Among the several determinants of child malnutrition – ranging from individual factors to societal ones – recent evidence indicates open defecation as an important determinant responsible for child malnutrition. This research brief explores the association between underweight children (0-6 years) and open defecation in the context of Indian Sundarbans, where low body weight is considered as an indicator of childhood malnutrition.
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In this paper ex ante inequality measure is used to estimate inequality in childhood chronic under-nutrition among different vulnerable subgroups. Results found that vulnerability to consumption poverty aggravated chronic under-nutrition among less vulnerable groups mainly among those who perceived that unqualified providers provided quality service and were very effective during crisis.The paper finally suggests several policy suggestions for different vulnerable segments.
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এফ.এইচ.এস.- ইন্ডিয়া ২০০৯ সাল থেকেই সুন্দরবনের মানুষের স্বাস্থ্যের ওপর গবেষণার কাজ চালাচ্ছে। বর্তমানে (২০১০ সাল থেকে) এফ.এইচ.এস. শিশু স্বাস্থ্যের ওপর বেশি গুরুত্ব দিয়ে কাজ করছে। সম্প্রতি সুন্দরবনের পাথরপ্রতিমা ব্লকে শিশু -স্বাস্থ্যের ওপর একটি সমীক্ষা করা হয়েছে। বর্তমান রিপোর্টটিতে এলাকার শিশু স্বাস্থ্যের বিভিন্ন দিক ও তার বর্তমান অবস্থা, স্বাস্থ্য পরিষেবার ক্ষেত্রে ফাঁকফোকর গুলি ও সম্ভাব্য সমাধানসূত্র তুলে ধরার চেষ্টা করা হয়েছে। এফ.এইচ.এস.- ইন্ডিয়ার এই গবেষণাটি আরও বেশি করে সুন্দরবনের মানুষের মাঝে পৌঁছে দেওয়ার জন্য এই বাংলা সংস্করণটি প্রকাশিত হল।
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Based on a household survey in Indian Sundarbans hit by tropical cyclone Aila in May 2009, this study tests for evidence and argues that health and climatic shocks are essentially linked forming a continuum and with exposure to a marginal one, coping mechanisms and welfare outcomes triggered in the response is significantly affected.
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Using data from a household survey in West Bengal, the purpose of this paper is to identify the relative risks of catastrophic healthcare expenditures for different types of health need, and the impact of such expenditure on household coping strategies. It concludes that Catastrophic health spending is an important problem for the population in West Bengal. More attention is needed on the poverty-inducing effects of long-term expenditures on chronic illness, given that existing schemes only address hospitalization.
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The health situation of children in the Indian Sundarbans couldn’t be more precarious. Facing chronic malnutrition as well as a high prevalence of easily preventable but highly communicable diseases, access for children to health services in the region is complicated by the rough terrain and the winding tidal rivers of the deltaic region.The key question is, what can be done to improve the health situation of children in the Sundarbans? This briefing answers that question by outlining the several methodologies employed in the study. It then considers both the demand and supply sides for child-centred health services in the block. It concludes with recommendations for beginning to repair the fractured health system there.
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The dynamics of informal health markets in marginalised regions are relevant to policy discourse in India, but are poorly understood. The authors examine how informal health markets operate from the viewpoint of informal providers (those without any government-recognised medical degrees, otherwise known as RMPs) by drawing upon data from a household survey in 2002, a provider census in 2004 and ongoing field observations from a research site in Koppal district, Karnataka, India.
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Professor Barun Kanjilal of IIHMR and the FHS India team outlines findings from the first Sundarbans Health Watch. The findings are from several in-depth studies into the health situation of children in a representative block of the Indian Sundarbans -- Patharpratima.
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How Healthy are the Children of the Indian Sundarbans?\n\nIn early 2012, Future Health Systems India set out to answer this question. It undertook a study in one representative block (geographically and socially) of the Sundarbans: Patharpratima.\n\nThe key statistics presented in the following charts relate to our sample block (FHS 2012) in comparison to West Bengal (District Level Household Survey [DLHS-3] 2007-08) and Rural India overall (DLHS-3).\n\nAll findings and data can be found in the Sundarbans Health Watch Report (August 2013).
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The present report focuses on one of the more vulnerable blocks of the Sundarbans in West Bengal, India -- namely Patharpratima -- as a representative block of the Sundarbans. To understand the root of the problem, the study takes a child health right approach and attempts to understand whether and to what extent the rights are protected, especially in climatically challenged areas such as the Sundarbans. In a nutshell, this report generates research evidence on the barriers to service delivery and access of health care services for children and endeavours to find out ways to make the system more effective in the Sundarbans.
