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Addressing poverty through disease control programmes: examples from Tuberculosis control in India
Vishnu Kamineni, Nevin Wilson, Anand Das, Srinath Satyanarayana, Sarabjit Chadha, Kuldeep Sachdeva, Lakbir Chauhan
International Journal for Equity in Health , 2012, DOI: 10.1186/1475-9276-11-17
Abstract: A national level workshop was held with participation from all relevant stakeholder groups. This study conducted during the stakeholder workshop adopted participatory research methods. The data was elicited through consultative and collegiate processes. The research study also factored information from primary and secondary sources that included literature review examining poverty headcount ratios and below poverty line population in the country; and quasi-profiling assessments to identify poor, backward and tribal districts as defined by the TB programme in India.Results revealed that current pro-poor initiatives in TB control included collaboration with private providers and engaging community to improve access among the poor to TB diagnostic and treatment services. The participants identified gaps in existing pro-poor strategies that related to implementation of advocacy, communication and social mobilisation; decentralisation of DOT; and incentives for the poor through the available schemes for public-private partnerships and provided key recommendations for action. Synergies between TB control programme and centrally sponsored social welfare schemes and state specific social welfare programmes aimed at benefitting the poor were unclear.Further in-depth analysis and systems/policy/operations research exploring pro-poor initiatives, in particular examining service delivery synergies between existing poverty alleviation schemes and TB control programme is essential. The understanding, reflection and knowledge of the key stakeholders during this participatory workshop provides recommendations for action, further planning and research on pro-poor TB centric interventions in the country.India is the highest tuberculosis (TB) burden country in the world, accounting for nearly one-fifth or 21% of all tuberculosis cases [1]. In 2009, out of the estimated global annual incidence of 9.4 million TB cases, nearly 2 million cases were estimated to have occurred in India [1,2
Mill on Poverty, Population and Poor Relief  [cached]
Michael Quinn
Revue d’études Benthamiennes , 2008, DOI: 10.4000/etudes-benthamiennes.185
Abstract: This paper analyses the views of Bentham, Malthus, and Mill, on poverty, population, and poor relief, in order to investigate the influence of the two former on the latter. It argues that all three shared two basic assumptions which led them to frame a similar problem. Mill, like Bentham, and unlike Malthus, defended the public provision of relief to indigence on utilitarian grounds, while his position on the conditions of that relief was impeccably Benthamic. However, Bentham’s poor plan was itself premised, in the absence of perceived population pressure, on deliberate expansion of both population and of subsistence, while Mill had absorbed Malthus’s lesson that restriction on growth of population was the pre-requisite for improvement in the material condition of the labouring poor. For Mill, the legislative imposition in 1834 of the conditions of relief envisaged by Bentham as deterrents to unjust claims, served to rescue the poor laws from Malthus’s fears of their effect in encouraging irresponsible procreation.
Relationship between Nutritional Support and Tuberculosis Treatment Outcomes in West Bengal, India  [PDF]
Blesson Samue, Tyson Volkmann, Sushma Cornelius, Sugata Mukhopadhay,   MejoJose, Kaushik Mitra, Ajay M. V. Kumar, John E. Oeltmann, Sidhajyoti Parija, Aslesh Ottapura Prabhakaran, Patrick K. Moonan, Vineet K. Chadha
Journal of Tuberculosis Research (JTR) , 2016, DOI: 10.4236/jtr.2016.44023
Abstract: Introduction: Poverty and poor nutrition are associated with the risk of developing tuberculosis (TB). Socioeconomic factors may interfere with anti-tuberculosis treatment compliance and its outcome. We examined whether providing nutritional support (monthly supply of rice and lentil beans) to TB patients who live below the poverty line was associated with TB treatment outcome. Methods: This was a retrospective cohort study of sputum smear-positive pulmonary TB patients living below the poverty line (income of <$1.25 per day) registered for anti-tuberculosis treatment in two rural districts of West Bengal, India during 2012 to 2013. We compared treatment outcomes among patients who received nutritional support with those who did not. A log-binomial regression model was used to assess the relation between nutritional support and unsuccessful treatment outcome (loss-to-follow-up, treatment failure and death). Results: Of 173 TB patients provided nutritional support, 15 (9%) had unsuccessful treatment outcomes, while 84 (21%) of the 400 not provided nutrition support had unsuccessful treatment outcomes (p < 0.001). After adjusting for age, sex and previous treatment, those who received nutritional support had a 50% reduced risk of unsuccessful treatment outcome than those who did not receive nutritional support (Relative Risk: 0.51; 95% Confidence Intervals: 0.30 - 0.86). Conclusion: Under programmatic conditions, monthly rations of rice and lentils were associated with lower risk of unsuccessful treatment outcome among impoverished TB patients. Given the relatively small financial commitment needed per patient ($10 per patient per month), the national TB programme should consider scaling up nutritional support among TB patients living below the poverty line.
