Below Poverty Line Research Articles

Evaluating the Impact of Fair Price Shops on Food Security: A Comprehensive Study within the Aspirational District Programme in Hazaribagh, Jharkhand

Abstract The Aspirational District Programme, initiated by Prime Minister Narendra Modi in January 2018, aims to promote equitable development across 115 identified districts in India, including 19 in Jharkhand, with Hazaribagh situated in the North Chotanagpur division. This program operates under 49 indicators spread across five key sectors: Health and Nutrition, Education, Agriculture and Water Resources, Financial Inclusion and Skill Development, and Basic Infrastructure. A critical aspect of this initiative is the Health and Nutrition sector, which emphasizes the provision of nutritious food to ensure that no one faces hunger. Food security is vital in assessing whether individuals have consistent access to food, particularly through the Public Distribution System (PDS). This system includes numerous Fair Price Shops, or ration shops, tasked with delivering essential goods to individuals categorized as Below Poverty Line (BPL), Priority House Holds (PHH), and those under the Antyodaya Anna Yojana (AAY) in Jharkhand, aimed at supporting the most impoverished families with subsidized rates set by the central government. My research focuses on several Fair Price Shops in Hazaribagh district, employing survey methods to gather primary data. The objective is to gain insights into the actual conditions of these ration shops and to evaluate the extent of benefits received by the local population.

Assessing Post-traumatic Stress Disorder and Social Determinants Among COVID-19 Case-Contact Dyads in Household Settings.

Coronavirus disease 2019 (COVID-19)is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).The COVID-19 outbreak raised several public and mental health concerns including tremendous psychological distress. To assess post-traumatic stress disorder (PTSD) among COVID-19-positive patientsand household contacts and to determine the socio-demographic factors associated with PTSD in the study population. A cross-sectional study was conducted among COVID-19-positive patients and their family members in Ernakulam district. A daily list of COVID-19-positive patients was obtained from the district officials. Confirmed cases and their close contacts in households were contacted over telephone and were interviewed after obtaining consent. Post-traumatic stress was assessed by the PTSD Symptom Scale - Interview Version (PSS-I-5) questionnaire. There were 279 study participants, of whom 93 were COVID-19 positive and the remaining 186 were their contacts.More than a third (34, 36.6%) of cases suffered from PTSD while about a fifth (40, 21.5%) of contacts suffered from PTSD. Among cases, persons belonging to the below poverty line (BPL) had 2.9l (1.19, 7.24) times higher risk compared to those above poverty line (APL). Women also had a 2.8 (1.14, 7.01) higher odds compared to males. Among contacts, graduates had a 9.54 (95% CI: 1.84, 49.36) increased odds whereas homemakers were found to be protected (0.195 (0.06, 0.66)) against PTSD compared to the employed group. Psychological counselling and support are essential for addressing PTSD among women and those living with BPL, as these groups are disproportionately affected.

Status of vector protection measures and awareness regarding vector borne diseases in families residing in a "Nirmal Gram Puraskar" village in India.

