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Microfinance can be used to reach women and adolescent girls with HIV prevention education. We report findings from a cluster-randomized control trial among 55 villages in West Bengal to determine the impact of non-formal education on knowledge, attitudes and behaviors for HIV prevention and savings. Multilevel regression models were used to evaluate differences between groups for key outcomes while adjusting for cluster correlation and differences in baseline characteristics. Women and girls who received HIV education showed significant gains in HIV knowledge, awareness that condoms can prevent HIV, self-efficacy for HIV prevention, and confirmed use of clean needles, as compared to the control group. Condom use was rare and did not improve for women. While HIV testing was uncommon, knowledge of HIV-testing resources significantly increased among girls, and trended in the positive direction among women in intervention groups. Conversely, the savings education showed no impact on financial knowledge or behavior change.

India is often characterized as an emerging economic super power. The huge demographic dividend, the high quality engineering and management talent, the powerful Indian diaspora and the emerging Indian transnational--kneeling the optimism. In contrast, there is another profile of India which is rather gloomy. This is the country with the largest number of the poor, illiterates and unemployed in the world. High infant mortality, morbidity and widespread anaemia among women and children continue. India suffers from acute economic and social disparities. This article addresses four dimensions of such disparities, viz. regional, rural-urban, social, and gender. There is empirical evidence to indicate that during the last two decades all these disparities have been increasing. As a result of economic reforms, the southern and western States experienced accelerated economic and social development as compared to northern and eastern States. This has led to widening gap in income, poverty and other indicators of development between the two regions. Rural-urban divide also widened in the wake of reforms. While large and medium cities experience unprecedented economic prosperity, the rural areas experience economic stagnation. As a result, there is widespread agrarian distress which results in farmers' suicide and rural unrest. Socially backward sections, especially scheduled castes and tribes (SCs and STs) have gained little from the new prosperity which rewards disproportionately those with assets, skills and higher education. STs have often been victims of development as a result of displacement. The gender gap in social and economic status, traditionally more in India as compared to other societies; has further widened by the economic reforms and globalization. The approach paper to the Eleventh Plan stresses the importance of more inclusive economic growth. It emphasizes the need for bridging the divides discussed in this article. Unless these are achieved in a time-bound manner, there could be serious adverse implications for the Indian economy, society and politics.

The social aspects of drought-induced morbidity and mortality in India are analyzed in this study. "As a sample study, mortality trends in Rajasthan State in India in the 1980s were analysed to correlate the increased death rate with the drought of 1987. It is demonstrated that drought-induced malnutrition is the root cause of death. Sociologically, populations are divided into three sections--fragile, resilient and potent--which are differently affected by droughts, the fragile section suffering worst.", (excerpt)

This paper assesses the feasibility of sustainable development for various low-income countries in the context of prospective population growth. In that context, development that is sustainable is development that does not endanger the natural systems that support life on earth. Since a short time has elapsed since the Mexico City Conference, not all the developmental goals highlighted at that meeting could be reviewed. Emphasis in this paper is placed on an assessment of recent trends in food production and availability, employment and poverty issues, with an emphasis on India, China, and a few other Asian countries on which the author has had access to information. In the view of the author, the key to sustained development in the face of likely continued population growth up to the end of the 21st century lies in technological change and effective use of the human and physical resources in developing countries. Adequate planning and judicious adaptation of the institutional framework can help to avoid the suffering and misery of millions of people currently alive and also those who will be born during further decades.

Educational access in developing countries has improved significantly in recent years, but less evidence is available on learning and learning progress in comparative perspective. This paper employs data from Young Lives to examine levels and trends in cognitive skill development and the links to enrolment in school across the four study countries for pupils aged five to 15. Non-continuous patterns of enrolment are linked to lower learning levels in all countries, as are key indicators of home background disadvantage. Large differences in learning and learning progress are also found between the four countries' education sytems, with "learning gains" being typically highest in Vietnam and much lower in India (Andhra Pradesh) and Ethiopia. Inequalities linked to prior learning and home backgrounds are wide in Peru, while in Ethiopia and India relatively low levels of learning progress are a more general concern. In Ethiopia, both enrolment and quality improvements remain priorities for policy, while in India high levels of primary school enrolment, at younger ages than in the other study countries, suggest that comprehensive quality improvements may be required, nonetheless with a focus on disadvantaged pupils and those with low attainment in the early years.

