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  • Xavier Institute of Social Service
    Dr Camil Bulcke Path
    Ranchi - 834001
    Jharkhand, India
  • 91-651-2200873 Extn. 401
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  • Dr. Anant Kumar is a Fulbright Scholar at the Public Health Leadership Programme, Gillings School of Global Public He... moreedit
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This book presents a visionary leadership framework and its application to deliver superior value in health. It provides an insight on how to create shared vision, assess vision-reality gap, identify paths to pursue, inspire and empower... more
This book presents a visionary leadership framework and its application to deliver superior value in health. It provides an insight on how to create shared vision, assess vision-reality gap, identify paths to pursue, inspire and empower stakeholders, and utilize results-based management to deliver superior value. The volume is based on training modules and materials developed under several projects on leadership development for programme managers in the health sector during the period 2000-2010. They have their genesis in a leadership development project –implemented in four countries in Asia and Africa. Then they were adapted and improvised for use in a leadership development project for teams of programme managers from six countries in Asia and the leadership development and organizational effectiveness project in India. The framework is validated by its application to several success examples of health programs. By linking leadership and management in health rather than juxtaposing them, the book argues that the task of every health professional requires a mix of leadership and management although their relative emphasis may vary depending upon the context and content of the health program. It will then equip the health professional to not only improve personal performance but also enhance the value that their health programs will generate for their beneficiaries.
"Commons are neither private property nor open access resources. This is not nationalised property either. Commons are the resources used by recognizable group of people who derive their livelihood (part or full) from these as well as... more
"Commons are neither private property nor open access resources. This is not nationalised property either. Commons are the resources used by recognizable group of people who derive their livelihood (part or full) from these as well as recognize their role as steward or guardian of the same resources.

Governance of commons has become immensely significant because of growing encroachment on commons and subsequent privatization of the same in a conspicuous manner. Such attempts not only deprive commoner’s access to commons but also wipe out the flow of ecological, social and bequeath benefits of commons. This book tries to have (a) better conceptualisation of harmonic cohabitation of resource conservation and livelihood generation and (b) evidences of sustainable reconciliation between governance of commons, conservation of resources and livelihood security of commoners.

The book is divided into five sections and each section has a specific emphasis. Emphasis of the first section is ‘governance of commons’. Likewise, the focus of the second section is ‘commons and livelihood’ and third section is ‘effect of climate change on commons’. Sections four and five accentuate respectively on ‘poverty, social exclusion and commons’ and ‘stories of commons’.
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The book highlights the Mental Health services in India from public health perspective considering preventive and curative aspects of mental health recognising the socio cultural factors in mental health services. It looks into the... more
The book highlights the Mental Health services in India from public health perspective considering preventive and curative aspects of mental health recognising the socio cultural factors in mental health services. It looks into the various conceptual issues and concerns related to mental health services in India. Author has made an attempt to understand and examine the various issues related to mental health viz., concept and scope of mental health, various dimensions and component of mental health, nature of mental health and illness, perception and cultural issues involved in understanding of mental health, theories, definitions and other issues. It also gives historical perspective of the development of mental health as a discipline and the development of the mental health services in India since colonial period. It investigates and focuses on the mental health services delivery with reference to District Mental Health Programme and National Mental Health Programme in India.
Research Interests:
The chapter reviews the importance of collaboration and partnership for global health and tries to develop an understanding of the challenges and opportunities related to fostering global health collaborations and partnerships.
The purpose of this chapter is to carry out situational analysis and identify future directions for population stabilisation in Bihar, India through examining the programmes and policies that would help achieve this.
Medical and Health Commons (MHC) are any sets of resources and institutions including the individuals that a community recognizes as being accessible to all members of that community in improving their health and wellbeing. Although... more
Medical and Health Commons (MHC) are any sets of resources and institutions including the individuals that a community recognizes as being accessible to all members of that community in improving their health and wellbeing. Although commons literature recognizes medical and health commons as an emerging commons, individuals as medical and health common existed in all the societies and culture from centuries in different forms and names. The nature and structure of these commons may differ; they have strong influence on community in improving their life. This paper shows and discusses the Accredited Social Health Activists (ASHAs) under National Rural Health Mission programme as a new emerging medical and health commons in rural India, its strength, and future prospects. The paper is based on an empirical study on 80 ASHA (Sahiyas) and 67 village health committee representatives from three districts (Deoghar, Palamau and Koderma) in Jharkhand state of India. Quantitative data were collected through self administered questionnaire and qualitative data were collected through focus group discussions, select case studies, and interview with key stakeholders. The findings show that although the Sahiyas are emerging as a new medical and health commons, there are also threats considering the entrusted social and community responsibility, absence of institutional history, and a new identity. Nevertheless, in conclusion, we can say that Sahiyas as medical and health commons are giving an opportunity and space to people to meet, learn about health issues, and gain the skills for a healthy living to promote health and prevent illness.
