Poverty Line Households Research Articles

A cross sectional study on infant and young child feeding practices: a keep for successful nutrition in under-five children attending rural Anganwadi centres, Mysuru

Background: Optimal infant and young child feeding practices (IYCF) are crucial for nutritional status, growth, development, health, and ultimately the survival of children. Even with several national schemes and programs in place, India’s progress in tackling the problem of child malnutrition is slow. This study aims to estimate the prevalence of undernutrition and infant and young child feeding factors determining undernutrition among under five children in rural Mysuru.Methods: A cross sectional study was conducted among under five children who are registered in Anganwadi centres in the rural field practice area of JSS Medical College. 261 children were chosen as per population proportionate to the size sampling technique.Results: The mean age of the children was 2.8±1.2 years and 86.6% belonged to Below Poverty Line households.70.1% received breastfeeding within an hour of birth. Exclusive breastfeeding for 6 months was provided for 67.4% of the children. The prevalence of underweight, stunting, and wasting was 13.8%, 16.5%, and 5.7% respectively. The undernutrition among children was associated with the type of economic card and birth weight of the child.Conclusion: IYCF is a key area to improve child survival and promote healthy growth and development. The study calls for attention to be placed on improving and promoting participatory nutrition education to raise awareness, health literacy, and foster behavioural change communication for improved child feeding and caring practices. Additionally, sociocultural determinants of feeding practices should be addressed in the design of nutritional interventions.

Symptomatic survey of COVID-19 in the rural health and demographic surveillance site of Maharashtra, India.

The COVID-19 epidemic is fast-evolving and restrictions to contain it changes quickly. The secondary attack rate (SAR) indicates the infectiousness at the household level, and it provides a clue of load of infections in the community. Rapid implementation of a large scale, but brief survey provides a nationally representative view of the pandemic's progression and impact as well as the effect of the measures taken to control the spread. This cross-sectional study was done for a period of 2 months July-August 2020, in one of the rural health and demographic surveillance system (HDSS) site in India among 11,507 households having 46,571 individuals with the objective to determine the prevalence of the COVID-19 infection and to estimate the family SAR. The data were collected using the mobile phone by calling the head of the households registered under the HDSS. The research tool was created using questions based on the guidelines provided by the Ministry of Health and Family Welfare, India. The interviewers were first trained in data collection. The households of 33,780 individuals were contacted and 33 patients were diagnosed as COVID positive, prevalence rate of 0.1% was thus documented through telephonic survey. The mean age of COVID patients was found to be 37 ± 16 years, and 63% of the diagnosed patients were males, majority of them belonged to above poverty line households. During the survey, 46 individuals reported to have the symptoms suggestive of COVID, fever and cough were the most commonly reported symptoms. The family SAR of 17.2% was documented. Thus to conclude a low COVID-19 prevalence rate of 0.1%, a higher family SAR of 17.2% was reported in the current study. Timely diagnosis and quarantine of close contacts should be continued to be implemented rigorously to prevent the spread of the COVID-19 virus. These efforts will be useful to contain the epidemic before it reaches an alarming level in the rural areas.

Household Cooking Fuel Patterns in Rural India: Pre- and Post-Pradhan Mantri Ujjwala Yojana

This article analyses the performance and limitations of the Pradhan Mantri Ujjwala Yojana (PMUY), a central scheme launched in the year 2016 for the provision of liquefied petroleum gas (LPG) connections to Below Poverty Line households in the country. It shows that the scheme offered more than 80 million LPG connections and contributed to a sharp replacement of traditional fuel (firewood, kerosene, dung cake, etc.) between the years 2014 and 2018. However, a large share of these new consumers appears to have stopped LPG consumption soon after the distribution under the scheme. This is clearly evident in the huge number of inactive LPG connections which continue to increase—from 35.8 million inactive connections in the country in 2017 to 43.2 million in 2019. Though PMUY contributed to the increase in LPG connections, it failed to accelerate its consumption demand among the beneficiaries. Nearly ₹128 billion has been spent by the government in form of subsidies and around 70% of the PMUY beneficiaries have availed loans from Oil Manufacturing Companies (OMCs). If the LPG consumption fails to accelerate, these one-time subsidies provided by the government will fail to achieve the objective and the loans disbursed by the OMCs may turn into non-performing assets.

