ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Understanding High Mortality among Private Facility Births in Rural Uttar Pradesh

In the last 15 years, there has been a large increase in facility births and a large decline in home births across India. In Uttar Pradesh, increases in facility birth have led to puzzlingly little decline in neonatal mortality. This paper investigates the role of private facilities in providing care at birth to rural residents of UP. Approximately one in five births of rural UP residents takes place in a private facility. These births experience a stunningly high neonatal mortality rate of 53 deaths per 1,000, compared to 32 among births in public facilities, and 40 among home births. This research seeks to understand why mortality rates are higher in private facilities than public facilities.

Revisiting Open Defecation

Since October 2014, the Government of India has worked towards the goal of eliminating open defecation by 2019 through the Swachh Bharat Mission. In June 2014, the results of a survey of rural sanitation behaviour in North India were first reported. The results from a late 2018 survey that revisited households from the 2014 survey in four states—Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh—are presented. Although rural latrine ownership increased considerably over this period, open defecation remains very common in these four states. There is substantial heterogeneity across states in what the sbm did and how. These outcomes suggest the need for a transparent, fact-based public dialogue about the sbm, its costs and benefits, and its accomplishments and means.

Persistence of Solid Fuel Use in Rural North India

Survey evidence from rural North India showing persistent solid fuel use despite increases in liquefied petroleum gas ownership is presented. Although three-quarters of survey households in these states had LPG, almost all also had a stove that uses solid fuels. Among those owning both, almost three-quarters used solid fuels the day before the survey. Household economic status, relative costs of cooking fuels, gender inequality, and beliefs about solid fuels were important contributors to high solid fuel use. To realise the full health benefits of the LPG expansion, attention must now be turned towards encouraging exclusive LPG use.

Experiences and Perceptions of Discrimination among Dalits and Muslims

Through the use of new survey data, the experiences and perceptions of discrimination among Dalits and Muslims have been quantified. One important result is that many respondents report experiencing discrimination at school and in interactions with government officials. These results are even more worrisome when we consider that self-reports of discrimination perhaps underestimate the true extent of the problem.

Child Height in India

An analysis of child height-for-age using the newly released data from the National Family Health Survey-4 indicates that the average child height increased by about four-tenths of a height-for-age standard deviation between 2005 and 2015. Although important, this increase is small relative to India’s overall height deficit, and relative to economic progress; children in India remain among the shortest in the world. It is unsurprising that the increase in height-for-age has been modest because none of the principal factors responsible for India’s poor child height outcomes have substantially improved over the last decade. Familiar patterns of regional, sex, and caste disadvantage are reflected in child height in 2015.

Open Defecation in Rural India, 2015–16

The Government of India’s NFHS–4 offers the best new data on open defecation in rural India to be eleased in over a decade. Although open defecation has become less common than it was 10 years ago, it is still highly prevalent, with more than half of rural households reporting open defecation. On average, change has been slow, even during the period of the Swachh Bharat Mission.

Explicit Prejudice

A representative phone survey to study explicit prejudice against women and Dalits in Delhi, Mumbai, Uttar Pradesh, and Rajasthan reveals widespread prejudice in several domains and discusses the consequences for women and Dalits, and society as a whole. The results suggest the need for a more robust public discourse and active approach to measuring and challenging prejudice and discrimination.

Understanding Open Defecation in Rural India

India has far higher open defecation rates than other developing regions where people are poorer, literacy rates are lower, and water is relatively more scarce. In practice, government programmes in rural India have paid little attention in understanding why so many rural Indians defecate in the open rather than use affordable pit latrines. Drawing on new data, a study points out that widespread open defecation in rural India is on account of beliefs, values, and norms about purity, pollution, caste, and untouchability that cause people to reject affordable latrines. Future rural sanitation programmes must address villagers’ ideas about pollution, pit-emptying, and untouchability, and should do so in ways that accelerate progress towards social equality for Dalits rather than delay it.

Revealed Preference for Open Defecation

Despite economic growth, government latrine construction, and increasing recognition among policymakers that open defecation constitutes a health and human capital crisis, it remains stubbornly widespread in rural India. We present evidence from new survey data collected in Bihar, Haryana, Madhya Pradesh, Rajasthan and Uttar Pradesh. Many survey respondents' behaviour reveals a preference for open defecation: over 40% of households with a working latrine have at least one member who defecates in the open. Our data predict that if the government were to build a latrine for every rural household that lacks one, without changing sanitation preferences, most people in our sample in these states would nevertheless defecate in the open. Policymakers in India must lead a large-scale campaign to promote latrine use.

Wealth and Health of Children in India

What are the relationships between wealth and children's health in India's states that are as populous as many other countries? Presenting a state-level analysis of the association between state net domestic product per capita and three children's health indicators, this paper describes how these relationships differ in the last two rounds of the National Family Health Survey. It finds evidence that the cross-sectional relationships between aggregate wealth and children's health indicators are positive, yet the association was less steep in the mid-2000s than in the late 1990s. It also finds a negative relationship between growth in SNDP per capita and improvement in state-level children's health indicators. These findings are consistent with the hypothesis that the kinds of investments which improve health may lead to economic growth, rather than vice versa.

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