Flies Without Borders: Lessons from Chennai on improving India's municipal public health services.

India's cities face key challenges to improving public health outcomes. First, unequally distributed public resources create insanitary conditions, especially in slums - threatening everyone's health, as suggested by poor child growth even amongst the wealthiest. Second, devolving services to elected bodies works poorly for highly technical services like public health. Third, services are highly fragmented. This paper examines the differences in the organisation and management of municipal services in Chennai and Delhi, two cities with sharply contrasting health indicators. Chennai mitigates these challenges by retaining professional management of service delivery and actively serving vulnerable populations - while services in Delhi are quite constrained. Management and institutional issues have received inadequate attention in the public health literature on developing countries, and the policy lessons from Chennai have wide relevance.

Implications of China's future bride shortage for the geographical distribution and social protection needs of never-married men.

Because sex ratios at birth have risen sharply in China in recent decades, an increasing proportion of men will be unable to find a bride, and will face old age without the support of a wife and children. We project the proportions of never-married men and their geographical distribution in China in the coming decades. Our projections assume that two tendencies in current marriage patterns will persist: that women will continue to migrate to wealthier areas and to prefer men with better prospects. We find that, by 2030, more than 20 per cent of men in China aged 30-39 will never have married, and that the proportion will be especially high among poor men in low-income provinces that are least able to provide social protection programmes. The projected geographic concentration of bachelors could be socially disruptive, and the results suggest a need to expand the coverage and central financing of social protection programmes.

Is banning sex-selection the best approach for reducing prenatal discrimination?

Pressure to ban prenatal sex-selection has grown with rising sex ratios at birth in some countries. Governments feel pressured to act, and bans seem an immediate step they can take. However, such bans have been in place for some time in South Korea, China, and India and the available evidence suggests they are difficult to implement and have limited impact. This is indicated most clearly in the Chinese census data, which throw light on the mixed effects of a very intensive effort to implement the ban. Studies show that bans on sex-selection have negative consequences for unwanted girls and their mothers. By contrast, studies show that other policies - including mass messaging and measures to increase gender equity - show fairly quick impact in reducing son preference and increasing parental investment in girls. Such policies can permanently lower son preference and sex-selection, while also improving girls' life-chances.

Implementing public health regulations in developing countries: lessons from the OECD countries.

Developing country efforts to enforce basic public health standards are often hindered by limited agency resources and poorly designed enforcement mechanisms, including excessive reliance on slow and erratic judicial systems. Traditional public health regulation can therefore be difficult to implement. This article examines innovative approaches to the implementation of public health regulations that have emerged in recent years within the OECD countries. These approaches aim to improve compliance with health standards among the different actors while reducing dependence on the legal system and the administrative resources of public health agencies in developing countries. Developing countries may find some useful lessons from these approaches that can be adapted for use in their own institutional settings.