What prevents India from becoming a social development leader
In terms of sanitation and child nutrition, India fares worse than most of its neighbouring countries
In the first edition of An Uncertain Glory: India And Its Contradictions, we argued that India’s development strategy is fundamentally flawed—that it overlooks the central role of human capabilities, both as valuable in themselves and as means of further progress. That basic deficiency has not been removed over these years. Some gains have been made, and some new—and serious—problems have also emerged, but the basic neglect of the transformative role of empowered human beings in economic and social progress remains.
Signs of Change
The general lethargy of social policy in India has found further expression, in recent years, in a dearth of social statistics. For example, the fourth round of the National Family Health Survey (NFHS-4) did not happen until 2015-16, a full ten years after the third round. In Bangladesh, by contrast, the Demographic and Health Survey (international equivalent of NFHS) has happened at regular intervals of three years or so since the early 1990s.
The release of NFHS-4 data, and just before that, of the findings of the Rapid Survey on Children (2013-14), point to an important pattern: a modest but noticeable acceleration in the progress of social indicators in the ten-year period that followed NFHS-3. To illustrate, the proportion of stunted or underweight children declined significantly during that period, at least compared with the glacial improvement of earlier periods. Similarly, there was faster progress in youth literacy rates, in child mortality rates and in maternal mortality.
Progress was, to be sure, not spectacular, but it was still significant compared with the sluggish improvements that preceded. This advance received some attention in the Global Multidimensional Poverty Index report, prepared by the Oxford Poverty and Human Development Initiative (OPHI) in 2018. According to the estimates presented in this report, the proportion of India’s population living in multidimensional poverty declined by nearly 50 per cent between 2005-6 and 2015-16.
It has also been observed that areas of relatively rapid progress have tended to be those where strong initiatives have occurred. Child vaccination is one example. In our earlier work, we discussed India’s abysmal record in this field, and the extraordinary inertia behind it. But we also noted some signs of positive change, notably with the mobilisation of frontline health workers, the Accredited Social Health Activists (ASHAs). The NFHS-4 findings point to significant progress on this front, with the proportion of children fully immunized jumping by about 30 percentage points between 2005-6 and 2015-16 in many of the lagging states—Bihar, Jharkhand, Uttar Pradesh, Rajasthan among others. There is still plenty of work to do: child immunization rates remain much lower in India than in Bangladesh. But at least India is beginning to look more like Bangladesh in this respect than like sub-Saharan Africa.
One reason why this is worth mentioning is that there has been a tendency in recent years to denigrate the achievements of the initiatives in that period and to grumble about wasteful spending on social programmes such as midday meals, the National Rural Employment Guarantee Act (NREGA), the public distribution system and the Integrated Child Development Services (ICDS). This is an oddly biased assessment, and the evidence actually suggests that things were moving in the right direction. Rapid economic growth has of course helped, partly by raising private incomes and partly by generating public revenue. But the social initiatives of this period also deserve considerable credit. Indeed, many of these social programmes have had good results. For instance, India’s midday meal scheme has well-documented effects on school attendance, child nutrition and even pupil achievements. Social security pensions, meagre as they are, bring some relief in the harsh lives of millions of widowed, elderly or disabled persons. The public distribution system has become an invaluable source of economic security for poor households, not just in forward states like Tamil Nadu but even in problematic states like Jharkhand where it used to be largely non-functional. Of course, there is some waste in the social sector, just as there is much waste elsewhere. The lesson is not to dismantle the system but to improve it—and there is plenty of evidence that this can be done.
The Indian Enigma
Despite some accelerated progress in the decade preceding NFHS-4, India’s social indicators in 2015-16 were still far from flattering. In fact, many of them were still worse than those of India’s south Asian neighbours (Bangladesh, Bhutan, Nepal, Sri Lanka), with the partial exception of Pakistan. To illustrate, only Pakistan now has a lower life expectancy, higher child mortality rate and higher fertility rate. In terms of sanitation and child nutrition, India fares worse than all these neighbouring countries. Literacy rates in the younger age groups are also lower in India than in all other south Asian countries except Pakistan and Nepal. Perhaps the gap is narrowing over time, but it is still there.
This is puzzling, considering that India’s per-capita GDP is almost twice as high as that of Bangladesh and three times as high as Nepal’s. We discussed this puzzle in earlier work, but a little more can be said today in the light of recent research. Briefly, there is growing evidence that India’s poor social indicators, relative to neighbouring countries with lower per-capita GDP, are closely connected with various forms of economic and social inequality.
Some aspects of that connection are reasonably familiar (for instance, the role of extreme gender inequality in stifling social progress in India), but others have now come to light. Consider, for instance, child mortality rates in India and Bangladesh. On average, they are a little higher in India. In the top wealth quintile, however, they are lower in India than in Bangladesh, and the opposite applies in the bottom wealth quintile. In other words, the relatively high mortality rate of Indian children reflects a huge mortality disadvantage of poor children vis-à-vis rich children (with mortality rates of 75 and 25 per 1,000 live births, respectively, in the 0-5 age group). A similar point, it appears, applies to pupil achievements in primary schools: well-off Indian children are doing just as well as (if not better than) well-off Bangladeshi children, but India has much larger educational disparities between the rich and the poor.
Another example is that of sanitation. This is a field where India has lagged behind not only south Asia but most of the rest of the world as well. Why so? One partial answer relates to gender inequality: Indian women are the first victims of inadequate sanitation, but they have little voice and power within the household. Of course, this may be true in many other countries as well. India, however, also has special problems related to the caste system. It is the caste system, and its obsession with purity and pollution, that creates a phobia of human waste in Indian society, where the ‘dirty’ job of emptying latrine pits is left to specific castes of manual scavengers. Naturally, Dalits are now reluctant to do this, and no-one else is willing either. During the last few years, the two-pit latrine design, which makes the task of removing human waste relatively simple and harmless, has gained wide acceptance. Despite the government’s claims, however, open defecation is still very common in India.
It is not surprising that class, caste and gender inequalities have played an important role in preventing India from becoming a social development leader in south Asia. This connection reinforces the need to recognise the extreme nature of social inequality in India. Few countries have such an oppressive social system.
Extracted from the introduction to the second edition of An Uncertain Glory: India And Its Contradictions with permission from Penguin Random House India.
FIRST PUBLISHED20.03.2020 | 05:04 PM IST