RAJIV GANDHI INSTITUTE OF PUBLIC HEALTH AND

CENTRE FOR DISEASE CONTROL, RGUHS. BANGALORE

PROFORMA

PROPOSAL OF RESEARCH STDY FOR APPROVAL BY THE INSTITUTIONAL ETHICS COMMITTEE

OF RGIPH AND CDC, RGUHS, BANGALORE -41:

For Faculty

1. Name of the Principal Investigator ,Basic and PG degrees , Designation, Address,

Mobile Numbers and Email IDs:

Name (Dr./Kum./Smt./Shri) : Dr Pallavi Sarji Uthkarsh

First name(s) Dr Pallavi Sarji

Surname: Uthkarsh

2. Designation: Associate professor

3. Complete Postal Address, : 233/SO1, Chandralok heights, West of Chord Road, 2 nd Stage,
Rajajinagar Bangalore,560086 Telephone Number, 9945232944

e-mail :pallavisarji@yahoo.com

5. Educational Qualification :

Bachelor of Medicine and Bangalore Medical College and Research Institute, Rajiv Gandhi
Bachelor of Surgery University of Health Sciences, Bangalore. India(2006)
(MBBS)
MD in Community Medicine
MS Ramaiah Medical College and
researchinstitute,Bangalore India.(2010)
DNB in Community
Medicine
 National Board of Examinations India.(2011)

(PHD)road traffic injury Maastricht (Netherlands)

prevention

2. Date of Joining the institution and tenure of appointment : March 2016,One year
renewable

3. Name of the Co-Investigator/s, Designation/s, Address/es, Mobile Numbers and Email

IDs:

.1. Name (Dr./Kum./Smt./Shri): Dr. Allen Prabhaker Ugargol

First name(s) Dr. Allen Prabhaker

Surname: Ugargol

2. Designation: Associate Professor

3. Complete Postal Address:

B-1008, Gopalan Residency, Telecom Layout, Bangalore 560023

Telephone Number: 8095719044

e-mail: allen.ugargol@gmail.com

4. Educational Qualification:

Bachelor of Dental M.R. Ambedkar Dental College and Hospital, Rajiv Gandhi
Surgery (BDS) University of Health Sciences, Bangalore, India (1999)
Master of Public Health
(MPH) Sree Chitra Tirunal Institute for Medical Sciences &
Technology (SCTIMST), Trivandrum, India (2007)
Fellowship in Health
Informatics (FHI) London School of Hygiene & Tropical Medicine (LSHTM),
London, United Kingdom.

(PhD) University of Groningen, The Netherlands.

4. Title of the Research study: availability of essential trauma care services at different levels of
health care facilities of public health system in karnataka

Objectives:
1.Toassesstheorganizationalandadministrativesetupinhealthcarefacilitiesfor
deliveringessentialtraumacareinKarnataka
2. To assess the infrastructural capability, equipment and supplies available to
provideessentialtraumacare
3.Toestimatecurrenthumanresourcecapabilitytodeliveressentialtraumacare
andtoassessthetrainingneedsofhealthcarepersonneltodeliveressentialtrauma
care.

6. Material and Methods (in brief): Materials and Methods:

Study area: Karnataka, India

Study design: cross sectional study

Study duration: 12 months

Sampling method: Stratified random sampling

Sample size: 72 health centers across four administrative divisions of Karnataka will be assessed.
Which includes, 40 primary health centres, 12 community health centres, 12 taluk hospitals, 4
hospitals associated with government medical colleges , 4 district hospitals, and Trauma centres
Methods:

Datawillbecollectedthroughacombinationofdirectfacilityinventoryinthehealthcaresettingand

indepthinterviewswithkeyadministratorsandhospitalstakeholdersusingvalidatedchecklistsby

Researchofficersalongwithoneinvestigator.

7. Place of study / setting: Study area: Karnataka, India

8. Duration of the study (with dates): Study is for a period of one year which will
commence after final approval by ICMR

9. Ethical Issues involved [list out]: none.

Current study does not require any investigations or interventions to be done on

patients/humans /animals.So no other ethical issues are involved except maintaining privacy
,anonymity and confidentiality of the subjects.

he current
study
does not
require
any
investigati
on
or
interventi
ons to be
conducted
on
patients
or other
humans or
animals.

So no
other
ethical
issues are
involved
except
maintainin
g privacy,
anonymity
and
confidenti
ality of
the study
subjects.
Eth.ica
l
Issues
involv
ed:

The
current
study
does not
require
any
investigati
on
or
interventi
ons to be
conducted
on
patients
or other
humans or
animals.

So no
other
ethical
issues are
involved
except
maintainin
g privacy,
anonymity
and
confidenti
ality of
the study
subjects
10. How are these addressed in the study [in brief]: privacy,confidentaility and anonymity
of the sujects will be ensured.Informed verbal consent will be taken before the interviews.

11. What is the current status of the study? :

waiting for the approval of ICMR.

In the Process of refining the study instrument.

Co-Investigator/s Principal Investigator Head of the Department

[Signature & Seal] [Signature & Seal] [Signature & Seal]

DR ALLEN .P. UGARAGOL DR.PALLAVI SARJI UTHKARSH DR.PALLAVI SARJI UTHKARSH

Date: