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Time of India
3 days ago
- Health
- Time of India
One in five women in WHO Southeast Asia region covered under health insurance, study estimates
New Delhi: About one in every five women in the WHO Southeast Asia Region , including India, are covered under a health insurance, a study published in The Lancet Regional Health Southeast Asia has estimated. One in eight women in the region - defined by the World Health Organization (WHO) - were enrolled in social security schemes. At the same time, only one in thirteen had privately purchased or commercial insurance, the analysis reveals. The 'WHO Southeast Asia Region' includes India, among other countries such as Bangladesh, Myanmar and Indonesia. Researchers from Health Systems Transformation Platform and Population Council Consulting Private Limited, New Delhi, also found that one in four men in the region had health insurance coverage, with the highest prevalence seen in Indonesia at over 56 per cent and lowest in Myanmar at about 1.5 per cent. In India, the prevalence of health insurance uptake was 53 per cent among women and 56 per cent among men, the team found. The highest levels of health insurance coverage for women and men in the region were found in Indonesia, while the lowest levels were reported in Bangladesh and Myanmar, respectively. Equity in accessing quality healthcare without experiencing financial hardship is key to achieving Universal Health Coverage (UHC) - one of the core aims of the United Nations' Sustainable Development Goals - especially in low- and middle-income countries in the WHO Southeast Asia Region, the authors of the study said. They added that healthcare demands and costs are expected to rise in the region as populations age. However, high out-of-pocket expenditures remain a barrier despite health insurance programmes in the region, they said. The study analysed socioeconomic and demographic factors to estimate coverage under any health insurance, using data from Demographic and Health Surveys (2015-2022) conducted in the WHO Southeast Asia Region every five years. "Approximately one in five women in the region were covered by any form of health insurance," the authors wrote. "In contrast, one in four men in the region had any health insurance coverage, with the highest prevalence observed in Indonesia (56.6 per cent) and the lowest in Myanmar (1.4 per cent)," they wrote. Older age, higher education levels, and higher exposure to media were found to positively influence insurance coverage for both men and women in India, Indonesia, Nepal, Bangladesh and Myanmar. Further, beyond individual factors, contextual ones such as government commitment, design and implementation of insurance schemes and economic conditions are crucial in determining health insurance coverage, the authors said. Traditional beliefs and a lack of trust in formal financial systems can hinder insurance adoption among South Asian communities, they added. Evidence suggests that in rural areas of India, Nepal and Bangladesh, people relied on community-based informal support systems over formal insurance, reflecting cultural preferences that affect enrolment rates, the team said. The study's findings, therefore, highlight that country-specific contexts need to be addressed to effectively expand health insurance coverage, the authors said. They suggested policies should prioritise building sustainable health financing systems, making healthcare infrastructures more resilient, and fostering widespread awareness in the community about the benefits of health insurance. Further, strategies aimed at resolving socioeconomic disparities and for the underinsured populations are vital in advancing equitable health insurance access and accelerating progress towards UHC, the team said. PTI
The Hindu
3 days ago
- Health
- The Hindu
One in five women in WHO Southeast Asia region covered under health insurance, study estimates
About one in every five women in the WHO Southeast Asia Region, including India, are covered under a health insurance, a study published in The Lancet Regional Health Southeast Asia has estimated. One in eight women in the region — defined by the World Health Organization (WHO) — were enrolled in social security schemes. At the same time, only one in thirteen had privately purchased or commercial insurance, the analysis reveals. The 'WHO Southeast Asia Region' includes India, among other countries such as Bangladesh, Myanmar and Indonesia. Researchers from Health Systems Transformation Platform and Population Council Consulting Private Limited, New Delhi, also found that one in four men in the region had health insurance coverage, with the highest prevalence seen in Indonesia at over 56 per cent and lowest in Myanmar at about 1.5 per cent. In India, the prevalence of health insurance uptake was 53 per cent among women and 56 per cent among men, the team found. The highest levels of health insurance coverage for women and men in the region were found in Indonesia, while the lowest levels were reported in Bangladesh and Myanmar, respectively. Addressing limited health insurance coverage Equity in accessing quality healthcare without experiencing financial hardship is key to achieving Universal Health Coverage (UHC) — one of the core aims of the United Nations' Sustainable Development Goals — especially in low- and middle-income countries in the WHO Southeast Asia Region, the authors of the study said. They added that healthcare demands and costs are expected to rise in the region as populations age. However, high out-of-pocket expenditures remain a barrier despite health insurance programmes in the region, they said. The study analysed socioeconomic and demographic factors to estimate coverage under any health insurance, using data from Demographic and Health Surveys (2015-2022) conducted in the WHO Southeast Asia Region every five years. "Approximately one in five women in the region were covered by any form of health insurance," the authors