Jalandhar Pradhan | National Institute of Technology Rourkela (original) (raw)

Papers by Jalandhar Pradhan

BMC Public Health

Background Empirically, the official measurement of multidimensional poverty often shows children... more Background Empirically, the official measurement of multidimensional poverty often shows children as the poorest age group. According to Global Multidimensional Poverty Index report, Africa and South Asia bear the highest burden multidimensional child poverty (MCP). Around one-third of children aged 0–4 are multidimensionally poor in India. Policymakers in India must have appropriate information on child poverty to alleviate poverty. The purpose of this paper is to examine MCP trends and track efforts to reduce child poverty at the national level across geographic regions, castes, and religious groups. Methods We used the Alkire-Foster method to calculate the MCP index (MCPI) among children aged 0–4 using the latest two rounds of National Family Health Survey data (2015–16 and 2019–21). We applied the Shapley decomposition method to analyse the marginal contribution of incidence and intensity that lead to changes in MCPI. Results In India, the incidence of child poverty reduced by m...

Health and Quality of Life Outcomes, Dec 1, 2015

Background: Life Satisfaction (LS) is an indicator of subjective well-being (SWB) among the elder... more Background: Life Satisfaction (LS) is an indicator of subjective well-being (SWB) among the elderly, and is directly associated with health and mortality. Present study deals with the factors associated with the LS among the rural elderly in Odisha, India. Methods: A cross-sectional survey using multi-stage random sampling procedure was conducted among elderly (60+ years) in Bargarh district of Odisha. The survey was conducted among 310 respondents. Hierarchical regression analysis was used to assess the adjusted effect of various socioeconomic , demographic, health conditions (physical and mental), social support and effects of multi-morbidity on LS. Results: Cognitive health was the most influential factor in determining LS among both men (β = 0.327) and women (β = 0.329). Individual's social support also plays an influential role in LS among rural elderly. Elderly who are living alone and have any sort of disability and had low score of activities of daily living (ADL) have also reported significantly lower perceived LS for both the genders. Conclusion: It is necessary to analyze and identify the major factors which can improve upon the level of LS among the elderly population. Better understanding of these factors can help in removing the superfluous anxiety of old age in the mindset of people which is pervading in the society.

Research Square (Research Square), Jan 27, 2023

Background Population health is considered as a vital component for a nation's overall well-being... more Background Population health is considered as a vital component for a nation's overall well-being and development. To achieve a sustainable level of human development, reduction in the level of health inequalities and an increase in interstate convergence in health indicators is necessary. Evaluation of the convergence patterns can aid the government in monitoring the health progress across the Indian states. This study investigates the progressive changes in the convergence and divergence patterns in health status across major states of India from 1990 to 2018. Methods Sigma plots (σ), kernel density plots, and Philips and Sul (2007) methods are used to test the convergence, divergence, and club convergence patterns in the health indicators at the state level. Results The result of the sigma convergence suggests that life expectancy at birth has converged across all states. After 2006, however, the infant mortality rate, neonatal mortality rate, and total fertility rate experienced a divergence pattern. Findings of the study indicates that life expectancy at birth is converging in the same direction across all states, falling into the same club (club one). However, considerable cross-state variations and evidence of clubs' convergence and divergence are observed in the domains of infant mortality rate, neonatal death rate, and total fertility rate. As suggested by the kernel density estimates, life expectancy at birth strati es, polarizes, and becomes unimodal over the time period, although with a single stable state. A bimodal distribution was found for infant, neonatal, and total fertility rates. Conclusions Therefore, in order to reduce health variations and to improve health outcomes for each group of individuals, healthcare strategies must consider each club's transition path, while placing special attention to divergence states.