A significant number of “marginalized” population groups are denied their health rights, healthcare access, benefits of government health programs, and other health-related social security benefits. These population groups, particularly... more
A significant number of “marginalized” population groups are denied their health rights, healthcare access, benefits of government health programs, and other health-related social security benefits. These population groups, particularly the rickshaw pullers of India, are vulnerable because of their poor social and economic status, migration history, lack of permanent settlements, lack of social capital, and so on. These reasons, coupled with other social-political reasons, lead to no or limited access to health services and poor health conditions. This study intends to explore and understand the context and health seeking behavior of rickshaw pullers in Ranchi, the capital city of Jharkhand state in India, with special reference to wider social determinants of health such as, access, affordability, and delivery of health services. The data was collected from 1,000 rickshaw pullers from 40 “rickshaw garages” in Ranchi. The findings of the study show that rickshaw pullers can't afford to “attach” much importance to their health due to various reasons and suffer from a variety of occupational and other illnesses. The health conditions of the rickshaw pullers are affected by poverty, negligence, illiteracy, lack of awareness and unavailability of affordable, quality health services. These are only a symptom of the larger structural issues affecting health. The study suggests that rickshaw pullers, being a marginalized and excluded population group, require special health and social security programs that include safe, affordable, and accessible services along with a special focus on health education, behavior change, and promotion of appropriate health-seeking behavior.
Cleft lip and palate is a very common condition which is globally undertreated. This case report shows how cleft lip surgery can transform patient's lives, self-perception, and their self-esteem through a visionary and adaptive leadership... more
Cleft lip and palate is a very common condition which is globally undertreated. This case report shows how cleft lip surgery can transform patient's lives, self-perception, and their self-esteem through a visionary and adaptive leadership of a few social workers and medical doctors in resource constrained settings. The case report also shows that when treated, the benefits to the patient and their family are lifelong and disproportionately large compared to the degree of effort and cost of doing the reconstruction; and puts forth the case for educating physicians to maximize their societal benefit through work in resource-constrained settings.
The existing gender analysis frameworks start with a premise that men and women are equal and should be treated equally. These frameworks give emphasis on equal distribution of resources between men and women and believe that this will... more
The existing gender analysis frameworks start with a premise that men and women are equal and should be treated equally. These frameworks give emphasis on equal distribution of resources between men and women and believe that this will bring equality which is not always true. Despite equal distribution of resources, women tend to suffer and experience discrimination in many areas of their lives such as the power to control resources within social relationships, and the need for emotional security and reproductive rights within interpersonal relationships. These frameworks believe that patriarchy as an institution plays an important role in women’s oppression, exploitation, and it is a barrier in their empowerment and rights. Thus, some think that by ensuring equal distribution of resources and empowering women economically, institutions like patriarchy can be challenged. These frameworks are
based on proposed equality principle which puts men and women in competing roles. Thus, the real equality will never be achieved. Contrary to the existing gender analysis frameworks, the Complementing Gender Analysis framework proposed by the author provides a new approach toward gender analysis which not only recognizes the role of economic empowerment and equal distribution of resources but suggests to incorporate the concept and role of social capital, equity, and doing gender in gender analysis which is based on perceived equity principle, putting men and women in complementing roles that may lead to equality. In this article the author reviews the mainstream gender theories in development from the viewpoint of the complementary roles of gender. This alternative view is argued based on existing literature and an anecdote of observations made by the author. While criticizing the equality theory, the author offers equity theory in resolving the gender conflict by using the concept of social and psychological capital.
Citing a case of Taj Mahal, the paper examines maternal death and issues emblematic of reproductive health in India today. It compares maternal death 382 years ago and today and suggests solutions to improve maternal health and reduce... more
Citing a case of Taj Mahal, the paper examines maternal death and issues emblematic of reproductive health in India today. It compares maternal death 382 years ago and today and suggests solutions to improve maternal health and reduce maternal mortality citing the case of Queen Ulrika Eleonora’s solution.
