Districts Of India Research Articles

Inflammatory agriculture: Political ecologies of health and fertilizers in India

Across India, many farmers contend that synthetic nitrogenous fertilizers do more than impact soils, but also lead to tasteless food crops and weakened bodies more susceptible to aches, pains, and diseases. Although these complaints, long-documented across South Asia, have been theorized as embodied critiques of development or as reflecting hybrid epistemologies, there has been strikingly little focus on the potential biophysical currents that may underpin these perceptions of fertilizer harm. This paper works to fill this gap, analyzing qualitative data collected from farmers in two remote eastern Indian districts using an “integrated” political ecology of health (PEH) framework that utilizes two main approaches to examine bodily materiality and health. In particular, the framework looks at the multi-scalar political economies, cultural forms of meaning-making, as well as the visceral, affective ways that respondents come to see synthetic fertilizers as the cause of barren lands, tasteless foods, and weakened bodies. The article then deploys a critical reading of bioscientific literature to interpret respondent narratives and zoom in onto potential bio-social mechanisms that may help illuminate claims of fertilizer harm in new ways. In particular, I present evidence around how phytochemicals—literally chemicals produced by plants—may shift due to chemical fertilizer use in ways that may matter for hunger and health. Yet, not losing sight of the affective ways crops are grown, consumed, and discussed, I also highlight research examining how beliefs and perceptions measurably modify physiological responses to food in positive or adverse ways through the still ill-understood placebo/nocebo effect. The goal of such analysis is not to present a tidy conclusion to questions of fertilizer–health connections but demonstrate how a PEH that remains attentive to power, discourse, and materiality can bring disparate streams of thought together to forge pathways for transdisciplinary research and practice.

Understanding Differences in Behaviour Patterns of Healthcare Service Elements Among Regions Applying Data Mining

Maternal and child healthcare (MCH) has always been regarded as one of the important issues globally. The aim of this article is to find out all frequently occurring healthcare service elements along with their availability conditions and their interactions with other health system (HS) elements, when coverage of priority MCH intervention was either poor or moderate or good in any region. Association rule mining technique has been used to understand the probability of occurrences of different healthcare service elements among regions. Along with the proposed analytical framework, an interactive decision support system (DSS) has also been developed on a web platform, which would help healthcare policymakers to integrate the analytical framework easily in their processes of decision-making. The system has been developed by using Shiny package on R software. Data for all variables are collected for 584 Indian districts from the third phase of district-level household and facility survey. From results, it is observed that community healthcare services, sub-centre (SC)-level healthcare services and PHC-level healthcare services of a region are very much interlinked with each other, and their relationships define the healthcare condition of that region.

Lung Function Reference Equations for Indian Ethnic Groups Based on a Handheld Forced Oscillation Device for Age 9-19 Years.

To develop regression equations to predict forced oscillation technique (FOT) parameters in Indian children and adolescents. Lung function was assessed in a multigeographic cohort of residential school children using a portable FOT-based device (PulmoScan) and spirometry. FOT measurements were performed in 1497 study participants, aged 9-19 y, from 8 Indian districts. Bland-Altman analysis was performed for additional 32 adult subjects to compare the results of PulmoScan to a standard IOS device in an outpatient setting. Reference equations were developed for Rrs and Xrs from the data of healthy subjects with normal spirometry using multivariate regression model for Indo-European, Dravidian, and mixed ethnic groups. X5 (bias = 0.02) showed a better agreement than resistance parameters (R5 bias = 0.75, R20 bias = -0.22) in IOS/PulmoScan comparison. Anthropometric variables (age, height, and weight) were positively correlated with reactance (X5) and negatively with resistance parameters (R5, R10, R15, and R20), with most associations being stronger in boys. Final regression model considered ethnicity as a key determinant along with anthropometry. Multiethnic reference equations were developed for Indian children aged 9-19 y based on a novel handheld FOT device.

A cross sectional study to examine factors influencing COVID-19 vaccine acceptance, hesitancy and refusal in urban and rural settings in Tamil Nadu, India.

