Healthcare benefits linked with Below Poverty Line registration in India: Observations from Maharashtra Anaemia Study (MAS) [version 1; peer review: 2 approved]

Ahankari, Anand; Fogarty, Andrew; Tata, Laila; Myles, Puja

Abstract

© 2017 Ahankari A et al. A 2015 Lancet paper by Patel et al. on healthcare access in India comprehensively discussed national health programmes where some benefits are linked with the country's Below Poverty Line (BPL) registration scheme. BPL registration aims to support poor families by providing free/subsidised healthcare. Technical issues in obtaining BPL registration by poor families have been previously reported in the Indian literature; however there are no data on family assets of BPL registrants. Here, we provide evidence of family-level assets among BPL registration holders (and non-BPL households) using original research data from the Maharashtra Anaemia Study (MAS). Social and health data from 287 pregnant women and 891 adolescent girls (representing 1178 family households) across 34 villages in Maharashtra state, India, were analysed. Several assets were shown to be similarly distributed between BPL and non-BPL households; a large proportion of families who would probably be eligible were not registered, whereas BPL-registered families often had significant assets that should not make them eligible. This is likely to be the first published evidence where asset distribution such as agricultural land, housing structures and livestock are compared between BPL and non-BPL households in a rural population. These findings may help planning BPL administration to allocate health benefits equitably, which is an integral part of national health programmes.

Citation

Ahankari, A., Fogarty, A., Tata, L., & Myles, P. (2017). Healthcare benefits linked with Below Poverty Line registration in India: Observations from Maharashtra Anaemia Study (MAS) [version 1; peer review: 2 approved]. F1000Research, 6, Article 25. https://doi.org/10.12688/f1000research.10556.1

• Journal Article Type: Article
• Acceptance Date: Jan 2, 2017
• Online Publication Date: Jan 9, 2017
• Publication Date: Jan 1, 2017
• Deposit Date: Feb 22, 2018
• Publicly Available Date: Mar 9, 2018
• Journal: F1000Research
• Electronic ISSN: 2046-1402
• Publisher: F1000Research
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Article Number: 25
• DOI: https://doi.org/10.12688/f1000research.10556.1
• Public URL: https://hull-repository.worktribe.com/output/596850
• Publisher URL: https://f1000research.com/articles/6-25/
• Additional Information: Referee status: Indexed; Referee Report: 10.5256/f1000research.11375.r19107, Sunil M. Sagare, Department of Community Medicine, MIMSR Medical College, Latur, Maharashtra, India, 19 Jan 2017, version 1, indexed; Referee Comment: Anand Ahankari; Posted: 05 Mar 2017; Dear Dr Sagare, Thank you for reviewing and submitting your comments, much appreciated. Dr Anand Ahankari. ; Referee Report: 10.5256/f1000research.11375.r19814, Umesh Wadgave, Mahesh Khairnar, Bharati Vidyapeeth Deemed University Dental College and Hospital, Sangli, Maharashtra, India, 06 Feb 2017, version 1, indexed; Referee Comment: Anand Ahankari; Posted: 24 Mar 2017; Dear Dr Wadgave and Dr Khairnar, Thank you for your valuable time to review our research article. I have provided a brief response to your comments below. Regarding comment 1, 2, 4, 6 and 7: This paper used a retrospective dataset available from Maharashtra Anaemia Study, where the primary objective was to identify risk factors associated with adolescent and pregnancy anaemia in rural population of Maharashtra state of India. We had limited data on social class and family assets, which was used against the BPL status in the analysis. We agree that our variables are different compared to the listed BPL indicators. Nevertheless, our data reported discrepancies in the current BPL status, which is an incidental finding. We suggested to investigate the current challenges in the BPL administration to ensure appropriate allocation and monitoring. We have not suggested any policy changes based on our research. We acknowledge limitations of our study, and further work is necessary to address the outlined challenges. Due to article length restrictions, we could not add more on the study strengths and limitations. We hope that readers will find this comment section useful for additional clarification. Regarding comment 3: The article has only one table (Table 1). In this table, there are 2 sections, adolescent girls and pregnant women. Each section used different variables (from 2 individual datasets). Therefore, statistical presentations are different as presented in the Table 1 for each study group. Regarding comment 5: As you may see in the attached datasets, we collected different set of variables from study participants, thus analysis was conducted independently for the two study groups. Data from pregnant women had more variables compared to adolescent girl dataset. Therefore, we could not combine these to form a single source. I hope that F1000Research readers will find this section useful. Thank you once again for providing this opportunity to respond to your comments. Dr Anand Ahankari; Grant Information: The Maharashtra Anaemia Study (MAS) was conducted as part of Dr Anand Ahankari’s PhD programme with the University of Nottingham UK, which was sponsored by the University’s Vice Chancellor Scholarship for Research Excellence International 2013 (Tuition fee support, Ref 12031). The anaemia project conducted in Maharashtra, India, was a joint collaboration between the University of Nottingham and the Halo Medical Foundation (HMF), with the latter providing laboratory testing and data storage facilities. Project management and data collection were funded by Dr Hardikar through the Maharashtra Foundation, USA. Dr Ahankari also received a bursary from the Durga Devi Charitable Trust, India during the PhD studies. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.; Copyright: This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Data associated with the article are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication).
• Contract Date: Mar 9, 2018