Growth of small scale industries in India: Some policy issues.

A major objective of planned economic development has been industrialisation and employment generation. The industrial policy resolutions had, from time to time, encouraged the growth of small scale industries in order to generate employment, promote balanced regional growth, have equitable distribution of wealth anf promote exports. The analysis in the paper is based on the data available from the ASI; Development Commissioner, Small Scale Industries; and the plan documents. A comparison is made between the performance of large industries, modern SSI and traditional industries. It is found that the smaller SSIs are growing not only numerically but also in terms of employment, investment and output. SSIs in the factory sector (synonymous with larger SSIs) have however, not been showing any growth in the number of factories and employment, through capital is being accumulated at a fast pace. It is felt that some of the policies of the government are making capital cheaper vis-a-vis labour and there has been a tendency to substitute capital for labour among the large scale units and SSIs in factory sector. In terms of size, the larger units among the SSIs are becoming larger and small are becoming smaller. As regards efficiency of the units, while labour productivity is higher in larger SSIs, smaller units have better utilization of scarce capital and are also more labour intensive. The traditional industries have also been performing well in terms of labour absorption and capacity to earn foreign exchange. In this context, it is important to review whether the current policies to set up new units be encouraged, or should the government policies be directed to promote the growth of existing SSIs. It is also important to examine the growth of SSIs in the context of more liberal economy and see what kind of technonology-flexible pecialisation or mass production-should be followed for further growth and to encourage employment generation.Small scale industries

Antibacterial Activity of Amchur (Dried Pulp of Unripe Mangifera indica) Extracts on Some Indigenous Oral Microbiota Causing Dental Caries

The antibacterial activity of amchur (dried pulp of unripe Mangifera indica) extract (50% ethanol) was tested against ten bacterial strains causing dental plaque by agar well diffusion method. The crude extract showed a broad spectrum of antibacterial activity inhibiting both the groups of Gram-positive & Gram-negative bacteria. The extract was most effective against Bacillus sp., followed by Staphylococcus mutans and Pseudomonas sp., whereas Halobacterium sp. was found to be the most resistant. Chlorhexidine (present in mouthwashes to prevent infection of dental caries) was used as a positive control. Natural extract of amchur was found to be more effective as compared to chlorhexidine. This study shows the potential of amchur in the treatment of dental caries

Health and Millennium Development Goal 1: Reducing Out-of-pocket Expenditures to Reduce Income Poverty - Evidence from India

The first of the eight Millennium Development Goals is to halve extreme poverty and hunger by 2015. In India, thirty two and a half million people fall below the national poverty line by making out-of- pocket payments for health care in a single year. This paper shows how in a country with large out of pocket payments, targeting a few poor states, rural areas and urban poor could drastically bring down the number of people falling below the poverty line and also reduce the poverty deepening effect for those already below the poverty line. High expenditures on drugs are shown to be one of the main reasons for high out of pocket payments. Improved drug availability in public facilities and totally subsidizing the urban poor and rural areas are required for reducing the poverty impact of out of pocket payments. [EQUITAP WP No. 15].out of pocket payments, urban poor, poor state, Poverty, health care payments, Millennium Development Goals, Equity, India, line, country

1 Health economist, World Health Organization (WHO), Geneva. 2 Takemi Fellow

Out-of-pocket (OOP) expenditure on health care has significant implications for poverty in many developing countries. This paper aims to assess the differential impact of OOP expenditure and its components, such as expenditure on inpatient care, outpatient care and on drugs, across different income quintiles, between developed and less developed regions in India. It also attempts to measure poverty at disaggregated rural-urban and state levels. Based on Consumer Expenditure Survey (CES) data from the National Sample Survey (NSS), conducted in 1999-2000, the share of households' expenditure on health services and drugs was calculated. The number of individuals below the state-specific rural and urban poverty line in 17 major states, with and without netting out OOP expenditure, was determined. This also enabled the calculation of the poverty gap or poverty deepening in each region. Estimates show that OOP expenditure is about 5% of total household expenditure (ranging from about 2% in Assam to almost 7% in Kerala) with a higher proportion being recorded in rural areas and affluent states. Purchase of drugs constitutes 70% of the total OOP expenditure. Approximately 32.5 million persons fell below the poverty line in 1999-2000 through OOP payments, implying that the overall poverty increase after accounting for OOP expenditure is 3.2% (as against a rise of 2.2% shown in earlier literature). Also, the poverty headcount increase and poverty deepening is much higher in poorer states and rural areas compared with affluent states and urban areas, except in the case of Maharashtra. High OOP payment share in total health expenditures did not always imply a high poverty headcount; state-specific economic and social factors played a role. The paper argues for better methods of capturing drugs expenditure in household surveys and recommends that special attention be paid to expenditures on drugs, in particular for the poor. Targeted policies in just five poor states to reduce OOP expenditure could help to prevent almost 60% of the poverty headcount increase through OOP payments

