Profile

	Dr. A. K. Aggarwal
	Designation : Professor & Head
	Department : Community Medicine and School of Public Health
	aggarwal.arunkumar@pgimer.edu.in

:: Contact Details

Phone No.

7087008218

Ext No.

5218

:: Educational Qualification

Graduation

M.B.B.S

Post Graduation

MD (PSM)

Other Qualification.(1)

DNB (HHA)

:: Area of Interest

Area Of Interest

1. Reproductive Health
2. Child Health
3. Quality of care
4. Micronutrient deficiency diseases
5. Operational research

:: Research & Projects

Extramural Projects

Ongoing Projects

Monitoring Implementation of Infant Death reviews/ Still Birth Reviews/ Maternal Death Reviews/ Pneumonia, Diarrhoea, Anaemia, Malnutrition control progorame in 10 districts of Haryana.( NHM Haryana)
Monitoring Implementation of ICDS programme in Chandigah ( NIPPCCID New Delhi)
Facilitation of Data usage in Haryana ( NHM Haryana)

Proposals Under Consideration

Effectiveness of clinic based targetted interventions over other strategies to promote husbands involvement in planning for delivery and complications in a district in Haryana.( NHM Haryana and WHO Geneva)

Research Highlights

Focus of my research work has been on issues pertaining to reproductive and child health, operational research on implementation of the national programmes, health systems research for quality of care measurement and improvement, community participation through women empowerment for health service improvement, development of verbal autopsy tools to ascertain causes of deaths for maternal and neonatal deaths, validation of verbal autopsy tools for neonatal deaths and still births, mapping iodine deficiency disorders and creating awareness about use of iodised salt, promotion of iron rich diet and use of iron and folic acid tablets during antenatal period.

Development and use of tools

Tools to measure quality of various contraceptive method use were developed and applied during endline evaluation of the UNFPA funded area health and family welfare programme in Himachal Pradesh and then subsequently were used in Sirmour district for quality measurement and improvement through health system in operations research mode with full involvement of the district health and administrative authorities.

Modules for organising comprehensive reproductive and child health camps were developed. District health system used these modules and formats and it helped to establish a system to improve the quality of care. Our efforts were also useful to streamline the ambulance use in district Sirmour.

Verbal autopsy tools were developed and used to assess extent and causes of maternal mortality in Haryana, after their successful use in Himachal Pradesh. These studies are important benchmark studies that would be useful to assess the extent of change in future.

Syndromic protocols for diagnosis and management of reproductive tract infections as developed by NACO and GOI were modified and used to assess the suitability, identify operational problems, and test their usefulness in improving the case management at peripheral health service units. We have further modified the treatment algorithms based upon our experience. We were able to implement these protocols in our clinics and it helped to improve the case management practices.

Verbal autopsy tools and methods are increasingly used due to lack of good registration systems. However, for neonatal and stillbirths, valid tools were still not available. We have validated the WHO verbal autopsy tools for neonatal deaths and stillbirths. Validated tools would prove to be important and useful for all researchers and program managers in the field.

Municipal Solid Waste management is an important neglected area. Comprehensive methodology and tools for MSW assessment of a place were not available. We have developed tools to assess MSW management of place, using rigorous method of Delphi validation. We have tested these tools for assessments at Chandigarh and Hyderabad.

Biomedical waste management and safe injection practices are yet other challenges for health care institutions. We have devised tools, used these tools and derived important lessons for effectively managing the associated challenges and to produce positive results.

Quality of care assessments of health care institutions is an important challenge. We developed tools and used the tools to measure quality of care of medical and surgery OPDs in a tertiary care institute. The study could be a landmark study for similar institutes for introducing quality improvements.

Evaluation of New Training Strategy

Integrated Management of Neonatal and Childhood Illnesses (IMNCI) is a flagship strategy under NRHM to reduce childhood mortality. Major bottleneck is to train the entire workforce with standard 8 days training. We successfully demonstrated that same training package can be delivered in 5 days, with interrupted deliver of package: 3 days (Friday, Saturday and Sunday), and another 2 days in next week ( Friday and Saturday). It ensures minimal disruption of services in the health centers and also is convenient for participants as well as resource persons. This package if adopted by GOI and various states has huge potential of cost savings and fast delivery of contents.

