Two important sets of numbers and rankings have emerged recently that India needs to analyse more carefully. Rankings matter greatly to the ruling government of India. Not necessarily because they reflect important and appalling facts about a worsening situation on the ground, but conversely because of the opportunity they present for chest-thumping. Any rankings, even if specious, if seen to flatter the current government, are put out with a drumroll. Exhibit A would be the prime minister recently talking up the Global Innovations Index, created by INSEAD, a business school, and World Business, a British magazine, where India climbed 35 notches from 81 in 2015 to 46 in 2021.
However, there are other key numbers that bust this narrative. We learnt this month that India’s rankings in the United Nations Human Development Index continue to fall. After the dip recorded in 2020, India has fallen further to 132 of 191 countries. The global scenario is replete with conversations about inequality, stress and misery being on the rise. Among India’s neighbours, Sri Lanka, China, Bangladesh and Bhutan are ranked above India. Only three countries, Pakistan, Nepal, and Myanmar are worse off. Most countries registered a decline in their HDI value in 2020 or in 2021. But India, apart from its own HDI value declining, also fell relative to other countries.
The HDI value is defined by the World Health Organisation as a summary composite measure of a country's average achievements in health, knowledge and standard of living. The HDI sets a minimum and a maximum for each dimension, called ‘goalposts’ and then plots where each country stands in relation to these goalposts. The value is between 0 and 1. The higher a country's human development, the higher its HDI value. India’s 2021 HDI value of 0.633 puts it in the medium human development category, lower than its value of 0.645 in the 2020 report.
Secondly, last month the Harvard Center for Population and Development Studies assessed the performance of India’s states and districts on the POSHAN Abhiyan, a programme launched in March 2018 with a stated aim to achieve improvement in the nutritional status of pregnant women, adolescent girls, lactating mothers, and children under six. The study was conducted by Geographic Insights, a research lab based at the center. India’s NITI Aayog is listed as one of the collaborators of Geographic Insights.
Harvard’s ranking of states and districts yielded some stunning results. Gujarat has the lowest rank at 28 and a key performance indicator score of 0.176 compared to the top three states: Manipur at 0.919, Mizoram at 0.837 and Kerala at 0.766. Nine out of the ten districts at the bottom, with the ranks 695 to 704, are tribal districts. Six of these are in Gujarat.
Numbers from the National Family Health Survey for 2015-16 and 2019-21 were used to draw up the rankings. These bring the focus on commonly occurring forms of nutritional deprivation among children in India and provide a very comprehensive measure for evaluating the success of the POSHAN Abhiyan.
After its launch, the scheme itself was criticised for matching high-sounding targets with paltry budget allocations. Economist Jean Drèze estimated that taking inflation into account, the allocation for the mid-day meal scheme had been reduced by 32.3% between 2014 and 2021. The mid-day meal scheme was implemented in all states under the orders of the Supreme Court of India in 2002. But the name of the scheme was changed to PM-POSHAN, or Pradhan Mantri Poshan Shakti Nirman scheme, in September 2021.
Countries are judged by where they stand on the quality of life of their people. Large countries especially, where human beings are both a wealth and resource, must be evaluated on the metrics that make ordinary lives better. This would include first, survivability of children born and good health to serve as a foundation for the nation. The Gross Domestic Product is an important metric but it is not enough for ‘growth’ to be rising. The quality of the growth is also critical and this is determined by human development indicators such as maternal and child health. This is shorthand for the health of societies, globally. This cannot be seen as a sidebar about some poor children not getting enough food to eat. This reflects the state of the nation.
Currently, India’s young are numerous and are poised to be its primary earners and basic base of citizenry in a few decades. Modern biological sciences provide ample and compelling evidence that the foundations of lifelong health are built early, with emphasis on the prenatal period and first few years after birth. Conversely, if children are to languish under lack of food and nutrition, implications for the years ahead are clear.
