Transcript Panel 4: Implementing Social Policy In India Wednesday

13th Symposium on
Development and Social Transformation
Panel 4: Implementing Social Policy In India
Wednesday, April 19th (1:30-2:45pm)
13th Symposium on
Development and Social Transformation
Panel 4: Implementing Social Policy In India
India’s Population: An Overview
Anuradha Chagti
INDIA’S POPULATION: AN
OVERVIEW
ANURADHA CHAGTI
The Teeming Millions

1027 Million on 1st March
2001.

Population multiplied by 5
times in the last century.

Second most populous
country in the world.

Poised to cross China’s
population by 2045.
History of Population Growth

Although the birth rate in India has been falling since the 1960s, it
was only during 1991-2001 that it fell significantly faster than the
death rate - so bringing about a clear reduction

India is now entering the second phase of the
demographic transition.
Population Characteristics

The decadal growth rate of
India’s population was 21.3%
in the last decade. Great
variation among the states
with Bihar recording the
highest decadal growth rate of
28.4% and Kerala the lowest
at 9.4%.

Uttar Pradesh continues to be
the most populace state with a
population of 166 million.

The density of India is 324
persons per square. West
Bengal has the highest density
(904) followed by Bihar (880)
Population Characteristics (cont)

Sex ratio is 933. Kerala highest sex
ratio (1058) and Haryana the
lowest (861)

The child sex ratio (0-6 age group)
927 in 2001. The sharpest decline
has been in the richer northern
states.

The literacy rate for population
seven years and over was 65.4%
in 2001. Highest in Kerala 90.9%
and the lowest Bihar 47.5%.

For
the
first
time
since
independence an absolute decline
in the number of illiterate persons:
by 32 million during the last
decade.
Is the Growth Sustainable?
Questions are being raised about India’s ability to
sustain such a large population especially in the
realms of
Health
Food
and education
and water
Environmental
damage
Government Initiatives

Pre 1990’s
Dominated b demographic goals. Target
oriented. Focused primarily on sterilization,
largely obviating client choice and limiting
availability to a narrow range of services.

1997 onwards
Approach shifted to address health and family
welfare. Focus on client choice, service quality,
gender issues and underserved groups, including
adolescents, post menopausal women and men
Challenges

Expanding services

Informed Choices

Access to quality care

Training

Monitoring and evaluation

Message development
Future Projections
Prof Swaminathan :
TFR trends from 1971-96 for larger
States, TFR of 2.1 for the country
achievable only by 2026. Estimated
population of 1,409 million in 2026 and
stable level of 1,628 million by 2051.
National Population Policy 2000 projections:
If the TFR of 2.1 by 2010 then 1,330
million in 2026 and in 2046 reach a
peak of 1,417 million.
There is a 200-million difference —
almost as much as Indonesia's
demographic size — between the two
levels of projected populations — a clear
indication of the need to take the task of
population stabilization seriously
Policy implications