Mosquito-bome diseases are increasing problems in various parts of the world, causing high mortality and morbidity for humans. This study was done to assess the vector protection measures taken by rural below poverty line (BPL) families, and to assess the awareness about vector-borne diseases along with Total Sanitation Campaign (TSC) in rural BPL families. A cross-sectional study was conducted in a rural area which won "Nirmal Gram Puraskar" Award i.e., "clean village" among 96 below BPL families for a period of three months. These families (every 5 th ) were selected by systematic random sampling until we reached a sample size. Basic socio-demographic details, status of vector protection measures, solid waste management, vector-borne diseases and total sanitation campaign details were collected from the study participants. Pretested, semi-structured questionnaire was applied to the head of the families which included sanitation status at home by house-to-house visit. Data collected was analysed using SPSS version 20 and presented as frequency, percentages, mean and standard deviation. Among 96 families studied (454 adults and children), 84 (87.5%) were males and 12 (12.5%) were females. Among these, 291 (64.1%) were using one or the other mosquito protection measures, 52 (54.2%) were using bednets and 23 (23.9%) used coils. 12 families (12.5%) were not using any mosquito protection measures. In our study, 66 (68.8%) families had individual household latrine (IHHL) and 50 (52.1%) had open drainage. Even though 314 participants had an access to individual household latrine, 20 (6.36%) had practice of open air defecation compared to 127 (90.7%) who practiced open air defecation without an access to individual household latrine. When asked about the awareness regarding vector-borne diseases, 56 (58.3%) were aware about chikungunya, 47 (48.9%) about dengue, 46 (47.9%) about malaria, 14 (14.6%) and only 5 (5.2%) families were aware about Japanese encephalitis. In this study, 37 (38.5%) were aware about the total sanitation campaign and 40 (41.6%) about the government support for sanitation. While there is a general awareness of vector-borne diseases, the implementation of vector protection measures is not uniform across the village. There is a need for targeted interventions to improve the effectiveness of vector protection measures and increase awareness among the community.

IJCM_385A: Establishment of a CKD Screening and treatment program at a secondary care hospital in rural Karnataka - A case study

Background: With the rapidly increasing incidence of kidney disease due to the rise in non- communicable diseases like diabetes and hypertension in India, a felt need for easily accessible Dialysis unit was found during the community assessment. Chronic Kidney Disease (CKD) education and screening program was also proposed to be established along with this to improve awareness and early detection. This would help in health system strengthening and prevent patients from travelling to far away locations for the dialysis sessions. Objective: 1. To conduct CKD education and screening camps in rural areas of Karkala taluk Methodology: The project was implemented for a duration of 12 months starting from July 2021. Camps were held along with help from local clubs & Rotary Club. The following blood tests were carried out: Glycosylated Hemoglobin, Random Blood Sugar (RBS) or Fasting Blood Sugar (FBS), Serum Creatinine and Lipid Profile. These tests were done free of cost for all camp attendees. If the parameters were found to be abnormal, they were referred to Dr TMA Pai Rotary Hospital, Karkala for confirmation of the diagnosis and further management. Along with screening, Health education sessions were also be carried out to create awareness regarding diabetes and Chronic Kidney Disease among the rural population. The Dialysis unit was set up with 3 dialysis machines with funding from Rotary International under the Global Grant scheme. Dialysis was provided at subsidized to Below Poverty Line (BPL) patients. Results: A total of 10 CKD screening & awareness camps were held during the project period. A total of 588 patients were screened. 132 were referred for further management. 8 patients were referred for Dialysis. Average of 170 dialysis sessions are carried out per months. 805 participants attended the training sessions. Conclusion: Similar set ups in rural areas will help in early detection of CKD and make dialysis more affordable and accessible.

The Framework For Adaptive Governance In Odisha: A Special Reference To Climate Change And Disaster Management

Odisha is known as a highly disaster-prone state. In the last half-decade, the state has faced more than a dozen disaster occurrences. Due to poor weather conditions, the coastal belts often remained in an alarming situation. Even though the state has witnessed so many small and big floods and bad air streaming over the years that resulted in crop failure, acute poverty, property damages, and human losses. Farmer suicide is also a related problem to it. Disaster has left the state poor, weaker but also helpless, and vulnerable. It badly affected the economic and administrative structure of state machinery. In the same way, the continuous disaster risk in coastal areas of Odisha has highly influenced untold human suffering. Some of the important regions of the coastal belt or the eastern cities of Odisha like Paradeep, Berhampur, Puri, and Balasore; whereas West Bengal and Andhra Pradesh will come under tremendous disaster every year. These regions are even under heavy alert in governmental planning to protect lives from possible disaster risks. Even from an economic point of view, it is not doubtful that Odisha is a poor state. Most people depend on agriculture and crop production as their life support system and their occupations rely on sea areas. And more than 30 percent of people still rely on government schemes under the Below Poverty Line (BPL). Hence any unprecedented disasters make possible countless properties, infrastructure, shelters, and lives and livelihood losses in the states. So, stress is placed on the government and governance process, to tackle disaster damage in Odisha with zero casualties. Institutional capacity building is a significant step with the help of stakeholders and local communities to enhance the maximum possibilities against regular disasters. Thus, the study will focus on the role of adaptive governance structure in countering climate change and disaster risks in Odisha. At the same time, it focuses on the resilience step to be taken in protecting lives, livelihoods, and properties in the hands of effective governance.

