POVERTY AND HEALTH RESEARCH CHALLENGES FROM THE ...[1]

PLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+-+I%0d%0a%0d%0aHANDLING+CONTEXT+SINCE+1990s%0d%0a%e2%80%a2+%e2%80%a2+%e2%80%a2+%e2%80%a2+%e2%80%a2+Poverty+Social+and+Economic+inequalities+(between+and+within+countries+and+people)+People+moving+into+poverty+People+socially+excluded+or+marginalized+Health+consequences+of+poverty+and+marginalized+are+better+documented%0d%0a%0d%0a%e2%80%a2%0d%0a%e2%80%a2+%e2%80%a2%0d%0a%0d%0aNew+economic+policies+weakening+state+commitment+to+health+of+the+poor%0d%0aHealth+sector+reforms+eroding+effectiveness+of+weak+public+health+system+particularly+for+poor+Unregulated+private+sector+growth+undermining+poor+people%e2%80%99s+access+to+health%0d%0a%0d%0aEMERGING+CONSENSUS%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+II%0d%0a%0d%0aIMPERATIVES+FOR+RESEARCHERS%0d%0a%e2%80%a2+%e2%80%a2+%e2%80%a2+%e2%80%a2+Measuring+%e2%80%98poverty%e2%80%99+-+WHAT+%26+HOW+Contextualising+%e2%80%98poverty%e2%80%99+in+our+problem+analysis+Capturing+the+realities+of+poor+people%e2%80%99s+lives+Keeping+%e2%80%98poor+and+marginalised%e2%80%99+in+context+when+concluding%0d%0a-+Access+to+health+interventions+-+Effects+of+health+interventions+-+Recommendations+from+operational+or+health+system+research%0d%0a%0d%0a*+Going+beyond+bio-medical+determinism+to+social+determinants+like+%3a%0d%0a-+Class+-+Gender+-+Stigma+-+Ethnic+discrimination+-+Access+and+denial+-+Human+rights+violation+-+Violence%2c+etc%0d%0a%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+III+A%0d%0a%0d%0aGRASSROOTS+PERSPECTIVES%0d%0a%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+III+B%0d%0a%0d%0aREACHING+THE+POOR+-+UNDERSTANDING+THEIR+LIVES%0d%0a%e2%80%a2+NUTRITION+INSECURITY+%e2%80%a2+RURAL+%2f+URBAN+INDEBTEDNESS+%e2%80%a2+HEALTH+CARE+EXPENSES+%e2%80%a2+PUBLIC+HEALTH+%2f+PRIMARY+HEALTH+CARE+DEVALUATION%0d%0a%0d%0a%e2%80%a2+EXPLOITATION+BY+COMMERCIAL+MEDICAL+%2f+HEALTH+CARE%0d%0a%e2%80%a2+ENVIRONMENTAL+DEGRATION+%e2%80%a2+UNEMPLOYMENT%0d%0a%0d%0a(Do+our+research+strategies+and+protocols+capture+or+contextualise+these+aspects%3f)%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+-+IV%0d%0a%0d%0aCASE+STUDIES%0d%0a%e2%80%a2+HEALTH+AND+SOCIAL+EXCLUSION%0d%0a(DALITS+and+ADIVASIS+in+INDIA)%0d%0a%0d%0a%e2%80%a2%0d%0a%0d%0aGLOBALISATION+AND+ITS+EFFECT+ON+WOMEN%0d%0a(gender+approach+to+Health)%0d%0a%0d%0a%e2%80%a2+%e2%80%a2%0d%0a%0d%0aINDEBTEDNESS+AND+ILL+HEALTH+SOCIAL+CONSEQUENCES+OF+TB%0d%0a%0d%0a%e2%80%a2%0d%0a%e2%80%a2%0d%0a%0d%0aBEDNETS+FOR+THE+POOR%0d%0aASSAULT+ON+THE+BASIC+DETERMINANTS+OF+HEALTH%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+IVA%0d%0a%0d%0aDIFFERENTIALS+IN+HEALTH+STATUS+AMONG+THE+MARGINALISED+GROUPS%0d%0aindicators+GROUPS+INFANT+MORTALITY+%2f+1000+84.2+UNDER+5+MORTALITY+%2f+1000+126.6+%25+OF+CHILDREN+UNDERWEIGHT+55.9%0d%0a%0d%0aSTs%0d%0a%0d%0aSCs%0d%0a%0d%0a83.0%0d%0a%0d%0a119.3%0d%0a%0d%0a53.5%0d%0a%0d%0aOBCs%0d%0a%0d%0a76.0%0d%0a%0d%0a103.1%0d%0a%0d%0a47.3%0d%0a%0d%0aOthers%0d%0a%0d%0a