Brief details of Public Health Experience

2010:

  • Appointed as the only external member in “Karnataka State Committee for creation of Public Health Department”.
  • Conducting doctoral level research on “Prevalence of Job stress, General Health Profile and Hypertension among Professionals in Information Technology sector, Bengaluru, India”.
  • Working as faculty at Indian Institute of Public Health- Hyderabad.

 2008-2009:

  • Special Academic Reader during the quarters Fall 2008 and winter 2009 for teaching Graduade level courses in Epidemiology (200A and 200B) with Dr.Jorn Olsen and Beate Ritz: Core courses for Graduate students in department of Epidemiology.
  • Special Academic Reader during Spring 2009 for teaching Epidemiology 227: AIDS, A major Public Health Challenge, Instructor: Dr.Roger Detels, MD, MS.
  • As Special Academic reader, duties included conduct of discussion sections for graduate students in Epidemiology, office hours, and participation in composition, grading of exercises and examinations. Nominated for the “Best TA of School of Public Health”, have won certificate of recognization from PHSA.

 2006-2008:

  • Teaching Assistant: International Fogarty Programme for HIV-AIDS, under Dr.Roger Detels, MD, MS, Principal investigator for the course “Rapid Surveys in Developing countries”
  • Research Associate, Multicenter AIDS Cohort Study (MACS), UCLA AIDS Institute with Dr.Roger Detels, MD, MS, Principal investigator.
  • Conducted a research evaluation of Immunization programme in Bellary, Karnataka under guidance of Dr.Jorn Olsen, Chair, Epidemiology, UCLA. Status: Under revision for Publishing.
  • 2001-2006: State Surveillance Medical Officer and Regional Coordinator, 2001– 2006: World Health Organization, National Polio Surveillance Project-India.
  • State level coordination of Polio and Measles activities on behalf of World Health Organization
  • Network building and Partnership Coordination involving Chief Secretary, Secretary, Health & Family Welfare, Commissioner, Director of Health, Project Director (RCH), UNICEF, and Rotary international and other key organizations.
  • Responsible for Initiation and Advocacy for the Measles surveillance in the state of Karnataka that provided impetus for Multi Year Strategic Plan for Measles control in India and for the constitution and sustained performance of State Core Group on routine Immunization for Karnataka.
  • Demonstrated strong skills in advocacy, Perseverance and technical guidance as per the programmatic requirements.
  • Selected to lead Measles Surveillance at National level for India in WHO.
  • Selected by the country headquarters to be in charge (Additional responsibility) Regional Coordinator that included financial responsibility of NPSP- WHO units in Southern India.
  • Has been deployed as special coordinator of Polio immunization activities in the high risk states of Uttar Pradesh, Bihar, Gujarath and Andhra Pradesh over 24 months.
  • As Chief Consultant for Research, Victoria Foundation, Bangalore, conducted studies on Immunization programs, Maternal & Child Health programs. Key project: Evaluation of Maternal and Neonatal Tetanus elimination in Karnataka for WHO-PATH, GoI.
  • Training State level officers, NGOs, District health officers, RCH officers and Medical officers on Polio-eradication activities, Routine Immunization and other Vaccine preventable diseases. Responsible for Induction training to Consultants, Immunization selected by UNICEF in the state of Karnataka.
  • Academic teaching to Medical postgraduates in Medical colleges of Bangalore on Immunization, RCH, Surveillance for Vaccine Preventable diseases.

2000-2001:

  •  Junior resident, All India Institute of Medical Sciences, New Delhi. Positions Held: Junior Resident, Center for Community Medicine, Blood Bank
  • Conducted Knowledge, Attitude & Practices survey regarding blood donation awareness, National Health Programmes at All India Institute of Medical Sciences, New Delhi
  • Planned and conducted free health blood donation campaigns in the slums of New Delhi.
  • Carried hospital and field based surveillance to detect the prevalence rate of HIV in the STD patients.
  • Was managing and analyzing all the data related to the blood donors and especially of HIV patients. 

1998-1999:

  • Pre-Registration House officer, Kasturba Hospital, Manipal, India.
  • Conducted a study on Prevalence of Contraceptives in Udupi district with Dr.Shalini, Professor, Department of Community Medicine, KMC, Manipal.