Background: Construction laborers succumb to poor health due to the inherent workplace health hazards and poor socio-economic living conditions. With rising healthcare expenses, the increased risk of poor health may aggravate their economic status, pushing them deeper into poverty. Settings and Design: The current cross-sectional multicenter study comprehensively investigated the determinants of health, health-seeking behavior, and poor economic impact regarding catastrophic health expenditure (CHE) among construction laborers. Methods and Material: We collected details on illnesses among self and family members of the construction laborers that required healthcare visits during the previous year and their approximate expenses. Among the 1110 participants with complete data, 37% reported illness requiring a healthcare visit either for self or a family member. Results: Regression models to ascertain demographic and living condition determinants of perceived illness revealed an increased risk of illness when the kitchen is shared with the living space (OR = 1.87) and use unhygienic smoky cooking fuels (OR = 1.87). More than 25% of those who reported illness incurred CHE. Conclusion: We conclude that the frequency of perceived illness and the economic impact, i.e., CHE is relatively higher among the construction laborers. Our results demonstrate that poor living conditions add to the burden of morbidity in construction workers and families. Providing healthcare coverage for this population and engaging and educating them about affordable healthcare are necessary future steps to prevent the worsening of the economic situation. [ABSTRACT FROM AUTHOR]

This article offers a framework to help decide between national and local lockdown in response to the coronavirus pandemic. The approach is to find the optimum level of lockdown that balances the benefits (avoided ailments) of lockdown against its cost (arising from reduced economic output). With the path of the pathogen being unknown, India may have to consider a rolling lockdown: that is, open the economy which would probably risk a flare up of the virus due to increased human interaction, and before the virus hits a threshold shut down the economy to control the virus, and then open it again. This balancing act between opening and closing the economy is probably necessary till a remedy is found to deal with the virus. Finally, timely and reliable testing is the most preferred way because it can do two things at once: it can lower the transmission of ailments and make local lockdown far more viable by identifying critical areas and hotspots. Extensive testing would generate granular data of affected areas, which can limit application of rolling lockdown to the affected districts only. With the availability of granular data, the choice between national and local lockdown would become choice between district (say) and tehsil lockdown. The analysis below is framed in terms of national and local lockdown although it applies with respect to district and tehsil lockdown. [ABSTRACT FROM AUTHOR]

This article reviews changes in knowledge and thinking about labour and employment issues in India, on the basis of the author's experience over the last 50 years. It examines six issues: employment deficits; the mode of production; labour institutions and labour market segmentation; wages; the quality of work; and poverty and inequality. In each case there is a brief overview of the history of research into and perceptions of these issues, followed by comments on some key outstanding questions today. The article then draws on the views of some leading participants in the Indian Society of Labour Economics to identify the highest priorities for research and policy in the coming years, concluding that the central issue is the quantity and quality of employment, and the social and economic processes that drive employment patterns, but that new approaches need to be developed if India's employment problems are to be adequately addressed. [ABSTRACT FROM AUTHOR]

Objective: To determine whether Rojiroti microfinance, for poor Indian women, improves child nutrition.Design: Cluster randomised trial.Setting: Tolas (village communities) in Bihar State.Participants: Women and children under 5 years.Interventions: With Rojiroti microfinance, women form self-help groups and save their money to provide loans to group members. After 6 months, they receive larger external loans. Tolas were randomised to receive Rojiroti immediately or after 18 months.Outcome Measures: The primary analysis compared the mean weight for height Z score (WHZ) of children under 5 years in the intervention versus control tolas who attended for weight and height measurement 18 months after randomisation. Secondary outcomes were weight for age Z score (WAZ), height for age Z score, mid-upper arm circumference (MUAC), wasting, underweight and stunting.Results: We randomised 28 tolas to each arm and collected data from 2469 children (1560 mothers) at baseline and 2064 children (1326 mothers) at follow-up. WHZ was calculated for 1718 children at baseline and 1377 (674 intervention and 703 control) at follow-up. At 18 months, mean WHZ was significantly higher for intervention (-1.02) versus controls (-1.37; regression coefficient adjusted for clustering β=0.38, 95% CI 0.16 to 0.61, p=0.001). Significantly fewer children were wasted in the intervention group (122, 18%) versus control (200, 29%; OR=0.46, 95% CI 0.28 to 0.74, p=0.002). Mean WAZ was better in the intervention group (-2.13 vs -2.37; β=0.27, 95% CI 0.11 to 0.43, p=0.001) as was MUAC (13.6 cm vs 13.4 cm; β=0.22, 95% CI 0.03 to 0.40, p=0.02). In an analysis adjusting for baseline nutritional measures (259 intervention children and 300 control), only WAZ and % underweight showed significant differences in favour of the intervention.Conclusion: In marginalised communities in rural India, child nutrition was better in those who received Rojiroti microfinance, compared with controls.Trial Registration Number: NCT01845545. [ABSTRACT FROM AUTHOR]