61.8%0d%0a%0d%0a82.6%0d%0a%0d%0a41.1%0d%0a%0d%0aAll+(India)%0d%0a%0d%0a70.0%0d%0a%0d%0a94.9%0d%0a%0d%0a47.0%0d%0a%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+IV+B%0d%0a%0d%0aGLOBALISATION+AND+ITS+EFECTS+ON+WOMEN%0d%0a%e2%80%a2+Women+work+force+in+informal%0d%0a%e2%80%93+%e2%80%93+-+Unorganized+sectors+-+Lack+of+social+security%0d%0a%0d%0a%e2%80%a2+%e2%80%a2+%e2%80%a2%0d%0a%0d%0aCommodification+of+women+Violence+%26+crime+against+women+Rising+cost+of+health+care%0d%0a%e2%80%93+%e2%80%93+-+Home+care+-+Work+for+women%0d%0a%0d%0a%e2%80%a2+%e2%80%a2+%e2%80%a2+%e2%80%a2+%e2%80%a2%0d%0a%0d%0aState+Government+subsidy+to+Health+Glorification+of+technology+Primary+Health+Care+Preventive+and+Promotive+Care+Role+of+international+%2f+donor+agencies+in+policy%0d%0a%0d%0a(negative+influences)%0d%0a%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+IV+C%0d%0a%0d%0aINDEBTEDNESS+AND+ILL+HEALTH%0d%0a%0d%0a%e2%80%a2+A%0d%0a%0d%0aHOUSEHOLD+ILL+HEALTH%0d%0a%0d%0aINDEBTEDNESS%0d%0a%0d%0aPOVERTY+CYCLE%0d%0a%0d%0aPUBLIC+SECTOR%0d%0a%0d%0aPOVERTY%0d%0a%0d%0aMEDICAL+%2f+HEALTH+CARE%0d%0a%0d%0aALLEVIATING+EFFECT%0d%0a%0d%0a%e2%80%a2+B.+NATIONAL+%2f+INTERNATIONAL+DEBT%0d%0a%e2%80%a2+Lowered+Life+Expectancy+%e2%80%a2+Debt+Repayment+3-4+times+health+expenditure%0d%0a(BMA%2c+2000)%0d%0a%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+IV+D%0d%0a%0d%0aSOCIAL+CONSEQUENCES+OF+TB%0d%0a%0d%0a%e2%80%a2+Adverse+economic+effects+(57%25)+mortgaging%2c+selling+assets%2c+taking+loans.+%e2%80%a2+Disability+and+inability+to+work+(26.5%25)+%e2%80%a2+Adverse+effects+of+above+on+treatment+(53%25)+delayed%2c+irregular%2c+incomplete.%0d%0aDISEASE+ISPOSSESSION+DISABILITY+DISCONTINUATION%0d%0a%0d%0aof+treatment%0d%0aTHESE+ASPECTS+ARE+SUBMERGED+BY+THE+PREDOMINANTLY+TECHNICAL+FRAMEWORK+OF+TB+CONTROL+STRATEGIES%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+IV+E%0d%0a%0d%0aTRIBAL+POPULATION+BEHAVIOUR+IN+MANDLA+(MP)+(in+relation+to+bed+net+use)%0d%0a%0d%0aCOMMUNITY+SURVEY+NIGHT+MAHUA+COLLECTION+16%25+SLEEP+IN+FIELDS+12%25+TENDU+LEAF+COLLECTION+21%25+FISHING+8%25%0d%0a(1%2c200+PEOPLE+OUT+BEFORE+DAWN+OUT+OF+2000)%0d%0aSingh%2c+N%2c+Mishra%2c+A.K.%2c+Khan+M.T.+1992+in+Community+Participation+in+Malaria+Control+V.P.+Sharma+(Ed)+MRC+(ICMR)+1993%0d%0a%0d%0a(Malaria+is+a+poverty+issue+as+well!)%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+IV+F%0d%0a%0d%0aASSAULT+ON+DETERMINANTS+OF+HEALTH%0d%0a%e2%80%a2+Privatisation+of+water+Increased+water+cess%3b+buying+up+of+rivers%3b+pollution+of+rivers+bottled+water+costing+more+than+milk.+Onslaughts+on+the+environment+Corporate+liability+Primary+commodity+crop+prices+crash%0d%0arural+%2f+agricultural+distress+%26+impoverishment%0d%0a%0d%0a%e2%80%a2+%e2%80%a2+%e2%80%a2+%e2%80%a2+%e2%80%a2%0d%0a%0d%0aLifting+of+quantitative+restrictions+%2f+tariff%0d%0areductions+-+cottage+industries+%2f+small+scale+industries+affected%0d%0a%0d%0aIncreased+conflict%2c+violence%2c+war+Increased+marketing+of+health+risks%0d%0aalcohol%2c+tobacco%2c+junk+foods%2c+unhealthy