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    Addressing data and methodological limitations in estimating catastrophic health spending and impoverishment in India, 2004-18
    (Int. J. Equity Health, 2021) Sanjay K. Mohanty; Laxmi Kant Dwivedi
    BackgroundEstimates of catastrophic health expenditure (CHE) are counterintuitive to researchers, policy makers, and developmental partners due to data and methodological limitation. While inferences drawn from use of capacity-to-pay (CTP) and budget share (BS) approaches are inconsistent, the non-availability of data on food expenditure in the health survey in India is an added limitation.MethodsUsing data from the health and consumption surveys of National Sample Surveys over 14years, we have overcome these limitations and estimated the incidence and intensity of CHE and impoverishment using the CTP approach.ResultsThe incidence of CHE for health services in India was 12.5% in 2004, 13.4% in 2014 and 9.1% by 2018. Among those households incurring CHE, they spent 1.25 times of their capacity to pay in 2004 (intensity of CHE), 1.71 times in 2014 and 1.31 times by 2018. The impoverishment due to health spending was 4.8% in 2004, 5.1% in 2014 and 3.3% in 2018. The state variations in incidence and intensity of CHE and incidence of impoverishment is large. The concentration index (CI) of CHE was -0.16 in 2004, -0.18 in 2014 and-0.22 in 2018 suggesting increasing inequality over time. The concentration curves based on CTP approach suggests that the CHE was concentrated among poor. The odds of incurring CHE were lowest among the richest households [OR 0.22; 95% CI: 0.21, 0.24], households with elderly members [OR 1.20; 95% CI:1.12, 1.18] and households using both inpatient and outpatient services [OR 2.80, 95% CI 2.66, 2.95]. Access to health insurance reduced the chance of CHE and impoverishment among the richest households. The pattern of impoverishment was similar to that of CHE.ConclusionIn the last 14years, the CHE and impoverishment in India has declined while inequality in CHE has increased.
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    A retrospective approach to assess human health risks associated with growing air pollution in urbanized area of Thar Desert, western Rajasthan, India
    (J. Environ. Health Sci. Eng, 2014) Harcharan Singh Rumana; Ramesh Chandra Sharma; Vikas Beniwal; Anil Kumar Sharma
    Air pollution has been a matter of great concern globally because of the associated health risks to individuals. The situation is getting worse in developing countries with more urbanization, industrialization and more importantly the rapidly growing population posing a threat to human life in the form of pulmonary, cardiovascular, carcinogenic or asthmatic diseases by accumulating toxic pollutants, harmful gases, metals, hydrocarbons etc. Objective: The present study was undertaken to assess the magnitude of ambient air pollutants and their human health risks like respiratory ailments, infectious diseases, cardiovascular diseases and cancer using a Retrospective Approach of Bart Ostra. Methodology: The parameters PM2.5, PM10, NOx, SO2, NH3 and O-3 were monitored at all selected study sites monitored through a high volume sampler (APM 451 Envirotech, Envirotech Instruments Pvt. Ltd., New Delhi, India). Retrospective Approach was used for assessment of risk factors and disease burden of respiratory and cardiopulmonary health problems. Results: Environmental burden of disease showed that the problem of health related to air pollution is a main concern particularly in the growing cities of India. High to critical level of air pollution including PM10, PM2.5, NOx, SO2, NH3 and O-3 was observed in all seasons at traffic intersections and commercial sites. The respiratory infections (25% incidence in population exposed to indoor smoke problems) and a prevalence of asthma/COPD (4.4%) in households exposed to high vehicular pollution along with signs of coronary artery/heart disease and/or hypertension and cancers (37.9-52.2%), were reported requiring preventive measures. Conclusion: The study reflects a great concern for the mankind with the need of having streamline ways to limit air pollution and emphasize upon efficiently determining the risk of illness upon exposure to air pollution.
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    Health problems and health-seeking behavior of Muslim women in southern India
    (Journal of Education and Health Promotion, 2024) I Nasreen; Mohammed Guthigar; Irene Veigas
    The health of women and girls is of particular concern because, in many societies, they are disadvantaged by discrimination rooted in sociocultural factors that prevent them from benefiting from quality health services and attaining the best possible level of health. Muslim women face a number of unique health challenges, including discrimination, poverty, and lack of access to healthcare. These challenges can lead to a number of health problems, including mental health issues, chronic diseases, and infectious diseases.