The Ministry of Health and Public Welfare in New Delhi recently released data from the third National Family Health Survey (NHFS-3), based on a nationally representative sample of women aged 15-49 year women. The survey provides information on health and welfare for nearly 200,000 women, as well as their spouses and children. For a variety of reasons, this survey is a potential gold mine for public health, health economics, and public policy research projects. You can have a look at the details here. The summary report, which is very thorough and serves as an excellent reference for all things public health in India, is available via the same link. It is essential reading for all Indophiles, whatever your discipline or persuasion may be.
I've glanced through the summary report myself and have found some really interesting things (some of which will likely serve as fodder for research in the coming months). Here is a sampling:
1) The NFHS-3 is the first large scale all-India survey to include HIV testing. Surprisingly, despite local resistance in states like Nagaland, nearly 82% of eligible women and men were tested. This is a lot higher than I would have imagined given stigma around HIV/AIDS combined with voluntary testing. The survey finds that 0.28% of adults 15-49 have tested positive for HIV, that the prevalence of HIV is much higher in urban areas and among men. Also, HIV in India does not seem to discriminate by caste or level of wealth. In fact, the highest positive rate is among one of the top wealth quintiles in the sample.
2) Over 70% of children under 5 are considered to be stunted (i.e., below 2 sd from the median height for a child of given gender and age in months). However, only 32.9% of all children in the sample received services from the Integrated Child Development Services (ICDS) program, a village level intervention designed to provide basic health, nutrition and educational services mothers and young children, which now has very wide coverage in India. This isn't an issue of coverage: that 32.9% figure applies to all children who live in an area with ICDS facilities. I find this really interesting. ICDS offers free services and free food and children are malnourished. So why aren't more mothers taking it up? There are a variety of reasons why this could happen: ICDS is perceived to be ineffective; supply-side problems, such as failure to staff the clinics; high opportunity costs to attending ICDS (long-queues, remote locations); lack of knowledge among mothers or heterogeneous treatment effects that induce self-selection among certain classes of families. I think it would be interesting to compute (heterogeneous?) returns to the ICDS program and get a sense of why people are not going.
3) Less than half of all households in India use adequately iodized salt. This could have tremendous long-term consequences, especially for young children. Check out this important and interesting paper by Erica Field, et al, for more information.
4) The data is representative at the state level as well, and its always fun to compare how different states do with respect to various health indicators. Obviously, there is a great deal of variance among states in population health status.
5) There is plenty of other interesting information on anemia among men, women and children, female bargaining power and domestic violence, knowledge and attitudes about HIV/AIDS, household socioeconomic status, and so forth. Again, its a pretty rich survey for public health stuff, and I encourage you to check it out.
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