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.
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.
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
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
|
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 (French: Le 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.