Human–river interaction and perceived morbidities: A cross-sectional study on River Killi, Kerala

Abstract INTRODUCTION: Almost all water resources around the world have been polluted by human activities. River pollution from industries and agricultural/domestic areas is ultimately affecting human life. It is important to understand such a problem from a public health angle as well as from the perspective of the river bank population. OBJECTIVE: The study examines the public health dimensions of human-river interaction in relation to the riverbank population and to assess their morbidity profile with respect to river Killi in Trivandrum district, Kerala. METHODOLOGY: The full stretch of the river was divided into grids for every 3 kms. and houses from alternate grids within 50 meters from the river edge were selected for the study. Data collection among 302 riverbank residents was done based on a pre-tested, semi-structured interview schedule in addition to in-depth interviews among 15 stakeholders. RESULTS: The study results showed that 161 (53.3%) households belonged to the Below Poverty Line (BPL) and 169 (56%) respondents were from low socioeconomic status. The human-river interaction was significantly associated with the place of residence (rural/urban) and their economic status. Common self-reported morbidities include itching on the skin (16.2%) and fungal infections (12.9%). The riverbank population also stated their vulnerability to flooding during the rainy season and the unavailability of fresh water during dry summer. The cleaning program by the government had a positive impact on river cleanliness. However, in many places along the stretch of the river, sewage drainage, waste dumping and aquatic weeds are still a problem. CONCLUSION: This study shows several factors that disturbed the positive human-river interaction. A collaborative approach including stakeholders and the riverbank population for better river management and persistent surveillance on river water quality and health evaluation of the riverbank population are needed.

The effectiveness of a government-sponsored health protection scheme in reducing financial risks for the below-poverty-line population in Bangladesh.

The Government of Bangladesh is piloting a non-contributory health protection scheme called Shasthyo Surokhsha Karmasuchi (SSK) to increase access to quality essential healthcare services for the below-poverty-line (BPL) population. This paper assesses the effect of the SSK scheme on out-of-pocket expenditure (OOPE) for healthcare, catastrophic health expenditure (CHE) and economic impoverishment of the enrolled population. A comparative cross-sectional study was conducted in Tangail District, where the SSK was implemented. From August 2019 to March 2020, a total of 2315 BPL households (HHs) (1170 intervention and 1145 comparison) that had at least one individual with inpatient care experience in the last 12 months were surveyed. A household is said to have incurred CHE if their OOPE for healthcare exceeds the total (or non-food) HH's expenditure threshold. Multiple regression analysis was performed using OOPE, incidence of CHE and impoverishment as dependent variables and SSK membership status, actual BPL status and benefits use status as the main explanatory variables. Overall, the OOPE was significantly lower (P < 0.01) in the intervention areas (Bangladeshi Taka (BDT) 23 366) compared with the comparison areas (BDT 24 757). Regression analysis revealed that the OOPE, CHE incidence at threshold of 10% of total expenditure and 40% of non-food expenditure and impoverishment were 33% (P < 0.01), 46% (P < 0.01), 42% (P < 0.01) and 30% (P < 0.01) lower, respectively, in the intervention areas than in the comparison areas. Additionally, HHs that utilized SSK benefits experienced even lower OOPE by 92% (P < 0.01), CHE incidence at 10% and 40% threshold levels by 72% (P < 0.01) and 59% (P < 0.01), respectively, and impoverishment by 27% at 10% level of significance. These findings demonstrated the significant positive effect of the SSK in reducing financial burdens associated with healthcare utilization among the enrolled HHs. This illustrates the importance of the nationwide scaling up of the scheme in Bangladesh to reduce the undue financial risk of healthcare utilization for those in poverty.

