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Based upon research in the state of Bihar, India, this article argues that informal access to medicines in Northern India is a core element of the government of healthcare. Informal providers such as unlicensed village doctors and unlicensed drug sellers play a major role in access to medicines in Bihar, in the particular context of the dismantling of public procurement services. Building on recent works in the socio-anthropology of pharmaceuticals, the article shows the importance of taking into account the political economy of drugs in India, in order to understand local problems of access more fully. If informal providers occupy such an important position in the government of healthcare in India, this is partly due to the shaping of healthcare as access to drugs on health markets. Elaborating the argument from interviews with health professionals and patients, the article first shows the situation of public healthcare and public procurement in Bihar; then it presents the role of informal medicine providers; lastly, it shows how patients deal with the fact that they live in a ‘pharmaceutical world’ where access to health equates with access to medicines. [ABSTRACT FROM AUTHOR]

Copyright of Social & Cultural Geography is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper assesses the food security implications of the out-migration of men for rural households headed by women. Recent transformations in the socio-economic landscape of the Global South involve an increasing number of rural households shifting towards urban-nonfarm, migration-based livelihoods. In many rural societies, social and cultural norms restricting women's mobility means migration is usually undertaken by men, leading to a phenomenon of left-behind women. The absence of men requires women to assume the role of household heads. This often triggers fundamental changes in intrahousehold gender power relations. However, little is known about the effects of these changes on household food security outcomes. Drawing on primary field research in western Bihar in India, this article attempts to highlight interconnections between migration, women left behind and household food security and, in doing so, makes two key contributions. First, with a focus on gender social roles, the paper shows that the two oft-cited impacts of migration of men—'improved autonomy' and 'increased responsibility' for left-behind women—provide conceptual pathways to understand migration-gender-food security linkages. Second, it provides evidence on how changes in women's roles under conditions of such migration intersect with household food security. The findings indicate a gender-based disadvantage in food security outcomes faced by household headed by women, offsetting even the potentially positive influence of improved female autonomy. The paper argues for the need to address socio-economic mechanisms underpinning gender-based vulnerabilities to food security. [ABSTRACT FROM AUTHOR]

This study examines the coverage and effect of cash transfers and food subsidies in India during the COVID-19 pandemic. It is based on a primary survey of rural women in the state of Bihar – an underdeveloped state with poor public delivery systems – undertaken in January–March and September–November 2020. Although the coverage of cash transfers was wider than that of food subsidies, respondents receiving cereals and pulses under the Public Distribution System reported a lower probability of suffering from food insecurity vis-à-vis cash subsidies. The study suggests that food subsidies may be more effective when supply chains break down. [ABSTRACT FROM AUTHOR]

This paper studies the impact of the flooding of the Kosi river on the timing of marriage in the Indian state of Bihar, one of the world's poorest regions. Using a difference-in-differences design, we show that the Kosi floods reduced men's age at marriage by almost a year and women's age at marriage by over 4 months. The Kosi floods also decreased the secondary school completion rates of married men and women and married women's command over economic resources. We interpret these results within a framework of marriage markets, where in the absence of complete credit markets, marriage market payments (dowry) help smooth consumption in response to adverse income shocks. In support of this framework, we find that the impact of the Kosi floods is more pronounced among Hindus (for whom dowry is the traditional marriage payment norm) and among the landless (who are more credit-constrained). [ABSTRACT FROM AUTHOR]

This paper examines various features of energy and groundwater irrigation nexus in a highly irrigated ecosystem of north western India. The study is based both on primary and secondary sources of data. Electric tube-wells account for about 72 percent of the total tube-wells population and consume about 40 percent of the total electricity consumption. Power subsidies account approximately 46 percent of the total subsidies disbursed which stimulate the groundwater development. The area irrigated by means of tube-wells has enlarged from 22 to 58 percent. Rice and sugarcane crops are the key consumers of energy both in terms of average energy consumption as well as per hectare of cultivated land. The average use factor of tube-wells is about 7.5 times high during kharif than in rabi season. Farmers have yielded high economic productivity under all crops with the exception of rice than other states such as Uttar Pradesh, Bihar and Gujarat. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Social Intervention: Theory & Practice is the property of Universiteit Utrecht and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Bihar, India's poorest state, witnessed impressive yield growth in its three principal crops during the last decade or so. This paper examines whether a reduction in regional yield disparities accompanied these state-level productivity gains. The convergence test allows the district-specific element of productivity to vary with time, thus permitting divergence in interim phases. District rice yields converged towards a common growth path. The results for wheat and maize are not as conclusive. However, there is strong evidence of divergence for each crop in recent years. This divergence, nonetheless, happens in the presence of club convergence. The club classification transcends agro-climatic boundaries, indicating a role for policy to aid growth in the lagging districts. The shifts in credit allocation over the years do not appear to be driving the yield divergence, highlighting the limitations of a macro credit-driven policy. [ABSTRACT FROM AUTHOR]

The disease control program is critical to the agenda of social justice. A generalist approach to the disease control program involves understanding its complexity and prevention from various perspectives, including ecological theory. The integration of the disease control program into the existing healthcare delivery system has been advocated over many decades, with an emphasis on the medical model of disease control. Integration has been widely considered as a means to achieve an effective and efficient health system. This approach has been widely adopted in low-middle-income countries to integrate vertical programs such as leprosy, malaria, HIV/AIDs, and others. However, studies suggest that there is a lack of evidence about the effectiveness of health system integration. The available evidence shows that integration of the health system can have a mixed, negative, or no impact on the health system. This growing enthusiasm toward health system integration is primarily based on the perceived benefits of an integrated approach. This discussion paper draws on the experience of the integration of the National Leprosy Elimination Program in India. It highlights the factors that affected the integration of leprosy programs in Bihar and also affected the pursuit of social justice for people who have been marginalized in our modern world. [ABSTRACT FROM AUTHOR]

