3 rd International conference on Rural India: Achieving Millennium Development Goals and Grassroots Development

Transcription

1 3 rd International conference on Rural India: Achieving Millennium Development Goals and Grassroots Development Interstate and Intrastate variations in India is key challenge to achieve MDGs Nilay Ranjan B.Shadrach C-5, Qutab Institutional Area New Delhi-16 Tel

2 Millennium Development Goals and Targets Vision and Action The Millennium Development Goals (MDGs) are time bound quantitative targets for overcoming human development. They include halving income poverty and hunger, achieving universal primary education and gender equality, reducing infant and child mortality by two thirds and maternal mortality by three quarters, reversing the spread of HIV/AIDS and other communicable diseases, and having the proportion of people without access to safe water. These targets are to be achieved by 2015, from their levels in 1990 (United Nations 2000). These goals are solidly anchored, both in terms of substance as well as process, into human rights. In terms of substantive linkages, MDGs represent human rights goals because they focus on basic human development. MDGs have placed renewed emphasis on poverty reduction. Almost all the countries in the world, including India, have committed themselves to attaining the targets embodied in the Millennium Declaration by If we assess the progress in the last five years on all the MDGs targets, we wonder if India will be able to attain all of the MDGs, and whether there are some MDGs that India will be able to attain. There is even less understanding of what it will take by the way of economic growth, infrastructure investments, and sectoral interventions- to attain different MDGs. In the case of India which represents a large geographical and socio economic variation, the millennium development (MD) indicators need a disaggregate assessment of MDGs progress. Rural India, which constitutes the larger portion of the total population, requires a separate strategy and a separate set of indicators for the MDGs targets. The success of MDGs can be visualized if the socio, cultural, geographical and regional issue can be addressed during the setting up indicators and targets. In this paper an attempt has been made to assess the progress on different MDGs; specially reference has been made to people assessments on the MDGs. The paper also tries to suggest certain actions, which are needed to achieve the desired targets. 2

3 Goal 1: Eradicate extreme poverty and hunger In terms of poverty eradication, the MDG targets to bring down to half, between 1990 and 2015, the proportion of people whose income is less than $ 1 day. It also proposes to halve, between 1990 and 2015, the proportion of people who suffer from hunger. For India this would mean bringing down the headcount ratio of calories deficiency from 62.2% in 1990 to 31.15% in Calories deficiency is pervasive in India. In more than one half (53%) of India s population consumed fewer calories than it required. In the year the percentage of such population was 6o%. This is nearly double the estimated national incidence of consumption poverty of %. There are large interstate variations in the extent of hunger and poverty, with Assam topping the list with nearly 78% of the population being calories deficient. The other northeastern states, Goa and Andhra Pradesh also have very high proportions of calories-deficient population. At the same time the other extreme, Jammu and Kashmir, Rajasthan and Uttar Pradesh have lower rates of calories deficiency (30%-38%). The rate at which hunger poverty declined during the 1990s also varies significantly across states. Uttar Pradesh as well as many of the Northeastern states, such as Mizoram, Manipur, Arunachal Pradesh and Nagaland, experienced large declines (greater than 10%) in hunger poverty between and while four states-haryana, Assam, West Bengal and Jammu & Kashmir-experienced an increase in the incidence of hunger. Within-state differences are also large. For incidence, the incidence of hungerpoverty varies from 48% to 75% within the state of Gujarat. The reasons for such variance are many like the size of land holding in rural areas, level of education of the adult members in urban areas, access to safe drinking water particularly in the poor states, level of economic growth and access to means of food production. A group of NGOs join together to fight against poverty. The group also organised a meeting called Peoples Summit against poverty. The team 3

4 assessed the progress on MDGs and submitted a report entitled Securing Rights: A Citizens Report on MDGs. The report reflected the voices of the people living in the rural India across 13 states and in 1500 villages. The key findings of the report on poverty and hunger are as follows; According to government estimation the proportion of people living below poverty line was brought down to 27% by but at the same time calories intake information showed that nearly 70% of the rural population was in the poverty bracket. Nearly 14 % of the villages reported seeing hunger and starvation As many as 48% of the villages reported poor communities that have to skip meals More than 88% of the villages report that the work is not available all year round Only 5% of the men and 3.8% of women in the villages reported work for more than 25 days in a month In more than 68% of the villages were of the opinion that facilities like PDS did not meet the needs of the people Only 37.2 of villages report women owning agricultural land In more than 75% of the villages widow pension scheme covered less than 30% of the eligible widows In 82% of the villages women reported not getting equal wages. Suggestions All of this reflects the urgency for region specific strategy to achieve the MDGs targets. The strategy also needs specific attention for different group like women, dalit and minority groups. The level and reason for poverty varies from the region to groups. If we all are committed to reduce poverty to 31.15% by 2015, all the Stakeholders of the society have to take the responsibility to the guide the direction of poverty alleviation movement. There is an urgent need to reduce indebtedness of small and marginal farmers and agriculture labourers. There is a need to improve the Public Distribution System (PDS) with special emphasis on quality and accessibility. There is also a need to ensure socio- 4