Smart Cards for All: Digitalisation of Universal Health Coverage in India

In less than ten years, India has launched colossal biometric databases. One among them is related to the first ‘free’ health coverage scheme offered by the government of India: the Rashtriya Swasthya Bima Yojna (RSBY). Based on a public–private partnership between government and private companies, RSBY national scheme was launched in 2008, as a first step towards universal health coverage in a country where households endorse 70% of health expenses. The first phase of RSBY offers to cover ₹30,000 ($600) of inpatient expenses per year for five members of a below poverty line household and is now piloted in several Indian States to include outpatient expenses and above poverty line families too. RSBY relies exclusively on a centralised digital artefact to function, made visible by the ‘RSBY Smart Card’, a chip enabled plastic card containing personal data of individual and their family counting and conditioning the granting of health services to them; thus, no smart card means no health coverage. Till date 120 million Indians have been registered in the RSBY database. This article analyses how health accessibility is crafted under the RSBY scheme by questioning two central dimensions of this data-driven digital health scheme: the smart card technology and the public–private partnership, whereas RSBY scheme promises health coverage for all, its digital infrastructures may complicate access to health services, and reveal new patterns of exclusion of individuals. Thus, we will detail how smartcards technologies and private providers condition access to health care in India.

Impact of Out of Pocket Health Expenditure on Consumption Pattern of Below Poverty Line Households in India

Financial burden from health expenditure is a serious cause of concern for low-income and developing countries. Studies have shown that low public investment in health, lack of adequate safety net mechanisms and poor quality of public health system in these countries are few basic grounds for placing high financial burden on people. In order to make both ends meet during illness, poor people resort to various alternative means. One of the popular strategies adopted is to reduce or reallocate the consumption bundle, so as to meet the medical expenditure. The impact of out of pocket (OOP) health expenditure on the consumer expenditure has immediate and direct impact especially among the poor sections of the society. This article aims to study the impact of out of pocket health expenditure on the constituents of consumer expenditure and how the composition of consumer expenditure differs with the levels of out of pocket expenditure among different consumption quintiles. The study uses IHDS household level survey data for the year 2011–2012. A mean comparison test is carried out to check whether significant difference exists in the consumption bundles of households with and without medical expenditure. A system of Engel curves is estimated with seemingly unrelated regression equation (SURE) to study the impact of out of pocket medical expenses on the consumption bundle. The results show that there exists significant difference in the share of different consumption items in the consumption bundles of households with and without out of pocket expenditure. Despite having larger share for food expenditure, poor households tend to protect the consumption of food share in the bundle. Compensation for rise in medical expenses is reflected in the reduced share of non-food expenditure items like fuel, education, entertainment, clothing and footwear. With high share of out of pocket expenditure, poor households in the states with high public health expenditure mainly reduced their education expenditure whereas consumption of most of the non-food items were reduced by poor households in low public health expenditure states.

What Lessons should Pradhan Mantri Jan Arogya Yojana Learn from the Shortfalls of Rashtriya Swasthya Bima Yojana: The Case of Rashtriya Swasthya Bima Yojana in Chhattisgarh.