Poverty: socioeconomic characterization at tuberculosis
Santos, Maria de Lourdes Sperli Geraldes;Vendramini, Silvia Helena Figueiredo;Gazetta, Claudia Eli;Oliveira, Sonia Aparecida Cruz;Villa, Tereza Cristina Scatena;
Revista Latino-Americana de Enfermagem , 2007, DOI: 10.1590/S0104-11692007000700008
Abstract: this study aimed to evaluate the epidemiological status of tuberculosis regarding to the socioeconomic characteristics of s?o josé do rio preto between 1998 and 2004. indexes estimated for 432 urban census tracts from the demographic census of 2000, sorted systematically according to the values of socioeconomic factors and grouped into quartiles were taken into account. the socioeconomic characterization was outlined based on schooling, income, and number of residents. the incidence rates were considered for 1998, 1999, 2003, and 2004. the socioeconomic factor accounted for 87% of the total variation. the disease prevalence is higher in the poorest areas. the incidence rate and the risk of being infected by tb in the poorest areas declined in 2003 and 2004. the results confirm that tb is determined by the population's living conditions in the city studied. it strengthens the relevance of understanding the tb conditional social factors to transform the worrisome scenario in which this population is inserted.
Indian Streams Research Journal , 2013,
Abstract: Approximately 22% people in India from the whole population are below the poverty line according to a report of the Lok Shasan. It has been 65 years since India has become independent, but still the Government has not succeeded in wiping out poverty in India. The percentage of people below poverty line given by the Government is misleading. 40% to 50% of people are still cursed to live under the poverty line. The roots of the poverty are in the social, economic and political system. Nobody becomes poor by choice. Because if there are no poor people who will do the worthless jobs? The political, social and economic system benefits from the poverty. The poverty actually makes all these system works. The economics are based on this concept only.
“...But the Poor Opted for the Evangelicals!”– Evangelicals, Poverty and Prosperity
G van der Watt
Acta Theologica , 2012,
Abstract: This article discusses developments in the historical discourse on evangelicalism, poverty and prosperity. Have the global evangelical celebrations of 2010 bridged the dichotomy between social responsibility (Ecumenicals) and the proclamation of salvation (Evangelicals)? The article focuses on the rapid growth of a specific brand of evangelicalism, namely “prosperity faith” as predisposition within the neo-Pentecostal churches, especially throughout sub-Saharan Africa. In an appreciative, but critical enquiry, this article reflects on the radical claim of dispensing “health and wealth” to the desperately poor. Are proponents of prosperity faith putting forward a credible answer to poverty, a new entrepreneurial and creative evangelical response to the call for social responsibility? Or will the poor ultimately be disillusioned? What challenges are posed to Evangelicals?
Women, immigration, poverty and tuberculosis
Lucio Casali, Mariano E Crapa
Multidisciplinary Respiratory Medicine , 2010, DOI: 10.1186/2049-6958-5-6-398
Abstract: TB is the disease of poverty, affecting the most vulnerable groups of the world's population: more than half of TB-related deaths occur in Asia while the greatest TB burden as percentage of population is in Africa. Other factors closely connected to the social realities of low income countries, like malnutrition and food insecurity, can contribute to make the situation worse and other important factors like smoking or comorbidities such as diabetes can further increase the burden of TB.The diffusion of the HIV epidemic has provoked a "feminization" of this infection with a great burden of HIV-associated TB. The frequent extension of TB to the reproductive organs in females can be a cause of infertility. In some countries such as Pakistan and Afghanistan more women with TB are detected than men. In some areas of the undeveloped world women with TB are discriminated against and stigmatized by their families and communities. The stigma is always extended to their children who are marginalized and forced to abandon school.These are some of the critical points that highlight the importance of looking at TB not only as a masculine disease. We must consider that the points mentioned above describe a situation where TB is the leading cause of "healthy years" lost among women in young age. In this framework, migration from low-income countries constitutes another dramatic aspect of the problem.However other co-factors must be investigated, i.e. the possible presence of anemia that can be caused both by food restriction and iron deficiency and/or by parasitic infestations which contribute to microscopic blood loss in the stool [2]. Usually hypochromic and microcytic anemia coexist, so that, after having excluded a form of Mediterranean anemia, a conservative approach based on iron supplementation or an iron-rich diet is recommended. Of course any abnormality identified in the presence of stool ova and parasites needs to be treated as well. Should this approach fail it is then
Social Protection and Poverty Reduction in Four Selected Southeast Asian Countries: An Analysis of the Healthcare Sector towards Pro-Poor Growth  [cached]
Senadjki Abdelhak,Jamalludin Sulaiman
Asian Social Science , 2012, DOI: 10.5539/ass.v8n3p270
Abstract: This study explores key ideas needed in the current debate on the development of healthcare schemes and programs against poverty in four selected Southeast Asian countries; Vietnam, Indonesia, Thailand and the Philippines. It also traces the reasons why some of these countries have failed to achieve relative pro-poor growth through healthcare schemes. Using the poverty line of the four selected countries and Panel Data Analysis, the present study found that in Indonesia, Philippines and Vietnam, poor people do not benefit from the healthcare services provided by the government. In Vietnam the situation is even worse as the results showed that an increase in government expenditure on health led to increased poverty incidences. One of the possibilities for this to occur is that when government increases expenditure in healthcare sector, this causes a trade-off in other logistic sectors.