wrote. "In contrast, one in four men in the region had any health insurance coverage, with the highest prevalence observed in Indonesia (56.6 per cent) and the lowest in Myanmar (1.4 per cent)," they wrote. Older age, higher education levels, and higher exposure to media were found to positively influence insurance coverage for both men and women in India, Indonesia, Nepal, Bangladesh and Myanmar. Beyond individual factors Further, beyond individual factors, contextual ones such as government commitment, design and implementation of insurance schemes and economic conditions are crucial in determining health insurance coverage, the authors said. Traditional beliefs and a lack of trust in formal financial systems can hinder insurance adoption among South Asian communities, they added. Evidence suggests that in rural areas of India, Nepal and Bangladesh, people relied on community-based informal support systems over formal insurance, reflecting cultural preferences that affect enrolment rates, the team said. Bridging the health coverage gap The study's findings, therefore, highlight that country-specific contexts need to be addressed to effectively expand health insurance coverage, the authors said. They suggested policies should prioritise building sustainable health financing systems, making healthcare infrastructures more resilient, and fostering widespread awareness in the community about the benefits of health insurance. Further, strategies aimed at resolving socioeconomic disparities and for the underinsured populations are vital in advancing equitable health insurance access and accelerating progress towards UHC, the team said.
Daily Maverick
06-07-2025
- Health
- Daily Maverick
Free education benefits poorest girls most, Burundi study shows
New research in Burundi shows that scrapping primary school fees lifts all boats – but it's the poorest who benefit most in reproductive choices, literacy and income. Teenage pregnancy rates remain high across many parts of the developing world. In Africa, on average, about one in 10 girls between the ages of 15 and 19 has already given birth. These early pregnancies often come with serious consequences for young mothers and their children. They are linked to lower education levels, poorer health outcomes and reduced economic opportunities. Scientists, development agencies and NGOs have long heralded education as a powerful tool to reduce early childbearing. Education may directly influence women's reproductive behaviour, but it can also improve their employment and income-generating opportunities, leading them to postpone pregnancy. But does access to basic education for young girls result in such successes uniformly across population groups? We are economists who conducted a study to explore the effect of primary school education on fertility and its related outcomes in Burundi. A bold education reform took place in that country in 2005: the government abolished formal school fees for primary education. As a result, many children who had been excluded from school by cost were able to get a basic education. The free primary education policy displays a natural experiment for researchers interested in the effects of education. Because the reform applied only to children young enough to be in school, we could compare girls who were eligible for free schooling with those who were just too old to be eligible (but similar in other ways). This allowed us to track the policy's direct and causal effects. Indeed, we see that Burundi's free primary education policy increased educational attainment of women by 1.22 years on average. Our findings also provide new, robust evidence that education can reduce downstream effects, as we see teenage childbearing reducing by as much as 6.9 percentage points. In other words, whereas about 37% of teenage women who did not benefit from free primary education had given birth before the age of 20, only 30% of those eligible for free primary education had done so. Importantly, and new in our findings, education conferred the greatest benefit to girls from the poorest segment of society. Our study thereby underscores an important lesson for policymakers: education policies can be highly effective, but not necessarily for everyone in the same way. A natural experiment in Burundi We used nationally representative data from Burundi's Demographic and Health Surveys to establish the effects of education. We compared women born between 1987 and 1991 with those born between 1992 and 1996 – aged 14 to 18 and nine to 13, respectively, when the free school policy took effect. We applied modern econometric techniques to identify the increase in years of schooling induced by the policy. We then examined the effect of this increase in schooling on girls' outcomes, including teenage pregnancy, literacy and the likelihood of working for cash income, among other outcomes. The results were striking. Girls who had been young enough to benefit from free schooling gained, on average, 1.22 more years of education thanks to the programme. That corresponds to a 34% increase in the years of education compared with similar women who missed out on the policy. Crucially, this increase occurred across the board – both poor and wealthier women gained more education. But there was a twist: only young women from poor backgrounds seemed to reap broader benefits from that extra schooling. For girls from very low-income households, one additional year of schooling reduced the likelihood of becoming a teenage mother by nearly seven percentage points. It also decreased their desired number of children and boosted their literacy and chances of working for a cash income outside their own home. These are all powerful indicators of women gaining autonomy and making more informed reproductive choices. Although girls from wealthier households experienced an increase in education too, this additional schooling showed no measurable effect on fertility, literacy or employment outcomes for them. Thus, we did not find any statistically