Background: School environments affect health and academic outcomes. With increasing secondary school retention in low-income and middle-income countries, promoting quality school social environments could offer a scalable opportunity to improve adolescent health and wellbeing.Methods: We did a cluster-randomised trial to assess the effectiveness of a multi-component whole-school health promotion intervention (SEHER) with integrated economic and process evaluations in grade 9 students (aged 13-14 years) at government-run secondary schools in the Nalanda district of Bihar state, India. Schools were randomly assigned (1:1:1) to three groups: the SEHER intervention delivered by a lay counsellor (the SEHER Mitra [SM] group), the SEHER intervention delivered by a teacher (teacher as SEHER Mitra [TSM] group), and a control group in which only the standard government-run classroom-based life-skills Adolescence Education Program was implemented. The primary outcome was school climate measured with the Beyond Blue School Climate Questionnaire (BBSCQ). Students were assessed at the start of the academic year (June, 2015) and again 8 months later at the end of the academic year (March, 2016) via self-completed questionnaires. This study is registered with ClinicalTrials.gov, number NCT02484014.Findings: Of the 112 eligible schools in the Nalanda district, 75 were randomly selected to participate in the trial. We randomly assigned 25 schools to each of the three groups. One school subsequently dropped out of the TSM group, leaving 24 schools in this group. The baseline survey included a total of 13 035 participants, and the endpoint survey included 14 414 participants. Participants in the SM-delivered intervention schools had substantially higher school climate scores at endpoint survey than those in the control group (BBSCQ baseline-adjusted mean difference [aMD] 7·57 [95% CI 6·11-9·03]; effect size 1·88 [95% CI 1·44-2·32], p<0·0001) and the TSM-delivered intervention (aMD 7·57 [95% CI 6·06-9·08]; effect size 1·88 [95% CI 1·43-2·34], p<0·0001). There was no effect of the TSM-delivered intervention compared with control (aMD -0·009 [95% CI -1·53 to 1·51], effect size 0·00 [95% CI -0·45 to 0·44], p=0·99). Compared with the control group, participants in the SM-delivered intervention schools had moderate to large improvements in the secondary outcomes of depression (aMD -1·23 [95% CI -1·89 to -0·57]), bullying (aMD -0·91 [95% CI -1·15 to -0·66]), violence victimisation (odds ratio [OR] 0·62 [95% CI 0·46-0·84]), violence perpetration (OR 0·68 [95% CI 0·48-0·96]), attitude towards gender equity (aMD 0·41 [95% CI 0·21-0·61]), and knowledge of reproductive and sexual health (aMD 0·29 [95% CI 0·06-0·53]). Similar results for these secondary outcomes were noted for the comparison between SM-delivered intervention schools and TSM-delivered intervention schools (depression: aMD -1·23 [95% CI -1·91 to -0·55]; bullying: aMD -0·83 [95% CI -1·08 to -0·57]; violence victimisation: OR 0·49 [95% CI 0·35-0·67]; violence perpetration: OR 0·49 [95% CI 0·34-0·71]; attitude towards gender equity: aMD 0·23 [95% CI 0·02-0·44]; and knowledge of reproductive and sexual health: aMD 0·22 [95% CI -0·02 to 0·47]). However, no effects on these secondary outcomes were observed for the TSM-delivered intervention schools compared with the control group (depression: aMD -0·03 [95% CI -0·70 to 0·65]; bullying: aMD -0·08 [95% CI -0·34 to 0·18]; violence victimisation: OR 1·27 [95% CI 0·93-1·73]; violence perpetration: OR 1·37 [95% CI 0·95-1·95]; attitude towards gender equity: aMD 0·17 [95% CI -0·09 to 0·38]; and knowledge of reproductive and sexual health: aMD 0·06 [95% CI -0·18 to 0·32]).Interpretation: The multi-component whole-school SEHER health promotion intervention had substantial beneficial effects on school climate and health-related outcomes when delivered by lay counsellors, but no effects when delivered by teachers. Future research should focus on the evaluation of the scaling up of the SEHER intervention in diverse contexts and delivery agents.Funding: John D. and Catherine T. MacArthur Foundation, USA and the United Nations Population Fund India Office. [ABSTRACT FROM AUTHOR]