(i) Decentralized Planning and Program Implementation

(ii) Convergence of Service Delivery at Village Levels

(iii) Empowering Women for Improved Health and
Nutrition

(iv) Child Health and Survival

(v) Meeting the Unmet Needs for Family Welfare Services

(vi) Collaboration With and Commitments from NonGovernment Organizations and the Private Sector
THANK YOU
13th Symposium on
Development and Social Transformation
Panel 4: Implementing Social Policy In India
The Evolution Of The Family Welfare
Program In India
Tapan Ray
Evolution of the family
welfare program in India
Tapan Ray
Evolution and Delivery of
Family Welfare Programme in India
• Tyranny of Targets – The Fourth Plan (1966-74)
• Emergency excesses in the field of
sterilizations (mid –70s)
• Voluntary sterilization camps re-started with
the new technology of laparoscopic
sterilization (1980s)
• 1992 – Eighth Five Year Plan – calls for review
of targets
• 1994 – Changes in the approach to Family
Planning service delivery since ICPD
• 1996 – Target Free Approach announced
• 1999 – Community Needs Assessment Approach
(CNAA)
• 2000 – National Population Policy
Evolution of Maternal and Child health programmes in India
Year
Milestones
1952
1977
Family Planning Programme adopted by Govt. of
India (GOI)
Dept. of Family Planning created in Ministry of
Health
Medical Termination of Pregnancy Act (MTP
Act) 1971
Renaming of Family Planning to Family Welfare
1978
Expanded Programme on Immunization (EPI)
1985
1996
Universal Immunization Programme (UIP)+ National
Oral Rehydration Therapy (ORT) Programme
Child Survival and Safe Motherhood Programme
(CSSM)
Target-free approach
1997
Reproductive and Child Health Programme -1 (RCH-1)
2005
Reproductive and Child Health Programme -2 (RCH-2)
1961
1971
1992
Adverse Effects of a
Population Control Programme

Pressure for undergoing sterilization,
undermining human rights

Health repercussions of hastily done
sterilization operations in makeshift camps–
infections, complications, failure rates,
sometimes death

Inadequate attention to safety-inadequate
screening and follow-up

Health services do not have provisions to
deal with women’s genuine health problems

Poor quality of curative services
International Conference on
Population and Development Cairo 1994
• Adoption of the Programme of Action on
population and development for the next 20
years
• New strategy emphasized the linkages between
population and development
• Focus on meeting the needs of individual women
and men rather than on achieving demographic
targets
• Empowering women and providing them with more
choices through expanded access to education
and health services promoting skill development
and employment
• Importance of equity in gender relations
• Enhance access to appropriate information and
services
Attaining the Millennium
Development Goals
Infant Mortality in India
• Infant
mortality rate
(0-1 year) per
1,000 live
births (UNICEF
estimates)
World
55
Developed
Regions………………………6
90
80
70
60
50
40
30
20
10
0
84
74
1990
1995
68
2000
Year
63
2003
Source: WHO
Child Mortality in India
• Children under
five mortality
rate per 1,000
live births
(UNICEF
estimates)
World
80
Developed
Regions………………………7
140
120
100
123
104
94
87
80
60
40
20
0
1990 1995 2000 2003
Year
Maternal Mortality in India
• Maternal
mortality ratio
per 100,000
live births
(WHO, UNICEF,
UNFPA)
World
400
Developed
Regions…………………14
600
500
570
540
440
400
300
200
100
0
1990 1995 2000
Year
MDGs and the Tenth Plan
Targets
Goal 4 : Reduce
child mortality
• Target 5:
Reduce by twothirds, between
1990 and 2015,
the under-five
mortality rate
• Tenth Plan
targets infant
mortality rate
(IMR) of 45 per
thousand live
births by 2007
and 28 by 2012
MDGs and the Tenth Plan
Targets
Goal 5 : Improve
maternal health
• Target 6: Reduce
the maternal
mortality ratio
by three-quarters
between 1990 and
2015
• Tenth Plan
targets
reduction in
the maternal
mortality ratio
from 4 in 19992000 to 2 per
1000 live
births in 2007
and 1 by 2012
NP
Policy
2000 (by
2010)
Tenth Plan
Goals (20022007)
RCH II Goals
(2005-2010)
Population
Growth
16.2% (20012011)
16.2% (20012011)
-
-
Infant
Mortality
45/1000
35/1000
30/1000
28/1000
Under 5
Mortality Rate
-
-
-
Reduce by
2/3rds
from 1990
levels
Maternal
Mortality Ratio
200/100,000
150/100,000
100/100,
000
Reduce by
3/4th from
1990
levels
Total Fertility
Rate
2.3
2.2
2.1
-
Couple
Protection Rate
65%
65%
Meet
100%
needs
-
Indicator
MD
Goals (by
2015)
Rate
Key Facts

Decline in IMR but maternal mortality high

Inter- and intra- state variations in levels
and in rates of change (Kerala 14 Orissa 96)