Routledge eBooks, Jul 10, 2023

Routledge eBooks, Jul 10, 2023

Routledge eBooks, Jul 10, 2023

Routledge eBooks, Jul 10, 2023

Routledge eBooks, Jul 10, 2023

Objective: To investigate associations between economic inequality in preterm delivery. Methods: ... more Objective: To investigate associations between economic inequality in preterm delivery. Methods: The present secondary analysis included cross-sectional data collected in interviews with patients following delivery at 103 hospitals in Tehran, Iran, between July 6 and 21, 2015. Principal component analysis was used to measure the socioeconomic status of participants and the concentration index was used to measure inequalities in preterm delivery among patients of different socioeconomic status. Results: Data were included from 5170 patients. The concentration index for preterm delivery was 0.087 (95% confidence interval 0.036-0.134), indicating that preterm deliveries were concentrated among patients with higher socioeconomic status. Higher socioeconomic status (94%), younger maternal age (29%), younger paternal age (21%), and being a homemaker (17%) had the highest positive contributions to the measured inequalities in preterm deliveries; vaginal delivery (-58%) had the highest negative contribution. Conclusion: Preterm deliveries were distributed unequally among the study patients in Iran, and were concentrated among patients of higher socioeconomic status. Alongside future etiological studies, reproductive programs in Iran should focus on this population to redress the observed inequality.

Routledge eBooks, Jul 10, 2023

Child Indicators Research

Research Square (Research Square), Mar 20, 2023

Background Social isolation and loneliness can be detrimental to the overall functioning of the o... more Background Social isolation and loneliness can be detrimental to the overall functioning of the older adults. The study examines the impact of social isolation and loneliness on the psychological well-being of older adults residing in various old-age homes in India and investigates the mediating role of gender, marital status, and education level in the way social isolation and loneliness affect psychological well-being. Methods 320 individuals aged sixty years or above participated in the study. Data were collected using standardized measures like Lubben Social Network Scale-6, revised UCLA Loneliness Scale, and shortened version of psychological well-being scale by Ryff & Keyes (1995). Multivariate and mediation analysis were performed to understand the associations of social isolation and loneliness with psychological well-being. Results A statistically signi cant MANOVA effect was obtained for social isolation (F = 3.836, p < .01), and loneliness (F = 3.782, p < .01). Gender and education as independent factors were signi cantly associated with the psychological well-being of individuals. However, both gender and education did not mediate the impact of social isolation and loneliness on the psychological well-being of older adults. Further, marital status had a partial mediating effect on the relationship between social isolation, loneliness, and psychological well-being. Conclusions The ndings of the study can be incorporated into measures aiming at alleviation of feelings of social isolation and loneliness among the elderly. Further, the ndings can be used to design various intervention strategies aimed at the reduction of social isolation and loneliness among older adults and the restoration of their psychological well-being.

BMC Geriatrics, Feb 10, 2023

Objective This article aims to examine the level of life satisfaction (LS) among Indian older adu... more Objective This article aims to examine the level of life satisfaction (LS) among Indian older adults and to determine whether their living arrangement is one of the potential determinants of their level of LS. Methods Data was drawn from the first and most recent wave of Longitudinal Ageing Study in India conducted in 2017-18. Using the Satisfaction with Life Scale, the level of LS was assessed for 30,370 elderly aged 60 +. Bivariate analysis was carried out to see the variation in the level of LS across elderlies with different socio-demographic characteristics. To investigate the association between LS and living arrangements and the selected socio-demographic factors multinomial logistic regression model was fitted. Result The findings reveal that 25.4% and 45.5% of the elderlies have reported having a low and high level of LS, respectively. Living alone was associated with low level of LS. Co-residing with a spouse was associated with a higher likelihood of reporting high level of LS. The study also found that having both spouse and children as coresident increases the likelihood of reporting high level of LS (RRR = 3.15, 95%CI = 2.3-4.28). Elderly with self-reported poor health, limitation in more than two activities of daily living and presence of depressive symptoms were significantly associated with reporting low level of LS. However, being diagnosed with more than three chronic illnesses was associated with high level of LS (RRR = 1.41, 95%CI = 1.25-1.59). Older adults with the following characteristics were more likely to report a lower level of LS: male, 60-64 years old, no or few years of schooling, unmarried, working, rural resident, living in a poor household, Scheduled Caste and Tribe. Conclusion The level of life satisfaction in Indian older adults is significantly associated with their living arrangements, thus suggesting that the LS of older adults could be facilitated through interventions that consider their living arrangements. Older adults with various personal and household characteristics were identified as vulnerable groups, who should be the prime targets of the existing welfare policies.

