Monetary and Multidimensional Poverty in Kerala: A Review of Recent Evidence

Although income based poverty estimates and assessment still guide much of the national policies in India, there is wider recognition of non-income dimensions of poverty than twenty years back. The last ten years especially has seen significant developments in the conceptualization and application of multidimensional poverty. The original capabilities idea became theoretically more robust and its measurement improved with the application of the multidimensional poverty index (MPI). Even before multidimensional conceptualizations of development and poverty made their way into the mainstream, this was discussed and debated in the special context of Kerala, which showed the paradox of low income-high human development. Further, Kerala had made its own contribution to the multidimensional analysis toolkit by developing a risk index through participatory methods to assess poverty

Addressing water stress through wastewater reuse: Complexities and challenges in Bangalore, India

Wastewater reuse is an important adaptation option for mitigating water stress in rapidly growing urban centres. But, wastewater reuse is easier said than done, particularly in developing countries. The task becomes even more challenging when one takes a basin-level perspective. We illustrate these challenges by studying the Vrishabhavathy River in Bangalore, India, which carries almost half of the city’s wastewater. First, we find that the sewage treatment plant (STP) located on this river does not function efficiently and no positive impact of effluent discharge on river water quality was observed. Second, while the Sewerage Board has implem ented conventional centralized sewage treatment and proposed its expansion and even larger scale projects, decentralized wastewater treatment, advocated by many civil society groups, may be more cost effective. Options at all scales, however, face several institutional challenges in implementation. Third, while untreated wastewater is a health hazard for downstream farmers using this water for irrigation, substantial wastewater recycling upstream would have a negative impact on their livelihoods by reducing the quantity of water available for irrigation. In addition, as the Vrishabhavathy is a tributary of the inter-state river Cauvery, reduced flows might impact on inter-state water sharing commitments complicating matters further. Realizing the potential of wastewater reuse in Bangalore will thus require techno-institutional integration and thinking at a basin scal

Going with the flow? Urban wastewater and livelihoods change in peri-urban Bengaluru

As cities grow, peri-urban areas and surrounding villages undergo rapid changes in land use, environment and livelihoods. The conventional view on change in peri-urban areas is one of shifts in livelihoods away from agriculture towards urban jobs, as well as keeping lands fallow, to be taken up by real estate or industries. Further, people in peri-urban areas experience huge changes in the nature of and control over local natural resources. This is particularly so in the case of water resources. The demand for water from expanding cities is often met by sourcing it from peri-urban areas. In addition, domestic sewage and industrial discharges from cities put pressure on lakes and rivers, and the impact of pollution is felt in surrounding landscapes. Planners and policymakers have been grappling with the implications of such transformations for both agricultural production and environmental sustainability. Here we examine the case of peri-urban Bengaluru to ask the questions: is abandoning agriculture inevitable in the wake of urbanisation or can there be other trajectories? How have peri-urban farmers been responding to water pollution and changes in irrigation water quality

Water Management in Arkavathy basin: a situation analysis

The Arkavathy sub-basin, which is part of the Cauvery basin, is a highly stressed, rapidly urbanising watershed on the outskirts of the city of Bengaluru. The purpose of this situation analysis document is to summarise the current state of knowledge on water management in the Arkavathy sub-basin and identify critical knowledge gaps to inform future researchers in the basin. It is hoped that such an analysis will help those studying or working on water issues in the basin itself, and also provide useful insights for other such urbanising basins. The Arkavathy sub-basin is located in the state of Karnataka in India (see Figure 1). It covers an area of 4,253 km2, and is part of the inter-state Cauvery River basin. The sub-basin covers parts of eight taluka – Doddaballapur, Nelamangala, Magadi, Bangalore North, Bangalore South, Ramanagara, Anekal and Kanakapura within three districts – Bangalore Urban, Bangalore Rural and Ramanagara. The total population in the sub-basin was 72 lakhs in 2001 and is estimated to be approximately 86 lakhs in 2011. This is distributed approximately 50:50 between urban and rural settlements (although the urban share is growing rapidly), with 33 lakhs from Bengaluru city (more than one-third of Bengaluru’s total population). There are also four major Class II towns: Doddaballapur, Nelamangala, Ramanagara, and Kanakapura with populations ranging from 35,000 to 95,000. In spite of rapid urbanisation, there are still 1,107 revenue villages with populations ranging from less than 10 to 6,0001, and agriculture continues to be the mainstay of a large number of them

Whose river? The changing waterscape of the upper Arkavathy under urbanisation

Urban areas in India have been experiencing unprecedented population and economic growth in the last decade. As cities grow and incomes rise, a new challenge has arisen: that of supplying domestic water reliably, and of reasonable quality, to this rapidly growing urban population, while ensuring that the well-being of future generations is not jeopardised

Thinking about Urban Resilience: The Case of Water Scarcity and Wastewater Reuse in Bengaluru

WITH ORIGINS in the ecological sciences, the concept of resilience gained currency in the context of climate change. The ‘classical’ ecological notions of resilience emphasize recovery to a prior state in the aftermath of stress or shock. The broader social-ecological notion of resilience focuses on learning, innovation, adaptive capacity and transformation (Folke, 2006: 259). The literature on urban resilience (Leichenko, 2011; Romero Lankao and Qin, 2011: 145-6) discusses systems bouncing back to ‘equilibrium’ in the aftermath of shocks, such as natural disasters (drawing from the classical literature), as well as the adaptive capacities of systems to long-term stressors or shifts such as climate change

Subannular left ventricular pseudoaneurysm following mitral valve replacement

Delayed development of left ventricular pseudoaneurysm is a rare late complication of mitral valve prosthesis and requires early surgical intervention. Here we describe the occurrence of such a complication diagnosed 6-months after the valve surgery in a 60-year-old lady. The anatomic delineation of subannular left ventricular pseudoaneurysm using multiple imaging modalities including CT angiography is also being discussed

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Participation in the Knowledge Society: the Free and Open Source Software (FOSS) movement compared with participatory development

The possibilities and limits of participation at the ‘bottom’ (represented, for example, by PRA and PLA) have been well articulated in development literature. However, the emergence of the Knowledge Society has opened up spaces for what we could call participation at the ‘top’ (free software, wiki, open access), the implications of which Development Studies is only beginning to grapple with. Building upon recent debates on the issue, we take the cases of the free software movement and participatory development, arguing that they share common ground in several ways. We aim to offer a few pointers on conceptualising development in the Knowledge Society

Data Discrepancies: interpreting rural water data in the Decadal census

The census provides data on access to drinking water sources in urban and rural areas. The data are used by government departments to assess the status of water supply in India, and by researchers to understand access to water sources across regions and among different sections of society. Census 2011 reports that 30.8% of households in rural India access taps for drinking water, and the Ministry of Drinking Water and Sanitation (MDWS) uses this as an indicator of piped water coverage (Government of India 2013). While “access to taps” is the terminology used by the census, “piped water coverage” is the terminology used by the MDWS. The ministry aims to cover 90% of rural households with piped water supply by 2022, at 70 lpcd (litres per capita per day), which includes both potable and non-potable water. In this article, we point out aspects that should be considered while interpreting decadal census data on rural water, drawing upon different components of the census data itself, and a year-long fi eld study conducted in 2013–14 covering 518 households in 16 villages around Bengaluru in Karnataka. First, we show that there are discrepancies in data on water sources between house listing data and village amenities data, both from the 2011 Census for the 16 villages that we surveyed. Second, we discuss whether census data on access to taps can be used as an indicator of piped water coverage. Third, we look at the reliability of data collected from households related to treated water