Determinants of internal migrant health and the healthy migrant effect in South India: a mixed methods study
- BMC International Health and Human Rights,
Internal labour migration is an important and necessary livelihood strategy for millions of individuals and households in India. However, the precarious position of migrant workers within Indian society may have consequences for the health of these individuals. Previous research on the connections between health and labour mobility within India have primarily focused on the negative health outcomes associated with this practice. Thus, there is a need to better identify the determinants of internal migrant health and how these determinants shape migrant health outcomes.
An exploratory mixed methods study was conducted in 26 villages in the Krishnagiri district of Tamil Nadu. Sixty-six semi-structured interviews were completed using snowball sampling, followed by 300 household surveys using multi-stage random sampling. For qualitative data, an analysis of themes and content was completed. For quantitative data, information on current participation in internal labour migration, in addition to self-reported morbidity and determinants of internal migrant health, was collected. Morbidity categories were compared between migrant and non-migrant adults (age 14–65 years) using a Fisher’s exact test.
Of the 300 households surveyed, 137 households (45.7%) had at least one current migrant member, with 205 migrant and 1012 non-migrant adults (age 14–65 years) included in this study.
The health profile of migrant and non-migrants was similar in this setting, with 53 migrants (25.9%) currently suffering from a health problem compared to 273 non-migrants (27.0%). Migrant households identified both occupational and livelihood factors that contributed to changes in the health of their migrant members. These determinants of internal migrant health were corroborated and further expanded on through the semi-structured interviews.
Internal labour migration in and of itself is not a determinant of health, as participation in labour mobility can contribute to an improvement in health, a decline in health, or no change in health among migrant workers. Targeted public health interventions should focus on addressing the determinants of internal migrant health to enhance the contributions these individuals can make to their households and villages of origin.
Will Skill-Based Immigration Policies Lead to Lower Remittances? An Analysis of the Relations between Education, Sponsorship, and Remittances
Sankar Mukhopadhyay, Miaomiao Zou
IZA Discussion Paper No. 11330, February 2018
As more and more developed countries adopt policies that favor highly educated immigrants, the impact of such policies on developing countries remains unclear. Some researchers have argued that migrants who are more educated tend to bring their immediate family members to the host country, and thus, send less money to the source country in remittances. While there is numerous papers documenting association between education and remittance, whether that is related to sponsorship decision remains under-explored. Using individual level panel data from the New Immigrant Survey, we show that sponsoring family members leads to lower remittance. Furthermore, we show that college educated immigrants from high-income families are less likely to sponsor relatives, presumably because of relatively higher opportunity cost of migration of their relatives. Together, these two results suggest a positive association between education and remittances, which is indeed, what we find in the data. Our extended analysis shows that alternative explanations (such as higher income of more educated immigrants, or repaying implicit educational loans) cannot completely explain the positive association between education and remittances. Our results suggest that skill-based immigration policies are likely to result in more remittances.
Note from Editors by S. K. Thorat
- Globalization and Health,
Drug shortages and increasing generic drug prices are associated with low levels of competition. Mergers and acquisitions impact the level of competition. Record merger and acquisition activity was reported for the pharmaceutical sector in 2014/15, yet information on mergers and acquisitions in the generic drug sector are absent from the literature. This information is necessary to understand if and how such mergers and acquisitions can be a factor in drug shortages and increasing prices.
Data on completed merger and acquisition deals that had a generic drug company being taken over (i.e. ‘target’) were extracted from Bloomberg Finance L.P. The number and announced value of deals are presented globally, for the United States, and globally excluding the United States annually from 1995 to 2016 in United States dollars.
Generic drug companies comprised 9.3% of the value of all deals with pharmaceutical targets occurring from 1995 to 2016. Globally, in 1995 there were no deals, in 2014 there were 22 deals worth $1.86 billion, in 2015 there were 34 deals totalling $33.56 billion, and in 2016 there were 42 deals worth in excess of $44 billion. This substantial increase was partially attributed to Teva’s 2016 acquisition of Allergan’s generic drug business. The surge in mergers and acquisitions for 2015/16 was driven by deals in the United States, where they represented 89.7% of the dollar value of deals in those years.
The recent blitz in mergers and acquisitions signals that the generic drug industry is undergoing a transformation, especially in the United States. This restructuring can negatively affect the level of competition that might impact prices and shortages for some products, emphasizing the importance of updating regulations and procurement policies.
Does equity in healthcare spending exist among Indian states? Explaining regional variations from national sample survey data
- International Journal for Equity in Health,
Equity and justice in healthcare payment form an integral part of health policy and planning. In the majority of low and middle-income countries (LMICs), healthcare inequalities are further aggravated by Out of Pocket Expenditure (OOPE). This paper examines the pattern of health equity and regional disparities in healthcare spending among Indian states by applying Andersen’s behavioural model of healthcare utilization.
The present study uses data from the 66th quinquennial round of Consumer Expenditure Survey, of the National Sample Survey Organization (NSSO), conducted in 2009–10 by Ministry of Statistics and Programme Implementation (MoSPI), Government of India (GoI). To measure equity and regional disparities in healthcare expenditure, states have been categorized under three heads on the basis of monthly OOPE i.e., Category A (OOPE > =INR 100); Category B (OOPE between INR 50 to 99) and Category C (OOPE < INR 50). Multiple Generalised Linear Regression Model (GLRM) has been employed to explore the effect of various socio-economic covariates on the level of OOPE.
The gap in the ratio of average healthcare spending between the poorest and richest households was maximum in Category A states (richest/poorest = 14.60), followed by Category B(richest/poorest 11.70) and Category C (richest/poorest 11.40). Results also indicate geographical concentration of lower level healthcare spending among Indian states (e.g., Odisha, Chhattisgarh and all the north-eastern states). Results from the multivariate analysis suggest that people residing in urban areas, having higher economic status, belonging to non-Muslim communities, non-Scheduled Tribes (STs), and non-poor households spend more on healthcare than their counterparts.
In spite of various efforts by the government to reduce the burden of healthcare spending, widespread inequalities in healthcare expenditure are prevalent. Households with high healthcare needs (SCs/STs, and the poor) are in a more disadvantaged position in terms of spending on health care. It has also been observed that spending on healthcare was comparatively lower among backward or isolated states. No doubt, the overall social security measures should be enhanced, but at the same time, looking at the regional differences, more priority should be assigned to the disadvantaged states to reduce the burden of OOPE. It is proposed that there is need to increase government spending, especially for the disadvantaged states and population, to minimise the burden of OOPE.
Care policies and reconciliation of work and family life: experiences of women workers. by Samantroy, Ellina; Khurana, Sakshi
Influence of NREGS on Agricultural Wage Determination in West Bengal: A Dynamic Panel Approach. by Kundu, Amit; Talukdar, Sanjib
International Worker Migration and Remittances in South Asia: A Landscape of India’s Emerging Scenario. by Bhat, Mohd.; Rather, Tareak
Workers on the move: Migrated labour in India in early 21st century. by Majumder, Rajarshi; Naaz, Farhat
7.5 Crore Green Jobs? Assessing the Greenness of MGNREGA Work by Bhaskar, Anjor; Shah, Amod; Gupta, Sunil