International Journal of Human Rights in Healthcare

Purpose The purpose of this study is to examine the socio-economic inequalities that exist in the... more Purpose The purpose of this study is to examine the socio-economic inequalities that exist in the use of unhygienic menstrual practices in India and its states, as well as to identify the contribution of various socio-economic factors that leads to these inequalities. Design/methodology/approach Data from the National Family Health Survey-5 (2019–21) for 240,285 menstruating women aged 15–24 years is used to examine the above objectives. The concentration index for unhygienic menstrual practices is calculated to measure the socio-economic inequalities, which are then decomposed into their determining factors. Findings The state of Punjab experiencing the highest level of economic inequality, followed by Telangana and Haryana. The results from decomposition analysis suggest that rural residence (13%), illiteracy (7%), poor economic status (53%), not reading newspaper (12%) and not watching TV (14%) contribute 99% to the total socio-economic inequality in using unhygienic menstrual pr...

PLOS ONE

Background Non-communicable diseases (NCDs) are the leading global cause of death and disproporti... more Background Non-communicable diseases (NCDs) are the leading global cause of death and disproportionately concentrate among those living in low-income and middle-income countries. However, its economic impact on households remains less well known in the Indian context. This study aims to assess the economic impact of NCDs in terms of out-of-pocket expenditure (OOPE) and its catastrophic impact on NCDs affected households in India. Materials and methods Data were collected from the 75th round of the National Sample Survey Office, Government of India, conducted in the year 2017–18. This is the latest round of data available on health, which constitutes a sample of 113,823 households. The collection of data is based on a stratified multi-stage sampling method. Generalised Linear Regression model was employed to identify the socio-economic covariates associated with the catastrophic health expenditure (CHE) on hospitalisation. Results The result shows a higher burden of OOPE on NCDs affe...

Public Health

OBJECTIVE This study aims to address the question that whether out-of-pocket expenditure (OOPE) o... more OBJECTIVE This study aims to address the question that whether out-of-pocket expenditure (OOPE) on institutional deliveries remained high or reduced over time in India, in particular after the introduction of conditional cash transfer (CCT) incentive programmes such as Janani Suraksha Yojana (JSY) in 2005. STUDY DESIGN The study presents the trends in average OOPE on institutional deliveries in India, in an effort to evaluate the impact of the JSY programme on it. METHODS For the purpose, the study used recently released 75th round of National Sample Survey data, 2017/18 about household social consumption (Health) and two of its previous rounds in 2004 and 2014. RESULTS The results suggest that, except at rural public facilities, the average OOPE for institutional delivery has increased significantly in both rural and urban areas from 2004 to 2017/18, even after adjusting to inflation in the prices. In addition, the results have shown that overall 14 of 33 states for rural public facilities, 20 of 25 states in rural private facilities, 21 of 32 states in urban public facilities and 29 of 32 states in urban private facilities have experienced more than 50% raise in OOPE on institutional delivery during 2004-2017/18, despite JSY incentives. CONCLUSION The findings suggest that the current level of JSY incentives will not be sufficient to avoid catastrophic spending on institutional deliveries for the households as the incentives in several states are much less than the state average OOPE per delivery. Thus, there is a need to consider a raise in the state or central contribution for CCT under the JSY programme to reduce the burden of OOPE on institutional deliveries through recently launched Pradhan Mantri Matru Vandana Yojana.

Child: Care, Health and Development, 2010

Background An effort has been made in this paper to examine the impact of community and househol... more Background An effort has been made in this paper to examine the impact of community and household vis‐à‐vis individual‐level variables on immunization coverage among Indian children.Methods National Family Health Survey‐2 data set has been used for the analysis. Multilevel regression analyses have been used to explore the relative effects of community‐, household‐ and individual‐level factors on immunization coverage. Three community‐level variables, i.e. availability of health facilities, availability of all‐weather roads and information, education and communication (IEC) activities conducted during last year, are included in this analysis.Results Availability of health facility and information, education and communication activities plays a significant role in determining the level of immunization coverage among children. Even with community‐level variables in the model, individual‐level variables, i.e. parent's education, birth order of child and number of antenatal care v...

