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Since inception, National Sample Survey (NSS) is the only large-scale household survey in India, periodically collecting data on morbidity and health care conditions in the country. In these surveys, information for all members of sample households was gathered either from head or a key informant of the household. This paper aims to discuss these issues.

This study was developed to examine whether the use of proxy respondents influences population estimates of morbidity prevalence rates and factors associated with morbidity prevalence rates among adults based on latest 60th round NSS data on morbidity and health care.

The results showed that use of proxy in this survey had severely affected morbidity prevalence rates among adult persons aged 18 years and above. The result showed that use of proxy in the NSS 60th round survey had resulted in underestimation of morbidity prevalence rates among adults in such a way that overall morbidity prevalence rate was 45 per cent higher in direct interviews (148 per 1,000 adult persons) compared to those answered by proxies (81, p<0.001). There were variations in underreporting of morbidities by socio-economic and demographic characteristics of proxies but the direction of the association was the same.

The study conclude that morbidity data from the NSS can be used regardless of use of proxies and that the association between worse health condition and socio-economic and demographic factors persisted even when information was collected from a proxy. However, suitable adjustments for proxy-reporting should be made while estimating realistic population at risk from the NSS data.

This is the first manuscript that has made an attempt to examine the effect of proxy-reporting on morbidity prevalence in NSS data. Since its inception in 1955, NSS data are the only data source available in India on morbidity and health care conditions. A large number of research manuscripts have been published using this data and there were serious concerns among the researchers on data quality particularly about the reporting of health status. NSS 60th round first time provided information on reporting status, i.e. proxy vs self. In this context, the present study made an effort in this direction.

A plethora of studies have documented evidence on morbidity patterns and treatment-seeking behaviour among older persons in India. However, so far no attempt has been made to understand differences in the morbidity prevalence rates and utilization of health care services among older adults between religion groups in India. The purpose of this paper is to make an effort in this direction.

Multivariate logistic regression models were fitted to examine the association between socio-demographic conditions and morbidity prevalence and health care-seeking behaviours among the two religion groups: Hindu and Muslim. Data from the 60th round of the National Sample Survey in 2004 were used.

This study provided interesting evidence that, overall, the morbidity prevalence rate was higher among Muslim older persons than their Hindu counterparts by seven percentage points and Hindu scheduled caste (SC) and scheduled tribe (ST) counterpart population (compared to SCs eight percentage points, and STs 20 percentage points); income had no association with the burden of disease among Muslim older population – an older person belonging to the first income quintile was equally likely to report ill-health as an older person of the fifth income quintile. However, despite the low socio-economic status, Muslim older persons were more likely to seek treatment for ill-health compared to Hindu older persons but spent less money for treatment. Also, loss of household income due to sickness was greater among Muslim compared to Hindu older adults.

The findings of this study are important to support the policy makers and health care providers in identifying individuals “at risk” and could be integrated into the current programs of social, economic and health security for the older persons.

The purpose of this paper is to analyze the overall morbidity prevalence and their differentials among emigrants’ and non-emigrants’ wives in Kerala, India.

The study is based on the third round of The Kerala Migration Survey-2007 data. The third round of KMS was perhaps the first survey which has collected data on Indian emigration and morbidity scenario during 2007 at the household and individual level. Descriptive statistics, binary logistic regression models, and Oaxaca decomposition models were used to examine the disease differentials among emigrants’ and non-emigrants’ wives.

The paper shows that household size is negatively associated with chronic disease and incidence of morbidity is much lower among emigrants’ wives. The result also shows that among women, those who stay with a husband or whose husbands are elsewhere in India show a higher incidence of morbidity than those whose husbands are abroad, owing to the limited scope of activity as well as freedom in lifestyle and for taking independent decisions. Thus, it can be concluded that for women, the scope of activity and the freedom to live are important factors contributing to the level of morbidity. Blinder-Oaxaca decomposition results show that non-poor households and non-Muslim religion are in a disadvantageous position in terms of chronic morbidity.

This paper is based on the cross-sectional nature of data; this is an obvious limitation on the effect of emigration on morbidity differentials among emigrants’ and non-emigrants’ wives.

There are few or rare studies conducted so far to investigate the effect of migration on the health of the spouses or families left behind.

Internal migration has grown intensively in India in the present decades, far greater than international migration, though the latter has received far more attention in literature and public policy. Among internal migrants, seasonal movement is another growing phenomenon in India which has received the least attention till now. The purpose of the study is to show the intensities of short-term morbidity and major morbidity among the rural and urban internal migrants and how such disease burdens have affected the health of regular/permanent and temporary/seasonal migrants.

