Wednesday, 31 January 2018

India: Governance and Human Development

Dr. Devendra Kothari
Population and Development Analyst
Forum for Population Action


“The focus should be on Minimum Government but Maximum Governance.”

Narendra Modi
Prime Minister o India

Recently the terms "governance" and "good governance" are being increasingly used in development debate. Bad governance is being increasingly regarded as one of the root causes of all evil within our societies. While India is a prosperous country, people have been deprived of its benefits due to poor governance. [1]

 

The post seeks an answer to the question of what good governance is and what its relationship with human development (HD) is.

 

Government and governance are two very similar words. People often get confused about the differences between “governance” and “government.” Government is a group of people who rule or run the administration of a country. 

On the other hand, governance is the act of governing; exercising authority. Good governance is an indeterminate term used in the international development literature to describe how public institutions conduct public affairs and manage public resources. It involves the process of decision-making and the process by which decisions are implemented or not implemented. [2]  Good governance has some major characteristics. It is participatory, accountable, transparent, efficient and effective, and follows the rule of law. It assures that corruption is minimized, and the voices of the vulnerable are heard in decision-making. It is also responsive to the present and future needs of society. Actually the term good governance has become synonymous to “effective” management.  
The United Nations Development Programme (UNDP) and scholars connect human development very closely with good governance.  Al Haq together with Amartya Sen went on to develop the Human Development Index (HDI) to measure human development. In the introduction of the first Human Development Report, HD was defined as: “...a process of enlarging people's choices … most critical of these wide ranging choices are to live a long and healthy life, to be educated and to have access to resources needed for a decent standard of living”. [3]


The Human Development Report 2016 does not speak very high about India’s achievements in enlarging people’s capabilities and improving their well-being. India ranks 131 of 188 countries when it comes to the HDI. This puts it in the ‘medium’ category. The HDI combines a country’s average achievements in health, education and income. India’s HDI, at 0.624, makes it the third SAARC country on the list, behind Sri Lanka and Maldives (both of which fall in the ‘high’ HDI category). One can argue that they are small countries.  A comparison should be made between equals.

India – China and Human Development:
Calculations of historical Human Development Index scores indicate that from the same starting point in 1950 [4]  China’s HDI score was 12 per cent higher than India’s in 1979 and 20 per cent higher in 2015.  This raises the question: How was China able to promote human development as measured by the levels of education, health, and material well-being?

This question has been analyzed by Mattias Ottervik of Lund University, Sweden in a paper: ’Good’ Governance and Human Development: The Case of China and India. [5]  According to Ottervik, the relationship between good governance and human development is strong, but it is the minimalist aspect of governance, “effectiveness”, that has the largest impact on human development in China as compared to India. “China was able to realize a comparatively high level of human development through effective governance which could autonomously formulate and implement policies. Though well-intended, India’s leadership seems to not have had the same ability to formulate or implement policies without influence of social forces”, writes Ottervik.

As a result, from the same starting position in 1950, China and India’s human development quickly diverged after eighties. By 2015 China’s adult literacy rate was almost one-third more that of India’s and life expectancy was almost ten years longer. Same could be said about infant mortality rate and other indicators of human development. As a result, the value of Human Development Index was 0.738 in China while it was 0.624 in India in 2015. The World Bank data  also shows that China’s percapita income is more than five times that of India.  

Human development has always been important priority for China in its quest for economic development. Available research shows that investments in HD fundamentals like education, health, sanitation and water as well as population stabilization account for China’s phenomenal growth since the late 1980s. “And, as India charts its course for the future, the productivity and skill level of its workforce is becoming even more critical”, writes Bill Gates, a well-wisher of India. [6] India can learn a lot from the Chinese experiences, as how one can manage human development with right type of implementation strategies based on good governance.


Health and Education- a case study:
According to the Economic Survey 2018, which was presented in Parliament in January 2018, India did not give due importance to the management issues of human development in the past. [7]  The public investment in social infrastructure like education and health and their effective management is critical in the development of an economy, the Survey noted.  While India has had a target of increasing public spending in health and education, in reality expenditure has remained stagnant (as a percentage of GDP) for years, and in some cases even reduced.  “As a percentage of GDP, the expenditure on education which remained stagnant around 3.1 per cent during the period 2009-10 to 2013-14, however, declined to 2.8 per cent in 2014-15,” the Survey added. India can realize a comparatively high level of economic development like China within a generation through effective management of healthcare and education among other human development inputs.

