PROJECTS

SHARE INDIA (SOCIETY FOR HEALTH ALLIED RESEARCH AND EDUCATION INDIA), a society not for profit registered under A.P. Public Societies Registration Act, 1350 Fasli, vide registration No.306 of 1986, on 6th February, 1986. The society is recognized as Scientific and Industrial Research Organization – SIRO, by Ministry of Science and Technology, Department of Scientific and Industrial Research, Govt. of India. The society is totally devoted to research, is an organization funded by non-profitable trust sponsored by non-resident Indians from America, is located in the campus of MIMS at Ghanpur Village. Medchal Mandal, R.R.District. The research work commenced in 1992 with initiation of Rural Effective Affordable Comprehensive Health (REACH)

Core Values that guide SHARE India are -

Respect for the dignity of the people we serve
Innovation through research using technologic, social and cultural tools
Skills through continuous improvement in knowledge by networking and collaboration
Empathy understanding the needs of, and compassion for the suffering of the people we serve

ONGOING PROJECTS

Rural Effective Affordable and Comprehensive Health Care (REACH):

The REACH project has developed a dynamic model of primary health care for 40 villages of the Medchal Mandal, Andhra Pradesh. The focus of its activities has been prenatal care of pregnant women, immunization of infants and family planning interventions. REACH believes that by using a comprehensive mapping and tracking mechanisms of individuals and households, targeted service delivery is possible. This is supported by a beneficiary / household level tracking mechanism innovatively used with a GIS interface in Medchal Mandal, Andhra Pradesh. This database currently covers 8,431 households in 40 villages, comprising 45952 individuals. REACH’s intervention has been able to attain 97.49% (2011) immunization coverage along with a reduction in infant mortality and maternal mortality rates in the region. SHARE is currently supporting the replication of this model in Moinabad, Andhra Pradesh and Rajasthan.

Longitudinal Indian Family hEalth Study (LIFE):

The LIFE study examines socio-economic and environmental influences on children’s health and development in India. It aims to understand the link between the environmental conditions in which Indian women conceive, go through their pregnancy and give birth, as well as their physical and mental health during this period. By linking environmental factors to health outcome measures, the LIFE Study has the potential to pinpoint the root causes of many conditions that are excessively prevalent in India, including low birth weight, pre-term birth, other pregnancy outcomes and diseases or development disorders of early childhood. This study is being conducted in 40 villages in Medchal mandal and till date 1200 fertile married women in the age group 15 to 35 years have been enrolled in this study.

Mobility and Independent Living in Elders Study (MILES):

The MILES study is in collaboration with the University of Pittsburgh and it examines the incidence of risk factors for disability and age related diseases in the population of older adults of age 60 years and above. The study is designed to enrol 250 men and 250 women aged 60 years and over in 10 randomly selected villages in Medchal Mandal to get full baseline data on various parameters. The participants will then be followed annually for a period of five years for evaluation of mobility impairment and mortality. Pre-test has been carried out in two villages for the study instruments and developing logistics of the survey operation. Recruitment of participants will commence by end of January 2012. The study is approved by ICMR as International Collaborative Research Project.

Fogarty International Research Training Grant:

The Graduate School of Public Health at the University of Pittsburgh has been awarded a grant of about a million dollar from Fogarty International Center for providing training on research methodology to the faculty of MediCiti Institute of Medical Sciences for a period of 5 years. The first training course on “Introduction to Chronic Disease Research Methods” is proposed to be conducted in Hyderabad in March 2012. Dr. Clare Bunker of the Department of Epidemiology at the University of Pittsburgh has been designated as the coordinator of the training program.

Public Health Management Institute (PHMI):

PHMI focuses on capacity development and strengthening of public health systems and professionals. It provides technical assistance to National AIDS Control Organization and various State AIDS Control Societies in undertaking evidence based planning as well as trainings of various cadres of their teams. PHMI was involved in the development of National Level Training Modules for District AIDS Prevention and Control Units (DAPCUs) and also trained 189 DAPCUs across 22 states. Post this national level training, PHMI is providing mentorship to these DAPCUs through feedback on their reporting, tele-cons and field visits. A fellow ship program titled “Public Health Field Leadership Fellowship” was conducted to enhance skills and capacities of public health professionals in government, private and non-governmental agencies. It drew participation from medical, health and other social science experts. This fellowship was evaluated by Indian Institute of Public Health Hyderabad. PHMI has conducted various training programs for personnel working in National HIV program on Program Management, Data for decision making, Data Management, Basic analysis skills using MS Excel and Epi-Info, GIS tools using Epi-Info, Arc GIS, etc.

Strengthening Nursing Expertise on HIV / AIDS (SNEH):

SNEH aims at strengthening health systems through a holistic institutional capacity developmental approach. It works with nursing councils, associations and institutions responsible for strengthening and supporting pre-service and in-service training of nurses involved in HIV/AIDS care and support. It seeks to build and sustain their overall institutional capacity, in areas such as: accreditation, policy review and development, continuing education, curriculum development, and nursing human resource information systems. SHARE – India is a consortium partner in this project with Family Health International (FHI), Catholic Health Association of India (CHAI) and Trained Nurses Association of India (TNAI) in close collaboration and support of the National AIDS Control Organization and Centers for Disease Control and Prevention (CDC).

