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ItemUse of complementary and alternative therapies among rural tb patients in Nalgonda, Andhra Pradesh: A qualitative study( 2014-01-01)Background: A considerable number of studies have been conducted on health seeking behaviour of TB patients in different parts of the world. However, these studies largely ignored the prevalence and use of complementary and alternative medical practices (CAM) among TB patients. This present study was prompted by the recognition that, an understanding of different factors influencing CAM use in a medically pluralistic setting has important implications for providing patient-centred comprehensive care, and improving the quality of life for TB patients. Aim: The objective of the study was to explore the reasons and motivations for the use of Complementary and Alternative Medicine (CAM) therapies among rural TB patients. Methods: A sample of 110 respondents were recruited purposively from two selected rural TB units at Yadagirigutta and Chintapally in Nalgonda district in Andhra Pradesh (A.P.). Semi-structured interview schedule and case study methods were used for the collection of primary data. A qualitative content analysis method was employed to analyse and interpret the data. Results: TB patients employed a variety of alternative therapies such as massage, prayer, amulets, diet, faith or spiritual healing, restriction in alcohol consumption and smoking, abstinence from sex, and herbal teas as an adjunct to biomedical TB treatment. Engaging in alternative medical practices resulted in a sense control and relief from physical and psychological suffering and trauma associated TB illness. Conclusion: There is a need on the part of the health care professionals and health policy managers to gain insight into the motivations and reasons for CAM use among the TB patients. Such a shift in thinking will impact on reducing non-compliance, and identifying and dealing with unmet needs of patients which are seen as major deterrents to successful TB control programmes.
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ItemThe magic mountain revisited: History of the madanapalle TB sanatorium( 2008-08-16)The sanatorium was central to tuberculosis treatment in the 19th and early 20th centuries. The long-drawn nature of treatment and the highly infectious nature of the disease made the sanatorium regimen effective and popular before antibiotics entered the scene. The sanatorium was not just a hospital, it was a social world - isolated from the rest of society it created its own definition of "community". Now it has faded from public memory. This paper revisits the sanatorium in an effort to uncover and construct the social history of tb in India. The Union Mission Tuberculosis Sanatorium in Chittoor district, Andhra Pradesh, provides the site for this historical enquiry.
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ItemLack of community participation in the sarva shiksha abhiyan: A case study( 2009-02-21)The Sarva Shiksha Abhiyan, among other things, seeks to promote community participation in school education. The programme has completed its first phase of five years of implementation. This article evaluates the working of the school education management committee in a tribal area of East Godavari district of Andhra Pradesh. It shows that community participation in improving education is negligible and that members of the SEMCs have limited awareness of the SSA.
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ItemPsychosocial trauma of diagnosis: A qualitative study on rural TB patients' experiences in Nalgonda District, Andhra Pradesh( 2013-09-17)Background: The current tuberculosis (TB) control strategy in India largely ignores psychosocial needs of the patients. The present study was prompted by the recognition that, if TB treatment is to be culturally sensitive and effective, the psychosocial problems and issues need to be recognized and addressed. Aims: The main aim of this study was to explore psychosocial problems and issues among rural patients being diagnosed with TB. Methods: 110 respondents who had known about their TB diagnosis less than two months prior to conducting the interviews were recruited purposively from two selected rural TB units at Yadagirigutta and Chintapally in Nalgonda district in Andhra Pradesh (A.P.). Semi-structured interview schedule was used for the collection of primary data. A qualitative content analysis method was employed to analyze and interpret the data. Data analysis was carried out following multi-step procedure that consisted of data reduction, coding and identification of dominant themes. Results: The diagnosis of TB was generally seen as a shocking and demoralizing experience, and raised a host of social and psychological problems among the patients. Six prominent themes emerged from the in-depth interviews with the respondents: i) worry, ii) disbelief, iii) embarrassment, iv) fear of death, v) fate, and vi) relief. Conclusion: Effective care for TB requires a much broader approach beyond focusing on anti-tuberculosis drugs and diagnostic techniques. For medical care to be most effective and acceptable to patients, general practitioners should treat both illness and disease in their patients at the same time. Knowledge of the nature of psychosocial problems is crucial for the design of new approaches and methods to improve the quality of life of TB patients.
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Item‘Outsourced pregnancy’: Surrogate narratives from Hyderabad( 2019-06-01)Surrogacy has always been contested and much debated in India since its legalisation in 2002, and the recent Surrogacy (Regulation) Bill, 2016, has led to a renewed engagement with it. The advent of assisted reproductive technologies (ART) provided an opportunity for the medical establishment, market and infertile couples to come together in a mutually beneficial arrangement, which is made possible by a surrogate. ART, while medicalising the reproductive capacity of women, also calls for a redefining of the concepts of ‘motherhood’, family and reproductive choice. This article primarily documents the experiences of surrogates through their narratives about the continuous struggle with themselves, their families and the medical establishment. In this matrix of unequal power relations that surrogacy epitomises, the surrogate has a precarious voice. The article argues that while surrogacy extracts a physiological and emotional price that the surrogates pay, it is empowering in a limited way. It offers women economic opportunities of a scale otherwise denied to them, enabling them to fight a life of poverty.