Читать книгу India - Craig Jeffrey - Страница 31

Economists associated with the World Bank, Gaurav Datt, Rinku Murgai and Martin Ravallion, point out that among developing countries, India has the longest series of national household surveys suitable for tracking living conditions, and they have reported on their findings from these data for the 60 years from 1957 to 2012 (Datt et al. 2016a, 2016b). Their analysis refers to the definition of the poverty line established by the Planning Commission in the 1970s (the one anchored in the nutritional norms of 2,400/2,100 calories per person per day), updated in the conventional way, using urban and rural price indices. They find that there has been a definite downward trend in poverty since the early 1970s, according to the standard measures, with acceleration after 1991 – when India embarked upon the economic reforms described in chapter 2 – despite increasing inequality. Poverty reduction since 1991 has been more responsive to growth than it was before – there has been a higher growth elasticity of poverty incidence reduction. Still, as Ravallion has shown elsewhere, the growth elasticity of poverty in China, historically, has been about twice that of India, probably because of more favourable initial conditions. With relatively low inequality in access to land and human capital, the poor in China have gained more from growth (though over time these favourable conditions have been eroded with increasing inequality in incomes and in education and health), while opportunities for the poor in India have been restricted by low levels of education and health (Ravallion 2012).

The strong suggestion in this analysis that India’s policy shift at the beginning of the 1990s, and the higher and more consistent economic growth that the country has seen since then, has had positive outcomes in terms of poverty reduction, is apparently confirmed in other analyses that focus more on the trends of the last two decades. Himanshu and Kunal Sen, whose analysis refers to the Tendulkar measure of the poverty line, present evidence that leads them to the ‘inescapable conclusion that poverty has declined faster [over the period 2004–05 to 2009–10, when India was experiencing ‘superfast’ growth] than in the previous period [1993–94 to 2004–05]’ (2014: 78). They estimate that the rate of poverty decline in the more recent period was 1.12 per cent per annum (even though their figures are lower, for reasons that they explain, than those of the Planning Commission), compared with 0.74 per cent per annum over the previous decade. One measure of the intensity of poverty, the poverty gap, shows marginally better improvement in the later period than the earlier one; but according to a second measure, the squared poverty gap, performance in the later period was worse. This suggests the possibility that the poverty decline was associated with an increasing share in the population of those who are vulnerable to falling into poverty (see also Dang and Lanjouw 2015). And Himanshu and Sen find slower improvements in consumption expenditure among the most vulnerable people – those employed as agricultural labourers in the rural economy, and as casual daily paid wage labour in the towns – by comparison with all households (Himanshu and Sen 2014: 81–3).

This, ultimately mixed picture of recent trends, is borne out also in research by the World Bank economists Amber Narayan and Rinku Murgai (2016). They too refer to Tendulkar-based poverty estimates, and report that the pace of poverty reduction accelerated after 2004–05 – and then increased even further in the two years after 2009–10. This accelerated rate has been found surprising, however, given the deceleration of the economy in this period (as discussed in chapter 2), and it has also been pointed out that 2009–10 was a year of particularly severe drought – so we should probably not build too much upon the apparently sharp increase in the rate of poverty reduction after 2010 (see ‘Editorial’ 2013). Prosperity has been rising, Narayan and Murgai find, but the share of the bottom 40 per cent of the population in total consumption has fallen, with the rate of growth in this bottom group lagging behind the rate of growth of consumption for the population as a whole (in line with Himanshu and Sen’s observations regarding agricultural and casual labourers). The authors comment that poverty reduction would have been greater had consumption growth in the lower half of the population matched or exceeded average gains for the population. This finding recalls those of Petia Topolova for the period from 1993–94 to 2004–05, when there was also a shift in the distribution of income against the officially poor (in contrast to what had happened in the 1980s). Topolova concluded that ‘Distribution neutral growth would have generated a poverty decline in rural India that was 22 per cent higher; in urban areas, the decline in poverty would have been 76 per cent higher’ (2008: 8). Increasing inequality does matter, in relation to poverty reduction.