The (Possible) Function of the Beatitude of the Poor in the Context of the Struggle against Poverty
J Kügler
Acta Theologica , 2012,
Abstract: The article focuses on the beatitude of the poor in the social and religious context of historical Jesus. The original version of this makarism has to be seen as a religious statement which is not meant as a program of social reform. Yet it has political and socio-ethical implications as it connects the poor with God and his kingdom. Those who are searching God have to go to the poor. A possible function of the beatitude of the poor in the struggle against poverty can be seen in the spiritual empowerment it gives to the poor themselves: Poverty is against God’s will; it is no divine punishment and does not separate from God. The poor will be liberated from suffering. Poverty has no place in the kingdom but will be eradicated.
Recurrent Tuberculosis of Greater Trochanter and Its Bursa  [PDF]
Keshav S. Shenoy,Santosh S. Jeevannavar,Prasanna Baindoor,Sunil Mannual,Savith V. Shetty
Case Reports in Orthopedics , 2013, DOI: 10.1155/2013/570956
Abstract: A 65-year-old female had a history of tuberculosis of the left greater trochanter 30 years ago. She underwent 6 months of chemotherapy after which the disease healed completely. Currently she presented to us with pain and swelling on the lateral aspect of left hip of 2-month duration. Clinical and radiological findings were suggestive of a recurrence. Biopsy was conclusive for tuberculosis. She was successfully treated with debridement and curettage with chemotherapy for 1 year. Recurrent tuberculosis of the greater trochanter is rare and should be aggressively treated. 1. Introduction Primary tubercular involvement of the greater trochanter and its overlying bursa is rare and accounts for 1-2% of all musculoskeletal tuberculosis [1]. The disease spreads to the trochanter most commonly by hematogenous means. The patient presents with lateral hip pain of prolonged duration with or without limp. Long-standing disease may involve the hip joint [2]. The differential diagnoses include tumors, septic bursitis, idiopathic bursitis, and osteochondritis [3]. Newer diagnostic modalities like CT and MRI scans help in early diagnosis and delineating the lesion better. Tubercular lesions are known to recur in people with poor immune function, especially elderly. We describe a 65-year-old lady with primary tuberculosis of the left greater trochanter and its overlying bursa treated successfully by chemotherapy, who presented to us with recurrent disease after 30 years. Excision of the bursa, curettage of the lytic lesion and antitubercular chemotherapy was curative. At 2-year followup, patient were asymptomatic and the disease had completely healed. 2. Case Report 65-year-old lady presented to us with a history of pain and swelling on the lateral aspect of left hip of 2-month duration. Both pain and swelling were gradual in onset and progressive in nature. Pain was constant, dull aching type, increasing on weight bearing and partially relieved with analgesics. There was no history of trauma, fever, or other constitutional symptoms. She did not have any other comorbid illness. Thirty years back patient had pain and swelling on the lateral aspect of left thigh along with a discharging sinus. She was diagnosed to have tuberculosis of the left trochanteric bursa based on the clinical and radiological findings. Short course antitubercular chemotherapy for 6 months was curative and the patient was asymptomatic since then. 2.1. Clinical Examination General physical examination was unremarkable. On local examination, there was a fluctuant swelling measuring about 8 × 4?cm on
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