Communication - Publications

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    Agency and servitude in platform labour: a feminist analysis of blended cultures
    ( 2021-01-01) Komarraju, Sai Amulya ; Arora, Payal ; Raman, Usha
    Digital labour platforms have become important sites of negotiation between expressions of micro-entrepreneurship, worker freedom and dignity of work. In the Global South, these negotiations are overlaid on an already fraught relationship mediated by the dynamics of caste and culture, to the usual politics of difference. Urban Company (UC), an app-based, on-demand platform in India that connects service providers offering home-based services to potential customers, lists professionalised services that have hitherto been considered part of a ‘culture of servitude’, performed by historically marginalised groups afforded little dignity of labour. Such platforms offer the possibility of disrupting the entrenched ‘master-servant’ relationship that exists in many traditional cultures in the Global South by their ostensibly professional approach. While service providers now have the opportunity for self-employment and gain ‘respectability’ by being associated with the platform, UC claims to have leveraged AI to automate discipline in everything the providers do. Using interviews with UC women service providers involved in beauty work and software development engineers, this paper explores the agency afforded to service partners in both professional and personal spheres. Further, we propose the term blended cultures to think about the ways in which algorithms and human cultures mutually (re)make each other.
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    An integrated community and primary healthcare worker intervention to reduce stigma and improve management of common mental disorders in rural India: protocol for the SMART Mental Health programme
    ( 2021-12-01) Daniel, Mercian ; Maulik, Pallab K. ; Kallakuri, Sudha ; Kaur, Amanpreet ; Devarapalli, Siddhardha ; Mukherjee, Ankita ; Bhattacharya, Amritendu ; Billot, Laurent ; Thornicroft, Graham ; Praveen, Devarsetty ; Raman, Usha ; Sagar, Rajesh ; Kant, Shashi ; Essue, Beverley ; Chatterjee, Susmita ; Saxena, Shekhar ; Patel, Anushka ; Peiris, David
    Background: Around 1 in 7 people in India are impacted by mental illness. The treatment gap for people with mental disorders is as high as 75–95%. Health care systems, especially in rural regions in India, face substantial challenges to address these gaps in care, and innovative strategies are needed. Methods: We hypothesise that an intervention involving an anti-stigma campaign and a mobile-technology-based electronic decision support system will result in reduced stigma and improved mental health for adults at high risk of common mental disorders. It will be implemented as a parallel-group cluster randomised, controlled trial in 44 primary health centre clusters servicing 133 villages in rural Andhra Pradesh and Haryana. Adults aged ≥ 18 years will be screened for depression, anxiety and suicide based on Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorders (GAD-7) scores. Two evaluation cohorts will be derived—a high-risk cohort with elevated PHQ-9, GAD-7 or suicide risk and a non-high-risk cohort comprising an equal number of people not at elevated risk based on these scores. Outcome analyses will be conducted blinded to intervention allocation. Expected outcomes: The primary study outcome is the difference in mean behaviour scores at 12 months in the combined ‘high-risk’ and ‘non-high-risk’ cohort and the mean difference in PHQ-9 scores at 12 months in the ‘high-risk’ cohort. Secondary outcomes include depression and anxiety remission rates in the high-risk cohort at 6 and 12 months, the proportion of high-risk individuals who have visited a doctor at least once in the previous 12 months, and change from baseline in mean stigma, mental health knowledge and attitude scores in the combined non-high-risk and high-risk cohort. Trial outcomes will be accompanied by detailed economic and process evaluations. Significance: The findings are likely to inform policy on a low-cost scalable solution to destigmatise common mental disorders and reduce the treatment gap for under-served populations in low-and middle-income country settings. Trial registration: Clinical Trial Registry India CTRI/2018/08/015355. Registered on 16 August 2018.
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    Blindness and poverty in India: The way forward
    ( 2007-11-01) Khanna, Rohit ; Raman, Usha ; Rao, Gullapalli N.
    A few recent studies have shown that poverty is an exacerbating and often determining factor in the incidence of disabling conditions, including visual impairment. Recent estimates from the World Health Organization indicate that 90 per cent of all those affected by visual impairment live in the poorest countries of the world. India is home to one-fifth of the world's visually impaired people and therefore, any strategies to combat avoidable blindness must take into account the socio-economic conditions within which people live. This paper looks at the relationship between poverty and blindness in India and suggests strategies to address blindness prevention in a comprehensive manner. © 2007 Optometrists Association Australia.
