User:Akalra.18/sandbox

education in US hanoi

Area
1. Jaipur 2. Rajasthan 3. Public health system in India 4. health in India

final: Public health system in India

Sector
1. Feminization of poverty 2. Public health

final: Feminization of poverty

Evaluating Possible Articles
1. Feminization of poverty:

This article is rated as B class and ranges from low to high importance on multiple different WikiProjects. The talk page for this article is lengthy and details many issues with outdated or incorrect sources. Another issue discussed is that it doesn’t have enough of an international focus.

What I noticed while reading through the article is that it needs organizational help. There are many sections under Measures of Poverty that should really be moved to Causes. In fact, all four sections of Health, Education, Decision-making power, and Sexual violence should be moved as they relay information that doesn't have to do with how to measure poverty. Instead, they discuss info that can be discussed as an adding factor of the feminization of poverty. The Decision-making power section can then be combined with Social and cultural exclusions in the Causes section.

There is also some repetition in some of the sections, such as the Single mother household section. The fact that single mothers have a lack of resources and very low income was repeated multiple times throughout the four paragraphs. This can definitely be shortened.

Another fact that can be added is that of honor killing, female infanticide, or female foeticide. This would show that there is an inherent gender inequality in multiple countries that would contribute to the feminization of poverty. A new section can be made, or it could be put under the Social and cultural exclusions section.

Lastly, the sections on Religions and Countries is very short and not at all detailed. Information on India (my PE focus country) can be added as well as info on some of the religions of India.

Overall, the tone of the article is pretty neutral and no where did I find an opinionated sentence. Everything is pretty relevant to the topic, except for the Measuring Poverty section which just describes methods in stead of relating them to the topic. To fix this, after reordering the page the Measuring Poverty section can be added to by listing some statistics found by the three measurement methods mentioned in relation to the feminization of poverty. There are a few more links that can be added, such as gender discrimination, that would help readers link ideas to other wiki pages.

2. Public health systems in India:

This article is extremely short and is rated as stub and low importance on just one project. The talk page only has one post about needing to add more points from a certain textbook. Learning about public health systems in India is related to my PE because I would be working myself at a government funded clinic in a semi urban area. Thus, my overall goal for this page would be to expand it and make it more useful, as well as to gain knowledge to help me during my PE.

The first thing that I think needs work is the description of India's current public health system. The page mentions that it is comprised of certain facilities and it also describes what these facilities do. However, that is as far as it goes. I would like to expand this by explaining some goals of the public health system, the state of public health in India today (why the system is needed), and shortcomings of the system. This information can be added to different sections of the page. Research on differences in rural versus urban public health systems (such as Community Health Centre CHCs versus Primary Health Centres) can also be incorporated.

Otherwise, the short page seems to be neutral and just relays some very basic information. There is a lot of work that can be done to broaden the scope of the page. The second reference of the page is temporarily out of order, so if it seems to always be out of order that reference should be removed/replaced.

Feminization of poverty
1. We Are Poor but So Many: The Story of Self-Employed Women in India (South Asia Series) This book details the stories of women who have suffered from inequalities but have gained some form of relief from the organization called SEWA, which the author of this book began. It also discusses economic difficulties that all women in India face today. The arguments presented in this source can help me with understanding more about the inequality in poverty itself that is prevalent and disadvantages women. I can borrow ideas of what exactly the women of India face, as well as some possible relief efforts that are present today today to help me compose my literature review.

2. Access to health care among poor elderly women in India: how far do policies respond to women's realities? This journal article characterizes the problem of healthcare for women, particularly elderly women, and concludes that the state should have a more active role in implementing care. I could use some of the facts written in the first few pages detailing the state of gender inequality in the poverty sphere present in India today. It would also be beneficial to me and my practice experience to include some of the arguments about health, as that is what my PE is about.