Healthcare: The public healthcare in India is in shambles and it is not only the question of woefully underfunded but a very good example of ineffective or poor governance. For example, more than 70 children lost their lives in a tragic incident of medical mismanagement  in a day at the 800 bedded BRD Government Medical College Hospital in Gorakhpur, Uttar Pradesh in the last week of September 2017. Most deaths were reported from the neonatal and encephalitis wards. These deaths were reportedly caused due to non-availability of liquid oxygen, since its supply was stopped due to non-payment of outstanding accumulated dues worth Rs 6.8 million that the hospital owed to Pushpa Sales, the sole supplier of liquid oxygen to the hospital. [8]  

 

The management of the hospital has been so abysmal in the last few years that tragedies like this have been a daily occurrence. According to official records, during 2012-2017, more than 3,000 children died at the BRD Hospital. Most of the deaths were attributed to acute encephalitis syndrome (AES) caused by the Japanese encephalitis. According to the institution's former principal and head of pediatrics department KP Kushwaha, these officials’ numbers are actually understated. Other medical practitioners have blamed the hospital's negligence as a major factor behind the high number of child deaths. [9]


The tragedy has ignited outrage across the country and abroad. Nobel Peace laureate Kailash Satyarthi termed the tragedy a “massacre”. It has also evoked a political firestorm over allegations of administrative lapses and Gorakhpur being UP Chief Minister Yogi Adityanath’s constituency for almost 20 years. If hospital, located in the chief minister’s town, could not be managed properly then what would happen to other hospitals or public services.

The State governments in India take ‘immediate actions’ on such tragedies.   In the name of the action, the state government of Uttar Pradesh suspended (not terminated) the head of BRD Medical College and ordered an investigation into contracts to supply oxygen, a routine action taken in each and every incidence of mismanagement in the country   in the name of ‘good’ governance.

This pathetic state of healthcare is not unique to the public hospitals but also private ones and their functioning must be improved too. Several high-profile cases have been reported in the media with blame being generously meted out. [10] The fragile but extremely essential equation of trust has gone. On the other hand, Government-run or public hospitals are theoretically free for everyone, but quality is poor and corruption is endemic.  This is a sorry state of affairs of India’s health services, and it must be resolved.

The Economic Survey 2017-18, therefore, noted that India is in desperate need of universal healthcare. If the government were to increase government spending on healthcare from the current below 1.5 per cent levels to UN recommended 2.5 per cent levels, it would not improve health conditions of millions of Indians unless ‘good’ governance is simultaneously brought in.

And activists and experts have been screaming for better healthcare reforms for years. That could be the reason why the editor of the world's most revered medical journal - The Lancet - said that failing to combat non communicable and communicable diseases will cost India's health system and social care "enormously making India collapse”. [11]  And yet, despite all the warnings, despite all the preventable deaths, healthcare in India continuously remains in shambles.

Education: Does India’s education system gear enough to meet the challenge of low productivity? Considering India’s poor education system from top to bottom one cannot be too optimistic about it. To improve the quality of education, the school education is the first step towards that direction.  In the HDPlus framework, therefore, education is a significant input to empower people.[12]

With enrollment reaching at least 97 per cent since 2009, and girls making up 55 per cent of new students between 2007 and 2015, it is clear that many problems of access to schooling have been addressed. The problem is now of quality, not quantity. "My biggest disappointment is the education system (in India). I do want to create higher expectations about it”, writes Bill Gates of Bill & Melinda Gates Foundation. [13]

For a country that aims to be a global growth hub, the latest Annual Status of Education Report (ASER) for rural India makes for dismal reading. The survey for the report carried out across 24 states in 2017 paints a sorry picture of school education. Focussing on 14-18 year old students who comprise the first batch to pass Class VIII after the implementation of the Right to Education Act, the report finds that one-fourth of the students are unable to read their own language fluently, while 57 per cent of them struggle to solve a simple sum of division.

These findings clearly show that school education in India suffers from serious systemic lacunae. And these cannot be addressed through legislations alone without improving the management of the schools. “While enrollment rates in schools have gone up significantly, learning outcomes appear to have stagnated. For a large section of secondary and higher secondary students in this country, it hardly matters whether they are in school or not”, noted TOT editorial. [14]

This massive shortfall in skilling, which cannot be made up for with “Skill India” programmes, has serious repercussions for India’s economy and society. With more than a million youth joining the workforce every month, poor education standards mean that many of them won’t be employable. That in turn could see unemployed youngsters channel their energies towards destructive ends, turning India’s demographic dividend into a demographic time bomb, added TOT Edit.  The only solution is to focus on improving education quality in schools through measures such as hiring and assessing teachers on merit, or rigorous mapping of learning outcomes by involving the community, as noted in my paper - Managing School Education in India. [15]

Also, the higher education and research sector is not in good shape due to the over-regulation and under funding. The Times Higher Education World University Rankings, founded in 2004, provide the definitive list of the world's best universities, evaluated across teaching, research, international outlook, reputation and more. THE’s data are trusted by governments and universities and are a vital resource for students, helping them choose where to study. According to THE not a single Indian university/institute has been able to get a place in the top 200 world university rankings during 2015 to 2016. [16] The rankings reveal that IIS lies between 251 and 300 and IIT-B is ranked between 351 and 400. IIT - Delhi, Kharagpur, Madras, Guwahati, Kanpur, Roorkee among others have made it to the top 600 universities in the world.

