Articles by Nikhil Srivastav

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.

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Our Essential Workers Need Essential Care

Vol. 55, Issue No. 31, 01 Aug, 2020

Nikhil Srivastav, Aditi Priya, Payal Hathi

Through personal interviews of healthcare workers in India, the state of front-line workers in dealing with Covid-19 in the country is discussed. Lack of personal protective equipment and beds as well as the caste system that operates when it comes to doing cleaning work in the hospitals aggravates the already debilitating condition of healthcare personnel. Despite being the most important stakeholders of health in rural areas, the accredited social health activists are leading a life full of struggles.

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Revisiting Open Defecation

Vol. 55, Issue No. 21, 23 May, 2020

Aashish Gupta, Nazar Khalid, Devashish Deshpande, Payal Hathi, Avani Kapur, Nikhil Srivastav, Sangita Vyas, Dean Spears, Diane Coffey

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.

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Caste Prejudice and Infection

Vol. 55, Issue No. 16, 18 Apr, 2020

Payal Hathi, Nikhil Srivastav

In light of India’s continuing efforts to reduce maternal mortality, why government hospitals continue to be dangerously unhygienic, posing serious infection risks to patients, is explored.

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Access to Latrines

Vol. 55, Issue No. 10, 07 Mar, 2020

Nikhil Srivastav

The Right to Sanitation in India: Critical Perspectives edited by Philippe Cullet, Sujith Koonan, and Lovleen Bhullar, New Delhi: Oxford University Press, 2019; pp xxvii + 435, `1,295.

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Persistence of Solid Fuel Use in Rural North India

Vol. 55, Issue No. 3, 18 Jan, 2020

Aashish Gupta, Sangita Vyas, Payal Hathi, Nazar Khalid, Nikhil Srivastav, Dean Spears, Diane Coffey

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.

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The Challenge of Breastfeeding Sensitisation

Vol. 53, Issue No. 9, 03 Mar, 2018

Mothers’ Absolute Affection, the nationwide programme to improve breastfeeding, attempts to achieve the same by incentivising frontline health workers to create awareness on the issue. However, a pilot study shows that hiring breastfeeding consultants at the district hospital level is not only more economically feasible, but also results in improved breastfeeding rates.

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Understanding Open Defecation in Rural India

Vol. 52, Issue No. 1, 07 Jan, 2017

Diane Coffey, Aashish Gupta, Payal Hathi, Dean Spears, Nikhil Srivastav, Sangita Vyas

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.

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Revealed Preference for Open Defecation

Vol. 49, Issue No. 38, 20 Sep, 2014

Aashish Gupta, Dean Spears, Diane Coffey, Nidhi Khurana, Nikhil Srivastav, Payal Hathi, Sangita Vyas

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.