3. Women in Poverty: Canada and India My next article basically illustrates the larger number of problems women face than men in poverty while comparing India and Canada, claiming that poverty in both have similarities. This source is super useful for my literature review, as it discusses inequalities in work, social disparities, and how the government completely ignores the feminization of poverty in India. It can help me detail what poverty in India looks like today.

4. Sex Differentials in Childhood Feeding, Health Care, and Nutritional Status in India This article details sex differences in numerous important social and cultural factors that can help me understand how women bear the burden of poverty more than men. The data collected was from National Family Health Surveys the government conducted. The findings of the article conclude that gender discrimination is not inherently present, but instead depends on order of birth, sex of previously born siblings, and of course inclination to have a mother. This is what causes there to be large amounts of sex selected abortion and discrimination in healthcare.

5.  Falling Sex Ratio and Health Deprivation of Women in India: An Interface between Resource, Culture and Gender This source details the cultural background for gender discrimination in healthcare, nutrition, freedom, employment, household activities etc. It encloses demographic details of mortality and sex ratio, as well as analyzing policies made to advance women's rights. I will be using these ideas in my article in order to further analyze why women are more impoverished than men.

6. Status, Caste, and the Time Allocation of Women in Rural India This source goes into details about the time that women spend on activities when they rise to a different social class. It talks a lot about how women's behavior is related to social status. I can use some information in this source to add to my employment and home life sections of the article.

7. Gender Disparities in Educational Trajectories in India: Do Females Become More Robust at Higher Levels? My seventh source outlines information on school attendance rates for Indian children. The goal of the paper is to analyze gender inequality at every stage of education and it goes through an experiment to do so. I can use some of the statistics found to support my points on the inequality in female education in India.

8. "Women, Health and Public Services in India : Why Are States Different?" This book outlines numerous problems that women face in India, including education, employment, status etc. The chapter I am taking information from details inequalities in female status due to the general system present in India, and the negative repercussions of this inequality.

9. "Re-thinking the ‘‘Feminization of Poverty’’ in Relation to Aggregate Gender Indices" This ninth source outlines poverty with relation to different indices of measurement. It also focuses on critiques of the terms feminization of poverty and explains why this characterization may be false. The information that I have used from this source details how women are also now faced with the burden of solving poverty themselves.

10. "Addressing World Poverty through Women and Girls: A feminized solution?" This source provided critique of the feminization of poverty and the Girl Effect. It argued that this characterization distracts from women's rights and also classifies all women as a homogeneous mass, which is untrue. It also discussed the error in claiming it is possible to end poverty before it starts. This is the information that I am using to edit my article.

Public health systems in India
1. Health systems in India This journal article describes public health infrastructure in India and how there have been some initiatives to focus on women and children health, but these initiatives focus on the wrong aspects that take too long to have effects. It details information on public health services the government offers, which would be very helpful in expanding the second section of the Wikipedia article.

2. Understanding Government Failure in Public Health Services My second source explains the failures of the public health system in India, including aspects such as corruption, overcrowding, and mistrust. It concludes that missing accountability is what seriously damages the system. I could borrow these ideas as I plan on making a section that discusses the precise deficiencies of India's public health system.

3. Unmet National Health Needs: Visions of Public Health Foundation of India This third source discusses an organization that was started in 2006 called Public Health Foundation of India with the objective of incorporating public health policies and professionals into the healthcare sphere. This article argues the necessity of more public health officials educating others on necessary approaches to improving health of those in low-income areas. I believe that I should write about the PHFI in my literature review as it is part of the government's public health initiatives, and this article will give me a good idea of what exactly it does and what it has the capacity to do.

4. "Twelfth Five Year Plan" This source is one that I found from source #1 in this list. It details India's 5 year plan from 2012-2017. There is no longer a 5 year plan because the government has transitioned to the think tank NITI Ayaog. This report details the plan for India's healthcare sector for 2012-2017 and also mentions numerous drawbacks with it. This information is very applicable to me as I will be adding a section with drawbacks. It also provides details on the public health system already instilled in India which I will incorporate in the facilities section.