Migration and mobilities are vastly underestimated in India. In particular, circular migration remains poorly captured as circular migrants move back and forth between source and destination regions. Based on survey data from rural Bihar, an important source region of migration in India, this paper finds that a vast majority of migrants work and live in precarity in predominantly urban and prosperous destinations across India. However, those at the lowest rungs of the social and economic ladder in source regions—the scheduled castes and scheduled tribes, other backward classes I and the labouring class—are the worst off at destination; they are part of the most precarious shorter-term migration streams, earn the lowest incomes, have the poorest conditions of work, and live in the harshest circumstances. The paper shows that social and economic hierarchies, and in turn, precarity in source region is reproduced at destination, and, thus, there is little evidence that spatial mobility is associated with social mobility. Focusing on migrants' location, work, employment, income, housing, and access to basic services at destination, the paper foregrounds migrant precarity and adds to a small body of empirical literature that is significant in understanding the spatial and structural elements of circular migration in India and in turn, the migration crisis that emerged as a result of the economic shock of the COVID 19 pandemic. [ABSTRACT FROM AUTHOR]

This paper tries to understand the nature and extent of inequality across states of India with special reference to Bihar. The study is based on secondary data collected from various sources, including NSSO, NFHS and other government/non-government documents and reports. The study analyzes inequalities under four themes: livelihood, education, health and gender. The analysis finds that, however, some positive changes can be seen in terms of enrolment in case of primary education, but still, productivity of education is the lowest in Bihar. The state government has invested money in attracting students to government schools, but because of a low per capita expenditure on education, access to facilities like computers in schools is the lowest in Bihar. In the case of health expenditure, the people of Bihar have to bear significantly higher per capita out of pocket expenditure. Though, Bihar has achieved higher growth in the last couple of years but the level of female empowerment is still very low in the state. Thus, this study finds that Bihar is still at lowest position in all four themes across states of India and, people of this state are facing grim challenges related to livelihood, quality education and health. [ABSTRACT FROM AUTHOR]

Although the importance of working with young men to transform traditional gender norms has been widely acknowledged, programmes for young men remain sparse in highly gender stratified settings such as India, and those that have been implemented have not reached those in rural areas and those out-of-school. Drawing on data from a cluster randomised controlled trial with panel surveys, of a gender-transformative life skills education and sports-coaching programme conducted among young men aged 13-21 who were members of youth clubs, this paper examines the extent to which it transformed the gender role attitudes of young men and instilled in them attitudes rejecting violence against women and girls. The intervention succeeded in changing gender role attitudes and notions of masculinity, attitudes about men's controlling behaviours over women/girls, attitudes about men's perpetration of violence on a woman/girl and perceptions about peer reactions to young men acting in gender-equitable ways. Effects were particularly significant among young men who attended regularly, underscoring the importance of regular attendance in such programmes. [ABSTRACT FROM AUTHOR]

Commitment or political will is often notable by its absence. While lack of commitment is a key factor in policy failure, it has been challenging to identify and operationalize how commitment can shape successful implementation. This article applies Brinkerhoff's (2000) framework of expressions of commitment to explain how commitment of policy elites shape policy implementation processes. Evidence for five characteristics of commitment traces these expressions from two types of policy elites — politicians and bureaucrats. Primary data from four Indian states were used—Chhatisgarh, Assam, Bihar and Andhra Pradesh—to examine the case of the Mahatma Gandhi National Rural Employment Act (MGNREGA). The data were collected through interviews with state‐level elites, supplemented by secondary data on the political economy of these states. In explaining how successes and failures of the MGNREGA are attributable to the commitment of these actors, the article considers the politics of policy implementation. It argues that commitment is critical at the sub‐national level in India, and explains the different outcomes of MGNREGA in the four states. The article considers how to strengthen policy implementation, and demonstrates that this can be done through capitalizing on positive feedback loops between different strands of commitment, as well as between commitment of administrative elites and political party leaders. The paper concludes that commitment and capacity feed off each other, improving implementation of social policies. [ABSTRACT FROM AUTHOR]

Financial inclusion involves providing suitable products and services to meet transactional, payment, savings, credit, and insurance needs. While India has progressed in financial inclusion, challenges persist in low-income regions and among marginalised groups. This study assesses the National Strategy for Financial Inclusion (NSFI) 2019–2024 and its potential to address such challenges in Bihar, one of India's poorest states. Field inquiries and interviews with households and bank managers were conducted. The findings reveal that despite NSFI's potential, unawareness, insufficient income, documentation requirements, and lack of trust in the system is persisting and factors such as- region, social groups, gender, age, education, and occupation continue to influence banking participation. So, the study recommends increased awareness, financial literacy, and reduced financial service costs tailored to Bihar's needs and other low-income regions. In addition, strengthening the regulatory framework for informal financial services is suggested. [ABSTRACT FROM AUTHOR]

Background: Asymptomatic Leishmania donovani infections outnumber clinical presentations, however the predictors for development of active disease are not well known. We aimed to identify serological, immunological and genetic markers for progression from L. donovani infection to clinical Visceral Leishmaniasis (VL). Methods: We enrolled all residents >2 years of age in 27 VL endemic villages in Bihar (India). Blood samples collected on filter paper on two occasions 6–12 months apart, were tested for antibodies against L. donovani with rK39-ELISA and DAT. Sero converters, (negative for both tests in the first round but positive on either of the two during the second round) and controls (negative on both tests on both occasions) were followed for three years. At the start of follow-up venous blood was collected for the following tests: DAT, rK39- ELISA, Quantiferon assay, SNP/HLA genotyping and L.donovani specific quantitative PCR. Results: Among 1,606 subjects enrolled,17 (8/476 seroconverters and 9/1,130 controls) developed VL (OR 3.1; 95% CI 1.1–8.3). High DAT and rK39 ELISA antibody titers as well as positive qPCR were strongly and significantly associated with progression from seroconversion to VL with odds ratios of 19.1, 30.3 and 20.9 respectively. Most VL cases arose early (median 5 months) during follow-up. Conclusion: We confirmed the strong association between high DAT and/or rK39 titers and progression to disease among asymptomatic subjects and identified qPCR as an additional predictor. Low predictive values do not warrant prophylactic treatment but as most progressed to VL early during follow-up, careful oberservation of these subjects for at least 6 months is indicated. [ABSTRACT FROM AUTHOR]

