Despite many achievements in recent years, especially on the economic front, which saw India emerge as the second fastest growing economy in the world, India continues to perform poorly on most counts in the social sector. India's standing with reference to other countries in South Asia as far as social sector indicators are concerned has slipped considerably since the early 1990's and with the exception of Nepal and Afghanistan, for most indicators other countries in the region, most notably Bangladesh have over-taken India in the last two decades.
The child malnutrition rate in India is 46 percent which is the largest number of under-nourished children in the world. More than half of Indian women are anaemic and close to a third of all children born in India are low birth weight. What is of more concern, that according to the National Family Health Survey there has been little progress made on the child malnutrition front between the 1999 and 2006, with just one per cent reduction in child malnutrition, in the years of very high economic growth. 38 percent of Indian children are stunted and close to a fifth of Indian children are wasted.
What is more ironic is that this situation of chronic malnutrition persists despite the fact that India has achieved self-sufficiency in food grain production and is a net exporter of food, in most years, over the past few decades. India's record in other sectors is not too impressive with close to a third of the population living below the official poverty line, according to a report of the Planning Commission. United Nations data show that in sanitation, more than half of the open defecations in the world in any given day are in India, and only a third of the population has access to a private toilet.
A plethora of social welfare programmes and fundamental rights
Despite this and what is perhaps less well known is that India has a plethora of social welfare programmes covering the entire population across all sectors including food, employment, health, education, and social assistance like pensions for the aged and the disabled. There are more than 66 centrally sponsored programs supported financially by the central government and many more that are paid out of state and local budgets. The total budget outlay of the central government for social sectors stands at around 2 percent of the GDP and total spending in these sectors including the contribution of the states is around 7 percent of the GDP. However, the average spending in the OECD countries on the social sectors, despite the recession, is nearly double that figure.
The outlay for the Sarva Shiksha Abhiyan – or Education for All Movement – which is the flagship programme on education of the government of India is around 2.4 billion Euros. The total food subsidy that the Government provides including spending on procurement from farmers, and the public distribution system is around 12 billion Euros.
Despite the fiscal conservatism in recent years, what has marked out Indian social policy since 2004 onwards is the trend of consolidating the gains in the social sectors through rights based legislations that have been passed by Parliament. The series of laws passed by Parliament in the past decade cover the rights to education, food, employment, information, compensation and rehabilitation in case of land acquisition and land for forest dwellers.
These laws are creating fundamental rights within the constitutional scheme of things whereas earlier these rights were largely enshrined as directive principles of state policy that were more a statement of intent rather than justifiable entitlements that the citizens could claim from the state. This is a bold departure in social policy not just for India, but also globally where the role of the state has been increasingly shrinking. It is in sharp contrast to what is happening in developed countries, including in Europe, where the post-war consensus on the welfare state is gradually unravelling.
Government programs provision for free health care at the primary and secondary level, free and universal education, pensions for the aged, widows and persons with disability, construction of private toilets, housing in rural areas for the poor, homeless shelters in urban areas, free school meals for children studying in government and government-aided schools, maternity entitlements and provisioning of one free meal a day or take home rations for children under the age of six as well, amongst a whole host of other programs.
That India's social sector statistics have not shown significant improvement in the past twenty years is a testament to the fact that significant challenges in implementing these programs. Lack of accountability of government, absence of transparency and corruption plague India's social sector programming. While systemic checks and balances exist on paper, many of these are bypassed. On the positive side, the right to information and the recent public agitation by the anti-corruption movement, have considerably empowered citizens to protest against leakages in government schemes. Innovations like public "social audits", where information on government schemes are made public, with officials in attendance, are also making a significant dent in increasing accountability.
The right to food, the right to life
To understand opportunities and challenges that exist in social sector programming, we can take the example of the National Food Security Act that was legislated in September 2013. Despite having one of the largest stock-holding programs in the world with an average of close to 60 million tonnes of food grain stock in a year, malnutrition and hunger persist in India.
It is in this context that the Indian Supreme Court intervened in 2001, after a petition was filed by the People's Union for Civil Liberties (PUCL), a leading human rights organization in the country, and has since then passed more than 150 orders in what has been acknowledged as the leading case on the right to food anywhere in the world. Supreme Court orders covered a wide gamut of food and employment schemes and the Supreme Court upheld the principle that all food programs of the government were legal entitlements covered under Article 21 of the Indian Constitution, which guarantees the right to life and personal liberty. What is notable here the Court specifically interpreted the right to food as a part of the right to life, even though the Indian Constitution does not explicitly mention the right to food as a fundamental right.
After more than a decade of struggle within the court and a nation-wide movement by the right to food campaign, the Indian Parliament finally legislated the National Food Security Act, 2013 (NFSA) in September 2013. It broadly follows a life cycle approach and covers almost every age group of resident Indians. Children are covered from birth to the age of six through the Integrated Child Development Services (ICDS), through schooling till the upper primary level through the Mid Day Meal Scheme (MDMS) and pregnant and lactating mothers, by maternity entitlements and supplementary feeding through the Integrated Child Development Services (ICDS).
It has provisions for the promotion of exclusive breast-feeding amongst all children under the age of six months. For children in the age group of six months to six years, the NFSA guarantees either take home rations or a hot, cooked meal, served at one of the 1.6 million centres operated by the ICDS which is the only institutional mechanism for children under the age of six. It also provides free meals for all pregnant and lactating mothers in the country and in addition provides for a maternity entitlement of 75 Euros, spread over six months, for every pregnant and lactating mother in the country. It also guarantees a free mid day meal to every child attending primary and upper primary grades in all government or government aided schools. All the above mentioned programmes are universal and non subject to any targeting or means testing.
