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Bani Mandir: Solving Problems in Rural India

Problems in Rural India
Despite the country’s soaring GDP, India is home to almost a quarter of the world’s poor population. Although India lifted 270 million people out of poverty between 2006 and 2016, 270 million more people continue to live below the global poverty line. The extreme poverty that India’s poor faces disproportionately affects rural populations and women, who receive fewer opportunities in education, healthcare and employment.

Named after the goddess of education, nonprofit Bani Mandir works to elevate people in India’s most vulnerable communities by solving problems in rural India. The organization, based in West Bengal, India, aims to address the root causes of poverty, particularly in rural areas and among women. By providing solutions to education inequality, access to healthcare and women’s opportunities, Bani Mandir empowers India’s rural poor.

Education

One of the root causes of poverty is a lack of education. Access to education is integral to lifting people out of poverty, as education reduces inequality and drastically improves the opportunities students obtain as they age. In India, where 45% of the poor population is illiterate, improving access to education in rural areas is vital.

Girls in India, particularly those living in poverty, face additional barriers when it comes to attending school. India gave girls the right to education in 2009. However, many girls are still unable to attend school due to housework responsibilities, stigma and health concerns. The lack of girls in school contributes to fewer women in the workforce. Women make up only 25% of the labor force in India.

To increase enrollment of girls and students from rural areas, Bani Mandir has provided education for more than 10,000 students, maintaining equal representation between girls and boys. Bani Mandir also helps children receive sufficient nutrition support and trains teachers in effective teaching practices. These advancements are improving the quality of education for a larger number of students.

Access to Healthcare

In India, rural communities receive significantly less access to healthcare. Due to the lack of health facilities and insufficient awareness about the benefits of healthcare, many workers in rural communities are unwilling to sacrifice a day’s wages to attend a healthcare visit. Additionally, women in India receive less access to healthcare than men. In a 2019 study, men and boys were two times as likely to visit a healthcare facility. The study also found that many women who should have seen a doctor did not.

To improve access to healthcare in India’s vulnerable communities, Bani Mandir offers comprehensive healthcare programs. Women make up 60% of those benefiting from Bani Mandir’s health services. Bani Mandir’s 23 health projects served more than 3,500 people living in rural villages and slums. The organization also arranged more than 100 health camps to address immediate medical needs. Finally, Bani Mandir partners with schools to provide health programs to students. Its work is encouraging students to seek healthcare and to grow up in a culture where going to the doctor is standard practice.

Women’s Empowerment

Since many women are often denied access to education and healthcare, their employment opportunities are limited. Furthermore, employment is not a guarantee of equal treatment. In fact, pay inequalities result in men making 65% more than women for the same labor. Although gender equality in India is a constitutional right, many women are unaware of their rights and of the ways they can support themselves financially.

Bani Mandir offers more than 375 self-help groups across 30 villages and supports more than 15,000 women and girls to help eliminate problems in rural India. These women’s empowerment groups educate women about their rights, organize finances and offer loans for small businesses, encouraging female entrepreneurs. Bani Mandir also aims to change societal perceptions and stigmas against women by educating broader communities. Bani Mandir’s programs are educating upwards of 10,000 community members about women’s rights issues.

By addressing the problems in rural India pertaining to poverty, such as education, healthcare and women’s opportunities, Bani Mandir is inciting change across entire communities and improving the lives of rural populations. The organization also offers services that improve sanitation, care for the elderly and support for abandoned children. With its wide scope, Bani Mandir is providing countless examples of concrete ways to create change. To build upon the positive change that Bani Mandir and other nonprofits have inspired, the Indian government should sharpen its laws around gender equality to ensure that women and girls obtain adequate access to employment, healthcare and education.