Proven links between disability and poverty suggest that development programmes and policies that are not disability-inclusive will leave persons with disabilities behind. Despite this, there is limited quantitative evidence on livelihood opportunities amongst adults with disabilities in Low and Middle Income Countries. This study adds to the limited evidence base, contributing data from one African and one Asian Setting. We undertook a population-based case–control study of adults (18+) with and without disabilities in North-West Cameroon and in Telangana State, India. We found that adults with disabilities were five times less likely to be working compared to age-sex matched controls in both settings. Amongst adults with disabilities, current age, marital status and disability type were key predictors of working. Inclusive programmes are therefore needed to provide adequate opportunities to participate in livelihood prospects for adults with disabilities in Cameroon and India, on an equal basis as others. These findings are of crucial importance at this stage of the Sustainable Development Agenda, to ensure that the mandate of inclusive development is achieved. [ABSTRACT FROM AUTHOR]

Trickle-down has been addressed, so far, using income-based measures of inequality and poverty. However concerns over the inequality in access to other dimensions important for quality of life remains. I revisit trickle-down using the Alkire and Foster (J Public Econ 95(7-8), 2011) class of measures to estimate multidimensional poverty in India. Using NSS data estimates are presented for the 16 major states and are compared to income-based measures. Adding dimensions in poverty measurement results in the reversal of several income-based conclusions about poverty across regions. The paper also finds that contrary to income-based findings, Muslims are less poor than Hindus under the multidimensional criteria. [ABSTRACT FROM AUTHOR]

Objective We report inequity in out-of-pocket payments (OOPP) for hospitalisation in India between 1995 and 2014 contrasting older population (60 years or more) with a population under 60 years (younger population). Methods We used data from nationwide healthcare surveys conducted in India by the National Sample Survey Organisation in 1995–96, 2004 and 2014 with the sample sizes ranging from 333,104 to 629,888. We used generalised linear and fractional response models to study the determinants of OOPP and their burden (share of OOPP in household consumption expenditure) at a constant price. The relationship between predicted OOPP and its burden with monthly per capita consumption expenditure (MPCE) quintiles and selected socioeconomic characteristics were used to examine vertical and horizontal inequities in OOPP. Results The older population had higher OOPP for hospitalisation at all time points (range: 1.15–1.48 times) and a greater increase between 1995–96 and 2014 than the younger population (2.43 vs 1.88 times). Between 1995–96 and 2014, the increase in predicted mean OOPP for hospitalisation was higher for the poorest than the richest (3.38 vs 1.85 times) older population. The increase in predicted mean OOPP was higher for the poorest (2.32 vs 1.46 times) and poor (2.87 vs 1.05 times) older population between 1995–96 and 2004 than in the latter decade. In 2014, across all MPCE quintiles, the burden of OOPP was higher for the less developed states, females, private hospitals, and non-communicable disease and injuries, more so for the older than the younger population. In 2014, the predicted absolute OOPP for hospitalisation was positively associated with MPCE quintiles; however, the burden of OOPP was negatively associated with MPCE quintiles indicating a regressive system of healthcare financing. Conclusion High OOPP for hospitalisation and greater inequity among older population calls for better risk pooling and prepayment mechanisms in India. [ABSTRACT FROM AUTHOR]

