GS-2: Issues Relating to Development and Management of Social Sector/Services relating to Health, Education, Human Resources, Issues relating to Poverty and Hunger.

Key phrases: NFHS-5 data, BIMARU states, Welfare state

Why in news:

• The recently released National Family Health Survey (NFHS-5) data shows New Welfarism.
• The recently released second and final phase of NFHS-5, covered 11 states including Uttar Pradesh, Tamil Nadu, Punjab, Rajasthan, Madhya Pradesh, Jharkhand, Haryana, and Chhattisgarh.
• The survey for the latest data was conducted in two waves, the first before the pandemic and the second during the peak of the second wave (October/November 2020 – March/April 2021).

Analysis:

The concept of Welfare state:

• A welfare state is a concept of government where the state plays a key role in the protection and promotion of the economic and social well-being of its citizens.
• It is based on the principles of equality of opportunity, equitable distribution of wealth, and public responsibility for those unable to avail themselves of the minimal provisions for a good life.
• The Directive Principles of State Policy, under Art 38 of the Indian Constitution reflects that India is a welfare state.
• Food security to all Indians are guaranteed under the National Food Security Act, 2013 where the government provides food grains to people at a very subsidised rate.
• There are public health insurance schemes, social aid to families and new mothers, free school meals, pension schemes and unemployment benefit schemes run both at the federal and the state level.
• As of 2020, the government's expenditure on social security and welfare (direct cash transfers, financial inclusion, health insurance, subsidies, rural employment guarantee), was approximately ₹1,400,000 crore (US$190 billion), which was 7.3 percent of gross domestic product (GDP).

Comparing phase 1 and phase 2 of NFHS-5 and the idea of Welfarism:

• Phase 1 data showed: The success of the government’s New Welfarism — the public provision of essential, and essentially private, goods and services such as cooking gas, toilets, bank accounts, power, housing, and cash.
• The final phase data showed that household access to improved sanitation, cooking gas and bank accounts used by women have significantly increased. The improvements are as striking as they were based on the performance of the phase 1 states.
• In all cases, access has increased significantly, although claims of India being 100 percent open defecation-free still remain excessive.
• Phase 1 data showed setbacks in health and nutrition outcomes for children such as stunting, and the prevalence of anaemia and diarrhoea.
• Earlier it was found that child stunting had stagnated between 2015 and 2019 after decades of progress. When phase 2 states are added, India-wide, stunting has declined although the pace of improvement has slowed down post-2015 compared with the previous decade.
• Nearly all the phase 2 states show large improvements, whereas most of the phase 1 states exhibited a deterioration in performance.
• For instance, Madhya Pradesh now has fewer stunted children than Gujarat; Uttar Pradesh and Jharkhand are almost at par with Gujarat.
• On child stunting, the old BIMARU states (excepting Bihar) are no longer the laggards; the laggards are Gujarat, Maharashtra, and Karnataka, and to a lesser extent, West Bengal, Andhra Pradesh and Telangana.
• The decline in stunting achieved by the poorer states such as UP, MP, Chhattisgarh and Rajasthan would be all the more remarkable given the overall weakness in the economy between 2015 and 2021.

About the BIMARU States:

• The term BIMARU – an abbreviation for Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh – was coined in 1980 by the demographer Ashish Bose.
• Mr. Bose examined a range of demographic indicators to conclude that these states, home to 40 percent of the country’s population, lagged significantly behind the southern states, and were contributing the most to India’s population explosion.
• He also looked at five additional indicators including per capita income.
• BIMARU has a resemblance to a Hindi word bimar meaning “sick”. This was used to refer to the poor economic conditions within those states.
• Several studies, including those by the UN, showed that the performance of the BIMARU states was dragging down the GDP growth rate of India.

Literacy in these states

• The literacy rates in these states according to the 2011 census are Bihar 63.8%, Rajasthan 67.1%, Jharkhand 67.6%, Madhya Pradesh 70.6% and Uttar Pradesh 71.7% against a national average of 74.04%.
• While they trail the national average in the current literacy rate, they are registering very healthy growth rates in literacy comfortably outpacing states like Andhra Pradesh (67.7%) and Chhattisgarh (71%), which have comparable literacy levels (the exception being Rajasthan).

Health care in these states

• The life expectancy in BIMARU states is lower than in other Indian states. In fact, it is lower than the average life expectancy of India as a whole, implying that these states bring down the overall average as a whole.

Population growth in these states

• The BIMARU states have some of the highest fertility rates in India. In 2010, the total fertility rate was 3.9 for Bihar, 3.5 for Uttar Pradesh, 3.2 for Madhya Pradesh, and 3.1 for Rajasthan, compared to 2.5 for India as a whole.
• This leads to high population growth in these states than the rest of India

NITI Aayog’s report

• A recent report by the NITI Aayog ‘Healthy States, Progressive India’ said the ‘BIMARU’ states are at the bottom along with Odisha.
• The report says there was a “large gap” in the performance of “best and least performing states and Union Territories.”
• It noted that all states have “substantial scope” for improvement.

Way forward

• Finally, health and nutrition are also determined by actions of the states, stunting outcomes reflect on their performance.
• Neither success nor failure seems to be the monopoly of any one political party. The improvements in Rajasthan have happened under the Congress, in MP and Haryana under the BJP, in Odisha under the BJD, and in UP under both Samajwadi Party and BJP; and the stagnation/setbacks have occurred in Gujarat (BJP), West Bengal (Trinamool), and Telangana (TRS).
• Hence it is very important for cooperative federalism to coexist between states and the Centre to improve the health and nutrition status of the poor and vulnerable and thereby increasing the overall welfare of the country.

Source: Indian Express

Prelims question:

Q. With reference to the concept of welfare state, consider the following statements:

1. A welfare state is a concept of government where the state plays a key role in the protection and promotion of the economic and social well-being of its citizens.
2. All laissez-faire states are welfare states, as the former describes an environment in which transactions between private parties are free from state intervention.

Which of the statements given above are correct?

(a) Both 1 and 2

(b) 2 only

(c) 1 only

(d) Neither 1 nor 2

Answer: (a)