International Journal of Geriatric Psychiatry

Journal of Social and Economic Development

Cancer patients in India often face the burden of paying out-of-pocket (OOP) for their treatment ... more Cancer patients in India often face the burden of paying out-of-pocket (OOP) for their treatment that is not covered by any health insurance. Moreover, inequities in OOP payment are also found among these patients. This study aims to determine horizontal and vertical inequity in OOP expenditure associated with cancer hospitalisation in India and analyse the demographic and socioeconomic determinants of these expenditures. Data has been retrieved from 75th round of the National Sample Survey Office (NSSO), conducted by the Government of India between July 2017 and June 2018. To analyse horizontal and vertical inequity, mean predicted OOP payment has been used across the monthly per capita consumption expenditure (MPCE) quintiles and other demographic and socioeconomic variables. The Generalised Linear Regression Model (GLRM) has been applied to study the determinants of OOP expenditure. The result of vertical inequity shows that the predicted mean OOP expenditure is more for lower-income quintiles, indicates a regressive nature of health financing for cancer treatment in India. Non-schedule caste and tribe (SC/ST) people have a higher percentage of OOP expenditure as compared to their SC/ST counterparts in the poor and middle-income quintiles, whereas for the richer income quintiles, OOP expenditure is higher for SC/ST population. The mean OOP cost is also higher for the male respondents than the female across all the quintiles. The result of GLRM shows that predicted OOP expenditure is significantly associated with residence, gender, insurance coverage, and level of care. India is experiencing a higher burden of OOP expenditure for cancer hospitalisation and widespread inequities in paying for this expenditure. Indian government and policymakers must act to remove these underlying barriers to provide affordable, equitable, and universal cancer care for the entire population.

BMC Public Health

Background Empirically, the official measurement of multidimensional poverty often shows children... more Background Empirically, the official measurement of multidimensional poverty often shows children as the poorest age group. According to Global Multidimensional Poverty Index report, Africa and South Asia bear the highest burden multidimensional child poverty (MCP). Around one-third of children aged 0–4 are multidimensionally poor in India. Policymakers in India must have appropriate information on child poverty to alleviate poverty. The purpose of this paper is to examine MCP trends and track efforts to reduce child poverty at the national level across geographic regions, castes, and religious groups. Methods We used the Alkire-Foster method to calculate the MCP index (MCPI) among children aged 0–4 using the latest two rounds of National Family Health Survey data (2015–16 and 2019–21). We applied the Shapley decomposition method to analyse the marginal contribution of incidence and intensity that lead to changes in MCPI. Results In India, the incidence of child poverty reduced by m...

Health and Quality of Life Outcomes, Dec 1, 2015

Background: Life Satisfaction (LS) is an indicator of subjective well-being (SWB) among the elder... more Background: Life Satisfaction (LS) is an indicator of subjective well-being (SWB) among the elderly, and is directly associated with health and mortality. Present study deals with the factors associated with the LS among the rural elderly in Odisha, India. Methods: A cross-sectional survey using multi-stage random sampling procedure was conducted among elderly (60+ years) in Bargarh district of Odisha. The survey was conducted among 310 respondents. Hierarchical regression analysis was used to assess the adjusted effect of various socioeconomic , demographic, health conditions (physical and mental), social support and effects of multi-morbidity on LS. Results: Cognitive health was the most influential factor in determining LS among both men (β = 0.327) and women (β = 0.329). Individual's social support also plays an influential role in LS among rural elderly. Elderly who are living alone and have any sort of disability and had low score of activities of daily living (ADL) have also reported significantly lower perceived LS for both the genders. Conclusion: It is necessary to analyze and identify the major factors which can improve upon the level of LS among the elderly population. Better understanding of these factors can help in removing the superfluous anxiety of old age in the mindset of people which is pervading in the society.