On the other hand, in 2016, 63 universities in USA made into the top 200, while the UK claims 10 places, two shy of last year’s sum. Although Western universities continue to dominate the highest spots, Asian institutions have been gaining ground – 19 of which reached the top 200 in 2016, up from 15 the previous year. The region’s best performing university has reached a new high this year. The National University of Singapore made it to 24th place, an increase of two positions. Mainland China takes four places in the top 200, up from two last year, with its leader Peking University joining the top 30, in 29th place (up from 42nd last year), and its regional rival Tsinghua University making its debut in the top 40, in 35th place (up from joint 47th). Meanwhile, Hong Kong claims five top 200 positions, up from three last year, making it the most-represented Asian region in the top 200. It is led by the University of Hong Kong in joint 43rd place, a modest hop up from joint 44th last year. Hong Kong’s improved performance is largely owing to increased institutional and research income and greater research productivity, as per THE.

Meanwhile, India’s leading university/institute  – the Indian  Institute of Sciences (IIS)  – is edging closer to the top 200, claiming a spot in the 201-250 band in 2016, its highest ever position. It is, therefore, low probability that the Indian universities/institutes are making international strides in near future. We have   a different idea about education and a different way of going about it. Indian universities/institutes create a much “pressured environment”, have “a lot of learning by rote” and there is “not a lot of discussion in classes”. “I don’t know if that would translate globally, except in some of the narrow scientific and technical areas”, as noted by Richard Robison, emeritus professor in the Asia Research Centre at Murdoch University.[17] In addition, the leadership of most of the universities is debatable.

Universities are considered the nurseries of young intellect, and I witnessed this as a student at the Harvard and Australian National University in the seventies. For the past few years, however, most of the Indian universities and colleges are in the limelight for the wrong reasons. “The horror stories that regularly come out of various campuses, colleges and even schools indicate that many of India’s hallowed teaching institutions like Banaras Hindu University, Jawaharlal Nehru University, Osmania University  among others are fast losing “the tag of ‘temples of learning’ and are being transformed into houses of infamy”, noted   by Prabhu Chawla, a renowned journalist. [18] Criminal incidents within their precincts are being whitewashed with hollow definitions of ideology. If a student(s) commits suicide in Hyderabad, mysteriously disappears from JNU or is assaulted in BHU Campus, [19] there are always people or motivated NGOs around looking for an opportunity to turn the incident into a controversy to score brownie points.

Discussion and conclusion:
The Modi Government has been doing the heavy lifting to empower the people through various human development schemes [20]  Recently, Prime Minister Narendra Modi promised Rs 10,000 crore or Rs 1,00,000 million and autonomy to 20 universities — 10 public and 10 private — in the country so as to compete globally and be counted among the world’s best institutions. [21] In addition to funding, rigorous research capacity should be at the heart of developing these institutions that could be able to engage with the real problems of India as well as developing world. However, it remains to be seen whether our decision makers are willing to accept the advice that this doesn’t simply mean producing more PhDs and there ought to be a focus upon creating ‘elite’ institutions that serve as exemplars.

Similarly, healthcare emerged as the buzzword of the 2018-19 Budgets, because it offers 10 crore or 100 million families (that is about 500 million people) up to 500,000 rupees, or about $7,860, of coverage each year. That sum, while small by Western standards, would be enough to cover the equivalent of five heart surgeries in India. Some public health experts, however, noted that the government’s proposals do little to prevent poor health in the first place. India is plagued by increasing levels of water and air pollution. Malnutrition, poor sanitation and lack of proper housing also remain major problems. [22]  

What should be agenda for enhancing capabilities or human development?  Addressing WEF at Davos, Prime Minister Narendra Modi promised that “red tape would be replaced by a red carpet for business”. Same is urgently required for the human development efforts. Just throwing money at the problem will not suffice; governments must also improve administration of public services including healthcare, education, sanitation and water, so that they deliver better outcomes. So, good governance must get the priority that is an administration that is accountable to its public.

The elephant in the room is that India’s growth is not really leading to the burgeoning middle class in the absence of robust and comprehensive human development strategy, as was envisaged and as did happen in China and East Asia.  IMF projects GDP growth during 2018-19 at 7.4 per cent will surpass China’s (6.8%). A more disturbing statistic, however,  is that the total increase in wealth earned by the 67 crore or 670 million Indians who make up the poorer half of the population was a mere 1 per cent last year. [23] This suggests wealth is not trickling down to the poorer half of the population. Governments at all levels are aware of challenges ahead and there have been haphazard attempts to solve them. This now requires a more coherent approach which fits into the overall reform package that brings in more scientific methods into human development and simultaneously fixes the malfunctioning system with good governance.

