How India can adopt low-cost, effective ideas to improve its living standards

The Pushti Apa was a familiar face in Bangladesh for several years With a job title that literally translates to ldquonutrition sistersrdquo these public health workers were reminiscent of Indiarsquos ASHA task force They educated new and young mothers about what food was the best for their babies and children why only breast milk is better than suji in the first six months and the benefits of protein sources like eggs and fishThe Pushti Aparsquos digital counterpart was the Doctor Apa a mass media campaign aimed yet again at mothers and mothersinlaw which normalised the image of a breastfeeding mother in the countryrsquos rural quartersAcross the border and closer home a ldquocoyrdquo media campaign to promote breastfeeding with Madhuri Dixit as brand ambassador ldquowas a whimperrdquo writes academic Swati Narayan in her book Unequal Why India Lags Behind its Neighbours But why compare India to the countries it shares borders with at allSwati Narayanrsquos book Unequal Why India Lags Behind its Neighbours was cited in the winter session of the Rajya Sabha Pic CourtesySiyahiFor starters Nepal and Bangladesh have managed to save more infants and reduce their mortality rates 29 for every 1000 children below Indiarsquos own 33The differences when it comes to open defecation are even more startling As per a Joint Monitoring Programme JMP report released by the World HealthOrganization WHO and the United Nations Childrenrsquos Fund UNICEF 17 per cent of the rural population still used the great outdoors and 25 per cent didnrsquot have access to basic sanitation facilities in 2022 By this point Bangladesh had ensured that 99 per cent of its population could walk up to a toiletThese numbers can seem surprising if contradictory to urban Indians mere days ago Mumbai outdid Beijing as the Asian city that is home to the most number of billionairesmdash92 of themWomen take part in the World Hand Washing Day 2021 organised by the Department of Public Health Engineering in Dhaka Bangladesh made headlines a few years ago for eradicating open defecation PicGetty ImagesYet when it comes to factors like happiness we languish near the back of the class in South Asia Countries like Sri Lanka Maldives and Bhutan race ahead of us in the UNrsquos Human Development Index HDIThrough conversations with experts in economics public health and sociology midday asks what lessons India can learn from its neighbours as it journeys towards being a superpower and why international scorecards are met with rejection and denialTHE YEARS 2015 and 2016 took Swati Narayan then a doctoral student at the Tata Institute of Social Sciences to districts across Bihar Nepal and Bangladesh It is these journeys and the primary data she gathered that form the backbone of Unequal which was quoted by Rashtriya Janata Dalrsquos Manoj Kumar Jha in the last winter session of the Rajya SabhaK Seeta Prabhu Sreeparna Chattopadhyay and Subhashree DuttaMany of the community programmes Narayan cites in her book like the Pushti Apas are lowcost effective ideas that India could implement with tweaks As she revisits her fieldwork she recalls an example of community forestry from Nepal ldquoVillages here have forestry groups that shore up their finances not just by selling commodities from the forest without depleting it they divide their earnings as per a budget designed based on caste gender and age Even children are accounted for through the sales of produce like bamboo or firewood Some villages have used these earnings to purchase solar panels or to develop roadsrdquo she sharesIn comparing our neighbouring countries to Indian states of corresponding sizes what comes across frequently in Narayanrsquos book are the divisions and disparities caused by caste class religion and gender ldquoThese inequalities are aggravated because theyrsquore compounding each other This manifests in differences like that between the salary of the government school sweeper with that of the teacherrdquo says the author who teaches social policiesEchoing this sentiment Sreeparna Chattopadhyay associate professor of Sociology at FLAME university says that the inequality and precarity that accompanies everyday life in India has much to do with how citizens experience happiness Crucially as per the latest World Happiness Report India stands at the 126th positionldquoAlongside the high rates of absolute and relative inequality peoplersquos ability to act on their aspirations is compromised in Indiahellip Factors like happiness are related to the quality of healthcare one receives the meaningfulness of onersquos life and work as well as onersquos connectedness to larger societyrdquo Chattopadhyay explains ldquoCountries which consistently perform well on Happiness Indicesmdashlike Finland and Denmarkmdashare entrenched in welfare and social schemes that step up so that misfortunes loss of the primary breadwinner being retrenched doesnrsquot become injusticerdquoWithin India itself there emerges a north vs south divide when it comes to HDI with states like Kerala and Goa occupying the top ranks while the performance of Bihar Jharkhand and Uttar Pradesh remains poor K Seeta Prabhu former head of the UNDPrsquos Human Development Resource Centre Delhi highlights how those Southern states which invested in the social sector reaped benefits in the long run ldquoThe Kerala example is well known as early as 1817 the then ruler of Travancore Rani Gouri Parvathy