Date of Award

Spring 5-10-2014

Degree Type



Health Promotion, Education and Behavior

Director of Thesis

Deborah Billings

First Reader

David Simmons


This project resulted from collaboration between USC student organization GlobeMed and the Alternative for Rural Movement (ARM), a non-governmental organization in Odisha, India. Rajendra Rana, the head of ARM, expressed the need to delineate the factors underlying the tendency of rural Odishan women to deliver with unskilled birth attendants as opposed to institutionally. A literature review was conducted to explore possible economic, cultural, and social factors. During five weeks in Odisha, discussions with women's groups, community health workers, and ARM staff members built on the literature review. A preliminary survey and plan for its dissemination were developed. The community based participatory research (CBPR) method was researched and chosen because of its alignment with GlobeMed and ARM's goals of community empowerment and sustainability. Training for dissemination was scheduled to begin in January 2014, but a cyclone led to concerns about directing ARM's resources away from the disaster. Plans were postponed until May 2014. Principal findings are the possible factors that could underlie the decisions rural women make including: cultural preferences for delivering with family, power dynamics attached to the traditional birth attendant, cultural meanings attached to birth, lingering mistrust in health care providers due to the sterilization campaigns of the 1970's, cost, distance, and lack of knowledge. The issue is complex, and the right questions must be asked in order for ARM to solve this problem within its community. Through the project, the investigators strengthened the partnership and provided an avenue for learning for future students of public health at USC.


© 2014, Sarah Law and Runjhun Bhatia