Session 5: Health

The afternoon session on health was chaired by Rakesh Sarwal (Planning Commission) with the first presentation from Chander Kumar Singh (TERI) and Prabhat Barnwal (Columbia University) examining the business of reducing the arsenic poisoning of millions across rural India. The research suggests that a semi-commercial approach to testing can reduce arsenic poisoning. After delivering a public-health message describing the risks of high-arsenic groundwater, field staff offered testing at a fixed price to each household. They found that the proportion of households buying a test gradually declined as the price increased from Rs10 to Rs50. The researchers found that if the test was priced at Rs20, more than two-thirds of villages were willing to pay for the test. This would be sufficient to cover the costs (salary and transportation) of a tester with secondary education, assuming they conducted 10-20 tests per day. The policy perspective was provided by Sheela Prasad (Ministry of Health and Family Welfare) who said that this study was very timely, especially considering 34% of the wells in the study had arsenic levels above 50 micrograms per litre (10 is the recommended maximum). She argued that awareness needed to be generated about the negative health implications of arsenic in well water, and that a graded fee structure may be necessary so that households paid more according to their wealth. Finally, she recommended that supply-side issues also needed to be addressed so that disadvantaged groups have access to clean water.

Nidhiya Menon (Brandeis University) discussed the seasonal effects of water quality on infant and child health, focusing on the impact of fertiliser use as part of the green revolution. A dramatic explosion in the use of fertiliser in India from the 1960s led to children being exposed, both in utero and after birth to fertilisers, as women themselves are continually exposed due to their work at the forefront of farming activities. Her research has found that the presence of agrichemicals in water in the month of conception significantly increases infant and neo-natal mortality. In addition, exposure to agrichemicals in the month of conception has significantly negative impacts on height-for-age and weight-for-age at age five. It is noteworthy that month of conception exposure to agrichemicals in water has effects on both short and long-term outcomes. Her findings highlight the tension between greater use of fertiliser to improve yields and the negative health impacts of such use. Sheela Prasad (Ministry of Health and Family Welfare) noted the policy relevance of this research, particularly given that India’s 12th Five Year Plan contains the goal to reduce the current rate of infant mortality (44 children per 1000 live births) to only 25 deaths per 1000 live births.