Epidemiologic Features of Vulvovaginal Candidiasis among Reproductive-Age Women in India

Background. Vulvovaginal candidiasis is characterized by curd-like vaginal discharge and itching, and is associated with considerable health and economic costs. Materials and Methods. We examined the incidence, prevalence, and risk factors for vulvovaginal candidiasis among a cohort of 898 women in south India. Participants completed three study visits over six months, comprised of a structured interview and a pelvic examination. Results. The positive predictive values for diagnosis of vulvovaginal candidiasis using individual signs or symptoms were low (<19%). We did not find strong evidence for associations between sociodemographic characteristics and the prevalence of vulvovaginal candidiasis. Women clinically diagnosed with bacterial vaginosis had a higher prevalence of vulvovaginal candidiasis (Prevalence 12%, 95% CI 8.2, 15.8) compared to women assessed to be negative for bacterial vaginosis (Prevalence 6.5%, 95% 5.3, 7.6); however, differences in the prevalence of vulvovaginal candidiasis were not observed by the presence or absence of laboratory-confirmed bacterial vaginosis. Conclusions. For correct diagnosis of vulvovaginal candidiasis, laboratory confirmation of infection with Candida is necessary as well as assessment of whether the discharge has been caused by bacterial vaginosis. Studies are needed of women infected with Candida yeast species to determine the risk factors for yeast’s overgrowth.

Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India

Background While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations. Methods A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery. Results Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. While increasing numbers of women were accessing antenatal care and delivering in hospitals, large disparities were found in uptake of these services among different castes. Mothers belonging to general castes were almost twice as likely to have an institutional birth as compared to scheduled castes and tribes. Mothers belonging to other backward caste or general castes had 1.8 times higher odds (95% CI: 1.21, 2.89) of having an institutional delivery as compared to scheduled castes and tribes. In multivariable analysis, which adjusted for inter- and intra-village variance, Below Poverty Line status, caste, and receiving antenatal care were all associated with institutional delivery. Conclusion The results of the study suggest that while the Indian Government has made significant progress in increasing antenatal care and institutional deliveries among rural populations, further success in lowering maternal mortality will likely hinge on the success of NRHM programs focused on serving marginalized groups. Health interventions which target SC/ST may also have to address both perceived and actual stigma and discrimination, in addition to providing needed services. Strategies for overcoming these barriers may include sensitization of healthcare workers, targeted health education and outreach, and culturally appropriate community-level interventions. Addressing the needs of these communities will be critical to achieving Millennium Development Goal Five by 2015.

Hindutva meets globalization: The impact on Hindu urban media women

This study examines the impact of globalization and religious nationalism on the personal and professional lives of urban Hindu middle class media women. The research demonstrates how newly strengthened forces of globalization and Hindutva shape Indian womanhood. The research rests on various data that reveal how Indian women interpret and negotiate constructed identities. The study seeks to give voice to the objectified by scrutinizing and challenging the stereotypical modern faces of Indian womanhood seen in the narratives of globalization and Hindutva. Feminist open-ended interviewing was conducted in English and Hindi in New Delhi, the capital of India, with 23 Hindu women, employed by electronic and print media corporations. Accumulated data were analyzed and interpreted using feminist critical discourse analysis. Findings from the study indicate that while the Indian middle class women have embraced professional opportunities presented by globalization, they remain circumscribed by mutating gender politics. The research also finds that as academic and professional progress empower the women within their homes, their public lives have become fraught with increasing gender violence and decreasing recourse to justice. Therefore, women accept the power stratification of their lives as being dependent on spatial and temporal distinctions, and have learnt to engage and strategize with the public environment for physical safety and personal-professional progress. While the media women see systemic masculine domination as being symbiotic with tenets of religious nationalism, they exhibit an unquestioned embracing of capitalism/globalization as the means of empowerment. My research also strongly indicates the importance of the media’s role in shaping gender dynamics in a global context. In conclusion, my research shows the mediawomen’s immense agency in pursuing academic and professional careers while being aware of deeply ingrained gender roles through their strong commitment towards their families. The findings of this study contribute to the literature on Third World nationalism, urban globalization and understandings of reworked-renewed masculine domination. Finally, the study also engages with recent scholarship on the Indian middle class (See Nanda 2010; Shenoy 2009; Lukose 2005; and Radhakrishnan 2006) while simultaneously addressing the notions of privilege and disengagement levied at the middle class woman, a symbiosis of idealization and imprisonment.