significant impact of increased schooling for these girls. In other words, the free primary education programme in Burundi increased the number of years of education for girls in general, but the downstream effects of that education appear to have materialised only for the very poor. Why does household wealth matter? Why would women from relatively wealthier families not benefit equally from more education? One reason could be that somewhat wealthier households had already ensured higher levels of education for their daughters, even before school fees were abolished in Burundi. The education reform thus made less of a difference in their lives. Very poor families, on the other hand, were far more likely to be constrained by the costs of primary education. When that barrier was removed, their daughters could finally access schooling, and this had transformative effects also for sexual and reproductive health. For the most disadvantaged, education is more likely to open up new economic opportunities. We found that policy-induced education increased their likelihood of working outside their own household for a cash income, which raises the opportunity cost of early childbearing. The classic economic theory by Nobel Prize laureate Gary Becker and colleague Jacob Mincer suggests that when women have better employment prospects, they are more likely to postpone childbirth. And they invest more in their children but tend to have fewer of them. This is precisely what we observed in our data. Education also seems to empower women by increasing their knowledge and capacity to access information. We found that literacy rates among poor women rose significantly with each added year of schooling. Another prominent theory in the literature on education is that educated women are more likely to understand and use contraception, make informed reproductive decisions and challenge traditional gender norms. Rethinking one-size-fits-all policies Our study underscores an important lesson for policymakers: education policies can be highly effective, but not necessarily for everyone in the same way. When evaluating the success of reforms like free primary education, we must go beyond average effects. Aggregated data can mask substantial differences between groups. If we had only looked at average outcomes, we might have concluded that free schooling had little effect on teenage childbearing. But by disaggregating our data by household wealth, we see a different and far more hopeful picture. Free schooling has powerful effects – if we know where to look. DM First published by The Conversation. Frederik Wild is a postdoctoral researcher at the University of Heidelberg in Germany. David Stadelmann is chair of economic policy and economic development at Bayreuth University in Germany. This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R35.
The Hindu
10-06-2025
- Politics
- The Hindu
India's population reaches 146.39 crore, fertility rate drops below replacement level: UN report
India's population is estimated to have reached 146.39 crore by April, says a new UN demographic report, which adds that the country's total fertility rate (TFR) has declined to 1.9, falling below the replacement level of 2.1. The population is expected to grow to 170 crore before starting to dip in about 40 years, the report titled 'State of the World Population 2025: The Real Fertility Crisis' says. It calls India the 'world's most populous nation', while pegging former leader China's current population at 141.61 crore. The demographic indicators in the United Nations Population Fund report for 2025 are close to India's own projection of its population published in 2019 by a technical group of experts. According to these projections, India, as of 2025, is estimated to have a population of 141.10 crore. The decennial Census, due to have been conducted in 2021, has been delayed and the government has now announced that it will be completed by March 2027. The last Census was conducted in 2011. According to the latest Sample Registration System statistical report published by the Office of the Registrar General of India for 2021, the TFR in India was 2.0, the same as the year before, with the report saying that the replacement level TFR 'has been attained' nationally. The TFR measures the number of children a woman is expected to have throughout their reproductive age. Replacement level TFR is the rate needed for each generation to replace the previous generation's population. The real crisis The UN report says that millions of people are not able to realise their real fertility goals. Calling this the 'real' crisis, and not overpopulation or underpopulation, the report calls for the pursuit of reproductive agency — a person's ability to make free and informed choices about sex, contraception and starting a family — in a changing world. India's youth population remains significant, with about 24% of the population in the age bracket of 0-14, 17% in age group of 10-19, and 26% in the age group of 10-24. Further, the report estimates that 68% of the population in India is of working age (15-64 years). The elderly population (65 and older) currently stands at 7%, a figure that is expected to rise in the coming decades as life expectancy improves, it adds, confirming the projections the government in India has been working with. The UN report says that as of 2025, life expectancy at birth is projected to be 71 years for men and 74 years for women. The report says its statistical tables on demographic indicators 'draw on nationally representative household surveys' such as 'Demographic and Health Surveys (DHS) Multiple Indicator Cluster Surveys (MICS), United Nations organizations estimates, and inter-agency estimates'. 'They also include the latest population estimates and projections from World Population Prospects: The 2024 revision, and Model-based Estimates and Projections of Family Planning Indicators 2024 (United Nations Department of Economic and Social Affairs, Population Division),' it adds.