Introduction: The existence of a social gradient in tobacco use has been clearly established in a number of countries with people with lower socioeconomic status being more likely to use tobacco. It is not clear how far this gradient is evident within severely deprived communities. This study assessed the association between occupation as a marker of socioeconomic status and use of smoked and smokeless tobacco within "slum" areas of Delhi, India.Methods: A census survey of 11 888 households, comprising 30 655 adults from 28 low-income communities (14 government-authorized and 14 unauthorized settlements called "Jhuggi-Jhopri/JJ" clusters) was conducted in 2012. The survey assessed age, sex, household size, occupational group, and current tobacco use. Independent associations with tobacco use were conducted using complex samples regression analysis, stratified by gender.Results: A quarter of participants (24.3%, 95% confidence interval [CI] 21.5-27.5) used any tobacco. Slightly more people used smoked (14.6%, 95% CI 12.9-16.3) than smokeless (12.6%, 95% CI 10.7-14.8) tobacco, with a small minority being dual users (2.7%, 95% CI 2.1-3.5). Prevalence of any tobacco use was highest in unskilled (45.13%, 95% CI 42.4-47.9) and skilled (46.2%, 95% CI 41.1-51.4) manual occupations and lower in nonmanual (30.3%, 95% CI 26.2-34.7) occupations and those who were unemployed (29.0%, 95% CI 25.3-33.0). This was confirmed in adjusted analysis in men but associations were more complex in women.Conclusions: Use of smoked and smokeless tobacco in low-income urban communities in India has a complex association with occupational status with both nonmanual occupation and unemployment being associated with lower prevalence of smoked and smokeless tobacco in men.Implications: Tobacco use in high-income countries shows a strong inverse relationship with social grade, income, and deprivation such that use is much more common among those who can least afford it. This study is the first to look at this social gradient in the context of low-income communities in India, finding that both unemployment and nonmanual occupation were associated with lower rates of tobacco use in men. The data present a challenge to existing explanations of the social gradient, requiring further consideration of the conditions under which affordability may work to reduce health inequalities arising from tobacco use. [ABSTRACT FROM AUTHOR]

Child labour is a multi-faceted problem. When we hear about child labour, generally we think of market work, i.e. children employed in mines and factories. Yet only small portion of child labour are engaged in market work particularly in developing countries like ours. Those children who are working in household industries are often excluded by researchers and policy planners. Thus leaving us with a limited knowledge about the possible causes of child labour in the home based industries like carpet weaving in Jammu and Kashmir state. To fill this gap, an attempt is made in the present study to analyse various determinants of child labour in the carpet weaving industry of Kashmir, so that necessary measures can be suggested for its reduction. Data has been collected from a sample of 960 sampled households with the help of interview schedules from four selected districts of Kashmir Valley. Our results shows that low socio-economic status i.e. low income of the family, illiteracy of household head and large size of the family force the children to enter into the labour market at their tender age. Further, we found because of growing educated unemployment problem in the state, parents prefer to employ their children in the labour market instead of schooling. The study suggests that child labour can be reduced if parents are compensated equal to the earnings of their children and their educational cost. [ABSTRACT FROM AUTHOR]

