Human Development in India - NCAER

health and medical care 115Box 7.3Television and HIV/AIDS EducationTelevision (TV) has played an important role in disseminating information about HIV/AIDS. The NFHS found that nearly 80 per cent of theindividuals who have heard of AIDS have done so through television. This is not surprising, given that television has emerged as one of themost powerful forces for the transmission of information in the modern world. The proportion of women with any awareness of AIDS is barely28 per cent among those who rarely or never watch TV, and 76 per cent among those who regularly watch TV.Thus, the data support the notion that television programming is an important cornerstone of the AIDS prevention strategy. However, thereare two major problems on relying solely on TV to obtain information about HIV/AIDS. Although television appears to be a fine mediumfor providing basic information, its educational value remains unknown. For example, with urban residence, state of residence, education,and household consumption held constant, women who watch TV are 2.5 times more likely to know that that HIV/AIDS is spread throughsexual contact. On the other hand, there is little difference between TV watchers and non-watchers regarding beliefs that AIDS is spreadthrough mosquito bites, or by sharing food and utensils with an infected person. Thus, it appears that while sound bites focusing on warningsabout sexual contact or blood transfusions are easily conveyed, the more complex understanding needed to prevent the stigmatization of anHIV-infected individual is difficult to convey through TV programmes.Another problem in relying largely on TV is that TV watching for women is more common in some parts of the country than in others,and among some social groups compared to others. Only about 45 per cent women in Bihar, Uttar Pradesh, Jharkhand, and Rajasthanwatch TV, even occasionally, compared with 75–80 per cent in Maharashtra, Kerala, Tamil Nadu, and Punjab. Similarly, only 60 per centof Dalit women and 42 per cent of Adivasi women watch TV, compared to more than 80 per cent of forward caste women. Not surprisingly,these figures regarding differences in TV watching are reflected in AIDS awareness. Only 30–45 per cent women in Bihar, Uttar Pradesh,Jharkhand, and Rajasthan have AIDS awareness, compared with 80–95 per cent for Maharashtra, Kerala, and Tamil Nadu. Similarly, while77 per cent of the forward caste women have heard of AIDS, only 31 per cent of Adivasi women know anything about it.These statistics strongly suggest that television programming for increasing AIDS awareness was an effective strategy in the early stagesof AIDS prevention, but that the strategy now needs to be broadened. Education must be increased both among individuals who havenever heard of HIV/AIDS, and among men and women who have some awareness. Developing these strategies will require strengtheningthe community based initiatives being organized by the National AIDS Control Organization and greater involvement of health servicespersonnel than has been the case so far. Although TV will continue to play a role in AIDS education, it is clear that the easy fruit has alreadybeen plucked and that much hard work remains to be done.Source: IHDS 2004–5 data.education. The south consistently leads the country inreporting low levels of short-term morbidity and higherlevels of health care. More southerners report themselves tobe in good or very good health, fewer report short-termillnesses, and expectant mothers there report fewer medicalproblems than elsewhere in the country. Disabilities don’tshow the same southern advantage, but these are themselvesthe result of better health and longer life expectancy in thesouth. Better health means older people and, thus, moredisabilities and greater mortality risks. Higher long-termmorbidity rates in the south also result from this older agestructure (and from the IHDS’ emphasis on physiciandiagnoses as evidence of long-term morbidity). Chapter 8carries this theme further. Southern states have lower infantand child mortality, and greater levels of vaccination than thecentral plains. Better medical care undoubtedly contributesto the south’s health advantage. The south outperforms therest of the country on every indicator of maternal medicalcare. More physician assisted deliveries in recognized medicalfacilities, more complete antenatal testing, and more commonante and postnatal physician examinations. All of these mayalso combine to reduce infant and child mortality.The consistent urban bias in Indian health also deservescloser attention. City- and town-dwellers more often perceivethemselves to be healthy, less often report suffering fromminor illnesses, and are incapacitated for shorter periodswhen sick. Medical care is more accessible to them when theyget sick and, perhaps more surprisingly, they spend somewhatless money on a typical minor illness than a villager. Urbanmothers have fewer pregnancy problems and get much betterantenatal, delivery, and postnatal care. The urban–ruraldifferences are not as great as the state differences, but theconsistency of the urban advantage across so many indicatorstestifies to the pervasive inequality rural residents suffer.Only a small part of these regional inequalities resultfrom differences in population composition. To some extent,individuals in the south and cities report lower morbidityand have better medical care because the people living thereare better educated and have higher incomes. But most of theregional inequalities would remain even if we looked only atequivalent people, for instance, at primary school graduatesin households with median incomes. Most of the regionaldifferences are contextual. Everybody benefits from living inKerala, regardless of his or her social position. Nevertheless,social inequalities matter. The poor, the illiterate, and thesocially discriminated are disadvantaged in health and medicalcare, as they are in all aspects of life. The differences aresmaller than the regional differences, but they are real.Finally, the survey results also confirm the obvious factthat aging brings more health problems. Coughs, fevers, anddiarrhoea may be especially common among children, buteven short-term morbidity increases after middle age. Becauseof India’s current youthful age structure, most illnesses anddisabilities occur among the non-elderly, so the strongrelationships with age may not be as obvious to the casualobserver (or the policy maker) as they are in more developed