May 29, 2017 | Manisha Karne (Professor in Development Economics)
Public support for education and health care has been historically low in India, averaging less than four percent of GDP for education and 1 percent of the GDP. Apart from this, there is also underutilization of funds at the national level. The replication of this is found in Maharashtra’s economy. The average health expenditure on education as percent of GSDP in Maharashtra from 2001 to 2015-16 has been only 2.54 percent of GSDP of the state whereas the average health expenditure as percent of GSDP in Maharashtra from 2001 to 2015-16 has been very low at 0.45 percent of GSDP.
Maharashtra is a leading economy in the country, its performance in education health, nutrition and tribal development is also considered to be better compared to the national average. However, there are many shortfalls in primary education, health, nutrition, and tribal development especially when inter-district performance is taken into consideration. Apart from its performance being below the benchmark in certain indicators, there are serious issues of inter-district and social disparity in outcomes. The objective of this background note is two-fold 1. To examine the outcomes in view of the budgetary allocations to these sector 2. To identify the shortfalls to initiate dialogue for relevant revisions in the state budget.
2. Education in Maharashtra:
Education has the potential to increase opportunity for deprived classes and it enables them to have social mobility. Equality of geographical, economic and social access to education is considered important for breaking generational cycles of deprivation for children belonging to the socially excluded classes. It is important to assess how inclusive the education policy has been in expanding and broadening of economic, geographical and social access to education for all.
As far as general education in concerned, the literacy rate of the State is 82.3 per cent against 73 per cent at All-India level as per Population census, 2011. The rural –urban gap in literacy has reduced from 15.1 to 11.7 from 2001 to 2011 in the state. The gender gap has also declined from 18.9 to 11.5 during the same period (Census, 2011). There is convergence in literacy rate in general population and SC, ST and Minorities in Maharashtra. However, the gap between general population and ST and Minorities (i.e. the social gap) is still noticeable. The gap is reducing for SC faster than that for ST population.
This gap is indicates that basic educational needs of the SC and ST have been seriously undermined in the past. Apparently affecting adversely life chances of vast sections of those who have remained mostly deprived.
2.1 Inter-district variation in educational indicators:
Maharashtra has 35 revenue districts; divided into six revenue divisions. There are eight educational regions for the purpose of monitoring. At present, there are 351 educational blocks, 351 block resource centers (BRCs), 56 urban resource centers (URCs) (BRC in urban areas are referred to as URC) and 6170 cluster resource centers (CRCs) in the State. 43 educationally backward blocks have been identified in 10 districts, namely, Beed, Gadchiroli, Hingoli, Thane, Jalna, Kolhapur, Parbhani, Nanded, Nandurbar, and Nashik. Though Maharashtra is marching ahead of many other states in India, there are 57 blocks that have LR below the national average and 13 blocks in the country have LR lesser than the backward states in India.
Kelkar committee report has ranked district on Gender gap and Education Development Measure which is as below.
These laggard districts mainly belong to Marathawada and Vidarbha region. Districts like Sindhudurg, Kolhapur, Raigadh, Satara which are performing well on educational backwardness measure are also the best performing districts in other indicators too.
The State has been giving importance to primary education, which has resulted in consistent achievement in educational outcomes at primary level. Apart from the initiatives taken under SSA, free education up to XII class is provided to girls. The state also has excellent higher educational institutions in the fields of engineering, medical and management. The educational outcome play important role in human development hence, we observe that Maharashtra’s HDI is better than India’s Human Development Index (0.467) whereas, it is 0.572 for the State.
The Education Development Index (EDI) for primary and upper primary levels of education and is computed by National University of Educational Planning and Administration (NUEPA). A composite index for elementary education which is exclusively based on the ‘District Information System indicates that the State ranks 13th at primary, 16th at upper primary and 13th at composite levels with EDI 0.63, 0.67 and 0.65 respectively.
The state government in the year 2000 committed that it will be spending 7 percent of its SDP on general and technical education, it spent only 2.41 % of its SDP (2012-13). The planned expenditure on education has also remained low at 3.25 %, though the non-plan expenditure on education is more than ten percent. The norm of spending at least 75 percent the total funds for this sector of it on primary education is also not fulfilled. It has remained 47 percent on an average for 2004-2013.
1.2 Key indicators of Primary Education in Maharashtra:
• Improved access to schools due to Sarva Shiksha Abhiyan since 2005.
• On an average 47 percent is spent on primary education in the last one decade which is less than the commitment of the government.
• Rural- urban gap in enrolment is reducing rapidly.
• Pupil-Teacher ratio is 29.1 which a positive sign.
• Increase in the number of schools at secondary level especially in the urban areas.
With urbanization demand for schools is growing rapidly in the urban areas, however, this demand is increasingly met by unaided schools. These schools charge comparatively higher fees and the quality is not necessarily good.