issued a decree to provide universal free education to all children Similarly Tamil Nadu was the first state to introduce welfare programmes such as midday meals for school children as far back as 1956 The advantages of an early start are evident in the current social attainmentsrdquo says Prabhu who is a Visiting Professor at the Institute for Human Development and Senior Advisor at the Tata Institute of Social SciencesItrsquos crucial to remember that India gets a number of things right The midday meal scheme for example is considered the worldrsquos largest school meal programme as it feeds nine crore children across the country Though the scheme has been criticised in certain states for the exclusion of proteinrich ingredients like eggs and incidents of malpractice and slippages are reported providing primary school children with hot cooked food has led to positive academic outcomesBengalurubased nonprofit The Nudge Institute encourages the building of resilient livelihoods across urban and rural India Subhashree Dutta managing partner at TheNudge Centre for Social Innovation elucidates the strides India has made in poverty alleviation ldquoIndia has many social welfare schemes that have been successful such as the Antyoday Yojana for skill development or the MGNREGA scheme which promises unskilled manual work for 100 days per year to adult persons of all rural householdsrdquo says Dutta who also cites Vietnam and Indonesia as examples of successful poverty alleviation Dutta also emphasises the importance of SelfHelp Groups SHGs ldquoIndia currently has 12 million SHGs of which 88 per cent are female led The SHG Bank Linkage project which provides small loans for taking up livelihood options covers 142 million families with savings deposits of R47240 croresrdquo she explainsThere is no onesizefitsall approach that can satisfy the needs and aspirations of every person in the room Prabhu reminds us ldquoThe challenge is to find local contextspecific initiatives that are designed and implemented with the participation of people that can spur progress in social sectorsrdquo she says adding that India has witnessed several innovative initiatives such as the Prime Ministerrsquos Rural Development Programme and Aspirational Districts ProgrammeIN OCTOBER 2023 when the Global Hunger Index was released India sat at the dismal 111th spot among 125 countries with particular focus on the undernutrition of its children The Women and Child Development Ministry rejected the Indexrsquos findings accusing it of suffering from ldquoserious methodological issuesrdquo and showing ldquoa malafide intentrdquo In one of Unequalrsquos early chapters Narayan addresses this denial ldquoUnless the doctor admits the patient is sick there is no hope of finding a curerdquoIn a similar vein Chattopadhyay draws our attention to a development in recent years where it was suggested that anaemia was being overdiagnosed in India Experts said this was a consequence of following the WHOrsquos 11 grams per decilitre cutoff to diagnose the condition As per the latest National Health Survey 20192021 586 per cent of children and 531 per cent of girls and women between the ages of 15 to 49 are living with the conditionmdashbut this data and the very methods used to obtain it have since been questionedA study by researchers from three institutes argued that the cutoff defined by the WHO was based on haemoglobin levels among White populations An Indian cutoff based on dietary and health factors specific to our country would reduce the prevalence and burden of anaemia significantly they asserted The drop would be a significant one from 35 per cent to 11 per cent ldquoThresholds in indices should be carefully defined by studying years of data across populationshellip what would the consequences of lowering the anaemia threshold from 11 to 10 be in a country where we have seen high levels of related conditions like malnutrition and maternal deathrdquo Chattopadhyay asksLast week speculations about a homegrown democracy index developed by an Indian think tank took rootmdashreportedly a response to global agencies downgrading Indiarsquos score as a democracy The question at the heart of these responses is why is data from indices and international studies perceived with suspicion and scepticismPrabhu says producing regular reliable data about a variety of factors is key to ensuring the ground reality in any country is correctly represented ldquoFor example the population census that provides authentic data on a number of crucial indicators has been inordinately delayed in India In the absence of government data international agencies use estimates by researchers whose methods of estimation may produce results that are seemingly at variance with the ground reality that is observed This provides scope for claims and counterclaimsrdquo Prabhu explains She adds that in a country as large as ours where averages can be misleading data from districts and talukas should be obtained to monitor progress and act quicklyAs our conversation turns towards the Press Freedom Index by Reporters Without Borders and India 161 and Pakistanrsquos 150 respective positions on it Chattopadhyay says ldquoPerhaps there is a case to be made about reassessing some aspects of these Indices But the baby should not be thrown out with the bathwaterrdquo111Indiarsquos rank on Global Hunger Index out of 125 countries126Indiarsquos rank on World Happiness Report out of 143 countries92No of billionaires residing in Mumbai