Research

Statement of Research Interests 

In Asia, there is an imperative need to implement the practice of evidence-based public health policy, planning, and spending. My earlier and ongoing research provides the appropriate evidence, which can guide the formulation of policy to bring in positive change that we can see in our lifetime. I am focused shaping my career towards independence and in building a long-term career in academic public health. Therefore, my future research plan is dedicated to exploring the impact of tackling determinants in the maternal and psychosocial environment and thereby promote positive health in populations through appropriate interventions.

The focus of my research is through the realization of the following objectives.

  1. Generating evidence regarding maternal and psychosocial environment of NCDs
  2. Explore the appropriate interventions through pilot projects
  3. Ensuring evidence-based public health policy planning and implementation

Objectives (a) and (b) help in identification and prioritization of maternal determinants of childhood obesity (and subsequent risk of diabetes and hypertension) in Asia.  The evidence available in the next three years will aid in the generation of rigorous, feasible and contextually specific population-based pilot interventions. The objective (c) will be achieved through the implementation of pilot interventions based on objectives (a) & (b). The three objectives together will contribute to logical and empirically grounded choices of public health interventions.

In the next few years, I want to pilot the interventions based on the results of the research on the role of the maternal and psychosocial environment of NCDs in different populations. The overall results from testing the interventions will result in the implementation of evidence-based public health. In the next 5 years, I wish to inculcate the evidence into policy formulations at the national and international level to influence policymakers to bring positive changes with respect to NCD prevention and control. Due to demographic transition and lifestyle changes, the aging Asian populations continually are affected by NCDs. My engagement of research and advocacy in NCDs will aid in improving the health of an aging population and improve productivity. I am uniquely positioned to study the effects from an intergenerational perspective and earnestly believe that the positive changes will see the transformation of societies in the next two decades. Therefore, my long-term goal is to ensure healthy populations are sustained through integrated technical and advocacy efforts. My track record of working in public health over 17 years has provided a clear resolve for the achieving the objectives listed above.

Details of Earlier Research

[2009-2012, University of California Los Angeles]

Summary: Hypertension is a major contributor to the worldwide epidemic of cardiovascular disease (CVD).[1,2] It is estimated that hypertension causes 7.5 million deaths worldwide amounting to 12.8% of the total of all annual deaths.[3] Many risk factors leading to hypertension are modifiable and therefore provide an opportunity for preventive efforts.[4] There is an imperative need for population-based research to understand the modifiable factors such as job stress in leading to Hypertension.[4] I chose workplace settings for the research as they provide opportunities to explore determinants of these negative behaviors and are amenable to interventions.[1]

I led a moderately large study (N = 1071) in the software professionals in Bangalore, India employed at 27 different IT companies. The focus of our study was to study the association of Job stress and Hypertension as well as understanding the on the age gradient of hypertension prevalence. The research established a higher prevalence of hypertension in the younger age cohort, affecting 31% professionals with 5% having malignant levels of hypertension. It was known earlier that south Asians are predisposed to be hypertensive a decade earlier compared the developed countries.[6] Our research suggested that hypertension in IT/ITES professionals occurs a decade earlier compared to the rest of India and two decades earlier compared to developed countries.[7] This suggests that if untreated, these professionals would go on to develop cardiovascular diseases (CVD) at an early age. The results also indicated that 46% of professionals were in pre-hypertension. In addition, I found that the dimensions of workplace autonomy and workplace environment are associated with hypertension.

