On health and fertility the Economic Survery has noted signs of a, “sign of growing regional inequality among the Indian states.”
While life expectancy of Indians has improved, the annual Survey noted that mother and children were bearing the brunt of a weak health system.
It stated that despite growing rapidly on average, there is sign of growing regional inequality among the Indian states. This is puzzling because the underlying forces in favour of equalization within India — namely strong and rising movements of goods and people — are strongly evident.
“One possible hypothesis that there might be governance traps that impede the catch-up process,” but does not explain what these traps may be. “But why such traps persist if competitive federalism is forcing change upon the lagging states remains an open question,” according to the survey.
According to Dr.Shakthi Selvaraj, health economist with the Public Health Foundation of India the Survey — which is an annual assessment of trends in the sector — has failed to note any specific progress in the last year.
“The central message is that life expectancy has gone up- although it is hugely affected by interventions other than health like education, unemployment etc. There seems to a broad brush because the survey does not look at morbidity or mortality caused by infectious and non-communicable disease (NDCs).
“While IMR is a central outcome, that alone has been factored in with years lost or economic cost of NCDs and infectious disease not even figuring in this chapter. In fact, it makes no mention of NCDs at all, which is among the biggest disease burden in India.”
Further, the survey notes that with regards to life expectancy, the Indian states are close to where they should be given their level of income. “However, this is not true of IMR, suggesting that the ‘mother and child’ (discussed also in last year’s Survey) bear the brunt of weaker delivery of health services.
“What really stands out in the international comparison is fertility and how much better the Indian states are performing than their international counterparts on that metric. These unusually large declines in fertility have strong — and positive — implications for India’s demographic dividend going forward,” the survey states.