Violence against women is a serious social and mental health problem and human rights abuse worldwide. It is an extremely complex phenomenon, deeply rooted in gender based power relations, sexuality, self-identity, and social institutions... more
Violence against women is a serious social and mental health problem and human rights abuse worldwide. It is an extremely complex phenomenon, deeply rooted in gender based power relations, sexuality, self-identity, and social institutions that pose a serious threat to women's mental health. This paper discusses the various factors behind violence against women with some cases and its consequences on women's mental health and wellbeing. The paper suggests that recognizing violence against women as a mental health issue is an essential first step which requires concerted and multi-sector responses backed by strong political commitment aimed at ending discrimination and violence against women.
Operations research is mainly applied to decision making in industries and corporations using quantitative methods to optimize production. The applications of operations research in social sciences research or health research in HIV,... more
Operations research is mainly applied to decision making in industries and corporations using quantitative methods to optimize production. The applications of operations research in social sciences research or health research in HIV, service delivery, and program performance improvement are minimal. Considering the complexity of the HIV/AIDS epidemic, it is imperative to learn from operations research in scaling up HIV treatment, prevention, and intervention in resource-poor settings. In this article the author discusses the methodological issues in operations research within the context of HIV/AIDS research. The author also suggests a framework for using operations research in the field of HIV/AIDS research and program intervention.
Training needs assessments are pivotal for any capacity building program. Building capacity of service providers and staff involved in HIV/AIDS intervention programs is crucial because of the distinct nature of such programs. It requires... more
Training needs assessments are pivotal for any capacity building program. Building capacity of service providers and staff involved in HIV/AIDS intervention programs is crucial because of the distinct nature of such programs. It requires specific knowledge, skills, and attitudes that are of utmost importance, influencing the reach of the program and its impact in halting and reversing the epidemic. This study was conducted to identify the training needs assessment of personnel involved in targeted intervention for high risk populations vulnerable to HIV infection in Jharkhand, India. Through the study the authors critically examine the existing training needs and gaps and suggest strategies to address them.
The paper suggests that investing in adolescents' health and rights will yield large benefits for generations to come.
The paper examines the state of mental health services in India from a public health perspective, considering preventive and promotive aspects of mental health and recognising the socio-cultural factors in mental health services. The... more
The paper examines the state of mental health services in India from a public health perspective, considering preventive and promotive aspects of mental health and recognising the socio-cultural factors in mental health services. The study also review the development of mental health services in India and to analyse the implementation of the District Mental Health Programme (DMHP) under the National Mental Health Programme (NMHP) in India.
In the past five-six years, many people, friends, and students showed interest and contacted me to take my advice about opening a Non Government Organisation (NGO). Most of these people were doing well in their life but their hearts were... more
In the past five-six years, many people, friends, and students showed interest and contacted me to take my advice about opening a Non Government Organisation (NGO). Most of these people were doing well in their life but their hearts were crying to help people and bring change in the society. They were moved by the poverty, illiteracy, etc, ﴾as expressed by them﴿ and determined to open an NGO to serve the people. In reality, these people’s hearts were crying to bring changes in their own lives. They wanted to properly utilize their connections. Despite my advice and suggestions (do not open an NGO), most of these people opened an NGO which forced me to rethink ‘what was that strong drive which was stronger than my advice’. I thought to explore and examine the real motive behind it which is discussed in this paper.
This article is an attempt to present and elaborate the HIV/AIDS scenario in Jharkhand state of India, services available, key issues, challenges, and concerns at various levels to mitigate the epidemic. It also examines the role of... more
This article is an attempt to present and elaborate the HIV/AIDS scenario in Jharkhand state of India, services available, key issues, challenges, and concerns at various levels to mitigate the epidemic. It also examines the role of different stakeholders and agencies in halting and reversing the epidemic. The findings show that there are various challenges that need immediate attention. The article critically examines these issues in detail and suggests the approach to address the epidemic.