PROJECTS COMPLETED

Community Access to Cervical Health (CATCH):

This project was started under Indo-US joint collaboration grant with John Hopkins University, Department of Biotechnology, NIH and CDFD to know the causes and prevalence of cervical cancer amongst the rural women in Medchal Mandal, Andhra Pradesh. The program funds community wide education programs, recruitment of women for cervical and HPV screening, followed by colposcopy-directed biopsy testing for positive screened patients and free treatment of CIN 2 and other deadly diseases.  The publications that came out of the study are listed in the publications section.



Andhra Pradesh AIDS Consortium (APAIDSCON):

APAIDSCON was a consortium of 20 private medical colleges across 16 districts in the state of A.P. The consortium was constituted to promote HIV service delivery in the private sector including prevention, diagnosis, care, treatment, follow-up and related aspects.  A few accomplishments of the project have been the establishment of 15 Stand -alone Integrated Counselling and Testing Centres (ICTCs), 5 Facility-ICTCs within the consortium partners and 45 F-ICTCs in private Nursing Hospitals. Two Community Care Centres were established in the Medical Colleges with support from NACO. 34371 PLHIV were provided Out Patient or In Patient services and 4165 PLHIV accessed subsidized CD4 testing facility through the consortium physicians during the period November 2006- May 2011. 298894 individuals were counselled and tested at these centres of which 1,28,811 were pregnant women additionally, 500 deliveries of positive pregnant women were undertaken through the consortium and Nevaripine coverage to Mother and Baby pairs (MB pair) was 94%.



Estimating Lower Limit of Hemoglobin in Hyderabad:

A scientific paper entitled “When is a south Indian really anaemic?” has been sent to the Journal of Association of Physicians of India (JAPI) for publication. The objective of the paper was to determine the normal ranges of Haemoglobin and cut off values in healthy young adults of Hyderabad, Southern India and to compare the values with American whites and WHO criteria. The study concludes that South Indian adult males have Hb values similar to American male adults, but South Indian adult non-pregnant females have considerably lower Hb levels than American adult non-pregnant females, thereby questioning the appropriateness of WHO or US criteria for detection of anaemia in South Indian non-pregnant female adults.



Rural-Urban Epidemiologic Transition of Risk Factors for Coronary Artery Disease in College Students of Hyderabad and Nearby Rural Area – A Pilot Study:

Massive urbanization in developing nations like India is predicted to cause epidemiologic transition to increased Coronary Artery Disease (CAD). To evaluate the rural-urban epidemiologic transition, risk factors for CAD were measured in two groups of subjects; Rural and Urban college students and it was found that, epidemiologic transition to higher risk for CAD is found in urban youth of Hyderabad compared to nearby villages, with increases in values of most parameters which are associated with increased risk for CAD. These findings need to be confirmed in extended studies to plan public health interventions to counteract the adverse effects of urbanization in early life.

PROPOSED PROJECTS

Intestinal Parasitic and vaginal Infections in Pregnancy Outcome Study (IPVI):

Parasitic infection is common in India, affecting two-thirds of the population. Despite the fact that parasitic infections may cause or increase maternal morbidity in pregnancy, the relationships between parasites and adverse birth outcomes are not clear. The transmission of these organisms is not clear. This study will be an international collaborative research project undertaken by SHARE India in collaboration with MedCiti Institute of Medical Sciences (MIMS) and University of Pittsburgh. The findings of the study will lead to new knowledge regarding the prevalence and risk factors of pregnancy outcomes like low birth weight, pre-term birth and spontaneous abortions in rural areas of India.

Placenta Study:

Placenta protocol study is part of LIFE study. It is proposed to examine 350 placentas per year. Placenta from LIFE women delivered at MediCiti hospital are being collected to examine the role of various bacteria in chorioamnionitis and whether preterm deliveries are associated with Chorioamnionitis (infection of placenta and membranes). Vaginal swabs have been collected from amnion and chorion. Gross details of the placenta will be collected. Placenta, membranes, umbilical cord will be sectioned and analysed for chorioamnionitis.

Determinants of Infant Mortality:

Using the retrospective and cross-sectional data, a detailed report on socioeconomic and demographic determinants of infant mortality in Medchal mandal has been prepared. A scientific paper entitled “Determinants of Infant mortality in rural Andhra Pradesh, India” has been prepared and sent to Indian Journal of Public Health for publication.

Prospective dengue sero-prevalence study in 5 to 10 year-old children in India:

Dengue fever (DF) is of public health importance in India because of the epidemic outbreaks and morbidity. The epidemiological patterns observed in the recent past indicate that the country is endemic for dengue with documented outbreaks of DF and DHF. A sero-prevalence study is proposed, in a sample of children to assess the prevalence of dengue‐specific antibodies which will allow assessing if there has been dengue transmission in the community in recent years (5 years).
Sero-prevalence in children age between the ages of 5 to10 shall be able to provide insight into approximate average annual incidence of new dengue infection over the last 5-10 years. It is additionally planned to analyse JE-specific antibodies in this population, to determine exposure of the Japanese Encephalitis Virus (Flavivirus) in this area. This study is proposed to be conducted in collaboration with Sanofi Pasteur Institute France and is coordinated by its local branch in India.