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

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Investigating Interstate Variations in the COVID-19 Outcomes in India

The variations in COVID-19 infections and deaths reported in Indian states as of 31 March 2021 have been analysed. While the proportion of people living in densely populated areas, per capita net state domestic product, and proportion of aged people explained the variations in COVID-19 infections, in the case of deaths, an additional contributing factor was identified in per capita public health infrastructure. The curious situation of income increasing COVID-19 transmissions and deaths could probably be explained by the considerable proportion of people in some high-income states living in congested slums under extreme poverty with poor access to basic infrastructure, and the high mobility and exposure of some of these states to domestic and international travel footprint, and large migrant population, all resulting in increased risks.

Accumulation of Poor Health Infrastructure

India has to substantially scale up its health infrastructure to protect lives and livelihoods.

 

The Interstate Variation in Mortality from COVID-19 in India

While the response to COVID-19 by the Government of India has been more or less uniform across the country, in that a lockdown was imposed throughout, the death rate has varied across the states. This suggests that region-specific factors are likely to be relevant to the determination of this rate. A significant aspect of this study is the use of three different measures of the death rate in the empirical exercise. This showed all three measures of the death rate to be strongly related to health expenditure as a share of the gross domestic product but hardly at all to public health infrastructure. This can be interpreted as a sign of the role of the public health system—comprising medical personnel, infrastructure and protocols—in the prevention of death, with health expenditure as a key determinant of its effectiveness. It has an implication for public policy beyond the immediate health emergency due to COVID-19.

ASHA Workers’ Struggle for Recognition

ASHA workers’ resistance underscores recognising workers’ rights as central to reimagining public health.

Infrastructural Ephemera and Public Health in Pakistan

“Infrastructural ephemera” as a set of spontaneous affective relations critical to the success of large-scale projects of urban governance in the urban South are examined. The deep contradictions underscoring the labours of women employed as community health workers in Lyari Town, Karachi, at a time of intense gang violence, are explored. Drawing on two years of field research as a polio vaccinator in Lyari, the reach (and limits) of daptability, skills, and labour (physical, mental, and emotional) involved in the maintenance and repair of a fragile public health infrastructure are explored. Maintaining “community health” also involves dealing mortal and aspirational death to those that provide infrastructural labour to the project of giving life.

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