This article reviews and discusses the problems, responses, and concerns of orphans and vulnerable children in India. The article shows that HIV/AIDS programs and interventions are vital for survival and welfare of orphan and vulnerable... more
This article reviews and discusses the problems, responses, and concerns of orphans and vulnerable children in India. The article shows that HIV/AIDS programs and interventions are vital for survival and welfare of orphan and vulnerable children, but they have reached only to a small fraction of the most vulnerable children. The article suggests a number of measures that government and civil society could take to address the problems and emphasizes the need to learn from other countries’ experience and initiatives in developing appropriate policy and programmes for orphan and vulnerable children.
In the absence of any systemic data, with more men coming up and reporting violence by women, it is important to understand and examine the issue of violence against men by women and associated factors. With changing gender roles and... more
In the absence of any systemic data, with more men coming up and reporting violence by women, it is important to understand and examine the issue of violence against men by women and associated factors. With changing gender roles and power relations, the author predicts that this will increase in the future, which will have far-reaching consequences and implications for the larger society and relationships between men and women. The paper attempts to understand the dynamics and factors that play or will play a crucial role in escalating violence against men by women. The paper is based on authors counseling sessions, discussion with men victims of violence, and other secondary sources.
The study highlights the challenges and opportunities in HIV/AIDS counseling. The major challenges are recruiting the right individuals and their capacity building and retention. The finding shows that most of the counselors are not... more
The study highlights the challenges and opportunities in HIV/AIDS counseling. The major challenges are recruiting the right individuals and their capacity building and retention. The finding shows that most of the counselors are not befitting in terms of qualification and experience besides motivation, remuneration, and other issues. The study suggests that to ensure the effective counseling to reverse the epidemic, it is important to focus on such issues through appropriate policy interventions.
Mental health services in India are neglected area which needs immediate attention from the government, policymakers, and civil society or- ganizations. Despite, National Mental Health Pro- gramme since 1982 and National Rural Health... more
Mental health services in India are neglected area which needs immediate attention from the government, policymakers, and civil society or- ganizations. Despite, National Mental Health Pro- gramme since 1982 and National Rural Health Mission, there has been a very little effort so far to provide mental health services in rural areas. With increase in population, changing life-style, unemployment, lack of social support and in- creasing insecurity, it is predicted that there would be a substantial increase in the number of people suffering from mental illness in rural areas. Considering the mental health needs of the rural community and the treatment gap, the paper is an attempt to remind and advocate for rural mental health services and suggest a model to reduce the treatment gap.

Keywords: Mental Health; Policy; Rural; India; Services; Treatment Gap; NMHP; DMHP; NRHM
The study attempts to find out the existing social and cultural practices regarding menstruation, awareness levels, and the behavioral changes that come about in adolescent girls during menstruation, their perception about menarche, how... more
The study attempts to find out the existing social and cultural practices regarding menstruation, awareness levels, and the behavioral changes that come about in adolescent girls during menstruation, their perception about menarche, how do they treat it, and the various taboos, norms, and cultural practices associated with menarche. The study was conducted on 117 adolescent girls (age 11–20 years) and 41 mothers from various communities and classes in Ranchi comprising residential colonies and urban slums. The findings unfolds many practices: cultural and social restrictions associated with menstruation, myth, and misconception; the adaptability of the adolescent girls toward it; their reaction, reaction of the family; realization of the importance of menstruation; and the changes that have come in their life after menarche and their resistance to such changes. The article also suggests the strategies to improve menstrual health and hygiene among adolescent girls. The study concludes that cultural and social practices regarding menstruation depend on girls’ education, attitude, family environment, culture, and belief.
Improving rural health service delivery is a major challenge in India as 73 percent of its population resides in rural areas. Recognizing the need to improve rural health service delivery, the Government of India launched the National... more
Improving rural health service delivery is a major challenge in India as 73 percent of its population resides in rural areas. Recognizing the need to improve rural health service delivery, the Government of India launched the National Rural Health Mission (NRHM) in 2005. The NRHM aims to undertake architectural correction of the rural health system through communitization, improved management, flexible financing, innovations in human resource management, and strengthened monitoring against standards.

This paper describes an innovative leadership development and organizational effectiveness intervention for district health teams comprising district and block (sub-district) level health officials in three districts of Jharkhand, a state with low socio-economic conditions. The intervention over a period of three years comprised of a sequence of short-term training programmes in leadership and organizational effectiveness with on-the-job support through follow-up between training programmes. The intervention led to increased focus on health system performance by the district health teams in these districts although the results varied.