5 economic security of the retrenched workers of closed industry. The rural connectivity and more livelihood opportunities for the rural people can only lower the level of people below the poverty line. Goal 2 &3: Achieve universal primary education and gender equity in education The MDG is to ensure that, by 2015, all children are in school, the net primary enrollment ratio is 100%, and that all the pupils entering grade 1 are retained until grade 5. India has made rapid strides in education during the last 4-5 decades. The gross primary enrollment rate, which was only 43% in , reached 100% by , and has fallen slightly since then. An average gross primary enrollment rate of 95% for the country in for the country masks wide variations across states. Gross primary enrollment rates vary from a low of 65% in Uttar Pradesh to a high of 139% in Sikkim. In addition, there are large differences across states in the primary attendance rate. Attendance rates for the age group 6-11 exceed 90% in nine (9) stateskerala, Tamil Nadu, Maharashtra, Goa, Himachal Pradesh, and the states of the Northeast. At the other end, the rates are only 75% or lower in Bihar, Orissa, Rajasthan, Uttar Pradesh and Madhya Pradesh. With only 53 % of children aged 6-11 attending school, Bihar ranks as the poorest performing state on school attendance in the country. There is a large discrepancy between the age specific and net primary rate in all the states. Even in the states having high attendance rates among 6-11 years olds, the net primary attendance rate is significantly lower. In Bihar, a mere 28% of children aged 6-11 attend primary school. According to the NSS 55 th round data, there were nearly 30 million out of school children aged 6-11 in India in Nearly half of all these children come from the two states of Uttar Pradesh and Bihar. School nonattendance is also very highly concentrated in relatively few villages in the country. A mere 10% of villages in the country account for nearly one-half of all out of-school children aged 6-11, while 20% of villages account for three quarters of all out of school children. Most likely, these villages are scheduled tribe habitations that do not have a 5

6 primary school of their own and are not within easy walking reach of a primary school. They are also likely to be poor villages where the opportunity cost of child labour is high. The key findings of the citizen report on Education are as follows: Only 53.4% of habitations have primary schooling facility within IKM High dropout rates 35.06% in Extreme focus on enrolment and neglect of what happens after the enrollment Shortage of school teachers (estimated at million for both primary and upper primary sections One out of every six primary schools in the country is a single teacher school Nearly 68% villages reported that there were children working for wages In early 62% of the villages there were girls of school going age not enrolled More than 51% of villages reported that they were dissatisfied with the education services Only 40% of the primary and secondary schools have toilets for the girls Almost all the villages reported discrimination in access for certain social groups. Suggestions There is a need to conduct a detailed analysis of state expenditure on elementary education, apart from central government support under Sarva Sikha Abhiyan (SSA). There is also need for more focus on schooling processes and outcomes. The critical processes that could make significant difference to improve the internal and external efficiency of the school system need a relook. More focuses needed on management of schools and teaching learning processes in the classroom. 6

7 Goal 4: Reduce child mortality The MDG is to reduce infant and child mortality by two-third between 1990 and For India, this would imply a reduction of the infant mortality rate (IMR) to 27 and of the under five-mortality rate to 32 by Despite infant mortality having declined impressively in India - from infant deaths per 1,000 live births in the early 1970s to 68 in 2000 the absolute levels of infant and child mortality are still too high (about 68 infant and 95 child deaths per 1000 live births in ). Nearly 1.75 million children die each year in the country before reaching the age of one. In addition, India compares poorly on the pace of IMR reduction to several other countries in South and Southeast Asia, including Bangladesh. There are large interstate and intrastate variations in IMR in the country, with the IMR ranging from a low of 14 for kerala to a high of 96 for Orissa. The rate of progress on IMR reduction has also varied significantly across sub-national units. States such as Bihar and U.P, which had among the highest IMRs in the country in 1981, were among the top performers in IMR reduction over the period On the other hand, Andhra Pradesh and Karnataka had the slowest rate of IMR decline over the two decades. In general, there was some convergence in IMRs, so that inter-state disparity in infant mortality decreased between 1981 and The NFHS-2 data are also shows that infant deaths are concentrated in a relatively small number of districts and villages in the country. During , a fifth of the country s districts and villages accounted for one-half of all infant deaths in the country. The key findings of the citizen s report on child mortality rate are as follow Most public sector hospitals are located in urban areas Rural health facilities are understaffed by over 50% 2 Lakh infants die every year due to preventable illness Only 21% of the villages have Primary Health Centres In nearly 70% of the villages, people have to walk more than 3km to access a health facility Only 22% of the villages have trained doctors available at the centre Only 25.6 of the villages reported availability of medicines 7

