Tuesday, 24 September 2013

India: Why pace of development is slow?

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

What the future holds for every Indian is more queues and troublesome time ahead unless India concentrates on basic issues.

Anniversaries like Independence Day are a time for celebration, but they are also a time for introspection.  India has just celebrated its 66th birthday on 15th August, a healthy age among the nations that emerged after World War II. However, sixty years of a planned economy has not been able to resolve some basic issues. We have the largest number of hungry, malnourished and illiterate people in the world, terrible infant and maternal mortality. These are facts the Indian elite does not want to look at, as noted by Jayati Ghosh, one of the world's leading development economists.[1]  “We just want to prove we have arrived at the world stage”.  

In comparison of with other developing countries, India has fallen badly in major development indicators. One of the strong indicators of a nation’s progress is the state of life expectancy at birth.  It measures overall quality of life or welfare in a country. Life expectancy, not surprising, is low in India, as compared to other countries.  Table 1 indicates that an Indian born today is projected to live to the age of 64, which is one of the lowest among major developing countries. The table indicates that around fifty years ago, there were no great variations in the life expectancy between India and other populated Asian countries like China and Indonesia, but since then gap has increased sharply. A variation in life expectancy is mostly caused by differences in public heath, medical care, living conditions, nutrition, etc.  

Poverty, easy to spot but hard to define, is another indicator of development. The United States of America sets its poverty line at just over $30 a day per person. Any income below that amount is judged inadequate for the provision of fundamental wants. The threshold for dire poverty in developing countries is set much lower by the World Bank, at $1.25 a day of consumption (rather than income). This is an international yardstick by which poverty reduction in developing countries is measured. Table 1 indicates that one-third of India's population is living below International Poverty Line (IPL).[2] A comparison of other Asian countries reveals that the poverty rate in China and Indonesia was much less than India during the reference period - 2009-2011, but that was not the case around twenty years ago. The hype about India’s post-liberalization success has been busted by none other than the World Bank. The data available shows that the rate of poverty decline in India was faster between 1981 and 1990 than between 1990 and 2005. The poverty rate - those below IPL - for India declined from 59.8% in 1981 to 51.3% by 1990, or 8.5 percentage points over nine years. Between 1990 and 2005 it declined to 41.6% - a drop of 9.7 percentage points over 15 years; however   the number of people below the IPL increased to 455 million in 2005 from 420 million people in 1981. On the other hand, East Asia’s progress has been dramatic since 1981, when it was the poorest region in the world. For example, in China, the number of people living on less than $ 1.25 a day in 2005 has dropped from 835 million in 1981 to 207 million in 2005.[3]  It is observed that more and more people in India could fall into extreme poverty due to soaring food and energy prices in coming years.

 Table 1: Trends in development  indictors, selected countries
Selected Countries
Life expectancy at birth
(in years)*
% of Population living under $1.25 per  day ( IPL)**
Source: *World Population Prospects: The 2012 Revision; **World Bank Development Research Group.

ndia is heading towards an unstable situation of extreme danger or difficulty that could lead to despair, social instability, political strife, policymaking paralysis and capital flight as well as a rapid collapse in growth rates. Growth of the Indian economy, measured in terms of GDP, has already touched a decade low of less than 5% in 2012-13. Further, the country has recorded the all-time low in exchange rate of Rs 68.80 to a US dollar. These developments could be seen as a manifestation of poor development planning. It appears that efforts made over the years for improving socio-economic standards have partially been neutralized by the rapid growth of population. Fast growing population leads to a significant diversion of national investable resources to consumption, which could otherwise be used for increasing investment and productivity and for improving the quality of public social services.
In the last 66 years, the population of India has increased more than three and half times from 350 million in 1947 to 1250 million in 2013; and is projected to reach 1640 million by the year 2060. Population is increasing mainly because more than two in five pregnancies are unintended/unplanned or simply unwanted by the women who experience them and more than half of these pregnancies result in births that spur continued population growth. Around 26.5 million children are born in India every year and out of them about 6 million have been classified as unwanted. Further, based on the National Family Health Surveys, it is estimated that there were around 450 million people out of 1210 million in India in 2011  who were product of unwanted  pregnancies, and most of them were from the lower economic strata.[4] The consequences of unwanted pregnancy are serious, slowing down the process of socio-economic development. It is because unwanted childbearing results in poor physical growth, reduced school performance, diminished   concentration in daily tasks thus impacting work capacity and work output resulting in diminished earning capacity. And this is reflected in widespread hunger, poverty, poor governance, as well as increasing scarcity of basic resources like food, water and space in several parts of India despite concerted developmental efforts since 1991. India’s large unwanted fertility, a threat to sustainable development, demands immediate attention. On the other hand, most of the developing countries, during their initial stage of development, gave importance or urgency to the issue of population stabilization.[5] On an average, a woman in India produces 2.6 children during her lifetime. The replacement level fertility of 2.1 children per woman, required to initiate the process of population stabilization, has already been achieved by Thailand (1.5), China (1.6), Brazil (1.7) and even Islamic country Iran (1.9), as shown in Table 2.  Indonesia, another Muslim dominating country is going to attain it within couple of years; However, India will not achieve this level before 2035, as per the UN Population Division.