1.3. The Challenges faced by Primary education in Maharashtra
The target of all children in school could not be achieved fully even in 2014-15.
• The number of Single teacher schools in various districts of Maharashtra is notable. (Approx. 3000)
• Fulfilment of RTE norms for schools is mandatory; however, relevance of these norms is generally ignored. Non-fulfilment of norms for girl’s toilet, kitchen shed, ramp, and compound wall are reported.
• School infrastructure is in a bad state in many schools, no provision in the schools to make the payment of power bills, sanitation is poor. Drinking water facility still missing in the interior areas. (approx. 13000 schools are without power supply). Classrooms are inadequate, in 2012, 22,000 classrooms were in shortage as compared to the requirement in the state. Nearly 14 percent of schools in the state lack separate toilet facility for girls. The urbanized districts like Thane, Mumbai Raigad, and Pune have shortage of classrooms in schools leading to adverse student classroom ratio.
• Need to improve the capacity of Tribal schools for the larger outreach of these schools.
• Regular supply of school uniform and other material is important for incentivizing the attendance rate and for improving the retention rate.
• Regular supply and better quality of Mid-Day meal are also needed for the same reason.
• There is need to target out of school children in a better way for making the primary education inclusive. (92,000 children are still out of school-DISE, 2014-15), the number is higher in backward districts of the state indicating inter-district variation in this number. Similarly, there is an increase in the number of single teacher schools in mainly backward districts of Maharashtra such as Akola, Bhandara, and Amravati and also in Thane.
• In several districts in Maharashtra 35-50 % students who do not complete the schooling cycle. (Kelkar Committee Report)
There is sharp inter-district as well as intra-district variation in female literacy, for example Nandurbar has just 0.77 villages having female literacy rate equivalent to the state average and Gadhchiroli has 4.6 percent of the villages in the same category.
Apparently, these districts primarily backward in all other indicators of development. Nandurbar is ranked as the bottom most districts in Education backwardness measure in the same report. (Kelkar Committee Report)
As per the ASER (2014-15) report 65.9 percent of children in II to V standard could actually read standard I level book and 32.8 percent could do subtraction or more of standard I level. So, there is a serious concern about the quality of education imparted at primary level.
3. Health and Nutritional scenarios in Maharashtra
Maharashtra is one the six states which has performed well on the health indicators laid out in the MDGs. The progress in IMR and under 5 mortality can be seen in the following graph.
The state has achievements in health indicators such as in Total Fertility Rate, Contraceptive Use, Birth assisted, Institutional deliveries, it is among the top five states in India. However, there are many shortfalls and again the state average is camouflaging the inter-district district disparity.
The average health expenditure as percent of GSDP in Maharashtra from 2001 to 2015-16 has been very low at 0.45 percent of GSDP of the state. This naturally increases burden on out of pocket expenditure leading to a system dominated by out-of-pocket expenditures, the poor, who have the greater probability of falling ill due to poor nutrition, unhealthy living conditions, etc. pay disproportionately more on health than the rich and access to health care is dependent on the ability to pay. As a result, the public health care is criticized on the grounds of insufficient health coverage, sharp reductions in capital investments in public health infrastructure and deterioration in the quality of public health services leading to higher dependence on highly unregulated private health care services.
The Independent Commission on Development and Health in India has ranked the states on the basis of Staff, Infrastructure and Supply of drugs (SIS index) in health. In this study, there has been an attempt to match the SIS Index (i.e., staff, infrastructure and supply of drugs) with the Performance Index (i.e., percent of women who received full ANC, percent of institutional delivery, percent of women whose delivery was attended by skilled personnel, percent of children (age: 12-35 months) who received full immunisation and percent of children who did not receive any immunisation) for all the states in India and more importantly, for all the districts in India. Matching the SIS Index and the Performance Index at the state level reveal interesting results.
There are five states, namely, Maharashtra, Gujarat, Punjab, Arunachal Pradesh and Tripura where there is a mismatch as the SIS falls in the Best category and Performance Index is not in the same category. It indicates that in spite of good SIS, they have not been able to show good performance.
At the inter-district level the composite score for rural SIS index for the better performing districts such as Satara, Thane, Ahmednagar, and Sindhudurg is maximum i.e. between 16 and 18 whereas for other districts the score is between 13 and 15 and Gondiya has the lowest score of 10-12.In public health delivery system (performance Index) Sindhudurg has the highest score (28-30) and Gadhchiroli, Gondiya, Dhule, Nandurbar, Chnadrapur, Nanded and Osmanabad have the worst score. One can observe the worst performers remain the same in this list too.
Similar results on inter-district disparity in the health indicators have been given in the health score computed by Kelkar committee report. A comparison with HDI and per capita income for the top three and bottom three ranks in the state is given in the table below.
