Focuses on 'The Human Development Reports' of the United Nations Development Programme, that attempts to take on the task of incorporating the view of human beings as ends in the accounting and assessment of development. Need to adequately acknowledge the importance of human efforts, skills and talents; Progress of the conditions of human living; Distributional adjustment to the income component.

The Income Component of the Human Development Index

The authors develop an approach to morbidity definition and measurement review specific methods and present a framework for classifying different types of morbidity indicators. They examine various approaches to the interactions between morbidity and mortality change illustrating these with selected data from India the United States and Ghana. (SUMMARY IN FRE AND SPA) (EXCERPT)

https://www.jstor.org/stable/pdfplus/1973655.pdf

Understanding morbidity change.

In the Indian context, a household's caste characteristics are most relevant for identifying its poverty and vulnerability status. Inadequate provision of public health care, the near-absence of health insurance and increasing dependence on the private health sector have impoverished the poor and the marginalised, especially the scheduled tribe population. This study examines caste-based inequalities in households' out-of-pocket health expenditure in the south Indian state of Kerala and provides evidence on the consequent financial burden inflicted upon households in different caste groups. Using data from a 2003-2004 panel survey in Kottathara Panchayat that collected detailed information on health care consumption from 543 households, we analysed inequality in per capita out-of-pocket health expenditure across castes by considering households' health care needs and types of care utilised. We used multivariate regression to measure the caste-based inequality in health expenditure. To assess health expenditure burden, we analysed households incurring high health expenses and their sources of finance for meeting health expenses. The per capita health expenditures reported by four caste groups accord with their status in the caste hierarchy. This was confirmed by multivariate analysis after controlling for health care needs and influential confounders. Households with high health care needs are more disadvantaged in terms of spending on health care. Households with high health care needs are generally at higher risk of spending heavily on health care. Hospitalisation expenditure was found to have the most impoverishing impacts, especially on backward caste households. Caste-based inequality in household health expenditure reflects unequal access to quality health care by different caste groups. Households with high health care needs and chronic health care needs are most affected by this inequality. Households in the most marginalised castes and with high health care need require protection against impoverishing health expenditures. Special emphasis must be given to funding hospitalisation, as this expenditure puts households most at risk in terms of mobilising monetary resources. However, designing protection instruments requires deeper understanding of how the uncovered financial burden of out-patient and hospitalisation expenditure creates negative consequences and of the relative magnitude of this burden on households.

/pdf/social-class-related-inequalities-in-household-health-45mwvev6jw.pdf

Social class related inequalities in household health expenditure and economic burden: evidence from Kerala, south India

Social factors influencing the acquisition of antibiotics without prescription in Kerala State, south India

This paper is complementary to my earlier paper on Public Intervention and Poverty Alleviation: Declining Incidence of Rural Poverty in Kerala (published in 1995). The objective of this paper is to go beyond the notion of income-poverty and consider the achievements in advancing basic human capabilities. Written for an Asian audience, the paper highlights Kerala's achievements in advancing basic human capabilities to an extent that is far above than would be warranted by its per capita income. For this reason, the experience of Kerala, along with a few other countries, has received considerable attention in the development literature. This paper highlights Kerala's achievements by comparing them with six Asian countries' performance. These countries are: India, China, Thailand, Malasia, Indonesia and Sri Lanka. After examining the significance of Kerala's achievements, the paper discusses Kerala's record in relation to the selected six Asian countries. In addition, the paper also briefly deals with Kerala's achievements in relation to all-India since the Indian experience in general is one of slow progress and the task ahead is quite considerable both in absolute terms as well as in relation to most other countries. Emphasis has been given to public action by which Kerala has achieved considerable reduction in poverty. Here I have identified education as the central process through which other changes in society, especially for the poor, were brought about. In this process, the importance and impact of historical factors in poverty alleviation have been highlighted. Finally an attempt has been made to draw some lessons from the Kerala experience by focusing on the role of public action.

http://unpan1.un.org/intradoc/groups/public/documents/apcity/unpan010701.pdf

P. G. K. Panikar

Papers

Health status of Kerala : the paradox of economic backwardness and health development