Even more significantly, Narayan and Murgai also report a lot of churning, with a fairly high rate of downward as well as upward mobility (as Dang and Lanjouw 2015 also show), and they find that though the ‘middle class’, who are neither poor nor vulnerable to poverty, has increased as a share of the population (from 23 to 34 per cent), it is still the case that ‘Those who are in the vulnerable group struggle to rise into the middle class, despite the opportunities afforded by rapid economic growth’ (2016: 7). The point here is pithily put by a former civil servant, now professor of public policy, Anirudh Krishna, who writes:

Official statistics tend to depict a rosy-picture of fast declining poverty [exactly as the studies we have reviewed seem, at first, to show], suggesting a situation in which people are only moving up – and out of poverty. But India has one of the highest rates of poverty creation internationally. Between three and five per cent of the country’s population falls into poverty each year, adding to the large number of people already poor … Vulnerability to shocks is pervasive. Many who have moved out of poverty continue feeling its gravitational attraction (2017: 22).

Krishna points out that, according to the findings of a fairly large body of micro-studies, large numbers of people experience big fluctuations in their economic circumstances, moving into and out of poverty. Research undertaken in different parts of India has shown between 55 and 88 per cent of all households as having experienced poverty for the entire year or for shorter periods (Krishna 2017: 99). Krishna provides a summary of data from studies of movement into and out of poverty in four states, and from three all-India studies. The most recent of these (for the period 1993–2005) shows 4 per cent more households moved into than out of poverty (2017, table 4.1, p. 102). And data from Krishna’s own studies in four states and two cities showed that more than 80 per cent of households that had succeeded in ‘escaping’ from poverty remained stuck within ‘the zone of poverty’. The pathway out of poverty most commonly followed – migration to the city – has inbuilt limitations because secure, formal jobs are very rarely open to poorly educated, low-skilled migrants from rural areas. The activities in which employment has been growing include, especially, construction, in which there are very few ‘good jobs’. Also, the numbers of those employed in transport, as drivers, have been growing relatively fast, as have the numbers employed in retail sales, in catering, as maids, and in personal services. Very few of these jobs will offer either much security or more than a rather basic income. In line with Krishna’s findings, Narayan and Murgai, and Dang and Lanjouw, find that higher levels of education, urban residence, being engaged in wage work, and belonging to social groups other than Dalit, adivasi or OBC, are positively associated with higher-than-average chances of upward mobility – suggesting that the objectives of ‘inclusive growth’ have been at least somewhat disappointed. We say more about this later.

Krishna makes the very important point that ‘The repeated observation of pervasive poverty creation suggests that something is deeply wrong with a policy that has a lot to say about raising people above the poverty line but contains nothing at all about preventing future poverty’ (2017: 103). His own extensive research into poverty dynamics in India has shown that though no single type of event, or particular household characteristic, is responsible for pushing people into poverty, ill-health has been found everywhere to be significant. He reports, ‘Between 3.5 per cent and 6.6 per cent of households in rural areas, and between 2.5 per cent and 5 per cent of urban households, averaging 5 per cent of the entire population, fall below the poverty line each year on account of poor health and the high cost of qualified medical care’ (2017: 105). So fixing health care, making it more accessible to poor people, and more effective, is the critically important preventive measure that will save people from being pitched into poverty. Yet public expenditure on health in India remains very low, at about 1 per cent of GDP, comparing very unfavourably with comparator countries – not that more funding alone will solve the problems of the health care system. Krishna, again, comments, ‘In Bangladesh, Vietnam and Thailand, countries whose recent growth record is no better than India’s, people spend less, incurring fewer debts, for obtaining medical treatment’ (2017: 115). It is to be hoped that a massive new health insurance scheme – known as Ayushman Bharat – announced by the Finance Minister in the Budget of 2018 will serve to correct India’s very poor record in regard to the provision of health care.