Community Empowerment and Health Education Research

Women groups in Sirmour district were empowered to participate in the quality measurement, give feedback and participate in the quality improvement. Studies were done to find the extent of iodine deficiency disorders, and use of iodised salt in northern India. Laboratory to measure urinary iodine and do quantitative estimation of iodine in salt was set-up. Documentary film :Anokhi Cheeje was developed during Iodised salt promotion programme in RaipurRani block that led to improved salt use practices and empowerment of village Sarpanches to get their salts tested and sensitization of district health officials to improve their monitoring practices. Awareness campaign on reproductive tract infections and sexually transmitted diseases in a rural area of Haryana led to increase in knowledge on RTIs/STIs and clinic attendance.

Research output from other studies like psychosocial development assessment of children, hypothermia and LBW studies were fed into our community health care service programme to improve child health care practices

Production of Health Education Materials and Documentary Films:

Designed and developed pamphlets on _ Anaemia and involvement of husbands for antenatal care, and Reproductive tract infections.
Developed, directed and edited documentary film on iodine deficiency disorders: Anokhi Cheeje. Film aims to create awareness about importance of iodised salt particularly its link to low IQ levels in children. Film has been used for education in Haryana, Punjab and Uttar Pradesh,
Developed and edited film for training of medical officers on Rheumatic fever/ Rheumatic heart disease.

Specific Research Learnings

Reproductive health

In a community based survey done in 1997, prevalence was reproductive tract infections among rural married women was found to be very high. To tackle this problem, a study was done to findout agreement of symptoms enquiry with clinical diagnosis. Existing syndromic protocols were revised based upon this experience. These protocols can now be used in our country setting where prevalence of these infections is high, and facilities for examination and laboratory are very limited. Another experience in the study done in year 1997 was that people donot avail health care services even if free camps are organized in their own villages. Nation wide huge sum of money is invested in organizing similar types of camps. Therefore, another study was planned to find out which strategy is better for improving the health care utilization. It was learnt that mix of approaches, that is village based health services coupled with one to one health education and counseling is a better way of providing services. Lessons about delivering health education messages to men and women were also learnt. This information can be useful to better utilize budget allocated for such activities in our country. In yet another study (PhD Thesis) a reproductive education package was developed and delivered through alternate strategies. We learnt that peer education approach was cost economic and equally effective approach compared to traditional didactic lecture method approach.

Child Health

Research was done to understand the factors associated with neonatal mortality in a hilly north Indian state, to gauze the level of competence of health care workers for assessing the severity of illness among young infants. Govt. of India has initiated Integreted Management of Neonatal and Childhood Illnesses to tackle such a high load of childhood mortality. We have initiated further research based upon our experiences how best to implement GOI programme on IMNCI.

Research was done to understand some operational aspects of Global programme for eradication of poliomyelitis. Health workers understanding of Vaccine vial monitors was reasonable, house to house strategy although very resource intensive did contribute to improve immunization coverage by few percent, coverage of PPI in Haryana was found to be high. Recommendation has been made to include Zinc in the treatment protocols of diarrhea and ARI management at health workers level.

No significant association of birth weight with blood pressure among children 7-8 years was found in a rural area. Twelve years experience of successful implementation of community based RF/RHD programme was documented. Studies on parasitic diseases revealed high prevalence of Toxocara eggs, anticysticercus antibodies and human toxocariasis in and around Chandigarh.

Training evaluations for traditional birth attendants and anganwari workers revealed that monthly continuing training sessions conducted in routine are effective in improving knowledge of these workers. Such models can be adopted country wide and would be cost effective.

