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

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

P1030184

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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New paper on the relationship between village conflict and OD

conflict and od

Waterlines recently published Dean, Diane and my paper on the relationship between social fragmentation in villages and the persistence of open defecation in India.  We use quantitative data to show the correlation between perceptions of village conflict, both general and caste-based, and open defecation, and qualitative data to explain how caste hierarchy could be a mechanism linking conflict and open defecation.

We hope that this paper pushes all of us working on sanitation in India to think beyond traditional approaches to motivating latrine use.  We must seriously question whether popular methods that rely on collaboration can be effective in a context like rural India where deep social divisions continue to govern interactions in daily life.  Experimentation is critical to finding strategies that will work in tackling India’s unique open defecation challenge.

If you have access to Waterlines, you can find the paper here. Otherwise, you can read it here.

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30,000 babies in UP

Picture8

 

Neonatal mortality is the number of babies, per 1000 live births, that die in the first 28 days of life.  Postneonatal mortality is the number of babies, per 1000 live births, that die between 29 days and a year.  Infant mortality is the sum of these two rates, that is, the number of babies, per 1000 live births, who die in the first year.  These numbers are considered good summary measures of population health.

The graphs below (also shown here) show state level differences in neonatal, postneonatal, and infant mortality from two of India’s most recent datasets – the Annual Health Survey (AHS) and the Sample Registration System (SRS).  The results for most states, and most rates, are quite similar.  The exception is neonatal mortality in Uttar Pradesh.

SRS reports UP’s neonatal mortality rate as 43.9 while the AHS reports it as 50.0.  As stand-alone rates, these numbers do not seem so wildly different, but because Uttar Pradesh has such a large population, the discrepancy in neonatal deaths between the two sources is over 30,000 deaths!  Perhaps another survey is in order.

No matter which of the surveys you use, Uttar Pradesh has one of the highest neonatal mortality (NNM) rates in the country.  That over 200,000 babies die in Uttar Pradesh every year is a tragedy.  These are babies who have been loved by parents and grandparents and siblings and neighbors.

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