Kannan E.,Institute for Social and Economic Change ISEC
Indian Journal of Agricultural Economics | Year: 2012
India has made tremendous progress in increasing production of staple grains like wheat and rice since the introduction of yield improving technology in the 1960s. A combination of policy measures like subsidization of inputs, output price, external trade and marketing support were introduced to encourage the farmers to produce these important cereals. The Government of India implements the largest food intervention program called public distribution system (PDS) through which primarily foodgrains are distributed at subsidized rate to all eligible households. The eligible households are given ration cards to buy fixed rations of foodgrains. For ensuring long term food security, sufficient amount of foodgrains should be made available domestically in a sustainable manner. The favorable economic conditions are necessary for the agricultural sector to enhance the food production and to keep pace with growing demand for different types of foods.
Sood N.,University of Southern California |
Ugargol A.P.,Institute for Social and Economic Change ISEC |
Barnes K.,University of Southern California |
Mahajan A.,University of California at Los Angeles
BMJ Open | Year: 2016
Objectives: The high prevalence of coronary heart disease and dramatic growth of cardiac interventions in India motivate an evaluation of the appropriateness of coronary revascularisation procedures in India. Although, appropriate-use criteria (AUC) have been used to analyse the appropriateness of cardiovascular care in the USA, they are yet to be applied to care in India. In our study, we apply AUC to cardiac care in Karnataka, India, compare our results to international applications of AUC, and suggest ways to improve the appropriateness of care in India. Setting: Data were collected from the Vajpayee Arogyashree Scheme, a government-sponsored health insurance scheme in Karnataka, India. These data were collected as part of the preauthorisation process for cardiac procedures. Participants: The final data included a random sample of 600 patients from 28 hospitals in Karnataka, who obtained coronary artery bypass grafting or percutaneous coronary intervention between 1 October 2014 and 31 December 2014. Primary and secondary outcome measures: We obtained our primary baseline results using a random imputation simulation to fill in missing data. Our secondary outcome measure was a best case-worst case scenario where missing data were filled to give the lowest or highest number of appropriate cases. Results: Of the cases, 86.7% (CI 0.837% to 0.892%) were deemed appropriate, 3.65% (CI 0.023% to 0.055%) were inappropriate and 9.63% (CI 0.074% to 0.123%) were uncertain. Conclusions: The vast majority of cardiac revascularisation procedures performed on beneficiaries of a government-sponsored insurance programme in India were found to be appropriate. These results meet or exceed levels of appropriate use of cardiac care in the USA.
Ghatak A.,Gujarat Institute of Development Research |
Madheswaran S.,Institute for Social and Economic Change ISEC
Journal of Health Management | Year: 2014
In an agrarian economy economic impact of illness acts not only through out of pocket expenditure, but also through loss of labour time and wages at the individual level. Using the information collected from 676 respondents at selected villages in West Bengal from 2009 to 2010, the present paper examines the impact of health on labour supply behaviour and wages. Theoretically the study borrows the idea of nutrition-based efficiency wage hypothesis and builds a conceptual framework based on capability approach. The methodology follows a household production function model. Nutritional dimension of health as indicated by body mass index (BMI) has been found to have a positive and significant impact on labour supply for both the male and female respondents. Age is found to have significantly non-linear impact on labour supply. Hence, public policies to improve the sex and age composition of the households through appropriate channels, that is, health and fertility may be necessary. Finally, the results suggest a revision in the design of the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) programme by integrating it with other developmental programmes on health, sanitation and skill development in order to ensure productivity of rural manual labourers. Experience of some other countries like South Africa and Brazil suggests the need to integrate public works programmes with programmes that target health and family welfare issues particularly in the context of rural livelihood. © 2014 Indian Institute of Health Management Research.
