Role of Private Hospitals in Kerala : An Exploration

This is an attempt to understand the characteristics of private hospitals and the equity in accessing their services, using secondary data available for the period 1986-2004. The data indicates that private hospitals did not expand in numbers but a strong consolidation by large hospitals has taken place. [Working Paper No. 400]Privatehospitals,healthsystem,equity,Kerala

School Educational Attainment in Kerela: Trends and Differentials

This paper examines the trends and differentials in school educational attainment in Kerala, the State that ranks right on top in terms of human development in India. The trend analysis is based on a cohort-level comparison of educational attainment while the differential analysis is done using life table techniques. The analysis is based on data on educational attainment of the household population in the National Family Health Survey (2005-06). The unique features of this paper are that it provides comparable time-series data on entry to different stages of the schooling system, right from the time the State was formed in 1956, and that it analyses the probabilities of continuing from the first standard to the higher secondary level across different sub-groups of the population.[Working Paper 429]schooling, continuity, inequality, social divide, educational attainment, Kerala

Gender dynamics in data collection on reproductive health: field experiences in Kerala, India

Reproductive health researchers tend to choose interviewers of the same sex as those interviewed. In many societies, it is considered unacceptable for men to interview women on topics of an intensely personal nature like sexuality or contraceptive use. In this paper, the author analyzes 21 interviews and 16 focus group discussions (FGDs) undertaken during a field study on the Quality of Services in the Indian Family Welfare Programs conducted in Kerala. The analysis was based on the model which identifies the principal participants in the interview as the respondent and the interviewer. In all these cases the contradiction between the gendered roles of the interviewer and interviewee are visible. However, if viewed in the context of the model provided by Briggs, it is clear that these contradictions are due to the differences in the social roles that the interviewers assumed and that the respondents ascribed to them and in the interactional goals of the interviewers and the respondents. Contradictions were also experienced during the FGDs. Educational sessions on contraception are a good tool for gathering sensitive information instead of the conventional interview, where the gendered roles are so crucial to the information gathering exercise itself

Risk of diabetes and expected years in life without diabetes among adults from an urban community in India: findings from a retrospective cohort

Abstract Background Diabetes prevalence has increased over the past few decades, and the shift of the burden of diabetes from the older population to the younger population has increased the exposure of longer durations in a morbid state. The study aimed at ascertaining the likelihood of progression to diabetes and to estimate the onset of diabetes within the urban community of Mumbai. Methods This study utilized an observational retrospective non-diabetic cohort comprising 1629 individuals enrolled in a health security scheme. Ten years of data were extracted from electronic medical records, and the life table approach was employed to assess the probability of advancing to diabetes and estimate the expected number of years lived without a diabetes diagnosis. Results The study revealed a 42% overall probability of diabetes progression, with age and gender variations. Males (44%) show higher probabilities than females (40%) of developing diabetes. Diabetes likelihood rises with age, peaking in males aged 55–59 and females aged 65–69. Males aged 30–34 exhibit a faster progression (10.6 years to diagnosis) compared to females (12.3 years). Conclusion The study’s outcomes have significant implications for the importance of early diabetes detection. Progression patterns suggest that younger cohorts exhibit a comparatively slower rate of progression compared to older cohorts

Inpatient care of the elderly in Brazil and India: assessing social inequalities

The rapidly growing older adult populations in Brazil and India present major challenges for health systems in these countries, especially with regard to the equitable provision of inpatient care. The objective of this study was to contrast inequalities in both the receipt of inpatient care and the length of time that care was received among adults aged over 60 in two large countries with different modes of health service delivery. Using the Brazilian National Household Survey from 2003 and the Indian National Sample Survey Organisation survey from 2004 inequalities by wealth (measured by income in Brazil and consumption in India) were assessed using concentration curves and indices. Inequalities were also examined through the use of zero-truncated negative binomial models, studying differences in receipt of care and length of stay by region, health insurance, education and reported health status. Results indicated that there was no evidence of inequality in Brazil for both receipt and length of stay by income per capita. However, in India there was a pro-rich bias in the receipt of care, although once care was received there was no difference by consumption per capita for the length of stay. In both countries the higher educated and those with health insurance were more likely to receive care, while the higher educated had longer stays in hospital in Brazil. The health system reforms that have been undertaken in Brazil could be credited as a driver for reducing healthcare inequalities amongst the elderly, while the significant differences by wealth in India shows that reform is still needed to ensure the poor have access to inpatient care. Health reforms that move towards a more public funding model of service delivery in India may reduce inequality in elderly inpatient care in the country