The low quality of health care in developing countries reduces the poor's incentives to use quality health services and their demand for health insurance. Using data from a field experiment in India, I show that randomly offering insurance policyholders a free preventive checkup with a qualified doctor has a twofold effect: receiving this additional benefit raises willingness to pay to renew health insurance by 53%, doubling the likelihood of hypothetical renewal; exposed individuals are 10 percentage points more likely to consult a qualified practitioner when ill after the checkup. Both effects are concentrated on poorer households. There is no effect on health knowledge and healthcare spending. This suggests that exposing insured households to quality preventive care can be a cost-effective way of raising the demand for quality health care and retaining policyholders in the insurance scheme. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Lack of access to finance is identified as one of the major causes of poverty and unemployment. Microfinance is considered to be one of the important tools for expanding access to financial services like savings, credit, insurance, and remittances. MFIs are social enterprises, and have to manage their financial resources without depending on subsidies and grants. In this context, the efficiency of MFIs becomes an important factor in deciding the sustainability of the organizations. Previous studies on MFI efficiency have been mainly cross-country comparisons. No study has attempted to explore the relation between size and efficiency of MFIs. This paper raises a basic question: 'Does size of the organizations affect efficiency of the MFIs? The study is based on secondary data. Based on their gross loan portfolio, the study classified MFIs across three categories: small (less than Rs.1,000 m), medium (Rs.1,000 m - 5,000 m) and large (more than Rs.5,000 m). The data was collected for 89 MFIs across these categories on four parameters: two parameters for inputs (asset and operating expense); and two parameters for outputs (loan outstanding and number of active borrowers). By using the data envelopment analysis (DEA) technique the study tries to identify the most efficient MFIs in each category along with average efficiency and minimum efficiency of these categories. The findings reported a clear linkage between the size and efficiency of the organizations. This study justifies the recent step of asset capping for Indian MFIs by the Reserve Bank of India. Keywords: data envelopment analysis (DEA), microfinance institutions (MFIs), efficiency Lack of access to finance has been identified as one of the major causes of poverty and unemployment. Microfinance is defined as provision of varied financial services such as savings, credit, insurance, and money transfers to poor people. Affordable, timely, and adequate credit plays an important role in expanding access to finance. The provision of finance for poor people has remained an integral part of India's inclusion policy for over 100 years. The objective of the cooperative Act of 1904 was to save farmers from indebtedness by providing them with affordable credit. Since then, various policy amendments have been made to increase the financial inclusion of farmers. Microfinance in some form or other has always remained an important intervention by policy-makers in developing countries. In addition to financial services, microfinance institutions (MFIs) also help in increasing the profitability of agriculture by providing technical support to farmers. [ABSTRACT FROM AUTHOR]

Health management information systems (HMIS) produce large amounts of data about health service provision and population health, and provide opportunities for data-based decision-making in decentralized health systems. Yet the data are little-used locally. A well-defined approach to district-level decision-making using health data would help better meet the needs of the local population. In this second of four papers on district decision-making for health in low-income settings, our aim was to explore ways in which district administrators and health managers in low- and lower-middle-income countries use health data to make decisions, to describe the decision-making tools they used and identify challenges encountered when using these tools. A systematic literature review, following PRISMA guidelines, was undertaken. Experts were consulted about key sources of information. A search strategy was developed for 14 online databases of peer reviewed and grey literature. The resources were screened independently by two reviewers using pre-defined inclusion criteria. The 14 papers included were assessed for the quality of reported evidence and a descriptive evidence synthesis of the review findings was undertaken. We found 12 examples of tools to assist district-level decision-making, all of which included two key stages-identification of priorities, and development of an action plan to address them. Of those tools with more steps, four included steps to review or monitor the action plan agreed, suggesting the use of HMIS data. In eight papers HMIS data were used for prioritization. Challenges to decision-making processes fell into three main categories: the availability and quality of health and health facility data; human dynamics and financial constraints. Our findings suggest that evidence is available about a limited range of processes that include the use of data for decision-making at district level. Standardization and pre-testing in diverse settings would increase the potential that these tools could be used more widely. [ABSTRACT FROM AUTHOR]

Low-resource settings often have limited use of local data for health system planning and decision-making. To promote local data use for decision-making and priority setting, we propose an adapted framework: a data-informed platform for health (DIPH) aimed at guiding coordination, bringing together key data from the public and private sectors on inputs and processes. In working to transform this framework from a concept to a health systems initiative, we undertook a series of implementation research activities including background assessment, testing and scaling up of the intervention. This first paper of four reports the feasibility of the approach in a district health systems context in five districts of India, Nigeria and Ethiopia. We selected five districts using predefined criteria and in collaboration with governments. After scoping visits, an in-depth field visit included interviews with key health stakeholders, focus group discussions with service-delivery staff and record review. For analysis, we used five dimensions of feasibility research based on the TELOS framework: technology and systems, economic, legal and political, operational and scheduling feasibility. We found no standardized process for data-based district level decision-making, and substantial obstacles in all three countries. Compared with study areas in Ethiopia and Nigeria, the health system in Uttar Pradesh is relatively amenable to the DIPH, having relative strengths in infrastructure, technological and technical expertise, and financial resources, as well as a district-level stakeholder forum. However, a key challenge is the absence of an effective legal framework for engagement with India's extensive private health sector. While priority-setting may depend on factors beyond better use of local data, we conclude that a formative phase of intervention development and pilot-testing is warranted as a next step. [ABSTRACT FROM AUTHOR]