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    Clinician-patient communication in a glaucoma clinic in India
    ( 2011-03-01) Mocherla, Shobha ; Raman, Usha ; Holden, Brien
    We compiled data from nonparticipant observations of clinician-patient communication in clinical interactions in a tertiary care eye hospital in India. Applying elements of the French philosopher Michel Foucault's concept of power and knowledge, we deconstructed the structuring and moderating influences on the expert/nonexpert dyad. We found that clinicians enforce their "disciplining power" through varying degrees of communicativeness to bring about compliance in the patient. Clinicians appear to classify the patient as "participant" or "deviant" based on the patient's "internalization" of instructions, and then communicate in predictable ways with the patient. Patients can also wield power, communicating it by understanding and following or not understanding and not clarifying/verifying instructions in the clinic, and thereafter failing to comply with the clinician's advice. We suggest that clinicians need to hone their communication skills both to optimally utilize interactions in the clinic and to encourage patient compliance, thereby making possible better treatment outcomes. © The Author(s) 2011.
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    Communicating Nutrition in Community Settings: Case Studies in Critical Examination of Institutional Approaches in India
    ( 2014-03-01) Gavaravarapu, Subba Rao M. ; Pavarala, Vinod
    With co-existence of under-nutrition and obesity among its people, malnutrition afflicts India like a double-edged sword. The search for solutions has often pointed at 'Nutrition Communication' as a tool in alleviating malnutrition. This study, through three case studies in India, attempts to critically examine how various organizations engaged in nutrition communication perceive, develop and implement communicative processes. These case studies typically combined data collection methods like information gathering and interviews. We realize nutrition communication programmes are top-down, expert-driven and are often denied planning, evaluation or budgets. We argue that factors such as the organization's knowledge of the nutrition problem(s), perceptions of the key communicators, their motivation levels and personal biases also affect the design and implementation of nutrition communication programmes. © 2014 Mudra Institute of Communications.
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    Community radio 'under progress' resuming a paused revolution
    ( 2015-12-19) Pavarala, Vinod
    Community radio produced, controlled and owned by the people can empower the marginalised and address the "voice poverty" which afflicts South Asia. The article details the macro-level institutional environment required for a democratic and sustainable community radio sector and identifies the challenges involved in making the sector vibrant and dynamic in the South Asian region.
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    Considering ethics in community eye health planning: perspectives from an existing model.
    ( 2011-01-01) Raman, Usha ; Sheeladevi, Sethu
    Despite the widespread acceptance of the principles of the Alma Ata Declaration of 1978 and the subsequent amendments, health for all has remained a distant dream in many parts of the developing world. Concerns such as the economic efficiency of health systems and their reach and coverage have dominated discussions of public health, with ethics remaining at best a shadowy set of assumptions or at worst completely ignored. Similarly, questions of ethics have been taken for granted and rarely addressed directly in the design of public health models across sectors and are rarely explicitly addressed. This paper uses the experience of the L V Prasad Eye Institute's (LVPEI) pyramidal model of eye healthcare delivery to explore ethical issues in the design and implementation of public health interventions. The LVPEI model evolved over time from its beginnings as a tertiary care centre to a network that spans all levels of eye care service delivery from the community through primary and secondary levels. A previously published analytical framework is applied to this model and the utility of this framework as well as the ethics of the LVPEI model are interrogated. An analytical and prescriptive framework is then evolved that could be used to build in and evaluate ethics in other public health delivery models.
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    Conversing Ethics in India’s News Media: A capabilities approach to journalism ethics education and training
    ( 2019-04-21) Rao, Shakuntala ; Malik, Kanchan K.
    This paper identifies the significant ethical challenges expressed by journalists and editors working in media companies in the city of Hyderabad, India. Keeping those dilemmas and challenges in mind, the authors propose economist and Noble laureate Amartya Sen’s capabilities approach as a theoretical outline for the development of future journalism ethics curricula. The major challenges described by the journalists and editors were cross-media ownership, which fosters a political economy focused on revenue generation rather than journalism for public good; problems with the publication of inaccurate information, which are now precipitated by the omnipresence of social media; and a culture of “democratic deficit” where journalists find it increasingly difficult to practice journalism safely and to report about poverty, corruption, crime, environment, caste, and gender. The specific knowledge systems from Sen’s capabilities approach suggested for integration are the study and coverage of injustices in a democratic society; the focus on whether people have flourishing lives that give them the opportunities, freedoms, and choices they need; and economic and political freedoms that give journalists an understanding and appreciation for reporting on inequality and strengthening democratic institutions.
