research and policy advocacy for health & wellbeing in India.

Sanitation

Exploring the causes and consequences of widespread open defecation in India

Read More
Sanitation

Social Inequality

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

Read More
Social Inequality

Maternal Health

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

Read More
Maternal Health

Sanitation and Infant mortality externalities paper on fivethirtyeight

DSC00225 This week, FiveThirtyEight blog highlighted a newly-released working paper by Dean Spears and I. The paper, now posted as part of the National Bureau of Economic Research's working paper series, studies the infant mortality externalities of poor sanitation. The paper, "Neighborhood Sanitation and Infant Mortality," can be downloaded at no cost from the Social Science Research Network. ...Read More..

Is Some Vaccine Worse than None? The Rubella Vaccine Threshold Effect

state level covariates The issue: Vaccines are the most effective tools to defend against viral infection. Diseases that use to be common causes of illnesses and deaths around the world, such as smallpox, measles, diphtheria, pertussis, influenza, and Haemophilus influenzae type b (Hib) and rubella can be prevented via vaccines and as a result have either been eradicated (smallpox), or have been tremendously reduced over the past century. For example, rubella, a disease that, when contracted by pregnant women, can result in death of the fetus or birth defects in the infant, has been eliminated in the Americas since 2009 and has decreased substantially in Europe.1, 2 Therefore, when India’s Ministry of Health announced in 2014 that they plan to introduce rubella-containing vaccine (RCV) into their national measles routine childhood immunization program,3, 4 at first glance this seemed like a great and straight forward public health intervention.  It might save a lot of children from being born with birth defects: it is estimated that 110,000 infants (95% CI 14,000 – 308,000) are born each year with congenital rubella syndrome.5   The rubella vaccine is safe and effective - 95-100% of susceptible individuals over a year old develop rubella anti-bodies, which protect them against the disease,...Read More..

Nikhil and Sangita on NDTV, discussing the Swacch Bharat Mission

Just two days ago, award winning journalist Sreenivasan Jain and Manas Roshan of NDTV did a story on the Swachh Bharat Mission as part of their investigative show, Truth Versus Hype.  You can watch the show here. The show was quite remarkable. For the first time on national television, someone said that they do not like government toilets because they thought that their pits were too small (3:34 minutes into the show). They also said that the pits, according to them, would fill up in a month or two. As those who have followed r.i.c.e. research on perceptions of toilets in rural India know, this is just not true. The Indian government actually builds nice toilets (if there is no corruption, that is) which meet WHO requirements for pit size, and these pits would last a family of 5 more than 5 years.  The world over, people use these pit latrines, saving themselves and others from disease and death. As the culture and sanitation paper shows,  rural Indians think that these pits are too small for their use because they are anxious that they will have to empty the pits once they fill up. Feces are considered ritually polluting, and dealing with...Read More..

  • Tags:

What can India learn from France about open defecation?

deanamse In reciprocation for my visit to India last year, Dean came to France at the end of March to visit the Aix-Marseille School of Economics. A great time was had by all, in particular the participants of Dean's seminar on March 31, where he presented a paper entitled "Neighborhood Sanitation and Infant Mortality."  In this paper, Dean and Mike Geruso show that the Muslim mortality puzzle can be explained by the latrine use of neighbours, which can in turn be explained by the religion of those neighbours: Muslims are much more likely to use latrines than Hindus in India, despite their relative poverty.  It was probably the most attentive and interested audience I have seen at a seminar in all of my time at AMSE. Dean returned to India, but I am sure that the memories of the bright blue skies, the clean-ish streets, and the plentiful public toilets of Provence will persist for a long time to come.  Inspired by the visit, I wrote an article that appears in today on how the culture of smoking in France could inform those working to reduce open defecation in India....Read More..

  • Tags:

Bus ko rasta do

16THOPEDBRT_2374964f (Part of the Bus Rapid Transit Corridor in Sheikh Sarai in Delhi.  Photo: RV Moorthy) If you haven't already seen it, do check out Aashish and Karthik's wonder op-ed on public transit in today's Hindu.  It talks about how lack of willingness on the part of rich Delhites to sacrifice road-space for the convenience for poorer commuters, and for better air quality, rather than any intrinsic problem with BRT technology, gets in the way of a functioning bus rapid transit system in Delhi.  My favorite line in the op-ed is the last one: "Many commentators seem to believe that the involvement of international expertise in the design of Delhi’s BRT will solve its woes, but experts in physical design will have no remedy to offer for this deeper malaise of indifference." As with open defecation, the problem here is not with the technology.  ...Read More..

  • Tags:

We don’t clean toilets!

Anil K. Rajvanshi, an Indian academic and the Director of an agricultural institute in Maharastra, recently wrote an article titled ‘The Un-Swachh Truth’ in the Huffington Post. The points which the author takes up in the article resonate with our findings from the “switching study” that one reason people defecate in the open rather than use latrines is because they don’t want to deal with feces. In the article Dr. Rajvanshi reflects on one of the most difficult aspects of his job as director of the institute: trying to keep the toilets clean. Despite his efforts, the educated scientists in the institute remained reluctant to taking turns and cleaning the toilets themselves. In fact Dr. Rajvanshi said that even when he made it mandatory for people to clean the toilet, if they wanted to use it, most of his staff members chose to use the fields for almost two years. Though the incident which Dr. Rajvanshi talks about is an anecdote, it is an important and meaningful one. In fact most people in rural north India have attitudes towards emptying their latrine pitsthat are similar to those of Dr. Rajvanshi’s staff towards cleaning toilets. Villagers similarly think it is not...Read More..

  • Tags: