Panel 11: Improving Health, Safety, and the Environment
Thursday, November 17 (4:15-5:30)
12th Symposium on
Development and Social Transformation
Social Marketing of Health Policy: A Case Study of HIV/AIDS Programme in Thailand
Jyoti Shankar Choudhary
Panel 11: Improving Health, Safety, and the Environment
12th Symposium on
Development and Social Transformation
Need for Social Marketing
Constraints of conventional methods of
policy formulation and implementation Need for using Commercial Marketing
concepts
What is Social Marketing?
Devising strategies for Behaviour Change by using
concepts from commercial marketing4 Ps of Marketing: Product PricePlacement Promotion
HIV/AIDS in Thailand- A Situation Analysis
Statistical data in 1991 No. of HIV infections– 1% of 65m pop. No. of new HIV infections, every year
-140,000 44% of sex workers in Chiang Mai
(North Thailand) infected with AIDS ( Sentinel Survey,1989)
HIV/AIDS in Thailand- A Situation Analysis
Nation’s Response : Mode of DenialThai to Thai transmission not
evident Response geared to screen
foreigners Only $180,000 spent in 1988
HIV/AIDS in Thailand: Policy Intervention
Revised Policy Intervention-1991:Positioning Strategy
Programme under the PMOProgramme integrated into 5
yr.plan:funding implicationsTechnical/non govt. appointments
Phased ApproachThree Phases
Segmentation and Targeting Based on a nation wide research
Social Mobilisation & Advocacy an integral part of the programme
HIV/AIDS in Thailand: Policy InterventionPhase I (1991-1996)
Segmentation & Targeting: High risk GroupCSWs Injectible Drug usersSchool Children and Youth
Emphasis on creating awareness through:Mass mediaSchool ProgrammeCommunity based programme-100% condom prog.
Social Mobilisation Programmes through:MilitaryMonks
Repealed repressive policies like mandatory disclosure of identity for AIDS patients
HIV/AIDS in Thailand: Policy Intervention
Phase II: (1996-2000):
Focus on PLWHA as main target group Establishment of groups like PLA,
through out Emphasis on Mother to Child mode of
transmission Introduction of AZT drug Greater role for Media-all reports on HIV
published in media
HIV/AIDS in Thailand: Policy Intervention
Phase III (2001-2006):Consolidation of the earlier phases International Cooperation
Lessons for India
Shortcomings of the programmeInequal focus of the target groups Changing routes of transmissionSustainability not in-built in the
programme
Lessons for India
Inferences from the programmeAppropriate Positioning of the
programme Prominence of Advocacy &Social
MobilisationEmphasis on Research & its
dissemination to the public at largeRole of Media in creating the ownership
among various segments of the society
OSH Management in Indian Mining Sector—Lessons from the USA
Partha Sarathi Banerjee
Panel 11: Improving Health, Safety, and the Environment
12th Symposium on
Development and Social Transformation
PREAMBLE
• Globally mineral/mining sector is considered as a high risk industry.
• Better technology & innovative OSH management practices have brought down Injury/Fatality Rate in this sector world wide.
• However, in India, such measures have almost become asymptotic over the last two decades, even after intensified regulatory efforts.
VARIATION IN FATALITY RATE OVER LAST CENTURY
SOURCE: GOI STATISTICS
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1
DECADES
FR
1901-10
1911-20
1921-30
1931-40
1941-50
1951-60
1961-70
1971-80
1981-90
1991-00
CHALLENGES AHEAD
• The existing ‘centralized regulatory policy’ in the country is likely to face challenge in the future due to:
growing size/ complexity of the industry,
liberalization of the sector to foreign/ private participation and
down sizing of government resources for regulation.
REGULATION AS A POLICY TOOL
• Regulation as a policy tool is often in disfavor in the industry because:
the regulation cost is viewed as borne by the regulated industry while most benefits go to others.
Economists often criticize regulation as an inefficient substitution of centralized decision making for the alleged rationality of the market.
WHAT NEXT?
• Can every public problem be solved through deregulation and by relying on market/devising better incentives?
• No, Importance of coercive policy has been strongly felt after every disaster/ major failure in the industry.
• Even in US political landscape regulation-bashing remains a hardy perennial. TAMING REGULATION BY NAKAMURA & CHURCH
LIVING WITH REGULATION
• How OSH management can be made more effective?
Use of COST OF SAFETY model for analyzing costs, preparing budgets and setting realistic safety goals.
Devising positive & negative incentives in Workmen’s Compensation & Accident Insurance System based on Injury Performance Statistics.
Continued.
Shifting from existing rigid ‘centralized regulatory policy’ to a more flexible ‘co-operative self regulation’ policy- ‘regulatory pluralism'.
Self regulation may be objectively based on ‘quantitative risk assessment’ of work places and ‘injury rate goal setting’.
Example: Successful OSHA (California) experimentation on Cooperative Compliance Program during 1979-84.REFORMING THE WORKPLACE BY REES
COST OF SAFETY MODEL
COST
Prevention+ Detection Costs
Internal + External Failure Costs
Safety Level
Optimal Equilibrium Point
Explanations
• Preventive Costs to keep defects from occurring; Design, Process, Technology, Safe Material costs etc.
• Detection Costs to minimize defects; Safety Inspection, OH surveillance costs.
• Internal Failure Costs i.e; post incident costs; WC , Enquiry costs etc.
• External Failure Costs i.e; Regulatory fines, Public image Costs etc.
Analysis of Policies Regarding Disposal of Industrial Batteries in USA
Vijay Bishnoi
Panel 11: Improving Health, Safety, and the Environment
12th Symposium on
Development and Social Transformation
TYPES OF BATTERIES
WET-CELL: Lead acid batteries used to power vehicles and by industry.
