Coping to Covid-19 in Uttar Pradesh, India: Evidence from NSSO 76 th Round Data

This paper aims at identifying key determinants, which influence and motivates households to wash hand on a regular basis with soap and water before taking meal and after open defecation in urban Uttar Pradesh using house-hold-level 76 th round NSSO data (July-December 2018). Binary logistic regression model results show households those are having access to safe and sufficient water throughout the year are also more likely to wash their hands compare to those households that don’t have access to water. Therefore, increasing investment in WASH services would act as an important mechanism to mitigate the secondary effects of Covid-19 in communities.

vid-19 cases were limited within few urban pockets of India. However, due to late implementation of various measures by Government such as travel advisory issued to Ports and International Airports, testing of covid-19 to foreign travelers, lack of contact tracing, slow sample testing of Covid-19, inadequate appropriate measures to retain reverse migration, it spread to rural pockets too. This has also been seen in the pre and post-lockdown periods. In India, cases are slowly increasing during pre-lockdown period (February-March, 2020), moderately increased during lockdown period (April-July, 2020), and sharply increased during post-lockdown period (August to till now). During pre-lockdown period, Covid-19 cases were only 1257, during lockdown period cases were 16, 38,870, while post-lockdown period 90, 04, 365 cases were reported. This shows transitional shift in the number of Covid-19 cases and effectiveness of lockdown measures. https: //www.mygov.in/covid-19 Though lockdown measures are helped in the lowering of the graph of Covid-19 cases, the economic cost of lockdown was unprecedented and huge. The Gross Domestic Product (GDP) of Indian economy has contracted to negative growth up to 23.9% in the April-June quarter of 2020 fiscal year (MOSPI, 2020: pp. 15-23). This is the worst decline ever recorded as India started compiling GDP statistics on a quarterly basis since 1996. The main reason for dramatic decline in GDP is unplanned lockdown measure. Due to lockdown, private consumption was declined 27% from 59%, while private investment fell by 74% in 2020. Lockdown was severely affected to unorganized sector's worker. All top employment providing section including construction report sharp decline, due to this, unemployment rate rose 6.7% on 15 March to 26% on 19 April, 2020. A joint report published by International Labor Organization and Asian Development Bank (2020) predicted that if corrective measures will not take then India would go into recession (Singh, 2020d: pp. 17-34;Singh, 2018: pp. 1-16).
In Utter Pradesh, Covid-19 has severely affected the population both in terms of life and livelihood. With inadequate health infrastructure (only 18 medical collages over 204.20 million population) highlights the susceptibility of population. More than 75% of population in Uttar Pradesh is residing in rural areas without safe drinking water and sanitation facilities, which is highly vulnerable to Covid-19 pandemic. Covid-19 cases were reported a transitional shift from urban pockets to rural areas during post-lockdown period (Table 1). Uttar Pradesh is divided into four economic regions namely Western, Central, Eastern  (Jamie, 2020: pp. 1-5) and workplace (Singh, 2020c: pp. 1-4), while no study has assessed the determinants of hand-washing in urban Uttar Pradesh using latest NSSO data. Thus, we take an opportune to examine urban health infrastructure, behavioral aspect of washing hands, its determinants and linked with the feasibility of to prevent spread of Covid-19 in urban Uttar Pradesh.
Hence, the study uses household level secondary data collected from nationally representative National Sample Survey Office (NSSO) of 76 th round, which was conducted during July-December 2018. Here it is important to mention that NSSO data was collected earlier from the Covid-19 emergences, but due to data was scientifically and representatively collected household-level information, therefore, easily capable to replicate the coping response of urban population to deal with any future health crisis.
Paper designs into four section. Emergence of Covid-19 and its impact on human health were discussed in Section 1. Section 2 provides information about study area, data sources, and estimation method, while results are presented in