Indoor residual spraying (IRS) is used to control visceral leishmaniasis (VL) in India, but it is poorly quality assured. Quality assurance was performed in eight VL endemic districts in Bihar State, India, in 2014. Residual dichlorodiphenyltrichloroethane (DDT) was sampled from walls using Bostik tape discs, and DDT concentrations [grams of active ingredient per square meter (g ai/m²)] were determined using HPLC. Pre-IRS surveys were performed in three districts, and post-IRS surveys were performed in eight districts. A 20% threshold above and below the target spray of 1.0 g ai/m² was defined as "in range." The entomological assessments were made in four districts in IRS and non- IRS villages. Vector densities were measured: pre-IRS and 1 and 3 mo post-IRS. Insecticide susceptibility to 4% DDT and 0.05% deltamethrin WHO-impregnated papers was determined with wild-caught sand flies. The majority (329 of 360, 91.3%) of pre-IRS samples had residual DDT concentrations of <0.1 g ai/m². The mean residual concentration of DDT post-IRS was 0.37 g ai/m²; 84.9% of walls were undersprayed, 7.4% were sprayed in range, and 7.6% were oversprayed. The abundance of sand flies in IRS and non-IRS villages was significantly different at 1 mo post-IRS only. Sand flies were highly resistant to DDT but susceptible to deltamethrin. The Stockholm Convention, ratified by India in 2006, calls for the complete phasing out of DDT as soon as practical, with limited use in the interim where no viable IRS alternatives exist. Given the poor quality of the DDT-based IRS, ready availability of pyrethroids, and susceptibility profile of Indian sand flies, the continued use of DDT in this IRS program is questionable. [ABSTRACT FROM AUTHOR]

This paper analyzes excess female infant mortality and the gender gap in infant care in the East-Central state of Bihar, India. Using pooled data from three waves of the National Family Health Surveys (1992–3; 1998–9; 2005–6) in a panel analysis, it compares female infant mortality rates in Bihar to those in thirteen major Indian states. These comparisons suggest that females in Bihar experience a statistically significant excess infant mortality when compared to female infants in less gender-biased states in eastern, western, and southern regions, but not when compared to more gender-biased states in northern and central regions. An estimated 23 percent of female infant deaths in Bihar are excess. Examination of infant care demonstrates that a gender gap in Bacillus Calmette–Guérin (BCG) vaccination is the single most important driver of excess female infant mortality, followed by gaps in vaccination for polio; diphtheria, pertussis, tuberculosis (DPT); and measles. [ABSTRACT FROM AUTHOR]

This paper investigates the underlying causes of poor economic growth of Bihar and Uttar Pradesh (UP), India, despite being endowed with relatively rich natural resources. Against the conventional view, the analysis reveals that poor economic growth is not due to a particular factor but an outcome of a myriad of social, economic and political factors rooted in structural, historical and macro-economic policies. The economic marginalization of Bihar and UP began in the colonial era through the establishment of an exploitative landlord class, which constantly resisted economic and social development even after independence in 1947. The process of marginalization has further been reinforced by the federal central government's policy of 'freight equalization', which nullified the comparative advantage of Bihar and UP in natural resources by subsidizing railway freights of industrial inputs like coal, iron ore, steel, cement and other bulk resources. This, combined with relatively low financial resources received from central government over the consecutive plan periods, has undermined these states' capacity to invest in health, education, and other social and physical infrastructure and resulted in low human development. The poor performance of Bihar and UP may be attributed to low human capital, weak institutions and poor infrastructure coupled with political instability and social conflict rooted in sectarian politics based on caste, class and ethnic division. [ABSTRACT FROM AUTHOR]

Poverty affects many people, but the ramifications and impacts affect all aspects of society. Information about the incidence of poverty is therefore an important parameter of the population for policy analysis and decision making. In order to provide specific, targeted solutions when addressing poverty disadvantage small area statistics are needed. Surveys are typically designed and planned to produce reliable estimates of population characteristics of interest mainly at higher geographic area such as national and state level. Sample sizes are usually not large enough to provide reliable estimates for disaggregated analysis. In many instances estimates are required for areas of the population for which the survey providing the data was unplanned. Then, for areas with small sample sizes, direct survey estimation of population characteristics based only on the data available from the particular area tends to be unreliable. This paper describes an application of small area estimation (SAE) approach to improve the precision of estimates of poverty incidence at district level in the State of Bihar in India by linking data from the Household Consumer Expenditure Survey 2011–12 of NSSO and the Population Census 2011. The results show that the district level estimates generated by SAE method are more precise and representative. In contrast, the direct survey estimates based on survey data alone are less stable. [ABSTRACT FROM AUTHOR]

The paper engages with the water economies of Bodh Gaya, a small but prominent Buddhist town located in Bihar, India. We analysed the water economies using the neo-Polanyian idea of instituted economic processes. The anthropological approach to water economies helps us explain how drinking water has been produced, distributed, appropriated, and consumed in Bodh Gaya over the last seven decades. The paper argues that the centralised grid-based water supply system, which aims to provide universal access to drinking water to the whole town, has failed to develop. Water as a universal public good was never established in Bodh Gaya. Water was produced, distributed, appropriated and consumed in diverse ways by different groups of individuals and communities. Water remained a community-owned resource, a private, semi-public good, and recently, a commodity, but not purely a public good. Instead of relying on the ideals of centralised grid-based water supply networks to make water available for the whole populace, a more decentralised and hybrid service delivery institutions are needed to reach the diverse local population. The decentralised public water provisioning systems must be supported through appropriate regulatory measures and participatory planning initiatives to make it socially just and environmentally benign. [ABSTRACT FROM AUTHOR]

