Vaishnavi Jayakumar Profile picture
Jun 7, 2023 22 tweets 10 min read Read on X
2500+ people endorsed overnight, the disability sector's representation to @MoHFW_INDIA minister @mansukhmandviya on restoring the suddenly dropped questions from the upcoming National Family Health survey NFHS-6. Read it @ bit.ly/question-of-in…

#NfhsDrops #QuestionOfInclusion Jigsaw of letters NFHS with...
Will be going through the NFHS-6 questionnaire compilation today.

And posting thoughts and doubts as I go along on this thread.

drive.google.com/file/d/1nVC-0a…

Starting with a term I've never heard of : GAUNA -
apparently rooted in child marriage customs as the 'consummation ritual '
indiatoday.in/india/story/ch…

So this send off to house of 'husband' after menarche for consummation / the start of actual married life is apparently a custom in some North Indian states.
In some cases gauna occurs only after legal age but pestering happens 😑

#NFHS-6 #ChildMarriage
Read that there's no legal age for gauna as it would mean acknowledgement of child marriage. 🤔

But if the legal age is 18 for women, why ask NFHS-6 question on marital status for 13 & above females only? 13 year old girl being married is in any case illegal, why half measures?  CURRENT MARITAL STATUS (ag...
It's good that we're specifically asked this question instead of a default assumed.

Except, sex & gender conflation?

"Always confirm the sex of a person before recording it in Column (4) since there are many names that
may be given to a male, a female, & a transgender person" Screenshot of initial listi...
Given gender dysphoria, and health needs of transgender and non-binary communities, perhaps the 2 step process in #NFHS-6 could record both sex at birth (if instrumentally necessary) and current gender identity.
Any advocacy on this so far @chennaipride ?

nationalacademies.org/news/2022/03/n…
The questions on school education present lost opportunities to incorporate disability (developmental delay vs typical age ranges) &reason for not attending school - whether locomotor disability & transport not accessible / admission refused due to disability / CWSN - HBE student CODES FOR Q. 25 (Reason for...
Pleased to note that in new entry Q 30, in NFHS-6 household schedule 'vaccine centre not accessible' is listed as a response code for reason for not taking Covid-19 vaccine. (except one suspects that they probably meant distance rather than accessibility from a disability POV!) NFHS-6 codes for Q-30 (Reas...
This bit must be due to copy paste of DHS templates. I know standardisation and global comparison, but asking if every household has a boat with motor? Kitchen garden?

Wish mix of responses was from most to least likely.

Kitchen having exhaust fan? Why not add windows too? Question 46 of items owned ...
Grinned at the parquet flooring option!

In NFHS-6, HH Q 29, why not ask about bank account holding on a member basis (rather than a household basis) given growing DBT push?

Disability has been dropped for some new Covid related questions.

And now for the women's schedule...
In NFHS -6 woman's schedule's Q 242 'Main reason for abortion' options include male foetus and female foetus.

How can these be options given the PC-PNDT Act?

(Also how come father in law is exempt from machinations?! And unplanned pregnancy = euphemism for unprotected sex 😃) Question 242 of Woman's Sch...
Spot the difference in women's question 262 vs 263 in NFHS-6.

Is it what's been used during menstruation from the beginning of time vs what was last used?
How's it relevant? Wouldn't it be more useful to ask how many hours the sanitary pad was typically used without changing it? Questions 262 - 265 in Wome...
As a matter of interest are pregnant persons registered in urban settings too by govt staff?

With this mother and child protection card?

I'd be interested in the socioeconomic profile of people using pregnancy testing kits in India. Questions 409-413 of NFHS-6...
Dear @IIPSMumbai , please add option "No I couldn't give the pneumococcal vaccine to my child because the @MoHFW_INDIA made a mess of ordering PCV in 2022" to questions on PCV in NFHS-6.

bit.ly/no-pcv NFHS-6 women's schedule que...
Quite a bit of NFHS is the same health awareness questions repeated in 3 years while nothing has really been done to change awareness / perceptions.

What is the point of a whole page of HIV awareness queries - if a person gets an answer wrong, are they told the right answer? HIV Awareness in NFHS-6 wom...
That's 5.5 PAGES of questions on HIV in the NFHS-6 Women's schedule.

If cribbing about the length of the questionnaire, you know where to cut. This seems a bit dated.

Reading the woman's questionnaire leaves me angry at the focus on child-bearing, child-rearing and violence.
Now for the NFHS-6 Men's Schedule.

Funny how polyandry isn't provided for - women's schedule asks how many wives the husband has, and the man is asked how many wives he has.