– Melina Stavropoulos
Photo: Unsplash

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Lepra: Fighting Leprosy in India

Leprosy in India
In addition to widespread poverty and striking inequality, India has the highest number of leprosy cases in the world, with more than 120,000 cases in 2019. Although the disease is curable, leprosy has been neglected by the Indian government since it was considered to be eliminated in 2005. The government reallocated resources that once maintained health services, trained professionals and prioritized curing leprosy. The resurgence of the disease was met with a limited government response. Today, the government does not detect approximately 50% of new leprosy cases. As a result, leprosy in India remains a significant health crisis.

The Disease of Poverty

Despite the country’s soaring GDP, India is home to one of the highest populations of the world’s poor, with more than 300 million people living in poverty. 70% of the country’s population lives in rural areas and does not reap the benefits of India’s urban wealth. Leprosy, a “disease of poverty,” disproportionately affects India’s rural poor. Lepra has since emerged to combat the detrimental effects leprosy has on those diagnosed with the disease. The organization aims to prevent, treat and reduce stigma around leprosy in the communities it serves.

3 Ways Leprosy Affects India’s Rural Poor:

  1. In India that discriminate against people affected by leprosy. For example, leprosy is deemed an adequate reason for divorce, and people with visible leprosy are legally prevented from forms of public transport such as trains. Additionally, people with leprosy face tremendous social stigma and are often ostracized from their communities due to lack of awareness about the disease.
  2. India’s rural population has limited access to healthcare. Rural populations have fewer health facilities available to them despite higher rates of diseases in these communities. These deficiencies in diagnostic facilities and trained professionals leaves many leprosy cases undiagnosed.
  3. People in poor, rural areas are more likely to contract leprosy due to malnutrition and living conditions. Although more than 90% of people are naturally immune to leprosy and the disease is not easily transmitted, those with immune systems weakened by other illnesses, malnutrition or poor living conditions are more likely to contract the disease. India’s malnutrition rates are higher in rural areas than in urban areas. Poor hygiene and sanitation in rural areas coupled with malnutrition make these populations more likely to contract diseases such as leprosy.

Lepra: The Good News

Lepra was founded in Hyderabad, India in 1989 as a partner of Lepra UK. The organization began by supporting the implementation of the Indian government’s National Leprosy Eradication Programme. Lepra has since expanded dramatically, now working in 156 districts in 9 states. Lepra caters its leprosy response to the different districts it serves. However, its core programs focus on detecting new cases, disability prevention and care, empowerment and inclusion. The organization prioritizes vulnerable, poor populations such as women, children and those living in slums.

Since its founding, Lepra has treated more than 565,000 affected individuals, provided disability care for more than 95,000 people, and produced specialized protective footwear for more than 250,000 people. Lepra organizes multiple projects in each of the 9 states it serves. It also offers services to combat lymphatic filariasis, tuberculosis, HIV/AIDS and eye issues.

In Delhi, Lepra’s West Delhi Referral Centre conducts screenings and surveys in schools and regularly follows up with the families of infected children until they are cured. The project also informs people affected by leprosy of their rights and engages in community outreach to reduce prejudice against those affected by the disease.

Moving Forward

Since rural poor populations are most affected by leprosy, it is essential that the Indian government invest in health facilities, train professionals to address the disease in poor regions and reform the laws discriminating against people with leprosy. Lepra’s programs and projects pave the way for leprosy to be eliminated in India and for those affected by leprosy to gain societal acceptance.

– Melina Stavropoulos
Photo: Unsplash

Innovations in India Help Fight COVID-19

Innovations in IndiaThe COVID-19 pandemic has required inventive thinking in creating solutions, for both fighting the virus directly and for living a socially distanced society. The country of India has shown a spurt in innovations that have proved valuable to COVID-19 ridden populations; from hand sanitizer dispensers to machines that ventilate public areas. Technology can help improve the lives in which it is implemented and give hope to the global population by showing how collaboration and creativity can improve everyday life in an arduous time.