Childhood Leprosy in Postelimination Era: A Clinico-Epidemiological Prospective Observational Study from India

Background: Although India has achieved national level elimination of leprosy in December 2005, it reports highest number of leprosy cases in the world. Incidence of leprosy amongst young children indicates active foci of transmission in the community, making it a robust epidemiological indicator to assess the progress of leprosy control programs. Aim and Objectives: To study prevalence, clinical spectrum, patterns of extracutaneous involvement, reactions, relapse, demographic profile, anthropometric characteristics of children with leprosy. Materials and Methods: A prospective observational study of children younger than 14 years old with clinical signs and symptoms of leprosy, including cases diagnosed from October 2018 through September 2020 at a tertiary hospital in Eastern India. Results: Childhood leprosy constituted of 10.4% of total new leprosy cases. Mean age observed was 11.14 ± 1.5 years. 30.4% were females and 69.6% were males. The mean average duration was 9.95 ± 12.3 months. 82.1% of children belong to below poverty line (BPL) status. 19.6% of children had malnourishment/stunting/thinness, and 55.4% had anemia. 84.1% presented with skin discoloration. The most common site affected was upper limb (57.1%). 29.2% had contact history. A single case of relapse (1.7%) was reported. Most common peripheral nerve involved was ulnar nerve (67.8%). 8.9% of children had type 1 lepra reaction, and 1.7% had type 2 lepra reaction. 73.21% presented with borderline tuberculoid clinical type of leprosy. 19.6% showed slit skin smear positivity. Conclusion: Pockets of high endemicity of childhood leprosy as detected in the current study point toward the unmet need of better healthcare facilities along with increased awareness, campaigns, and school surveys for early diagnosis and treatment for the prevention of complications and spread in community.

Poverty Reduction through MGNREGA in Himachal Pradesh

People are considered poor if their levels of income and consumption fall below a given minimum level necessary to fulfill their basic needs. Poverty reduction aims at improving the quality of life through various government schemes launched from time to time. The Mahatma Gandhi National Rural Employment Guarantee Act, 2005 or MNREGA is one such scheme that provides hundred days of guaranteed employment to each household in a financial year. The present paper is an endeavour to study the impact of the scheme on poverty reduction in the Sirmour and Solan districts of the states of Himachal Pradesh. For this study, 400 below poverty line (BPL) MNREGA beneficiaries were selected and data collected with the help of a questionnaire on aspects like food availability, earnings, expenditure patterns, risk management, and savings, among others. Their level of living has improved significantly, and the scheme has been proven to be an important source for their income and survival. The study also revealed that after MNREGA employment, the poor were able to procure food grains from fair price shops and grain shops. The findings also show that expenditure on the education of children, medical facilities, insurance, entertainment, social occasions, etc. has increased in poor households after the implementation of MNREGA.

Healthier mind builds healthier nation under ABArK

Background: The State of Karnataka launched a scheme called “Arogya Karnataka” as a part of universal health coverage following the Karnataka Integrated Public Health Policy 2017 and Karnataka Vision 2025 document. With the goal of achieving universal health coverage (UHC), Karnataka, a national leader in healthcare, launched the Arogya Karnataka scheme in March 2018. It was later integrated with the government of India's national health protection scheme Ayushman Bharat Pradhan Mantri Jan Arogya Yojana(AB-PMJAY) to help with financial protection. Mental health, as defined by the World Health Organization (WHO), refers to “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”. Methods: A cross-sectional analysis of data collected from the State Health Agency, Suvarna Arogya Suraksha Trust (SAST) portal. The study was conducted for a period 12 months from January to December 2022. Results: The study included 7292 mental disorder patients, majority of were male (70.95%), having age group of 31-45 years (45.41%), and belonged to the Below poverty line (BPL) (94.54%). Majority of cases were psychoactive substance use (64%) followed by Schizophrenia (22%) and Mental Retardation (14%). Conclusions: Ayushman Bharat –PM-JAY Arogya Karnataka (AB-PMJAY ArK) has potential to reduce the out of pocket expenditure, distress financing and reduce catastrophic health expenditure which will lead to significant impact on health indices.

