Monday, 31 October 2011

What the poverty debate in India misses?

Devendra Kothari
Prof. Population program Management

The latest controversy over India’s poverty line argues that there is an urgent need to look at the issue from a pragmatic perspective.  The blog aims to provoke discussion and mobilize support for reproductive health services to expedite the process of alleviating poverty in India.

The Planning Commission,   an institution of Government of India, which formulates socio-economic policies including Five-Year Plans, filed an affidavit in the Supreme Court in the last week of September 2011 claiming that the "poverty line of Rs. 26[1]  and Rs. 32  for rural and urban areas respectively ensures the adequacy of private expenditure on food, health and education". According to this, a family of five spending less than Rs 4,824 (at June 2011 prices) in urban areas would come in the Below Poverty Line (BPL) category. The expenditure limit for a family in rural areas is being fixed at Rs 3,905. The affidavit could not have come at a worse time when food inflation is pushing poor households to the wall.

This created hue and cry throughout the country. Some prominent NGOs/experts including some members of the Indian ruling party’s think tank - National Advisory Council (NAC) - under the chairmanship of Mrs. Sonia Gandhi argued that the affidavit is a document, no less historically significant than the "India Shining" campaign that brought the downfall of a previous regime, because it reflected arrogance and contempt for the poor comparable to the views held by the Planning Commission.  In an open letter to Dr. Montek Singh Ahluwalia, Planning Commission Deputy Chairman, Mrs. Aruna Roy, member of NAC, demanded “withdraw the affidavit on the poverty line or resign”. The letter states that “If Rs 26 for rural areas and Rs. 32 for urban areas per capita expenditure was ‘adequate’ then it is not clear to us that why Planning Commission members are paid up to one hundred and fifteen times the amount (not counting the perks of free housing and health care and numerous other benefits that is enjoyed by you and members of the Planning Commission)”. It is interesting to note that in recent years, especially during the high economic growth, India has fallen further behind neighboring and poorer (in terms of per capita income) Bangladesh, in terms of most of the human development indicators.

It appears that the Planning Commission wanted to peg the number of beneficiaries of Centre's welfare schemes by reducing the number of poor people in India. The formal de-coupling of poverty and entitlements such as subsidized food, fuel and fertilizer is significant because of indications that a move was on to reduce the subsidy burden.  Seeking to counter the perception of insensitivity, the Government of India has agreed to remove caps on the number of poor an individual State can have and formally de-linked subsidies from the income threshold, but did not agree to change its definition of poverty, at least immediately. is argued that by relaxing the definition would open the floodgates for enumeration as poor, straining the exchequer in the process[2].  

One can also argue that by adopting proposed yardstick of poverty line, India will probably exceed the UN Millennium Development Goals (MDGs)[3] of halving poverty between 1991 and 2015. “Even so, argued economist Swaminathan Aiyar[4], “India will be a poor country for a long time. Forget statistics - just see the horrific workers’ hovels at construction sites. Workers nevertheless come because rural conditions are even worse”.

Is there any other way out to poverty alleviation? There is a need to take a pragmatic approach to poverty alleviation, which means addressing its root causes – including unplanned and unwanted fertility.  One should also build the capacity of women and men to move beyond poverty, training them in the skills, methods, knowledge and leadership needed to take self-reliant actions so they can meet their own basic needs, improve their communities and build better futures for themselves and their children. Available  data indicate that avoiding unwanted /unplanned fertility can be another but effective way to handle the poverty issue, as observed in many countries including Bangladesh and in some States of India. For this, one must empower people especially those belonging to the bottom of the pyramid to have children by choice not by chance.

One of the background characteristics used throughout the National Family Health Survey (NFHS–3) Report is an index of the economic status of households called the Wealth Index. The NFHS-3 economic status index was constructed using 33 household asset data and housing characteristics[5]. Accordingly, households have been divided into five categories[6]. To make point, I will   concentrate on three categories: Lowest, Middle and Highest.  The Table 1 provides some basic information about household by this index. The table reveals that differences by economic status are large for every selected variable. The proportion of men who have never attended school declines from  47% for men in the lowest wealth quintile to only 2% for men in the highest category; and the corresponding decrease in the proportion of women who never  attended school declines  sharply  from 77%  in the lowest category to only 8%  for women in the highest category.   Further, only 11% of women in the lowest economic strata have completed standard six and above of education, compared with 84% of women in the highest economic class.  Unless we focus on this segment, which constitutes around two-third of total population, achieving eradication of extreme poverty and hunger (MDG 1) within a reasonable time span will be a dream. Here the “Bottom of the Pyramid” approach, coined by Prahlad, could be of great help[7]. In other words, India needs class-specific measures to alleviate poverty.

Table 1: Distribution of households by some selected indicators according to household economic status, 2005-06        
Economic Status
% of men never attended school
% of women never attended school
% if women completed standard 6 and above
Number of children per woman  (TFR)
Number of unwanted children/woman
% of births of  order  four or higher
% of couples having  unmet need for contraception
% of  couples  protected by modern contraceptives
% of  couples  protected by spacing methods
Source: National Family Health Survey- 3, 2005-06, IIPS, Mumbai 2007.