In which settings can bicycles help to improve girls' education in low-income countries? This paper analyzes the complementarity between all-weather roads and a bicycle program in India aimed at increasing girls' secondary school enrollment. Using a triple-difference strategy, I find that the program benefits girls living 3–10 km away from schools with all-weather road connections, increasing their enrollment by 60 percent and reducing the gender enrollment gap by 51 percent. There are no effects for girls in villages without all-weather roads or girls living more than 10 km from school. The findings emphasize the importance and interdependence of road infrastructure, mode of transport, and distance to school for improving girls' education in India. • Bicycle program for girls in Bihar, India, reduces the gender education gap. • Bicycle program is only effective if high-quality road infrastructure is available and schools are nearby. • Interdependence of mode of transport (bicycles), road infrastructure, and nearby schools for girls' education choice in India. • Triple-difference estimation. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have demonstrated that high-risk fertility behaviour (HRFB), which includes maternal age below 18 or above 34 years, short birth intervals (less than 24 months), and high parity (birth order above 4), is associated with adverse maternal and child health outcomes. There is a substantial research gap in the domain of high-risk fertility behaviour in the Indian context. Therefore, this study is designed to investigate the current trends and patterns in the prevalence of high-risk births among Indian women, with a primary focus on identifying contributing factors associated with this prevalence. Methods: The study utilized data from the nationally representative National Family Health Survey (NFHS), which has been conducted in five rounds since 1992–93. Data from all rounds were used to assess the overall trend. However, data from the most recent round of NFHS, conducted during 2019–21, were employed to evaluate current levels and patterns of HRFB prevalence and to identify socio-economic and demographic predictors of HRFB using binomial and multinomial logistic regression models. Results: The prevalence of HRFB has exhibited a consistent decreasing pattern from 1992 to 93 to 2019–21 in India. However, 29.56% of married women continue to experience high-risk births with notably higher rates in several states (e.g., 49.85% in Meghalaya and 46.41% in Bihar). Furthermore, socio-demographic factors like wealth index, educational level, social group, religion, mass media exposure, family size, age at marriage, type and region of residence, and reproductive factors like birth intention, place and type of delivery, ANC visits and current contraceptive use were identified as significant predictors of high-risk births among women in India. Conclusion: Despite a 20.4 percentage point decline in HRFB prevalence over the past three decades, a significant proportion of women in specific regions and demographic subgroups continue to experience high-risk births. Therefore, the present study recommends interventions aimed at preventing high-risk births among women in India, with particular emphasis on states with high HRFB prevalence and women from socioeconomically disadvantaged backgrounds. [ABSTRACT FROM AUTHOR]

With the politics of the environment so fundamental to the development process in rural India, this paper analyses the relations between water discourses and drinking water technology. First, the national discourses of water are analysed using key policy and populist documents. Second, the paper presents ethnographic fieldwork studying the politics of drinking water in rural Bihar, where the relative merits of borehole handpumps and open wells are contested. The links between the national discourses and local contestation over appropriate technology are examined. The paper argues both policy and traditionalist perspectives are too technologically deterministic to adequately account for the myriad challenges of delivering rural water supply. The emphasis on technology, rather than service levels, creates the conditions in which capability traps emerge in terms of service provision. This is not only in terms of monitoring regimes but in the very practices of rural actors who use certain water supply technologies under an illusion of safety. With a focus on furthering the policy debate, the paper considers ways forward and suggests that a move from a binary understanding of access to a holistic measure of service levels will reduce the potential for political contestation and capability traps in rural water supply. [ABSTRACT FROM AUTHOR]

Despite having equally vast endowments of natural resources and similar socioeconomic profiles, the Indian states of Bihar and Odisha pursued markedly different development strategies during India's first decade of economic liberalization. Whereas Bihar turned away from its natural resource sector and adopted policies of social empowerment, Odisha courted private investment in extractive industries and aggressively pursued market reforms. To account for this divergence, we argue that the social composition of political power in each state directly shaped the strategies that leaders embraced towards the natural resource sector and overall development. This paper makes contributions to the writings on natural resources and the political economy of India. We show that the presence of abundant natural resources does not necessarily result in a predictable pathway of sectoral and economic policy outcomes. Instead, social factors can be a powerful determinant of how resource-rich states approach their economies. [ABSTRACT FROM AUTHOR]

The paper examines the nature and development of the participatory water institutions in the eastern Indo-Gangetic plains of India, focusing on the aspects of structure, participation, and devolution. Though the physical development of irrigation has made considerable progress in India, the proper management and distribution of water has poised many difficulties. The consequences of this are poor efficiency in water use, inequity in distribution, disputes, high cost, and substantial under-utilization of the potential created. On the other hand, institutional initiatives that aim to improve water management and distribution are seen in some areas/locations, and show a process of arriving at better institutional arrangements. Water institutions are crucial for eastern India and though there are a few examples of spontaneous bottom-up initiatives, much of this development is driven by external interventions including laws, policies, and government programs. Even though under the government interventions, the guidelines and policies are usually uniform and top-down, the local uptake and adoption show substantial variation and divergence and this deserves study. The research is based on review of the literature as well as on six in-depth case studies, and also responses of 510 households involved with 51 participatory water institutions in the setting of the eastern Indo-Gangetic plains states of Assam and Bihar. The paper first takes a brief look at the literature on the foundations and experiences of participatory irrigation management (PIM), and then examines through the case studies and data, the development and variation in the PIM water institution in the given setting. It examines features such as laws, membership, structure, inclusion, participation/involvement and devolution. It finds that inclusion of various groups of people in the institutions is quite good except for women and youth. However, actual involvement of different people varies substantially. The issue of devolution/decentralization versus centralization in decision-making is very important to PIM, and varies across the structure and functions. The association of involvement and devolution to performance indicates that the active involvement of some functionaries and groups is very important, and that devolution in several decisions can considerably enhance performance. The observations provide many useful insights for policy and institutional design which can help improve water resource management in the eastern Indo-Gangetic plains. [ABSTRACT FROM AUTHOR]