Research Square (Research Square), Jan 27, 2023

Background Population health is considered as a vital component for a nation's overall well-being... more Background Population health is considered as a vital component for a nation's overall well-being and development. To achieve a sustainable level of human development, reduction in the level of health inequalities and an increase in interstate convergence in health indicators is necessary. Evaluation of the convergence patterns can aid the government in monitoring the health progress across the Indian states. This study investigates the progressive changes in the convergence and divergence patterns in health status across major states of India from 1990 to 2018. Methods Sigma plots (σ), kernel density plots, and Philips and Sul (2007) methods are used to test the convergence, divergence, and club convergence patterns in the health indicators at the state level. Results The result of the sigma convergence suggests that life expectancy at birth has converged across all states. After 2006, however, the infant mortality rate, neonatal mortality rate, and total fertility rate experienced a divergence pattern. Findings of the study indicates that life expectancy at birth is converging in the same direction across all states, falling into the same club (club one). However, considerable cross-state variations and evidence of clubs' convergence and divergence are observed in the domains of infant mortality rate, neonatal death rate, and total fertility rate. As suggested by the kernel density estimates, life expectancy at birth strati es, polarizes, and becomes unimodal over the time period, although with a single stable state. A bimodal distribution was found for infant, neonatal, and total fertility rates. Conclusions Therefore, in order to reduce health variations and to improve health outcomes for each group of individuals, healthcare strategies must consider each club's transition path, while placing special attention to divergence states.

Routledge eBooks, Jul 10, 2023

Routledge eBooks, Jul 10, 2023

Routledge eBooks, Jul 10, 2023

Routledge eBooks, Jul 10, 2023

Routledge eBooks, Jul 10, 2023

Objective: To investigate associations between economic inequality in preterm delivery. Methods: ... more Objective: To investigate associations between economic inequality in preterm delivery. Methods: The present secondary analysis included cross-sectional data collected in interviews with patients following delivery at 103 hospitals in Tehran, Iran, between July 6 and 21, 2015. Principal component analysis was used to measure the socioeconomic status of participants and the concentration index was used to measure inequalities in preterm delivery among patients of different socioeconomic status. Results: Data were included from 5170 patients. The concentration index for preterm delivery was 0.087 (95% confidence interval 0.036-0.134), indicating that preterm deliveries were concentrated among patients with higher socioeconomic status. Higher socioeconomic status (94%), younger maternal age (29%), younger paternal age (21%), and being a homemaker (17%) had the highest positive contributions to the measured inequalities in preterm deliveries; vaginal delivery (-58%) had the highest negative contribution. Conclusion: Preterm deliveries were distributed unequally among the study patients in Iran, and were concentrated among patients of higher socioeconomic status. Alongside future etiological studies, reproductive programs in Iran should focus on this population to redress the observed inequality.

Routledge eBooks, Jul 10, 2023

Child Indicators Research

Research Square (Research Square), Mar 20, 2023

Background Social isolation and loneliness can be detrimental to the overall functioning of the o... more Background Social isolation and loneliness can be detrimental to the overall functioning of the older adults. The study examines the impact of social isolation and loneliness on the psychological well-being of older adults residing in various old-age homes in India and investigates the mediating role of gender, marital status, and education level in the way social isolation and loneliness affect psychological well-being. Methods 320 individuals aged sixty years or above participated in the study. Data were collected using standardized measures like Lubben Social Network Scale-6, revised UCLA Loneliness Scale, and shortened version of psychological well-being scale by Ryff & Keyes (1995). Multivariate and mediation analysis were performed to understand the associations of social isolation and loneliness with psychological well-being. Results A statistically signi cant MANOVA effect was obtained for social isolation (F = 3.836, p < .01), and loneliness (F = 3.782, p < .01). Gender and education as independent factors were signi cantly associated with the psychological well-being of individuals. However, both gender and education did not mediate the impact of social isolation and loneliness on the psychological well-being of older adults. Further, marital status had a partial mediating effect on the relationship between social isolation, loneliness, and psychological well-being. Conclusions The ndings of the study can be incorporated into measures aiming at alleviation of feelings of social isolation and loneliness among the elderly. Further, the ndings can be used to design various intervention strategies aimed at the reduction of social isolation and loneliness among older adults and the restoration of their psychological well-being.