Reducing out-of-pocket expenditures to reduce poverty: A disaggregated analysis at rural–urban and state level in India.

Out-of-pocket (OOP) expenditure on health care has significant implications for poverty in many developing countries. This paper aims to assess the differential impact of OOP expenditure and its components, such as expenditure on inpatient care, outpatient care and on drugs, across different income quintiles, between developed and less developed regions in India. It also attempts to measure poverty at disaggregated rural-urban and state levels. Based on Consumer Expenditure Survey (CES) data from the National Sample Survey (NSS), conducted in 1999-2000, the share of households' expenditure on health services and drugs was calculated. The number of individuals below the state-specific rural and urban poverty line in 17 major states, with and without netting out OOP expenditure, was determined. This also enabled the calculation of the poverty gap or poverty deepening in each region. Estimates show that OOP expenditure is about 5% of total household expenditure (ranging from about 2% in Assam to almost 7% in Kerala) with a higher proportion being recorded in rural areas and affluent states. Purchase of drugs constitutes 70% of the total OOP expenditure. Approximately 32.5 million persons fell below the poverty line in 1999-2000 through OOP payments, implying that the overall poverty increase after accounting for OOP expenditure is 3.2% (as against a rise of 2.2% shown in earlier literature). Also, the poverty headcount increase and poverty deepening is much higher in poorer states and rural areas compared with affluent states and urban areas, except in the case of Maharashtra. High OOP payment share in total health expenditures did not always imply a high poverty headcount; state-specific economic and social factors played a role. The paper argues for better methods of capturing drugs expenditure in household surveys and recommends that special attention be paid to expenditures on drugs, in particular for the poor. Targeted policies in just five poor states to reduce OOP expenditure could help to prevent almost 60% of the poverty headcount increase through OOP payments

Social and Economic Implications of Noncommunicable diseases in India

Noncommunicable diseases (NCDs) have become a major public health problem in India accounting for 62% of the total burden of foregone DALYs and 53% of total deaths. In this paper, we review the social and economic impact of NCDs in India. We outline this impact at household, health system and the macroeconomic level. Cardiovascular diseases (CVDs) figure at the top among the leading ten causes of adult (25–69 years) deaths in India. The effects of NCDs are inequitable with evidence of reversal in social gradient of risk factors and greater financial implications for the poorer households in India. Out-of-pocket expenditure associated with the acute and long-term effects of NCDs is high resulting in catastrophic health expenditure for the households. Study in India showed that about 25% of families with a member with CVD and 50% with cancer experience catastrophic expenditure and 10% and 25%, respectively, are driven to poverty. The odds of incurring catastrophic hospitalization expenditure were nearly 160% higher with cancer than the odds of incurring catastrophic spending when hospitalization was due to a communicable disease. These high numbers also pose significant challenge for the health system for providing treatment, care and support. The proportion of hospitalizations and outpatient consultations as a result of NCDs rose from 32% to 40% and 22% to 35%, respectively, within a decade from 1995 to 2004. In macroeconomic term, most of the estimates suggest that the NCDs in India account for an economic burden in the range of 5–10% of GDP, which is significant and slowing down GDP thus hampering development. While India is simultaneously experiencing several disease burdens due to old and new infections, nutritional deficiencies, chronic diseases, and injuries, individual interventions for clinical care are unlikely to be affordable on a large scale. While it is clear that “treating our way out” of the NCDs may not be the efficient way, it has to be strongly supplemented with population-based services aimed at health promotion and action on social determinants of health along with individual services. Since health sector alone cannot deal with the “chronic emergency” of NCDs, a multi-sectoral action addressing the social determinants and strengthening of health systems for universal coverage to population and individual services is required