Health Challenges
Though the government spending on health has increased over the last years and the been as important element in reducing poverty, much more attention is required of the poverty-health linkage. Child malnutrition and under-nutrition in particular, remains high, and improvements have been much lower than what would be expected given India’s pace of GDP growth. Besides inadequate access to public sector health facilities, there are also concerns with the quality of the services provided. This has resulted in an increase in the demand for private health care services, which create their own concerns given the wide differences in quality of private health care, high prices, which makes it unaffordable for many and high medical costs, which push many people into poverty. What is needed to meet this challenge is the complementarity between the high government spending in the health sector and reforms to improve accountability in service delivery, both by the private and public sector. Better regulation and oversight of private providers will play an important role. The design of the health insurance scheme, which the government is planning to toll out in the near future to improve access to health care, will be very critical to improved outcomes.
Regional disparities
Low- income states of Bihar, Odisha, and Madhya Pradesh are behind other states on most social indicators. The Multidimensional Poverty index (MP) study report indicates that eight Indian states, namely Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Uttar Pradesh, Rajasthan, Odisha, and West Bengal are home to 421 million multidimensional poor persons. Similarly disparities are evident in India at the inter- state and rural –urban level in the provision of basic services, which include water supply sanitation and clean energy.
Sanitation and drinking water-related challenges
India still faces challenges especially in rural areas in terms of sanitation, access to drinking water. Rural sanitation is a state subject and the Central government provides technical and financial assistance to supplement the efforts of the states. Initiatives like the Total Sanitation campaign (TSC) have been made under the Central Rural Sanitation Programme (CRSP) that envisages greater involvement of implementing agencies like panchayati Raj institutions and NGOs. The challenge of availability as well as quality in the distribution of drinking water still persists across various areas in the country.
Education access and quality
There has been a significant increase in absolute public and private spending, which has resulted in a marked expansion in the number of teachers and educational infrastructure. There has been considerable progress in increasing enrolment rates and reducing gender disparities, especially at the primary level. However, the problem of high drop-out rates and low student attendance continues. Enrolment rates at secondary and tertiary levels compare poorly with international levels and are particularly lower for females than males.
Learning outcomes among Indian school children are very low, relative to their curriculum, and inequality in learning levels is high. One of the reasons for this is the low teacher effectiveness particularly in public schools, which needs to be enhanced through effectiveness particularly in public schools, which needs to be enhanced through strengthening of incentives and accountability. Teacher absenteeism has been a persistent problem despite recent revisions in remuneration. This calls for a need to reform the terms of employment for teachers. Another issue of concern is the high student-teacher ratio, which reduces the teaching time available to each student.
While the country clearly has the opportunity to avail dividends from the changing demographic structure, benefits from this can be reaped only when the skill levels of the population is significantly improved and they are employable. This will require large outlays in vocational education and skill development by both the public and private sector.
Though the government spending on health has increased over the last years and the been as important element in reducing poverty, much more attention is required of the poverty-health linkage. Child malnutrition and under-nutrition in particular, remains high, and improvements have been much lower than what would be expected given India’s pace of GDP growth. Besides inadequate access to public sector health facilities, there are also concerns with the quality of the services provided. This has resulted in an increase in the demand for private health care services, which create their own concerns given the wide differences in quality of private health care, high prices, which makes it unaffordable for many and high medical costs, which push many people into poverty. What is needed to meet this challenge is the complementarity between the high government spending in the health sector and reforms to improve accountability in service delivery, both by the private and public sector. Better regulation and oversight of private providers will play an important role. The design of the health insurance scheme, which the government is planning to toll out in the near future to improve access to health care, will be very critical to improved outcomes.
Regional disparities
Low- income states of Bihar, Odisha, and Madhya Pradesh are behind other states on most social indicators. The Multidimensional Poverty index (MP) study report indicates that eight Indian states, namely Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Uttar Pradesh, Rajasthan, Odisha, and West Bengal are home to 421 million multidimensional poor persons. Similarly disparities are evident in India at the inter- state and rural –urban level in the provision of basic services, which include water supply sanitation and clean energy.
Sanitation and drinking water-related challenges
India still faces challenges especially in rural areas in terms of sanitation, access to drinking water. Rural sanitation is a state subject and the Central government provides technical and financial assistance to supplement the efforts of the states. Initiatives like the Total Sanitation campaign (TSC) have been made under the Central Rural Sanitation Programme (CRSP) that envisages greater involvement of implementing agencies like panchayati Raj institutions and NGOs. The challenge of availability as well as quality in the distribution of drinking water still persists across various areas in the country.
Education access and quality
There has been a significant increase in absolute public and private spending, which has resulted in a marked expansion in the number of teachers and educational infrastructure. There has been considerable progress in increasing enrolment rates and reducing gender disparities, especially at the primary level. However, the problem of high drop-out rates and low student attendance continues. Enrolment rates at secondary and tertiary levels compare poorly with international levels and are particularly lower for females than males.
Learning outcomes among Indian school children are very low, relative to their curriculum, and inequality in learning levels is high. One of the reasons for this is the low teacher effectiveness particularly in public schools, which needs to be enhanced through effectiveness particularly in public schools, which needs to be enhanced through strengthening of incentives and accountability. Teacher absenteeism has been a persistent problem despite recent revisions in remuneration. This calls for a need to reform the terms of employment for teachers. Another issue of concern is the high student-teacher ratio, which reduces the teaching time available to each student.
While the country clearly has the opportunity to avail dividends from the changing demographic structure, benefits from this can be reaped only when the skill levels of the population is significantly improved and they are employable. This will require large outlays in vocational education and skill development by both the public and private sector.
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