Srijit Mishra

Measuring the prevalence of chronic diseases using population surveys by pooling self-reported symptoms, diagnosis and treatments: results from the World Health Survey of 2003 for South Asia

ObjectivesMeasuring disease prevalence poses challenges in countries where information systems are poorly developed. Population surveys soliciting information on self-reported diagnosis also have limited capacity since they are influenced by informational and recall biases. Our aim is to propose a method to assess the prevalence of chronic disease by combining information on self-reported diagnosis, self-reported treatment and highly suggestive symptoms.MethodsAn expanded measure of prevalence was developed using data from the World Health Survey for Bangladesh, India and Sri Lanka. Algorithms were constructed for six chronic diseases.ResultsThe expanded measures of chronic disease increase the prevalence estimates. Prevalence varies across socio-demographic characteristics, such as age, education, socioeconomic status (SES), and country. Finally, the association, as also risk factor, between chronic disease status and poor self-rated health descriptions increases significantly when one takes into account highly suggestive symptoms of diseases.ConclusionsOur expanded measure of chronic disease could form a basis for surveillance of chronic diseases in countries where health information systems have been poorly developed. It represents an interesting trade-off between the bias associated with usual surveillance data and costs.

Progress in Human Development - Are we on the right path?

The conventional measure of the Human Development Index (HDI) is a linear average in three dimensions, HDI1. This is indifferent to uniformity in attainment across dimensions. An alternative, HDI2, based on the shortfall from the ideal using Euclidean distance, addresses the above anomaly. These two measures are used to analyse progress in human development for 127 countries over the period 1990-2004. Introducing the notion of an ideal path, measures of fluctuation and normalised-change are proposed. Empirical illustration highlights the pattern in Sub-Saharan countries, Commonwealth of Independent States (CIS), and some of the emerging economies.

On measuring group-differentials displayed by socio-economic indicators:An extension

In a recent paper, Mishra and Subramanian (2006) propose a measure to explain group-differential which is sensitive to levels in the sense that a given hiatus at lower levels of failure (or higher levels of attainment) is considered worse off. This article critically evaluates their method – refines their two axioms, adds an additional axiom of normalization and proposes an alternative which is more general. It proposes to reduce subjectivity when there is lower hiatus at lower levels of failure and also addresses scenarios when rank ordering of sub-groups will be reversed. Empirical illustration with infant mortality rate data for selected Indian states is also provided.

Farm Size and Returns to Cultivation in India: Revisiting an Old Debate

This paper revisits the long-debated question of the relationship between farm size and productivity by studying the relationship between area cultivated and net returns to cultivation in India using a nationally representative data-set. The analysis is carried out separately for the two major agricultural seasons, kharif and rabi, and for both the seasons pooled together. Our findings suggest the existence of an inverse relationship, even when we control for a number of household and farm characteristics and even when we treat factors such as household type (occupation), social group (caste), agro-climatic zone (region) and agricultural season as fixed effects. The result is also robust to correction for selection bias. However, the efficiency of the smallholder as a result of this greater productivity has to be treated with some caution as it ignores the low absolute levels of their returns, which raise questions about the sustainability of their livelihoods. This is further aggravated by the fact that they pay relatively higher unit costs and because of their greater dependence on purchased inputs.

Hunger, ethics and the right to food.

The management of hunger has to look into the issues of availability, accessibility and adequacy of food supply. From an ethical perspective, this paper argues in favour of the right to food. But, for this to become viable, the state has to come up with an appropriate and effective bill on food and nutrition security, address the issue of inadequate provisioning of storage space by state agencies leading to rotting of food grains--a criminal waste when people are dying of hunger; and rely on local level institutions involving the community, that complement the administrative structure to identify the poor and reduce exclusion and inclusion errors.

A MANUSH or HUMANS Characterisation of the Human Development Index

Abstract Proposing a set of axioms MANUSH (Monotonicity, Anonymity, Normalisation, Uniformity, Shortfall sensitivity, Hiatus sensitivity to level), this paper evaluates three aggregation methods of computing Human Development Index (HDI). The old measure of HDI, which is a linear average of the three dimensions, satisfies monotonicity, anonymity, and normalisation (or MAN) axioms. The current geometric mean approach additionally satisfies the axiom of uniformity, which penalises unbalanced development across dimensions. We propose ℋα measure, which for α ≥ 2 also satisfies axioms of shortfall sensitivity (emphases on the worse-off to better-off dimensions should be at least in proportion to their shortfalls) and hiatus sensitivity to level (higher overall attainment must simultaneously lead to a reduction in gap across dimensions). Special cases of ℋα are the linear average (α = 1), the displaced ideal (α = 2), and the leximin ordering (α → ∞) methods. For its axiomatic advantages, we propose to make use of the displaced ideal (α = 2) method in the computation of HDI replacing the current geometric mean.