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

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Polio Elimination: A Response

In Manoj Grover’s letter “Polio Elimination” (EPW, 17 May 2014) on two points in my article “Can the Polio Elimination Success Story Breed More Successes in India?” (EPW, 5 April 2014), the writer seems to answer the question in the negative, saying: “I cannot imagine any internal [read Indian]...

Safe Drinking Water in Slums

This article analyses the water, sanitation and hygiene situation in slum households and compares it with the non-slum urban households using data from the 2011 Census. It argues for a shift from the mere water supply coverage to an emphasis on quality water distribution. Intermittent water supply coupled with poor sanitation contributes to higher health risks. Promoting point-of-use water treatment and basic hygiene practices on safe handling and storage of water are important preventive health interventions. This article advocates for a shift from availability of infrastructure to delivery of service-level outcomes.

Performance-Based Incentives of the ASHA Scheme

A study of Accredited Social Health Activists in Shahapur taluka of Maharashtra, a drought-prone adivasi-inhabited area, shows that the remuneration of ASHAs is a growing concern both for them, as well as their families. Recognising their contribution to public health services, the government should provide fixed payment to them, beyond which task-based incentives should continue to be given, though at a revised rate. The current system of remuneration is making it difficult for ASHAs to meet their family's needs and the community's expectations. Further, payment and reimbursement procedures need to be simplified.

Education of Children with Disabilities in India

Illiteracy levels are high across all categories of disability and very high for children with visual, multiple and mental disabilities compared to national averages. Generating awareness that the disabled have full rights to appropriate education in mainstream schools and that it is the duty of those involved in administration at every level, including schools, to ensure that they have access to education is of utmost importance.

Polio Elimination

In the article titled “Can the Polio Elimination Success Story Breed More Successes in India?” by T Jacob John (EPW, 5 April 2014), the author makes a comment that India would have eliminated polio decades ago had it used inactivated poliovirus vaccine (IPV) in the universal immunisation programme...

Adult Under-Nutrition in India

The nutritional performance of adult women in India, at present, parallels a situation referred to famously as The Asian Enigma. Ramalingaswami, Jonsson and Rohde (1996) deployed this term to refer to the prevalence of higher levels of child undernutrition in south Asia, despite its much better performance in economic and social spheres, than Sub-Saharan Africa. The analysis established that the Asian enigma was essentially a “low birth weight enigma”, as the exceptionally high level of low birth weight was found to be the primary reason for the much higher incidence of under-nutrition, especially stunting, in south Asia than Sub-Saharan Africa (Osmani and Bhargava 1998). The low birth weight of babies relates essentially to the poor nutritional status of women (mothers, to be specific), which in itself has become a source for yet another enigmatic situation.

Wealth and Health of Children in India

What are the relationships between wealth and children's health in India's states that are as populous as many other countries? Presenting a state-level analysis of the association between state net domestic product per capita and three children's health indicators, this paper describes how these relationships differ in the last two rounds of the National Family Health Survey. It finds evidence that the cross-sectional relationships between aggregate wealth and children's health indicators are positive, yet the association was less steep in the mid-2000s than in the late 1990s. It also finds a negative relationship between growth in SNDP per capita and improvement in state-level children's health indicators. These findings are consistent with the hypothesis that the kinds of investments which improve health may lead to economic growth, rather than vice versa.

PDS and the Rise of NCDs in Rural India

Is there a connection between the public distribution system (PDS) and the increasing reports on the high incidences of Type II diabetes and cardiovascular diseases in rural India and among the poor in urban India? Why should these non-communicable diseases (NCDs) normally associated with...

Can the Polio Elimination Success Story Breed More Successes in India?

Overcoming formidable biological and sociocultural barriers, India eliminated wild polioviruses from its territory in January 2011. Looking back, it is obvious that the best policy would have been to introduce the inactivated poliovirus vaccine to prevent polio in every vaccinated child, and to use oral poliovirus vaccine by pulse campaigns to eliminate WPVs rapidly. This would have eliminated polio decades ago. Now that WPVs have been eliminated, IPV must be introduced as a prelude to withdrawing OPV. The road ahead is bumpy, but with the important lessons learnt so far, India can no longer pretend that it is too difficult to design a permanent public health infrastructure to control other communicable and non-communicable diseases.

Political Accountability for Outbreaks of Communicable Diseases

The political and bureaucratic "leadership" of India's public health services and programmes, unqualified and untrained for this role, has allowed foreign and international agencies to set the country's health agenda. In the process, while massive amounts are being pumped into health programmes, the health services have deteriorated and the poor continue to suffer.

Evaluating the Social Orientation of the Integrated Child Development Services Programme

Examining who the beneficiaries are of the Integrated Child Development Services programme, an spect that has been neglected, this paper presents econometric estimates regarding the relative strength of personal and household circumstances in determining the likelihood of utilising the programme's services. These estimates suggest that inter-group differences in utilisation rates have less to do with characteristics and much more to do with group identity. The paper also suggests a trade-off between quality and utilisation by hypothesising that the poor quality of services leads upper-caste mothers to exit the ICDS market and seek these services elsewhere.

Mid-Day Meals and Beyond

Siddheshwar Shukla’s article “Mid-Day Meal: Nutrition on Paper, Poor Food on the Plate” (EPW, 15 February 2014) was insightful. It highlights some pressing concerns through facts and f­igures on an issue which deals with the physical well-being of children. Nutritious food to schoolchildren is an...

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