Thomas M.B.,Institute for Social and Economic Change ISEC |
James K.S.,Institute for Social and Economic Change ISEC
Global Health Action | Year: 2014
Background: During the last century, Kerala witnessed drastic mortality reduction and high improvement in longevity. This achievement is often compared with that of developed countries. However, how far the early advantages in mortality reduction have further enhanced in Kerala remains unknown. In most developed countries, advanced stage of mortality reduction and further increase in longevity was achieved mainly due to the mortality shift from adult and older ages to oldest ages (Olshansky and Ault 1986). Objectives: Considering the lack of comprehensive study on the change in longevity in Kerala, this study focuses on discovering (i) the historical time-periods that provided the biggest gain to life expectancy and also the beneficiaries (by age group and sex) and (ii) the contributions of major groups of causes of death in mortality reduction and consequent improvement in longevity. Methodology and data: The study uses the methodology proposed by Olshansky and Ault in 1986. It used methods such as Temporary Life Expectancy (TLE), Annual Relative Change in TLE, Decomposition of changes in longevity among different age groups (gender and spatial) and causes of deaths, for the analysis. It used data from various sources such as Census, Civil Registration System (CRS) and Directorate of Health Services (DHS), as well as survey data from Sample Registration System (SRS) and Medically Certified Causes of Deaths (MCCD) for this study. Finding and conclusion: The study found that overall mortality dramatically declined in the state in the recent decades. Younger ages have contributed the most for this reduction. Therefore, further mortality reduction is possible in adult and early old ages. However, the contribution of these ages to life expectancy was lower than that of youngsters until 1991-2000 especially among males. This may indicate a slow progress towards the advanced stage of epidemiological transition characterized by high prevalence of non-communicable diseases. The paper concludes that although the health issues of infants, children, and mothers in the reproductive age group, are effectively addressed through various policies in Kerala, the state needs to focus more on the health problems of adults, especially males. © 2014 Muttikkal B. Thomas and Kuriath S. James.
Kannan E.,Institute for Social and Economic Change ISEC
Journal of Agrarian Change | Year: 2015
India's agricultural sector is at a crossroads, facing challenges of stagnation in crop yields, non-remunerative prices, falling crop incomes and tardy responses from public service systems. There are reports of peasant suicides due to non-profitability of farming. However, scant empirical evidence is available on changes in real income and wages in the Indian agricultural sector. The present study uses data from the National Accounts Statistics and Cost of Cultivation Surveys to analyse the changes in real income and discusses the underlying reasons. The study reveals that the purchasing power of farmers has remained low and has worsened over recent years. The value of crop output has increased, but a disproportionate rise in input costs has resulted in a fall in crop incomes in several states, with the agriculturally developed Punjab being an exception. Interestingly, real wage rates for agricultural labour have shown an increasing trend, indicating improvement in the welfare of labour. © 2014 John Wiley & Sons Ltd.
Nautiyal S.,Institute for Social and Economic Change ISEC
Journal of Mountain Science | Year: 2013
The aim of the study was to evaluate the impacts of the transition from wood fuel to Liquefied Petroleum Gas (LPG) from energy use and health perspectives along an altitudinal gradient (viz., lower altitude; middle altitude; and higher altitude) of the Central Himalayas. Empirical field study and questionnaire based survey was conducted for obtaining the data. A total of 20 households from each altitude were selected for obtaining reliable information on the actual quantity of fuelwood consumed. Of the 20 households, five households each based on the family size i.e., small families (<4 members), medium (5-8 members) and large (>9 members) from all the altitudinal regions were selected. This was followed by an administration of a questionnaire on the quantity of fuelwood consumed. After the completion of the questionnaire survey, the data was validated using a weighted survey for the randomly selected households for obtaining precise information on the actual quantity of fuelwood consumed. Energy analysis is done with respect to the time spent on fuelwood collection and energy value of burning of per kg of fuelwood. Study indicates that declining biomass requirement from forests contributes significantly towards energy conservation, also has positive impact on human health. Per capita annual energy expenditure on collection of fuelwood is 752 MJ which is higher than any other activity in villages of Central Himalaya. The LPG substitution has contributed to energy saving which is equivalent to 2976-3,742 MJ per capita per year in middle and lower altitudes respectively. In the higher altitude the energy saving is calculated to be about 257 MJ per capita per year. Replacing fuelwood with LPG has made positive impact on society in terms of improving the health while reducing diseases that are caused due to indoor air pollution. © 2013 Science Press, Institute of Mountain Hazards and Environment, CAS and Springer-Verlag Berlin Heidelberg.