+lifestyles%0d%0a%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+V%0d%0a%0d%0a%e2%80%98REDISCOVERING+ALMA+ATA+DECLARATION%e2%80%99+%e2%80%a2+FOCUS+ON+EQUITY%0d%0a%ef%83%b0+Disaggregating+data+%ef%83%b0+Collecting+social+-+economic+-+cultural+-+political+evidence%0d%0a%0d%0a%e2%80%a2+FOCUS+ON+APPROPRIATE+TECHNOLOGY%0d%0a%ef%83%b0+Is+it+relevant+to+lives+of+poor%3f+%ef%83%b0+Cost%3f+Access%3f+Social+control%3f%0d%0a%0d%0a%e2%80%a2+FOCUS+ON+INTER-SECTORAL+APPROACH%0d%0a%ef%83%b0+Are+there+factors+beyond+bio-medical+Epidemiology+to+explain+the+evidence%3f%0d%0a%0d%0a%e2%80%a2+FOCUS+ON+COMMUNITY+PARTICIPATION%0d%0a%ef%83%b0+Is+the+community+involved+in+the+situation+and+problem+analysis%3f+%ef%83%b0+Is+the+community+involved+in+interpreting+the+data%3f%0d%0a%0d%0a%e2%80%a2+FOCUS+ON+HEALTH+AS+A+RIGHT%0d%0a%ef%83%b0+Does+your+research+finding+reach+people+%2f+community+to+empower+them%3f%0d%0a%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+VI%0d%0a%0d%0aTB+AND+SOCIETY+%3a+LEVELS+OF+ANALYSIS+AND+SOLUTIONS%0d%0aLEVELS+OF+ANALYSIS+OF+TB+CAUSAL+UNDERSTANDING+SOLUTIONS+%2f+CONTROL+STRATEGIES+BCG%2c+case+finding+and+domiciliary+chemotherapy+Development+and+welfare+%e2%80%93+income+generation%2c+improved+housing%2c+social+security+Land+reforms%2c+social+movements%0d%0a%0d%0aSurface+phenomenon%0d%0a%0d%0aInfectious+disease+%2f+germ+theory%0d%0a%0d%0aImmediate+cause%0d%0a%0d%0aUnder-nutrition+%2f+low+resistance%2c+poor+housing%2c+low+income+%2f+purchasing+capacity+Poverty+%2f+deprivation%2c+unequal+access+to+resources+Contradictions+and+inequalities+in+socio-economic+and+political+systems+at+international%2c+natioal+and+local+levels%0d%0a%0d%0aUnderlying+cause+(symptom+of+inequitable+social+relations)+Basic+cause+(deeper+societal+inequities+with+alienation%2c+exclusion+and+vulnerability)%0d%0a%0d%0aMore+just+international+trade%2c+finance+and+political+relations%2c+etc.%0d%0a%0d%0aARE+RESEARCHERS+READY+TO+STUDY+DEEPER+DETERMINANTS%3f%0d%0aGFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0a%0d%0a%0cPLENARY+POVERTY+AND+HEALTH+RESEARCH+CHALLENGES+FROM+THE+PERSPECTIVES+OF+THE+POOR+AND+SOCIAL+EXCLUDED+%e2%80%93+VII%0d%0a%0d%0aPEOPLE%e2%80%99S+CHARTER+FOR+HEALTH+(PREAMBLE)%0d%0a%e2%80%a2+%e2%80%a2+%e2%80%a2+%e2%80%a2+HEALTH+IS+A+SOCIAL+%2f+ECONOMIC+%2f+POLITICAL+ISSUE+FUNDAMENTAL+HUMAN+RIGHT+INEQUALITY%2c+POVERTY%2c+EXPLOITATION%2c+VIOLENCE+AND+INJUSTICE+ARE+AT+ROOTS+OF+ILL+HEALTH+HEALTH+FOR+ALL+MEANS+%3a%0d%0a%e2%80%93+%e2%80%93+%e2%80%93+CHALLENGE+POWERFUL+INTERESTS+OPPOSE+GLOBALISATION+DRASTICALLY+CHANGE+POLITICAL+AND+ECONOMIC+PRIORITIES%0d%0a%0d%0a%e2%80%a2%0d%0a%0d%0aCHARTER+BUILDS+ON+%3a%0d%0a%e2%80%93+%e2%80%93+%e2%80%93+PERSPECTIVES+OF+VOICES+RARELY+HEARD+ENCOURAGESD+PEOPLE+TO+DEVELOP+THEIR+OWN+SOLUTIONS+HOLDS+ACCOUNTABLE%0d%0a%e2%80%a2+%e2%80%a2+%e2%80%a2+%e2%80%a2+Local+authorities+National+Governments+International+Organisations+Corporations%0d%0a%0d%0a(PCH+Challenge+to+Researchers)+GFHR+FORUM+7+-+Ravi+Narayan%2c+PHM%0d%0aPHA+2000%2c+Savar%0d%0a%0d%0a%0c