Context:Publicly funded health insurance has been rolled out by many states as well central government. As it is being seen as a way of protection against catastrophic health expenditure. Rashtriya Swasthya Bima Yojana (RSBY) has been one such attempt succeeded by the recent scheme Ayushman Bharat, which provides coverage of 5 lacs for each family per year.Aims:To assess RSBY on issues of equity across the state of Chhattisgarh.Materials and Methods:The district-wise secondary data for Chhattisgarh were obtained from the official state website of RSBY maintained by the Government of Chhattisgarh. The data were utilized to estimate the claim ratio (procedure wise as well as district wise), enrollment pattern, rate of hospitalization, and average costs of hospitalization across the district to compare the change in trends since 2011 till 2017.Results:There is an overall increase in enrollment, utilization, and number of empanelled hospitals. Also, a higher conversion ratio (i.e., increased proportion of the below poverty line households enrolled) shows a positive sign of improved coverage. All the districts faired on an average, barring Sukma with lowest enrollment rate (55%) probably due to poor accessibility and political disturbances.Conclusions:Although there has been an increase in the overall utilization, procedure-wise claims, and enrollment, there are signs of inequity, namely the skewed distribution of empanelled hospitals. Therefore, good or bad, RSBY offers important lessons to be learned for Ayushman Bharat.

(Re)investigation of Rural Women’s Labour Supply in India: The Impact of Household Poverty Status—A Panel Data Analysis

This article examines the role of household poverty in shaping rural female labour supply using the unique panel dataset of India Human Development Survey. The results using Vella and Verbeek’s two-step panel estimation reveal the presence of a backward-sloping labour supply curve for rural women from below poverty line households, and an upward-sloping labour supply for rural women from above poverty line (APL) households. This implies the existence of ‘forced’ or ‘need-based’ participation among poor women and justifies why they work long hours in poorly paid hazardous jobs. The article also finds horizontal labour supply among agriculture wage workers and for Adivasi and Dalit rural women to some extent, reflecting limited job options, and surplus unskilled labour who are unable to demand higher wages for their labour supply. On the other hand, when categorised by occupation type, the downward-sloping labour supply for rural women from APL households indicates the dominance of the income effect over the substitution effect, and the socio-cultural factors that gain strength as income levels increase. JEL Classification: J220, R21, J16, R230, I32

Levels, trends and socio-economic correlates of caesarean section deliveries

Purpose Caesarean section (CS) is being used as a life-saving surgical tool when complications arise in the process of childbirth. CS rates have dramatically increased across the world, especially in recent decades. In this background, the purpose of this paper is to explore the CS rates and its determinants in Karnataka, India. Design/methodology/approach The study uses multiple rounds of the District Level Household Survey (DLHS) data to show the trends, differentials and determinants in CS deliveries. Both bivariate and multivariate analyses have been carried out, and the χ2 test and logistic regression models were applied. Findings Result shows a sharp increase in CS rates across Karnataka; further, this is high and reaches an alarming level in southern parts of the state. Along with a huge rural–urban difference, significant biological and socio-economic differences were observed. Further, a very dramatic increase in the CS rate was observed in private health facilities, whereas it was stagnant or even decreased in public health facilities during recent years. Mothers age at birth, birth weight, birth order, multiple births, birth institution and place of residence were significantly associated with CS delivery. Unlike these biological factors, the social-economic factors like maternal education, caste, religion and below poverty line household were not found to be significant in determining CS deliveries. Originality/value A strong policy to address the dramatic increase in CS deliveries is the need of the hour. Further, there should be a proper mechanism at national, state and sub-state level to provide appropriate checks and monitoring for CS deliveries which are unnecessary.

ICT in banking: A study with reference to below poverty line households in Mangalore

ICT in banking: A study with reference to below poverty line households in Mangalore

Reforming capital subsidy scheme to finance energy transition for the below poverty line communities in rural India

India's rural poor are caught in a downward energy poverty cycle with either a lack of access to modern energy sources or reliable grid electricity supply. Overcoming these barriers will require strategies that account for extremely low levels of income, lack of access to finance, poor awareness of alternative energy technologies and deficient post-installation service on solar home systems (SHSs). Our study is novel in examining reasons accounting for the slow adoption of SHSs in rural areas from the perspective of a rural (Grameen) bank. We reveal current government energy policies especially SHS subsidy scheme, largely exclude those below the poverty line. This self-induced socioeconomic barrier, in turn, limits the involvement of the banking sector who report additional barriers including higher lending costs and financial risks coupled with internally restrictive lending practices. We propose a revised framework the Rural Energy Transformation through Pro-Poor Subsidy to support an SHS capital subsidy scheme which specifically includes below poverty line households, and incorporates an electronic subsidy disbursement mechanism designed to improve efficiency and effective delivery between five key actors. These include the National Bank for Agriculture and Rural Development, the Regional Rural Banks and suppliers deploying and maintaining subsidised SHS and the rural households. The framework would establish a contractual partnership between banks and suppliers, and at a policy level would require the government to mandate banks to lend at low margins and offer dedicated subsidy benefits to low-income populations to enable a rural energy transformation.