Given Krishna’s well-reasoned arguments, the picture of health in India that comes from recent official studies is quite depressing. A massive report, entitled India: Health of the Nation’s States, was published by the Government of India in November 2017, accompanied by paper published in the medical journal The Lancet (2017), based on studies of a very large number of disease conditions and injuries and risk factors over a 26-year period (Bhuyan 2017). Health is a state responsibility in India, and though some funding, as well as policy and legislation, is provided by central government, states have wide scope in implementation. The largest proportion of health spending comes from the states’ budgets. Over time, each of the states has developed its own health story, and there are very large inequalities. Nine states – Assam, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand and Uttar Pradesh – have been classified as ‘high focus’, implying that they need special attention. Together they account for disproportionate shares of infant, child and maternal deaths, even while failing to spend the funds that they have allocated for healthcare. In some cases, even when these states have increased spending, outcomes have not improved by as much as might have been expected, because of inadequacies in the existing health infrastructure and personnel (Rao 2017).

The disparities between states in regard to health care, which belie the stated intentions of planners and policy makers to achieve ‘inclusive growth’, are reproduced in comparisons of poverty reduction. Both Himanshu and Sen, and Narayan and Murgai find higher rates of poverty decline in initially richer states, so that there is increasing divergence between all the major states. There is an increased concentration of those who are most vulnerable to poverty in the states that are classified as ‘low income’ (Assam, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan and Uttar Pradesh). Given their large populations and their poverty rates, UP, Bihar and MP together account now for 44.2 per cent of all India’s poor people (Narayan and Murgai 2016: fig. 11a). Except in the case of Odisha, poorer states (notably Assam, Bihar, Chhattisgarh and Jharkhand) have shown only marginal decline, or even some increase in the incidence of poverty (Himanshu and Sen 2014: 80). And simplistic arguments about the positive relationship between economic growth and poverty reduction are belied by the observation that the states that have seen the highest rates of growth of net state domestic product, since 2004–05 – states such as Bihar, UP, Chhattisgarh and Odisha – have not generally (the exception is Odisha) seen high rates of poverty reduction. Indeed, poverty actually increased in Chhattisgarh between 2004–05 and 2009–10 (Himanshu and Sen 2014: 86). Work by Radhakrishna (2015), using somewhat different measures, reaches the same conclusions for the period since India initiated economic reforms: growth has been pro-rich and urban-biased; welfare improvements would have been better if inequality had not increased; inter-state inequalities increased, and the slowest reduction in poverty has been witnessed in the states with the highest initial incidence of poverty. Growth has certainly not made for ‘inclusive growth’ by reducing the disparities in levels of well-being across the major states.

The question then arises as to how far the trends that are shown up using conventional poverty measures are qualified when account is taken of a range of direct indicators of well-being. Some of these measures radically qualify the suggestion that deprivation is being very significantly reduced in India, as a result of high rates of economic growth. India’s infant mortality rate in 2012 was 47 per 1,000 births, three times the rates in China, Brazil and Russia, and about 20 per cent higher than the international trend predicts for a country with India’s GDP per capita (Coffey and Spears 2017: 5). According to data from the National Family Health Survey (NFHS) of 2005–06, after twenty years of high rates of economic growth, 48 per cent of Indian children under the age of five were stunted (low height for age), and 43 per cent were underweight. These figures had come down by 2015–16, according to NFHS-4, but there were still more than a third of Indian children who were abnormally short and skinny. The numbers of those who were found to be stunted stood at 38 per cent, and 36 per cent were underweight, while the share of children who were wasted (low weight for height) actually increased from 19.8 to 21 per cent. More than one-third of India’s children were at risk of permanent physical and/or mental impairment as a result of poor nutrition. Indian children are shorter, on average, than children in Sub-Saharan Africa who are poorer; and ‘height is steeply associated with cognitive achievement in a developing country such as India’, as Coffey and Spears explain (2017: 136). These authors point out that while differences in height reflect both genetic differences and differences in the health and nutrition of young children, ‘genetic differences would not cause height and cognitive achievement to be correlated; the correlation is a product of children’s environments’ (2017: 136).