Table 2: Trends in total fertility, infant mortality and literacy rates , selected countries
Number of children per woman (TFR)*
Infant deaths per 1000 births (IMR)*
% literates (age 15 and over  who can read and write)**

Source: *World Population Prospects: The 2012 Revision and **CIA World Fact book.

Poverty and fertility are two important and closely related aspects of welfare. It is evident from Tables 1 and 2 that slow population growth leads to rapid decline in poverty.  Why our politicians find that unbelievable? The present ‘development’ strategy is failing. It is s not delivering welfare. The ongoing debate on the views of Amartya Sen and Jagdish Bhagwati/Arvind Panagariya has generated more heat than light. This is presented as distribution versus growth argument.  That is wrong, as argued by Jayati Ghosh. India needs a balanced ‘development’ strategy. Mere focus on boosting growth through large investment and opening up the economy without emphasizing on human development is not a panacea for India’s long-term economic challenges. On the other hand, an excessive focus on subsidy and dole-driven policies could slam the brakes on the economy and drag people below the poverty line, rather than push up per capita income and welfare. The Food Security Bill, for example, is a bad policy measure and does no service to the poor. It fails the country on the two critical counts: on economic implications and winning the war against malnutrition.  Real prosperity can only be brought about by focusing on basic structural changes aiming to improve human resources, as has been done by many developing countries including China, Indonesia, Sri Lanka, Thailand and Brazil (Table 2).  

Now question arises as how to forge ahead.  I believe that a stable population is most important ingredient in the sustainable development agenda. A popularly held belief is that as a country becomes economically more prosperous, its fertility declines significantly and leads to a stable population. However, this is a simplistic view of a complex phenomenon.  Since the introduction of market-based economic reforms in 1991, India has become one of the fastest growing major economies in the world. The economic reforms completed 20 years in 2011, however during this period, India’s population increased by 365 million, much more than the population of USA - the third most populous country in the world. This raises the question: Is Development the Best Contraceptive or Are Contraceptives?  It is argued that there is a need to go beyond the prevailing notion that economic development is an essential precondition for fertility transition, since it provided only a partial explanation for the monumental changes taking place in fertility behavior, especially in low-income economies.[6] An experiment, carried out in a selected group of villages in Comilla district of Bangladesh, finds that equitable, even-handed development may be a good 'contraceptive', but is not a realistic alternative to family planning effort.[7]  Also, there are some examples from India.  Andhra Pradesh is one such example. During the early nineties, the State Government decided to revamp its family planning program to reduce population growth. It was a political decision that increased the use of contraceptives significantly. As per the NFHS-3, more than two-third of married women in Andhra Pradesh were using modern contraception in 2005-06, the highest in the country. It had dramatic impact on fertility by reducing unwanted pregnancies.  Andhra Pradesh exhibits one of the   lowest fertility among major states of India – 1.8 children per woman in 2011, and its decadal population growth declined from 24.4% in 1991 to 11.1% in 2011. It is interesting to note that married women in Andhra with no education or less than 5 years of education are more likely to use contraception than women with more education, since quality reproductive health services are easily available looking to the needs of clients.[8] 
The persistence of high levels of fertility in India especially in Four Large North Indian States of Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh is mainly driven by poor access to family planning;[9] education and reproductive health provision are crucial elements in reducing fertility. Universal access to quality contraceptives is not yet a reality in India — especially among the poorest. The country wide, 15 million women would like to delay or prevent pregnancy, but are not using effective contraception. Simply meeting this ‘unmet need’ for contraception[10] would go a long way towards lowering fertility. Further, the demand for family planning is expected to soar in coming years as millions of young people become sexually active and smaller families become the norm especially in poor performing States. So letting women have the means to manage their childbearing will help to make India a more stable place. Hence, a decisive action is needed now and it is the need of the hour.  Key to this new approach should be to provide quality reproductive health services with contraceptive choices. [11]  When women have access to contraception appropriate to their needs, desires, and budgets,the potential benefits are many, including reduced maternal and child mortality as well as lesser number of abortions and unwanted pregnancies. In addition to its health benefits, family planning allows families and communities to invest more in education and health care and helps reduce poverty, as argued by the President of Population Council, Peter J. Donaldson.[12] In other words, children by choice not by chance are the only way poor can aspire a better life. 

Another issue which needs equal attention is quality of education, especially female education. Unless education is rescued from quagmire of mediocrity, all talk about developing a skilled human resource pool and realizing the country`s demographic dividend will be without substance; and the country would be inching closer to demographic disaster.[13] As such, investment in education has to be increased to improve the quality of education especially at the government schools and colleges/universities where most of the students are from poor and rural families. Hence, instead of wasting money and time on enacting legislations like RTE that might turn out to be road blokes for the implementation of a sound education policy, the government would do well to open more educational institutions with good infrastructure and well-trained teachers and free them from political interference. 