This present paper has been developed on the basis of data of India Human Development Survey-II (IHDS-II), 2011–2012, has been availed to find out the intensities of short-term morbidity and major morbidity among the rural and urban migrants as well as the health condition of the seasonal migrants. For the analysis of regular or permanent migrants, a total of 3,288 migrants (of which 1,136 rural migrants and 2,152 urban migrants) were surveyed in IHDS-II, 2011–2012, regarding the persistence of different types of short-term morbidity among the migrant class. Two-sample (rural migrants and urban migrants) “t” test for mean difference with unequal variances with null hypothesis – H0: diff = 0, and alternate hypothesis – Ha: diff < 0; Ha: diff > 0 where diff = mean (rural) – mean (urban) has been executed. For the seasonal migrants a sample of 41,424 migrants of which 2,691 seasonal migrant workers and 38,733 non-seasonal migrant workers were surveyed in IHDS-II, 2011–2012, to find out their health condition. OLS regression on the number of medical treatments undertaken in a month on the nature of migrant workers has been conducted. Socio-economic factors (like adult literacy) and basic amenities required for a healthy living (like indoor piped drinking water, separate kitchen in the household, household having a flush toilet, household having electricity and intake of meals everyday) are taken as control variables in the regression analysis.

The results of morbidity analysis in this paper show that the morbidity patterns among the migrants vary with the geographical differences. The short-term morbidity and that of the major morbidity show different proneness to ill health for rural and urban migrants. However, seasonal migrants are more susceptible to ill health than the regular migrants and are also potential for generating health risks. Also lack of provision of basic services creates negative health impact on seasonal migrants.

The paper is based on secondary data and hence lacks numerous relevant health issues of migrants in rural and urban sectors which could have been possible through primary data survey.

Migration and migrants are a relevant issue both internationally and nationally. Economic development of a country like India depends to a greater extent on the contributions of migrant labourers as majority of the labourers in India belong to informal sector of which most of the workers are from migrant class.

Migrants contribution to economic development depend on their productive capacity and hence health of these section of people is a relevant issue. This study is based on the morbidity pattern of migrants both regular and seasonal migrants and their susceptibility in various geographical locations and provision of basic amenities.

This work is original research study by the author.

Studies have reported increased psychiatric morbidity among young detainees, with as many as three‐quarters reported to have one or more psychiatric disorders. Despite this, however, there is a dearth of published work among young inmates of prisons, remand homes or borstal institutions in Nigeria. The aim of this study was to assess possible psychiatric morbidity among young inmates of a borstal institution in Nigeria and to determine the factors that may be associated with this morbidity. Fifty‐three inmates of one of the two existing borstal institution in Nigeria were assessed for psychiatric morbidity using the 12‐item General Health Questionnaire (GHQ‐12). The GHQ‐12 scores were compared with the socio‐demographic factors of the respondents. Twenty‐eight (52.8%) of the inmates were over 18 years old, 35.8% were in the middle position within the family, 62.3% were of Christian faith, and 64.2% had their parents still living together. Seventeen (32.1%) of the inmates were from Hausa ethnic extraction, 58.5% stayed for more than 6 months at the borstal institution, and 81.1% were brought to the institution by their parents. The mean age of the inmates was 17.3 years (range, 14‐23 years) and 26 (49.1%) of them were GHQ‐positive. There was no statistically significant difference between the mean age of GHQ‐positive and GHQ‐negative inmates (F=1.73, p=0.19), and none of the socio‐demographic variables were significantly associated with psychiatric morbidity (i.e. GHQ‐12 positivity). The study observed a high prevalence of undetected psychiatric morbidity among inmates at the borstal institution. Efforts should be intensified by the authority responsible for managing the Nigerian prison services (including the borstal institutions) to improve mental health services.

I am going to give you a really personal paper — personal because its based on my experiences, delving and fighting my way into the morass on morbidity data and all there is to get, and trying to put it into some order. To paraphrase Shakespeare's Mark Anthony ‘We only die once’ that's mortality ‘but before we do we suffer many ills’ and that's morbidity. The frequency and the cost of morbidity is more important than mortality which is a very final exit. Therefore logically we need to know very much more about morbidity than mortality but however, and I suppose that's the reason for this meeting, collection and trying to get morbidity statistics is difficult as Michael Alderson referred to in his paper (see pp.183–186).

Around three million infants die within the first four weeks of life each year – nearly all (98%) of these deaths occur in developing countries. Approximately one million newborns die each year in India. Therefore, this study aims to determine the patterns of reported neonatal morbidity and care-seeking behavior and identify factors associated with it.

A cross-sectional study was conducted during November 2016. A systematic random sampling technique was used to select the sample. Statistical techniques like Binary Logistic regression and chi-square test were used.