The Dynamics of Finance-Growth-Inequality Nexus: Theory and Evidence for India

The paper critically inquires the ‘finance-growth-inequality’ nexus based on an econometric analysis of the IHDS Survey data for two rounds – 2005-06 and 2011-12. The study attempts to assess the co-evolution of finance-growth-inequality in an intertemporal framework. At the household level asset is still the most important determinant of bank loans inspite of several policy measures aimed at financial inclusion. However, the probability of receiving a bank loan increases if any member of the household is active participant of the local level government or caste association. The most important finding of the paper pertains to the econometric result that the household asset grows at the same rate independent of the source of loans - banks or informal moneylenders though the level effect (intercept) is higher if the loan is obtained from banks or lower if the household lives below poverty line. The same observation is also confirmed for per capita income of the households. The phenomenon is explained in a theoretical model of intertemporal choice of entrepreneur-investor to show that if there are both formal and informal sources of borrowing with a constraint on the formal sector borrowing and no constraint on the latter, then growth rates of asset and income are determined by the informal sector interest rate. This result can be generalised for any number of sources of borrowing. This questions the conventional wisdom regarding the policy aimed at financial inclusion. Inequality of income increases independent of the source of borrowing, though the households living below poverty line are worse off in general. If the major source of borrowing is bank for the business and industry then inequality increases more for the above poverty line households than if the major source is moneylenders or the households belong to the below poverty line category. Moneylenders as the source of borrowing is not as regressive as is believed. So the whole issue of financial inclusion needs a review in the light of the findings of the paper.

Empowerment of Rural Women through SHGs: A Study in Telangana

The self-help group (SHG) is a powerful instrument to empower economically backward women of rural India as the women members under the SHG not only can earn income but they feel empowered also. With the launching of Swarnajaynti Gram Swarozgar Yojana (SGSY) by the Ministry of Rural Development, Government of India from April 1999, subsequently rechristened as Deen Dayal Antyodaya Yojana–National Rural Livelihood Mission (DAY-NRLM) self-help group approach (SHG) has been given utmost importance in India for the development of rural women mainly focusing on below poverty line households. SHG concept is popular in many rural areas of India as through economic development and subsequently empowering, rural women have got a solid platform. This research article has discussed the how rural women after forming SHGs in Ranga Reddy district (R.R. District) of Telangana were not only earning and contributing to the family but felt empowered also. The study was carried out at Gandipet village of Gandipet Mandal, Ranga Reddy (R.R.) district in September 2017. The some women members of 10 different SHGs were contacted and few individual cases are presented here.

IDENTIFIKASI KARAKTERISTIK ANAK PUTUS SEKOLAH DI JAWA BARAT DENGAN REGRESI LOGISTIK

School dropouts are the problem in education which is the condition of children who do not have the opportunity to complete their education that they couldnt obtain degree certificate due to certain factors. Based on SUSENAS 2013, there is 2.15% of children aged 7-15 years old in West Java who dropped out of school. Three aspects that have great potential on the incidence of school dropouts are characteristic of social, economy, and demography. This study uses logistic regression analysis to determine the effect of school dropouts by the three aspects. The results of logistic regression analysis at 5% significance level indicates that the characteristics of social, economy, and demography that have significant effect on the incidence of school dropouts are the low education of household head, more than four household members, less than the poverty line household expenditure per capita, residence location in urban areas, and boys. The resulting model is sufficientfor estimation with the sensitivity value of 70.20% and the area under the ROC curve of 76.42%.
 Keywords: logistic regression, ROC curve, school children, sensitivity.

