ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

Articles By Imrana Qadeer

COVID-19: Reinforcing the ‘Technical Fix’ and Distorting Public Health in India

The article reflects upon the possible reasons for the feeble response to the second wave of the pandemic and the consequences and limitations of the measures and policies set into motion by the state. It also looks at what lessons can be taken from history to design a feasible, scientific, humane, public health approach. 

 

Impact of Public Distribution System on Quality and Diversity of Food Consumption

The public distribution system is criticised for encouraging the poor to satiate their hunger with cheap cereals at the expense of other non-cereal food items, thus indirectly aggravating deficiencies of protein and other nutrients. An in-depth analysis shows that this is not actually so; the consumption of some non-cereal foods increases with the consumption of cereals, indicating a complementary relationship. This becomes possible through the implicit savings the PDS generates for its beneficiaries, due to subsidised cereal prices. Despite this, nutrient deficiency among poorer sections persists, and a comprehensive expansion of the PDS introducing certain non-cereal foods into its ambit can help tackle this issue.

 

Public Good Perspective of Public Health

India’s response to the COVID-19 pandemic is linked to its abandonment of the welfare state, marginalisation of public good principle and collapse and fragmentation of the public health system. As COVID-19 cases surge, many states could barely treat patients needing medical support due to bed shortages and poor infrastructural facilities. The overwhelmed system disrupted routine and emergency non-COVID services as well. The interstate differences in coping with COVID-19 are rooted in the public sector health infrastructure, investment in rural services and disease control programmes. A comprehensive healthcare system is needed as COVID-19 is not the end of the problem of the globalisation of epidemics.

Significance of Testing for Identification of COVID-19

The official and media discourse in India often focuses on the cumulative or daily detection of infected cases irrespective of the number of people tested and thus confuses the issue of disease progression. Based on the analysis of the number of infected cases identified and the number of people tested in eight states in India, it is emphasised that identification and quarantine of those who are infected slows down the spread of the disease. Mobilising resources towards the primary healthcare system for expanding contact tracing and investing in additional facilities to quarantine and treat infected patients is suggested.

Interpretations and Implications of Increasing Obesity in India

The National Family Health Survey-3 and 4 data show that in the past 10 years, overweight/obesity among women in terms of Body Mass Index has increased quite sharply. In the Indian context, undernutrition and obesity are not separate problems. A large proportion of overweight/obese women are undernourished, with small stature, food transition towards more fats and increasingly sedentary lifestyles making them vulnerable towards being overweight/obese. More diversified diet reduces the risk of overweight/obesity. It is suggested that adequate and good quality diversified diets need to be ensured for comprehensive energy and nutrient adequacy. This requires an overhaul of India’s food programmes.

Medical Tourism in India: Progress or Predicament?

It is estimated that the size of the medical tourism market in the country will be Rs 1,95,000 crore in 2012. Based on a literature review of healthcare business media, policy documents and a few academic papers, this essay looks at the scope for medical tourism in India and situates it within the Asian context. It traces shifts in policy with the growth of a tertiary corporate health sector that is urban-centric, and subject to minimal regulation and monitoring. The State acts primarily as a steward. The essay also examines the implications of medical tourism for general medical care and how such policy shifts distort health systems. This analysis raises questions of accessibility, affordability, and ethics in medical care, and asks if it is sensible to promote medical tourism in a democratic welfare state, with poor public healthcare facilities for the masses.