The second wave of the COVID-19 pandemic left the Indian healthcare system overwhelmed. The severity of a third wave will depend on the success of the vaccination drive; however, even with a safe and effective COVID-19 vaccine, hesitancy can be an obstacle to achieving high levels of coverage. Our study aims to estimate the population's acceptance of the COVID-19 vaccine in an Indian district. A pilot community-based cross-sectional study was conducted from March-May 2021. The data was collected from eight primary health centres in Tamil Nadu. The eligible study participants were interviewed using a self-constructed questionnaire. A total of 3,130 individuals responded to the survey. Multinomial logistic regression was performed to assess the factors influencing COVID-19 vaccine hesitancy and refusal. Results of our study showed that 46% percent (n = 1432) of the respondents would accept the COVID-19 vaccine if available. Acceptance for the COVID-19 vaccine was higher among males (54%), individuals aged 18-24years (62%), those with higher education (77%), having the higher income (73%), and employed (51%). Individuals with no education (OR: 2.799, 95% CI = 1.103-7.108), and low income (OR: OR: 10.299, 95% CI: 4.879-21.741), were significant predictors of vaccine hesitancy (p < 0.05). Living in urban residence (OR: 0.699, 95% CI = 0.55-0.888) and age between 18 to 25 years (OR: 0.549, 95% CI = 0.309-0.977) were protective factor of COVID-19 vaccine hesitancy. While individuals in the age group 25-54years (OR = 1.601, 95%CI = 1.086-2.359), fewer education (OR = 4.8, 95% CI = 2.448-9.412,), low income (OR = 2.628, 95% CI = 1.777-3.887) and unemployment (OR = 1.351, 95% CI = 1.06-1.722) had high odds of refusing the COVID-19 vaccine. Concerns and suspicions about the safety of the COVID-19 vaccine (63%) was the major reasons causing hesitancy towards the COVID-19 vaccine The public health authorities and government need to design, develop and implement targeted interventions to enhance awareness about COVID-19 vaccines, and barriers and enablers to vaccine acceptance among individuals across diverse settings. Emphasis on involving local and religious leaders, ASHA workers, community healthcare workers, Anganwadi workers, and auxiliary nurse midwives can help to overcome context-specific barriers in areas of low COVID-19 vaccine acceptance, especially in rural settings.

Explaining Connectedness: An Exploration of the Factors Affecting Internet Access in India

Access to the internet can promote education, upskilling, human capital, and national and international economic outcomes. However, the household internet access rate in India in 2011 was 10.1% (Roser et al., 2015). Using data from the 2011 Indian Census, this study analyses the impact of computer access, area, literacy, and working rates alongside a gender perspective to explain district-wise household internet access. The analysis demonstrates that access to computers, area, male activity, and literacy significantly explain the internet access rates observed in Indian districts. The study concludes that socio-demographic factors influence the internet uptake and digital divide in India. The conclusion of this paper contributes to theoretical discussions of the digital divide in the modern history of India and provides implications for policy and market expansion in India.

Hydrogeochemical Survey along the Northern Coastal Region of Ramanathapuram District, Tamilnadu, India

Ramanathapuram is a drought-prone southern Indian district that was selected for conducting a hydrogeochemical study. Groundwater samples from 40 locations were collected during January 2020 (pandemic interdiction according to COVID) and January 2021. The hydrogeochemical properties of the groundwater samples were evaluated and compared with drinking water regulations to assess their water quality. The order of cation dominance was as follows: Na+ &gt; Ca2+ &gt; K+ &gt; Mg2+ in January 2020 and Na+ &gt; Ca2+ &gt; Mg2+ &gt; K+ in January 2021 with respect to the mean value. The order of anion dominance was as follows: Cl− &gt; HCO3− &gt; SO42− &gt; NO3− &gt; F− in January 2020 and Cl− &gt; SO42− &gt; HCO3− &gt; NO3− &gt; F− in January 2021 with respect to the mean value. In the study area, the southern coastal region was identified as a groundwater-polluted zone through spatial analysis based on all analysis results. The irrigation water quality was analyzed using various calculated indices, such as Na% (percent sodium), SAR (sodium absorption ratio), PI (permeability index), MgC (magnesium risk), RSC (residual sodium concentration), and KI (Kelly ratio), demonstrating the suitability of the groundwater for irrigation in most parts of the study area. This was also confirmed by the Na% vs. EC Plot, USSL, and Doneen’s Plot for PI. In addition, the WQI results for drinking water and irrigation confirmed the suitability of the groundwater in most parts of the study area, except for the coastal regions. The dominant hydrogeologic facies of Na+-Cl−, Ca2+-Mg2+-SO42−, and Ca2+-Mg2+-Cl− types illustrated by the Piper diagram indicate the mixing process of freshwater with saline water in the coastal aquifers. Rock–water interaction and evaporation were the main controllers of groundwater geochemistry in the study area, as determined using the Gibbs plot. Ion exchange, seawater intrusion, weathering of carbonates, and the dissolution of calcium and gypsum minerals from the aquifer were identified as the major geogenic processes controlling groundwater chemistry using the Chadha plot, scatter plot, and Cl−/HCO3− ratio. Further, multivariate statistical approaches also confirmed the strong mutual relationship among the parameters, several factors controlling hydrogeochemistry, and grouping of water samples based on the parameters. Appropriate artificial recharge techniques must be used in the affected regions to stop seawater intrusion and increase freshwater recharge.