Improving Health

Indian companies have created products that will be advantageous in the midst of the changing world, focusing on both assisting those who are sick and on preventing more cases. A company called Asimov Robotics has created a human-like robot that fights COVID-19 in these various ways. To assist the overworked healthcare employees, the Asimov robot has been placed in various hospitals that house COVID-19 patients, where it wheels around and delivers food and medicine. The robots also help with defensive medicine and are placed in the entrances of highly populated areas where they can dispense COVID-19 health materials, from hand sanitizer to face masks.

Connecting Business

Collaboration is key to fighting any widespread problem. A governmental agency called Kerala Startup Mission based in Kerala, a southern state in India is fighting COVID-19 by connecting and supporting entrepreneurs. During the COVID-19 pandemic, the agency has supported innovations and creative thinkers and has made plans for building old businesses back up and starting new ones.

New businesses, even, have been started in the midst of an economic crisis. GoK Direct app was created by Kerala Startup Mission and another platform called Okopy, which helps “curb the spread of fake news.” The mission has also helped incubate other ideas for telemedicine, software for keeping track of governmental staff, and other innovations in India that improve the vital communication during this time.

The connection between Indian businesses and international business has been especially prevalent as the global population fights COVID-19. Indian businesses and Noora Health, a global health initiative, have created places where citizens of India can reach information and relieve WHO-verified accurate information about COVID-19. There has been an acceleration of projects such as Namaste Nurses and tele-training, which work to revamp and restore the healthcare workforce. With a stronger connection between businesses, communication in the general public can increase and adapt to the unique circumstances of living in a socially-distanced world.

Repurposing for New Problems

The repurposing of innovations in India is an innovation within itself as it has proved to be a rapid way of creating successful products to fight COVID-19. Repurposing of technology simply means shifting it from a pre-COVID-19 society to one that is submerged in the evolving crisis. For example, Qure.ai is a company based in Mumbai which helped with imaging scans for tuberculosis patients but is now working on improving COVID-19 diagnosis.

The innovations in India are key to developing a world that functions around norms designed for the prevention of a communicable virus. The improvement of health, the connection between business, and the repurposed technology using the creative minds and the supportive institutions of India’s government has made the country successful at progressing towards a safer and more effective society. With the dynamic timeline of the COVID-19 battle, it is innovations like these that give hope for a life that can be lived in a normal but safe manner.

– Jennifer Long
Photo: Unsplash

Disability Services in India

Disability Services in IndiaThe fight for the rights of the disabled has been a long and treacherous road. Even today, many regard disabilities as the karmic result of the disabled person’s sins from a previous life and shame them for it. Here is a brief summary of the movement for rights and disability services in India.

History

People with disabilities largely lived as societal “outcasts” until and even throughout the 1970s. Individuals began to advocate for rights and disability services in the 1970s, but the movement itself did not really take off until the 1980s. Throughout the 1980s, the Indian welfare system became more of a developmental system, shifting the stigma surrounding the disabled as being charity cases. People also began focusing on disability services in India within the medical system by the end of the 1980s.

The Rehabilitation Council of India was set up in 1986, which regulated and standardized rehabilitation programs for the disabled. This was followed by the Mental Health Act, which was passed in 1987 and focused on regulating standards in mental health institutions. The People With Disabilities Act (PWDA) was passed in 1995, which reserved 3% of governmental positions for people with disabilities.

Current Legislation

Employer requirements in India have been expanded over the past few decades to provide accessibility and equality to disabled employees. These include providing training, benefits and accessible environments for disabled people. Businesses also are required to conform to governmental accessibility requirements on all new builds and must frame and publish an Equal Opportunities Policy that shows posts and vacancies in the company suitable for people with disabilities. Employers are not allowed to fire an employee because of any disability sustained while employed.

Disability Services in India Today

The 2011 national census in India reported that 26.8 million people, or 2.21% of the population, suffer from some kind of disability. However, disabilities in India are ill-defined vastly underreported. If a citizen is educated and/or working, it is likely that the census taker will not report them as disabled, no matter what their condition is. Because of this, the global census estimates that the disabled population in India is closer to 15%.