This article aims to unravel how a weak state develops state capacity – an aspect hitherto ignored in mainstream literature. This is a study of a sub-national case of Bihar in India. Historically, Bihar is considered a weak state, lacking state capacity. Yet, improvements have occurred in recent decades. By profiling two areas of improved outcomes: infrastructure (roads and bridges) and welfare (distribution of bicycles to school-going girls), the article argues that the improvements are the outcome of the political and bureaucratic elite's ideas and political will. The case of Bihar shows that the rationalities within a state depend on social learning, puzzling, and powering, having a powerful impact on policy paradigms even in weak states. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In a number of countries, youth unemployment is a pressing concern. In India, 54% of the country's population is below the age of 25 and faces a high rate of (disguised) unemployment. To augment youth employment, the Government of India has launched a number of skills training programs. This paper deals with participation in and the impact of one of these programs [Deen Dayal Upadhyaya Grameen Kaushal Yojana (DDUGKY)] located in rural Bihar, one of India's poorest states. The analysis is based on data collected in mid-2016 and compares trained participants with non-participants who applied for the scheme but eventually did not attend. We find that the training program squarely reaches the intended target group—rural poor youth. Initially, the program leads to a 29 percentage point increase in the employment rate of the trained graduates. However, 2–6 months after the training, the employment effect of the program drops to zero. A third of the placed graduates leave their jobs due to caste-based discrimination, and another third leave due to a mismatch between the salaries offered and their living costs. The upshot is that while the training program enhances job market prospects, other labor market factors undo the positive effects. [ABSTRACT FROM AUTHOR]

Highlights • We use field experiments in India to understand how farmers process information. • Most farmers simplify judgments by using only a portion of the information set. • Nearly 40% of farmers rely on first impressions to make subsequent judgments. • More than 36% of farmers use only the most recent piece of information. • Farmers who simplify judgments are less likely to cultivate rice hybrids. Abstract Much empirical research that has shown that an individual's decision to adopt a new technology is the result of learning – both in personal experimentation as well as observing the experimentation of others. Yet even casual observation would suggest significant heterogeneity learning processes, manifesting itself in widely varying patterns of adoption over space and time. In this paper we explore this heterogeneity in the context of early adoption of hybrid rice in rural India. Using specially-designed experiments conducted as part of a primary survey in the field, we are able to identify which of four broad learning heuristics most accurately reflects individuals' information processing strategies. Linking these learning heuristics with observed use of rice hybrids, we demonstrate that pure Bayesian learning is well suited for the tinkering and marginal adjustments that would be required to learn about a technology like hybrid rice, but is also more cognitively taxing, requiring a longer memory and more complex updating processes. Consequently, only about 25 percent of the farmers in our sample can be characterized as pure Bayesian learners. Present-biased learning and relying on first impressions will likely hinder adoption of a technology like hybrid rice, even after controlling for access to credit and a rudimentary proxy for intelligence. [ABSTRACT FROM AUTHOR]

Objective Visceral Leishmaniasis (VL) is highly prevalent in Bihar, India. India and its neighbours aim at eliminating VL, but several knowledge gaps in the epidemiology of VL may hamper that effort. The prevalence of asymptomatic infections with Leishmania donovani and their role in transmission dynamics are not well understood. We report data from a sero-survey in Bihar. Methods Demographic and immunological surveys were carried out in July and November 2006, respectively in 16 highly VL endemic foci in Muzaffarpur district in Bihar. Household and individual information was gathered and capillary blood samples were collected on filter papers. Direct agglutination test (DAT) was used to determine infected individuals (cut-off titre 1:1600). DAT results were tabulated against individual and household variables. A multivariate generalized estimating equation (GEE) model was used to study the prevalence of serologically positive individuals taking into account the clustering at household and cluster levels. Results Of study subjects 18% were DAT positive, and this proportion increased with age. Women had a significantly lower prevalence than men >14 years old. Owning domestic animals (cows, buffaloes or goats) was associated with a higher risk of being DAT positive [OR 1.16 (95% CI 1.01–1.32)], but socio-economic status was not. Conclusions Prevalence of leishmanial antibodies was high in these communities, but variable. Demographic factors (i.e. marriage) may explain the lower DAT positivity in women >14 years of age. Within these homogeneously poor communities, socio-economic status was not linked to L. donovani infection risk at the individual level, but ownership of domestic animals was. [ABSTRACT FROM AUTHOR]

The subject matter of this paper, in general, is federalism in India. Three recent instances of the impact of Article 356 - the 'Emergency Provisions' - are analyzed to study two questions. How is federalism affected when different political parties are in power in the States and at the federal level, and does the current coalition government's experience help or hinder federalism? As to the first question, the two States of Jharkhand and Bihar, with particular emphasis on the latter, in the aftermath of the 2005 elections are examined. In both cases, it was blatant federal intervention that led to the dismissal of the duly elected governments in these States solely on political considerations and the advice of the Governors who were appointed by the federal government. The third is the case of the State of Uttar Pradesh where in 2006-2007 an attempted use of this Article was thwarted by the Election Commission. As to the second question, the use or the very threat of using Article 356 to dismiss duly elected State governments under the pressure of coalition partners at the Centre does not augur well for constitutional government or coalitions, and certainly not for federalism. In any case, Indian federalism lives up to the moniker as pointed out by C. H. Alexandrovictz that it is sue generis. [ABSTRACT FROM AUTHOR]