5. Better Health Systems for India's Poor: Findings, Analysis, and Options This book, or the chapter I am taking information from, details the public health system in India and focuses on financing of the public health system. It also mentions many faults with it. This information can easily be incorporated into my article as I want to find out more about the drawbacks of the system.

6. The Challenges Confronting Public Hospitals in India, Their Origins, and Possible Solutions This source reviews the secondary level of primary health centers to the tertiary level of general hospitals. It discusses their advantages and disadvantages, as well as other challenges public hospitals face. This source is very useful in my descriptions of the current system and it's drawbacks.

7. "Public Health Education in India – Reforms or Revolution?" This source gives a summary of what the 1999 WHO meeting in Calcutta, India decided. It also lists several factors for why despite this meeting, India is still failing in public health education. I can particularly use information from this source to add to my education section.

8. "Guidelines for District Hospitals" This source details all guidelines and failure of the District Hospitals of India. I am using this source for basic data on what a district hospital is and what it's drawbacks are. However, the source all details numerous regulations for what the hospitals should look like.

9. "Public Health in India: Dangerous Neglect" This ninth source gave a summary of why public health is important in India. It then went on to discuss public health in the colonial period and then post-colonial modern period of India. It concluded with hope for the future incorporation of public health into more regular life and better implementation, similar to western USA models. I am using some information in the history section to add to my background in the article.

10. "Health care and equity in India" This article was extremely useful as it gave numerous important statistics which I can use for the background or history sections of the article. It also discussed quite a few critiques of the public health system, including overcrowding, lack of funding, and inept providers. I used a lot of the information presented to improve my edits.

Synthesizing Information into a Draft
All the information I have written is in my own words! My plans for rearrangement include: 1. moving all four sections of Health, Education, Decision-making power, and Sexual violence as they relay information that doesn't have to do with how to measure poverty. Instead, they discuss info that can be discussed as an adding factor of the feminization of poverty. 2. The Decision-making power section can then be combined with Social and cultural exclusion 3. There is some repetition in some of the sections, such as the Single mother household section. The fact that single mothers have a lack of resources and very low income was repeated multiple times throughout the four paragraphs. This can definitely be shortened. 4. make sure all citations are working

Background
The modern public health system in India evolved due to a number of influences from the past 70 years, including British influence from the colonial period. The need for an efficient and effective public health system in India is large. 20% of all maternal deaths and 25% of all child deaths in the world occur in India. 69 out of 1000 children are dead by the time they reach the age of 5. 58% of Indians are immunized in urban areas compared to only 39% in rural areas. Communicable disease is the cause of death for 53% of all deaths in India.

Public health initiatives that affect people in all states, such as the National Mental Health Program, are instilled by the Union Ministry of Health & Family Welfare. There are multiple systems set up in rural and urban areas of India including Primary Health Centers, Community Health Centers, Sub Centers, and Government Hospitals. These agencies must follow the standards set by Indian Public Health Standards documents that are revised when needed.

History
Public health systems in the colonial period were focused on health care for British citizens that were living in India. The period saw research institutions, public health legislation, and sanitation departments, although only 3% of Indian households had toilets at this time. Annual health reports were released and the prevention of contagious disease outbreaks was stressed. At the end of the colonial period, death rates from infectious diseases such as cholera had fallen to a low, although other diseases were still rampant.

In modern day India, the spread of communicable diseases is under better control and now non-communicable diseases, especially cardiovascular diseases, are major killers. Health care reform was a priority of the 1946 Bhore Committee Report which suggested the implementation of a health care system that was financed at least in part by the Indian government. In 1983 the first National Health Policy (NHP) of India was created with the goals of establishing a system with primary-care facilities and a referral system. In 2002, the updated NHP focused on improving the practicality and reach of the system as well as incorporating private and public clinics into the health sphere.