Citizens matter, as do their capabilities. Their intrinsic worth must matter to the government of the day, irrespective of who they are, their faith, caste or gender. Pakistani economist Dr Mahbub ul Haq is credited with the concept of the Human Development Index which is now seen as an indispensable tool for any discussion on national wellbeing. The concept embodies Haq’s friend and India’s own Nobel laureate Amartya Sen’s “human capabilities” approach, which focussed on the actual lived life of people. The two were friends at Cambridge and much was discussed between them on putting the person at the centre of methods to study levels of economic attainment. All in all, a fall in HDI is of great concern to what is happening on the ground, even as the government is more keen to speak about India being the “fastest growing” economy, its “recovery” from the pandemic and other such half-truths.
The almost unreported evaluation by Harvard of POSHAN is even more revelatory, and that may explain why it did not find its way on to the NITI Aayog website. But it is only appropriate to take the right lessons from it. The state rankings make it clear that Modi’s “double engine” claim is a myth, apart from being anti-federal. BJP-ruled states are amongst the worst performing despite eight years of a fully empowered BJP at the centre.
The 2014 election was contested by the BJP riding on Narendra Modi’s performance as chief minister of Gujarat for 12 years; hence the ‘Gujarat Model.’ Three chief ministers on, it remains a matter of prestige and a pocket borough of the two top most political leaders of the BJP, making it 20 long years of uninterrupted rule. If so many years of the Gujarat model gave us this—the bottom rank of all states and six of ten worst off districts in the country—being from the state on such an important metric, implications of replicating the “Gujarat Model” would amount to an infliction and reflect on why the rest of India, under the sway of such thinking, is rapidly going down on these scores. Harvard instead recommends that Gujarat learn from Kerala, Mizoram and Manipur.
It is important to note here what Narendra Modi, as chief minister, had said about malnutrition in Gujarat ten years ago. In an interview to The Wall Street Journal in August 2012, he had attributed his state’s high rates of malnutrition to vegetarianism and figure-conscious Gujarati girls. “The middle class is more beauty-conscious than health-conscious—that is a challenge,” he said. This assessment instils zero faith in the Gujarat model, indicating that the government has known this but chooses to see this dangerous problem in such a manner.
A falling HDI and the details in the POSHAN mapping are loudly saying that extra dry rations of five kilogram per person to the 800 million already getting ration under the Food Security Act is not enough. Projecting them as beneficiaries of the PM’s personal charity does not solve the more fundamental problems of nutrition and well-being.
That India has added to the ranks of growing poor during and after the pandemic means that inequality has been hard to fight or even bring on the agenda. Data and facts on the ground make it clear that the country’s economic inequality is deeply connected with structural social inequalities. A 2010 report by the Commission for the Economically Backward Classes found that just five percent of India was economically backward or what may constitute ‘EWS,’ if you took away those covered by the reservation pool of the Dalits, Adivasis and OBCs. There is a near-perfect fit of class with social identity.
No politics that harps on preserving ancient Indian “values” or ways of doing things can be counted upon for economic upliftment and bettering lives. A fundamental break with the social status-quo is vital for economic upliftment. It may be no coincidence that after decades of an untrammelled run provided to the BJP in Gujarat, all of its six districts that figure in the bottom of the pile are Adivasi districts.
Dr Abhay Bang, the co-founder of Society for Education, Action and Research in Community Health in Maharashtra’s Gadchiroli, has also headed a committee tasked with making recommendations for tribal health by this government and submitted its report in 2018. It has been met with radio silence from the Modi government since. Commenting on the Harvard study, Bang stressed that we need to study the Gujarat model of development verses the Manipur, Meghalaya and Kerala model, given that these states fared much better. “What did they do differently?” He said it is a tragedy that nine out of the ten districts at the bottom of all districts in India when ranked by the nutritional status of children are tribal districts. “India is truly a paradoxical country. A tribal woman at the apex and 20 million tribal children at the bottom. The elected representative democracy seems to fail its children in general, and tribal in particular.”