Devaki Nambiar
Datos Biográficos
| ID | 247423 |
|---|---|
| NOMBRE | Devaki Nambiar |
| NOMBRES | Devaki |
| APELLIDO | Nambiar |
| FIRMA | NAMBIAR D |
| AFILIACIONES | George Institute for Global Health |
| ORCID | 0000-0001-5682-6109 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 53 |
| TOTAL DE CITAS | 25 |
| TOTAL COMO AUTOR | 53 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2010 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 4 |
Understanding pathways from primary health care to universal health coverage outcomes
Introduction: Primary Health Care (PHC) rooted in community empowerment, integrated service delivery, and multisectoral action is central to efforts toward Universal Health Coverage (UHC), yet little is known about how PHC reforms influence UHC outcomes across contexts. This review examines how PHC approaches affect population coverage, service coverage, and financial protection by identifying what works, for whom, under what circumstances, and w…
Inclusiveness of social participation for health reform
OBJECTIVE: In 2024, the 77th World Health Assembly adopted a resolution on social participation for health (SPH), underscoring the importance of inclusive health system decision-making to achieve universal health coverage. Inclusion-oriented SPH is key to achieving health equity, enabling the needs and perspectives of marginalized communities to reflect in decisions, yet many initiatives fall short. A realist review sought to determine the contex…
WHO launches global network of institutes to strengthen capacity for health inequality monitoring
This article introduces the global WHO-managed Health Inequality Monitoring Network, which is dedicated to strengthening and expanding health inequality monitoring practices at global, regional and country levels. Launched in 2025, the Health Inequality Monitoring Network consists of 12 inaugural institutional members, represented by over 140 affiliated individuals spanning all world regions. The Network aims to: strengthen capacities for health …
Youth collective action for accountability towards sexual and reproductive health (SRH) rights
In the field of sexual and reproductive health and rights (SRHR), there is a growing consensus that participation is critical to ensuring that the voices of youth are heard and their agency is exercised in a way that enables them to practice active citizenship. This includes collective action to hold duty bearers and power holders to account for their rights. Youth are increasingly being seen as important constituents; however, despite the growth…
Is breastfeeding ‘exclusive’? Barriers facing global health professionals and proposed solutions
The good, the bad, and the ugly
As with most technology-driven change, e-pharmacy markets have expanded faster than the pace of regulation, particularly in low- and middle-income countries. We developed and applied a checklist to assess compliance with best practices and regulations by e-pharmacies serving clients in India and Kenya, two countries with contrasting regulatory environments. We defined e-pharmacies as businesses selling prescription-only medicines directly to cons…
How to (or how not to)…Enhance equity in the conduct of global health research
Global health research can either challenge or reinforce power imbalances in knowledge production, funding, agenda-setting, authorship, data access, and capacity-building. These inequities are shaped by colonial legacies, funding disparities, extractive partnerships, and Global North dominance over Global South priorities. They manifest in research conduct, procedural ethics, and ethics-in-practice. While much literature focuses on individual or …
How equitable is the conduct of public health research? Findings across case studies from India and Australia
Case studies of equity integration in research revealed strategies as well as challenges. Many strategies as well as challenges were shared across studies, whether focused on health equity as a topic or not. Overall equity-focused projects had more leeway to focus on process related aspects within study scope, although all studies found ways to change "how" research was done. There is a critical need to frame equity integration not merely as an i…
I would be very proud to be part of an initiative that didn’t exclude people because it was hard”
The distribution of heath equity responsibilities, as we demonstrated through a ToC of a decentralised, place-based reform, present risk to health equity prioritisation. Risks were particularly present when local resourcing and capacity were stretched, and limited policy guardrails were in place to counteract decision-making tensions, such as clear health equity accountabilities, responsibilities, and actions
Visualizing health inequality data
Several resources and tools have been developed for carrying out health inequality analysis, including the preparation of disaggregated data and calculation of summary measures of health inequality. There is also a body of literature that addresses best practices for the preparation of commonly used graphs and maps. There is, however, little guidance for the selection and design of appropriate data visuals for corresponding health inequality data…
Health in Kerala
The findings suggest that custom made policies are required to address the specific health needs of underserved population rather than a doing "more of same" approach
Understanding the emergence of ‘Communitization’ under India’s National Rural Health Mission (NRHM)
India's experience with the National Rural Health Mission (NRHM) is notable on account of nationally formalising - at scale - community action in service delivery, monitoring, and planning of health services. A study was undertaken to document and create a historical record of NRHM's 'communitization' processes. The oral history method of the Witness Seminar was adopted and two virtual seminars with five and nine participants, respectively, were …
Exploring the road to public healthcare accessibility