Study Area and Data Sources
Uttar Pradesh is the most populous state of India and located 26.85˚ North and 80.95˚ East. The state is divided into 18 divisions and 75 districts. It covered around 243,290 square kilometers of geographical area, and has 19, 98, 12, 341 population (Census, 2011: pp. 12-20). Nearly 22.27% of population in Uttar Pradesh live in urban areas. Population density of Uttar Pradesh is 828 person per square kilometer, while literacy rate is 71.10% (Singh, 2019: pp. 1-14).
The present study uses 76 th round of National Sample Survey data collected by the National Statistical Office (NSO) of Ministry of Statistics and Programme Implementation (MOSPI), Government of India. NSO carried out a survey on "Drinking Water, Sanitation, Hygiene and Housing Condition" during July-December 2018 covering 1, 06, 837 households at all India level and 12,423 samples were collected from Uttar Pradesh. Further, out of 12,423 samples, 67% and 33% were collected from rural and urban areas respectively. As this study assessing the urban health infrastructure, therefore, our study was restricted to urban data viz., 4073 samples.

Estimation Method
In order to capture determinants of hand wash practices (which is main coping strategy suggested by WHO to cope with Covid-19), 76 th NSSO round enquired whether household members regularly wash their hand before taking meal and wash their hand after defecation, binary logistic regression was employed (Singh, 2020b: pp. 1-13). The coping strategy (hand wash) is the dichotomous dependent variable (Y) of this model having binary value of one (1) if the household adapts hand wash as a coping strategy to covid-19, and zero (0) if otherwise (Singh, 2020a: pp. 1-23). The model also assumes that use of coping strategy is a log-linear function of the exogenous variables X 1 , X 2 of the term, which is as follows. In 1 where, L = logit model, P = is the probability of using coping strategy. Denote as

Socioeconomic Characteristics of Sample Household
Socioeconomic characteristics are reflections of society's risk aversion behaviour.  (Table 3).

Determinants of Hand Washing
Covid-19 is severely affecting worldwide, and in the absence of effective vaccine, preventive measure such as hand washing is one of prominent factor to protect from the pandemic. This study observes various factors that either restrict or motivate urban households to wash hand before taking food and after defecation. In urban Uttar Pradesh, caste, religion, education, asses to basic amenities, and experiences of epidemic such as malaria are vital factors that motivates households to clear their hand regularly. Binary logistic regression examines the probability of households that adopt a suitable coping strategy (hand washing) as a preventive measure of Covid-19. The decision of households is captured with values (1, 0). One (1) denotes that households who adopted to Covid-19, while zero (0) denotes households who did not adopt to Covid-19. The estimated results of logit model predicted that about 94% of responses are correct (Table 4). The result fits at 1% (Prob > chi2) level of significance as indicated by LR chi-square, which confirms that variables captured in this model is valid. It further confirms that determinants of willingness of households perfectly adopting hand washing as coping strategy in dealing with Covid-19 in the study area.  hygiene conditions, hence, more likely to wash their hands compare to households do not these facilities. Moreover, households experiencing floods and mosquitoes in the rainy season face challenges of epidemic. Therefore, they are more likely to wash their hands to avoid infection from pandemic like Covid-19 too. Lastly, proper ventilation provides clean and safe air to the households' members and helps in dealing to seasonal diseases.
In totality, the odd ratio statistics reveal that an educated households who is getting sufficient water and having past experiences of health disease are more likely to wash their hands than others.

Conclusion and Policy Recommendation
The paper provides an overall understanding of coping method of hand washing As far as limitations of this study are a concern, it must be noted that research is not entirely definitive in the certain areas, such as urban design and environmental causes, and new and related results can appear in the coming months in view of the emerging pandemic. In order to update the results of this initial analysis, more assessments are required in the coming months as well as to provide information on existing under-graduated topics such as the long-term socioeconomic and environmental implications and how the pandemic could change population behavior and urban governance. Such type of study is particularly important because the full socioeconomic impacts of the pandemic may take some more time to appear. Future papers should also involve analysis of temporal evolution of the evidence related to different issues discussed in this study to explore possible lines of convergence and divergence.
Finally, the need for serious thinking on the importance of cities and how they are managed are highlighted in this crisis. It is hopeful that, after the significant effect of the pandemic on towns, planners and communities, support for transformational actions would be more effective in tackling other major challenges, including climate change, which arise over cities.