Background: Estimating the burden of disease attributable to long-term exposure to fine particulate matter (PM2.5) in ambient air requires knowledge of both the shape and magnitude of the relative ...

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An Integrated Risk Function for Estimating the Global Burden of Disease Attributable to Ambient Fine Particulate Matter Exposure

Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach.

http://re.indiaenvironmentportal.org.in/files/health%20and%20equity.pdf

Health care and equity in India

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(10)62187-3.pdf

Stillbirths: Where? When? Why? How to make the data count?

Abstract There is a growing acknowledgement that micro-credit programs have potential for equitable and sustainable development. However, my anthropological research on the micro-credit program of the Grameen Bank shows that bank workers are expected to increase disbursement of loans among their members and press for high recovery rates to earn profit necessary for economic viability of the institution. To ensure timely repayment in the loan centers bank workers and borrowing peers inflict an intense pressure on women clients. In the study community many borrowers maintain their regular payment schedules through a process of loan recycling that considerably increases the debt-liability on the individual households, increases tension and frustration among household members, produces new forms of dominance over women and increases violence in society.

Micro-credit initiatives for equitable and sustainable development : who pays?; a case study of the Grameen Bank Program in rural Bangladesh

Regular use of alcohol and tobacco in India and its association with age, gender, and poverty.

Using demographic and health surveys conducted between 1998 and 2001 from seven countries (Armenia, Bangladesh, Cambodia, India, Kazakhstan, Nepal, and Turkey), the study found that acceptance of wife beating ranged from 29% in Nepal, to 57% in India (women only), and from 26% in Kazakhstan, to 56% in Turkey (men only). Increasing wealth predicted less acceptance of wife beating, except in Cambodia and Nepal. Higher education level was negatively associated with acceptance in Turkey and Bangladesh. Younger respondents justified wife beating more often, with some exceptions, showing persistent intergenerational transmission of gender norms. Working women were equally or more likely to justify wife beating compared to nonworking women. Men were significantly more likely to justify wife beating in Armenia, Nepal, and Turkey. Targeted proactive efforts are needed to change these norms, such as improving female literacy rates and other enabling factors.

Attitudes Toward Wife Beating A Cross-Country Study in Asia

Using data from the 60(th) round of the National Sample Survey of India (2004), the study investigates the incidence and correlates of 'catastrophic' maternal expenditure (ME) in India. Data on ME come from 6879 births that took place during 365 days prior to the survey. The study adapts earlier definitions and methods for catastrophic total health care expenditure to measure 'catastrophic' ME as: (i) maternal health care expenditure more than 10% of the annual normative household consumption expenditure (ME-1), and (ii) maternal health care expenditure more than 40% of the annual 'capacity to pay' (ME-2). The 'capacity to pay' was derived by subtracting state-wise poverty-line household expenditure from household consumption expenditure. The average maternal expenditure varied by place of delivery: US dollar 9.5, US dollar 24.7 and US dollar 104.3 for birth at home, in a public facility and in a private facility, respectively. Sixteen per cent of households incurred ME of more than 10% of total household consumption expenditure (ME-1), while 51% households incurred ME of more than 40% of household 'capacity to pay' (ME-2). While incidence of ME-1 increased with income decile, the reverse was observed for ME-2, reflecting higher non-utilization of institutional maternal care and its non-affordability among poorer households. All the households from the poorest decile and 99% from the second poorest decile paid more than 40% of their capacity to pay. Multivariate regression results indicate that antenatal care and delivery care in private facilities increased the chances of ME-1 and ME-2 (P < 0.001). Measuring maternal expenditure against 'capacity to pay' (ME-2) may be better than measuring it as a proportion of overall household expenditure when assessing financial constraints in the use of maternal services. Improving the performance of the public sector, appropriate regulation of and partnership with the private sector, and effective direct cash transfers to pregnant women in the poorest households may increase utilization of maternal services and reduce the financial distress associated with ME.

Incidence and correlates of 'catastrophic' maternal health care expenditure in India.

Objective To investigate the socio-economic differentials in the quality (clinical and interpersonal) of antenatal care and also the correlation between differentials in the quality and utilization of antenatal care.

Design The study uses cross-sectional, nationally representative data from National Family Health Survey (1998–99).

Setting Four south Indian states (Andhra Pradesh, Karnataka, Kerala and Tamil Nadu) and four north Indian states (Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh).

Main outcomes measured More than four antenatal care visits for utilization, and index of clinical, information and interpersonal quality of care.

Results Lower than desired quality of antenatal care was observed in both north and south Indian states, though the quality was significantly better in south India compared with north India, especially among the disadvantaged women. Significant socio-economic differentials in the quality of care were evident in both north and south India, but were more glaring in north India. A significantly positive relationship was observed between the quality and utilization of antenatal care in the rural areas from village-level multivariate analysis.

Discussion Poor quality of antenatal care is likely to reduce its utilization. Policy and program interventions to improve the quality of care of antenatal care, especially for the poor and other disadvantaged population groups, more so in north India, are essential to improve maternal health outcomes. The India's National Rural Health Mission (NRHM), launched in 2005, should lay greater emphasis on improving the quality of antenatal care, among other things, to increase utilization of antenatal care and achieve better maternal health outcomes.

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Sekhar Bonu

Papers

Regular use of alcohol and tobacco in India and its association with age, gender, and poverty.

Attitudes Toward Wife Beating A Cross-Country Study in Asia

Incidence and correlates of 'catastrophic' maternal health care expenditure in India.

Differentials in the quality of antenatal care in India

The impact of the national polio immunization campaign on levels and equity in immunization coverage: evidence from rural North India.