Check out answer code "ONLY one wife" 🤦🏾 NFHS-6 men's schedule quest...
Men : Women's number of sexual partner options in NFHS-6 = 9 : 7.

Same sex partner option is dropped for women, as is 'transgender'.

For a sex, violence and reproduction obsessed survey, that's quite a shortcoming! Q 407 in NFHS-6 Men's Sched...Q 809 in NFHS-6 Men's Sched...
Just like the NFHS-6 number of wives question which isn't reversed for the other gender, here's the question on justification for beating.

There has to be a better way to find out about intimate partner / domestic violence than these suggestive scenarios that normalise the issue Q 506 response options in N...
No 1137 in the NFHS-6 Women's schedule asks "As far as you know, did your father ever beat your mother?"

That's the final question in the deceptively titled section 11 : Household relations, which covers rape.

(Marital rape too).

Not asked in the Man's schedule. Wonder why. Table of contents section w...
Section 9 (Husband's background & Women's Work) in NFHS-6 women's schedule = Section 5 (Attitudes towards Gender roles) in the Men's.
That's the beating justification questions!
Zilch on mental health, even though preoccupied with pregnancy.
Other health issues are truly othered. Question : do you currently...
Verdict : this can be called the National Reproductive Health Survey, with a disturbing voyeuristic focus on sex and violence. Lots of socio-economic parameters to keep media and researchers busy for a couple of years. And health awareness testing in a vacuum.
WHERE'S THE HEALTH?

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More from @vjayakumar

Nov 1
🧵Social media outrage shouldn't surprise any longer, but enough already on Institute of Mental Health letter @U2Brutus_off @realitycheckind @GaneshKaladaran and other conspiracy theorists. 😡

What the TN Health Secretary seems to propose is change in FUNCTIONING not OWNERSHIP. I am of the firm view that given the challenges, the present organisational set up is not capable of handling the transformational change that is required at IMH. We need to bring several institutional reforms to ensure that IMH emerges as premier institution providing 'Gold Standards' of care for its inmates. This will require a complete 360-degree transformation.  Given the fact that the institute has huge opportunities to raise resources from national and international organisations as well as from the Corporate Social Responsibility (CSR) funds it needs a robust frame work to mobilise r...
What has been proposed instead of the current organisational setup is a FULLY OWNED GOVT company.

To distinguish from wholly owned govt COMMERCIAL companies like SIPCOT which are profit-seeking, it's stressed it should be a NOT FOR PROFIT company since it's not profit-seeking.
The term NON-PROFIT is sometimes conflated with NOT FOR PROFIT NGOS (whether NGO is society, trust or section 8 company), but here TN Govt is rightly retaining full ownership & responsibility of IMH's services. Just under a different type of govt entity, nothing to do with NGOs. Not for profit  IS NOT THE SAME  as Non-profits   All charitable NGOs are non-profits i.e. not for profit but All Non-profits ≠ NGOS  Many Govt enterprises can be not for profit too.
Read 8 tweets
Nov 10, 2023
🧵MDR-TB Drug shortage RTI response finally arrived, with some key information dodged. All information requested is available to anyone with access to Ni-kshay Aushadhi portal yet @TbDivision has ducked questions on the tender cancellation and delivery of late tender. Appealing.