Other studies on health system research have helped to understand the extent of drug abuse in rural area, morbidity profile in rural clinics, and possible association of early age at marriage with depression. Role internet in public health was also documented. These studies would be helpful to district program managers for planning their logistics and services.

Research In
Progress

As given before under extramural projects

Area Of
Specialization

1. Preventive and Social Medicine
2. Health and Hospital Administration

Future Plans

My interest is to undertake Implementation Research for Health Systems Strengthening with a focus on reproductive and child health. This would include research on issues of quality of care, death reviews, health financing, nutritional problems etc. Any collaborator interested in research on Iodine Deficiency Disorders, Anaemia, malnutrition, adolescent problems, addressing problems of high perinatal mortality, high maternal mortality, high childhood mortality and setting up of interventional / implementation research is welcome.

Member Of Professional
Bodies

1. Indian Association of Preventive and Social Medicine
2. Indian Association of Maternal and Child Health
3. Indian Public Health Association

:: Publications(In Vancouver Style)

SNO	Authors	Title	Journal
1	Aggarwal AK, Singh AJ.	Evaluation of cold chain system in rural areas of Haryana	Indian Pediatrics, 1995; vol.32: 31-34.
2	Kumar R, Iyengar S, Aggarwal AK, Gupta I, Kumar V.	Physical growth of rural preschool children in Haryana.	Indian J Maternal and Child Health, 1996; 7(1):16-19.
3	Kumar R, Aggarwal AK.	Accuracy of maternal perception of neonatal temperature.	Indian Pediatr, 1996; vol 33:583-585.
4	Aggarwal AK, Kumar R	Awareness of AIDS among school children in Haryana.	Indian Journal of Public Health, 1996; vol 40:38-45.
5	Kumar R, Aggarwal AK, Kaur M, Iyengar SD.	Factors influencing psychosocial development of preschool children in a rural area of Haryana, India.	Journal of Tropical Pediatrics, 1997; 43: 324-29.
6	Kumar R, Thakur JS, Aggarwal AK	Compliance of secondary prophylaxis for controlling Rheumatic fever and Rheumatic heart disease in a rural area of Northern India.	Indian Heart Journal,1997; May-June:283-288.
7	Kumar R, Kaur M, Aggarwal AK, Mahandiratta L.	Reproductive tract infections- and associated difficulties.	World Health Forum,1997; 18: 80-82
8	Kumar R, Aggarwal AK	Rapid survey for measuring the level and causes of maternal mortality.	Indian Journal of Community Medicine, 1997; 22(1):16-21.
9	Kumar R, Aggarwal AK.	Body temperature of home delivered newborns in North India.	Tropical doctor, 1998;28:134-136.
10	Gupta SS, Aggarwal AK, Singh MMC, Ranjan, Kaur A, and Kumar R	Vitamin A deficiency (VAD)- still a major problem among the underprivileged population.	Sight and life newsletter, 1998; 1: 23-25.
11	Aggarwal AK, Kumar R.	Low birth weight prevalance and antenatal care practices in a rural area of Haryana.	Indian Paediatrics, 1998;35:1031. (Letter to the Editor).
12	Aggarwal AK, Kumar R.	Medical audit of antenatal care and incidence of low birth weight in a rural area of Haryana.	Indian Journal of Maternal and Child Health, 1998; 9(3&4):68-71.
13	Kumar R, Aggarwal AK	Prevalence and risk factors of symptoms related to reproductive tract diseases among rural women of northern Haryana.	The Journal of Obstetrics and Gynaecology of India, 1998; 48:68-72
14	Ghosh D , Dhadwal D, Aggarwal AK, Mitra S, Garg SK, Kumar R etal.	Investigation of an epidemic of Reyes syndrome in northern region of India	Indian Pediatrics 1999, 36 :1097-1106.
15	Aggarwal AK, Kumar R, Gupta V, Sharma M.	Community based study of reproductive tract infections among ever married women of reproductive age in a rural area of Haryana, India	J.Communicable Diseases 1999, 31(4) 223-228.