Public health funding has been directed to helping the middle and upper classes, as it targets creating more health professional jobs, expanding research institutions, and improving training. This creates unequal access to health care for the lower classes who do not receive the benefits of this funding. Today, states pay for about 75% of the public healthcare system but insufficient state spending neglects the public health system in India. The country is currently attempting to move towards a western model of public health care systems and disease prevention.

Facilities
(already there on page) The healthcare system is organized into primary, secondary, and tertiary levels. At the primary level are Sub Centers and Primary Health Centers (PHCs). At the secondary level there are Community Health Centers (CHCs) and smaller Sub-District hospitals. Finally, the top level of public care provided by the government is the tertiary level, which consists of Medical Colleges and District/General hospitals. The number of PHCs, CHCs, Sub Centers, and District hospitals has increased in the past six years, although not all of them are up to the standards set by Indian Public Health Standards.

Sub Centers
A Sub Center is designed to serve extremely rural areas with the expenses fully covered by the national government. Mandates require health staff to be at least two workers (male and female) to serve a population of 5000 people (or 3000 in a remote, dangerous location). Sub Centers also work to educate rural peoples about healthy habits for a more long-term impact.

Primary Health Centers
Primary Health Centers exist in more developed rural areas of 30,000 or more (20,000 in remote areas) and serve as larger health clinics staffed with doctors and paramedics. Patients can be referred from local sub centers to the PHC for more complex cases. A major difference from Sub Centers is that state governments fund PHCs, not the national government. PHCs also function to improve health education with a larger emphasis on preventative measures.

Community Health Centers
A Community Health Center is also funded by state governments and accepts patients referred from Primary Health Centers. It serves 120,000 people in urban areas or 80,000 people in remote areas. Patients from these centers can be transferred to general hospitals for further treatments. Thus, CHC's are also considered to be first referral units, or FRUs, which are required to have obstetric care, new born/childcare, and blood storage capacities at all hours everyday of the week.

District Hospitals
District hospitals are the final referral centers for the primary and secondary levels of the public health system. It is expected that at least one hospital is in each district of India, although in 2010 it was recorded that only 605 hospitals exist when there are 640 districts. There are normally anywhere between 75 to 500 beds, depending on population demand. These district hospitals often lack modern equipment and relations with local blood banks.

Government Public Health Initiatives
In 2006, the Public Health Foundation of India was started by the Prime Minister of India as both a private and public initiative. The goal of this organization is to incorporate more public health policies and diverse professionals into the healthcare sphere. PHFI is also collaborating with international public health organizations to gather more knowledge and direct discussions around needs and improvements to the current system. Often officials in policy making positions have a gap in their education about public health, and MPH and PHD programs in public health are lacking in their number of students and resources. PHFI aims to further these programs and educate more people in this field. The research discovered would be made transparent to the Indian public at large, so that the entire nation is aware of health standards in the country.

Drawbacks
Drawbacks to India's public health system today include low quality care, corruption, unhappiness with the system, a lack of accountability, unethical care, overcrowding of clinics, poor cooperation between public and private spheres, barriers of access to services and medicines, lack of public health knowledge, and low affordability. . These drawbacks push wealthier Indians to use the private healthcare system, which is less accessible to low-income families, creating unequal medical treatment between classes.

Low quality care
Low quality care is prevalent due to misdiagnosis, under trained health professionals, and the prescription of incorrect medicines. A study discovered a doctor in a PHC in Delhi who prescribed the wrong treatment method 50% of the time. Indians in rural areas where this problem is rampant are prevented from improving their health situation. Enforcement and revision of the regulations set by the Union Ministry of Health & Family Welfare IPHS is also not strict. The Twelfth five year plan dictates a need to improve enforcement and institutionalize treatment methods across all clinics in the nation in order to increase the quality of care. There is also a lack of accountability across both private and public clinics in India, although public doctors feel less responsibility to treat their patients effectively than do doctors in private clinics. Impolite interactions from the clinic staff may lead to less effective procedures.

