OUR RESEARCH

We believe in continuous transformation through learning. Using the most up-to-date scientific advances and methods, we investigate every step of our work rigorously on the ground. We are proud to contribute to impactful and relevant research that meets the needs of local populations.

OUR RESEARCH

We believe in continuous transformation through learning. Using the most up-to-date scientific advances and methods, we investigate every step of our work rigorously on the ground. We are proud to contribute to impactful and relevant research that meets the needs of local populations.

2020

Myriam Cielo Pérez, Dinesh Chandra, Georges Koné. Rohit Singh, Valéry Ridde, Marie-Pierre Sylvestre, Aaditeshwar Seth, Mira Johri. Implementation fidelity and acceptability of an intervention to improve vaccination uptake and child health in rural India: a mixed methods evaluation of a pilot cluster randomized controlled trial. Implement Sci Commun 1, 88 (2020). https://doi.org/10.1186/s43058-020-00077-7

Johri M, Agarwal S, Khullar A, Chandra D, Pratap VS, Seth A. The first 100 days: How has COVID-19 affected poor and vulnerable groups in India? Under review

Pérez MC, Singh R, Chandra D, Ridde V, Seth A, Johri M. Development of an mHealth Behavior Change Communication Strategy: A case-study from rural Uttar Pradesh in India.  Proceedings of the 3rd ACM SIGCAS Conference on Computing and Sustainable Societies; Ecuador: Association for Computing Machinery; 2020. p. 274–8. 

2019

Johri M, Rodgers L, Chandra D, Abou Rizk C, Nash E and Mathur AK.
Implementation fidelity of Village Health and Nutrition Days in Hardoi District, Uttar Pradesh, India: A cross-sectional survey BMC Health Services Research 2019; 19(1): 756.

Johri M, Sylvestre MP, Koné GK, Chandra D, Subramanian SV (2019): Effects of improved drinking water quality on early childhood growth in rural Uttar Pradesh, India: A propensity-score analysis. PLOS ONE 14(1): e0209054.

2018

2016

Johri M, Perez MC, Arsenault C, Sharma JK, Pant Pai N, Pahwa S, Sylvestre MP: Estrategias para incrementar la demanda de vacunación infantil en países de ingresos bajos y medios: una revisión sistemática y un metanálisis, Rev. Fac. Nac. Salud Pública 2016; 34(2): 243-255. (Spanish versión of: https://dx.doi.org/10.2471/BLT.14.146951)

Mira Johri, SV Subramanian, Georges K. Koné, Sakshi Dudeja, Dinesh Chandra, Nanor Minoyan, Marie-Pierre Sylvestre, Smriti Pahwa : Maternal health literacy is associated with early childhood nutritional status in India, Journal of Nutrition 2016, 146(7):1402-10.

2015

Johri M, Perez MC, Arsenault C, Sharma JK, Pant Pai N, Pahwa S, Sylvestre MP: Strategies to increase the demand for childhood vaccination in developing countries: Systematic review and meta-analysis 2015 Bulletin of the World Health Organization 2015, 93(5):339-346C.

Johri M, Subramanian SV, Sylvestre MP, Dudeja S, Chandra D, Koné GK, Sharma JK, Pahwa S: Association between maternal health literacy and child vaccination in India: a cross-sectional study, J Epidemiol Community Health 2015, 69(9):849-857.

2014

Johri M, Chandra D, Subramanian SV, Sylvestre MP and Pahwa S: MDG 7c for safe drinking water in India: an illusive achievement. Lancet 2014, 383 (9926):1379

ABOUT OUR RESEARCH

The greater part of our work focusses on understanding deficits in immunization and developing and evaluating effective strategies to address them. As a majority of the immunization gap in India is due to factors related to lack of awareness, trust, fear of adverse events and low demand for immunisation, our work places considerable emphasis on social and behaviour change communication, community engagement, and empowerment, as well as on improving service efficiency and reach through stronger data systems.

Although focus is key to success, the realities of the field challenge any single-issue approach. Our vision of health is holistic and our research and intervention strategies address complex determinants including water, sanitation, and hygiene, nutrition, and social inequalities such as poverty and gender. We are particularly interested in the potential of the immunization platform to strengthen universal primary care services.

Water, sanitation and hygiene (WaSH) are key determinants of health, particularly for young children. Observation and experience tell us that health and early childhood development are severely compromised due to low levels of WaSH in our study site. Yet, in 2011, UN policymakers eager to fulfil MDG goals declared a victory in the area of drinking water, claiming that the MDG safe drinking water goal had been achieved in India and worldwide.

 

We conducted a head-to-head comparison of the UN MDG Target 7c indicator for safe drinking water with a measure of microbial water quality (reference standard). Our study revealed gross discrepancies between the UN MDG indicator and microbiological water quality. It documented a very high burden of infectious disease suggestive of WaSH failures in areas that had amply achieved MDG water targets.

 

Flawed data undermine effective research and appropriate action – such data contribute to ongoing failures to meet the needs of communities. We therefore called for an urgent reconsideration of the UN’s MDG target 7c indicator for safe drinking water. This work was featured in the Lancet in an editorial and sent as part of the media package to the high-level UN Sanitation and Water for All meeting in April 2014. Top Indian newspapers (including the national editions of the Times of India and the Hindu) also carried the story.

 

The new SDG water quality standard includes a measure of water quality. WaSH is a priority of the Indian government and continues to be a focal interest. Stay tuned for more updates in this sphere.

Life opportunities are shaped by social factors such as poverty, caste, social position and gender. Gender roles and gender inequity are pervasive structural determinants of health in our study area. While mothers are considered the primary caregivers for their children, they are often disempowered in their ability to make decisions within the household due to traditional gender roles and low levels of education and knowledge. Restrictions on mobility may also impede mothers’ ability to seek health care for their children.

 

Scientific research shows that women’s education is positively linked to child survival and flourishing, but educational status is difficult to modify in the short term. We investigated whether maternal health literacy, a rapidly modifiable factor related to mother’s education, was associated with children’s receipt of vaccines in two underserved Indian communities. We found that maternal health literacy is independently associated with child vaccination. This suggests that initiatives targeting mother’s understanding and awareness could help to improve vaccination coverage in lagging populations. The link between maternal education and vaccination coverage was also supported in global analyses. Building on this work, we have been building a gender-sensitive intervention approach to improve immunization uptake while including males and the entire community. Our research has helped to inform the work of the Equity Reference Group for Immunisation (ERG), an action-oriented think tank convened by UNICEF and the Bill & Melinda Gates Foundation to generate innovative ideas to accelerate progress on equity in immunisation.

 

Child undernutrition is prevalent in our study site, compromising healthy growth, development and life chances. Malnourished children are hardest hit by infectious diseases. Our research revealed that in resource-poor rural and urban settings in India, maternal health literacy is associated with chronic forms of child undernutrition. Programs targeting mother’s understanding and awareness may offer effective entry points for intervention to improve child nutrition. We continue to work on synergies.