BMC Geriatrics, Feb 10, 2023

Objective This article aims to examine the level of life satisfaction (LS) among Indian older adu... more Objective This article aims to examine the level of life satisfaction (LS) among Indian older adults and to determine whether their living arrangement is one of the potential determinants of their level of LS. Methods Data was drawn from the first and most recent wave of Longitudinal Ageing Study in India conducted in 2017-18. Using the Satisfaction with Life Scale, the level of LS was assessed for 30,370 elderly aged 60 +. Bivariate analysis was carried out to see the variation in the level of LS across elderlies with different socio-demographic characteristics. To investigate the association between LS and living arrangements and the selected socio-demographic factors multinomial logistic regression model was fitted. Result The findings reveal that 25.4% and 45.5% of the elderlies have reported having a low and high level of LS, respectively. Living alone was associated with low level of LS. Co-residing with a spouse was associated with a higher likelihood of reporting high level of LS. The study also found that having both spouse and children as coresident increases the likelihood of reporting high level of LS (RRR = 3.15, 95%CI = 2.3-4.28). Elderly with self-reported poor health, limitation in more than two activities of daily living and presence of depressive symptoms were significantly associated with reporting low level of LS. However, being diagnosed with more than three chronic illnesses was associated with high level of LS (RRR = 1.41, 95%CI = 1.25-1.59). Older adults with the following characteristics were more likely to report a lower level of LS: male, 60-64 years old, no or few years of schooling, unmarried, working, rural resident, living in a poor household, Scheduled Caste and Tribe. Conclusion The level of life satisfaction in Indian older adults is significantly associated with their living arrangements, thus suggesting that the LS of older adults could be facilitated through interventions that consider their living arrangements. Older adults with various personal and household characteristics were identified as vulnerable groups, who should be the prime targets of the existing welfare policies.

International Journal of Human Rights in Healthcare

Purpose The purpose of this study is to examine the socio-economic inequalities that exist in the... more Purpose The purpose of this study is to examine the socio-economic inequalities that exist in the use of unhygienic menstrual practices in India and its states, as well as to identify the contribution of various socio-economic factors that leads to these inequalities. Design/methodology/approach Data from the National Family Health Survey-5 (2019–21) for 240,285 menstruating women aged 15–24 years is used to examine the above objectives. The concentration index for unhygienic menstrual practices is calculated to measure the socio-economic inequalities, which are then decomposed into their determining factors. Findings The state of Punjab experiencing the highest level of economic inequality, followed by Telangana and Haryana. The results from decomposition analysis suggest that rural residence (13%), illiteracy (7%), poor economic status (53%), not reading newspaper (12%) and not watching TV (14%) contribute 99% to the total socio-economic inequality in using unhygienic menstrual pr...

PLOS ONE

Background Non-communicable diseases (NCDs) are the leading global cause of death and disproporti... more Background Non-communicable diseases (NCDs) are the leading global cause of death and disproportionately concentrate among those living in low-income and middle-income countries. However, its economic impact on households remains less well known in the Indian context. This study aims to assess the economic impact of NCDs in terms of out-of-pocket expenditure (OOPE) and its catastrophic impact on NCDs affected households in India. Materials and methods Data were collected from the 75th round of the National Sample Survey Office, Government of India, conducted in the year 2017–18. This is the latest round of data available on health, which constitutes a sample of 113,823 households. The collection of data is based on a stratified multi-stage sampling method. Generalised Linear Regression model was employed to identify the socio-economic covariates associated with the catastrophic health expenditure (CHE) on hospitalisation. Results The result shows a higher burden of OOPE on NCDs affe...