Construction of gender sensitive poverty line based on local perception: Evidence from Habra-II Block of West Bengal state in India

This study employs participatory well-being ranking (PWBR) exercise with men and women separately for generating gendered poverty line in Habra-II Block of West Bengal state of India. Men and women differ in a number of themes related to the experience of poverty. We quantify the gender disaggregated qualitative information collected through PWBR from eight village segments to arrive at poverty lines, followed by the generation of poverty statistics. Women and men differ in a number of themes related to poverty. Women use land, house type, dependent in the family, occupation and infrastructure to characterize poor households, and men use sanitation, business, land holding, farming, and occupations for the same. The differential gender perception results in different poverty lines and poverty statistics for men and women in most of the study villages. For most of the study villages women generated higher number of below poverty line households than men.

Out of Pocket Expenditure for Hospitalization among Below Poverty Line Households in District Solan, Himachal Pradesh, India, 2013.

IntroductionHealth insurance schemes, like Rashtriya Swasthya Bima Yojana (RSBY), should provide financial protection against catastrophic health costs by reducing out of pocket expenditure (OOPE) for hospitalizations. We estimated and compared the proportion and extent of OOPE among below poverty line (BPL) families beneficiaries and not beneficiaries by RSBY during hospitalizations in district Solan, H.P., India, 2013.MethodsWe conducted a cross sectional survey among hospitalized BPL families in the beneficiaries and non-beneficiaries groups. We compared proportion incurring OOPE and its extent during hospitalization, pre/post-hospitalization periods in different domains.ResultsOverall, proportion of non-beneficiaries who incurred OOPE was higher than the beneficiaries but it was not statistically significant (87.2% vs. 80.9%). The median overall OOPE was $39 (Rs 2567) in the non-beneficiaries group as compared to $ 11 (Rs 713) in the beneficiaries group (p<0.01). Median expenditure on in house and out house drugs and consumables was $ 23 (Rs 1500) in the non beneficiaries group as compared to nil in the beneficiaries group (p<0.01). Non-beneficiary status was significantly associated [OR: 2.4 (1.3–4.3)] with OOPE above median independently and also after adjusting for various covariates.ConclusionRSBY has decreased the extent of OOPE among the beneficiaries; however OOPE was incurred mainly due to purchase of drugs from outside the health facility. The treatment seeking behaviour in beneficiaries group has improved among comparatively older group with chronic conditions. RSBY has enabled beneficiaries to get more facilities such as drugs, consumables and diagnostics from the health facility.

Study of Awareness, Enrollment, and Utilization of Rashtriya Swasthya Bima Yojana (National Health Insurance Scheme) in Maharashtra, India.

Government of India launched a social health protection program called Rashtriya Swasthya Bima Yojana (RSBY) in the year 2008 to provide financial protection from catastrophic health expenses to below poverty line households (HHs). The objectives of the current paper are to assess the current status of RSBY in Maharashtra at each step of awareness, enrollment, and utilization. In addition, urban and rural areas were compared, and social, political, economic, and cultural (SPEC) factors responsible for the better or poor proportions, especially for the awareness of the scheme, were identified. The study followed mixed methods approach. For quantitative data, a systematic multistage sampling design was adopted in both rural and urban areas covering 6000 HHs across 22 districts. For qualitative data, five districts were selected to conduct Stakeholder Analysis, Focused Group Discussions, and In-Depth Interviews with key informants to supplement the findings. The data were analyzed using innovative SPEC-by-steps tool developed by Health Inc. It is seen that that the RSBY had a very limited success in Maharashtra. Out of 6000 HHs, only 29.7% were aware about the scheme and 21.6% were enrolled during the period of 2010-2012. Only 11.3% HHs reported that they were currently enrolled for RSBY. Although 1886 (33.1%) HHs reported at least one case of hospitalization in the last 1 year, only 16 (0.3%) HHs could actually utilize the benefits during hospitalization. It is seen that at each step, there is an increase in the exclusion of eligible HHs from the scheme. The participants felt that such schemes did not reach their intended beneficiaries due to various SPEC factors. The results of this study were quite similar to other studies done in the recent past. RSBY might still be continued in Maharashtra with modified focus along with good and improved strategy. Various other similar schemes in India can definitely learn few important lessons such as the need to improve awareness, issuing prompt enrollment cards with proper details, achieving universal enrollment, ongoing and prompt renewal, and ensuring proper utilization by proactively educating the vulnerable sections.

