Indubitably, broader economic growth - involving improvement in physical infrastructure, favorable macroeconomic indicators, stronger geopolitical positioning, greater global acceptability etc., is most desirable for a developing economy like India. However, the importance of improvement in social indicators, quality of life and sustainability cannot be disregarded as less important. In fact, if someone asks me to choose between a more equitable, just and sustainable society and a rich but unequal and unjust society pursuing an unsustainable path of development, I would definitely choose the former over the latter, without giving it a second thought.
India has seen consistent improvement in many social, quality of life and sustainability parameters in the past three decades particularly. All the governments have focused on improvement in factors like literacy, infant mortality, primary education, gender equality, poverty alleviation, regional equality etc. Several mission level programs National Literacy Mission, Rural Health Mission, Cleanliness Mission, Midday Meal program, National Food Security Mission, National Livelihood Mission, etc. have been successfully run. Several entitlement measures like right to employment (MNREGA), right to education (RTE), right to basic income (PM Kissan), etc. have been implemented, and these have shown tremendous results. Besides, a number of empowerment schemes like right to unique identity (Aadhar), financial inclusion (e.g., Jan Dhan), right to information (RTI), etc., have also made substantial contributions in improvement of qualitative parameters.
Nonetheless, there is still a lot of ground to be covered to make quality of life and sustainability parameters in India commensurate with the overall economic growth and development. For that the governments must reassess the speed and direction of economic growth and fine tune it to make it just, equitable and sustainable.
In this context, it may be pertinent to highlight some of the findings of the National Family and Health Survey (NFHS) -5, conducted by the International Institute of Population Sciences, designated nodal agency by Ministry of Health and Family Welfare (MoHFW), Government of India.
NFHS is conducted to collect data on health and family welfare, as well as data on emerging issues in these areas, such as levels of fertility, infant and child mortality, maternal and child health, and other health and family welfare indicators by background characteristics at the national and state levels. The survey also provides information on several emerging issues including perinatal mortality, high-risk sexual behaviour, safe injections, tuberculosis, non-communicable diseases, and the use of emergency contraception.
The information collected through NFHS assists policymakers and programme managers in setting benchmarks and examining progress over time in India’s health sector. Besides providing evidence on the effectiveness of ongoing programmes, NFHS data also helps in identifying the need for new programmes in specific health areas.
The following are some of the key findings of NFHS-5:
Positive
· Drinking water: 96% of households use an improved source of drinking water.
· Access to sanitation: 83% of households have access to a toilet facility.
· Electricity: 97% of households have electricity (95% of rural households and 99% of urban households).
· Aadhaar card: 90% of the household population have an Aadhaar card.
· Bank or post office account: 96% of households have a bank or post office account.
· Total Fertility rate: The total fertility rate (TFR) in India is 2.0 children per woman, which is slightly lower than the replacement level of fertility of 2.1 children per woman. Women in rural areas have higher fertility, on average, than women in urban areas (TFR of 2.1 versus 1.6 children).
· Vaccination: 77% of all children age 12-23 months have received all basic vaccinations. Between 2015-16 and 2019-21, this percentage increased more in rural areas (from 61% to 77%) than in urban areas (from 64% to 76%). Only 4% children received no vaccination.
Need improvement
· Cooking fuel: Only 59% of households use clean fuel for cooking.
· Birth registration: 89% of children under age five had their birth registered.
· School attendance: The net attendance ratio falls from 83% in primary school to 71% in middle, secondary, and higher secondary school. The main reason given for not attending school was that the child is not interested in studies (36% for male children and 21% for female children).
· Tobacco and alcohol use: 38% of men and 9 percent of women age 15 and over currently use any tobacco products.
· Drinking water: 49% of rural households rely on tube wells or boreholes for drinking water.
· Sanitation: 26% rural households are still using open defecation.
· Wealth inequality: 71% of the population in scheduled tribe households and 49% of the population in scheduled caste households are in the two lowest wealth quintiles.
· Education: Educational attainment increases with household wealth. Females in the lowest wealth quintile have completed a median of 0.4 years of schooling, compared with a median of 9.3 years for females in the highest wealth quintile. The median number of years of schooling was 3.7 years among males in the lowest wealth quintile and 10.0 years among those in the highest quintile.
The percentage of the household population with no schooling is higher in rural areas than urban areas (33% versus 17% for females and 16% versus 8% for males).
· Labor force participation: Men are more likely to be employed than women; 25% of women are currently employed, compared with 75% of men. 83% of employed women earn cash for their work (unorganized employment).
· Digital presence: One-third of women and slightly over half (51%) of men age 15-49 have ever used the internet.
· Child marriage: 38% of women marry before the legal minimum age of marriage of 18 years, and 23% of men marry before the minimum legal age of marriage of 21years.
· Infant mortality rate: The under-five mortality rate is 42 deaths per 1,000 live births, and the infant mortality rate is 35 deaths per 1,000 live births. The neonatal mortality rate is 25 deaths per 1,000 live births.
· Malnutrition: Eleven percent of all children age 6-23 months were fed the minimum acceptable diet. 36% children suffer from stunting and under-weight.
· Hypertension: 21% of women and 24% of men age 15 and over have hypertension. 39% of women and 49% of men age 15 and over are pre-hypertensive.
· Diabetes: 12% of women and 14% of men age 15 and over have random blood glucose levels greater than 140 mg/dl.
· Domestic violence: 45% of women and 44% of men agree with one or more of seven specified reasons for wife beating.
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