Screenshots of unanswere / improperly answered questions of RTI filed on 2023 MDR-TB Drug shortage in India. RTI reply can be read at https://docs.google.com/document/d/1a2i5l1yPd0B5DErffnRNrza56TZ_4qOE-UJL8he088M/edit?usp=drive_link
Screenshots of unanswere / improperly answered questions of RTI filed on 2023 MDR-TB Drug shortage in India. RTI reply can be read at https://docs.google.com/document/d/1a2i5l1yPd0B5DErffnRNrza56TZ_4qOE-UJL8he088M/edit?usp=drive_link
RTI reply denies communication to procure emergency supply locally while also stating that "States were requested to procure few drugs locally for a limited period by utilizing the approved budget under National Health Mission (NHM)."
Cost = ~8.65 crores. Potential loss 43 lakhs? Approximately 8.65 crores was spent by States National Health Mission Funds to meet the SOS requirements caused by tendering delays. Issue landing page = http://bit.ly/TB-or-not-2be  Spreadsheet chart derived from Annexure 4 of RTI response :  https://docs.google.com/spreadsheets/d/e/2PACX-1vRuFUfD2V65ZxmcD6e8WWIltdRGSmropG8LUbSAi9lwNPiWd4xHFArZY-O8ZN7_crYuRrB1DIKlNZGE/pubhtml?gid=1046679671&single=true
@ramyakannan @RupsaChak @ScienceTales @kalyanray30 @RemaNagarajan @pushpanarayan @Banjotkaur @tabassum_b @TbHivActivist @SpeakTB Stock at hand at CMSS warehouse & GMSD (c/o Union Govt) or State Drug Store is of no bearing to the patient. Last mile delivery starts with District Drug Store (DDS) which sends monthly drugs to TB Units & Peripheral Health Institutes. PHIs should also have 1 month reserve stock
Annexure 3 of RTI reply shows how the last level of supply chain is inadequate for MDR-TB drugs, especially Cycloserine which has less than a month's requirements from August 2023 at the DDS level. https://docs.google.com/document/d/1a2i5l1yPd0B5DErffnRNrza56TZ_4qOE-UJL8he088M/edit#heading=h.sg7nejtvrr1i   Issue landing = http://bit.ly/TB-or-not-2be
Annexure 3 of RTI reply shows how the last level of supply chain is inadequate for MDR-TB drugs. Actual distribution only happens from the District Drug Store level which (particularly in the case of Cycloserine and at some points Linezolid) is barely 20 - 40 % of the total drug stock instead of vice versa.  https://docs.google.com/document/d/1a2i5l1yPd0B5DErffnRNrza56TZ_4qOE-UJL8he088M/edit#heading=h.sg7nejtvrr1i   Issue landing = http://bit.ly/TB-or-not-2be
Read 5 tweets
Sep 26, 2023
Thread : Collating 2023 India's MDR TB drug shortage reports (via social media) below.

TB Mukt Abhiyan, ya TB Maut Abhiyan?

Wake up @nppa_india ! There's an MDR / XDR TB #DrugShortage - stockouts at DOTS centres, as well as private.

#TBornot2be
#AccounTBility

#TeamISthmUS
Read 36 tweets
Jun 15, 2023
THREAD : I only recently learnt that nearly all NTA tests are computerised.

This means that exam centres are dependent on computer labs of private colleges or on standalone online testing centres.

Elections have taught us, that any private institution, is bad news for access.. Plank of wood on 8 steps do...So called ramp in 3 unfaste...Karnataka polling booth ina...
Whether school or college, private organisations seem blissfully unaware that they're required by law to provide accessibility by 15-6-2022.
Private schools as polling booths have steadfastly refused to install permanent ramps despite a decade of advocacy
bit.ly/design4diversi…
So the Varanasi online testing centre (others weren't any better) had this steep incline masquerading as a wheelchair ramp last afternoon.

NTA was patient with our bombarding solutions by 4 architects for a temporary ramp before 3 pm today. So were Varanasi district officials. Front view of 6 riser stepp...Side view of 6 riser steppe...
Read 13 tweets
Jun 5, 2023
Baffled that public health policy organisations & professionals are mum about @IIPSMumbai dropping anemia ALTOGETHER from #NFHS-6, barring few voices below.

Why @jsa_india @SOCHARASOPHEA @PHMglobal @SNEHAmumbai @jan_arogya @CEHAT1 @napmindia @iphindia etc?

#QuestionOfInclusion Diagram of Prevalence of An...
2 decades of anemia data in NFHS dropped because ... What?

Here's the entire NFHS-6 set of schedules and manuals released quietly by IIPS after the disability sector made a noise :
drive.google.com/file/d/1nVC-0a…

References to anaemia still persist in the instructions to interviewers !
For 2 decades India (& the world) has been using capillary blood for demographic health surveys. IIPS made it clear that the data is not for diagnosis but estimates. If the evidence pointing to capillary blood Hb results being higher has been around for so long, why act only now?
Read 7 tweets
Oct 3, 2022
Ploughing through the 600 pages of Maharashtra Prison manual in prep for Fr Stan Swamy MSHRC hearing tomorrow.

It's so dated, it's mists of time.

Remembered Arun Ferreira's account of the absurd meal timings.

If the manual doesn't change, how can life?
beyondheadlines.in/2012/06/arun-f… Extract of prison routine f...Arun Ferreira article (link...
Why no dal on Sundays?

If you're prison labour you get more food, if you're not, rations get reduced?

29. It shall be the duty of the Supt to see that diet on the
highest scales is provided only to such prisoners as are employed bona
fide on hard labour & are doing full task.
While the Maharashtra prison manual has no caste based labour diktats , the Class I vs Class II prisoner terminology here is quite blatantly classist. During prison parade, one is Ek, do vs Attention, self shave vs barber, different diet, letter privileges etc
So this is telling: Maharashtra Prison Manual '...
Read 6 tweets

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