HDR 2005: Underinvestments in Human Development

The UN Human Development Report 2005 was released last month. A few India centric quotes.

Why has accelerated income growth not moved India onto a faster poverty reduction path? Extreme poverty is concentrated in rural areas of the northern poverty-belt states, including Bihar, Madhya Pradesh, Uttar Pradesh and West Bengal, while income growth has been most dynamic in other states, urban areas and the service sectors. While rural poverty has fallen rapidly in some states, such as Gujarat and Tamil Nadu, less progress has been achieved in thenor thern states.

At a national level, rural unemployment is rising, agricultural output is increasing at less than 2% a year, agricultural wages are stagnating, and growth is virtually "jobless". Every 1% of national income growth generated three times as many jobs in the 1980s as in the 1990s.

The deeper problem facing India is its human developme nt legacy. In particular, pervasive gender inequalities, interacting with rural poverty and inequalities between states, is undermining the potential for converting growth into human development.

Perhaps the starkest gender inequality is revealed by this simple fact: girls aged 1-5 are 50% more likely to die than boys. This fact translates into 130,000 "missing" girls. Female mortality rates remain higher than male mortality rates through age 30, reversing the typical demographic pattern. These gender differences reflect a widespread preference for sons, particularly in northern states. Girls, less valued than their brothers, are often brought to health facilities in more advanced stages of illness, taken to less qualified doctors and have less money spent on their healthcare. The low status and educational disadvantage suffered by women have a direct bearing on their health and their children's. About one-third of India's children are under weight at birth, reflecting poor maternal health.

Inadequate public health provision exacerbates vulnerability. Fifteen years after universal childhood immunization was introduced, national health surveys suggest that only 42% of children are fully immunized. Coverage is lowest in the states with the highest child death rates, and less than 20% in Bihar and Uttar Pradesh. India may be a world leader in computer software services, but when it comes to basic immunization services for children in poor rural areas, the record is less impressive.

Gender inequality is one of the most powerful brakes on human development. Women's education matters in its own right, but it is also closely associated with child mortality. The under-five mortality rate is more than twice as high for children of illiterate mothers as for children whose mothers have completed middle school. Apart from being less prone to undernutrition, better educated mothers are more likely to use basic health services, have fewer children at an older age and are more likely to space the births -- all factors positively associated with child survival. As well as depriving girls of a basic right, education inequalities in India translate into more child deaths.

State inequalities interact with gender- and income-based inequalities. Four states account for more than half of child deaths: Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh. These states also are marked by some of the deepest gender inequalities in India. Contrasts with Kerala are striking. Girls born in Kerala are five times more likely to reach their fifth birthday, are twice as likely to become literate and are likely to live 20 years longer than girls born in Uttar Pradesh. The differences are linked to the chronic underprovision of health services in high-mortality northern states, which is in turn linked to unaccountable state-level governance structures.

Translating economic success into human development advances will require public policies aimed explicitly at broadening the distribution of benefits from growth and global integration, increased public investment in rural areas and services and -- above all -- political leadership to end poor governance and address the underlying causes of gender inequality.