This paper estimates the effects of gender and social caste on poverty in India using measures of household wealth from the National Family Health Survey (NFHS). Our asset-based measures of poverty are conceptually different than official measures based on consumption expenditures. For the period 2005-2006, we find that female-headed households and households belonging to marginalized social classes are more likely to be poor than their counterparts. Whether a household belongs to marginalized social class is more strongly associated with poverty than the gender of the household head. [ABSTRACT FROM AUTHOR]

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Using the unit data from the 64th round of the National Sample Surveys, 2007-08 on employment, unemployment, and migration, covering 125,578 households, this paper estimates the level, depth, and severity of poverty among nonmigrants and intra-state migrants, inter-state migrants, and emigrants in India. Based on the out-migration of any members of the household for employment at place of origin and using place of last residence definition, households are classified into intrastate migrants, inter-state migrant, emigrants, and non-migrant households. Economic well-being of migrant's households at the place of origin is measured by consumption expenditure (income). A set of poverty indices, the poverty headcount ratio, poverty gap ratio, and square poverty gap, are estimated from the household consumption expenditure to measure the level, depth, and severity of poverty among migration categories. The official state-specific poverty line is used in estimating the poverty indices. Descriptive analyses and logistic regression analyses are used in the analyses. Results suggest that the level, depth, and severity of poverty among migrant households is lower than that among non-migrant households; however, it varies across migrant categories. The poverty head count ratio was 41 % among inter-state migrants, 31 % among intra-state migrants, 20 % among emigrants, and 39 % among non-migrants in India. The poverty gap ratio and squared poverty gap were highest among inter-state migrants. Two broad patterns emerge from the state level analyses. Barring Kerala and Punjab that have a higher percentage of emigrants, inter-state migration accounts for a larger share of employment-related migration from the less developed states of Uttar Pradesh, Bihar, Jharkhand, Chhattisgarh, and Odisha while intra-state migration accounts for a larger share in the developed states of Maharashtra, Gujarat, Karnataka, and Tamil Nadu. Second, the level, depth, and severity of inter-state migrants from less developed states is higher than that of intra-state migrants and non-migrants; however, the pattern is reversed in the more developed states of India. Adjusting for socioeconomic correlates, the odds of poor among intra-state migrants are lower than those among inter-state migrant's households. The study supports the proposition that migration and remittances in India are not panacea to structural development constraints and that poor long-distance migrants need to be integrated in poverty alleviation programs. [ABSTRACT FROM AUTHOR]

Introduction: In high-income countries, secondhand smoke (SHS) exposure is higher among disadvantaged groups. We examine socioeconomic inequalities in SHS exposure at home and at workplace in 15 low- and middle-income countries (LMICs).Methods: Secondary analyses of cross-sectional data from 15 LMICs participating in Global Adult Tobacco Survey (participants ≥ 15 years; 2008-2011) were used. Country-specific analyses using regression-based methods were used to estimate the magnitude of socioeconomic inequalities in SHS exposure: (1) Relative Index of Inequality and (2) Slope Index of Inequality.Results: SHS exposure at home ranged from 17.4% in Mexico to 73.1% in Vietnam; exposure at workplace ranged from 16.9% in Uruguay to 65.8% in Bangladesh. In India, Bangladesh, Thailand, Malaysia, Philippines, Vietnam, Uruguay, Poland, Turkey, Ukraine, and Egypt, SHS exposure at home reduced with increasing wealth (Relative Index of Inequality range: 1.13 [95% confidence interval [CI] 1.04-1.22] in Turkey to 3.31 [95% CI 2.91-3.77] in Thailand; Slope Index of Inequality range: 0.06 [95% CI 0.02-0.11] in Turkey to 0.43 [95% CI 0.38-0.48] in Philippines). In these 11 countries, and in China, SHS exposure at home reduced with increasing education. In India, Bangladesh, Thailand, and Philippines, SHS exposure at workplace reduced with increasing wealth. In India, Bangladesh, Thailand, Philippines, Vietnam, Poland, Russian Federation, Turkey, Ukraine, and Egypt, SHS exposure at workplace reduced with increasing education.Conclusion: SHS exposure at homes is higher among the socioeconomically disadvantaged in the majority of LMICs studied; at workplaces, exposure is higher among the less educated. Pro-equity tobacco control interventions alongside targeted efforts in these groups are recommended to reduce inequalities in SHS exposure.Implications: SHS exposure is higher among the socioeconomically disadvantaged groups in high-income countries. Comprehensive smoke-free policies are pro-equity for certain health outcomes that are strongly influenced by SHS exposure. Using nationally representative Global Adult Tobacco Survey (2008-2011) data from 15 LMICs, we studied socioeconomic inequalities in SHS exposure at homes and at workplaces. The study showed that in most LMICs, SHS exposure at homes is higher among the poor and the less educated. At workplaces, SHS exposure is higher among the less educated groups. Accelerating implementation of pro-equity tobacco control interventions and strengthening of efforts targeted at the socioeconomically disadvantaged groups are needed to reduce inequalities in SHS exposure in LMICs. [ABSTRACT FROM AUTHOR]

