human rights and romote ethical conduct in treatment 2rovisionE and, v contribute to addressing and resolving grievances about the health care system in general. 3. 6stablishing and maintaining the CFT#C 415. 6ach 29-4trial site5 unit &ill maintain a -F"$a5. 6ach -F"$- &ill be set u >ointly by community re resentatives and 29authority. "his &ill be done through rior a roval from .irector 2ublic 9ealth, and other district level /fficials follo&ing any locally acce ted rocess. b5. -ommunity re resentatives on the -F"$- must be dra&n mainly from the community surrounding the 29- 4trial site5, e*ce t for t&o resource ersons &ho may be dra&n from sta)eholder institutions beyond this community. "&o third of artici ants &ill be &omen. c5. -ommunity re resentatives must broadly re resent the community living in the coverage area of 29-.=hen electing the re resentatives, the follo&ing must also be consideredD inclusion of eo le affected 4self+family member5E diversity in terms of gender, race and ageE inclusion of marginali#ed members of the

CFTBC Version 0.1 dt.31.7.2013 community. 0 -F"$-s, 28s, and other 29-4trial site5 staff mustD 0 6ncourage active discussion and artici ation of -F"$-s in the &hole rocess of health care delivery including "$ control. 1 2roduce regular re orts at each site on the rogress of -F"$-s, and &or) to&ards solving roblems of accrual and com liance to :"", although -F"$-s &ill not artici ate directly in recruitment or retention. d5 Foles and res onsibilities of the -F"$0 6ach -F"$- &ill be guided by, but is not limited to, the follo&ing list of roles and res onsibilitiesD 4a5 6nsure information flo& bet&een 29- and artici ating communities, including to 0 facilitate information flo& from the 29- to the community on the results of the discussionE and, 1 ta)e res onsibility for ensuring targeted health careintervention ! health care including "$ control activities reaches the community. 1 6ducating the research team on community e* ectations, including to 1 0 hel and advise &omen on the community entry rocessE 1 hel and advise health care service rovider to rovide gender s ecific needs, 4c5 6ducation of the community on as ects of the "$, including to 1 4i5 romote individual and organi#ational learningE 4ii5 facilitate and conduct community a&areness1raising and learning events on different forms of "$,0.F "$,R.F "$ etc., and, 4iii5 conduct outreach rogrammes for s ecific grou s, e.g. adolescents. 4d5 Koicing community concerns, including to 1 4i5 assess community im act of &omen artici ation in health care service lanningE 4ii5 formulate recommendations regarding the gender s ecific needs 4iii5 ensure a &omen voice throughout the rocess of "$ control activities 4e5 -ontribute to human rights com liance and ethical conduct of health care services services, including 1 4i5 safeguarding the human and legal rights of &omen atients and communitiesE 4ii5 su orting the ethical conduct of ./"( rovision to &omen "$ atients, 4f5 0aintain a -F"$- handboo) that consists of the -F"$'uidelines, &omen "$ atients -harter of Fights and other information about atients, rights, treatment guidelines, -F"$- rosters, nomination forms, lin)s to "$ resources in the region+on the &eb, and reading lists.

CFTBC Version 0.1 dt.31.7.2013

5.(u

ort for -F"$-sD Foles and res onsibilities of 2rinci al 8nvestigators

415 "he 28s &ill rovide su ort to -F"$-s and su ort the artici ation of local -F"$- members in a regional -F"$- Forum. 4!5 29- units &ill rovide administrative su ort to the local -F"$-, including but not limited toD, com uter+8nternet access, tele hone, hotoco ying, fa* usage, and ostage. 6. /rgani#ational structure of the -F"$- and the -F"$- forum 415 "he organi#ational structure of the -F"$- &ill be determined by the community members and as such may vary. "he follo&ing must, ho&ever, be consistentD 4a5 6ach -F"$- must consist of no more than 15 members.. 4b5 0embershi of the -F"$- must be revie&ed every t&o years. 4c5 Fesource ersons &ill serve on the -F"$- for a redetermined eriod &hereas s ecialists in any area of interest to the -F"$- may also be re<uested to attend -F"$- meetings occasionally. 4d5 28s, ro>ect staff, resource ersons, and ad hoc s ecialists may not be voting members of the -F"$-. ?. 0eeting rocedures of the -F"$415 6ach -F"$- &ill meet at least si* times a year although the fre<uency may be increased &hen necessary. 4!5 6ach -F"$- member &ill receive an agenda rior to each meeting. 8. (ecretariat and administrative arrangements of the -F"$415 "he -F"$- should identify a &omen member -F"$-, referably &ith good &ritten and verbal communication s)ills, to function as a secretariat. 4!5 "he secretariat &ill be res onsible for the follo&ingD 4a5 to rovide administrative su ort for the ro er functioning of the -F"$- in line &ith its -onstitution and &ith the su ort of the 29-4trial site unit5, including distribution of the agenda and minutes rior to the meeting of the -F"$-E 4b5 to re are documents, agenda for forum meeting including basic facilities on the day of meeting 4c5 to liaise &ith members of the -F"$-, 28s and 294d5 to com ile re orts on the activities of the -F"$- for 29- and, &here a ro riate, for the .irectorate of 2ublic health 9. -a acity building and develo ment of the -F"$- members 415 28s, 29- staff, and -F"$- members &ill &or) together to educate and inform ne& members about all issues ertinent to the "$ control initiative and area s ecific needs. 4!5 (ome -F"$- meetings &ill be educational in nature, ensure general ca acity

CFTBC Version 0.1 dt.31.7.2013 building, 435 2ro>ect staff &ill inform -F"$-s about &or)sho s and conferences 4local and regional5 of interest to the -F"$-s. 10. ( ecific outreach rogrammes by -"$6ach -F"$- in collaboration &ith 29- must design and im lement outreach rogrammes to involve ersons of all socio1economic status, men and &omen, and adolescents. 11. -onsultation &ith the -F"$"he 28 or his+her delegate4s5 must consult &ith the -F"$- on all matters affecting the health care delivery including "$ case finding and case holding in each community, 1!. -onstitutions or terms of reference of the -F"$6ach -F"$- must develo and ado t a -onstitution or terms of reference that is consistent &ith these 'uidelines. "his document must address issues such as regular elections, com osition, membershi , office bearers, roles and res onsibilities, meetings, voting, conflict resolution and dissolution. 13. .issolution at closure of a trial site =hen a trial site unit closes do&n for any reason the -F"$- at that trial site must be dissolved.