Political competition and public healthcare: Evidence from India

• We examine the causal effect of political competition, measured as the effective number of parties (ENP), on healthcare provision in India. • We find that a 1 SD increase in ENP, raises the probability that a village has a health facility by 8%–15% across different facility-types. • By contrast, we do not observe ENP to exert a robust impact in affecting any of the indicators of health-centre capacity. • We show that prioritizing highly visible health centre access over less visible health centre capacity is electorally rewarding for incumbents. • We find that election-year cycles affect small-budget consumption items while political alignment affects sizeable public investment. In this paper, we examine the causal effect of political competition on public provision of healthcare. Specifically, we investigate whether the effect of political competition on more visible public goods (e.g. health centre access) differs from its impact on less visible public goods (e.g. health centre capacity such as doctors, medical supplies, etc.). Using granular data from three recent waves of the Indian District Level Household Survey (DLHS) during 2002–2013 and an instrumental variable approach, we find that incumbents respond to electoral competition, measured as the effective number of parties (ENP), by trading-off less visible health centre capacity for more visible access to health centres. We provide suggestive evidence that focusing on more visible health centres boosts the incumbent party’s re-election prospects providing a clear motive for incumbent’s action. In addition, we examine the effect of election-year cycles and the role of political alignment in healthcare provision and find compelling evidence of a political economic mechanism at work. By contrast, political competition has no measurable impact on key health outcomes. We conduct several robustness checks to ensure that our estimates are reliable. Thus, our results suggest that electoral competition must be accompanied by strong checks on accountability to improve health outcomes.

Association between vaccine preventable diseases in children and improved sanitation following a nationwide sanitation campaign in India: an ecological analysis

ObjectivePersistent exposure to faecal pathogens due to open defecation may cause environmental enteropathy that, in turn, may lead to undernutrition and vaccine failure in under 5-year-old (u5) children. The Swachh...

Identifying Geographical Heterogeneity in Associations between Under-Five Child Nutritional Status and Its Correlates Across Indian Districts

Identifying Geographical Heterogeneity in Associations between Under-Five Child Nutritional Status and Its Correlates Across Indian Districts

Rainfall shocks and fertilizer use: a district level study of India

AbstractIn the context of climate change and increasing occurrences of extreme events, it is essential to understand farmers' responses to weather shocks and adaptations. This paper uses a panel dataset of 311 selected Indian districts ranging from 1966 to 2009 to investigate how application of chemical fertilizers varies in response to rainfall shocks. Two rainfall shock measures are constructed based on deviation in rainfall from the normal, a categorical measure of rainfall shock; and another, a continuous index of negative rainfall deviation. Based on a panel fixed effect regression, the study finds no apparent reduction in the level of fertilizer use in negative rainfall shock years. However, with a one-year lagged rainfall shock, a reduction in fertilizer application rate is observed for the continuous drought index. Further, exposure to higher intensity droughts in the previous year leads to an increase in the amount of fertilizer application in the current year.

NREGA: An effective way to fight poverty

Public works programs, aimed at building a strong social safety net through redistribution of wealth and generation of meaningful employment, are becoming increasingly popular in developing countries. The National Rural Employment Guarantee Act (NREGA), enacted in August 2005, is one such program in India. This paper assesses causal impacts (Intent-to Treat) of NREGA on public works participation, labor force participation, and real wages of casual workers by exploiting its phased implementation across Indian districts. Using nationally representative data from Indian National Sample Surveys (NSS) and Difference-in Difference framework, we find that there is a strong gender dimension to the impacts of NREGA: it has a positive impact on the labor force participation and this impact is mainly driven by a much sharper impact on female labor force participation. Similarly, NREGA has a significant positive impact on the wages of female casual workers-real wages of female casual workers increased 8% more in NREGA districts compared with the increase experienced in non-NREGA districts. However, the impact of NREGA on wages of casual male workers has only been marginal (about 1%). Using data from pre-NREGA period, we also perform falsification exercise to demonstrate that the main conclusions are not confounded by pre-existing differential trends between NREGA and non-NREGA districts.