16	Aggarwal AK, Kumar R	Long terms effects of ICDS on behaviour and academic performance of school children in rural Haryana	Indian Journal of Community Medicine, 2000;15(3):124-128.
17	Aggarwal AK, Prakash KP, Bandyopadhyay S, Joshi K, Kar M, Kumar R.	Morbidity pattern among primary school children in rural Haryana.	Bulletin Post Graduate Institute of Medical Education and Research, Chandigarh 2000, 34: 49-52.
18	Prasad VS, Aggarwal AK, Kumar R	Cyber Public Health.	Indian Journal of Community Medicine, 2000;15(4):191-194 &196
19	Raizada A, Prasad VS, Aggarwal AK and Kumar R	Morbidity profile in primary care clinics.	Bulletin Post Graduate Institute of Medical Education and Research, Chandigarh 2000; 34 : 131-134 .
20	Aggarwal AK, Kumar R.	Impact of health education on the knowledge of anganwari workers regarding rheumatic fever/ rheumatic heart disease.	Indian J. Prev. Soc. Med. 2000; 31; 9-14.
21	Kumar R, Thakur JS, Aggarwal AK	Effect of continuing training on knowledge and practices of traditional birth attendants about maternal and newborn care	Indian J of Public Health 2000; 44: 118-123
22	Prasad VS, Duggal M, Aggarwal AK, Kumar R.	Animal bite management practices: A survey of health care providers in a community development block of Haryana.	Journal of Communicable Diseases 2001; 33: 266-273.
23	Prasad VS, Duggal M, Aggarwal AK, Kumar R, Devidayal	Intensive pulse polio immunisation, workers and vaccine vial monitors.	National Medical Journal of India 2001: 59.
24	Kumar R, Aggarwal AK, Raizada A, Prasad VS.	Coverage of Pulse Polio Immunisation in the state of Haryana.	Indian Journal of Community Medicine 2001; 26 (1): 31-35.
25	Kumar R, Raizada A, Aggarwal AK, Ganguly NK.	Community based RF/RHD cohort: twelve years experience.	Indian Heart Journal 2002; 54: 54-58.
26	Malla N, Aggarwal AK, Mahajan RC	A serological study of human toxocariasis in North India.	National Medical Journal of India 2002; 15:145-147.
27	Aggarwal AK, Kumar R, Kumar P	Early neonatal mortality in a hilly North Indian state: socio-demographic factors and treatment seeking practices.	Indian Journal of Preventive and Social Medicine 2003; 34:46-52
28	Bandyopadhyay S, Kumar R, Singhi S, Aggarwal AK	Are primary health workers skilled enough to assess the severity of illness among young infants?	Indian Pediatrics 2003; 40: 713-718.
29	Kumar R, Bandyopadhyay S, Aggarwal AK, Khullar M	Relation between birth weight and blood pressure among 7-8 year old rural children in India.	International Journal of Epidemiology, 2004, 33; 87-91
30	Aggarwal AK, Duggal M	Knowledge of men and women about reproductive tract infections and AIDS in a rural area of north India: impact of community based intervention.	Journal of Health and Population Nutrition, 2004; 22: 413-419
31	Grover A, Singh A, Aggarwal AK and Thakur JS.	Does Indian version of shake test correctly identify frozen damage vaccine?	Bulletin PGIMER 2004; 38:125-130.
32	Aggarwal AK, Kumar R	Syndromic management of vaginal discharge and pelvic inflammatory disease among women in a rural community of Haryana, India: Agreement of symptoms enquiry with clinical diagnosis	Journal of Communicable diseases 2004; 36:1-11.
33	Harjeet, Sahni D, Jit I, Aggarwal AK.	Shape, measurements and weight of the thyroid gland in northwest Indians.	Surgical and Radiologic Anatomy 2004; 26: 91-95.
34	Khurana S, Aggarwal AK, Malla N.	Comparative analysis of intestinal parasitic infections in slum, rural and urban population in around Union Territory Chandigarh.	J Communicable Diseases 2005; 37 (3):239-43.
35	Aggarwal AK.	Zinc deficiency public health perspective. Editorial	Indian Journal of Community Medicine 2005; 30: 73-74.
36	Parvej S, Kumar R, Walia I, Aggarwal AK.	Reproductive health education intervention trial.	Indian Journal of Pediatrics 2005; 72: 13-17
37	Bala A, Aggarwal AK.	Family Health Study: Core of public health practice. Letter to Editor	Indian Journal of Community Medicine 2005; 30: 99.