The results of the study showed that around 31% mothers of neonates reported that their neonates suffered from some kind of morbidity. Fever, jaundice, cough and cold, the low birth-weight and difficulty in breathing were the most common dangers signs reported. Birth order and mother’s knowledge of neonatal danger signs were found to be significantly associated with reporting of neonatal morbidity. In all 95% of the mothers sought care for their newborns. Among those who had problems, 59% consulted private hospitals/clinics, 30% visited District Hospital/Taluka Hospital or higher facilities and another 9% to Primary Health Centers/Community Health Centers. Further, findings show that nearly half of the neonates taken to government facilities have got free treatment, whereas an average cost of 7,156 INR were recorded for treatment, 935 INR for outpatient department and 13,774 INR for inpatient department cases.

There is an urgent need to implement intervention modalities that focus on increasing the level of parental education and access to treatment, and advocating the message regarding newborn danger signs during pregnancy is pinpointed.

Recent public health policy emphasizes the achievement of healthy aging as average life expectancy increases worldwide. Evidence for healthy aging from low- and middle-income countries (LMIC) is limited. The purpose of this paper is to assess the prospects of healthy aging and its associated factors in the Indian context.

The study was based on a national-level panel survey, the Indian Human Development Survey (IHDS) conducted in 2004-05 and 2011-12. The analytical sample consists of 10,218 elderly individuals who were 60 years old and above at the baseline. Change in health status was assessed based on disability and disease incidence at the follow-up. A generalized estimating equation (GEE) model was performed to assess health status change.

Increasing age was a risk factor for all dimensions of health outcomes. Elderly from the lowest wealth quintiles were more likely to lose health due to short-term morbidity, whereas the highest wealth quintiles were more likely to lose health due to long-term and multi-morbidity, indicating evidence for the presence of the “disease of affluence”. Social capital, such as living in a joint family acted as a protective factor against health risks.

With the results showing the evidence of the “disease of affluence” and “disease of poverty” in different health outcomes, there should be a health policy focus that copes with undergoing epidemiological transition. It is also important to pay attention to health-protecting factors such as social and familial support to achieve healthy aging.

In light of the clinical importance of understanding co-morbidity within offender populations, the purpose of this paper is to examine the prevalence and comorbidities of clinical disorder (Axis I) and personality disorder (Axis II) within a sample of high risk, male offenders located in a high secure, prison-based personality disorder treatment service.

The study utilised clinical assessment data for both Axis I diagnoses (Structured Clinical Interview for DSM-IV) and Axis II diagnoses (International Personality Disorder Examination) of 115 personality disordered offenders who met the criteria for the treatment service between 2004 and 2015.

Co-morbidity between Axis I and Axis II diagnoses was high, with 81 per cent of the sample having co-morbid personality disorder and clinical disorder diagnosis. The most prevalent Axis I disorder was substance misuse, and Axis II was antisocial, borderline, and paranoid personality disorder. Following χ² analysis, Cluster A personality disorder demonstrated co-morbidity with both mood disorder and schizophrenia/other psychotic disorder. Paranoid, schizoid, narcissistic, and avoidant personality disorder demonstrated a level of co-morbidity with Axis I disorders. There was no association found between the clinical disorders of substance use and anxiety with any personality disorder within this sample.

In part these results suggest that certain Axis II disorders may increase the risk of lifetime Axis I disorders.

The findings of no co-morbidity between the clinical disorders of substance use and anxiety with any personality disorder within sample are inconsistent to previous findings.

By bringing together aspects of sustainable forest management, population health, and local livelihoods, the purpose of this study was to characterize how household dependence on forest resources changes through three phases: the period before HIV became a problem in the household, the period during HIV-related morbidity, and after AIDS-related mortality.

Sixty semi-structured interviews were conducted with members of unaffected and HIV/AIDS-affected households in four case study districts in Malawi.

This study demonstrates that the relationship between HIV/AIDS and dependence on specific forest resources appears to correspond closely with the stage of the disease. Firewood and water were consistently ranked as being one of the three most important resources, regardless of HIV-affectedness. During the morbidity phase, respondents reported their need for medicinal plants increased substantially, along with other resources. The importance of timber increased significantly after HIV-related mortality.

Interview respondents themselves suggested key interventions that would assist households in the HIV/AIDS-mortality phase, in particular, to obtain the forest resources they require. These interventions could address the impacts of HIV/AIDS on the sustainability of important resources, compensate for a decreased availability of household labor, and foster greater access to these resources for vulnerable households in the four study sites.

In spite of the fact that forest resources can play a crucial role in enabling a household to control and adapt to the disease, research on the environmental dimensions of HIV/AIDS remains limited. This chapter helps to address this knowledge gap, suggests practical, innovative interventions that could alleviate some of the disease burden on rural Malawian households, and offers insight into potential areas of further inquiry in this research domain.