This table clearly mirrors on the a positive link between income and health outcome and HDI, improving livelihood options and employment opportunities seem to be the sustainable options for the worse performing districts, however, there is also a need to re-emphasize better delivery of health care services in these worse performing districts so as to improve the health score in such districts. Hence, higher allocations to health sector are justified. However, it has always been less than 1 percent of the GSDP
Public health expenditure as a percentage of total expenditure on health in Maharashtra is 8.0 in 2015-16 and it just behind two other states namely UP (12.2 Percent) and Rajasthan (9.5 percent), though there is a decline in this percentage in past three years from 9.3 and 9.4 in 2013-14 and 2014-2015. The total public expenditure on health is divided as 94.50 percent as revenue expenditure and only 5.50 is capital expenditure. This has obviously led to deterioration in public health infrastructure further increasing the burden on people forcing them to spend more from out of pocket. If we examine the component-wise break of public expenditure, it is indicative of urban bias in the provision of public health services as more is spent on urban areas as compared to rural areas in the state as indicated in the graph below.
Challenges faced by Health sector in Maharashtra:
Unregulated private sector with varying quality and under qualified practitioners
High percentage of out of pocket expenditure (80 to 85 percent) , due to decreasing public health expenditure which adversely affects the health outcomes
Substantial rural-urban and inter-district disparities in health outcomes mainly due to disparities in access to health care services, water and sanitation.
Social disparity reflects in variability in health outcome and nutritional status of SCs and STs. For example, children of STs are twice more likely be malnourished than other children.
Shortage of human resources in the health sector. Lower density of health workers as compared to the norm.
Weaknesses of the health care delivery mechanism (inadequate coverage by PHCs, ICDS, Ayush and RMPs)
3. Malnourishment in Maharashtra:
Malnourishment is the biggest challenge faced by Maharashtra. The problem of malnourishment and undernourishment is discussed in the context of a complete contradiction of economic and demographic achievement of the state on one hand and deaths due to undernourishment on the other.
The MPR of 2014-15 gives the ranking of the district as per their nutritional performance. The best five and worst five districts have been taken in the following table for highlighting the importance of the link between nutrition and income and livelihoods in the backward districts of Maharashtra. Except for Latur, all other districts in this category are also performing well on economic fronts whereas the worst five have predominantly tribal population which further highlights the failure of policies for tribal in the backward districts. The list of top five and bottom five districts in nutritional status is presented in the following Table.
Though Thane ranks among the top three (ranks third) in economic performance and has better physical and social infrastructure, undernourishment remains a big challenge for the district. The nutritional scenario is dismal in Thane district which has a tribal population mainly in Shahapur, Murbad and Bhiwandi. Urbanization in the district seems to have not resulted in many positive externalities for interior tribal blocks of Thane like Murbad and Shahapur which implies that urbanization and the benefits of urbanization have very limited spread effects in tribal areas. Those living in the interior areas are unaffected by the benefits of development. On the contrary, the tribal people living in the plain area and mainly near urban areas get some benefits of development and hence Bhiwandi in Thane district, for example, is has better nutritional status as compared to Shahapur and Murbad.
The intra-district analysis also indicates disturbing features. According to MPR, which has ranked 85 tribal talukas in Maharashtra on nutritional status, (MPR, 2015 on Nutrition by ICDS) the ranking indicate adverse nutritional scenario in most of the tribal talukas in Maharashtra.
For instance, Jawhar taluka in Palghar district is the worst block in the state. The miserable nutritional scenario in Palghar is indicated in the table below. Undernourishment has caused infant deaths in a short span of three months at the beginning of the current year.
For tackling the nutritional challenge, few studies have given emphasis on Nutrition Mission for Maharashtra at least for targeted districts, however, presently there is no separate budget for programmes or schemes such as Supplementary Nutrition Programme and the funding is expected to come from existing schemes and programmes such as NRHM/NHM, Human Development Mission, Village Health and Nutrition Committee Funds, Rogi Kalyan Samiti etc. Perhaps, while evaluating the performance of these districts, it is strongly felt that as the nutritional status is closely linked to the livelihood issue, it could be tackled with better implementation of MGNREGs in the backward districts.
Looking at the socioeconomic profile of the poorly performing districts/blocks on malnourishment, it is felt that the existence of SNP and ICDS in these blocks is not adequate, it appears that the health and the nutritional status of the population in the rural and the tribal areas cannot be improved only with such interventions. The nutritional status needs to be linked closely to the issue of livelihoods. In the absence of regular livelihood for poor in rural and tribal belt, public services alone do not seem to be offering a sustainable solution for their problems.