What factors influence women's political success in ethnically divided societies? Using an original survey experiment in the Indian state of Bihar, supplemented with qualitative interviews, we explore the impact of two factors—intersecting gender and caste identity, and the interaction of campaign appeal with voter experiences of caste discrimination—on women candidates' success in state-level elections. We find, first, that women voters prefer women candidates, and that Scheduled Caste and Muslim voters also prefer candidates from their in-groups. At the same time, we identify evidence of intersectional effects, namely, that Muslim women candidates suffer from a disadvantage vis-a-vis women candidates from other backgrounds. We also show that women voters prefer candidates who offer security, especially when the candidates are women. Finally, we demonstrate that personal experience with caste discrimination increases support for women candidates. These results indicate that voters see women leaders as well-placed to ameliorate their security vulnerabilities. [ABSTRACT FROM AUTHOR]

The transformational power of education is considered crucial to improving life outcomes. However, girls in rural India often still face barriers to learning. The literature notes economic and socio-cultural barriers to girls' education which both mediate, and are affected by, parental aspirations. This research explored the aspirations for girls' education of members of a grassroots microfinance organisation in rural Bihar through one-on-one interviews and focus group discussions. Economic factors, such as increased awareness of employment opportunities and changing financial situations enabled mothers to act on their pre-existing aspirations for daughters' education, supported by shifts in the requirement of higher levels of education for marriage. Mothers also emphasised the potential for education to enhance their daughters' wellbeing as influencing their aspirations. Therefore, policymakers must prioritise education that has a socially transformative agenda, as well as providing support to tackle economic and socio-cultural barriers to girls' education. [ABSTRACT FROM AUTHOR]

Self‐help groups (SHGs) are used as instruments for changes in health‐related behaviour. We evaluated the impact of the Health and Nutrition Strategy of JEEViKA on the dietary practices of infants in rural areas of Bihar. Propensity score matching revealed that the probability of exclusive breastfeeding until 6 months and starting complementary feeding after 6 months was higher by 5% and 3%, respectively, if the respondent was an SHG member. The average treatment effects on treated using attendance in meetings as the treatment variable found that the programme had increased breastfeeding only, with there being peer effects also. The study recommends encouraging attendance in SHG meetings. [ABSTRACT FROM AUTHOR]

Background: Circular migration is the dominant pattern of movement in India and is a livelihood strategy used by many food insecure rural households. Repeated shifts in food environments have important implications on household food security and dietary patterns but have not been studied. Objective: To explore differences in the food environment, food security, and food availability between home and destination spaces. Methods: Mixed-methods research was conducted among circular migrant families working and residing on brick kilns in the state of Bihar. Utilizing stratified cluster sampling, 2 rounds of cross-sectional data were collected from 2564 families. Additionally, 25 in-depth interviews were conducted with circular migrant parents, kiln owners, and labor contractors. The Food Insecurity Experience Scale was validated for use in our study population. Bivariate analyses were conducted to estimate the association of food insecurity with sociodemographic variables. Qualitative data were analyzed using descriptive thematic methods. Results: Seventy percent of respondents utilized at least one nonmarket source of food at the origin; at the destination, sources of food were limited to the private market. Despite higher food prices at the destination, perceived food affordability was higher during periods of migration, resulting in improved food security. Tubers, rice, and wheat were typically available in the household daily, whereas fruits, eggs, and dairy were typically unavailable during the week. Conclusions: Circular migration can enable short-term food security by improving food affordability. Policy frameworks must address the root causes of chronic food insecurity, especially among rural-to-rural circular migrant families. [ABSTRACT FROM AUTHOR]

This article seeks to address a thematic thread that remains relatively unexplored in historical disaster research—victimhood—through an analysis of publications by disaster relief funds and their supporters in the aftermath of the 1934 earthquake in Bihar in northern India. By examining the representations of victimhood, I aim to explore the historical significance of perceptions and constructions of victimhood in the late colonial period. Based on photographs, illustrations, and descriptions of suffering in images and texts, the article suggests that constructions of victimhood effectively relied on imagery that contained, on the one hand, an absence of bodies and, on the other, a feminized anthropomorphization of suffering. The narratives underlying such depictions of earthquake victims are based on a constitution of victimhood that relied on contemporary historical and culturally founded imageries. The analysis of images and texts focuses on how representations of disaster victims were effective in communicating suffering to audiences. I tentatively argue that historically and culturally founded tropes of what constituted a victim formed along two narratives of victimhood that appealed to a colonial and a nationalist readership respectively. These conceptualizations of victimhood formed the basis for collecting aid for relief and reconstruction, rather than the loss of life, dispossession, social marginalization, and displacement suffered by victims of the earthquake. [ABSTRACT FROM AUTHOR]

Engaging with different literatures in economic geography, postcolonial urbanism, and planetary urbanization, this article seeks to develop a theoretical understanding of remote urban formations taking shape in India's countryside. The analysis draws on extensive primary data collected at two study sites in Bihar and West Bengal, which rendered an uncommonly rich data set for such remote areas. We observe emergent urban formations that result from densification, expansion, and amalgamation of built-up environments and a massive shift of employment out of the agricultural sector. At the same time, alternative local economic opportunities are scarce, giving way to significant increases in circular labor migration. We introduce the concept of injected urbanism to denote a form of urbanization that is exogenously generated through remittances, in the absence of significant local agglomeration processes. The infusion of remittances drives local economic restructuring and the emergence of a consumption economy. Injected urbanism spurs local development, but its dependence on economic activity elsewhere raises important questions about its sustainability. [ABSTRACT FROM AUTHOR]