Without accurate data, the Indian government cannot accurately allocate funds for disability services, which includes inclusive education, medical support and construction of accessible infrastructure.

Non-Governmental Organizations (NGO’s) are a major source of disability rehabilitation in India but are starved for resources. There are about 1,600 voluntary disability service organizations in India, and they all compete for a small amount of government funding. Because of this, the staff members are grossly underpaid,  the conditions are poor and there is a lack of organization.

While changes are being made to create and expand disability services in India, there is little to no awareness about these changes or the issues themselves. For example, the government created a line of wheelchair-accessible buses but neglected to advertise for them or release the schedule for the buses. After several months of low wheelchair-user ridership, the buses discontinued services.

Despite this, more successful organizations have been able to provide services and raise awareness, such as the National Association for the Deaf and peer counselors in Mumbai offering services to people with disabilities living independently. Disability services in India have come a long way over the past 50 years, but raising awareness about the issues and changes that have already been made is the next step on the road to equal rights for those living with disabilities in India.

– Caroline Warrick-Schkolnik
Photo: Flickr

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The Hurdles Behind Healthcare in India

Health Care in India
The government of India and international organizations, like WHO, are attempting to improve healthcare in India to make it accessible for every section of its society. However, healthcare in India is far from reaching its goal of universal healthcare. The following are some of the hurdles that India faces.

Limited Healthcare Workforce

India’s population is around 1.3 billion, but it has a low number of medical and paramedical professionals. In fact, the density of doctors was 80 doctors per 100,000 of the population in 2001 and the number of nurses was 61 per 100,000. According to WHO recommendations, a physician to population ratio should be at least 1 to 1,000, whereas India’s physician population ratio is 1 to 1,674. India needs around 2.07 million more doctors to reach the goal of 1 to 1,000.

Despite the lack of medical professionals, the urban-rural disparity is also a major hurdle in healthcare in India. According to a WHO report, there were 1,225,381 health workers in urban areas in 2001 and 844,159 in rural areas. While 70 percent of India’s population resides in rural areas, access to healthcare is inefficient compared to urban areas. For example,84 percent of the 23,582 hospitals only hold 39 percent of the total of government beds.

To combat the limited number of healthcare professionals in India, the Indian Government has made a strategic investment in its healthcare. In 2005, it launched the National Rural Health Mission (NHM), which people know as the National Health Mission. The main purpose of this organization is to ensure quality and affordable healthcare for all. In addition to this, Nation Health Policy (NHP) 2017 focuses on the requirement of healthcare management in the country. This policy has implemented a new public health management cadre in all states.

Education and Medical Qualifications

A WHO report stated that India has to work on improving the education of its doctors. In fact, around 31.4 percent of allopathic doctors receive an education up to the secondary school level and even 57.3 percent did not have any medical qualifications. Meanwhile, only 67.1 percent of nurses and midwives had education up to the secondary level.

Lack of Awareness

Despite India’s fast economic development, people in the country often have low health awareness, low education status and poor functional literacy within the healthcare system. According to a report in the Indian Journal of Community Medicine, only one-third of the antenatal mothers in India have adequate knowledge of breastfeeding. It also stated that around 1 million newborn infants die every year because of umbilical cord infection which an optimal breastfeeding practice could avoid.

The Indian Government’s National Rural Health Mission intends to provide aid for neonatal and childhood illness through its existing healthcare delivery system. It has also created the Pradhan Mantri Matru Vandana Yojana and applied amendments to the Maternity Benefit Act, 1961. The amendment protects women’s employment as well as women’s and children’s well being during maternity. In 2016, the Indian Government started the Mothers Absolute Affection program, which is to promote, protect and support optimal breastfeeding across regions of the country.

Public and Private Healthcare

India’s interim budget only allocates 2.2 percent for healthcare. Despite several health reforms, the government is still not able to increase public health spending to 2.5 percent of its GDP. Right now, the current health expenditure in India is only 1.15-1.5 percent of its GDP.