The level of unwanted or unplanned fertility can be measured by comparing the total wanted fertility with the total or actual fertility. The total wanted fertility rate represents the level of fertility that theoretically would result if all unwanted births were prevented.  The proportion of births that were unwanted was the highest for births to women from the “bottom of pyramid”. Table 1 reveals that in India, the total wanted fertility rate of 2.4 children per woman, belonging to the lowest economic strata is lower by 1.5 children (that is by 38 percent) than the actual or total fertility of 3.9 children per woman. This means the households belonging to low economic strata have more children than they actually want and this can be seen throughout the country. The table also indicates that the level of unwanted fertility decreases sharply among women from the lowest economic strata to the women in the wealthiest class from 1.5 children per woman to 0.3 children per woman.  One can argue that total fertility rate would drop substantially among women from the lower strata if their unwanted fertility could be eliminated, and this will help them to improve the quality of life. 

Unmet need for family planning[8] is an important indicator of assessing the potential demand for family planning services or contraceptive devices. In spite of poverty and illiteracy, the prevailing unmet need for family planning services is surprising.  Table 1 indicates that unmet need for family planning decreases with an increase in economic status of households from 18% to 8% among highest economic category. For the first time ever around, half of the currently married women in reproductive ages (15-49 years) in India are protected by modern contraception, however, its use is uneven. Economic status has a positive effect on contraceptive use, with use increasing from 35% among married women in households in the lowest economic strata to 58% among those in the highest strata. The use of any modern spacing methods (Pills, IUCD, and Condom increased sharply from 4 percent among couples in the lowest strata to 22 percent among in the highest one (Table 1).  This  indicates that the use of existing spacing methods  is not very popular among women and men belonging to lower economic strata mainly due to inconvenience to use. Such a situation leaves couples with no choice except sterilization. This choice is not widely preferred by couples in the light of prevailing of high infant and child mortality, especially among the lowest economic strata.

Based on findings of the National Family Health Surveys (NFHSs 1, 2 and 3), it is estimated that currently there are around 450 million people in India who are product of unwanted/unplanned  fertility[9], and most of them are from the lowest economic strata.  The consequences of unintended pregnancy are serious, imposing significant burden on women and families, and in turn slowing down the process of economic emancipation thus creates obstacles in the process of poverty alleviation. In short, in the changed situation most of the people, belonging to the lowest economic strata, do not want more children. But, they still have them, primarily due to lack of client centered reproductive healthcare.  The real need is to provide services in un-served and underserved areas by realigning the capacity of health system to deliver quality care to suit the needs of clients, especially those belonging to the “bottom of pyramid”. Therefore, reproductive healthcare is an essential plank in empowering the poor. We need creative policies to strengthen this foundation.

 The next blog discusses the issue of creation of smaller States in India

[1] One American dollar is equal to Rs. (Rupees) 48.
[2] The number of poor entitled to BPL benefits, as per the affidavit, has been estimated at 407.4 million.
[3] The Millennium Development Goals (MDGs) are eight goals to be achieved by 2015 that respond to the world's main development challenges. The MDGs are drawn from the actions and targets contained in the Millennium Declaration that was adopted by 191 nations - and signed by 147 heads of state and governments (including India) during the UN Millennium Summit in September 2000. Recognizing the urgency of poverty issue, world leaders have made poverty a top priority as a part of Millennium Development Goal 1.The Eight MDGs are:  1. Eradicate extreme poverty and hunger; 2. Achieve universal primary education; 3. Promote gender equality and empower women; 4. Reduce child mortality; 5. Improve maternal health; 6. Combat HIV/AIDs, malaria and other diseases; 7. Ensure environmental sustainability; and 8. Develop a global partnership for development.
[4] For details, see article: Middle Class hypocrisy on poverty line, Times of India, dated Oct.2, 2011. 
[6] The five Wealth Index categories are: Lowest, Second, Middle, Fourth and Highest. For details, see NFHS-3. 2007.  India: National Family Health Survey, 2005-06. International Institute for Population Sciences, Mumbai. 
[7] For details, see:  CK Prahlad.  The Fortune at the Bottom of Pyramid: Eradicating Poverty through Profit.  Pearson Education, Inc, 2006. 
[8] The standard definition of unmet need depends upon the apparent inconsistency between a woman’s contraceptive behavior and her stated reproductive preferences. The concept of unmet need was highlighted first time in India in a study conducted by the author in Rajasthan in 1988 on behalf of Ministry of Health and Family Welfare, Government of India. Based on the field data, the study revealed that there was sizable number of eligible couples that were not using contraceptive methods but did not want another child. According to the study, 15 per cent of currently married couple in Rajasthan had unmet need for family planning services in 1988-89. For details, see Devendra Kothari, Family Planning Programme in Rajasthan: Beyond the Existing Approach, Indian Institute of Health Management Research, Jaipur, 1989. 
[9] Kothari Devendra. 2011. Implications of emerging demographic scenario: Based on the provisional results of the census of India 2011.  A Brief.  Management Institute of Population and Development, New Delhi.

1 comment:

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