Vijay Kumar Gaba

A few weeks ago, National Statistical Organization (NSO) released results of two important social sector surveys, i.e, Health and Education. The surveys conducted as part of 75th Round of Natinal Sample Survey (NSS) between July 2017 and June 2018, highlight some very important trends in household expenditure on Helath and Education. The key findings of the surveys are listed below:

State of "Healthcare" in India

• About 7% of rural population and 9% of urban population reported suffering from some ailment during the 15days reference period. 28% of people in 60yr+ category 11% in 45-59yr category reported ill.

• Since 2014, there has been a marked decline in number of people suffering from anemia and tuberculosis.

• About 3% of population required hospitalization in past 365 days. The rate of hospitalization was much higher (8.5%) in case of people above 60yr of age. On an average, about Rs. 16,676 in rural India and Rs. 26,475 in urban India were spent on medical expenditure for hospitalization.

• About 42% of population availed treatment in Public hospitals, 55% of population availed treatment in Private hospitals and 2.7% of population availed treatment in Charitable/ trust/ NGO-run hospitals.

• 95% of patients preferred allopathic treatment.

• About 14% of the rural population and 19% of the urban population had health expenditure coverage. Among them, about 13% of rural and 9% of urban population were covered by Government sponsored health insurance.

• Rural households primarily depended on their ‘household income/savings’ (80%) and on ‘borrowings’ (13%) for financing expenditure on hospitalisation. Dependence of the urban households on their ‘income/savings’ was slightly more (84%) for financing expenditure on hospitalisation, than on ‘borrowings’ (about 9%).

• In rural areas, about 90% childbirths were institutional (in Government/private hospitals) and in urban areas it was about 96%. Among women in the age-group 15-49 years, about 97% of women took pre-natal care and about 88% of women took post-natal care.

• Surgery was done in about 28% of hospital childbirths in India. In Government hospitals only about 17% of childbirths were surgery cases and, in Private hospitals about 55% of childbirths were surgery cases.

• In rural India, only about 28% (48% male and 10% female) aged persons (60yr above) and in urban India 33% (57% male and 11% female) aged persons are economically independent. The dependent aged persons are mostly supported by their own children (79% rural and 76% urban) or spouse.

• About 59% of boys and 60% of girls at all-India level had been fully immunised (i.e., received all 8 prescribed vaccinations). About 95% of children in rural India and 86% of children in urban India had received any vaccination from Government/ Public hospital (including HSC/PHC/CHC/Aganwari centre/mobile medical unit).

Household expenditure on Education in India

• Average household size in India is 4.3 (4.5 in rural areas and 3.8 in urban areas). Average no. of persons aged 3-35years per household was 2.4.

• Literacy rate among persons (aged7 years and above) in India is about 77.7%. Literacy rate is higher in males (84.7%) vs female (70.3%).

• ~32% of rural youth (15yr and above) and 14% of urban youth is still illiterate. Only ~6% rural population and ~22% of urban population is graduate or higher degree.

• In rural areas 92.7% of households and in urban areas, 87.2% of households reported availability of primary school within 1 km from the house. While only about 38% of rural households compared to around 70% of urban households reported secondary schools within such a distance.

• In rural areas 46.1% of males and 40.7% of females in the 3-35years age-group were currently attending educational institution. In urban areas these percentages were 46.7% and 42.6% respectively for males and females.

• 96.1% of students were in general education and remaining were in technical/professional education. Among the male students pursuing technical/professional education, 41.6% were pursuing engineering compared to 28.2% among the female students and 4.9% of the male students were pursuing medicine (which includes nursing) compared to 13.8% of the female students.

• In rural areas, 44.2% of the students at pre-primary level, 73.7% at primary level, 76.1% at upper primary/middle level, 68.0% at secondary & higher secondary level and 49.7% at graduate and above level attended Government institutions, while in urban areas, 13.9% at pre-primary level, 30.9% at primary level, 38.0% at upper primary level, 38.9% at secondary& higher secondary levels and 41.0% at graduate and above levels attended Government institutions.

• 77% of the students studying in Government institutions were receiving free education (nearly 81% in rural areas and 62% in urban areas). Percentage of students studying in private unaided institutions and receiving free education was nearly 2% in rural areas and 1% in urban areas.

• Nearly 14% students attending formal education received scholarship/stipend/ reimbursement for different level of current attendance.

• Average expenditure (Rs.)per student incurred during the current academic session for basic course was nearly Rs.8,331 for general courses, Rs.50,307 for technical/professional courses.

• Nearly 20% of students attending pre-primary and above level (21% of males and 19% of females) were taking private coaching in India. Incidence of taking private coaching was maximum at secondary level. (31% of male students and 29% of female students).

• Average expenditure in the current academic session for studying medicine in was Rs.31,309 in government institutions, Rs.1,01,154 in private aided and 94,658 in private unaided institutions. For engineering course, the expenditures were Rs. 39,165, Rs. 66,272 and Rs.69,155 in government, private aided and private unaided institutions respectively.

• Percentages of persons in the age group of 3-35 years dropping out of studies were nearly 14% in rural areas and 10% in urban areas. Among the ever enrolled persons of age 3-35 years, nearly 41% of males and 40% of females were not currently attending education in rural areas.

• Nearly 4% of rural households and 23% of urban household possessed computer.

• Among persons of age 15-29 years, nearly 24% in rural areas and 56% in urban areas were able to operate a computer.

• Nearly 24%of the households in the country had internet access in the survey year, 2017-18. The proportions were 15% among rural households and 42% among urban households. Nearly 35% of persons of age 15-29 years reported use of internet during the 30 days prior to the date of survey.

Observations

1.    The rural-urban and gender divide is still meaningful in the area of education and healthcare.

2.    The dependency ratio is very high for the aged. The social security penetration is abysmally low.

3.    Health insurance coverage continues to be low; thohg some improvement has been seen in past 5 years.

4.    At ~60%, immunization program coverage is very low.

5.    The traditional medicine system of India has lost its relevance.

6.    The average household size in urban India has fallen from 5 to below 4. One child is becoming a norm.

7.    Only ~4% students are taking professional/technical education.

8.    At secondary level, more than 60% rural children have to travel more than 1km to go to a school.

9.    Despite, more than two decades of total literacy mission, one third of rural youth are still "illiterate".

10.  Only one fourth households in the country have internet access. In rural areas the internet access is limited to just 15% of households.