8 In another 7 9% of the cases they thought no curative care was provided at the health centres Suggestions Infant mortality can be brought down considerably by first identifying and then targeting mortality reducing interventions to those districts and villages with the largest number of infant deaths in the country. Various research studies show that female literacy and the level of development in a state complement (rather than substitute for) each other in terms of their association with infant mortality. The magnitudes of the proposed interventions must be were scaled up so as to bring the poor states to the mean level of non-poor states. Merely increasing health spending will not be enough; the composition, quality and effectiveness of public spending is as important as raising its quantity. This is especially true of the poorer states in India, which are plagued with the most serious problems of governance and service delivery in the health sectors. Goal 5: Improve maternal morality rate The MDG is to reduce maternal mortality rate by two-third between 1990 and For India, this would imply a reduction of the deaths due to childbearing to 1 per 1000 by At present the deaths due to childbearing range from 4 to 5.5 per 1000 births. Maternal deaths due to complication in pregnancy and childbirth are among the leading cause of deaths among women in a number of states in India. As per the World Health Organisation (WHO), maternal death refers to death of women, while pregnant or within 42 days of termination of pregnancy irrespective of the duration and the site of pregnancy, from any cause related to or aggravated by pregnancy or its management but not from accidental or incidental causes. The maternal mortality ratio, defined as the number of maternal deaths per hundred thousand live births, was 408 at the national level for 1997 as per the estimates of Registrar General of India. The ratio at state level varies from 707 in Uttar Pradesh to 29 in Gujarat. 8

9 The cause of maternal mortality includes haemorrhage, sepsis, obstructed or prolonged labour, unsafe abortion and anaemia. In addition, the chance to death increase if complications arise in deliveries that do not take place in health institutions or if they cannot be quickly transported to a referral unit in case the need arises. The number of death in the rural area is much higher than urban areas. The level of literacy and availability health facilities plays an important role in determining the number of deaths during child bearing. The key findings of the citizen report on child mortality rate are as follows Nearly one Lakh mothers die during child birth annually Only 21% of the villages have primary health centres Only 22% of the villages have trained doctors available at the centres The goal of the National Health Programme to be achieved in the years 2000 remained unachieved Suggestions A large number of these deaths are preventable, if attention is paid to some of the conditions, prevailing in India, from which women often suffer. These include poor health care, often on account of lack of awareness of good health practices, poor nutrition, early marriage of women, particularly in Northern and Central parts of the country; high and closely spaced fertility that often stretches from adolescence to menopause, and the low status of women that marginalises them in decision making proces at all levels. Goal 7: Ensure environmental sustainability The MDG is to reduce the number of people without sustainable access to safe drinking water by half between 1990 and At present in India 84% of rural families and 95% of urban families have access to safe drinking water but not all source are sustainable. In the tenth five-year plan the government of India planned to provide 85% of people safe drinking water. As per the 9

