research and policy advocacy for health & wellbeing in India.

Sanitation

Exploring the causes and consequences of widespread open defecation in India

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Sanitation

Social Inequality

Understanding how social discrimination impacts child and maternal health in rural India

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Social Inequality

Maternal Health

Exploring challenges and policy responses to adequate nutrition in motherhood to improve child health

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Maternal Health

Mike at Penn

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Mike Geruso, member of rice’s board, was the presenter yesterday at Penn’s Business Economics and Public Policy seminar series. He presented his research on “Upcoding: Evidence from Medicare on Squishy Risk Adjustment”, co-authored with Timothy Layton. I have read Mike’s papers, but never heard him speak. The talk was a reminder for me of the extreme relevance Mike’s research, and how clear he is in his writing, presentation, figures and tables. Do check out his working paper here. I am posting the abstract below.

Upcoding — manipulation of patient diagnoses in order to game payment systems — has gained significant attention following the introduction of risk adjustment into US insurance markets. We provide new evidence that enrollees in private Medicare plans generate 6% to 16% higher diagnosis-based risk scores than they would generate under fee-for-service Medicare, where diagnoses do not affect payments. Our estimates imply upcoding generates billions of dollars in excess public spending annually and significant consumer choice distortions. We show that coding intensity increases with vertical integration, reflecting a principal-agent problem faced by insurers, who desire more intense coding from the physicians with whom they contract....Read More..

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Grant window: Work with r.i.c.e. and 3ie to learn how to promote the use of SBM latrines!

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We are delighted to announce that a grant window — in partnership with 3ie and the WASH team at the Gates Foundation — is now open for projects that can help us learn about how to promote the use of affordable pit latrines in rural India!  The Indian government, in its Swacch Bharat Mission, has announced plans to build about 100 million latrines throughout rural India.  This project is about finding ways to encourage people to use these latrines — strategies that build upon what is now known and being better understood about the social forces of caste, purity, pollution, and untouchability that prevent people from using and emptying normal latrine pits, and strategies that are affordable under the behavior change budget that is in principle allocated alongside the SBM latrine construction.

We are especially interested in interdisciplinary teams of social scientists, sanitation experts, and others all working together: perhaps an epidemiologist expert on sanitation, a sociologist familiar with the norms of caste in Indian villages, and an implementing organization with experience in making projects like this happen.  Our goal is to fund several projects at the same time so that we can compare and contrast what different teams are learning in different places with different strategies.  Importantly,

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Book chapter: Purity & pollution, caste, and open defecation

India vs Africa

Check out a new book chapter authored by Aashish, Diane, and Dean, called “Purity, pollution, and untouchability: challenges affecting the adoption, use, and sustainability of sanitation programmes in rural India” in the book “Sustainable Sanitation for all: Experiences, challenges and innovations“, published by Practical Action and edited by Petra Bongartz, Naomi Vernon and John Fox.

The chapter is available for download here. The whole book can also be downloaded, from here.

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check out this new article on caste & sanitation

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Thanks so much to Payal for sharing Nilanjana Sen’s new article at Fair Observer about caste & sanitation in India.  It talks about how India’s history and continuing practice of untouchability makes the adoption of simple latrines a unique challenge.  One of my favorite lines in the piece, which led me to set the village Ambedkar statue from Sitapur as the image for this post is:  “For Ambedkar, the problem of poor sanitation in India was a socio-cultural issue since the scavenger was invariably an Untouchable who was a permanent victim of his hereditary occupation.”

Check out the whole article here!

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Village sanitation and child health: Effects and external validity in a randomized field experiment in rural India|Jeffrey Hammer and Dean Spears

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This paper by Jeffrey and Dean reports a cluster randomized controlled trial of a village sanitation intervention conducted in rural Maharashtra,  designed to identify an effect of village sanitation on average child height. The paper got published on 20th April, 2016 in Journal of Health Economics.

Please read the article here. If you are not able to access the paper in the link provided, you can download the PDF from the research section of our website.

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