On assumption of office, Prime Minister Narendra Modi had emphasised the governance mantra, “maximum governance with minimum government”.  For this, one has to reduce the size of ministry and bureaucracy to build a strong and enabling system for good governance.

For example, several ministries have more than one minister of state, the Cabinet has expanded in number – to the level of the UPA’s Cabinet, ministers seem more interested in controlling what people eat than being preoccupied with good governance and others are obsessed with interfering in education by rewriting textbooks and controlling how students answer their roll calls.

Further, in order to achieve development in general and human development in particular, dynamic and vibrant bureaucracy is needed. “Though we need vision-based bureaucrats with far-sighted planning and strong will to implement it, but Indian bureaucracy seems to be conservative, less visionary and short sighted, also lacking aptitude and attitude which does not want to assimilate with society and changing politico-economic environment and the world”. [24] There is an urgent need to rethink about bureaucratic setup. In other word, we need to reconsider the current size of bureaucracy and nature of restructuring required to make it efficient by involving experts to help bureaucrats.

Also, empower local governments and create a culture that promotes direct citizen participation and engagement in planning and development processes. In Madhya Pradesh, for example, decentralized governance has increased the probability of a child completing grade 5 by 21 per cent. In addition, technology can bring greater efficiency to government systems, processes and interactions. Benefits to citizens include increased convenience and transparency in access to services, greater accountability, and avenues to expand the citizen voice.

At the moment, India is on the edge and it can take two routes. It can take a route of investing in its people and creating a thriving and flourishing future for India which has a part to play in world affairs or it can do what it is doing now and ignore human development in which case it will see increasing level of deteriorating low and order sweep across the country creating an unsustainable future and destroying national efforts to develop an inclusive and vibrant economy. And, India needs good governance, not governments to empower people.

It is hoped this post will deepen the discussion and accelerate the search for a better solution for human development and governance.


[1] This was noted by PM Modi on ‘Good Governance Day’ to celebrate the birthday of former premier Atal Bihari Vajpayee.

[2] UNESCAP. 2009.  “What is Good Governance?” United Nations Economic and Social Commission for Asia and the Pacific, Bangkok at: http://www.unescap.org/sites/default/files/good-governance.pdf



[3] UNDP. 1990. Human Development Report 1990. New York: United Nations Development Programme. Also see: UNDP. 2010. Human Development Report 2010. New York: United Nations Development Programme.

[4] Based on historical statistics, Crafts uses UN’s 2001 methodology to calculate historical HDI scores for several countries. While the absolute scores might be up to debate because of potential inaccuracies, the relative position seems well supported by other sources - from a similar position at their founding, China’s and India’s development level diverged as measured by education, health, and material well-being. Refer: Crafts, Nicholas. 1996. The Human Development Index: Some Historical Comparisons. London School of Economics & Political Science: Working Papers in Economic History. London: London School of Economic.

[5] Ottervik, Mattias. 2011. “‘Good’ Governance and Human Development: The Case of China and India”, STVK01,   Lund University,   Sweden. Also see at: https://lup.lub.lu.se/luur/download?func=downloadFile&recordOId=1968521&fileOId=1975767

[6] Gates, Bill. 2017. “Nurture India’s human capital: For rapid economic growth, paying attention to health and nutrition is essential”, Times of India  at https://blogs.timesofindia.indiatimes.com/toi-edit-page/nurture-indias-human-capital-for-rapid-economic-growth-paying-attention-to-health-and-nutrition-is-essential/

[7] BS Web Team. 1018. “Economic Survey 2018 crucial findings, projections: Mixing caution & optimism”, Business Standard at: http://www.business-standard.com/budget/article/mixing-caution-optimism-eco-survey-2018-s-crucial-findings-projections-118013000235_1.html 

[8] The private company, Pushpa Sales, wrote to the hospital repeatedly warning that supply of oxygen could be disrupted if dues were not cleared. The same was also publicised by local media outlets days before the deaths began. College officials said they had forwarded requests regarding the same to the State government but received no response.

[9] EPW Editorial. 2017. “When Children Die”, Economic & Political Weekly, 52 (33). Also see:  Singh, Manoj. 2017. “How Gorakhpur’s BRD Medical College Struggled With Money and Manpower for Years”, The Wire at: https://thewire.in/167498/gorakhpur-children-death-brd-medical-college-up-government/

[10] Recently, Fortis, Max and BL Kapoor Hospital have fallen prey to slander.  All these hospitals serve thousands of patients everyday in Delhi and NCR. 

[11] Refer article: Sinha, Kounteya. 2015. British medical journal Lancet to take Modi to task for ignoring health sector at https://timesofindia.indiatimes.com/india/Brtish-medical-journal-Lancet-to-take-Modi-to-task-for-ignoring-health-sector/articleshow/49484703.cms

[12] Kothari, Devendra. 2018. “Nurturing Human Development: A Strategy for New India”, will be published as an occasional paper by the Forum for Population Action in April, 2018.

