2022 Fellows

Hamied Fellows: Columbia University Mailman School of Public Health Fellows

Lauren Houghton, PhD, Msc
Assistant Professor
Department of Epidemiology

Understanding the vitality of ‘menstruation as a vital sign’ in Mumbai

Menstruation in India is highly stigmatized and is often perceived as a disease. However, there is growing interest in the de-stigmatization of menstruation in India. The framing of menstruation as a vital sign — that is a clinical marker to be considered when assessing health — may be an additional lever to aid in the de-stigmatization process. The purpose of this proposal is to do engage with Mumbai-based stakeholders to understand if “menstruation as a vital sign” should be a public health agenda to pursue across multiple levels.

Dr. Houghton takes a life course approach to understanding the intersection of cultural and hormonal factors in breast cancer carcinogenesis. She is interested in how culture gets beneath the skin, specifically in relation to women's reproductive lives from puberty to menstruation to child rearing. She has extensively worked with migrant studies in Bangladesh, the UK and Mongolia to better understand hormonal risk factors among females moving from low to high risk geographic areas. She has also conducted fieldwork with Native Americans in the southwest US, menopausal women in the UK and school girls in Bangladesh, and mothers in New York City. She is the Director of the Menstrual Health and Gender Justice Working Group at Columbia University and currently extending her work on menstruation from cisgender to transgender populations.

Kathrin Schilling, PhD
Assistant Professor
Department of Environmental Health Sciences & METALab Core Facility

Health Risk from Metal Exposure: Building the Analytical Foundation for Prospective Cohort Studies in India

Given the unprecedentedly fast-paced environmental changes due to the current climate crisis, risks for adverse health effects are rising. The World Health Organization (WHO) estimates that globally 25% of total disease burden is associated with environmental factors such as toxic metal exposure. Even if metals are ubiquitous and we are exposed to these toxic metals at low dose every day, exposure assessment and disease risk are still insufficient. Metals can increase our risk for dementia, infertility, diabetes and cancer. They are also known to cause damage to the liver, kidneys and brain, as well as the cardiovascular, nervous and endocrine systems and impact maternal health and fetal development. Exposure to toxic metals above safety standards is most critical in India, as risk for these diseases can have substantial social and economic impacts. This project's aim is to help accelerate research and innovation in the field of metal biomonitoring and environmental metal exposure studies in India.

Dr. Schilling is a geochemist and expert in metal analysis. She has been at the forefront of developing stable metal isotopes as biomarkers to answer a wide array of research questions, relevant for the diagnosis, prevention, and control of diseases and nutrient status. Her interdisciplinary approach brings techniques commonly used in Earth Sciences into solving new problems in Biomedical Sciences. For instance, she explores how these isotopic biomarkers can fulfill a much-needed role of tracing environmental sources of exposure to carcinogenic metals as well as help detect minute changes of metabolic processes in humans caused by disease development and progression.

Hameid Fellows: India

Soumitra Ghosh, PhD
Associate Professor, School of Health Systems Studies, Centre of Health Policy, Planning and Management
TATA Institute of Social Sciences (TISS)

Inequities in Access to Essential Medicines: Assessing the Impacts of Pharmaceutical Policy Interventions in India

Dr. Ghosh's project aims to better understand the impacts of policy measures to make medicines more affordable, especially for the socioeconomically disadvantaged. Lack of access to essential medicines in general and equitable access to essential medicines in particular is a major health policy concern in India. According to an estimate, a whopping 469 million Indians do not have regular access to essential medicines and medicines account for about 70 percent of household’s total out-of-pocket health payments. Studies show significant socioeconomic disparities in seeking medical care especially for chronic conditions such as hypertension, diabetes and heart disease. One-fifth of the tribal people diagnosed with major illnesses remained untreated in 2004. In an attempt to address issues of access to essential medicine, India has implemented a number of pharmaceutical policy interventions to control drug prices such as National Health Mission (NHM) and Drug Price Control Order (DPCO), as well as a governmental launch of a generic medicine scheme opening Jan Ausadhi Kendras (JAS) or ‘People’s Medicine Stores’ across the country. Despite the policy significance of the above measures, very little is known about their impacts in terms of making medicines affordable and accessible to the people and especially the socioeconomically disadvantaged.

Dr. Ghosh's research is mainly within the broad area of health, poverty, and labour covering topics such as under-nutrition, living conditions of tea garden workers, social determinants of diseases, health and nutritional status of tribal populations, inequality in health and health care, burden of out-of-pocket payments for health care, medical impoverishment, impact evaluation of health insurance programs, economic costs of NCDs, universal health care, social exclusion, and new health financing arrangements and access to medicine. His research has been published in leading national and international journals such as BMC Health Services Research, PLOS One, PLoS Medicine, and the British Medical Journal.

Daksha Parmar, PhD
Assistant Professor, Development Studies, Department of Humanities and Social Sciences; Associate Faculty, Jyoti and Bhupat Mehta School of Health Sciences and Technology              
Indian Institute of Technology (IIT) Guwahati

Strengthening Health Systems to Deliver Equitable Healthcare for Women and Children in Assam

Dr. Parmar's project is to gain understanding of the successful interventions, case studies, research papers and toolkits developed by the Columbia Mailman program “Averting Maternal Death and Disability (AMDD)” led by Lynn Freedman. Her ultimate goal is to achieve an understanding of the various dimensions of respectful maternity care, human rights in health and health systems accountability; and to think critically about what implementation might look like in the context of Assam to improve the responsiveness and performance of the health systems in order to address the critical health challenges that vulnerable communities face in accessing health services.

Dr. Parmar's research interests include Public Health and Development, Social Science Issues in Health, Gender and Health, Human Resources for Health in India, and the Interface of Frontline Healthcare Providers with Health Systems. Recently, her work has focused on the role of frontline workers in Assam during the Covid-19 pandemic.