South Asian Journal

Contents

In This Issue

(The views expressed in this journal are solely those of the authors)

Health Service Delivery in South Asia


	Feyza Bhatti (senior research fellow) and Shazra Murad (research fellow) at the Mahbub-ul-Haq Human Development Centre in Pakistan, provide a comparative overview of health indicators, health sector budgets, and service delivery in South Asia. The authors argue that, as a whole, South Asia has delivered poor health outcomes for a majority of its (largely poor) population, and highlight the disparities in provision of health services across regions, socioeconomic groups, rural and urban areas, and gender. The authors suggest a number of measures to combat this situation, including increased public funding for health, parallel provision of safe drinking water, sanitation, education, and nutrition; and regulation of the private sector to monitor its delivery of healthcare.

The State of
Health in
India


	Dr Mohan Rao, an academic at the Centre of Social Medicine and Community Health, Jawaharlal Nehru University, examines the state of health in India by tracing trends in key health indicators across different states, social classes, and gender. He finds that the poor bear the highest proportion of healthcare costs, and attributes India's high morbidity and mortality rates to low public investment in health. Dr Rao also examines private sector healthcare and health sector reforms. He concludes that India has confined the role of the state to legislation, thus failing to address issues of universal and equitable health service delivery.

Health Services
and Resource
Allocation
in Pakistan


	Rabea Malik, a research fellow at the Mahbub-ul-Haq Human Development Centre in Pakistan, assesses the country's health sector against the backdrop of targets set by the Millennium Development Goals. She finds that Pakistan has consistently underperformed on most health indicators, and traces this to inadequate and inefficient resource allocation, and consequently, to poor health service delivery. Ms Malik also examines the generally poor state of public healthcare facilities in contrast to private healthcare, but illustrates how at least one public sector programme - the Lady Health Workers Programme - has emerged as a significant success story.

Sri Lanka's
“Health
Miracle”


	Dr. Ravi P. Rannan-Eliya, founder of the recently re-established Institute for Health Policy, examines why Sri Lanka's health gains have outpaced those of any other South Asian country, and argues that this owes largely to the early introduction of democracy in the country. He illustrates the country's development of a highly dispersed rural health infrastructure and its early recognition that health policy should be preventative, not merely curative. In spite of its remarkable success, the author warns that Sri Lanka has now reached a point where substantial reforms will soon be necessary as increasing consumer expectations lead more Sri Lankans to opt for private sector healthcare. .

Forgotten Lessons:
One Year after
the Earthquake


	Moeen H. Cheema, an assistant professor of law and policy at the Lahore University of Management Sciences (LUMS) in Pakistan, reviews the efforts undertaken by various government, military, and civil bodies to estimate earthquake damage, coordinate relief efforts, determine eligibility for assistance, and distribute cash assistance in Pakistan-administered Kashmir. He also identifies and analyses the weaknesses inherent in these aspects of the disaster management plan being implemented, and suggests a number of sound structural and policy recommendations for the management of future disasters.

Sri Lanka: Peace Process under Thre


	Mohammad Ehsan, an assistant professor of public administration at the University of Dhaka, examines the state of human rights in Bangladesh in the context of local government. He suggests that local governments must function as decentralised, autonomous bodies if they are to ensure the protection of human rights as stipulated by the country's constitution. Mr Ehsan examines the reasons for ineffective governance, which include what he terms the “de-concentration” rather than devolution of power; the inefficacy of union parishads in maintaining law and order through effective village courts; the rampant abuse of power by the local elite; severe financial constraints on local governments; and lack of accountability, transparency, and public right to information.

Indian Public
Diplomacy and the
Nuclear Deal


	Radha Vij, a researcher at the Centre for Media Studies in India, examines the recent agreement on civilian nuclear energy cooperation signed between India and the US. Focusing on the role of India's English language media, she asks whether or not the two parties took into account the critical role of public diplomacy. Ms Vij suggests that traditional approaches to public diplomacy be redefined, and that India formalise the role of public diplomacy to maintain informed relationships with strategic audiences.

Migrant
Remittances
and Poverty
Alleviation in
Sri Lanka


	Ayako Kageyama, a postgraduate scholar at the London School of Economics and Political Science, reviews the empirical literature on current trends of remittances and their economic impact on the welfare in the case of Sri Lanka. She shows how workers' remittances have both positive and negative consequences for their home communities. Ms Kageyama finds that, economically, remittances benefit migrant households, particularly poorer ones, by increasing their short-term income. However, she concludes that migration and remittances are not a stand-alone measure for poverty alleviation, and need to be addressed by appropriate policies to address unexpected adverse effects.

Combating Child
Labour in India's
Services Sector


	Dr T. T. Sreekumar - assistant professor of communications and media at the National University of Singapore - and Dr. Gayathri - a consultant at the Institute for Human Development, India - examine the nature and extent of child labour and child abuse in India's services sector, focusing on the travel and catering industry. The authors assess the response of civil society to this serious concern against the backdrop of inadequate judicial and legal interventions. They argue that an “obligations-based approach” is preferable to a rights-based approach, given the difficulties of enforcing “children's rights” in a developing country.

Indian Women
and the Green
Revolution


	Dr Rupinder Kaur, an associate fellow at the National Council of Applied Economic Research in India, provides a case study of Indian Punjab in terms of how the “green revolution” has affected women's productivity, and criticises the assumption that all members of an agricultural household share equally in the benefits and burden of technological change. She finds that data collection methods and conceptual definitions in labour economics based on western experience prove inadequate when applied to developing countries such as India.

The Services
Sector
under SAFTA


	Shivraj Bhatt, a trade economist at South Asia Watch on Trade, Economics and Environment (SAWTEE) in Nepal, argues that integrating the services sector into the South Asian Free Trade Agreement (SAFTA) framework is essential if South Asian countries are to realise the benefits of a free-trade area. He evaluates the importance of the services sector for SAARC member countries and the country-specific challenges that this move would lead to in terms of the benefits and cost of service trade liberalisation. He finds that, despite certain inherent risks, the liberalisation of the services sector could have positive spill-over effects on other economic activities.

Viewpoint: Seven
Years under
General
Musharraf


	M. Ziauddin, a leading Pakistani journalist, takes an exceptionally critical view of the seven-year rule of President General Pervez Musharraf. Focusing on constitutional issues, and the North Waziristan and Balochistan imbroglios, Mr Ziauddin laments the overall performance of the government, its economic strategy, and approach towards the Indo-Pak peace process. While ignoring what good the Musharraf government has brought about with the reversal of a pro-jihad policy, he criticises what he considers to be quite devastative policies. Although he admits that the economy has witnessed a respectable growth rate, he reveals serious fears that the government's whole economic strategy has been instrumental in widening the gap between rich and poor.