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    Corruption as a site for contested meaning: Elite constructions in India
    ( 1993-12-01) Pavarala, Vinod
    This paper investigates the problem of corruption in India from a social constructionist perspective. The constructions of corruption among five elite groups (bureaucrats, judges, politicians, industrialists, and journalists) in the southern state of Andhra Pradesh were obtained through a total of 60 interviews. Members of these five elite groups play a critical role in constructing the problem of corruption for public discourse. These elite groups, with the possible exception of the media elite, are also primary targets of public accusations of corrupt behavior. This paper examines three major issues related to corruption: the definition of corruption, the so-called functionality of corruption, and the role of culture in fostering or inhibiting corruption. Narrow/legalistic or broad/moralistic definitions of corruption, the acceptance or rejection of functionality, and modernist or nationalist responses to the question of culture are shown to constitute the varied structures of reality constructed by the different elite groups. These constructions of the corrupt reality in India are explained with reference to specific interests of the elites and their positions in the social structure. Instead of treating corruption as an objective condition, this study seeks to view corruption as a process in which strategic elites in society, define the problem and negotiate solutions to it. © 1993 Human Sciences Press, Inc.
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    Dominant bodies and their ethical performances violence of caste embodiment in higher educational institutions
    ( 2020-01-18) Thirumal, P.
    The everyday normalised brutality that dominant upper-caste bodies seem to inflict on Dalit Bahujans in elite higher educational institutions is addressed in this article. The reproduction of everyday institutional embodiment displays a direction and an intensity that allow dominant bodies to realise their undiminished being. This direction and intensity are supposedly expressed through the arts of living of the upper castes, namely the domains of cellular, intellectual, and social reproduction.
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    Driving Social Change Through Forum Theatre: A Study of Jana Sanskriti in West Bengal, India
    ( 2019-12-01) Brahma, Jharna ; Pavarala, Vinod ; Belavadi, Vasuki
    This article examines Forum Theatre as a form of participatory communication for social change. Based on an ethnographic study of Jana Sanskriti (JS), a Forum Theatre group working for over three decades in the eastern Indian state of West Bengal, this article seeks to show how this form of theatre, developed by the Brazilian activist Augusto Boal, subverts the passivity inherent in the communicator–receiver model of the dominant paradigm by activating the critical consciousness of the spectator and triggering a process of social change through dialogue and discussion. JS has been using Forum Theatre to address some of the deeply entrenched social norms in rural West Bengal, including those related to patriarchy, child marriage, domestic violence, and maternal and child health related issues, by extending Boal’s notion of the ‘spect-actor’ to encourage the spectators to become ‘spect-activists’, who then are engaged in community-level work on social change. We suggest that this form of communication is clearly bottom-up, radically participatory, community-based and led by the oppressed, as has been advocated by several scholars working on communication for social change.
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    Driving Social Change Through Forum Theatre: A Study of Jana Sanskriti in West Bengal, India
    ( 2019-12-01) Brahma, Jharna ; Pavarala, Vinod ; Belavadi, Vasuki
    This article examines Forum Theatre as a form of participatory communication for social change. Based on an ethnographic study of Jana Sanskriti (JS), a Forum Theatre group working for over three decades in the eastern Indian state of West Bengal, this article seeks to show how this form of theatre, developed by the Brazilian activist Augusto Boal, subverts the passivity inherent in the communicator–receiver model of the dominant paradigm by activating the critical consciousness of the spectator and triggering a process of social change through dialogue and discussion. JS has been using Forum Theatre to address some of the deeply entrenched social norms in rural West Bengal, including those related to patriarchy, child marriage, domestic violence, and maternal and child health related issues, by extending Boal’s notion of the ‘spect-actor’ to encourage the spectators to become ‘spect-activists’, who then are engaged in community-level work on social change. We suggest that this form of communication is clearly bottom-up, radically participatory, community-based and led by the oppressed, as has been advocated by several scholars working on communication for social change.
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    Dynamics of fake news dissemination: A case study in the Indian context
    ( 2018-01-01) Shafi, Shuaib ; Ravikumar, Madhavi
    The potential to reach out to large mass of people in considerably shorter periods of time, though resulted in acceleration of news production, it also paved way to a sudden boom in circulation of fake news. The attempt made here is to understand the various factors that influence the propagation of fake news. With the assistance of an online quantitative survey, the demographic factors, social media habits, news consumption habits and fake news exposure of 163 people are closely observed to identify any sort of patterns across it. Further, the thematic aspects of the fake news items that are come across by maximum number of respondents are put into discussion, to identify the elements that determine popularity. It concludes with stressing the need to have a more nuanced understanding of onlinecommunities for a comprehensive understanding of ‘fake news dynamics’.
