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Our Essential Workers Need Essential Care

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.

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.

Caste Prejudice and Infection

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. Through interviews and observations at public hospitals in Uttar Pradesh, Bihar, and Madhya Pradesh, we find...

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.

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.
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