Corruption
Healthcare professionals take more time off from work than the amount they are allotted with the majority of absences being for no official reason. India's public healthcare system pays salaries during absences, leading to excessive personal days being paid for by the government. This phenomenon is especially heightened in Sub Centers and PHCs and results in expenditure that isn't correlated to better work performance.

Overcrowding of clinics
Clinics are overcrowded and understaffed without enough beds to support their patients. Statistics show that the number of health professionals in India is less than the average number for other developing nations. In rural Bihar the number of doctors is 0.3 for every 10,000 individuals. Urban hospitals have twice the number of beds than rural hospitals do but the number is still insufficient to provide for the large number of patients that visit. Sometimes patients are referred from rural areas to larger hospitals, increasing the overcrowding in urban cities.

Poor cooperation between public and private spheres
85% of visits to health practitioners are in private clinics or hospitals, many of which are paid for out of pocket. Money is spent on improving private services instead of on funding the public sector. Governmental failure to initiate and foster effective partnerships between the public and private healthcare spheres results in financial contracts that aren't negotiated to help the common man. These contracts would allow the private sector to finance projects to improve knowledge and facilities in the public sphere.

Barriers of access
Both social and financial inequality results in barriers of access to healthcare services in India. Services aren't accessible for the disabled, mentally challenged, and elderly populations. Mothers are disadvantaged and in many rural areas there is a lack of abortion services and contraception methods. Public clinics often have a shortage of the appropriate medicines or may supply them at excessively high prices, resulting in large out of pocket costs (even for those with insurance coverage Large distances prevent Indians from getting care, and if families travel the far distance there is low assurance that they will receive proper proper medical attention at that time.

Lack of public health knowledge
A knowledge gap among professionals in the public sphere further reduces the effectiveness of India's current public health system. The medical school programs of the country have a shortage of public health education and government officials are not trained enough to make effective policies. There are 286 courses related to health planning in 15 states and only 85 of these are considered courses that are competent enough to be labeled public health courses. Jobs for public health students are limited, reducing the incentives to study this subject. The general public also makes choices that are unknowingly harmful to the public health of the nation.

Women as a solution to poverty
Due to the feminization of poverty, women often face the burden of solving poverty. They are depicted as all having the same social standing and needs, even though this is not the case. This effect is exacerbated by the increased number of NGOs targeting solely female development. Women are expected to maintain the household as well as lift the family out of poverty, responsibilities which can add to the burden females face in developing nations.

India
The poverty that women experience in India is known as human poverty, or issues of inadequate food, housing, education, healthcare, sanitation, poor developmental policies, and more. Poverty has been prevalent in India for many years, but there was a noticeable increase after globalization in 1991 when the IMF instilled a structural adjustment program (SAP) in order to give India a loan. Large amounts of capital flowed into the country but also led to the exploitation of the Indian market, particularly of women for their cheap labor. This reduced their opportunities for education and escape from the poverty trap.

The Indian Constitution has proclaimed that all citizens have equal rights but this is not always practiced. Sex selective abortion is a wide phenomenon in India in which males are preferentially selected. In order to get married, it is not abnormal to see the girl's family paying dowry to the male's family. This leads to more sex selective abortion as females are more costly for the family, and less focus on female development.

Home life
Women are restricted in India due to a heavy dependency of social status on female appearance and activity around the home. Poor behavior on their part results in lower social status and shame for the male head of the family. Women are expected to maintain the household with a strict schedule. Husbands often move to the city to find work and leave their wife as the primary earner in their absence. Women in these situations may resort to using favors or borrowing money in order to survive, which they must later return in cash with interest. Young girls are especially vulnerable to prostitution or bribing as a form of repayment. Competition amongst women around water, food, and employment is also prevalent, especially in urban slums.