Apart from that, NFSA guarantees close to 820 million people, which represent 67 percent of the Indian population (75 percent in rural areas, 50 percent in urban areas), food grains at highly subsidized prices. Each individual is guaranteed at least 5 kilograms of rice, wheat or millets at 3 Rupees, 2 Rupees and 1 Rupee per kilogram respectively. Effectively this means around 25 kilogram per month per family (assuming an average family size of five) of rice, wheat or millets at 75 Rupees (90 Euros Cent), 50 Rupees (60 Euro Cents) and 25 Rupees (30 Euro Cents) respectively. Additionally, roughly 20 million of the poorest households receive an extra 10 kilograms of food grains at the same rate, so 35 kilograms altogether.
By all accounts the NFSA is one of the most comprehensive legislations on the right to food anywhere in the world. It has emerged from a strong public campaign, a series of judicial orders and a decisive mandate for pro-poor change that was delivered to the Government.
Challenges of financing and implementation
The major concerns regarding this legislation that have dominated the policy space have been two-fold. The first set of concerns is, understandably, on the fiscal constraints, especially in a recession-hit global economy that has also impacted India's growth rate in the last three years. It has been criticized, often unjustly, for being fiscally profligate and something that India just cannot afford to spend.
Nothing could be further from the truth. While it is true that the annual cost of this programme would eventually be close to 15 billion Euros, this expenditure represents less than one percent of India's GDP. Before the NFSA was legislated, India was spending close to 12 billion Euros in food subsidies and the additional increase, according to Government statistics is less than 4 billion Euros. The total expenditure on the food subsidy is marginally more than the defence expenditure of the country. Given the context of widespread malnutrition and hunger, the long-term costs of not dealing with this problem are likely to be much higher.
Food subsidies, as an overall percentage of the GDP, have always been less than one percent of the GDP throughout the past decade and is likely to be 1.3 percent of the GDP after the NFSA is fully implemented.
The second set of concerns regarding NFSA has largely been around the challenges of implementation. The failure of India's Public Distribution System (PDS) is well documented in many states, and critics of this legislation have pointed out that the intent of the NFSA may well be defeated if the delivery mechanism does not work. This is a valid criticism and an effective PDS is key to the benefits reaching the people. Some of the estimates peg the losses in the PDS close to 40 percent. However in recent years, many Indian states including Tamil Nadu, Chhattisgarh, Orissa and Himachal Pradesh have demonstrated that the PDS can be reformed effectively through greater transparency and accountability and appropriate use of technology.
The biggest challenge that remains though is the fact that India will need to do far more than just implement the NFSA to deal with the crisis of malnutrition in the country. While the interventions in maternity entitlements, free meals and subsidized food grains may partly solve the problem, they are unlikely to have a very major impact on child malnutrition figures. This is simply because the other social determinants that are key to reducing child malnutrition including access to clean drinking water, sanitation, and access to quality primary level health care are woefully inadequate. Recent evidence on stunting, for instance, establishes a very direct co-relation between access to sanitation and stunting. Since more than half of all open defecations in the world on any given day, are in India, unless this challenge is met, it is unlikely to make a major dent on the child malnutrition figures.
The largest employment program in the world
The experience with the Mahatma Gandhi National Rural Employment Guarantee Act passed in 2005 is similar. It was created to provide a legal entitlement of a hundred days of employment, every year, to every rural household in the country at minimum wages. It was primarily seen as a social protection measure for the most vulnerable people in rural India by providing employment opportunities. The annual cost of the program is roughly 4.5 billion Euros, though expenditure has been decreasing in recent years. The employment is to be provided within a fortnight of the demand for employment being made. In case the government is not able to provide employment, an unemployment allowance is to be provided to the job-seekers. The program now covers the entire country and has emerged as the largest employment program in the world.
More than 83 million persons were provided employment under the Act in 2013/14. Yet, the average days of employment provided stands far less than 100 days that are guaranteed and for most parts of the country it is less than 50 days. Despite many transparency and accountability measures that have been provided for in the legislation, corruption is routine and large-scale leakages are being investigated by the statutory government auditors and even the Supreme Court. Despite these challenges, the MGNREGA has had a salutary effect on all rural wages, participation of women in the program is extremely high as is the coverage of the most vulnerable families in the country.
The major bottleneck in the program remains the delayed payment of wages with workers routinely getting payments four to five months after the completion of the work. This acts as a major disincentive for participation in the MGNREGA and could well explain its declining popularity. In recent years, there has also been an acknowledgement that the program has not been able to create durable assets in villages that could potentially have led to an increase in agriculture productivity and strengthened infrastructure at the village level. This is now being sought to be corrected by more decentralized planning and creating a shelf of projects that are centred around natural resource management and livelihoods generation.
Public audits of expenditure popularly referred to as social audits, have been made mandatory, to curb corruption. All data pertaining to the MGNREGA is now online as an additional transparency measure. Many states are also leveraging information technology, including biometric identification of workers, to curb leakages.
India is at the cross-roads of social policy programming since despite very large scale expenditure, and a plethora of programs, the outcomes do not adequately reflect the investments that are being made. But there remains room for much optimism, because of increasing public awareness and the regimen of rights based legislation that are now being deepened across the country. There is much at stake here for India' development.