[13] Gates, Bill. 2017. “India’s education system needs to be far better than it is today, Times of India at: https://m.timesofindia.com/indias-education-system-needs-to-be-far-better-than-it-is-today/amp_articleshow/61679641.cms


[14] TOI Edit. 2018. Ticking bomb: Poor education standards could dash India’s hopes of becoming a leading power, Times of India at:  https://blogs.timesofindia.indiatimes.com/toi-editorials/ticking-bomb-poor-education-standards-could-dash-indias-hopes-of-becoming-a-leading-power/


[15] Kothari, Devendra. 2017. “Managing School Education in India”, Administrative Change, Vol. XLIV (2): 78-89.

[16] India Today. 2016. “World University Ranking 2015 to 2016: No Indian university in top 200, IITs and others in top 600”, India Today at: https://www.indiatoday.in/education-today/news/story/top-indian-universities-322233-2016-05-07

[17] THE. 2016. World University Rankings 2016-2017: results announced, Times Higher Education at: https://www.timeshighereducation.com/news/world-university-rankings-2016-2017-results-announced

[18] Chawla, Prabhu. 2017. “Political and business greed is sabotaging education with caste, crime and calumny”, Indian Express at: http://www.newindianexpress.com/opinions/2017/oct/01/political-and-business-greed-is-sabotaging-education-with-caste-crime-and-calumny-1665028--1.html


 [19] In September – October, 2017, Banaras Hindu University (BHU), one of the country’s most prestigious Central universities, was in the news not for its academic excellence but for having become a dreaded playground for goons to stalk and molest students. When the victims and their supporters protested, they were treated not with balm but with batons. Police registered an FIR against 1,200 students, placing their professional future in jeopardy.

[20] During the last three and half   years, the Modi government has embarked on ambitious structural reforms to enhance capabilities through initiatives such as Swachh Bharat (Clean India to strengthen the sanitation and hygiene), Skill India, Jan Dhan Yojana (People’s Bank Plan), Beti Bachao, Beti Padhao (to address the gender issues), and  Ujjwala Yojana (make availability of cooking gas to poor   households to empower women and protect their health as well as   reduce drudgery and the time spent on cooking) and the Saubhagya Yojana (to provide free electricity connection to poor families)  among others.

[21] Kumar, Arun. 2017. “20 best universities to get Rs 10,000 cr, autonomy”,  Hindustan Times at: https://www.hindustantimes.com/india-news/pm-modi-in-patna-20-universities-to-get-rs-10-000-crore-over-5-years-for-world-class-education-system/story-ITrXDsWL2jCo1kkQtwRgoN.html

[22] “India Wants to Give Half a Billion People Free Health Care”, The New York Times at: https://www.nytimes.com/2018/02/01/business/india-modi-health-care.html


[23] TOT Edit. 2018. “The other half: India is turning into a republic of inequality, meriting frank discussion”, Times of India at:  https://blogs.timesofindia.indiatimes.com/toi-editorials/the-other-half-india-is-turning-into-a-republic-of-inequality-meriting-frank-discussion/

[24] Biju, M.R. 2007.   Good governance and administrative practices, Mittal Publications, New Delhi

Sunday, 31 December 2017

India: The road to wider prosperity

Dr. Devendra Kothari
Population and Development Analyst
Forum for Population Action



On factors holding India back, my biggest disappointment is the low level of human development.

Bill Gates,
Co-Chair, Bill and Melinda Gates Foundation
Times of India, November, 2017

Happy 2018!


This is the season of resolutions. Let's discuss what should be New Year resolution for India. Prime Minister Narendra Modi, while addressing a joint meeting of the US Congress on June 8, 2016, shared his dream: “empowering every Indian by the 75th anniversary of India’s independence, through many social and economic transformations”. I think in the coming year India must earnestly initiate the process of empowering people.

For this, India has to address a range of contemporary questions. Among these, the question of human development is most important for sustainable and inclusive India.[1] Development economics in recent years have become more people centric than before. It has rediscovered that human beings are both the means and the end of economic development process, and without Human Development that process becomes hollow rhetoric. Therefore, India must quickly develop an agenda to expedite the process of human development. And, this will help to resolve most of the problems faced by the contemporary India since I strongly believe in the phrase: Change One Thing and Everything Changes.

Central to Human Development approach is the concept of capabilities. Basic capabilities valued by virtually everyone include: good health, access to knowledge, and a decent material standard of living. Other capabilities central to a fulfilling life could include the ability to participate in the decisions that affect one’s life, and to have control over one’s living environment. HD is, therefore, about the real freedom ordinary people have to decide who to be, what to do, and how to live. HD based strategies have been used as a weapon to empower people in many developing countries; these have proven to be quite effective.