Access to improved toilets can enhance physical and mental security among women. Therefore, it becomes critical to incorporate and understand their decisions on household toilet construction. Using survey data from 2528 households across urban slums, peri-urban and rural areas from the state of Bihar in India, we study two particularly relevant aspects surrounding women's decision making in sanitation. First, we examine if exclusive usage of toilets is systematically higher when the decision of its construction is taken solely by a woman. Secondly, we assess the potential household-level factors associated with women-led decision making. The findings, after accounting for the unobserved heterogeneity surrounding the selection of households with toilets, indicate a statistically insignificant increase in the likelihood of its exclusive usage in households where decision of its construction had been solely led by women. When we look at the settlement types individually, this relationship is found to be significant in the peri-urban areas. Additionally, among households with toilets, poorer women are more likely to take sole decisions about its construction. This, we argue is potentially because of sanitation interventions over the years that have been relatively successful in motivating poor women to influence toilet construction. [ABSTRACT FROM AUTHOR]

The COVID‐19 crisis re‐shaped many livelihood options and placed significant burdens on those with precarious incomes exacerbating persisting vulnerabilities, especially among a large section of the migrant population. This group faced a dual threat – both to their livelihood and health. To understand the consequences of this pandemic on the income of the migrant population, a household level survey was conducted in the state of Bihar, India, which is one of the highest migrant‐sending states. We examine the role of differences in the socio‐economic status of migrants and their households in determining the extent of vulnerability caused by the COVID‐19 crisis. Vulnerability is proxied by the income lost by migrants during the lockdown. The results suggest that households with diversified income portfolio, larger landholdings, and those receiving government benefits suffered significantly lower income loss whereas, larger household size and greater distance from town tended to escalate income loss. Additionally, private salaried workers faced higher income loss and an increment in years of education lowers the losses significantly. It is observed that individual‐level characteristics also played a significant role in determining economic loss due to the lockdown. Our findings suggest a binding necessity to actively shape policies considering the financial insecurity of vulnerable migrants at their destination and the household members at the origin. [ABSTRACT FROM AUTHOR]

The paper examines the nature and performance of participatory water institutions in eastern India using structural equation modelling. There is a crisis in the management of water in India, and this is often not about having too little water but about managing it poorly. It is now being widely recognized that engineering structures and solutions are not enough, and having effective water institutions is critical. These are urgently needed in eastern India for helping lift the region out of low incomes and poverty. However, creating good institutions is complex, and in this context, the fundamentals of new institutional economics, and management governance theory have suggested the importance of a number of key factors including five institutional features and eight rationalities. Based on this, a study was conducted in eastern India, sampling from the states of Assam and Bihar, covering 510 farm households across 51 water institutions. In order to understand and map the relationship and pathways across these key factors, a structural equation model is hypothesized. In the model, the five institutional features are considered determinants of the eight rationalities, and the rationalities are considered determinants of four performance goals. The performance on the goals determines the overall performance/success of the institution. Besides this, the institutional features and rationalities can also directly influence performance on the goals and the overall performance. The model is tested with data from the survey and different pathways that are robust are identified. The results can provide useful insights into the interlinkages and pathways of institutional behavior and can help policy and institution design for delivering more robust performance. The results show that one of the most important factors determining overall performance/success is technical rationality, and this deserves great attention. It includes technical expertise, sound location and quality of structures and equipment, and good maintenance. However, success is also strongly linked to performance on production/income goals, equity, and environment goals. These are, in turn, strongly related to achievement of economic, social, technical, and organizational rationalities, which call for attention to economic aspects such as crop choice and marketing, besides social aspects such as inclusion of women and poorer social groups, and organizational aspects such as member involvement and regular meetings. Further, the institutional features of clear objectives, good interactions, adaptive, correct scale, and compliance are important for achievement of almost all rationalities through various pathways, and should be strongly focused on in all the institutions. [ABSTRACT FROM AUTHOR]

The paper examines the extent, nature, and factors affecting women's involvement in participatory irrigation institutions of eastern India. Effective participatory water institutions are urgently needed to improve water management in eastern India, and a significant aspect of this is the involvement of women. There is inadequate representation, participation, and involvement of women in most water institutions. From the participatory and social point of view, this is a significant concern. The relevant data are obtained from the states of Assam and Bihar through a focused survey administered to 109 women in 30 water institutions, and a larger farmer-institutional survey covering 510 households and 51 water institutions. The research examines the extent and nature of the involvement of women in these institutions, as well as in farm decision-making, and the factors that prevent or foster their participation. Additionally, it examines the gender congruence in views regarding water institution activities and their performance, and the perceived benefits of formal involvement of women. The results show that their inclusion is very low (except required inclusion in Bihar), and the concerns of women are usually not being taken into account. Women are involved in farming and water management decisions jointly with men but not independently. Findings indicate that the views of women and men differ on many aspects, and so their inclusion is important. Responses indicate that if women participate formally in water user associations, it would enhance their social and economic standing, achieve greater gender balance, expand their awareness of water management, and contribute to better decision-making in the water institutions. [ABSTRACT FROM AUTHOR]

The paper examines the performance of participatory water institutions in India's Eastern Indo-Gangetic plains region using new institutional economics and management governance fundamentals. Water institutions are of great importance for water resource management in India's Eastern Indo-Gangetic plains since the region has relatively abundant water but lags behind significantly in economic development and growth with a high incidence of poverty. Engineering solutions to water management have been implemented but have not given good results principally because of weak institutional development and design in the region. Effective and efficient participatory water institutions are urgently needed. The research uses concepts from new institutional economics and management governance theory to build a conceptual framework for explaining the performance of participatory water institutions. The framework identifies eight institutional rationalities: technical, environmental, economic, social, political organizational, financial and government; as well as five institutional features: clear objectives, good interaction, adaptiveness, right scale, and compliance, as linked to performance. Based on this, a survey instrument was developed and a survey conducted obtaining responses from more than 500 households across 51 such institutions in the eastern Indo-Gangetic plains states of Assam and Bihar. The data were analyzed through statistical and econometric techniques including Ordered-Probit. The results support the relevance of the concepts in explaining performance of water institutions, and a number of drivers of performance were identified through Ordered-Probit, particularly, four rationalities—technical, economic, social and organizational, (with coefficients (0.4622, 0.3803, 0.4303, 0.2457) and three institutional features—good interaction, adaptiveness and appropriate scale (with coefficients 0.4242, 0.2703, 0.6756) (based on a 5-point Likert scale), as playing a positive and significant role in enhancing performance. The results provide a number of useful insights which can help guide interventions and policy towards better design and development of the water institutions, and help improve water resource management and livelihoods in the region. [ABSTRACT FROM AUTHOR]