Observer
06-05-2025
- Health
- Observer
America is erasing the data the world needs
In recent months, thousands of web pages and datasets have been removed from United States government websites. An informal army of 'data rescuers' has emerged to download, save and republish vital information, including some 300,000 datasets on before it is lost. But preserving existing data is only a temporary measure. The bigger question is how future data — particularly the health and climate data that are essential to guide policy — will be produced and published. This is not just an American problem. The US government has long supported the production of official statistics in low- and middle-income countries. For example, the Demographic and Health Surveys (DHS) programme has been helping to produce survey data on key indicators such as child health and nutrition in 90+ countries for more than 40 years. These data have guided the development of countless valuable initiatives, from a support programme for pregnant women in Pakistan to an app that broadens access to support for victims of domestic violence in Uganda. Ten of the 17 United Nations Sustainable Development Goals rely on DHS data to track progress. But US President Donald Trump's administration has now suspended the DHS programme indefinitely and is dissolving the US Agency for International Development (USAID), which runs it. Alternative means of producing important health, demographic and other social data are urgently needed. One useful change would be to make better use of administrative data — the data that flow through government systems every time a new patient enters a hospital, a classroom register is taken in a school, or a new baby is born — rather than relying primarily on surveys. With efforts to consolidate and streamline major household-survey programmes already under way, greater reliance on administrative data would simply require a shift in focus — and investment — by governments and development partners. Climate data are also under growing pressure. The US administration has removed or made less accessible datasets the world relies on to track and predict changes to the climate. Meanwhile, proposed funding cuts are casting doubt on the future collection and analysis of such data. Even the data that are collected might not be shared internationally, given America's withdrawal from multilateral initiatives like the Intergovernmental Panel on Climate Change. The US government has long supported the production of official statistics in low- and middle-income countries. While the European Union, Japan and others also have huge climate-data programmes, filling the gap left by the US will take considerable time and money, both of which are in short supply. Given this, innovators are needed to devise new tools and models; and to realise the full potential of new technologies, such as AI. The US government is not just erasing or obscuring data; it is also floating proposals to alter how data are reported. For example, Secretary of Commerce Howard Lutnick has suggested dropping government-spending measures from GDP calculations. This change would make it more difficult to assess the impact of the US administration's massive federal spending cuts on the US economy. But established norms exist for a reason: they ensure the reliability and comparability of data over time and across countries. Lutnick's proposed change would undermine the reliability and usefulness of cross-country GDP comparisons. The international statistical community must therefore hold firm in defending long-established methods and principles, with the support of partners who recognise the critical importance of this often-overlooked but essential government function. Statisticians, data scientists and open-data advocates around the world are developing strategies and taking action to recover, protect and future-proof data. Data producers and users, in the US and elsewhere, can support these efforts — which will be neither easy nor straightforward — in five ways. First, they should monitor developments carefully. What changes in data policy are governments announcing and on what time scale? When datasets are removed and then reposted, have they been altered? Tracking such changes is essential to support advocacy to restore essential data. Second, they should develop compelling use cases and advocacy alliances. Government data not only support social progress; businesses and AI systems also depend on comprehensive, high-quality data for innovation and decision-making. Major corporations, including tech companies at the forefront of AI development, are potential allies in advocating for the continued production and sharing of robust data in every country. Third, new data-collection strategies must be implemented. Faced with reduced funding, countries should streamline household surveys, expand the use of sources like administrative and citizen data, share satellite data and contribute to a robust global data ecosystem. Fourth, to discourage arbitrary changes that undermine analysis and complicate comparisons, standards for collecting and publishing statistical and other data, such as GDP, should be strengthened and publicised. Finally, given that prevailing methods for collecting and publishing national data were never perfect, the current upheaval can be viewed as an opportunity to collaborate to improve methodology and data governance. Any such effort to rethink how data is collected and used should emphasise global and regional collaboration, information sharing; and alignment of methods and standards. @Project Syndicate, 2025