The Indian healthcare system has two main branches. These branches are public and private. The federal and state government regulates the public healthcare systems, whereas medical professionals run private sectors independently. Public healthcare systems receive financing through taxes, while patient’s pay for private healthcare centers. Private healthcare facilities are generally available to people in urban areas. Public healthcare can offer people low cost or no-cost health services, but unfortunately, because of poor quality of services, public healthcare is not the first choice of India’s major population, even though most people from the lower socio-economic status uses this healthcare system. The private healthcare system has the latest technology, qualified doctors and other facilities, but private hospitals are out of reach of the general population who are below the poverty line.

The government is trying to fill the gap between public and private healthcare and has implemented the Rashtriya Swasthya Bima Yojna (RSBY) insurance plan to do this. The main purpose of this insurance plan is to provide low-cost insurance. According to the Indian Government’s data, around 44 percent of people from below the poverty line enrolled in RSBY from 2014 to 2015. Now the fund for this insurance scheme has increased from $4,000 to $14,000 per family. RSBY insurance could help impoverished people receive quality healthcare at a low cost. This subsidized healthcare policy would provide people a choice between public and private hospitals so they can receive quality treatment.

Fraudulence and Corruption

Fraudulence and corruption are big hurdles in healthcare in India. Corruption is common at both the higher and service delivery levels, undermining the accessibility, affordability and quality of healthcare. Some of the common problems at the service delivery level include absenteeism, informal payments from patients, embezzlement and theft, service provision, favoritism and manipulation of outcome data.

The nationwide average absentee rate for doctors and healthcare providers is around 40 percent. Meanwhile, in 2013, Oxfam reported that medical professionals performed many unnecessary hysterectomies on women. Additionally, there was a large conspiracy in healthcare construction in Orissa, India, where 54 of the 55 hospitals built in Orissa had construction problems. Moreover, according to The Guardian, “The Indian healthcare system is one of the most privatized and largely unregulated healthcare systems.” A report by Dr. Gadre found that large numbers of doctors give irrational drug prescriptions while hospital patients often receive pressure to pay for an unnecessary operation or procedure.

A limited workforce, lack of awareness, education and medical qualification of healthcare professionals, corruption and healthcare expenses are inhibiting the improvement of healthcare in India. However, the Indian Government has projected many programs and schemes to improve the healthcare condition of Indians. Organizations like WHO, UNICEF, the Bill and Melinda Gates Foundation are also providing aid. Through public contribution and the Indian Government’s efforts, India should eventually reach its goal of universal health coverage.

– Anuja Kumari


Photo: Flickr

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Utkrisht Bond Aims to Prevent Maternal Mortality in India

Maternal Mortality in India
USAID and its partner organizations implemented the development impact Utkrisht bond in February 2018. Many believe this is an innovative and cost-effective solution to end preventable maternal and child deaths in India.

The Utkrisht bond is targeted to assist the State of Rajasthan, where 80,000 babies die annually from inadequate medical care. But proponents hope the model can be used throughout India, which accounts for 20 percent of maternal and child deaths globally.

The development impact bond was announced in November of 2017 by USAID Administrator Mark Green at the Global Entrepreneurship Summit in India. It is expected to provide 600,000 women with improved healthcare access and potentially save 10,000 moms and newborns.

The bond works as a public-private partnership. Investors grant providers of maternal care with upfront capital. Then, outcome funders pay back the investors their principal plus a return if pre-agreed metrics are achieved. The investor, in this case, is the UBS Optimus Foundation, which has committed about $3 million. The organization works with philanthropists to bring sustainable benefits to vulnerable children.

Up to 440 private health facilities will then be operated with assistance from Population Services International (PSI) and the Hindustan Latex Family Planning Promotion Trust (HLFPPT), which also are co-investors providing 20 percent of the required capital. PSI is a global health nonprofit and the HLFPPT is an Indian nonprofit that works with maternal care.

