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

Articles By William Joe

Household Assets and Wealth Quintiles, India 2006–16

The potential of National Family Health Survey wealth index to contribute to the discourse on poverty and inequality in India is presented. Between 2005–06 and 2015–16, there have been improvements in ownership and access to fairly basic household assets and amenities, yet, much needs to be accomplished in the provisioning of pucca houses, clean cooking fuel, improved toilet facilities as well as access to the digital world through computers and the internet. Inter-household inequalities in asset ownership have declined, but there are large intergroup inequalities with particularly disadvantaged asset ownership profiles for Scheduled Caste, Scheduled Tribe and Muslim households. Interstate inequalities in asset ownership, however, have increased. The increased concentration of asset poor is found in Bihar, whereas Punjab and Haryana experience increased share of richest households. Overall, based on robustness checks, the NFHS wealth index is an important proxy of socio-economic status and offers considerable scope for timely and systematic analysis of economic inequalities.

Frequently Asked Questions on Child Anthropometric Failures in India

The National Family Health Survey is analysed to develop critical insights on child anthropometric failure in India. The analysis finds non-response of economic growth on nutritional well-being and greater burden among the poor as two fundamental concerns. This calls for strengthening developmental finance for socio-economic upliftment as well as enhanced programmatic support for nutritional interventions. The gaps in analytical inputs for programmatic purposes also deserves attention to unravel intricacies that otherwise remain obscured through customary enquiries. On the one hand, this may serve well to improve policy targeting, and on the other, this can help comprehend the nature and reasons of heterogeneities and inequities in nutritional outcomes across subgroups. Strengthening the analytical capacities of programme managers and health functionaries is recommended.

Robust Parliamentary Constituency Estimates

This article is a response to Srinivas Goli’s article “Unreliable Estimates of Child Malnutrition” (EPW, 9 February 2019) that had questioned the reliability of methodologies of Akshay Swaminathan et al’s article “Burden of Child Malnutrition in India: A View from Parliamentary Constituencies” (EPW, 12 January 2019). The reliability and usability of the methodologies proposed by Swaminathan et al have been reiterated, emphasising that these can provide broad assessments at the parliamentary constituency level.

Burden of Child Malnutrition in India

In India, monitoring and surveillance of health and well-being indicators have been focused primarily on the state and district levels. Analysing population data at the level of parliamentary constituencies has the potential to bring political accountability to the data-driven policy discourse that is currently based on district-level estimates. Using data from the fourth National Family Health Survey 2016, two geographic information systems methodologies have been developed and applied to provide estimates of four child malnutrition indicators (stunting, underweight, wasting, and anemia) for the 543 parliamentary constituencies in India. The results indicate that several constituencies experience a multiple burden of child malnutrition that must be addressed concurrently and as a priority.

Measuring Catastrophic Healthcare Expenditure

Catastrophic household healthcare expenditure is a prominent policy concern. The National Health Policy 2017 takes explicit cognisance of this issue and presents an empirical formulation to examine its incidence and patterns. However, the policy needs to account for household size variations to counter an implicit bias that tilts the estimates to reflect a higher concentration of catastrophic expenditure among the rich. This concern is illustrated using health data from the 71st round of the National Sample Survey. Further, a minor modification to unravel the socio-economic gradient in catastrophic healthcare expenditure has also been discussed.

Social Choice and Political Economy of Health

The National Health Policy, 2017 can be credited for an alternative vision towards the development of the health sector in India, but it falls short of expectations on certain counts. The core idea of strategic purchasing from the private sector is relevant, but can be incompatible with the existence of a robust public sector, particularly when reforms for enhancing the competitiveness of the public sector are undermined. Thus, the NHP essentially reopens the fundamental debate regarding the role of social choice mechanisms while deciding upon policy instruments and desirable outcomes. This has profound implications for the political economy of the health sector and can unintentionally catapult health as a salient feature in electoral politics.

Health Inequality in India: Evidence from NFHS 3

This article utilises the National Family Health Survey-3 data and presents an empirical assessment of income-related health inequality in India. It undertakes a state-level analysis of inequities in child health by employing the widely accepted measures of concentration curves and concentration indices. It finds that the poorer sections of the population are beleaguered with ill health whether in the quest for child survival or due to anxieties pertaining to child nutrition. Further, an attempt is made to comprehend the relationship between income inequality and health status in the Indian context. The analysis reveals that the degree of health inequalities escalates when the rising average income levels of the population are accompanied by rising income inequalities. The income-poor sections have different needs and therefore, planning and intervention necessitates an understanding of the sources of inequality and recognition of the vulnerable groups to arrive at efficient resource allocation and policy decisions.

Strategy of Zoning in Marine Fisheries: Evidence from Kerala

During the 1970s and the 1980s Kerala's marine fisheries witnessed several distributional conflicts between the traditional and the modern fishing units. As a remedial measure, zoning was introduced which prohibited mechanised fishing in the inshore waters and proscribed mechanised fishing during monsoons. This study presents a theoretical analysis of the measure and analyses the available data to comprehend its impact upon fisheries. It finds that zoning has had a positive impact upon the resource distribution patterns, but that it would offer only a short-term solution if the larger problems are left unaddressed.