Clustering of deaths in a few states

Gender disparity in infant mortality

Maternal education and female literacy

Strong inverse association with immunization
coverage

Ante-, neo-, and post-natal care
improvements will help reduce IMR

The MDGs CAN be attained
Goals of NRHM
• Reduction in Infant Mortality Rate (IMR) and
Maternal Mortality Ratio (MMR)
• Universal access to public health services such
as Women’s health, child health, water,
sanitation & hygiene, immunization, and
Nutrition.
• Prevention and control of communicable and noncommunicable diseases, including locally
endemic diseases
• Access to integrated comprehensive primary
healthcare
• Population stabilization, gender and
demographic balance.
• Revitalize local health traditions and
mainstream AYUSH
• Promotion of healthy life styles
What are the problems?

Basic housekeeping is lacking in this
sector;

Efficiency – converting interventions to
outcomes is poor;

Data systems are inadequate and needs to
be strengthened in numerous dimensions –
including coverage and quality;

Proper alignment of incentives.
How can this be done?
Improve social service delivery.
difficult since:
This is
It is more difficult to standardize quality
across services than products, as there is people
to people interaction;
Quality of service can be intangible;
Intimate contact between service provider and
service user
Some of these concerns could be addressed
through improving monitoring and evaluation.
13th Symposium on
Development and Social Transformation
Panel 4: Implementing Social Policy In India
Universalizing Education In India
Manmeet Mehta
Symposium on Development
and Social Transformation
Education Policy in India
Universalizing Elementary
Education
Manmeet Mehta
Spring 2006
Scope Of The Presentation
•
•
•
•
Background
Education for All – ‘Sarva Shiksha Abhiyaan’
Goals
SSA : A Critical Examination
– Design
– Financing
– Implementation
• Progress so far ( January 2006)
• Recommendations
Sarva Shiksha Abhiyaan: Highlights
• Sector-wide, Umbrella Program
• Decentralized planning and implementation –
‘Mission Mode’
• Context- specific interventions
• Partners – DFID, UNICEF, World Bank,EC
• Elementary Education : 68% share of total
education expenditure in the Tenth Plan
• States Commitment
– Maintained at pre SSA 2000 levels
– 75:25 from 2002-2007
– 50:50 from 2007 onwards
Background
• Multipartisan rhetoric
•
• World Education Forum, 2000
• From DPEP to SSA
– Access
– Equity
– Quality
• Policy shift
– National Level, Sector Wide Program
– Legislative Support
– Political Will
SSA : Objectives
• Increasing access
–
–
–
–
Increasing Enrolment
Improving transition rate
Improving infrastructure
Education Guarantee Scheme
• Improving equity
– Girls
– SC/ST
– Disabilities
• Improving quality
–
–
–
–
Teacher training
Pupil Teacher Ratio
Context specific curriculum ( BRC & CRC)
Improvement in student performance
Flow of Funds
Central Government
Ministry of HRD
State Govt. Treasury
State
Implementation
Society
District
SSA Framework: A Critical Glimpse
• Multiplicity of implementation agencies at the
district level
• No fixed criterion for release of Finances from
the Center
– 6 States (Sep 2005) lagged behind scheduled
disbursements
• Staffing and training
• Inter-state variations in performance
• Is it really innovative enough?
– Infrastructure design
• For e.g. Classroom design
Financial Framework
•
•
•
•
Education Cess of 2% on Personal Income
Investment by World Bank, DFID and EC
No fixed criterion for release of funds by Center
Sep 2005-State expenditure represented only
25% of the total allocation.
• States Financial Commitment increases on a
progressive basis
– Do they have the resources?
• Avoiding fund constraints
Implementation
• Multiplicity of Implementation Agencies at the
District Level
• Decentralized Planning
– Training for BRC and CRC staff critical
– Incorporating feedback
• Low level of awareness of procurement
procedures
• State Absorptive capacity
• Transparency in operations
• Addressing innovation – infrastructure, teacher
training
Progress so far – Jan 2006
• Access
– As on November 2005, only 9.6 million children of 614 years are out of school.
– As on March 2005, 187 million( out of 194 mn)
children of 6-14 years are enrolled in schools,
including alternative systems
– Infrastructure being increased ( but below target
level)
• New Schools operationalized (92%)
• Additional Classrooms ( 68%)
• Toilets (70%)
• Drinking Water facility (69%)
Progress so far – Jan 2006
• Equity
– Share of girls in primary school enrolment is
47% and for Upper primary stage, it is 45%
– Share of SC in total enrolment in primary is
21.3% and in upper primary, it is 19%
– Share of ST in total enrolment is 10.3% in
primary and 8.2% in upper primary stages.
– Share of children with disabilities is 1.37% in
primary and 0.96% in upper primary
Progress so far – Jan 2006
• Quality
– Assessment and Evaluation for setting
benchmarks for student performance in Grade
3,5,7 and 8
– Technical deficiency
– 27 % of teachers trained against sanctioned
– Over 95% of BRC and CRC
sanctioned becoming operational
Recommendations
• Rationalizing the implementation structure
• Training – BRC/CRC/ Teachers
• Accounting procedures strengthened
– Hand book, Training, Internal audit mechanism
• Tools for monitoring quality interventions
• Social Mapping
– Rajasthan : Child Tracking System
• Progress leveraged on quantity and expanded
scope of coverage
• The critical parameter : Quality of Education and
Schools
13th Symposium on
Development and Social Transformation
Panel 4: Implementing Social Policy In India
NGOs And Government: Collaboration At
The Cutting Edge
Chandan Sinha
NGOs and Government in India:
Collaboration at the Cutting edge?
by
Chandan Sinha
Two Questions

