Healthcare in India: Changing the Financing Strategy

The way in which healthcare is financed is critical for equity in access to healthcare. At present the proportion of public resources committed to healthcare in India is one of the lowest in the world, with less than one‐fifth of health expenditure being publicly financed. India has large‐scale poverty and yet the main source of financing healthcare is out‐of‐pocket expenditure. This is a cause of the huge inequities we see in access to healthcare. The article argues for strengthening public investment and expenditure in the health sector and suggests possible options for doing this. It also calls for a reform of the existing healthcare system by restructuring it to create a universal access mechanism which also factors in the private health sector. The article concludes that it is important to over‐emphasize the fact that health is a public or social good and so cannot be left to the vagaries of the market.     

Mental Health and Domestic Violence: 'I Call it Symptoms of Abuse'

Correspondence to Dr Cathy Humphreys, School of Health and Social Studies, University of Warwick CV4 7AL, UK. E-mail: c.f.Humphreys{at}warwick.ac.uk Summary Research evidence now clearly shows a direct link between women'sexperiences of domestic violence and heightened rates of depression,trauma symptoms, and selfharm. A research project based in Women'sAid outreach services provides further evidence of women's experiencesof severe emotional distress. However, their experiences ofmental health services were often found to be negative. A numberof practices within the medical model of mental health wereunhelpful including: the lack of recognition of trauma or provisionof trauma services; making the abuser invisible through focusingon the woman's mental health reified from her experiences ofabuse; blaming the victim; offering medication rather than counsellingsupport; the negative, consequent effects on child contact andchild protection proceedings if the woman is labelled with mentalhealth problems. Alternatively, women found services, oftenin the voluntary sector, helpful when they provided the followinginterventions: helping women name domestic violence; activelyasking about the abuse; attending to safety planning; respondingto women's specialist needs; and actively working with womento recover from abuse experiences. Support for her childrenwas also seen as very helpful. Implications for practice includethe commissioning of further services in the voluntary sector,addressing the inadequate response within the medical model,and increasing the sensitivity of responses to women's emotionaldistress across all sectors.     

Domestic Violence and Substance Use: Tackling Complexity

Domestic violence and substance use are issues which pervadesocial work practice, yet are often on the margins of the knowledgebase for practitioners and their managers. This article providesan overview of the literature on substance use and domesticviolence, highlighting the problems with the separation of bothpractice and policy in these areas. Research on substance useand the needs of women survivors of domestic violence are explored,alongside the more substantial literature on perpetrators ofdomestic violence and patterns of substance use. The problemsof a simplistic analysis which suggest that there is a causallink between substance use and domestic violence are highlighted.Using data from an on-going research project, the sources ofthe continuing and dysfunctional separation of work in theseareas are explored.     

Minimum wages and poverty with income-sharing

Textbook analysis tells us that in a competitive labor market, the introduction of a minimum wage above the competitive equilibrium wage will cause unemployment. This paper makes three contributions to the basic theory of the minimum wage. First, we analyze the effects of a higher minimum wage in terms of poverty rather than in terms of unemployment. Second, we extend the standard textbook model to allow for income-sharing between employed and unemployed persons in society. Third, we extend the basic model to deal with income sharing within families. We find that there are situations in which a higher minimum wage raises poverty, others where it reduces poverty, and yet others in which poverty is unchanged. We characterize precisely how the poverty effect depends on four parameters: the degree of poverty aversion, the elasticity of labor demand, the ratio of the minimum wage to the poverty line, and the extent of income-sharing. Thus, shifting the perspective from unemployment to poverty leads to a considerable enrichment of the theory of the minimum wage.      

Promoting psychosocial well-being in unaccompanied asylum seeking young people in the United Kingdom

Unaccompanied minors looking for asylum in industrialized nations come with a host of psychosocial needs associated with separation and settlement. They are also resourceful, and willing to make the best of themselves in their new environments. This paper reviews literature concerning vulnerability and resilience that has emerged from refugee related studies, and those from social work with children looked after by local authorities. In combining these two areas of enquiry, the paper tests the messages they contain in reference to the work of a young asylum seekers project run in the United Kingdom. It confirms the view that unaccompanied minors are children first and foremost, exhibiting understandable vulnerabilities associated with separation and trauma, as well as being carriers of capacities that can help them to recover and settle after arrival. In this paper, it is proposed that promoting psychosocial well‐being for unaccompanied minors involves entering the young people's inner and outer worlds with therapeutic care, to aid the processes of self‐recovery. It also involves finding ways to regenerate a lost sense of belonging and of being in charge of their lives. Examples from the project's work with the young people are used to illustrate the complexity of helping them find a sense of home within their new territories.     

Population growth and poverty measurement

If the absolute number of poor people goes up, but the fraction of people in poverty comes down, has poverty gone up or gone down? The economist’s instinct, framed by population replication axioms that undergird standard measures of poverty, is to say that in this case poverty has gone down. But this goes against the instinct of those who work directly with the poor, for whom the absolute numbers notion makes more sense as they cope with more poor on the streets or in the soup kitchens. This paper attempts to put these two conceptions of poverty into a common framework. Specifically, it presents an axiomatic development of a family of poverty measures without a population replication axiom. This family has an intuitive link to standard measures, but it also allows one or other of “the absolute numbers” or the “fraction in poverty” conception to be given greater weight by the choice of relevant parameters. We hope that this family will prove useful in empirical and policy work, where it is important to give both views of poverty—the economist’s and the practitioner’s—their due.