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Study links uneven urbanisation with high risk of cholera outbreaks

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Study links uneven urbanisation with high risk of cholera outbreaks

By Sunderarajan Padmanabhan

Families living in rural areas of districts at higher risk of cholera as funds for water and sanitation infrastructure are diverted to urban areas, say experts

New Delhi: Higher levels of urbanisation are no guarantee for preventing the outbreak of cholera. In fact, a new study by Indian and international experts seems to indicate that higher urbanisation also leads to an increased risk of a cholera epidemic since funds for water and sanitation infrastructure are often allocated disproportionately within an ‘urban’ district, with its rural areas receiving only a pittance.

In other words, the study blames the uneven allocation of funds for water and sanitation infrastructure within districts – urban centres getting more funds than rural areas within a district that is otherwise categorised as ‘urban’. The use of improved sanitation facilities in urban areas in India has increased to 63 per cent as of 2015 while it has gone up to only 28 per cent in rural areas.

“It appears that families living in rural areas of districts with more cities are at higher risk, perhaps because the resources in these districts are allocated to the urban areas, neglecting the rural areas of the district,” the researchers have observed in their study in journal PLOS One.

The study has also found that there seemed to be large scale underreporting of cholera cases. There is significant variation between actual number of cases being reported and ground reality based on the various risk factors. For instance, the study says, Uttar Pradesh did not report any case despite having areas that qualified as ‘high risk’ zones. The reasons for underreporting are limited disease surveillance, inadequate laboratory capacity especially at the peripheral health care centres, and reluctance on part of authorities to acknowledge the problem for fear of societal repercussions.

The findings are based on district level data of cases reported between 2010 to 2015 from the Integrated Disease Surveillance Programme, and socioeconomic characteristics and coverage of water and sanitation obtained from the 2011 census report. Researchers used this data to perform spatial analysis to identify cholera hotspots, and employed a modeling method called ‘zero-inflated Poisson regression’ to identify the factors associated with cholera and predicted case counts at district level.

A total of 27,615 cholera cases were reported during the six-year period. As many as 24 out of the 36 states in the country had reported cholera during these years. Of them, 13 States were classified as endemic. In terms of districts, out of the 641 districts in the country, 78 districts in 15 states were identified as “hotspots” based on the reported cases. However, 111 districts in nine states were identified as “hotspots” from model-based predicted number of cases.

Overall, one-fourth of the districts in India reported cholera and 90 districts of them have been identified as hotspots, making cholera is a widespread major public health problem in the country. It is major problem in West Bengal, Karnataka, Chhattisgarh, Punjab, and areas of Himachal Pradesh adjoining Punjab. In addition, most districts in Karnataka have been identified as cholera hotspots. The risk for cholera in a district is linked with poor sanitation and drainage conditions and urbanization level in the district.

The research team included Mohammad Ali and David A.Sack of Department of International Health, Johns Hopkins Bloomberg School of Public Health; Nirmal K. Ganguly, Sanjukta Sen Gupta, and Nisha Arora of Policy Center for Biomedical Research, Translational Health Science and Technology Institute; Pradeep Khasnobis and Srinivas Venkatesh of National Center for Disease Control; Dipika Sur of Indian Public Health Association; and Gopinath B. Nair of World Health Organization.

(This article is from a syndicated feed provided by the India Science Wire)

India News

PM Modi assures no discrimination in women’s quota, delimitation debate intensifies in Parliament

PM Narendra Modi has assured that women’s reservation will be implemented without discrimination, amid a heated debate over delimitation in Parliament.

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PM modi

Prime Minister Narendra Modi has assured that there will be no discrimination in the implementation of women’s reservation, as Parliament witnessed a sharp debate over the proposed linkage between the quota and delimitation exercise.

During the ongoing special session, the government reiterated its commitment to ensuring fair representation while addressing concerns raised by opposition parties regarding the timing and structure of the legislation.

The proposed framework aims to reserve 33 percent of seats for women in the Lok Sabha and state assemblies. However, its implementation is tied to a fresh delimitation exercise, which is expected after the next census.

Opposition questions timing and intent

Opposition leaders have raised concerns that linking the women’s quota to delimitation could delay its implementation. They argue that the process of redrawing constituencies may push the actual rollout further into the future.