10 National Family Health Survey (NFHS) II, the share of population having access to safe drinking water was nearly 78% in as against 62% in As with the census data, the proportion of population having access to safe drinking water was significantly higher in the urban areas at nearly 93% as against rural areas where it was around 72%. As per the census of India, if a household has access to drinking water supplied from a tap or a hand pump/tube well situated within or outside the premises, it is considered as having access to safe drinking water. Millions of people in country suffer from water borne diseases on account of lack of access to drinking water. It is the poor who suffer from higher prevalence of disease as compared to the rich. In 1991 census reported nearly 62% of households in India as having access to clean drinking water as compared to about 38 % in Over 81 % of urban households and around 56 % of rural households had access to safe drinking water in The corresponding figure for 1981 were 75% and 27% respectively. Among the major states, the situation is worst in Kerala, where less than onefifth of the households had access to safe drinking water. Much of the Kerala drinking water requirement is met from wells, which is not considered as safe drinking water. In a majority of northeastern states the proportion of households having access to safe drinking water is much lower than the national average. Among the bigger states, the proportion of households having access to safe drinking water was lower than the national average in Andhra Pradesh, Assam, Bihar, Madhya Pradesh, Orissa and Rajasthan. One the other hand, nearly 92 percent of rural households and 94 percent of urban households in Punjab had access to safe drinking water. In terms of population segments the access to safe drinking water varies between Scheduled caste (SC) and Scheduled tribe (ST) households, while the access of SC households is almost the same as that of other households in both rural and urban areas at the national level, in case of ST the access to safe drinking water is considerably lower. There are also considerable differences at state level. 10

11 The key findings of the citizen report are as follows Only 18% of the villages covered received drinking water at their doorstep Current programmes do not take into account the increase in number of people No figures are available on treated water and non treated water SC and ST population are major sufferers in terms of access to safe drinking water. Summary and recommendations From the above discussion we can say that attaining the MDGs will require action in the poorest states, districts and villages. Most importantly specific groups like women, SC, ST also need a separate strategy. Unfortunately, currently available data cannot allow identification of specific villages that account for most of the infant deaths, underweight children, or out-of-school children in the country, because most sample surveys are not large or representative enough at the village level. An ICT based MIS can be one of the viable solution to collect village level data and design the strategy for specific groups. Large improvements in all the MD indicators are possible with concerted action in many areas. Both general and sector-specific interventions will be important in attaining the MDGs. General intervention include: Economic growth Expanded adult male and female schooling Increased access to water and sanitation Improved electricity coverage Increased access to pucca roads Address the missing indicators in the MDGS like domestic violence, crime against women, participation of women in income generation 11

12 activities, access to opportunity for socially disadvantage groups in the development activities. Improved the ICT based information network among the community Sectoral interventions include: Increased government spending on health and family welfare, and elementary education. The health services including trained personnel and medicines should be made available at an affordable cost. More professional assisted deliveries Antenatal care coverage and tetanus toxoid immunization for pregnant women Increased number of primary schools per child aged 6-11 Reduction in the pupil teacher ratio Increased food grain per capita District wise computerized data for all the sector Specific interventions include: Ensuring that the income poor and the socially disadvantaged groups receive special attention and priority Taking urgent steps to reduce indebtedness of small and marginal farmers and agricultural labourers Improving the working conditions and wages of the agricultural and unorganized labour by guaranteeing minimum living wages, social security and regulation of work. Extending loan facilities at the low interest rates for the poor farmers The National Rural Health Mission (NRHM) focuses on the two key survival priorities of reducing first week/month neonatal mortality and maternal mortality. These are the major failures of healthcare to date. Lack of basic healthcare in rural areas is one of the prime reasons of indebtness of the rural poor, Dalits, and Tribes. Immediate steps need to be taken to complement NRHM as per the needs of the people and ensure free health care. 12

13 For the successful achievement of MDGs, targeting interventions, public spending, and economic growth opportunities to the poor states and, more specifically, to the poor districts and villages will be critical. MDGs also miss out some important issue like domestic violence, access to resource among different group female feticides etc which also need to be address. Finally, the importance of systematically monitoring MD outcomes at disaggregated levels and evaluating the impact of public programs cannot be overemphasized. Currently, UNDP have taken few initiatives to monitor progress towards attainment of the MDGs at the sub national level but there is need for more such interventions. Vision to achieve MDGs Finally, the MDGs cannot be achieved without clear vision for integrated and holistic perspective; To begin with, there is a need for: Enhanced social mobilization and more focused knowledge based advocacy coupled with transparency of action by national government as well as international agencies. Persistent social movements viewing universal basic need as integral components for establishing a democratic social polity. Revival of the human face of the education endeavour and an emphasis on social processes that will lead to a transformation of the socioeconomic conditions in the developing countries. Genuine partnership among all concerned on long term basis to protect human right and promotion of peoples well being Profound understanding of the constraints and capacities of specific countries, in ensuring basis human right, which is in fact long term social project. Involvement of partners at all levels-from local actors and NGOs to ministries and eminent moral authorities with realization that there is convergence of interest between agents of civil society and public institutions to see universal protest against hunger, diseases and exploitation. Identification of people, both as the most vulnerable members in the society and the also as most precious resource for the future. 13