38	Bala A, Bhatanagar GS, Goel RKD and Aggarwal AK.	Early age at marriage, childhood stressors and depression- clues from hospital based epidemiological study in and around Patiala, India.	Indian Journal of Preventive and Social Medicine 2005; 36: 26-33.
39	Khurana S, Aggarwal AK, Malla N.	Prevalence of anticysticercus antibodies in slum, rural and urban population in and around UT Chandigarh.	Indian J of Pathology and Microbiology 2006; 49: 51-53
40	Grover A, Lakshmi PVM, Aggarwal AK.	Evaluation of House to House Strategy for Intensive Pulse Polio Immunisation in Rural Area of Haryana	Indian Journal of Community Medicine 2006; 31: 33.
41	Aggarwal AK.	Can these two educational techniques be compared for valid interpretations? Rapid Response to the article Lin-Lin Su, Yap-Seng Chong, Yiong-Huak Chan, Yah-Shih Chan, Doris-Fok, Kay-Thwe Tun, Faith S P Ng and Mary Rauff. Antenatal education and postnatal support strategies for improving rates of exclusive breast feeding: randomised controlled trial. BMJ; 0:bmj.39279.656343.55v1.	British Medical Journal, 14th August 2007.
42	Rao BT, Aggarwal AK, Kumar R.	Dietary Intake in Third Trimester of Pregnancy and Prevalence of LBW: A Community- based Study in a Rural Area of Haryana.	Indian Journal of Community Medicine 2007; 32 :239-308.
43	Aggarwal AK, Gupta N.	Gender issues: Why I was not born as a son?	Indian Journal of Community Medicine 2007; 32: 173. (View Point).
44	Singh R, Bhansali A, Sialy R, Aggarwal A.	Prevalence of metabolic syndrome in adolescents from a north Indian population.	Diabetic Medicine 2007; 24 (2): 195-199.
45	Kishore MSS, Kumar P, Aggarwal AK.	Breastfeeding Knowledge and Practices in a Rural Population of North India: A Community-based Study.	J Trop Pediatrics 2008; doi: 10.1093/tropej/fmn 110
46	Chatterjee SS, Ray P, Aggarwal A, Das A, Sharma M.	A community based study on nasal carriage of Staphylococcus aureus.	Indian J Med Res 2009; 130: 742-748.