Is collaboration among GOs and NGOs at the
district level in India necessary and desirable
for effective service delivery?

If so, how may it be achieved?

Focus: India, District level, Service Delivery
State-NGO Relationships: Perspectives





Competition – a zero sum game
Principal-agent relationship
Exchange - NGOs as contractors
NGOs as para-statal organizations
Dangers of legitimizing the status quo
 Changing viewpoint
Consultative
 Contractual
 Collegiate

NGO-State relations in India

Post-independence growth

State as promoter

Central Social Welfare Board

Five Year Plans

Rural Development, Social Welfare, Health,
Environment
District Level Scenario

Each ploughs a lonely furrow

Mutual suspicion and distrust

Sporadic project based interaction

Avoidance or interference/encroachment
The Wages of Isolation …

Vulnerable populations sans services

Duplication of development investment

Poor provision of certain types of services

Expensive and inefficient service delivery

Wastage of scarce resources
Is Collaboration Necessary?
Or Desirable?

To ensure coverage of vulnerable population

To better utilize scarce resources

To better employ each other’s strengths & nullify
weaknesses

To enhance efficiency & effectiveness of service
delivery
Collaboration:
What can Government Bring to it?

A constructive policy framework

Main source of NGO resources

Replication, scaling up and mainstreaming of NGO
innovations

A critical role in developing capacity

NGOs acquire legitimacy
Collaboration:
What can NGOs Bring to it?


Local knowledge
Community development experience

Experimentation & innovation



Operational flexibility
Induce institutional reforms
Advocacy - issues of social change
Collaborative Relationships:
A Typology


Primary
Secondary

Supplementary

Complementary

Partnership
Role of the District Officer

Establish Coordinating Committees at the district
level

Joint Action Committees re specific projects

Develop standardized formats for agreement

System of periodic meetings

Maintaining databases
Role of State Government

Issue policy guidelines for the establishment
of formal mechanisms
Thank you!
13th Symposium on
Development and Social Transformation
Panel 4: Implementing Social Policy In India
Wednesday, April 19th (1:30-2:45pm)
Anuradha Chagti
India’s Population: An Overview
Tapan Ray
The Evolution Of The Family Welfare
Program In India
Manmeet Mehta
Universalizing Education In India
Chandan Sinha
NGOs And Government: Collaboration At
The Cutting Edge