Are Targeted Unconditional Cash Transfers Effective? Evidence from a Poor Region in India

The paper is based on a well-focused and purposive field survey of 200 randomly selected sample households (HHs) from 20 villages of Odisha (the poorest state) in India, provides a critique of present institutional arrangements for delivery of social security measures-in terms of outreach and effectiveness. The exercise shows, on the one hand, the dissonance between below poverty line households and asset/wealth position of households and thus there is strong evidence of inclusion and exclusion errors and on the other, weak targeting efficiency and an important determinant of which seems to be what is called HH social/structural capital.

Swarna Jayanti Shahari Rozgar Yojana: Well Intended Poorly Executed

Swarna Jayanti Shahari Rozgar Yojana (SJSRY) was introduced by the Indian Government in 1997-98 as an initiative to create self-employment opportunities to alleviate urban poverty. Under this scheme the Central and the State governments share the financial responsibility in the ratio of 75:25 for providing subsidised loans to the self-help groups (SHGs) promoted by local government bodies in urban areas. Various studies conducted on this scheme all over India indicate that due to various lacunae in the implementation of the scheme it has failed to achieve the objective of poverty alleviation through self-employment generation. This study is based on a random sample of SHGs from below poverty line households in Thane city for the implementation of SJSRY. The study shows that SJSRY has not achieved the desired results due to poor implementation. While greater emphasis was laid on the delivery of financial assistance, other vital linkages and support mechanism did not get the desired attention. The scheme can do well if an ecosystem is created by establishing institutional linkages for training, marketing and technical support for the SHGs combined with a fool proof supervisory framework to monitor the scheme.

Energy-microfinance intervention for below poverty line households in India

More than 72% of India's population resides in rural India 1 1 Census of India: http://www.censusindia.gov.in/Census_Data_2001/India_at_glance/rural.aspx (Last accessed on: 01/01/2008). and it also has a high concentration of people living under abject poverty. Of the total rural population 27.1–28.3% lives below the poverty line 2 2 In 1992, the Ministry of Rural Development, Government of India, undertook the task of identifying below poverty line households in rural India through periodic (approximately five-yearly) village censuses ( Jalan and Murgai, 2007). (BPL). A lack of energy-finance options is hampering the “quality of life” of the BPL community. The members of this disadvantaged household which forms 27.1% and 23.6% of the India's rural and urban population 3 3 The poverty ratio is as of the year 1999–00 ( Source: Ministry of Health & Family Welfare, Government of India, http://www.indiastat.com). has no ready access to mainstream finance or know—how of sustainable energy products nor do they have access to energy service providing agency. This lack of energy-finance options has provided the marginalized population little means to break the conventional energy paradigm and the corresponding poverty cycle. Considering the afore-mentioned problem we propose an energy-microfinance intervention or a model that encompasses two independent entities. One has an energy expertise and the other possesses finance management skills. Alternately, we also propose a special purpose entity that comprises of these two entities. This entity fosters different institutional, technical and financial engineering approaches to the provision of energy, finance and infrastructure services necessary for poverty alleviation.

Determining BPL Status Some Methodological Improvements

A draft paper on the 2002 method for identifying Below the Poverty Line households in rural India, which argues that mistargeting is significantly influenced by the measurement methodology, not only by corruption as has been supposed.