Research
In 1975, the Indira Gandhi government declared a state of emergency in India which led to the forced sterilization of millions of men and women over a 21-month period. This paper aims to understand the long-term impact of this forced sterilization on women's labor market outcomes in the 1990s. It argues that forced sterilization or sterilizations without sufficient information on alternatives could have potentially long-term consequences for female decision making and labor market outcomes. The primary determinant of a woman's value in a marital household in India is her fertility, which then contributes to her decision-making power. When her value and thus decision-making power is reduced through state-mandated sterilization, it could have long-run consequences not only on her health but also on her ability to work. The implementation of the forced sterilization campaign was at the district level by the district collector who received targets from the state Chief Minister who in turn was acting on orders of the central government. The study explores variations stemming from the intensities with which district collectors implemented the forced sterilization program locally, the age cohort of the respondent and the total number of children the respondent had during the campaign (1975-77) as different dimensions. Data derived from the first and second wave of the Demographic Health Survey’s Indian women’s module and the Indian District Census Handbook from 1980 is used in the analysis. Differences in differences estimates using age cohorts and district-level intensity of sterilization indicate that forced female sterilizations or exposure therein led to reduced paid labor market access. This is particularly evident in paid work and specifically agricultural labor. There is recent evidence that indicates that Indian men derive disutility from having a working wife. This mechanism of disutility is argued as a channel through which women's labor market outcomes are reduced when her fertility is ended externally by the state.
Institutional Trust and Women’s Healthcare Utilization
Despite concerted efforts by governments and policymakers, there is evidence that a significant proportion of women in India give birth at home, forgo institutional ante- and post-natal care as well as key vaccinations for their children. Existing research in the field indicate that there are economic factors such as out-of-pocket costs, transport costs as well as non-economic factors such as institutional mistrust that prevent the utilization of institutional health services. Deriving from this, the underutilization of skilled healthcare by women could stem from mistrust in political health institutions. However, given that trust is endogenous to healthcare utilization, to identify the causal role of trust, this study uses voter turnout rates in elections as an instrument. Using data from India, preliminary results from this study finds that institutional trust reduces delivery and ante-natal care at home and in private hospitals and increases similar services accessed in public hospitals.
This study looks jointly at the health effects of the world's largest demand-side maternal cash transfer program—India’s Janani Suraksha Yojana (JSY) and Accredited Social Health Activists (ASHA) interactions. Using difference-in-differences, I exploit the differences in the percentage coverage of both policy instruments across districts. I find that cash transfers under JSY and ASHA interactions increase delivery in a public institution and overall institutional delivery. However, the impact on neonatal delivery remains mixed. Additionally, the policy also has a heterogeneous impact on unintended outcomes such as antenatal care visits, breastfeeding, birth intervals, and incidence of caesarean sections.