Malaria Epidemiology Along the Indian Districts Bordering Bhutan and Implications for Malaria Elimination in the Region.

It is important for malaria-endemic countries to address malaria control across international borders, and in particular to prioritize appropriate rapid diagnosis, treatment and surveillance. Bhutan and India aim to achieve malaria elimination by 2023 and 2030 respectively. Malaria elimination along the Indo-Bhutan border is of common concern. We delineated malaria epidemiology along the border to provide a blueprint for focusing malaria control efforts in key foci within this region. Epidemiological data from 2015 to 2019 were analyzed, as the most drastic reductions in malaria burden across most parts of India were witnessed in this time frame. Several areas of concern include low surveillance in most border districts, favorable climatic conditions for perennial malaria transmission, and movement of potential parasite carriers because of the porous borders. India and Bhutan need to control the importation/exportation of malaria cases. We highlight the foci of concern for which implementing tailor-made malaria control strategies may benefit both countries.

Measles and Rubella Seroprevalence to Evaluate the Impact of the Mass Vaccination Campaigns in India: Pre-And Post- Cross-Sectional Household Serosurveys in Four Indian Districts, 2018-2020

Measles and Rubella Seroprevalence to Evaluate the Impact of the Mass Vaccination Campaigns in India: Pre-And Post- Cross-Sectional Household Serosurveys in Four Indian Districts, 2018-2020

Understanding the Change in the Prevalence and Factors Influencing the Childhood Stunting Using District-Level Data from NFHS-4 and NFHS-5 in India.

To compare the district level prevalence of childhood stunting between NFHS-4 and NFHS-5 and to explore the correlates of it at the district level. Although malnutrition rates in India have decreased over a period, country is still a home for the highest number of stunted and wasted children in the world. Among the South Asian countries, India has the second highest number of stunted children. An ecological study conducted by using the data from fourth and fifth round of National Family Health Survey. Study concentrated on percentage of children who were stunted across 692 Indian districts during 2 survey periods and its correlates from NFHS-5. District level change in childhood stunting was calculated by differencing the NFHS-5 estimates from NFHS-4. Descriptive statistics were used to understand the nature of the variables and Moran's I statistic was calculated to check for the spatial autocorrelation in the childhood stunting. Spatial error regression model was used to identify the correlates of childhood stunting. Among the Indian districts considered, 243 districts showed the increase in childhood stunting between the time periods considered. Currently, about 33.56% of children in India are stunted and there is high spatial disparity in the prevalence of childhood stunting among the districts of it. Major hotspots of childhood stunting were found in the parts of UP, Bihar, Jharkhand, and West Bengal. Households access to improved sanitation facility, iodized salt, clean fuel, women 10 plus years of schooling, post-natal care of mother were found to be the significant protective factors. Closed spacing of births, teenage pregnancy, low BMI of women, childhood diarrhea, and anemia were found to be the significant risk factors of childhood stunting. Stunting depends on several other factors apart from poverty, working on these factors will help in reducing childhood stunting in India.

POSA203 Assessment of Socio-Demographic Profiles of the Poisoning Cases in a Tertiary Care Hospital

Poisoning is an important cause of morbidity and mortality. It has been identified as a significant global public health problem. Our hospital is situated in a South Indian district of Karnataka where agriculture is the major occupation in rural Mysuru and many rural patients get admitted to emergency department of JSS Medical hospital, Mysuru due to poisoning.

Understanding dynamics of private tuberculosis pharmacy market: a qualitative inquiry from a South Indian district

ObjectivesIn India, retail private pharmacists (RPPs) are often patients’ first point of contact for diseases, including tuberculosis (TB). We assessed the factors influencing RPPs’ referral of patients with chest symptoms...

Antidote Mastery: A Survey of Antidote Knowledge and Availability among Physicians in a South Indian District

The exact frequency of poisoning is unclear, although it is the most prevalent cause of emergency room visits. It is a critical domain for emergency medicine practitioners, who are the first to see people who have been exposed to toxic substances. As a result, they must be aware of how to manage the poisoning. So, a survey was designed to identify their knowledge on antidotes for common poisonings, along with queries on antidotes and decontamination measures available within each hospital. A total of 232 people replied to the poll (77.33 % response rate). In general, data of antidotes are not found higher but differed based upon the antidote. Physicians who work in tertiary hospitals and more bedded hospitals appreciably served well. Merely 42.24 % of the 16 antidotes are accessible at each reporting hospitals on average; 18.1 % could acquire them from adjacent hospitals and 20.26 % could acquire them from a local distributor. Only 19.4 % of people can acquire an antidote within 2 h. The most common decontamination therapy is gastric lavage, while extracorporeal decontamination procedures 42.24 % and 36.64 % respectively are available in varying degrees. Knowledge of specific antidotes was shown to be connected to the size, type and location of the hospital in the East Godavari district, rather than individual physician characteristics. In roughly half of the hospitals assessed, significant antidotes are still unavailable or available within 2 h, even though all key acute decontamination therapies and procedures appear to be widely used.