The district health teams strengthened public-private partnerships, accelerated communitization process, improved functionality of facilities, and demonstrated role models. However, several factors also limited the potential impact of the intervention. These include serious human resource constraints, frequent transfers of district heads, procedural hurdles in funds flow from state to districts and quality of governance. Despite these constraints, leadership development and organizational effectiveness intervention is an effective instrument for strengthening rural health system. The paper presents recommendations on how its impact can be further increased.
It is assumed that self-help groups (SHGs) will play a larger role in its countribution towards improving women's health and empowerment as well as for achieving 'Millennium Development Goals' in developing countries. These assumptions... more
It is assumed that self-help groups (SHGs) will play a larger role in its countribution towards improving women's health and empowerment as well as for achieving 'Millennium Development Goals' in developing countries. These assumptions are largely based on the global neo-liberal agenda which suggests that the State should withdraw from social provisioning. The paper reviews scope and limitations of self-help groups in improving women's health and empowerment focusing on empirical work undertaken in one of the Indian States and reviews of existing literature.

Till date, the functioning of SHGs has been viewed only from an economic perspective. The existing approach emphasizes economic development of people and women in particular, in case of women SHGs. However, how these economic benefits are being translated into change in women's status, particularly their health status has not been explored. The paper explores the extent to which SHGs can be involved in attaining better health for women and children.
The paper is an attempt to understand the role of males in reproductive and sexual health decisions in relation to sexual and reproductive health rights and reproductive health programs including women's empowerment, and male involvement.
This paper attempts to examine and understand the low literacy level and education among tribal children in Jharkhand. The paper discusses the role of government, institutions, programmes and linkages between education and development.... more
This paper attempts to examine and understand the low literacy level and education among tribal children in Jharkhand. The paper discusses the role of government, institutions, programmes and linkages between education and development. Various programmes and schemes have been initiated but very few of them have reached the tribal children and benefited them. Many of the programmes did not benefit the tribal community because the programmes were not contextualized and localized considering regional, geographical and physical differences and barriers. Other reasons for not reaching the benefits of the programs to the tribals are lack of political will, corruption, and lesser attention on development in tribal areas. The paper highlights the need for special focus on tribal education, which is inclusive of context specific traditional and innovative interventions.
Aim: To present the epidemiology of brucellosis and to assess and suggest public health intervention strategies to control brucellosis in rural India. Methods: The paper is based on a review of various serological and other studies and... more
Aim: To present the epidemiology of brucellosis and to assess and suggest public health intervention strategies to control brucellosis in rural India.
Methods: The paper is based on a review of various serological and other studies and evidence on brucellosis in India.
Results: Brucellosis is present in all livestock systems. Although the true incidence for human brucellosis is not available, various state specific studies and extrapolated incidence (321 cases annually) have shown that it is a serious disease present in the population. The studies also show that there is a conducive condition and environment for wide-spread human infection on account of unhygienic conditions and poverty in rural areas which need public health attention and intervention.
Conclusion: The paper suggests that brucellosis needs to be included in public health education and public awareness programmes, particularly in the rural areas of India. It also suggests promoting safe livestock practices, active co-operation between health and veterinary services and a paradigm shift from the current ‘biomedical model’ to a ‘sociocultural model’ for the elimination of brucellosis in India.
Menon,Vineetha, P.R. Gopinathan, and K.N. Nair (eds.). 2005. Alleviating Poverty: Case Studies of Local-Level Linkages and Processes in the Developing World. New Delhi: Rainbow Publishers. Price: Rs. 525. Pages: 335. I n any discourse... more
Menon,Vineetha, P.R. Gopinathan, and K.N. Nair (eds.). 2005. Alleviating Poverty: Case Studies of Local-Level Linkages and Processes in the Developing World. New Delhi: Rainbow Publishers. Price: Rs. 525. Pages: 335.

I n any discourse on poverty, it is necessary to define and
understand the concept of poverty in the larger context
without losing the local context. Such an understanding
should be based on a perspective that focuses on benefits
accruing to the poor or deprived sections of the population in
their own milieu.We have seen that in most development
discourse, particularly in poverty alleviation programmes,
people who have benefited from the programmes are lower
middle class, less deprived sections of society or the rich
among the poor, i.e., those who have control over resources
or access to opportunity. However, this cannot be generalised
for all poverty alleviations experiment and programmes.
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