 

Why Human Development? The Human Development Report 2016, released by UNDP, does not speak very high about India’s achievement in enlarging people’s capabilities and improving their well-being. India ranks 131 of 188 when it comes to the Human Development Index. This puts it in the ‘medium’ category. The HDI combines a country’s average achievements in health, education and income. The commenting on India’s HDI listing, Bill Gates and Ratan Tata noted:  “Human capital is one of India’s greatest assets. Yet, the world’s fastest growing economy hasn’t touched millions of Indian citizens at the bottom of the economic pyramid.”  [2]

 

India houses enclaves of comfort for the few but are by no means redemptive for the many. In fact, inequality has accelerated in recent decades, according to Lucas Chancel, co-director of the World Inequality Lab at the Paris School of Economics.  The top 1% richest individuals in India captured 6% of total income in the early 1980s, and the value is now of 22%. Overall, the bottom 50% (app. 650 million people or 130 million families) in India still has little access to basic goods such as quality education, health or sanitation. Much more, therefore, can be done in terms of investments for the bottom income groups. “This will substantially increase income growth rates at the bottom, and the growth rates of the economy as a whole”, argued Prof. Chancel. [3]

This makes a strong case that India must convert its vast deprived population to a competitive advantage by enhancing productivity, and human development is one of the most important (or only) stimulants to that outcome.

The definition of HD as “enlarging people's choices'' is very broad, encompassing many issues. One has to narrow it down. To start with, the process of human development must focus on improving the quality of school education; enhancing primary health; strengthening WASH factors (Water, Sanitation and Hygiene), reducing gender gap; and most importantly, stabilizing the population by reducing incidence of unwanted child bearing and infant mortality. In addition, we recognize that shifting of access labour from agriculture to non-agriculture sectors and managing climate change including the quality of air are important inputs too in the process of human development.

The five areas we focus in this post by no means provide a comprehensive agenda to unlock the human potential, but we believe these are among the most significant inputs in the prevailing situation, if pursued as a package, as noted below:

1. Ensuring quality school education: [4]
Is India’s education system geared enough to meet the challenge of low productivity? Considering India’s poor education system from top to bottom one cannot be too optimistic about it. To improve the quality of education, the elementary education is the first step towards that direction.  There are many problems faced by India’s school education, however, the following four areas are crucial: 1) Empowering teacher, 2) Strengthening vocational education, 3) Promoting digital technology, and 4) Enhancing community participation.

2. Promoting healthy life: [5]
The positive health outcomes ultimately contribute to better educational outcomes and a more productive and higher-skilled labor force. India, therefore, must convert its young population to a competitive advantage; and primary health and nutrition are foundational to that outcome which promotes healthy life.

Most of the challenges facing India’s health system can be attributed to under investment and the inefficient use of resources, as argued by Dr. Prabhat Jha of the Centre for Global Health Research, University of Toronto.  [6]  An inadequate number of doctors as well as sub-standard training and a poor network of public hospitals, coupled with bureaucratic bungling, means India often struggles to spend even its meager allocated budgets.  As a result, the promise of universal health coverage will remain unfulfilled unless health is prioritized, as argued by Dr.  K. Srinath Reddy, President of the Public Health Foundation of India. [7] 

There is an urgent need to develop an effective healthcare delivery system, which addresses both communicable and non-communicable healthcare needs. For this, India needs to adopt an integrated national healthcare system built around a strong public primary care system with a clearly articulated supportive role for the private and indigenous sectors in the secondary and tertiary sectors.

3. Improving WASH factors:[8]
UNDP emphasizes that clean water and proper sanitation can make or break human development. [9]  The data from the World Health Organization and UNICEF, among others, indicate that it is the poorest, the young and the women and girls who suffer most from poor WASH (Water, Sanitation and Hygiene) services.[10]  Improvements to WASH, therefore, represent a good economic investment to unlock the human potential, since better WASH facilities means good health and higher levels of school achievement hence greater productivity.  “A study by the World Bank estimates that nearly 40% of India’s children are physically and cognitively stunted, primarily because of the lack of sanitation. Such a large proportion of our future workforce not being able to reach their full productive capacity poses a serious threat to our biggest strength – our demographic dividend”, referred by Arun Jaitely, India’s Finance Minister. [11]

In other words, better living conditions are key social determinants of human development agenda. Any improvement in access to toilet facilities, water, electricity and LPG is likely to result in a considerable reduction in domestic drudgery especially for girls/women, freeing up their time for other activities including schooling and perusing professional life.

 

4.  Promoting gender equality:[12]
It is impossible to think about the welfare and sustainable development of India unless the condition of women is improved.  It appears that female's abhivyakti (expression), khvaab (dream), or kalpana (fantasy) frightens us. And we want to regulate it by hook and crook. It appears “women are not born, but made”; what better than India to exemplify this statement by Simone de Beauvoir, made some 70 years ago.  [13]  The chains, therefore, that tie women down are not only external but are welded together invisibly by dint of growing up in what is still a patriarchal society. Hence, we have to create conducive environment where women can chase big dreams and contribute country’s welfare and development. It is therefore important to address the root causes of gender discrimination manifested through son-preference and daughter-neglect. One has to recognize that high GDP or economic growth   alone does not automatically empower women nor does it reduce gender inequality.

