Good data critical to reducing poverty

Updated September 1, 2010 12:22:21

The UN is holding its world conference on the Millennium Development Goals in Melbourne but without good data it will be hard to know if those goals are being met.

The collection and use of data is critical in any outreach program.

Presenter: Sen Lam
Speaker: Dr Thelma Narayan, Indian epidemiologist and a member of the World Health Organisation's Commission on Social Determinants of Health

LAM: Dr Narayan, you've worked on rural health in India. First of all, tell us why data and information collection is important in helping to deliver good health care to the poor?

NARAYAN: Well, if we have certain goals that we have set for ourselves, we need to have some measure to know whether we're reaching our goals. And one of the important goals that we have is that of equity of achieving equity and health and access to health care. So this is vitally important to measure progress.

LAM: And where India is concerned, is such data properly collated and measured?

NARAYAN: Well, we do have difficulties because of the size of the population and the vastness of the country, but we have very good surveys that are conducted at regular intervals by specific organisations. Our routine data I have to say is limited and may not be completely valid.

LAM: And Thelma, we know of course that many factors affect health. For instance, war, globalisation, urbanisation, the lack of water. What are some of the factors affecting health for the poor in India?

NARAYAN: In fact, its these determinants of health, the underlying structural or social determinants of health that are extremely important and yes, defence expenditure does take away from the health and social sector budget, impact of globalisation...there is a big impact on livelihood. For instance in agriculture, 60 per cent of our population is dependent on agriculture and the prices of agricultural products as they go up and down the global markets affects this large proportion of our population. There are also local factors of course that affect agriculture. So you have a large number of farmers suicides that are happening over the past 15 to 20 years.

LAM: Well, you mentioned agriculture and of course much agricultural land has been destroyed in Pakistan. They are still struggling with its flood disaster. Polluted water is a major health threat to hundreds-of-thousands of survivors in Pakistan. Is access to clean water likely to figure as a major health issue in South Asia?

NARAYAN: It is, I mean there is a growing incidence of floods, landslides, etc. but there is also lowering of the water table and yes water is going to be one of the major issues. So some governments, especially local governments, municipal governments have already introduced water conservation measures have been mandatory, so rain water harvesting is mandatory in some cities like Bangalore, where I come from and in many other cities, but it is in our vast rural areas that we need to do much more water conservation.

LAM: And Thelma, India's economy of course has grown dramatically over the past ten years, 10-15 years. How has that affected public health, do you think, especially for the poor?

NARAYAN: Well, while there has been a huge economic growth, I have to say it has not resulted adequately in distributive justice and the large proportion of our children who are undernourished, of children are under five years of age we have about 40 per cent who are undernourished, and about 60 to 70 per cent of pregnant women are anaemic. So economic growth has not yet affected biological poverty or even the proportion of the people below the poverty line. We still have about 35 per cent of people as per official figures, but unofficially, some economists have said that about 70 per cent of people have a very low income that their daily per capita spending is extremely low and would be below the poverty line, our global poverty line if there was.

LAM: Well, that's quite a shocking statistic that you mentioned. Forty per cent of children under the age of five being undernourished. Obviously the government is not coping, so are people relying more and more from the help of the aid agencies?

NARAYAN: Well, we do have aid agencies, but in the health sector, the international aid only accounts for about 2 per cent of our spending on health. Nutrition, of course, is health-related. We do have some World Bank assistance, but there is government money, there is taxpayers money, I think there much more need, not just for political will, but for action, for political action, for social action to address these determinants. It is not a lack of resources alone. It is a question of distribution.