Living conditions are equally important in producing an enabling environment for development. Findings of the Census of India 2011 – Tables on Houses, Household Amenities and Assets indicate that   sub-human living conditions still haunt people.  Only 47% of households have a source of water within the premises while 53% of households travel more than half a kilometre in rural areas and more than 100 meters in urban areas to fetch their supplies. This problem is further compounded by lack of access to sanitation. About 53% of Indian households do not have a toilet within their premises. Only 28% of the households use LPG (Liquefied Petroleum Gas) as a cooing fuel. Around two-thirds of the total households have electricity as the main source of lighting in the country in 2011 while 31% still depend on kerosene. 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. [14]

I believe that the above measures that can turn around dejected scenario are not Solomon’s secrets. We have been discussing them since the launching of First Five Year Plan in 1951. However, successive governments have failed to satisfactorily cater to the reproductive and educational needs of the country. Maximum investment in human resources will bring highest dividends in terms of all round development. The question is not whether we act or not, but whether we act now or later and deal with much more dire and expensive consequences. What we do in the next few years especially during the period of Twelve Five Year Plan (2012-17) will determine India’s development scenario. There is no excuse for not trying.

[1] Jayati Ghosh, “Marie Antoinette economists have lost their basic grounding”, Times of India, August 5, 2013.

[2] As per the Planning Commission, Government of India, at the all India level share of the population below poverty line (BPL) was 21.9% in 2011-12, almost 270 million. This means that every fifth Indian lives below the poverty line.  The government has set the bar abysmally low, defining as BPL anyone earning Rs.  27.20 or less in rural areas and up to Rs 33.30 in urban areas. This is totally erroneous.

[4] Devendra Kothari, “Implications of Emerging Demographic Scenario: Based on the Provisional Results of Census of India 2011”,  A Brief,  a publication of Management Institute of Population and Development – A Unit of Parivar Seva Sanstha, New Delhi, 2011.  

[5] For example, in the late seventies, it was quickly realized by the policy makers of China that with half of the population under the age of 21, further growth was inevitable even if each family was quite small. Some drastic measures are needed. The “One Child Policy” backed by quality Family planning services  was the answer to that concern and the Chinese leader Deng Xiaoping announced it in 1979 to limit China’s population growth. Such interventions were also adopted in India during seventies.  Sanjay Gandhi, a member of the Nehru-Gandhi dynasty, publicly initiated a widespread compulsory sterilization programme to limit population growth. Journalist Vinod Mehta in his 1978 book -  The Sanjay Story -  states that the sterilization programmes were initiated at the behest of the IMF and the World Bank. But India could not continue with the program.

      [6] Kothari, Devendra and S.  Krishnaswamy. 2003. “Poverty, Family Planning and Fertility vis-a vis Management of Family Planning Services in India: A Case Study”. In Maria Eugenia COSIO-ZAVALA (Ed.). Poverty, Fertility and Family Planning, Paris: CICRED, 335-58.

[7] Barkat-e-khuda, Harbison SF, Robinson WC. 1990. “Is development really the best contraceptive? A 20-year trial in Comilla district, Bangladesh”. Asia Pac Popul J.:5(4):3-16.

[8] Kothari, Devendra. 2013.  “Managing unwanted fertility in India: Way forward”, a paper is prepared for the National Conference on National Rural Health Mission: A Review of Past Performance and Future Directions, organized by the Institute of Economic Growth, New Delhi , August 6-8, 2013.

[9] There is a wide diversity of fertility levels among States of India. The replacement level fertility of 2.1 children per woman, required to initiate the process of population stabilization, has already been attained by Tamil Nadu (1.7), (Andhra Pradesh (1.8), Kerala (1.8) and Karnataka (1.9).  On the other hand, Four Large North Indian States of Bihar (3.6), Uttar Pradesh (3.4), Madhya Pradesh (TFR 3.1) and Rajasthan (3.0) have a long way to go before they achieve this level.

[10] 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 or want to wait two or more years before having another child. According to the study, 15% of currently married women in Rajasthan had unmet need for family planning services. For details, see Devendra Kothari, Family Planning Programme in Rajasthan: Beyond the Existing Approach, Indian Institute of Health Management Research, Jaipur, 1989.

[11] Kothari, Devendra. 2012. “Empowering Women in India through better Reproductive Healthcare”, in Sheel Sharma and Angella Atwaru Ateri (eds.) Empowering Women through Better HealthCare and Nutrition in Developing Countries, New Delhi: Regency Publications, 2012, pp 68-86.

[12] “New Vision for Contraceptive Research and Development”, Blog Entries by Peter J. Donaldson, posted March 6, 2013.  Also see: “Controversy over Injectable contraceptives in India” Blog Entries by Devendra K Kothari at kotharionindia.blogspot.com, posted October 4, 2011.

[13] How India is managing its ‘Demographic Dividend”, Blog Entries by Devendra K Kothari at kotharionindia.blogspot.com, posted June 26, 2011.

[14] “Quality of life and living environment in India”, Blog Entries by Devendra K Kothari at kotharionindia.blogspot.com, posted September 9, 2012.