Accomplishments

  1. The earlier understanding was that the association between job strain and coronary heart disease (CHD) is weak, with job strain slightly increasing the risk of coronary diseases by 3.4% in the general population.[9] Our meta-analysis showed statistically significant associations with 30% higher risk of hypertension for those with job strain. This proves that job strain might be affecting the CHDs through hypertension. The paper on the meta-analysis of job stress and hypertension, therefore, is a significant contribution to the body of literature and would influence future research delineating the effects of stress on CHDs. As a testimony to the impact of the paper, the original paper by us was republished by the BMJ group in their postgraduate medical journal.
  2. It is important that individuals with higher stress have to change their lifestyle to prevent a progressive rise in BP using the recommended lifestyle modifications. [8] As a result of the findings from the study, the software companies have approached us and have requested to engage with them for improving health outcomes. I am in discussion with a major IT company to finalize the details of engagement towards improving the health of the employees.
  3. I have published extensively on this work. The Publications from this project are as follows.
    1. Babu, Giridhara R., et al. “Republished: Is hypertension associated with job strain? A meta-analysis of observational studies.” Postgraduate Medical Journal 90.1065 (2014): 402-409.
    2. Giridhara R Babu, T. Mahapatra, and R. Detels. “Job stress and hypertension in younger software professionals in India.” Indian Journal of Occupational and Environmental Medicine 17.3 (2013): 101.
    3. Babu GR, Jotheeswaran A, Mahapatra T, Mahapatra S, Kumar A SR, Detels R, Pearce N. Is hypertension associated with job strain? A meta-analysis of observational studies. Occup Environ Med. 2014 Mar; 71(3):220-7. doi: 10.1136/oemed-2013-101396. Epub 2013 Sep 24.
    4. Babu GR, Mahapatra T, Mahapatra S, Detels R. Sexual behavior and job stress in software professionals, Bengaluru – India. Indian J Occup Environ Med. 2013 May; 17(2):58-65. doi: 10.4103/0019-5278.123165.
    5. Babu GR, Mahapatra T, Detels R. Application of mixed methods for exploration of the association of job stress and hypertension among software professionals in Bengaluru, India. Indian J Occup Environ Med. 2013 May; 17(2):41-7. doi: 10.4103/0019-5278.123160.
    6. Babu GR. Prevalence of Job Stress, General Health Profile, and Hypertension Among Professionals in the Information Technology Sector in Bengaluru, India. Los Angeles: University of California, Los Angeles; 2012.
    7. Babu GR, Detels R. Prioritizing Social Actions And Involving Community For Prevention Of The Non-Communicable Diseases. The Internet Journal of Epidemiology. 2011;9(2).
    8. Giridhara R Babu, Sathyanarayana T N, Snehendu B Kar, Roger Detels. Perceived occupational stressors and the health of Software Professionals in Bengaluru, India. The Qualitative Report.
  4. Subsequent to the study in software professionals, we have now conducted the study in schoolteachers and employees of the health department. These studies are helping us to collate evidence on the worksite-based burden of NCDs and are helpful in designing the appropriate interventions. A series of papers are pending for publications on the burden of the diseases in different workgroups.
    1. Parimala, Giridhara R Babu, The Burden of Diabetes And Hypertension in the staff working in Directorate Of Health And Family Welfare Services, Bengaluru, Karnataka. [In press]
    2. Manjula, Sarin S, Giridhara R Babu. Prevalence of Diabetes Mellitus in School teachers of Bengaluru. [In press]
    3. Sudha BK, Sarin S, Giridhara R Babu Prevalence of Hypertension in School teachers of Bengaluru. [In press]

References for Details of Earlier Research:

  1. Giridhara R Babu, Mahapatra, and R. Detels. “Job stress and hypertension in younger software professionals in India.” Indian Journal of Occupational and Environmental Medicine 17.3 (2013): 101.
  2. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005;365:217–23.
  3. World Health Organization. Global Health Risks: mortality and Burden of Disease Attributable to Selected Major Risks. Geneva: World Health Organization, 2010; 2009.
  4. Srinath RK. Protecting the heart of global development. Heart Beat, The World Heart Federation Newsletter. 2005. Jun, [Last accessed on 2014 Jan 10].
  5. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part II: Variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation. 2001;104:2855–64.
  6. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349:1436–42.
  7. Reddy KS. India wakes up to the threat of cardiovascular diseases. J Am Coll Cardiol. 2007;50:1370–2.
  8. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–52.
  9. Kivimäkii M, Nyberg ST, Batty GD, et al. Job strain as a risk factor for coronary 
heart disease: a collaborative meta-analysis of individual participant data. Lancet 
2012;380:1491–7.

The research publications are listed in this link: Publications

Advocacy is provided in this link: Links

Professional Memberships

 

Education

  • Ph.D. (Epidemiology), University of California (UCLA), Los Angeles.
  • MPH: Masters in Public Health (Epidemiology), University of California (UCLA).
  • MBA: (Hospital and health Administration), IBMR, TASMAC, Pune.
  • PGMLE: Post Graduate Diploma in Medical Law & Ethics, National Law School of India University, Bangalore
  • MBBS: Bachelor of Medicine and Bachelor of Surgery, Kasturba Medical College, Manipal

Recent Papers and News

Visiting private clinic for immunisation?: Deccan Herald

Hypertension and high BP afflicts one-third of techies: Bangalore Mirror

Software professionals more prone to hypertension: study: The Hindu

Recent Papers :-

Assessment of screening practices for gestational hyperglycaemia in public health facilities: a descriptive study in Bangalore, India

Background. Screening and timely treatment of gestational hyperglycaemia (GH) is proved to be beneficial and improves maternal and foetal health outcomes. To understand screening practices, we explored the knowledge and perceptions of doctors working in public health facilities in Bangalore, India. We also studied participation factors by examining whether undergoing glucose estimation tests affects morning sickness in pregnant women.