Much depends upon whether or not children grow up in a healthy environment, and in India this is profoundly influenced, negatively, by the persistence of open defecation. According to NFHS-4 (2015–16), more than 56 per cent of all households did not have access to improved sanitation (though this was down from 70 per cent in 2005–06); and 52 per cent of all Indian households defecated in the open (63 per cent of rural households). And many of those who do have access to ‘improved sanitation’ continue to defecate in the open (though the Government of India’s Economic Survey for 2017–18 presents data showing that 91 per cent of those with toilets actually use them, suggesting that the Swachh Bharat Mission [SBM] – launched by prime minister Modi in 2015, with the objective of eliminating open defecation by 2 October 2019, the 150th anniversary of Gandhi’s birth – has had some success; and see Joshi 2018 for an upbeat account of the success of the SBM). We will return to the significance of these observations in chapter 4.

How, then, does the Multidimensional Poverty Index (MPI) reflect upon trends in the reduction of poverty and on improved well-being in India? This is calculated from the combination of ten indicators, each per household: (i) education: years of schooling; school attendance; (ii) health: under-5 mortality; nutrition; (iii) living standards: access to electricity; to improved sanitation; to piped water; housing quality; cooking fuel used; assets owned. Sabina Alkire and Suman Seth have calculated the MPI for India, and across Indian states, for the period 1999–2006 (Alkire and Seth 2015). Although they report that income poverty – or monetary deprivation – does not generally proxy accurately for other deprivations, their calculations of the reduction in the MPI over this period, across Indian states, do not suggest a very different picture from that based on the conventional poverty measures. They find a statistically significant decline in the MPI nationally – overall, India reduced the proportion of multidimensionally poor (a headcount ratio) by 8.3 per cent over the period, or by 1.2 percentage points per annum – a higher rate, in fact, than that of the reduction in monetary poverty over the period they have studied. In 2006 the headcount MPI for the country as a whole stood at 48.5 per cent. But neither West Bengal nor any of what used to be referred to as the BIMARU states (Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh) had reduced poverty by very much, whereas the four south Indian states, and Maharashtra, had all experienced very significant reductions. Across the various subgroups Alkire and Seth considered, too, poverty had fallen fastest among the least poor, so that disparities had increased between the groups. The Scheduled Tribes had experienced the slowest reduction in poverty. What is also striking, in the analyses of trends in the MPI, is India’s relatively poor performance by comparison especially with Bangladesh. India’s eastern neighbour has succeeded in reducing the MPI about twice as fast, though with a similar rate of growth of national income (Alkire and Seth 2015).

The picture that we take from the work of Himanshu and Sen, and that of Narayan and Murgai, on recent trends in poverty reduction, relating principally to the period of ‘superfast growth’ from around 2003, complemented by the observations of Krishna from empirical research on poverty dynamics, is a distinctly mixed one – an historically fast rate of decline of poverty in the aggregate (according to the conventional measures), but offset by increasing inequality and the persisting vulnerability of a large share of the population to downward movements into poverty. As Krishna says, ‘Policymakers in India have vested their hopes in the idea that economic growth will eventually eradicate poverty, and until then, palliatives like subsidized food or make-work programmes [on which see chapter 8 in this book] will be sufficient. These formulations have not been efficacious. A large share of India’s population – more than half by any reasonable measure – continues to live in the shadow of poverty, and many more remain vulnerable to becoming poor in future’ (2017: 113). The focus has been wrong. Vast intellectual and practical effort has gone into poverty measurement, and into bringing the aggregate numbers down by means of a myriad of programmes intended to alleviate poverty. This perhaps makes for good press for governments. Far too little attention has been given to the prevention of poverty through accessible and effective health care, or to improving people’s chances of taking advantage of opportunities in a growing economy through much better education and training. A disproportionately large share of Indians, historically, have had little or no education, while on the other hand a disproportionately large number have had tertiary education. Relatively few of them have had secondary education. The pattern and performance of education in India has restricted the chances for very many people of moving into more productive and better paid employment (see chapter 13).