Introduction: Many low- and middle-income countries (LMICs) have enacted legislation banning smoking in public places, yet enforcement remains challenging. The aim of this study was to assess the feasibility of using a validated low-cost methodology (the Dylos DC1700) to provide objective evidence of smoke-free (SF) law compliance in hospitality venues in urban LMIC settings, where outdoor air pollution levels are generally high.Methods: Teams measured indoor fine particulate matter (PM2.5) concentrations and systematically observed smoking behavior and SF signage in a convenience sample of hospitality venues (bars, restaurants, cafes, and hotels) covered by existing SF legislation in Mexico, Pakistan, Indonesia, Chad, Bangladesh, and India. Outdoor air PM2.5 was also measured on each sampling day.Results: Data were collected from 626 venues. Smoking was observed during almost one-third of visits with substantial differences between countries-from 5% in India to 72% in Chad. After excluding venues where other combustion sources were observed, secondhand smoke (SHS) derived PM2.5 was calculated by subtracting outdoor ambient PM2.5 concentrations from indoor measurements and was, on average, 34 µg/m(3) in venues with observed smoking-compared to an average value of 0 µg/m(3) in venues where smoking was not observed (P < .001). In over one-quarter of venues where smoking was observed the difference between indoor and outdoor PM2.5 concentrations exceeded 64 µg/m(3).Conclusions: This study suggests that low-cost air quality monitoring is a viable method for improving knowledge about environmental SHS and can provide indicative data on compliance with local and national SF legislation in hospitality venues in LMICs.Implications: Air quality monitoring can provide objective scientific data on SHS and air quality levels in venues to assess the effectiveness of SF laws and identify required improvements. Equipment costs and high outdoor air pollution levels have hitherto limited application in LMICs. This study tested the feasibility of using a validated low-cost methodology in hospitality venues in six LMIC urban settings and suggests this is a viable method for improving knowledge about SHS exposure and can provide indicative data on compliance with SF legislation. [ABSTRACT FROM AUTHOR]

Background: Rates of child malnutrition and mortality in India remain high. We tested the hypothesis that rising food prices are contributing to India's slow progress in improving childhood survival.Methods: Using rounds 2 and 3 (2002-08) of the Indian District Level Household Survey, we calculated neonatal, infant and under-five mortality rates in 364 districts, and merged these with district-level food price data from the National Sample Survey Office. Multivariate models were estimated, stratified into 27 less deprived states and territories and 8 deprived states ('Empowered Action Groups').Results: Between 2002 and 2008, the real price of food in India rose by 11.7%. A 1% increase in total food prices was associated with a 0.49% increase in neonatal (95% confidence interval (CI): 0.13% to 0.85%), but not infant or under-five mortality rates. Disaggregating by type of food and level of deprivation, in the eight deprived states, we found an elevation in neonatal mortality rates of 0.33% for each 1% increase in the price of meat (95% CI: 0.06% to 0.60%) and 0.10% for a 1% increase in dairy (95% CI: 0.01% to 0.20%). We also detected an adverse association of the price of dairy with infant (b = 0.09%; 95% CI: 0.01% to 0.16%) and under-five mortality rates (b = 0.10%; 95% CI: 0.03% to 0.17%). These associations were not detected in less deprived states and territories.Conclusions: Rising food prices, particularly of high-protein meat and dairy products, were associated with worse child mortality outcomes. These adverse associations were concentrated in the most deprived states. [ABSTRACT FROM AUTHOR]