The issue has triggered a broader political confrontation, with multiple parties questioning whether the move could alter representation across states.

Some critics have also alleged that the delimitation exercise could disproportionately benefit certain regions based on population, a charge the government has rejected.

Government reiterates commitment to fair implementation

Responding to these concerns, the Centre has maintained that the reforms are necessary to ensure accurate and updated representation based on population data.

Leaders from the ruling side have repeatedly emphasized that the process will be carried out transparently and without bias. The assurance that there will be “no discrimination” is aimed at addressing fears among states and opposition parties.

The debate marks a key moment in Parliament, with both sides engaging in intense exchanges over one of the most significant electoral reforms in recent years.

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Give all tickets to Muslim women, Amit Shah says, attacking Akhilesh Yadav on sub-quota demand

A sharp exchange between Amit Shah and Akhilesh Yadav in Parliament over sub-quota for Muslim women highlights key divisions on women’s reservation implementation.

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A heated exchange broke out in Parliament during discussions on the women’s reservation framework, with Union Home Minister Amit Shah and Samajwadi Party chief Akhilesh Yadav locking horns over the demand for a sub-quota for Muslim women.

The debate unfolded as the government pushed forward key legislative measures to implement 33% reservation for women in the Lok Sabha and state assemblies.

Akhilesh Yadav argued that the proposed reservation must ensure representation for women from marginalised communities, including Other Backward Classes (OBCs) and Muslim women. He said that without such provisions, large sections could remain excluded from political participation.

He also questioned the timing of the bill, alleging that the Centre was avoiding a caste census. According to him, a census would lead to renewed demands for caste-based reservations, which the government is reluctant to address.

Government rejects religion-based quota

Responding to the demand, Amit Shah made it clear that reservation based on religion is not permitted under the Constitution.

He stated that any proposal to provide quota to Muslims on religious grounds would be unconstitutional, firmly rejecting the idea of a separate sub-quota for Muslim women within the broader reservation framework.

The government has maintained that the existing framework already includes provisions for Scheduled Castes (SC) and Scheduled Tribes (ST) women within the overall reservation structure.

Wider political divide over implementation

The issue of sub-categorisation within the women’s quota has emerged as a major flashpoint, even as most opposition parties broadly support the idea of women’s reservation.

Samajwadi Party leaders reiterated that their support for the bill depends on inclusion of OBC and minority women, while the government continues to defend its constitutional position.

The debate is part of a broader discussion during the special Parliament session, where multiple bills linked to delimitation and implementation of the women’s quota are being taken up.

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No state will lose a seat, Centre assures as delimitation debate takes centre stage in Parliament

Parliament’s special session begins with key focus on implementing women’s reservation and delimitation, setting the stage for major electoral changes.

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Parliament

A special session of Parliament commenced on Thursday, with the Centre set to take up crucial legislation related to women’s reservation and delimitation of constituencies. The session, scheduled over three days, is expected to witness intense debate as the government pushes forward its legislative agenda.

At the centre of discussions is the proposal to operationalise the women’s reservation law, which seeks to allocate 33 percent of seats in the Lok Sabha and state assemblies to women. The law, passed earlier, requires enabling provisions before it can be implemented.

The rollout of the reservation is closely tied to the delimitation exercise — a process that redraws parliamentary constituencies based on updated population data. The implementation is expected only after the next census and delimitation process are completed.

The government is aiming to put in place the framework so that the reservation can be enforced in future elections, likely around 2029.

Delimitation and numbers at play

Delimitation is a key aspect of the proposed changes, as it will determine how seats are redistributed and which constituencies are reserved. The exercise is expected to reflect population shifts and may also involve an increase in the total number of Lok Sabha seats.

This linkage has made the issue politically sensitive, with several opposition parties backing women’s reservation in principle but raising concerns over how and when delimitation will be carried out.

Political reactions and expected debate

The session is likely to see sharp exchanges between the government and opposition. While there is broad agreement on increasing women’s representation, disagreements remain over the timing, process, and potential political implications of the delimitation exercise.

Some leaders have argued that delimitation could significantly alter the balance of representation among states, making it a contentious issue beyond the women’s quota itself.

The government, however, has framed the move as a step toward strengthening women’s participation in governance and ensuring more inclusive policymaking.

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