Person Perception of Students on Reservation in Higher Education in India

The present study aimed to determine the person perception of students on reservation in higher education. The respondents of the study were from three districts of Kerala. The data were collected using a Person Perception Scale. The brief profile of the total respondents ( N = 490) shows 195 boys and 295 girls; 305 rural and 185 urban; 320 government and 170 private; 338 Above Poverty Line (APL) and 152 Below Poverty Line (BPL)), respectively. The study adopted a random sampling technique. The data collected were analysed for mean, standard deviation and t-test techniques. The result of the study revealed that boys have a higher person perception than girls; rural students have a higher person perception than urban students; government school students have a higher person perception than private school students; students who belong to the APL category have a higher person perception than BPL category; regarding reservation in higher education. And in total, students possess an average level (60%) of person perception on reservation in higher education.

A Cross-sectional Study on Factors Influencing Health Services Utilisation for under-Five Morbidities in South Bengaluru

Background: World Health Organization (WHO) estimates that seeking prompt and appropriate healthcare could reduce child deaths by nearly 30%. In this background, the present study was conducted to 1. assess the health services utilization for diarrhoea and ARI (acute respiratory infections) among under-5 children in South Bengaluru, 2. determine the factors influencing mothers for utilization of health services.&#x0D; Methods: Authors conducted a cross-sectional study in 10 randomly selected wards of South Bengaluru from July, 2019 to January, 2020 using multistage sampling. 432 mothers with under-5 children were interviewed regarding morbidities of their children in the previous one month and the health services they utilised, using a semi-structured questionnaire derived from multiple indicator cluster survey (MICS) by UNICEF. Data were analysed using SPSS 21.0 for descriptive statistics and logistic regression.&#x0D; Results: 95 of the participants had illnesses in the past one month; but, only 41 had used health facilities for treatment, mainly in the private sector (68.3%). The reasons for non-utilization of healthcare services were negligence (36.9%), long waiting time at the center (22.4%), financial constraints (20.4%) and mothers’ jobs (9.6%). The most significant factors influencing the health services utilisation were: literacy status of the mother (predisposing factor), low socio-economic status/ BPL (below poverty line) families (enabling factor), and severity of symptoms (need factor).&#x0D; Conclusion: Utilisation of healthcare services for under-five morbidities in the studied population was inadequate. The influencing factors have to be addressed on a priority basis to fulfil the goal of universal health coverage.

Can training over phone calls help improve outcomes for COVID-19 positive patients under home isolation? An analysis of the COVID-19 Care Companion Program in Punjab, India

BackgroundPhone-supported recovery of COVID-19 patients in home isolation could be an effective way of addressing COVID-19 in contexts with limited resources. The COVID-19 Care Companion Program (CCP) is one such intervention, designed to support patients and their caregivers in remote, evidence-based management of COVID-19 symptoms. ObjectiveTo estimate the effect of providing phone-based training to COVID-19 patients and their caregivers on the likelihood of hospitalizations and mortality. MethodsA pragmatic randomized trial was conducted to assess the effect of a novel phone-based training program on COVID-19 home-isolated patient outcomes. The analysis compared the outcomes of death and hospitalizations in the teletraining intervention group (CCP) to those receiving standard of care (SoC). ResultsLogistic regression models adjusted for age, gender, education, occupation, and poverty, as measured by family possession of Below Poverty Line (BPL) card, were used to look at the effect of intervention on hospitalization and mortality. While the CCP intervention had no effect on 21-day mortality (OR 0.64; 95% CI, 0.19 to 2.12), it was associated with a 48% reduction in 21-day hospitalization (OR 0.52; 95% CI, 0.31 to 0.90). ConclusionCOVID-19 CCP teletraining intervention reduced the rate of hospitalization, potentially reducing the burden on hospitals.

