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Nap on HDI scores may land Kerala in an equilibrium trap

M Sarita Varma

Thiruvananthapuram  Kerala, India’s HDI (human development indices) posterboy for UNDP, is heading for an equilibrium trap. Nobody would suggest any quantitative fall from the Millennium Goals yet, but the state’s qualitative slide in education and health is too stark to be ignored without policy intervention.

High quality of life indices amidst low income/productivity growth still account for the dynamics of the much-debated Kerala development model. World resources programme (1998) notes that Kerala citizens enjoy life expectancy on par with Hungary, and literacy rates comparable with those in Norway. More recently, UNDP lauds “the sharp decline in fertility in highly literate states such as Kerala” thanks to “public debates” that spark development through democratic intervention. (UNDP Human Development Report, 2002).

However, there is yet to be any ‘public debate’ on the diminishing returns to investment from early strides in education and health sectors. Falling death and birth rates have left Kerala with a growing 60-plusser demographic profile (already 11.2% of population), aggravated by a high dependency ratio. S Irudayarajan, Centre for Development Studies, adds a bleak dimension of high morbidity rate to this elderly female profile. Demographists warn of a crossfire of first-generation poverty-linked diseases, second-generation life-style diseases and a third wave of infectious and behavioural pathologies.

Clearly, ‘the Hungary-level life expectancy’ in Kerala lacks the backing of Hungary-level affordable healthcare facilities. Treatment costs are nominal in sprawling medical college hospitals and primary health centres, which lack sufficient doctors, healthcare personnel and even stock of relevant medicines. A Rs 812-crore World Bank assistance to address the second generation health reforms is in pipeline. A caveat that the bank has set, is the raising of hospital fees.

Simultaneously, the state’s NRI wealth has bred a range of state-of-the-art speciality hospitals. Even the low wage earner has no qualms to turning to these private hospitals, found a study by the NGO, Public Affairs. But the Kerala psyche refuses to accept higher fees at government hospitals or health cess at the local body-level. State government’s campaign machinery that came out in flying colours in population control, has failed to address this social mindset.

All is not well in schools, as well. The bandwagon in literacy is not spontaneously geared to the best in primary schooling. In the backdrop of the Kumbhakonam fire, any neglect of physical facilities needs to be ranked criminal. The highest percentage of schools without secure compound walls is in this literate state, finds a National Institute of Education Planning & Implementation report (NIEPA: 2003).

More alarming is the fall in education quality. This is reflected in the state’s 40-lakh level of educated unemployment. Even the budgetary allotments for education and health are falling.

To consolidate the literacy rate advantage, the plan outlay to education should be stepped up, says KK George, director, Centre for Socio-economic and Environmental Studies. “On the non-plan side, the non-salary expenditure on education is less than 10%, leaving minimal resources for library upkeep” says Dr George.

The issue of spreading resources too thin is aggravated on higher education. Much of the state’s education spending feeds the primary- level. Higher education and technical education gets only 14% and 3% of this pie.

Based on Census data, anthropologist Robin Jeffrey had noted that Kerala’s milestones in life expectancy was built up on high budgetary outlays for schools and healthcare by the then princely states of Cochin and Travancore as early as 1911. The focus now seems lost.

Resting on its oars, just when the external economic waters turn more competitive, could not just land Kerala in a self-perpetuating equilibrium trap. The policy inertia could even cripple the state’s growth rate to below national average in a decade or two.

 
 

URL: http://www.financialexpress.com/fe_full_story.php?content_id=86925

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