Chasing a mirage?

The world is on the verge of reaching yet another milestone in December 2015 when the deadline to achieve the Millennium Development Goals (MDGs) expires. At the turn of the new millennium, the United Nations had unveiled a 15-year plan to make progress towards eradicating poverty, saving the lives of mothers and children, sending more girls to school and achieving gender equality. It was a broad-based people-oriented development agenda. Hectic discussions are now underway to prepare the world for post-2015 years with another set of goals. This time around, the agenda has been broadened from development to sustainable development, and the new goals will be called Sustainable Development Goals (SDGs).

The history of such global declarations and goals dates back to 1978 when health ministers under the aegis of the World Health Organisation coined a new agenda “Health for all” and set the year 2000 as the deadline. The goal was to achieve “a level of health that would enable all of the world's people to lead a socially and economically productive life”.  This was to be achieved through improvements in primary healthcare with community participation and by tackling underlying causes of poor health like poverty, illiteracy and poor sanitation. As 2000 approached and it was apparent that the world was far from achieving ‘health for all’ , a new agenda was set in the form of MDGs and now in 2015, when these goals are far from being achieved, we are talking of another deadline and a new set of goals – the SDGs. So, is it a case of changing goalposts every time we reach a deadline? Are development goals going to remain a mirage?

Even if it is a case of changing goalposts, these goals provide developing countries like India an opportunity to assess the progress they are making towards human development and to identify gaps in policies they are pursuing.  Despite apparent problems about data collection quality and methodologies adopted for data gathering, India appears to have made some progress to achieve the MGDs. It’s a mixed bag. Impressive improvements have been made on some goals, but progress has lagged in others – as summarised in a report released by the United Nations last week.

India has achieved the target of reducing poverty by half as per official national estimates and is close to doing so according to international estimates. This was partly due to high economic growth recorded in the 2000s and impact of MNREGA on rural employment and incomes of poor households. The country is on track to reach the target of reducing the number of underweight children. The target of achieving gender equality and empowerment of women –measured in terms of ratio of girls to boys in primary, secondary and tertiary education; and employment of women in non-farm sectors – has been partially met. The proportion of population without access to clean drinking water has also been halved, as targeted.

However, India is lagging and is not likely to achieve the targets by December 2015 in critical areas – reducing child and infant mortality, improving maternal health, improving access to sanitation, besides empowering women through wage employment and political participation and universal youth literacy. The reasons for this are clear – poor investment in human development. The UN report says that India has not been spending enough in health, nutrition, sanitation and quality of education compared to other developing countries in Asia.

For instance, India spends just 4.05 per cent of its GDP on health with only a third of it coming from public funds. The out-of-pocket expenditure of households on health is huge. An estimated 6.2 per cent of households in India fall below the poverty line solely due to expenses on health. India spends just 3.34 per cent of education-far below 6 percent of GDP norm set by Unesco.

Infrastructure development

Investments in overall infrastructure development could have unexpected fallout in sectors like health and education. Access to roads is a good proxy indictor for infrastructure development. For promoting institutional deliveries and discouraging home deliveries, cash incentives are being given to women while ambulance services have been introduced in many states. However, ambulances can’t reach villages and hamlets that are not connected by road. Women in labour have to be transported several kilometres in bullock cart or motorcycle to main road so that they can avail of the ambulance facility.

At times, they deliver on the way or develop life-threatening complications. Such women are denied cash incentives – and access to safe delivery – even though they opted for institutional deliveries in first place. All this happens due to lack of roads. The same holds true of health facilities with no electricity. Though phone connectivity has reached villages, roads and electricity are still stumbling blocks. This also has message for decision makers who fix priorities for infrastructure development such as roads.

As we move towards new set of goals post-2015, it is necessary to develop robust systems to measure our progress. Most government programmes focus on collecting data such as expenditure, personnel, equipment and training etc. While all this is important to assess progress made, we also need to measure how all these inputs are helping improvement of the outcome. If there are certain number of health facilities and doctors in a particular district, the result should be measured in terms of factors like number of children saved through timely vaccination, improvement in their nutritional status, safe deliveries etc.

Similarly, impact of educational infrastructure should be benchmarked against learning abilities of children attending schools rather than number of children and dropout rates alone. The conclusion of MDGs is the right time for India to nationally review the progress of the past 15 years, identify the gaps and move ahead with renewed determination. Otherwise, Sustainable Development Goals will be just another set of numbers and 2030 yet another mirage.
(The writer is a New Delhi-based columnist and author)