Background: The study examined the prevalence of self-reported menstrual irregularities during adolescence and explored the association of depressive symptoms with self-reported menstrual irregularities in adolescents in two major states of Uttar Pradesh and Bihar in India. Methods: This study is based on the data obtained from the first round of the "Understanding the lives of adolescents and young adults" (UDAYA, 2016) survey. The effective sample size for the study was 12,707 adolescent girls aged 10–19 years. A bivariate analysis with chi-square test was conducted to determine the self-reported menstrual irregularity by predictor variables. Multivariable logistic regression models were employed to examine the associations between self-reported menstrual irregularity, depressive symptoms and other explanatory variables. Results: A proportion of 11.22% of adolescent girls reported menstrual irregularity and 11.40% of the participants had mild depressive symptoms. Adolescent girls with mild (AOR: 2.15, CI: 1.85–2.51), moderate (AOR: 2.64, CI: 2.03–3.42) and severe depressive symptoms (AOR: 2.99, CI: 2.19–4.10) were more likely to have menstrual irregularity as compared to those who had minimal depressive symptoms. Physically active adolescent girls were less likely to report menstrual irregularity (AOR: 0.82, CI: 0.73–0.93) than physically inactive girls. Adolescent girls who used piece of cloth for menstrual hygiene practices (AOR: 1.17; CI: 1.02–1.35) and those who used either napkin or cloth or other materials (AOR: 1.32; CI: 1.14–1.54) had higher likelihood of menstrual irregularity as compared to those who used only sanitary napkins. Conclusion: A significant association of depressive symptoms with self-reported menstrual irregularity among adolescent girls was observed. Therefore, while treating females with irregular menstrual cycles, clinicians may need to pay greater attention to thir mental health peoblems. [ABSTRACT FROM AUTHOR]

Does deprivation of assets imply an increased likelihood of vulnerability to climate change? Our study attempts to answer this question by analyzing the multidimensional poverty in rural Bihar, followed by deciphering the link between the developed poverty index and vulnerability of agriculture to climate change. Vulnerability index used in the present study was developed under the National Initiative on Climate Resilient Agriculture (NICRA) by the Government of India. As most people in rural areas and those dependent on rural based livelihood activities (such as agriculture, forestry and livestock) are more vulnerable to vagaries of weather, related attributes (i.e. land ownership, livestock ownership as well as access to agriculture equipments) are included in our analysis. We found that the extent of multidimensional poverty in rural Bihar was 0.278 indicating that rural poor were deprived in 27.8 percent of the total potential deprivations that they could experience overall. It varied from 0.19 to 0.39 across districts. The findings highlight that a majority of the population were deprived in living standard dimension, followed by health and education dimensions. Further, the districts where the multidimensional poverty was high were also more vulnerable to climate change. The study advocates for formulation of district specific programs that can target major contributing factors resulting in reducing the extent of multidimensional poverty and vulnerability. [ABSTRACT FROM AUTHOR]

Drawing on data collected from a school-based study in India, this paper adds to the scant literature on the relationship between school quality and agency and attitudes of girls and boys in secondary schools; it also explores the better-researched association between school quality and academic competencies. The study was conducted among girls and boys in Class 10 in 30 government-run secondary schools in the state of Bihar. Findings show that classroom dynamics, particularly non-discriminatory treatment by teachers and their expression of gender egalitarian attitudes positively influenced gender role attitudes and awareness of health matters among girls and boys. It also influenced their academic performance. [ABSTRACT FROM AUTHOR]

Background: Glucocorticoids (GCs) are anti-inflammatory steroid medications prescribed globally by doctors for various illnesses and they are known to produce quick symptom relief. In India, they are among the cheapest and easily accessible over-the-counter medications. Thus, it can be misused, leading to many life-threatening illnesses such as diabetes mellitus, hypertension, overwhelming infections, Cushing's syndrome, and hypo-adrenal crisis. Objective: This study reports the misuse of GCs in a rural community in the state of Kerala, India, and compares it with the only other community GC misuse study in India, from the state of Bihar. Methods: A community-based cross-sectional survey of 452 households comprising 1,734 people was conducted in rural Konni, Kerala, during June and July of 2019. In each house, people who had been taking medications over the previous 6 months were interviewed. Results: Almost 2% (n = 31) had consumed one or more GCs in the last 6 months (95% CI: 1.3–2.5%). Of these, 26% (n = 8) were taking oral GCs and 36% (n = 11) of them were inappropriately using them based on current clinical guidelines. 29% (n = 9) had used GCs for more than 1 month. Conclusions: GC misuse exists in Kerala but not to the extent seen in Bihar. In Kerala, inhaled GCs are more common than oral GCs, and the prescription is obtained predominantly from qualified medical practitioners. The prevalence of prolonged GC use could be implicated as an underlying factor for diabetes, hypertension, osteoporosis, and cataracts. It is possible that approximately 220,000 people in Kerala may have a suppressed hypothalamus-pituitary-adrenal axis which can predispose them to a fatal hypo-adrenal crisis. [ABSTRACT FROM AUTHOR]