The 'Kerala Model of Development' has been applauded internationally for its success in recent years. However, this has not inured the state from the typical barriers to public sector health care use articulated by participants in the study, which match global evidence. In order to deepen the impact of public sector reforms, the state must try to meet service user expectations- especially among those left behind. This requires attention to qualit…
Are institutional deliveries equitable in the southern states of India? A benefit incidence analysis
Poorer groups utilize the public sector for institutional delivery in greater proportions than the private sector. Middle quintiles seem to benefit the most from public subsidy in terms of the median cost of service and non-payment. Greater efforts must be made to understand how and why these groups are being left behind and what policy measures can enhance their inclusion and financial risk protection
National Rural Health Mission reforms in light of decentralised planning in Kerala, India
The synergy between decentralised health planning and N(R)HM has significantly shaped and impacted the health sector, leading to innovative and inclusive programs that respond to local health needs and improved health system infrastructure. However, centralised health planning still belies the ethos and imperative of decentralisation - these contradictions may vex progress going forward and warrant further study
How to do (or not to do)…how to embed equity in the conduct of health research
Global health research reflects and can either perpetuate or challenge the complex power hierarchies and inequities that characterize our health systems and the societies in which they are situated. The imperative to embed equity in health research aligns with broader efforts globally to promote equitable partnerships among researchers, and between researchers and the communities potentially impacted by their research, or with whom knowledge is c…
Action on the social determinants for advancing health equity in the time of Covid-19
Since the 2008 publication of the reports of the Commission on Social Determinants of Health and its nine knowledge networks, substantial research has been undertaken to document and describe health inequities. The COVID-19 pandemic has underscored the need for a deeper understanding of, and broader action on, the social determinants of health. Building on this unique and critical opportunity, the World Health Organization is steering a multi-cou…
Assessing inequalities in publicly funded health insurance scheme coverage and out-of-pocket expenditure for hospitalization
While PFHIS seems to be appropriately targeting poorer populations, among the insured, OOPE for hospitalization persists. Among the uninsured, population subgroups with advantage are spending the greatest amount, raising questions about whether those facing relative disadvantage are forgoing care altogether or seeking care using cheaper, public avenues. Further policy action to more effectively reduce financial burden among left behind eligible p…
Who are the vulnerable, and how do we reach them? Perspectives of health system actors and community leaders in Kerala, India
Background Among the core principles of the 2030 agenda of Sustainable Development Goals (SDGs) is the call to Leave no One behind (LNOB), a principle that gained resonance as the world contended with the COVID-19 pandemic. The south Indian state of Kerala received acclaim globally for its efforts in managing COVID-19 pandemic. Less attention has been paid, however, to how inclusive this management was, as well as if and how those “left behind” i…
Gender-specific inequalities in coverage of Publicly Funded Health Insurance Schemes in Southern States of India
We found gender inequalities in self-reported enrolment in southern states with long-standing PFHIS. Inequalities favoured the poor, uneducated and elderly, which is to some extend desirable when rolling out a PFHIS intended for harder to reach populations. However, religion and caste-based inequalities, while reducing, were still prevalent among women. If PFHIS are to truly offer financial risk protection, they must address the intersecting marg…
Pivoting from systems “thinking” to systems “doing” in health systems—Documenting stakeholder perspectives from Southeast Asia
Applications of systems thinking in the context of Health Policy and Systems Research have been scarce, particularly in Low- and Middle-Income Countries (LMICs). Given the urgent need for addressing implementation challenges, the WHO Alliance for Health Policy and Systems Research, in collaboration with partners across five global regions, recently initiated a global community of practice for applied systems thinking in policy and practice contex…
Roles played by civil society organisations in supporting homeless people with health care-seeking and accessing the social determinants of health in Delhi, India
Civil Society Organisations (CSO) have played a significant role globally in improving access of under-served populations to healthcare, including the homeless. In India, while there exist small-scale initiatives such as night shelters and recovery shelters run by the urban local government in coordination with CSOs to support homeless people, evidence on how these services function and are experienced is lacking. This analysis sought to describe…
Bargaining with patriarchy through the life course
Women leaders in Kerala have faced shared challenges through their life-course to climb up the ranks of leadership; each leader has adopted unique ways of overcoming them and developed similarly unique leadership styles. At each life stage there were bargains with patriarchy - involving family members (often as allies), against formal and informal institutional rules, managers, peers and subordinates., which in turn suggests a feminist consciousn…
Health Inequality Monitoring channel on OpenWHO
WHO eLearning courses on health inequality monitoring are addressing the need for capacity strengthening in the collection, analysis and reporting of inequality data. They introduce learners to the foundational concepts, best practices, tools and skills required to conduct health inequality monitoring. The courses on the Health Inequality Monitoring channel demonstrate how technical information can be simplified and presented to broad audiences i…