Influence of agriculture on child nutrition through child feeding practices in India: A district-level analysis.

Malnutrition continues to be a primary concern for researchers and policymakers in India. There is limited scientific research on the effect of agriculture on child nutrition in the country using a large representative sample. To the best of our knowledge, no study has examined the spatial clustering of child malnutrition and its linkage with agricultural production at the district-level in the country. The present study aims to examine agricultural production's role in improving the nutritional status of Indian children through child feeding practices. The nutritional indicators of children from the National Family Health Survey-4 (2015-16) and the agricultural production data for all the 640 districts of India obtained from the District-Wise Crop Production Statistics (2015-16), published by the Ministry of Agriculture, Government of India were used for the analysis. The statistical analysis was undertaken in STATA (version 14.1). ArcMap (version 10.3), and GeoDa (version 1.8) were used for the spatial analysis. The study found a higher prevalence of malnutrition among children who had not received Minimum Meal Frequency (MMF), Minimum Dietary Diversity (MDD), and Minimum Acceptable Diet (MAD). Further, child feeding practices- MMF, MDD, and MAD- were positively associated with high yield rates of spices and cereals. The yield rate of cash crops, on the contrary, harmed child feeding practices. Production of pulses had a significant positive effect on MDD and MAD. Districts with high cereal yield rates ensured that children receive MMF and MAD. There is a significant spatial association between child feeding practices and malnutrition across Indian districts. The study suggests that adopting nutrient-sensitive agriculture may be the best approach to improving children's nutritional status.

Descriptive epidemiology of COVID-19 deaths in the North Indian district Kangra of Himachal Pradesh

Background: COVID-19 first reported in January 2020 in China has turned into a pandemic the kind that occurs only once in a century, with high mortality rate due to an infectious disease considered once as a thing of past. Caused by SARS-CoV-2 (an RNA virus) COVID-19 has caused over 170 million cases worldwide and around 3.8 million deaths worldwide. India alone has suffered the wrath of this nasty virus with cases approaching 30 million and over 0.4 million deaths till date. Occurring in various waves, the pandemic situation remains dynamic and evolving even today.Methods: We carried out retrospective analysis of all deaths due to COVID-19 occurring in district Kangra from March 2020 to June 2021. Descriptive data on all COVID-19 patients were collected and analysed including individuals who lost their life during the period.Results: From 20 March 2020 to 30 June 2021, a total of 45,871 cases and 1037 deaths (2.2%) were reported in Kangra district-33.8% of 3463 deaths that occurred in the entire state. The death rate per million population in Kangra was 64 compared to 47 for Himachal Pradesh and 30 for India as a whole. The mean age was 62.5 years (range 01 to 102 years); males 62.7 years and female 62.2 years.Conclusions: The biggest challenge for us as a country is that COVID-19 has penetrated into our densely placed population where practicing COVID-19 appropriate behaviour is merely an expectation that possibly can never be fulfilled despite most stringent of actions.

Development of a Biosecurity Index for the Districts of India for the Assessment of Capacity to Cope with Infectious Disease Outbreak

Background: In the context of newly emerging diseases, global health security has gained importance in recent years. The pandemic COVID-19 has reemphasized the significance. Despite increased attention to enhance health security, the existing capacities were not optimally prepared to respond to public health threats posed by emerging infectious diseases. Objective: The objective of the study was to develop a simple tool that can help monitor and build up the critical capacity to prevent, detect, respond and help identify the gaps in the preparedness of the health system. Methods: The cross-sectional study was conducted from January 2018 – December 2018 amongst the district level health functionaries like the disease surveillance, laboratory, and the animal health focal points in the selected districts across the three South Indian states. Results: The responses received from the participants of the study were scored and categorized by domains into a biosecurity index, which was easily adaptable to all districts and easy to implement by a district official or state health officer for the initial assessment. Data acquired from this tool could be analysed to build and inform readiness and response plans for preventing and controlling health emergencies. Conclusion: The biosecurity index developed for the Indian districts was an appropriate instrument for epidemic preparedness assessment.