One-Year follow-up of 50 Rural Underprivileged Type 1 Diabetes Children on Insulin Pump Therapy: Breaking Socio-Economic Barriers in Diabetes Technologies.

To audit the feasibility and clinical outcomes of fifty rural underprivileged children with Type 1 diabetes on insulin pump therapy for a one-year duration. All patients were audited from the Type 1 database of Madhuram Diabetes and Thyroid Centre (Unit of Idhayangal Charitable Trust www.idhayangal.org, NGO focussed on Type 1 diabetes from poor socio-economic strata). Below Poverty Line (BPL) was defined as any family earning less than Rs 2 lacs per annum. All children acted as their own controls managed on MDI for at least six months before pump start. Data were tabulated in Microsoft Excel and analysed. There were significant reductions in glycosylated haemoglobin at 6 months and one-year of insulin pump therapy compared to baseline pre-pump MDI values. In addition, significant reductions in diabetic ketoacidosis and severe hypoglycaemia admissions were seen. Insulin pump therapy without prejudice on indicated well-selected rural underprivileged children with Type 1 diabetes leads to clinically meaningful outcomes. NGO-Private-Industry partnership is vital to expand access of modern diabetes technologies to reach the most underprivileged.

A Cross-Sectional Study to Assess Nutritional Status of Adolescent Girls Using Body Mass Index

Background: Malnutrition continues to be a major public health problem worldwide. World's attention is now toward malnourished girls who are more likely to remain undernourished during adolescence and adulthood, and when pregnant, they are more likely to deliver low birth-weight babies creating a vicious cycle. Objectives: (1) To study sociodemographic profile of adolescent girls and (2) to study the association of undernutrition with sociodemographic status. Materials and Methods: This school-based cross-sectional study was conducted among 268 adolescent girls of 7th and 8th standard, from government high school of Karad. Quantitative data were analyzed using SPSS version 20 for calculating mean with standard deviation and Chi-square test was applied. Results: According to body mass index for age, the prevalence of undernutrition was 32.85%. Similarly undernutrition was found high among rural girls (35.4%), among girls of age group 12 (34.85%) and those who were pure vegetarian (37.3%). It was found very much high among three generation type family (45%). Significantly high proportion of girls with first birth order (38.3%), below poverty line (BPL) families (71.4%), and the girls taking &lt;3 meals per day (76.1%), were found to be undernourished. Skipping breakfast for 1-3 days per week (27.3%) and the girls using fast food (98.9%) as well as soft drinks (56.8%) showed high rate of undernutrition. Conclusion: Undernutrition was found to be prevalent among the rural adolescent girls with first birth order belonging to BPL families and associated with poor dietary habits.

Commentary: Aspheric intraocular lens may be the future but not always a simple solution.

