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

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Fiscal Challenges in Scaling Up Nutrition Interventions

Four states—Bihar, Chhattisgarh, Odisha, and Uttar Pradesh—together account for around 45% of stunted children in India. The existing literature makes a case for delivery of a host of specific interventions referred to as the direct nutrition interventions, along with sector-wise or systemic interventions, to bring about significant reductions in prevalence of stunting among children. An analysis of the delivery of DNIs in the said states shows that apart from the decline in fiscal priority for the DNIs during 2014–15 to 2017–18, there are also significant resource gaps for some of these interventions, which underscores the need for enhancing fiscal priority for these interventions.

Peer Support in Mental Healthcare

“Peers” are a resource that can be tapped into to support a wide variety of people in the mental health system. These are people who have lived experiences of recovery in mental health. This kind of support offers the peers a meaningful work opportunity, financial and social empowerment, and consolidates their recoveries. It also helps those who are currently suffering by enabling them to experience a peer’s caring and supportive assistance, patient listening and helpful advice in view of the hurried and professional approaches of mental health professionals.

Rethinking Effective Nutrition Convergence

The National Nutrition Mission has explicitly recognised the multisectoral nature of the challenge of malnutrition and has made “convergence” one of its key pillars. However, it does not yet have sharp operational clarity on how stakeholders can ensure that multiple programmes reach the same mother–child dyad in the first 1,000-day period. The article illustrates how data on co-coverage of interventions can be used to plan for and assess the success of efforts to strengthen convergence.

How a Flawed Understanding of PCOS Robs Women of Their ‘Femininity’

This article discusses the understanding of polycystic ovarian syndrome (PCOS) among medical professionals in the patriarchal framework and how women experience infantalisation at the hands of doctors.

Delivering Nutrition to Pregnant Women

To reduce the burden of maternal undernutrition in India, select nutrition interventions are delivered to pregnant women at scale through the National Health Mission. But in Purnea, a district in Bihar, delivery is constrained by poor planning and budgeting, delayed fund flow, and shortage of infrastructure and human resources; and funds are underutilised.

Hidden Hunger, Burdened Women

Reminiscent of poverty debates, serious undernutrition in India risks becoming a measurement quibble, unless we talk about unequal development gains and the answerability of governments towards less empowered citizens. Based on the simple counting of food consumed by 240 households and conversations with women, this article explores the contrast between local knowledge of what constitutes a “good diet” and the deficient meals consumed by people in Odisha, a state in eastern India. Effective interventions need to look beyond “maternal responsibility” and address entitlement uncertainties and gender inequality, in order to ensure essential nutrition and good health of vulnerable groups such as women and children.

The Mental Health Imbroglio

The question that needs to be asked is, how many of those being treated for mental illness are recovering? Does the current treatment regimen help people with recovery, or is it only a “treatment” option with an entry and no exit point? Psychiatric professionals need to focus on recovery.

Public Health Systems and Privatised Agendas

Examining how health policy has fared in India during the last five years shows the constriction of finances for major programmes like the National Health Mission and Reproductive and Child Health Programme that has led to under-resourced public systems. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana health insurance scheme would only end up diverting public resources towards commercial insurance companies and private hospitals, while having doubtful benefits for community health.

Public Health System Is Failing the Women Farmers

Maharashtra, with its drought-prone areas, is one of the states with the largest number of male farmer suicides. In the aftermath of these suicides, women farmers struggle on multiple fronts. A poor public health system further fails them and aggravates their plight.

Utilisation, Fund Flows and Public Financial Management under the National Health Mission

Since April 2014, funds for various centrally sponsored schemes, including the National Health Mission, are being transferred to implementing agencies through state treasuries. This has added an additional layer in the institutional structure for nhm fund flows. We analyse the utilisation of nhm funds in 29 states in two recent years, and the time taken for release of these funds from state treasuries to implementing agencies in three selected states: Bihar, Maharashtra, and Odisha. On average, only about 55% of funds allocated for nhm were utilised in 2015–16 and 2016–17. In Bihar and Maharashtra, this was partly due to significant delays in release of funds from state treasuries to implementing agencies. The delays were a result of complex administrative procedures associated with the release of nhm funds from state treasuries.

Compulsory Licensing of Pharmaceutical Patents in India

The trend of continued rejection of compulsory licence applications in India goes against the local generic drug manufacturers and public health safeguards incorporated in the Indian patent law. It raises serious questions about the intervening role of the state in patent monopoly to equalise the competing interests between patent holders and consumers of “public good.” This trend indicates a policy shift of the government regarding compulsory licensing.

Estimating Public Spending on Health

The use of information on withdrawals by Drawing and Disbursing Officers for improving the estimates of public spending for National Health Accounts in India is illustrated. Using information from Karnataka and Rajasthan, the study highlights the advantages of combining DDO-level information with budgetary data. The significant benefits of using DDO-level information in India have implications for better estimates of public spending and health policy design.

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