What do we do then? No doubt, expanding education and employment opportunities will help in achieving gender equality but that may take more time. To expedite the process, “we need men to be allies”, as argued by the Co-Chairman of the Bill and Melinda Gates Foundation, Melinda Gates, in her article: Women Transform Societies, based on Indian experiences. [14]  Expanding her argument, she writes: “women's empowerment can't be just about women; it also has to be about men - the fathers, brothers, husbands, and sons – with whom they live their lives”.

India’s sex ratio is the worst among the ten largest countries in the world by population – and it has been getting worse. There are 108 men per 100 women in India, as compared with China’s 106, figures from the United Nations showed. Thus, the path ahead looks long, winding and hazy. However, the present administration shows the promise and will to clean the path, albeit slowly. India is very lucky that present government recognizes that gender equality is part and parcel of the country's future; and campaigns like “Beti Bachao, Beti Padhao (save the girl child, educate the girl child) will help to arrest the epidemic of missing girls by removing the gender inequality.  In addition, there is a strong emphasis on mindset change through training, sensitization, awareness raising and community mobilization on ground.

5. Stabilizing population: [15]

With India confronting a host of major crises relating to poverty, governance, corruption (especially at the day-to-day level), social and religious conflicts, why should anyone be concerned about population?  The simple answer is that virtually all the major problems that confront India today relate in some critical way to galloping population. With density already great and living standards low, a continued increase in number means continued tragedy. The country already has over 1,335 million people (2017) and is adding more than 160 million each decade with 12 million young people entering the workforce each year.

China and India are the two most populated countries of the world. In 1990, population of China was 302 million more than India (Table 1). Due to higher population growth of India, population difference between these two countries is coming down quickly. In 2017, population of China is 70 million more than India. And in 2025, India will be the world most populated country of world with approximately 1.45 billion people. This has increased the pressure on resources whether natural or administrative.  Population density of India is 450 people per square km compare to 150 of China in 2017. So, India is three times denser than China.  The table also reveals that pressure of population, measured in terms of persons per square km., has increased significantly since 1990. It increased by slightly less than two times in last 27 years whereas the corresponding figure for china is 1.2 times.   China is 4th and India is 7th largest country in terms of area

Table 1: Population of India and China – a comparative statement, 1990-2050
Year
India
China
Population
in million
Yearly change
in million
Density (P/Km²)
Population
in million
Yearly change
in million
Density (P/Km²)
1
2
3
4
5
6
7
1990
870
17.7
293
1172
20.3
125
2000
1053
18.5
354
1283
8.6
137
2010
1230
17.4
414
1397
7.6
145
2017
1339
15.0
450
1409
6.0
150
2020
1383
14.8
465
1425
5.5
152
2030
1513
12.2
509
1441
0.5
154
2040
1605
8.2
540
1417
-3.2
151
2050
1659
4.5
558
1364
-6.0
145
Source:  Worldometers  (www.Worldometers.info)

Current population growth in India  is mainly fueled by unwanted fertility.  Around three in ten pregnancies are unintended/unplanned or simply unwanted by the women who experience them and these pregnancies result in births that spur continued population growth.  Around 27 million children are born in India every year, and out of this about 7-8 million births could be classified as unwanted.  It is estimated, based on the National Family Health Surveys, around 450 million people out of 1335 million in India in 2017 were the result of unwanted pregnancies. With such a large number of people resulting from unwanted pregnancies, how can one think about using them for the nation building?   The consequences of unwanted pregnancy are being reflected in widespread malnutrition, poor health, poverty, illiteracy, unemployment, regressing governance as well as increasing scarcity of basic resources like food, water and space despite concerted developmental efforts since 1991. 

How to implement the HD agenda?
The implementation strategy is based on a ‘whole child’ concept - that is child and his /her family - for human development efforts. The paper, therefore, proposes a framework – HDPlus - to unlock the human potential. The focus will be all government school-going-children aged 6-14 and their families. They will be provided all the selected human development inputs, if needed. Additional inputs could be added looking to the needs of particular people/area so this framework is being titled as “HDPlus”. It will be implemented by the government agencies in collaboration with civil organizations like PulsePolio campaign in the 1990s and 2000s. [16] Further, the focus of the various government schemes like Swachh Bharat, Skill India, Beti Bachao, Beti Padhao, Ujjwala Yojana, Saubhagya Yojana, etc. will be on the families of Government-school-going-children.