Decomposing socioeconomic inequality in blood pressure and blood glucose testing
While the magnitude of socioeconomic inequality in NCD risk factor testing did not appear to be very high in four Kerala districts, although levels were statistically significant in three of them. Greater exploration is needed on how education and caste contribute to these inequalities and their relationship to NCD risk factors such as family history. From such analyses, we may be able to identify entry points to mitigate inequalities in testing …
Sex work-related stigma
HIV-related stigma and NGO-isation in India
In response to World Bank critiques in 2007, the Indian Ministry of Health and Family Welfare declared that human immunodeficiency virus (HIV)-related stigma was a barrier to the participation of non-governmental organisations (NGOs) in the implementation of HIV prevention targeted interventions. Taking a deeper view of HIV-related stigma as a historically inflected process of devaluation, this article details the history and transformation of NG…
Understanding the Experiences of Health Care-Seeking Migrants in Delhi
Many studies have reported on issues of accessibility and quality of health care among the different vulnerable subgroups in urban locations. To date, no study has been done on the challenges faced by health care-seeking migrants (those traveling to cities for health reasons). This qualitative study used in-depth interviews and nonparticipant observation to examine the health problems, health care-seeking trajectories, and challenges faced by hea…
Getting the water-carrier to light the lamps
The government of India has, over the past decade, implemented the "integration" of traditional, complementary and alternative medical (TCAM) practitioners, specifically practitioners of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-rigpa, and Homoeopathy (collectively known by the acronym AYUSH), in government health services. A range of operational and ethical challenges has manifested during this process of large health system reform. We…
India's “tryst” with universal health coverage
Performance incentives for global health
Performance incentives for global health: Potential and pitfalls, by Rena Eichler, Ruth Levine, and the Performance-Based Incentives Working Group, Washington, DC, Centre for Global Development, 20
Duty and destiny
Nongovernmental organizations (NGOs) are increasingly providing critical health-related services to hard-to-reach populations. In India, stigma has been cited as a barrier to NGO participation in HIV-prevention activities with high-risk populations. Our study undertook to characterize and contextualize HIV-related stigma within HIV NGOs in Delhi, India. We investigated psychometric characteristics and correlates of HIV-related stigma in a sample …
Tabula diptycha
Stigma reduction efforts in Vietnam have been encumbered by contradictory and dynamic views of people living with HIV and the epidemic over the past two decades. World AIDS Day 2010 saw the launch of Pain and Hope, a museum exhibition showcasing the lives and experiences of Vietnamese people living with AIDS at the Vietnam Museum of Ethnology (VME). Between December 2010 and May 2011, a random sample of visitors completed exit surveys regarding t…
HIV-related stigma and NGO-isation in India
In response to World Bank critiques in 2007, the Indian Ministry of Health and Family Welfare declared that human immunodeficiency virus (HIV)-related stigma was a barrier to the participation of non-governmental organisations (NGOs) in the implementation of HIV prevention targeted interventions. Taking a deeper view of HIV-related stigma as a historically inflected process of devaluation, this article details the history and transformation of NG…
India's “tryst” with universal health coverage
Analysing implementer narratives on addressing health inequity through convergent action on the social determinants of health in India
This exercise demonstrated the possibility of constructive engagement between implementers and researchers to understand and theorize action on health equity and the social determinants of health. This heuristic developed may be of use not just for further research, but also for on-going appraisal and design of policy and praxis, both sensitive to and reflective of Indian concerns and understandings
Cultural consonance, constructions of science and co-existence
This review examined the determinants, patterns and imports of official recognition, and incorporation of different traditional, complementary and alternative systems of medicine (TCAM) in the public health establishment of low- and middle-income countries, with a particular focus on India. Public health systems in most countries have tended to establish health facilities centred on allopathy, and then to recognize or derecognize different TCAM b…
Fair publication of qualitative research in health systems
10.1186/s12939-016-0368-y
Getting the water-carrier to light the lamps
The government of India has, over the past decade, implemented the "integration" of traditional, complementary and alternative medical (TCAM) practitioners, specifically practitioners of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-rigpa, and Homoeopathy (collectively known by the acronym AYUSH), in government health services. A range of operational and ethical challenges has manifested during this process of large health system reform. We…
Countdown to 2030
Data source mapping
The task of health inequality monitoring is not possible without the availability of appropriate and high-quality data at various levels. Data source mapping - a process by which data sources are systematically enlisted, their properties detailed and each source appraised for the purposes of monitoring - is an essential initial step for health inequality monitoring. We outline a simple process along with a template for data source mapping and its…
Health Equity Assessment Toolkit Plus (Heat Plus)
