This study will provide valuable insights into the cognitive and affective aspect of mental illness among these population and thus help in implementing better policies in this regard, as this is fast becoming the talk of the day.

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Background:Equity in health care is defined as equal access to available care for equal need. Out-of-pocket expenditures are the most inequitable means of health care financing. These payments become catastrophic health expenditure (CHE) if it exceeds the household’s ‘Capacity to Pay’. As fairness is one of the fundamental objectives of the health system, identification of the factors responsible for these expenditures is important. Hence this study was conducted to find out the determinants of CHE and to explore the socioeconomic horizontal equity in relation to it. Methods:Total 352 households from 9 villages of Amdanga block, North 24 Parganas, were studied for 12 months. Annual out-of-pocket healthcare expenditure exceeding 40% of annual household non-food expenditure was classified as CHE and determinants of the same were identified using logit-model. Equity was measured by Concentration index and modified Kakwani measure (MDK). Results:Overall prevalence of CHE was 20.7% and highest (39.3%) in the second income quintile. The odds of incurring CHE were highest (35.43) for the households with member/s requiring inpatient treatment followed by households having more than five members (12.81). Negative value of concentration index and MDK indicated that the probability of incurring CHE was disproportionately concentrated among the poor and the financing system was degressive, however some amount of equity was noted in the poorest quintile. Conclusions:Apart from the poorest section in the community the poorer and middle income sections are still exposed to healthcare expenditure shocks and the health care spending was diverse and less equitable.

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Background: In India, about 85% of rural drinking water supply depends on groundwater. National Sample Survey, 65th round showed that 55% of rural households were served by a tube well.  But ground water pollution has drastically increased in last decade due to increased human activities. In India around 1.5 million children die of diarrhea and 37.7 million people are affected by waterborne diseases annually. The study was conducted to find out the prevalence of contamination of the tube well water and the factors associated with it.Methods: A cross-sectional study was conducted in nine randomly selected villages of the Amdanga Block, North 24-Paraganas district, West Bengal. Water samples of 90 tube wells were tested for the bacteriological contamination using K020 HiH2S Test Strips (Modified) and factors associated with contamination were identified using logit model.Results: The prevalence of tube well water contamination was estimated to be 45.6%. Bacterial contamination of water was found to be significantly (p<0.05) associated with the absence of casing, presence of bad odor in water, presence of habitation within 15 m area and presence of sanitary latrine within 15 m area of tube wells.Conclusions: Ground water pollution is increasing because of human activities, suboptimal maintenance and poor environmental management around the sources.  Routine surveillance of water sources, a sustainable system of maintenance and repair, and an effective waste management system in rural areas is required. Emphasis should also be given to household purification of water before consumption.