In order to maximize success, private facilities are the focus of the Utkrisht bond. They host more than 25 percent of institutional deliveries in Rajasthan and are used by women of all socioeconomic backgrounds, yet little has been done to improve their quality of care.

USAID and Merck for Mothers, a nonprofit with the goal to end maternal mortality, have each committed up to $4.5 million that will be paid if the heath facilities meet accreditation standards. This is a highly cost-effective method to save lives according to World Health Organization standards, which is particularly exciting to USAID.

“The pay for success approach ensures appropriate stewardship of U.S. taxpayer dollars, while unlocking both private capital and government resources for health,” USAID states.

While this is the first development impact bond targeted toward health, the future of the Utkrisht bond looks promising. If it is successful, more initiatives can be implemented that involve private-public cooperation and effective use of taxpayer money to save the lives of many women and children around the world.

– Sean Newhouse

Photo: Flickr

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US-Backed Public Health Programs in India Reduce Risk of Disease

US-Backed Health Programs in India Reduce Risk of Disease
India has a population of approximately 1.3 billion, making it the second-highest populated country in the world. With the exception of the Himalayan foothills and deserts in the northwest, a majority of the country sustains a very high population density that straddles the country’s river valleys. Due to its population density and sanitation conditions, Indian citizens face a high risk of infectious disease with the most common being bacterial diarrhea, hepatitis A & E and typhoid fever.

Public Health Programs

Because of the risk and occurrence of infectious diseases, public health programs in India continue to work with the United States Agency for International Development (USAID) as well as many other U.S backed organizations to decrease the risk of a disease pandemic.

Historically, U.S. public health programs in India foster positive health outcomes. For instance, because of World Health Organization (WHO) and Center for Disease Control (CDC) treatments in the 1990s and early 2000s, India is now polio-free.

In the early and mid-2000s, CDC and USAID programs identified the monsoon seasonality of influenza and shifted their recommendations to vaccinate before India’s monsoons occur, greatly benefiting civilian populations. Between 2009-2015, U.S. backed public health programs in India even developed 65 HIV reference laboratories certified under the CDC training programs, therefore increasing the access to effective testing and treatment programs.

Emerging Pandemic Threats Program

More recently, the United States developed USAID’s Emerging Pandemic Threats Program (EPT), a global health initiative that works in countries that are most vulnerable to the outbreaks of pandemics. This branch of USAID launched in February 2014 and maintains a growing partnership with over 50 nations, international organizations and non-governmental stakeholders to ensure that the country reduces the risk of infectious disease threats.

EPT in India

The Emerging Pandemic Threats Program in India strengthens the subcontinent’s capacity to detect threats of infectious disease through an early intervention approach. USAID works alongside WHO to fight antimicrobial resistance (AMR), which is defined as virus and bacteria’s ability to become resistant to already known and utilized antibiotic treatments.

Antimicrobial Resistance

Antimicrobial resistance occurs due to natural genetic changes viruses and bacteria undergo when they are initially exposed to an antibiotic. AMR is complicating the fight against the spread of tuberculosis, HIV and malaria, by making some current treatments ineffective.

EPT programs in India combat AMR by conducting targeted surveillance of key wildlife and livestock species, as well as those who handle the animals to identify harmful bacterias and viruses and develop new treatments against them.

Also, EPT programs in India collaborate with WHO to identify unknown harmful viruses in nature and better understand its biological characteristics. Through early monitoring of viruses and bacterias, public health professionals can more quickly develop working vaccines as well as preventative community health preparations to lower risk factors in India’s vulnerable populations.

Public Health Programs in India

EPT programs in India also work closely with the Food and Agriculture Organization of the United Nations (FAO) and the World Organization for Animal Health (OIE), encouraging a multi-sectoral response system to food safety hazards and educating farmers and food preparers of sanitary food and livestock keeping practices.

While India’s population density makes public health efforts difficult to perfect, U.S. efforts, as well as United Nations efforts, are working hard to decrease the risk of infectious disease and limit pandemic potential within the country.

– Danny Levy

Photo: Flickr