The basic aim of the project is to identify the determinants of health, including mental health, among the adult, and in particular the elderly, population of a poor, rural district in India, and to generate tools and methods to select and evaluate interventions that could improve their health. Specifically, we propose to accomplish three goals. First, we will analyze a new data set on health care facilities and the health status of people in 100 villages in Udaipur, Rajasthan that will be collected by August 2002. The data sources include an integrated socio-economic and health status household questionnaire, a survey of village infrastructure (roads, water, schools, environmental resources), a census of health facilities available to villagers and a detailed survey of all facilities (public and private, including traditional healers), and a continuous absenteeism survey conducted over the period of a year in all public health facilities serving the sample villages. Through these four sources, the data set will provide a comprehensive picture of the health status and health care services in rural North India. In particular, we will evaluate the relative importance of income, the health care system, and other public good, as well as their interactions, in determining health status. Second, we will conduct a new survey on the physical and mental health of widows, a particularly vulnerable group in India. Third, on the basis of the analysis of the existing data and the new survey on widows, we will help an NGO choose one or more interventions to improve the health status of adults and the elderly. The possible alternatives include incentives for doctors, nutrition supplements for adults and elderly, and help towards obtaining an old age or widow's pension. We will then evaluate the effect of these interventions on health and mental health, using a new round of data collection with a similar instrument, as well as data on intermediate outcomes most likely to be affected by the intervention. The intervention itself will be funded elsewhere;
our aim here is collection and analysis of data and the identification, planning and evaluation of a suitable intervention.
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