Nowadays, cataract surgery is not only to achieve the vision of 20/20; rather, it demands many other qualities of vision to be fulfilled as described by Despande et al.[1] Spherical aberration is one of the varieties of higher-order aberration (HOA) in the eye. The optical design of the aspheric intraocular lens (IOLs) reduced spherical aberrations and increased contrast sensitivity as described by Despande et al.[1] As described by the authors, the crystalline lenses lose their property of negative spherical aberration to compensate for the positive spherical aberration of the eye with overall near-zero spherical aberration of the young adult eyes or very minimal spherical aberration. Wavefront technology is used nowadays more frequently by an aberrometer to map the eye before any refractive surgery to detect any aberration so that customized compensatory optical solution can be done to that eye to achieve the best possible functional vision. Patients having age-related cataracts not only suffer from a decrease in vision but also loss of contrast, especially in mesopic conditions. They did not realize it at that time due to cataracts but after cataract surgery when their contrast also improves along with their vision they are the happiest patients. Theoretically, spherical aberrations increase the depth of focus but decrease modulation transfer function at high spatial frequencies at optimum focus. Spherical aberrations, therefore, play an important role in the balance between visual acuity and depth of focus.[2] Although aspheric IOLs are replacing the spherical IOLs in our country, still PMMA rigid IOL is implanted frequently in below poverty line ( BPL) and ration cardholder patients due to the issue of affordability. Another point to be noted is that the asphericity of aspheric IOL is lost and even leads to more aberrations such as coma and coma-like effects if the IOL is slightly decentred and tilted and these aberrations occur more in aspheric IOL than in spheric IOL and monofocal IOL than multifocal IOL in such scenarios.[3] That is the reason in 1980 and 1990 there was a reluctance for aspheric IOL. However, after the evolvement of phacoemulsification, better surgery techniques such as proper rhexis size, the problems of decentration and tilt has got reduced quite a lot so more and more aspheric IOLs are implanted. The spherical aberration reduced significantly in these aspheric IOL in larger pupil aperture such as in young patients who have undergone corneal refractive surgery, especially in mesopic and scotopic conditions. Thus, the aged population with a small pupil size and having less mesopic and scotopic activity may not need the aspheric IOL. Wavefront technology is used more before corneal refractive surgery or biopics, to measure the corneal and total aberration of eyes so that customized surgery can be planned accordingly for a better functional optical outcome. The future generation of cataract surgery will not be for the recognition acuity only rather for fully functional visual outcome and aberration-free vision. With the better technique of cataract surgery, day by day such as higher competency in phacoemulsification and nowadays femto laser-assisted cataract surgery where precise capsulorhexis is done, more and more aspheric IOL will be the choice of IOL in the coming days.

Factors affecting the healthcare utilization from Shasthyo Suroksha Karmasuchi scheme among the below-poverty-line population in one subdistrict in Bangladesh: a cross sectional study

BackgroundFinancing healthcare through out-of-pocket (OOP) payment is a major barrier in accessing healthcare for the poor people. The Health Economics Unit (HEU) of the Ministry of Health and Family Welfare of the government of Bangladesh has developed Shasthyo Suroksha Karmasuchi (SSK), a health protection scheme, with the aim of reducing OOP expenditure and improving access of the below-poverty-line (BPL) population to healthcare. The scheme started piloting in 2016 at Kalihati sub-district of Tangail District. Our objective was to assess healthcare utilization by the enrolled BPL population and to identify the factors those influencing their utilization of the scheme.MethodA cross-sectional household survey was conducted from July to September 2018 in the piloting sub-district. A total of 806 households were surveyed using a semi-structured questionnaire. Information on illness and sources of healthcare service were captured for the last 90 days before the survey. Multiple logistic regression models were applied to determine the factors related to utilization of healthcare from the SSK scheme and other medically trained providers (MTPs) by the SSK members for both inpatient and outpatient care.ResultA total of 781 (24.6%) people reported of suffering from illness of which 639 (81.8%) sought healthcare from any sources. About 8.0% (51 out of 639) of them sought healthcare from SSK scheme and 28.2% from other MTPs within 90 days preceding the survey. Households with knowledge about SSK scheme were more likely to utilize healthcare from the scheme and less likely to utilize healthcare from other MTPs. Non-BPL status and suffering from an accident/injury were significantly positively associated with utilization of healthcare from SSK scheme.ConclusionAmong the BPL population, healthcare utilization from the SSK scheme was very low compared to that of other MTPs. Effective strategies should be in place for improving knowledge of BPL population on SSK scheme and the benefits package of the scheme should be updated as per the need of the target population. Such initiative can be instrumental in increasing utilization of the scheme and ultimately will reduce the barriers of OOP payment among BPL population for accessing healthcare.