Design and Methods. We aimed to understand the screening practices and knowledge of doctors. A semi-structured questionnaire was self-administered by the 50 participant doctors, selected from the sampling frame comprising of all the doctors working in public health facilities. We included 105 pregnant women for baseline assessment, in whom a well-structured questionnaire was used.

Results. We reported that gestational diabetes mellitus (GDM) screening was done in nearly all the health centres (96%). However, only 12% of the doctors could provide all components of GDM diagnosis and management correctly and 46% would diagnose by using a random blood glucose test. A majority (92%) of the doctors had poor knowledge (68%) about the cut-off values of glucose tests. More than 80% of pregnant women experienced some discomfort mostly due to rapid ingestion glucose in short span of time.

Conclusions. Our study established that screening for GH is done in most public health facilities. Nonetheless, knowledge of doctors on the glucose tests and their interpretation needs improvement. Re-orientation trainings of the doctors can improve their knowledge and thereby can efficiently screen for GH. Further, adequate planning prior to the tests can aid successful completion of them.

The Epidemic of HIV, Syphilis, Chlamydia and Gonorrhea and the Correlates of Sexual Transmitted Infections among Men Who Have Sex with Men in Jiangsu, China, 2009

Background

In China, the HIV/AIDS epidemic is expanding among men who have sex with men (MSM). As independent risk factors of HIV infection, the epidemics of Chlamydia (CT) and Gonorrhea (NG) in MSM were not well studied, particular for the risk factors of these infectious. The objectives of current reported study were to understand the dynamics of HIV and other sexual transmitted infections (STIs) among MSM in Jiangsu, China, and to measure factors that correlated with STIs.

Methods

In order to gain more participants, a multisite cross-sectional study design was used in our study, by using convenience-sampling to recruit MSM in two Changzhou and Yangzhou, Jiangsu, China, between the July and October of 2009.

Results

In this comprehensive survey involving MSM in two cities of Jiangsu province of China, the prevalence of STIs of CT (6.54%), NG (3.63%), syphilis (20.34%) and HIV (11.62%) were measured. Overall, the STIs prevalence (CT, NG or syphilis) for the participants in our study was 26.39%, meanwhile, 3.4% (14 out of the 413) participants had at least two kinds of STIs. Meeting casual partners at parks, public restrooms or other public areas, having had anal sex with men in the past six months, having had STI symptoms in the past year were positively correlated with STIs positive, with adjusted ORs of 4.61(95%CI 1.03–20.75), 1.91(95%CI 1.14–3.21) and 2.36(95%CI 1.07,5.24).

Conclusion

Our study findings reiterate the fact that Chinese MSM are highly susceptible to acquiring syphilis, CT, NG and HIV, and there is an urgent need for intervention targeted towards this population. Behavioral measures should constitute an important part of the targeted intervention. Furthermore, the already implemented preventive and diagnostic services for HIV should be expanded to include syphilis CT and NG, too.

An appraisal of the tuberculosis programme in India using an ethics framework

This is a review of the manner in which the Revised National Tuberculosis Control Programme (RNTCP) is being implemented, with a focus on the attention being paid to ethical principles and the incorporation of these into the programme. The article elucidates how ethical principles can be applied to protect the rights of the potential beneficiaries of the RNTCP. The authors consider the RNTCP in the light of a framework that is usually applied in research to evaluate ethical principles in public health practice. The three key principles of the framework are: respect for persons, beneficence and justice. The authors propose that this framework be used to make an ethical evaluation of other public health programmes at several levels, since this could bring far- reaching benefits to society .

Consistently High Unprotected Anal Intercourse (UAI) and factors correlated with UAI among men who have sex with men: implication of a serial cross-sectional study in Guangzhou, China

Is hypertension associated with job strain? A meta-analysis of observational studies

Epidemiological Correlates of Breast Cancer in South India

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Quotes in Bangalore mirror

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Building a healthy Karnataka

Health risks prompt ban on sale of three generic prescription drugs

Don’t let pressure get to you

Trash menace haunts low-income areas