Udaya S. Mishra

India's elderly : burden or challenge?

Demography of Ageing Policies and Programmes The Living Conditions of the Elderly Perceptions of the Elderly Life Histories of the Elderly Conceptual Issues A Re-Examination Recommendations for Policy Actions

Demography of Indian Aging, 2001-2051

Summary India is the second largest country in the world, with 72 million elderly persons above 60 years of age as of 2001, compared to Chinas 127 million. One of the objectives of this paper is to assess the emerging scenario of elderly for the first half of the 21st century. According to projections, the elderly in the age group 60 and above is expected to increase from 71 million in 2001 to 179 million in 2031, and further to 301 million in 2051; in the case of those 70 years and older, they are projected to increase from 27 million in 2001 to 132 million in 2051. Among the elderly persons 80 and above, they are likely to improve their numbers from 5.4 million in 2021 to 32.0 million in 2051. The increasing number and proportion of elderly will have a direct impact on the demand for health services and pension and social security payments. Mobilizing resources for geriatric care and providing sufficient maintenance for the elderly will emerge as a major responsibility for heath-care providers and pension economists.

Socio-economic inequalities in child health: Recent evidence from India

Abstract This paper analyses the Indian National Family Health Survey (2005–2006) data to present certain broad descriptive features of child health inequalities in India and their distribution across well-defined socio-economic groups classified by gender and sector-of-origin, and their dispersal across space. This study finds that poorer sections of the population are beleaguered with ill health whether in the quest for child survival or due to anxieties pertaining to child nutrition. The concentration index value for the indicators of under-five mortality, full immunisation and underweight outcomes at the national level is calculated to be −0.159, 0.204 and −0.158, respectively. The other disturbing finding here is that there are reigning regional and gender disadvantages irrespective of the developmental status of the State. This study would not only help policymakers to recognise these persistent inequalities but also would help understand health performance at the state and regional levels thus facilitating targeting intervention.

Inequalities in Childhood Malnutrition in India: Some Evidence on Group Disparities

Abstract This paper examines inequalities in child malnutrition in India through three distinct — although inter‐related — types of empirical analysis. First, it reports the socio‐economic inequalities in childhood malnutrition across different Indian states. Second, it decomposes the gap in malnutrition between children belonging to poor and non‐poor households to understand the disadvantageous distribution of health determinants and their effects. This analysis indicates that the distribution of endowments and positive maternal characteristics are significant in widening the gap between the child malnutrition among poor and non‐poor households. Third, it examines the inter‐group disparities in child malnutrition and notes that child groups privileged in terms of income, mother’s nutritional status and education have lower malnutrition, whereas the group adverse in all three characteristics endures the most. The paper concludes that policies to reduce malnutrition inequalities should recognize that endowment revisions can be more effective if appended with behavioural interventions.

Correlates of female sterilization regret in the southern states of India.

This study analyses factors associated with the incidence of sterilization regret in the four south Indian states of Andhra Pradesh, Karnataka, Kerala and Tamil Nadu. Using data from the National Family Health Surveys, in all four states the incidence of regret was found to be less than 10% and the factors significantly associated with it were child loss experience and quality of services. Hence, there is a need to improve the quality of services, both in terms of counselling and service provision, and women need to be counselled about the permanent nature of sterilization in order to avoid future regret.

On measuring group-differentials displayed by socioeconomic indicators

This is a very short and elementary note which points (in a continuation of a recent tradition in the literature) to the importance of taking account of the level of a socioeconomic indicator in comparing group-differentials displayed by it. The requirement of ‘level sensitivity’ is captured in a couple of axioms, and a measure of differential, which satisfies both these axioms, is advanced. An empirical illustration of the notes concerns is also provided.

Induced abortion potential among Indian women

Information on abortion is limited and inaccurate, especially in the developing world, which has led to speculation on the prevalence of abortion in these regions. A rise in prevalence of abortion is mostly counted in terms of increase in the prevalence of induced abortions which reflects on the reproductive health of women. With the growing concern for the reproductive health of women, the study of abortion has drawn the attention of researchers world-wide. This paper is an attempt to assess the induced abortion potential among Indian women by utilizing information on proportion of unwanted and ill-timed pregnancies obtained through National Family Health Survey, India. This exercise may facilitate a better understanding of the exact prevalence of induced abortion, which necessarily should be less than the estimated potential depending on the levels of unwanted and ill-timed fertility.

Health Concerns among India's Elderly:

This article critically examines the health situation among elderly from two sets of independent sources. National Sample Survey in its 42 Round (July 1986-June 1987) canvassed a nationwide survey covering 50,000 households in 8312 villages and 4546 urban blocks in India to understand the socio-economic profile of aged persons. Secondly, an aging survey (1993) was conducted in Tamil Nadu, Kerala, Gujarat, and Karnataka states in India by the authors to study the elderly life in terms of general feeling, living arrangements, living support, social security, health, nutrition, their involvement in social and religious matters, views of old age homes and particularly life preparatory measures. The survey is based on interviews with about 2253 persons aged 60 years and above, of whom 1325 are males and 928 are females. In fact, this survey is a part of a larger study conducted for the Social Development Section, Economic and Social Commission for the Asia and Pacific (ESCAP), United Nations, Bangkok, along with four other South East Asian countries—China, Korea, Singapore, and Thailand. From the survey conducted by us, we report only the health aspects of the elderly in this paper. The last section examines the major cause of death among elderly as reported from the Model Registration System of the Registrar General of India and concludes with feasible policy prescriptions.

On Measuring Technical Efficiency of the Health System in India: An Application of Data Envelopment Analysis

Huge investments have been made in improving the health system of India since early independence, which has resulted in health outcomes such as infant and maternal maternity rates and life expectancy levels to exhibit impressive reductions and increments, respectively. Although at the national level these have been impressive, it is appalling at the state level. States such as Kerala and Tamil Nadu have always topped in displaying low infant and maternal mortality rates associated with high levels of health workers and infrastructure in contrast to states like Bihar and Uttar Pradesh. In the present study, we use data envelopment analysis (DEA) to assess and compare the health system across states of India. Using DEA, we attempt to derive desired levels of health manpower and infrastructure to be emulated, to make the health systems efficient. The study limits to two outputs and two inputs for 27 states of India and used the output oriented DEA. It was found that of the 27 states only six of them were technically efficient, having an efficiency score of 1.00. The remaining states were technically inefficient and were using more than required amount of inputs to achieve the current levels of output. These inefficient states could make their health system efficient by following the efficient states as peers.

On comparison of nutritional deprivation: an illustration using Foster Greer Thorbecke criterion

This is an illustrative note on application of Foster Greer Thorbecke (FGT) criterion to measurement and comparison of undernourishment among children. Given the semblance between head-count measure of poverty and measuring undernourishment among children, there arises a need for application of FGT criterion in assessment of undernourishment as well. This not only helps in assessing intensity and inequality aspect but also can adjust the head count accounting for both to make a valid comparison on levels of undernourishment across situations.