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    Effectiveness of arts interventions to reduce mental-health-related stigma among youth: a systematic review and meta-analysis
    ( 2021-12-01) Gaiha, Shivani Mathur ; Salisbury, Tatiana Taylor ; Usmani, Shamaila ; Koschorke, Mirja ; Raman, Usha ; Petticrew, Mark
    Background: Educational interventions engage youth using visual, literary and performing arts to combat stigma associated with mental health problems. However, it remains unknown whether arts interventions are effective in reducing mental-health-related stigma among youth and if so, then which specific art forms, duration and stigma-related components in content are successful. Methods: We searched 13 databases, including PubMed, Medline, Global Health, EMBASE, ADOLEC, Social Policy and Practice, Database of Promoting Health Effectiveness Reviews (DoPHER), Trials Register of Promoting Health Interventions (TRoPHI), EPPI-Centre database of health promotion research (Bibliomap), Web of Science, PsycINFO, Cochrane and Scopus for studies involving arts interventions aimed at reducing any or all components of mental-health-related stigma among youth (10–24-year-olds). Risk of bias was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Data were extracted into tables and analysed using RevMan 5.3.5. Results: Fifty-seven studies met our inclusion criteria (n = 41,621). Interventions using multiple art forms are effective in improving behaviour towards people with mental health problems to a small effect (effect size = 0.28, 95%CI 0.08–0.48; p = 0.007) No studies reported negative outcomes or unintended harms. Among studies using specific art forms, we observed high heterogeneity among intervention studies using theatre, multiple art forms, film and role play. Data in this review are inconclusive about the use of single versus multiple sessions and whether including all stigma components of knowledge, attitude and behaviour as intervention content are more effective relative to studies focused on these stigma components, individually. Common challenges faced by school-based arts interventions included lack of buy-in from school administrators and low engagement. No studies were reported from low- and middle-income countries. Conclusion: Arts interventions are effective in reducing mental-health-related stigma to a small effect. Interventions that employ multiple art forms together compared to studies employing film, theatre or role play are likely more effective in reducing mental-health-related stigma.
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    Everyday negotiations in managing presence: young people and social media in India
    ( 2021-01-01) Sarwatay, Devina ; Raman, Usha
    Young people’s lives are inextricably tied in with the digital, whether it is for education, engagement, leisure, or work. Studies from the Global North have examined children and social media from several perspectives, with discourse now veering towards a rights-based approach to foreground young people’s voices in a digital and social media world, something that is missing in countries like India. This paper drew on deep interactions with young people from a large Indian city to gain preliminary insights into social media practices and modes of engagement with particular reference to management of access, privacy, safety, and negotiating challenges or problem solving. Our study suggests that conversations about digital platforms, particularly social media spaces, in relation to children’s everyday life practices need to begin early, at the point when children begin interacting with these technologies. Critical digital literacy must recognize the agency of young people, their naturalized interactions with the digital world, as well as the complexities of family and school life that moderate such interactions. These contextual nuances become significant when framing regulatory policies, parental advisories and critical digital literacy and media education programs. This article adds to the slowly growing literature from the Global South that enhances and diversifies our understanding of how the ‘born digital’ generation lives with/in social media.
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    Expressions of equity: imbalances in the patient-clinician interaction.
    ( 2012-01-01) Mocherla, Shobha ; Raman, Usha ; Holden, Brien
    This paper reports patient perceptions of inequities in the doctor-patient interaction. A mixed method study was conducted in a tertiary eye care centre in southern India to gain an insight into patient understanding and satisfaction from clinician communication. Non-participant observations enabled us to map the sequence of communication opportunities in the clinical interaction, and in-depth interviews were used to identify patient perceptions of the content and clarity of clinician communication in a clinic for patients of glaucoma, a chronic eye disease. A 60-item instrument was administered to 550 participants in the quantitative phase to explore associations between patient expectations, experience and ratings of clinician communication and satisfaction with it. The qualitative results helped map the clinical interaction, highlighting the consequences of poor clinician communication. The quantitative phase showed that patients expected explanations about the disease, the opportunity to ask questions, receiving supportive signals, and being treated as equals. Most patients stated their information source on disease was their doctor, leading us to conclude that clinicians must utilise communication opportunities optimally to ensure every patient has an equal chance to correctly understand their disease and role in treatment. By consciously improving their communication and using it strategically, clinicians can help ensure effective treatment outcomes.
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    Framing Disability in the Indian News Media: A Political Economy Analysis of Representation
    ( 2016-07-01) Bendukurthi, Nookaraju ; Raman, Usha
    This article argues that the amount and nature of disability representation in English and Telugu news media directly and indirectly serves neo-liberal objectives. Disability construction in the Indian print news media may be construed as a product of the political economy of representation. News articles present disabled people as having ‘use value’ in society, ready to be offered for ‘exchange value’ in the market. These insights are derived from a close reading of news articles using framing analysis, which allowed us to explore the underlying political economy of disability coverage in mainstream news. This article situates the symbiotic economic relations established through the media’s consciously placed disability representation within the existing discourses related to disability. It also attempts to reevaluate the available themes on disability and media representation with a view to uncovering the implied meanings of political economy recurrent in print news in India.
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    IJO's 50: A time to reflect
    ( 2003-03-01) Raman, Usha