In sum, the main concern today is the impairment of human potential, which is not allowing India to reap its rich demographic dividend. Human Development, therefore, is more than a goal in itself. It is a precondition for meeting the challenges of reducing inequality, promoting sustainable development and building good governance. It is high time that the Government of India and research institutions focus on developing effective and smart human development agenda to unlock the human potential. 




[1] This post is based on the author’s recent work on Human Development, in which he argues: HD is the only option to resolve India’s myriad problems; and it can be a manifesto for change, since he believes in the phrase: Change One Thing and Everything Changes. For details see his forthcoming paper: Kothari, Devendra. 2018.”Nurturing Human Development: A strategy for New India”, FPA Occasional Paper, Forum for Population Action, Jaipur, India. For further information, contact: dkothari42@gmail.com.

[2]Bill Gates and Ratan Tata. 2016. “New nutrition report underscores the importance of leadership in addressing stunting in India”, Times of India at https://blogs.timesofindia.indiatimes.com/toi-editorials/new-nutrition-report-underscores-the-importance-of-leadership-in-addressing-stunting-in-india.

[3]  Lucas Chancel and Thomas Piketty. 2017.  “Indian income inequality, 1922-2014: From British Raj to Billionaire Raj?”  WID, World Working Paper Series No. 2017/11, World Inequality Lab, Paris School of Economics.  Also refer: Sharad Raghvan.  2017. ‘High growth does not necessarily mean high inequality, says Lucas Chancel’, The Hindu at http://www.thehindu.com/business/Economy/high-growth-does-not-necessarily-mean-high-inequality-says-lucas-chancel/article21653028.ece

[4] For details on education, refer: Kothari, Devendra. 2017. “Managing school education in India”, in Administrative Change, Vol. XLIV No. 2, pages 78-89.

[5] For details on health, refer: Kothari, Devendra. 2016.  “India needs efficient healthcare system for overall development” at: http://kotharionindia.blogspot.in/2016/06/india-needs-efficient-healthcare-system.html

[6] Jha and Laxminarayan. 2009. Choosing Health: An entitlement for all Indians, Centre for Global Health Research, Toronto.

[7] Reddy. KS. 2015.  “India's Aspirations for Universal Health Coverage”, N Engl J Med (373), pp.1-5.

[8] For details, refer:  Kothari Devendra. 2017.  “Water, Sanitation and Hygiene and human development in India” at: http://kotharionindia.blogspot.in/2017/04/water-sanitation-and-hygiene-and-human.html. Also see: Kothari Devendra. 2012. “West Bengal: Household amenities with special reference to water, sanitation and hygiene (WASH) and their implications” , Working paper   UNICEF, West Bengal, Kolkata.

[9] UNDP. 2006. Human Development Report 2006 - Beyond scarcity: Power, poverty and the global water crisis, United Nations Development Programme.

[10] Refer article: “WASH: water supply, sanitation and hygiene Human rights that are crucial to health and development” at:http://www.unicef.org/wash/files/1_WSSCC_JMP_Fact_Sheets_1_UK_LoRes.pdf.

[11] Jaitely, Arun. 2017. “Swachh Bharat: Universal sanitation is at the core of India’s development agenda, let us realise its promise”. TOT Edit Page at: https://blogs.timesofindia.indiatimes.com/arun-jaitleys-blog/economics-of-swachh-bharat-universal-sanitation-is-at-the-core-of-indias-development-agenda-let-us-realise-its-promise/

[12] Kothari, Devendra. 2014. “Empowering women in India: Need for a Feminist Agenda”, Journal of Health Management, 16 (2), pp 233-43. Also refer:  Kothari, Devendra. 2017, “India must go for gender equality”, Blog: Population and Development in India at:  http://kotharionindia.blogspot.in/2017/03/india-must-go-for-gender-equality.html 

[13] The Second Sex (FrenchLe Deuxième Sexe) is a 1949 book by Simone de Beauvoir, in which the author discusses the treatment of women throughout history.  The Second Sex is often regarded as a major work of feminist philosophy and the starting point of second-wave of feminism.  

[14] Gates, Melinda. 2016. “Women transform societies”, Times of India at: Blogs.timesofindia.indiatimes.com/toi-edit-page/women-transform-societies/

[15] Kothari, Devendra. 2014. “Managing Unwanted Fertility in India: Way Forward”, in Suresh Sharma and William Joe.   (eds.):   National Rural Health Mission: An Unfinished Agenda. Pp 25-36, New Delhi: Bookwell. Also see: Kothari, Devendra. 2016.” India: Why population matters?” Blog: Population and Development in India at: http://kotharionindia.blogspot.in/2015/04/india-why-population-matters.htm

[16] And the PulsPolio campaign, initiated to eradicate the polio in the country, could be the guiding strategy to unlock the human potential. PulsePolio was an immunization campaign initiated by the Rotary International and carried out by the Government of India to eliminate polio in India by vaccinating all children under the age of five years against the polio virus.