Public Health

OBJECTIVE This study aims to address the question that whether out-of-pocket expenditure (OOPE) o... more OBJECTIVE This study aims to address the question that whether out-of-pocket expenditure (OOPE) on institutional deliveries remained high or reduced over time in India, in particular after the introduction of conditional cash transfer (CCT) incentive programmes such as Janani Suraksha Yojana (JSY) in 2005. STUDY DESIGN The study presents the trends in average OOPE on institutional deliveries in India, in an effort to evaluate the impact of the JSY programme on it. METHODS For the purpose, the study used recently released 75th round of National Sample Survey data, 2017/18 about household social consumption (Health) and two of its previous rounds in 2004 and 2014. RESULTS The results suggest that, except at rural public facilities, the average OOPE for institutional delivery has increased significantly in both rural and urban areas from 2004 to 2017/18, even after adjusting to inflation in the prices. In addition, the results have shown that overall 14 of 33 states for rural public facilities, 20 of 25 states in rural private facilities, 21 of 32 states in urban public facilities and 29 of 32 states in urban private facilities have experienced more than 50% raise in OOPE on institutional delivery during 2004-2017/18, despite JSY incentives. CONCLUSION The findings suggest that the current level of JSY incentives will not be sufficient to avoid catastrophic spending on institutional deliveries for the households as the incentives in several states are much less than the state average OOPE per delivery. Thus, there is a need to consider a raise in the state or central contribution for CCT under the JSY programme to reduce the burden of OOPE on institutional deliveries through recently launched Pradhan Mantri Matru Vandana Yojana.

Child: Care, Health and Development, 2010

Background An effort has been made in this paper to examine the impact of community and househol... more Background An effort has been made in this paper to examine the impact of community and household vis‐à‐vis individual‐level variables on immunization coverage among Indian children.Methods National Family Health Survey‐2 data set has been used for the analysis. Multilevel regression analyses have been used to explore the relative effects of community‐, household‐ and individual‐level factors on immunization coverage. Three community‐level variables, i.e. availability of health facilities, availability of all‐weather roads and information, education and communication (IEC) activities conducted during last year, are included in this analysis.Results Availability of health facility and information, education and communication activities plays a significant role in determining the level of immunization coverage among children. Even with community‐level variables in the model, individual‐level variables, i.e. parent's education, birth order of child and number of antenatal care v...

International Journal of Geriatric Psychiatry

Journal of Social and Economic Development

Cancer patients in India often face the burden of paying out-of-pocket (OOP) for their treatment ... more Cancer patients in India often face the burden of paying out-of-pocket (OOP) for their treatment that is not covered by any health insurance. Moreover, inequities in OOP payment are also found among these patients. This study aims to determine horizontal and vertical inequity in OOP expenditure associated with cancer hospitalisation in India and analyse the demographic and socioeconomic determinants of these expenditures. Data has been retrieved from 75th round of the National Sample Survey Office (NSSO), conducted by the Government of India between July 2017 and June 2018. To analyse horizontal and vertical inequity, mean predicted OOP payment has been used across the monthly per capita consumption expenditure (MPCE) quintiles and other demographic and socioeconomic variables. The Generalised Linear Regression Model (GLRM) has been applied to study the determinants of OOP expenditure. The result of vertical inequity shows that the predicted mean OOP expenditure is more for lower-income quintiles, indicates a regressive nature of health financing for cancer treatment in India. Non-schedule caste and tribe (SC/ST) people have a higher percentage of OOP expenditure as compared to their SC/ST counterparts in the poor and middle-income quintiles, whereas for the richer income quintiles, OOP expenditure is higher for SC/ST population. The mean OOP cost is also higher for the male respondents than the female across all the quintiles. The result of GLRM shows that predicted OOP expenditure is significantly associated with residence, gender, insurance coverage, and level of care. India is experiencing a higher burden of OOP expenditure for cancer hospitalisation and widespread inequities in paying for this expenditure. Indian government and policymakers must act to remove these underlying barriers to provide affordable, equitable, and universal cancer care for the entire population.