There are 35 Districts in the State and the tribal population is largely concentrated in the western hilly Districts of Dhule, Nandurbar, Jalgaon, Nashik and Thane (Sahyadri Region) and the eastern Districts of Chandrapur, Gadchiroli, Bhandara, Gondiya, Nagpur, Amravati and Yavatmal (Gondwana Region). There are in all 47 Scheduled tribes in the state. The main tribes in Maharashtra are the Bhills, the Gonds, the MahadeoKolis, the Pawras, the Thakurs and the Varlis. There are three tribes Viz the Kolams (Yavatmal District), the Katkaris (mainly in Thane and Raigad Districts) and the MadiaGonds (Gadchiroli District) which have been notified as Primitive Tribes by the Government of India. As directed by the Government, in 1975-76 the villages where more than 50 Percent of the population was tribal were constituted into Integrated Tribal Development Projects (I.T.D.Ps.). There was 16 such Government of India approved I.T.D.Ps.
Maharashtra government resolution of September 2014 has provided the guidelines for the implementation of TSP and specified that the TSP should be exclusive of MLA Local Development Fund, Hilly Area Development fund and MGNREGA. The basic objective of the intervention in form of Tribal Sub-Plan was to improve the standard living of the tribal people. The funds under TSP have been categorized into four sectors for convenience viz. education, livelihood, employment, and infrastructure. In spite of all these efforts, the tribal population in Maharashtra is out of the mainstream of development.
For instance, Tribal population has 20 percent shortfall in male literacy, 40 percent shortfall in female literacy and the Immunity of tribal child is 39.3 percent as against 62.3 percent of the general population. The PCI and HDI score for tribal districts is much lower as compared to the better performing districts in Maharashtra. This clearly brings out the inadequacies of several government initiatives for tribal people.
On the basis of the population norm the government is committed to spend almost 9 percent (Currently the population is almost 9.4 of the state population) of the SDP for tribal development, however, the graph below clearly indicates that it has remained off-track for most of the years in the past.
TSP expenditure as proportion of the total Public expenditure in the state is indicated in the following graph.
Out of the total funds allocated 75 per cent of the funds should be spent on district schemes, however even this norm has been violated rampantly. On an average less than 50 percent is spent on district schemes. Also the funds spent as a substitute and not as “additionally” (Kelkar Committee Report)
The following table indicates the backlog of funds (unspent funds) for tribal development in the past 25 years. The total backlog in absolute terms has been to the extent of 10608.58 crores in Maharashtra which has caused substantial loss in term of tribal welfare.
4.1 Tribal development vs. others in the state:
Several studies have discussed the factors responsible for deprivation of the tribal population in the state. There is land alienation, deprivation of their traditional rights on forest, water and land, failure of land reforms for tribal, displacement of tribal due to development projects etc. All these issues have been discussed in detail Kelkar Committee Report. In fact the development indices computed in the Kelkar Committee Report on Regional Imbalance indicate that there are 15 Talukas which are termed as the most backward talukas on development indices are all tribal talukas. These Talukas are concentrated in five Districts of the state, namely Thane(Post-bifurcation these talukas are actually in newly constituted Palghar district), Nashik, Gadhchiroli, Amravati, and Nandurbar. Except for Thane and Nashik, the other three districts are reported as the most backward districts in Maharashtra on development related indicators by different studies. For example, Gadhchiroli and Nadurbar are at the bottom in PCI ranking and also in terms of education, Nandurbar has just 0.44 percent of the villages in the district having literacy above 70 percent for females.
Generally, female education and education for SCs and STs is considered as the best equalizer or an instrument to achieve social and economic development of the underprivileged groups (Maharashtra Development Report, 2007). But the district- wise analysis indicates that as far as economic, social and geographical access to education for these sections are concerned there are unfulfilled targets. Hence it is observed that not only the enrolment ratios are lower among these groups in many districts with a higher percentage of SC and ST population but the overall dropout rate for these two groups is also relatively higher. The dropout rate is higher for ST as compared to SC population. Following table indicates the disparity in development indicators between the general population and STs.
To conclude, analysis of these three major sectors of Maharashtra’s economy reveal that the budgetary provisions for Health, Education, and Tribal have always been lower than expected. In the graph below the expenditure on education and Medical and public health clearly support this statement.
In fact the even the funds allocated were also not spent fully and hence the unspent balance on these heads in past few years has remained a cause of concern and it is indicated in the graph below:
Though the literature suggests higher public expenditure could help in reducing the disparities and help in achieving the targets, there could be other determinants that help in reducing divergence in the outcome indicators for these sectors such as the governance structure which could be largely responsible for the inefficiency of the public expenditure. The question volume of allocations is examined here, but the how the funds are spent is a matter of implementation which is equally important.
Lastly, the policy makers should give some attention to educational disparity, health disparity and nutritional shortfalls and on tribal backwardness for achieving better outcomes for all the sections of population in the state by tackling these issues and this review of Maharashtra expects to provide some relevant inputs in the sectors discussed in the paper.
Kelkar Committee Report on Regional Imbalance (2013)