Uttar Pradesh

The Pradhan Mantri Kisan Samman Nidhi scheme aims to provide income support to farmers for easing their liquidity needs to facilitate timely access to inputs. This study, based on 1,406 farmers of Uttar Pradesh, uses a binary choice model to examine the targeting accuracy and correlates of the spending pattern of farmers. Triple difference with matching estimators is used to identify the differential impact of the scheme on the Krishi Vigyan Kendra beneficiaries. Results show that the scheme reached one-third farmers in the first three months of its implementation, and has significantly helped those who are relatively more dependent on agriculture and have poor access to credit. Moreover, the scheme has significantly stimulated the Krishi Vigyan Kendra's impact on the adoption of modern cultivars.

The public distribution system is the cornerstone of anti-poverty initiatives in India to address the issue of hunger and malnutrition, but is plagued with leakages and corruption. Though several possible reasons account for these problems, one factor that is generally overlooked is the lack of assessment of the preference of the beneficiaries in terms of product portfolio, selection, and delivery mechanisms. Through a mixed methods analysis across Bihar, Odisha and (eastern) Uttar Pradesh, this paper assesses the factors explaining the diversity in the preference for the delivery mechanism. What would be a straightforward choice problem among delivery mechanisms turns out to be far more intricate when mediated by contextual heterogeneity and unequal power relations at different levels. The results highlight the centrality of demand and build a case for demand assessment in improving the effectiveness of the system.

Building on an earlier publication using the same data set plus case studies of three facilities, the reasons for the low utilisation of public health facilities in Uttar Pradesh despite the prohibitively high costs of care in the private sector are explored. The likelihood of choosing a public provider for hospitalisation care was 4.8 times higher in the poorest quintile and 3.4 times as high for women. Where access to public sector services is an issue, many go without any treatment and this could appear in the data to be a higher proportion of private sector utilisation. Inadequate facility density is one barrier to access. Facilities, which are by policy designed to offer very limited types of services—to collect user fees and prescribe drugs and diagnostics to be bought outside, and with no continuity of care between primary and secondary levels—lead to the diminishing of credibility of the public healthcare services. When services are available and there are incentives that facilitate access, like for childbirth, the choice shifts in favour of public services. Market-defined perceptions of what is good healthcare and an understaffed and demoralised workforce also contribute to poor utilisation.

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