Gender and financial inclusion: does technology make a difference?

Using district-level survey data, the analysis assesses the impact of technology in fostering the financial inclusion of women in India. The findings show that women are 12% less likely to use a mobile phone while opening accounts and 9% less likely to actively use such accounts. Relatedly, account ownership and its use are less likely for women with mobile phones, especially in the post-PMJDY period. The evidence also reveals a differential impact of mobile phones on women across strata and primarily for below-poverty line respondents. The analysis suggests the need for carefully-crafted policies to address this mobile gender gap in order to further reduce the gender gap in financial inclusion.

A Study on the Effectiveness Pradhan Manthri Jan ArogyaYojana with Reference to Cherunniyoor Grama Panchayat

The saying ‘ health is wealth’ is very much true in the present fast-paced life and it signifies the importance and necessity of a well developed health care system. Ill health not only leads to financial bankruptcy but also gives a lot of sufferings to the affected individual and his/ her family. Good health is one of the most important pre requisite to human productivity which in turn leads to overall development of a society. Primary health care is the backbone of the Indian health system. Health problem can be occurred at any time for any one. To ensure “Health for all” is a huge challenge that confronts the authorities in India, given the country’s size and the diversity of its population in socio-economic, regional, and cultural terms. Accordingly, steps were initiated to provide health insurance to selected beneficiaries either at the state level or national level. PradhanManthri Jan ArogyaYojana Scheme was launched in 2018 by the Government of India, with the objective of providing health insuranceto the poorest strata of society, i.e. below poverty line (BPL) households. The primary aim of PMJAY is to protect BPL households from catastrophic health expenditure and to promote health-seeking behavior in them. The costs of this scheme are borne in the ratio of 3:1 between the central government and the state. The main objectives of the studies are to study the financial impact and effectiveness in the implementation of PMJAY among BPL families in CherunniyoorGramaPanchayat of Kerala state and to identify whether the PMJAY beneficiaries are satisfied with the amount provided for treatment under the Scheme.

Post-purchase Federal Financial Aid: How (in)Effective is the IRS's Student Loan Interest Deduction (SLID)in Reaching Lower-Income Taxpayers and Students?

Federal financial aid policies for higher education may be classified based on their “for-purchase” and “post-purchase” natures. The former include grants, loans, and workstudy and intend to help students finance or afford college attendance, persistence, and graduation. Post-purchase policies are designed to minimize financial burdens associated with having invested in college attendance and are granted as tax incentives/expenditures. One of these expenditures is the IRS’s Student Loan Interest Deduction (SLID)—which offers up to $2500 as an adjustment for taxable income based on having paid interest on student loans and has an annual cost of $12.81 billion—about 45.7% of the Pell grant cost. Despite this high cost, SLID has remained virtually unstudied. Accordingly, the study’s purpose is to assess how (in)effective SLID may be in reaching lower-income taxpayers. To address this purpose, we relied on an innovative analytic framework “multilevel modelling with spatial interaction effects” that allowed controlling for contextual and systemic observed and unobserved factors that may both affect college participation and may be related with SLID disbursements over and above income prospects. Data sources included the IRS, ACS, FBI, IPEDS, and the NPSAS:2015–2016. Findings revealed that SLID is regressive at the top, wealthier taxpayers and students attending more expensive colleges realize higher tax benefits than lower income taxpayers and students. Indeed, 75% of community college students were found to not be eligible to receive SLID—data and replication code (https://cutt.ly/COyfdKC) are provided. Is this the best use of this multibillion tax incentive? Is SLID designed to exclude the poorest, neediest students? A policy similar to Education Credits, focused on outstanding debt rather than on interest, that targets below-poverty line students with up to $5000 in debt, would represent a true commitment, and better use of public funds, to close socioeconomic gaps, by helping those more prone to default.