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Challenges of livelihood and inclusive rural development in the era of globalization deals with different challenges in rural development and recommended practical ideas for development. This book is an extremely timely publication when the prevailing situations are putting more and more emphasis on the sharing of knowledge and ideas in the development sector. The research papers highlighting strength of our programmes and focuses on the areas of intervention. Researchers and general readers will find this volume very informative and useful in the area of policy making.
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Policy-makers, entrepreneurs, academics and funders convened at the Rockefeller Foundation Bellagio Center from 10th-14th December 2012 to discuss the changing face of health markets, and in particular to consider future trends in such markets. Their aim was to promote a greater shared understanding and analysis of health market systems, and to consider how markets can better serve the needs of the poor in low- and middle-income countries (LMICs). This report is an attempt to capture the rich discussions held during the meeting, which reviewed the evolution of health markets, identified key drivers of and gaps resulting from their rapid development, and highlighted critical issues that must be tackled to ensure the poorest have access to safe, affordable, effective and equitable health services. The report concludes with recommendations for shaping future health markets as agreed during the meeting.
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There has been a dramatic spread of health markets in much of Asia and Africa over the past couple of decades. This has substantially increased the availability of health-related goods and services in all but the most remote localities, but it has created problems with safety, efficiency and cost. The effort to bring order to these chaotic markets is almost certain to become one of the greatest challenges in global health. This book documents the problems associated with unregulated health markets and presents innovative approaches that have emerged to address them. It outlines a framework that researchers, policy makers and social entrepreneurs can use to analyse health market systems and assess the likely outcome of alternative interventions. The book presents a new way of understanding highly marketised health systems, applies this understanding to an analysis of health markets in countries across Asia and Africa and identifies some of the major new developments for making these markets perform better in meeting the needs of the poor. It argues that it is time to move beyond ideological debates about the roles of public and private sectors in an ideal health system and focus more on understanding the operation of these markets and developing practical strategies for improving their performance. This book is ideal reading for researchers and students in public health, development studies, public policy and administration, health economics, medical anthropology, and science and technology studies. It is also a valuable resource for policy makers, social entrepreneurs, and planners and managers in public and private sector health systems, including pharmaceutical companies, aid agencies, NGOs and international organisations.
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In the second podcast from Future Health Systems, Jeff Knezovich visits the FHS Afghanistan team in Kabul to find out what sort of research they're currently undertaking, what challenges they face in attempting research in an insecure environment, and what it's like living and working in difficult security situations. He interviews Kojo, Melissa Roach and Anubhav Agarwal, who tell him about the community scorecard that FHS is in the process of piloting in several provinces in Afghanistan.
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Dr Barun Kanjilal of IIHMR gives an overview of the regulatory challenges associated with the rapid spread of health markets in India to the Health System Reform in Asia conference held in Hong Kong in early December 2011. He notes in particular the important role that informal providers have played in delivering health services in the wake of government reforms.
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Dr Asha George of JHSPH presents work on the role of informal health care providers in India at the Health System Reform in Asia conference held in December 2011 in Hong Kong. She compares West Bengal and Karnataka -- two states with very different health profiles -- providing both qualitative and quantitative insights into how and why the poor use poorly trained rural medical practitioners as their first port of call when accessing health services.
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User fees for primary care tend to suppress utilization, and many countries are experimenting with fee removal. Studies show that additional inputs are needed after removing fees, although well-documented experiences are lacking. This study presents data on the effects of fee removal on facility quality and utilization in Afghanistan, based on a pilot experiment and subsequent nationwide ban on fees.
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User fees are a known common barrier to using health services, particularly among the poor. When fees are present, many facilities have waiver systems for poor patients to exempt them from paying. Targeting waivers to patients who need them most has been a challenge, especially in fragile states, where relevant data are limited and trust in institutions is low. An analysis of the asset index of beneficiaries indicated that although targeting was progressive, significant leakage and high levels of under-coverage occurred; 42% of cards were used by people in the wealthiest three quintiles, and only 19% of people in the poorest quintile received a card. Households with waiver cards reported higher rates of care-seeking for recent illnesses compared to those without cards (p = 0.02).
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The authors examine the observed heterogeneity in self-assessed health (SAH) among the aged in India using data on health and living conditions of the elderly in India from the 60th Round of National Sample Survey (2004-2005). Results indicate that almost one fourth of the old in India rate their health as poor.
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Childhood chronic undernutrition and common childhood illness is highly prevalent in the Sundarbans delta region of West Bengal, India. The present work tested the hypothesis- frequent climatic shock is likely to predispose chronic and transient health shocks through behavioural responses of households in the presence of inaccessibility, inadequacy and acceptability barriers which act in the economy as long wave shocks.
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