Employment
The expectation for Indian women is to be the sole care taker and maintainer of the home. If women leave their children and work they are often left in the hands of a poor care taker (possibly the eldest daughter) and don't get enough resources for development. In many areas working outside of the home is seen as symbolic of having low status. Upper class women have similar social restrictions, although lower class females frequently have a larger necessity of the added income than upper class females. Men tend to send money back to extended family, whereas money that a woman makes goes to her husband. This reduces the incentive of the family to urge their daughter to find work as they wouldn't receive money but would face shame in society.

Conceptual barriers prevent women from being accepted as equally paid and equally able laborers. In many ways women are seen as excess reserve labor and get pushed into roles that are dirty, unorganized, arduous, and underdeveloped. They are hurt by the mechanization of industries and while self employment is a viable option, there is always a large risk of failure and exploitation.

Healthcare
Healthcare is difficult to access for women, particularly elderly women. Public clinics are overcrowded, understaffed, and have high transportation costs, while private clinics are too expensive without insurance. Females are more likely to get ill than males although males receive medical advice with higher frequency. Women frequently feel as if they are a burden to their husband or son when they get sick and require money to purchase the correct medicines. Some believe that their symptoms are not serious or important enough to spend money on. When women do receive some form of care, many times medical providers are biased against them and are partial to treating males over females. Many mothers also die during childbirth or pregnancy as they suffer from malnutrition and anemia. Over 50% of women in the National Family Health Surveys were anemic.

Nutrition
Poverty is a large source of malnutrition in women. Women in poverty are not allowed to eat the nutritious food that men are when it is available. While it is the women's job to obtain the food, it is fed to the males of the household. The 2005-2006 National family Health Survey found that more men drink milk and eat fruit in comparison to women, and that less than 5% of females in the states of Punjab, Haryana, and Rajasthan eat meat or eggs. Poor nutrition begins at a young age and gets worse as women mature and become mothers.

Education
Effective policies to aid in expanding female education aren't productively enforced by the Indian government. Data from the 2001 census showed that primary school completion rates were around 62% for males and 40% for females. Instead of being taught math, teenage girls are generally taught how to care for their siblings and cook food. Some families may believe men to be more qualified than women to get a higher paying job. In many instances this inequality between male and female education leads to child marriage, teenage pregnancies, and a male dominated household. Evidence suggests that educating girls results in reduced fertility, due to an urge to work and pursue higher social status. This lessens the financial burden on families.

To do
1. find more sources for Public health systems in India: general hospital, AIMS, medical colleges 2. find more sources for government initiatives in PH 3. find source for corruption information, low satisfaction levels, overcrowding of clinics, 4. find more sources for housing of females in India

=Universal Basic Income=

Something to consider is whether the universal basic income in India is financially feasible. Research indicates that in order to implement the UBI, existing welfare programs would have to be terminated to free up resources. This raises questions, especially about the Indian government's large programs such as the Food Subsidy or Public Distribution System (PDS) and the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) which would have to be stopped for the UBI to be implemented. Current social welfare schemes cost India about 3.7% of GDP, but UBI is expected to cost 4.9% of GDP. The question of where this extra funding will come from remains.

A key concern is with the "work unconditionality" of the basic income proposal by which the income is paid no matter a person's employment status. Some believe money should not be given to those who do not contribute to society through employment. Many fear these people would spend money on such items as alcohol, cigarettes, and other temptation goods. Another related prevailing fear is that a universal basic income will deter people from working or seeking work altogether.

Other options are being considered and proposed. One idea is to target certain populations instead of giving an income to the entire population. This idea is resisted by others for whom the universality is a fundamental and inviolable principle of the basic incomeIn order to reduce GDP expenditure on UBI, alternative proposals have been made. Two options for a more targeted program have been aired: The first is an "opt out" system in which the wealthiest 25% of India are given the option of withdrawing. The names of those in the top 25% who choose to remain in the program would be published, as a shaming device. The second option is to target specifically marginalized and vulnerable groups such as the disabled or widowed.