As a key step in advancing the sustainable development goals, the World Health Organisation (WHO) has placed emphasis on building capacity for measuring and monitoring health inequalities. A number of resources have been developed, including the Health Equity Assessment Toolkit (HEAT), a software application that facilitates the assessment of within-country health inequalities. Following user demand, an Upload Database Edition of HEAT, HEAT Plus,…
Capacity building for health inequality monitoring in Indonesia
BACKGROUND: Inequalities in health represent a major problem in many countries, including Indonesia. Addressing health inequality is a central component of the Sustainable Development Goals and a priority of the World Health Organization (WHO). WHO provides technical support for health inequality monitoring among its member states. Following a capacity-building workshop in the WHO South-East Asia Region in 2014, Indonesia expressed interest in in…
Subnational regional inequality in the public health development index in Indonesia
BACKGROUND: Achieving the Sustainable Development Goal of 'ensuring healthy lives and promoting well-being for all at all ages' necessitates regular monitoring of inequality in the availability of health-related infrastructure and access to services, and in health risks and outcomes. OBJECTIVES: To quantify subnational regional inequality in Indonesia using a composite index of public health infrastructure, services, behavioural risk factors and …
Monitoring health inequality in Indonesia
On the unraveling of ‘revitalization of local health traditions’ in India
Were we not enabled by ethnography as a method that changes its shape apace with emerging findings, we would have not been able to comprehensively answer our questions. This is critical because not only was this already a marginalized area of inquiry, but with any other method we risked reinforcing inequities by imposing epistemological and other hierarchies on our participants- whom we would argue were partners - in arriving at our conclusions
A light inside a pot’
Medicine and healing have been critical elements of nation-building and governance in India. There is a clear hierarchy: biomedicine, followed by systems like Ayurveda which are to be 'mainstreamed,' and local health traditions, which are to be 'revitalised'. Mindful that power nonetheless resides in positions of marginality, this analysis drew from a health system ethnography on revitalisation of local health traditions in three southern Indian …
Sex work-related stigma
Community health workers for pandemic response
INTRODUCTION: Coronavirus disease (COVID-19), affects 213 countries or territories globally. We received a request from National Health Systems Resource Centre, a public agency in India, to conduct rapid evidence synthesis (RES) on community health workers (CHWs) for COVID-19 prevention and control in 3 days. METHODS: We searched PubMed, websites of ministries (n=3), public agencies (n=6), multilateral institutions (n=3), COVID-19 resource aggreg…
Opportunities for gender transformative approaches in a community-based drowning reduction program in Bangladesh
The Anchal program both adapted to and shaped community gender norms and roles. The program has well-established relationships in the community and can be leveraged to implement gender transformative activities to improve gender-based equity. Health programs can broaden their impacts and target social determinants of health like gender equity to increase program sustainability and promote equitable health outcomes
Who will stand up for us?” the social determinants of health of women tea plantation workers in India
Years of subjugation of workers have led to their deep distrust in the system of which they are part. Acting on SDH will take time, deeper understanding of their relative and/or synergistic contribution, and require the building of stakeholdership. Notwithstanding this, to have heard from women workers themselves has been an important step in visibilizing and building accountability for action on the health and SDH of women in plantation estates
Understanding the Experiences of Health Care-Seeking Migrants in Delhi
Many studies have reported on issues of accessibility and quality of health care among the different vulnerable subgroups in urban locations. To date, no study has been done on the challenges faced by health care-seeking migrants (those traveling to cities for health reasons). This qualitative study used in-depth interviews and nonparticipant observation to examine the health problems, health care-seeking trajectories, and challenges faced by hea…
Telephony and trade-offs in fieldwork with the ‘unreached’
When COVID-19 hit India, a qualitative research study had been underway the southern state of Kerala, to understand the perspectives of the front-line health workers and the Kattunayakan tribal community towards health service utilisation. This community is relatively underserved, and a great deal of our emphasis was on understanding health system barriers experienced on both demand and supply side. COVID-19 showed us that these barriers pertain …
When technology precedes regulation
The recent growth of medicine sales online represents a major disruption to pharmacy markets, with COVID-19 encouraging this trend further. While e-pharmacy businesses were initially the preserve of high-income countries, in the past decade they have been growing rapidly in low-income and middle-income countries (LMICs). Public health concerns associated with e-pharmacy include the sale of prescription-only medicines without a prescription and th…
A rapid review of evidence on the determinants of and strategies for Covid-19 vaccine acceptance in low- and middle-income countries
BACKGROUND: Vaccine acceptance and hesitancy among the general population and health care workers play an important role in successfully controlling the Coronavirus Disease (COVID)-19 pandemic. While there is evidence for vaccine hesitancy across the globe, wide variation in factors influencing vaccine acceptance has been reported, mainly from High-Income Countries (HIC). However, the evidence from Low- and Middle-Income Countries (LMICs) remains…
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