DRY-CELL NON-RECHARGEABLE: These are the most common types of household alkaline battery.
DRY-CELL RECHARGEABLE : These are general purpose rechargeable batteries and include nickel cadmium, nickel metal hydride and lithium-ion batteries used in power tools, cordless appliances, mobile phones, etc.
ENVIRONMENTAL EFFECT Batteries contain toxic heavy metals like
cadmium, mercury and lead. When thrown away, however these batteries
can cause serious harm to human health and the environment as these heavy metals enter into food chain.
Possible health effects associated with ingestion or inhalation of heavy metals through water, food, or air include headaches, adnominal discomfort, seizures, comas and even cancer.
REGULATION
In USA lead-acid batteries were regulated at state level around 1990.
In 1996 a battery act was promulgated at federal level which regulated the disposal of used rechargeable batteries.
BCI and RBRC are the two NPO’s who developed the recycle program and also monitors recycling of used batteries.
MAIN POINTS OF US LEAD ACID BATTERY RECYCLING
Used batteries are to be recycled and not disposed of in landfill or incinerated.
Manufacturers collect spent batteries from consumers/ retailers when delivery shipments of new lead-acid batteries is done.
Financial incentive given to consumer for returning old battery which varies from state to state and is between $5 to $10 for each battery.
MAIN POINTS OF US LEAD ACID BATTERY RECYCLING…
Detailed regulation exist in USA as to how lead-acid batteries be transported which was issued by department of transportation around 1994.
Sustain publicity for educating public about environmental hazard and that battery should be recycled.
Consumer mainly responsible to send used battery to collection point or retailer.
Program is highly successful as recycling rate lead acid battery for the year 1999-2003 was 99.2%.
STATUS IN INDIA
In India regulation for disposal of lead acid batteries by recycle were promulgated in 2001 and is known as batteries (management and handling) rules, 2001. no regulation is available for disposal of other types of batteries.
Hazardous Wastes (Management and Handling) Rules, promulgated in 1989 for transporting hazardous wastes.
Batteries mainly disposed off thro auction to registered recyclers by government departments after 2001.
No collection system for used automotive battery.
STATUS IN INDIA…
Lead recycling not able to meet requirement.
Total consumption: - 190,000 MT
Indigenous production: - 55,000 MT
Import of pure lead: - 65,000 MT
From secondary smelters: - 70,000 MT
It is estimated that 50% of lead recycling is done by secondary smelters who do not have MOEF clearance and create pollution.
LESSONS FOR INDIA…
Introduce legislation for disposal of all types of batteries.
Introduce legislation for collection and transportation of used batteries.
Extensive publicity for creating awareness regarding environmental risk.
LESSONS FOR INDIA…
Financial incentive to be introduced for returning used automotive battery.
Collection centers should be established at large number of places for collection of used batteries.
Alternative employment work to be arranged for workers already in business of smelting.
The Impact of Orphanhood on Health Status and Education Attainment of Children in
Uganda
Loveena Dookhony
Panel 11: Improving Health, Safety, and the Environment
12th Symposium on
Development and Social Transformation
By 2003,
Number of Orphans: 43 millions (12.3 % of
children)
Number of AIDS Orphans: 12.3 millions
Children orphaned during the year: 5.3 millions
State of Sub- Saharan Africa
HIV Prevalence Rate: 14 % in 1980 to 5 % in 2001
However, Number of Orphans continued to riseOrphans as a percent of all children:
in 1990: 10%
in 2003: 14%
Number of Orphans: 2 millions, of which 48% are AIDS Orphans
Uganda as Case Study
STUDY
Orphans vs. Non Orphans
1. What is the impact of orphanhood on health? Who have been sick in the past 30
days?
Hypothesis:
Orphans, especially AIDS Orphans is more likely to
be sick.
Explanatory Variables
Child Characteristics:– Orphanhood Status, Gender, Relationship to Head of Household
Head of Household Characteristics: – Gender, Health, Education
Household Characteristics:– Wealth Index
Sickness according to Orphan Status
23%25% 25%
34%
0
5
10
15
20
25
30
35
40
Ma Dead Pa Dead Orphan AIDS Orphan
Causes of Sickness (29% were sick)
Other, 32%
HIV/Symptoms
13%
Malaria, 55%
Table 5. Predicting Health Status (Partial Results)
Marginal Effects
(1) (2) (3) (4) (5) (6)
0.0527 a
(0.0216)0.0518 a
(0.0215) Both dead
0.0459 a
(0.0118)0.0465 a
(0.0118) One Dead
0.0444 a
(0.0171)0.0434 a
(0.0171) Ma Dead
Pa Dead
0.0286 a
(0.0119)0.0292 a
(0.0119)
AIDS Orphan
0.0354 b
(0.0167)0.0343 b
(0.0166)
Note: Number of observation is 24,912. The data comes from the Uganda National Household Survey 2002/2003Standard errors are reported beneath the coefficient estimates.a indicates significance at 1% levelb indicates significance at 5% level.c indicates significance at 10% level.
Predicting Health Status (Partial Results)
Interpretation of Results
Probability of Sickness
Sick
Orphan 15%
AIDS Orphan 13%
Head of HH Sick 50%
Conclusion
Increasing Number of Orphans in Africa
Orphans, specially AIDS Orphans, are
disadvantaged in terms of education and health
compared to a non-orphan
Policy Implications?
Panel 11: Improving Health, Safety, and the Environment
Thursday, November 17 (4:15-5:30)
Jyoti Shankar Choudhary
Social Marketing of Health Policy
Partha Sarathi Banerjee OSH Management in Indian Mining
Vijay Bishnoi Disposal of Industrial Batteries
Loveena Dookhony Orphanhood and Education in Uganda
12th Symposium on
Development and Social Transformation
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