Lakshmana C.M.,Institute for Social and Economic Change ISEC
Journal of Health Management | Year: 2013
Increasing population, poverty and low status of socio-economic development have put more pressure on available resources in India. It has also posed several policy implications, in which the basic need of healthcare provision is one of the prime administrative tasks for the respective state governments in India. Higher proportion of child and elderly population in total, and the resultant higher dependency ratio in a particular area/region, will necessitate a commensurate increase in public healthcare facilities and hence higher monetary allocation. If a province has comparatively higher fertility rate it would necessitate higher allocation for maternal and child healthcare services. In this paper an attempt is made to examine the relationship between dependency ratio and healthcare expenditure (medical, public health and family welfare), as well as the proportion of healthcare expenditure in the Gross State Domestic Product (GSDP) in select four southern states of India. The analysis is based on available secondary data for various years. © 2013 Indian Institute of Health Management Research.
Rajesh K.,Institute for Social and Economic Change ISEC |
Thomas M.B.,Institute for Social and Economic Change ISEC
Journal of Health Management | Year: 2012
The democratic decentralization process was launched in Kerala with the Peoples Planning Campaign in 1996 followed by the 73rd and 74th Amendments to the Constitution of India and the passing of the Kerala Panchayat Raj Nagara Palika Act. One of the major objectives of the decentralization process in Kerala was to strengthen the public health care network and improve the quality of public health service delivery. This article attempts to analyze the transition in the health care sector during the last two decades linking it to the interventions of Local Self Governments (LSGs). It was found that decentralization improved infrastructure facilities and equipment in primary and secondary health care institutions and widened health care delivery. It succeeded in providing safe drinking water and sanitation facilities to the local people. The accountability of the public health care system was also enhanced. However, it could not address the issues of nutritional imbalance, old age care, lifestyle diseases and the changing morbidity pattern in the state. This article calls for a comprehensive health policy to ensure functional autonomy for LSGs to address the emerging health care needs in Kerala. © 2012 Indian Institute of Health Management Research.
Kannan E.,Jawaharlal Nehru University |
Ramappa K.B.,Institute for Social and Economic Change ISEC
Environment, Development and Sustainability | Year: 2016
Adoption of soil test-based nutrient management is important for achieving sustainable development of agriculture. The present study analysed the factors influencing the adoption of soil nutrient management technology package comprising adoption of soil test and recommended fertiliser by paddy farmers in the southern Indian state of Karnataka by using field survey data. Bivariate probit model was used to estimate the sequential adoption decisions on soil test and fertiliser application technologies. The study results showed that farmers’ training on fertiliser application and education had positive and significant effect on adoption of soil nutrient technology package. The likelihood of adoption of soil test technology decreases with increase in distance measured from farm to soil test laboratory. Availability of fewer family labour increases the probability of adoption of soil nutrient management technology. These results have significant policy implications for provision of soil testing facilities nearer to villages and for conducting periodical training programmes for encouraging the farmers to adopt soil test-based nutrient management. © 2016 Springer Science+Business Media Dordrecht
PubMed | Institute for Social and Economic Change ISEC, University of Southern California and University of California at Los Angeles
Type: Journal Article | Journal: BMJ open | Year: 2016
The high prevalence of coronary heart disease and dramatic growth of cardiac interventions in India motivate an evaluation of the appropriateness of coronary revascularisation procedures in India. Although, appropriate-use criteria (AUC) have been used to analyse the appropriateness of cardiovascular care in the USA, they are yet to be applied to care in India. In our study, we apply AUC to cardiac care in Karnataka, India, compare our results to international applications of AUC, and suggest ways to improve the appropriateness of care in India.Data were collected from the Vajpayee Arogyashree Scheme, a government-sponsored health insurance scheme in Karnataka, India. These data were collected as part of the preauthorisation process for cardiac procedures.The final data included a random sample of 600 patients from 28 hospitals in Karnataka, who obtained coronary artery bypass grafting or percutaneous coronary intervention between 1 October 2014 and 31 December 2014.We obtained our primary baseline results using a random imputation simulation to fill in missing data. Our secondary outcome measure was a best case-worst case scenario where missing data were filled to give the lowest or highest number of appropriate cases.Of the cases, 86.7% (CI 0.837% to 0.892%) were deemed appropriate, 3.65% (CI 0.023% to 0.055%) were inappropriate and 9.63% (CI 0.074% to 0.123%) were uncertain.The vast majority of cardiac revascularisation procedures performed on beneficiaries of a government-sponsored insurance programme in India were found to be appropriate. These results meet or exceed levels of appropriate use of cardiac care in the USA.