47	Dinesh Kumar; Arun K Aggarwal; Rajesh Kumar.	The effect of interrupted 5-day training on Integrated Management of Neonatal and Childhood Illness on the knowledge and skills of primary health care workers.	Health Policy and Planning 2009; doi: 10.1093/heapol/czn051
48	Kaur M, Aggarwal A	Audit maternal deaths to save mothers	Manthan 2010; XI.
49	Dogra V, Aggarwal AK	Association of Poultry Farms with House Fly and Morbidity: A comparative Study from Raipur Rani, Haryana.	Indian J Community Medicine, 2011; 35 : 473-477
50	Venkatachalam J, Kumar D, Gupta M, Aggarwal AK	Knowledge and Skills of Primary Health Care Workers trained on Integrated Management of Neonatal and Childhood Illness (IMNCI): Follow-up Assessment 3 year after the training.	Indian J Public Health, 2011; 55(4):298-302
51	Aggarwal AK, Jain V, Kumar R.	Validity of verbal autopsy for ascertaining the causes of stillbirth. doi:10.2471/BLT.10.076828. http://www.who.int/bulletin/volumes/89/1/10-076828.pdf.(accessed on 21.1.2011)	Bulletin World Health Organisation, 2011; 89: 31-40
52	Patro BK, Aggarwal AK	How honest is the h-index in measuring individual research output?	Journal of Postgraduate Medicine, 2011; 57: 264-65
53	Das S, Bhansali A, Dutta P, Aggarwal AK, Sachdeva N, Kumar D, Bhadada SK, Wadwa R, Upresh Y, Santosh R	Persistence of goitre in the post-iodisation phase: micronutrient deficiency or thyroid autoimmunity. Indian Journal of Medical Research	Indian Journal of Medical Research, 2011;133:103-109
54	Prinja S, Aggarwal AK, Kumar R, Kanavos P	User Charges in Health Care: Evidence of Effect on Service Utilization and Equity from North India.	Indian J Medical Research 2012; 136 (5): 868
55	Verma H, Aggarwal AK, Mohanty U, Rattan V	Access to Public Dental Care Facilities in Chandigarh, India: A Cross sectional study.	Indian J Dental Research 2012; 23(1): 121-26
56	Kumar R, Chakrabarti A, Aggarwal AK, Vohra H, Sagar V, Dhanda V, Sharma YP, Majumdar S, Hoe N, Krause RM.	Epidemiological surveillance of Streptococcus pyogenes pharyngitis and impetigo in a rural area of Panchkula District in Haryana, India.	Indian J Medical Research, 2012; 135:133-36
57	Puri N, Gupta A, Aggarwal AK, Kaushal V	Outpatient Satisfaction and Quality of Health Care in North Indian Medical Institute.	International J of Health Care Quality Assurance 2012; 25 (8): 3-3
58	Shewade HD, Aggarwal AK	Health sector reforms: Concepts, market based reforms and health inequity in India	Educational Research (ISSN: 2141-5161) Vol. 3(2) pp. 118-125 February 2012 Available online@ http://www.interesjournals.org/ER
59	Shewade HD, Aggarwal AK, Bharti B	Integrated Management of Neonatal and Childhood Illness (IMNCI): Skill Assessment of Health and Integrated Child Development Scheme (ICDS) Workers to Classify Sick Under-five Children.	Indian J Pediatre. DOI 10.1007/s12098-012-0835-4
60	Singh S, Kumar A, Gupta A, Aggarwal AK	Knowledge of Consumer Protection Act among Doctors from Government and Private Sectors of UT Chandigarh	Indian J of Medical Science ( Accepted)
61	Jeet G, Aggarwal AK	Operationalisation and Utilization of AYUSH clinics in Chandigarh, India: Cross-sectional evaluation study.	Indian Journal of Public Health Research Development 2012; 3 (2): 7-11
62	Shefali Godura, Arun Kumar Aggarwal, Rajesh Kumar, Prakash Bhatia.	Factors influencing household level municipal solid waste practices in urban areas of North and South India: A cross-sectional study,	Waste Management 2012; 32: 1728-1731
63	Gupta M, Venkatachalam J, Goyal N, Kaur R, Goel S, Kaur M, Aggarwal AK, Mohan P	Models of Supportive Supervision for IMNCI Supervision in selected districts of Bihar, Orissa and Rajasthan in India	Indian Journal of Public Health Research Development 2013, 4 (1): 224-228
64	Venkatachalam J, Kumar D, Gupta M, Aggarwal AK	Development of One day Refresher Training Course for Primary Health Care Workers on Integrated Management of Neonatal and Childhood Illness (IMNCI).	Indian Journal of Public Health Research Development 2013; 4 (1): 221-223
65	AK Aggarwal, P Kumar, S Pandit, R Kumar	Accuracy of WHO verbal autosy tool in determining major causes of neonatal deaths in India	PloS one 8 (1), e54865, 2013
66	Venkatachalam J, Gupta M, Aggarwal AK	Treatment Seeking Practices of Parents of Under-Fives in IMNCI Implemented district of North India	Indian Journal of Public Health Research Development.( Accepted)