Gujarat - the Social Sectors


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Education is clearly important in tapping the so-called demographic dividend. There is nothing automatic about a demographic dividend materializing. Among other things, that is a function of health and education outcomes. More specifically, there is question of skills. The overall skills deficit has often been flagged. For instance, in 2002, the S.P. Gupta Special Group constituted by the Planning Commission stated, “It should be noted, however, that on the average the skilled labour force at present is hardly around 6-8 per cent of the total, compared to more than 60 per cent in most of the developed and emerging developing countries.” In 2001, the Montek Singh Ahluwalia Task Force , again constituted by the Planning Commission, stated, “Only 5% of the Indian labour force in this age category has vocational skills.” While the numbers are marginally different, the Eleventh Five Year Plan document adds the following. “The NSS 61st Round results show that among persons of age 15-29 years, only about 2% are reported to have received formal vocational training and another 8% reported to have received non-formal vocational training indicating that very few young persons actually enter the world of work with any kind of formal vocational training.” Among the youth, most of those with formal training are in Kerala, Maharashtra, Tamil Nadu, Himachal Pradesh and Gujarat. A better indicator of a State’s performance is the share of the young population that has some variety of formal training. In this, Maharashtra, Kerala, Tamil Nadu, Gujarat and Andhra Pradesh perform well. Is this because there is better training capacity and infrastructure? Is it because industrial activity exists in these States? Is it because there is a positive correlation between some minimum level of educational attainment and acquisition of formal training? The answer is probably a combination of various factors.

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Gujarat - the Social Sectors

  1. 1. Gujarat - the Social Sectors Bibek Debroy October 2012 Indicus White Paper SeriesiAnalytics NDICUS
  2. 2. White PaperGujarat – the Social Sectors Bibek Debroy Indicus Analytics October 2012
  3. 3. Bibek Debroy Gujarat – the Social SectorsE ducation is clearly important in tapping the so-called demographic dividend. There is nothing automatic about a demographic dividend materializing. Among other things, that is a function of health and education outcomes. More specifically, there isquestion of skills. The overall skills deficit has often been flagged. For instance, in 2002, the S.P.Gupta Special Group1 constituted by the Planning Commission stated, “It should be noted,however, that on the average the skilled labour force at present is hardly around 6-8 per cent ofthe total, compared to more than 60 per cent in most of the developed and emerging developingcountries.” In 2001, the Montek Singh Ahluwalia Task Force2, again constituted by the PlanningCommission, stated, “Only 5% of the Indian labour force in this age category3 has vocationalskills.” While the numbers are marginally different, the Eleventh Five Year Plan document addsthe following.4 “The NSS 61st Round results show that among persons of age 15-29 years, onlyabout 2% are reported to have received formal vocational training and another 8% reported tohave received non-formal vocational training indicating that very few young persons actuallyenter the world of work with any kind of formal vocational training.” Among the youth, most ofthose with formal training are in Kerala, Maharashtra, Tamil Nadu, Himachal Pradesh andGujarat.5 A better indicator of a State’s performance is the share of the young population thathas some variety of formal training. In this, Maharashtra, Kerala, Tamil Nadu, Gujarat andAndhra Pradesh perform well. Is this because there is better training capacity and infrastructure?Is it because industrial activity exists in these States? Is it because there is a positive correlationbetween some minimum level of educational attainment and acquisition of formal training? Theanswer is probably a combination of various factors. The Approach Paper to the Eleventh Five Year Plan6 divides the discussion on educationinto five segments – elementary education, secondary education, technical/vocational educationand skill development, higher/technical education and adult literacy. Adult literacy is slightlydifferent. But the other four don’t represent neat water-tight compartments, in the sense thateducation is a continuum and one category spills over into another. The Ministry of HumanResources Development has some data on school education. These are provisional and they are1 Report of the Special Group on Targeting Ten Million Employment Opportunities per year over the Tenth Plan Period, PlanningCommission, May 2002, Report of the Task Force on Employment Opportunities, Planning Commission, July 2001, 20-24 age-group.4 Eleventh Five Year Plan, 2007-2012, Vol. I, ibid..5 Skill Formation and Employment Assurance in the Unorganized Sector, NCEUS, August 2008.6 Towards Faster and More Inclusive Growth, An Approach to the 11th Five Year Plan, Planning Commission, Government ofIndia, December 2006, White Paper Series 2
  4. 4. Bibek Debroy Gujarat – the Social Sectorsalso a bit dated, since they pertain to 2009.7 Table 1 is based on this and shows how Gujaratcompares, benchmarked against all-India figures. Since this is meant to be illustrative, Table 1has deliberately not been made exhaustive. However, Table 1 does tell us Gujarat has a problemwith number of female teachers, the overall number of teachers and gross enrolment ratios forgirls, SC-s and ST-s. Although it does not come across that clearly in Table 1, there are alsoproblems with retention and high drop-out rates and physical infrastructure. Some of Gujarat’sfigures may not look that bad if comparisons are made with all-India averages. However, for aneconomically developed State like Gujarat, is an all-India average the right benchmark to use?Or, in the area of education, should Gujarat be benchmarked against better States? Having saidthis, there are two additional points to be borne in mind. First, have there been temporalimprovements over time and have remedial measures been taken? Table 2, based on the DISEdataset, clearly shows these temporal improvements.8 Table 1: Gujarat’s school education indicators Indicator Gujarat All-India% of pre-primary/primary/junior 100 86basic school teachers whoare trainedNo. of female teachers/100male teachers, pre- 64 86primary/primary/juniorbasic schoolNo. of female teachers/100male teachers, higher 48 65secondary schools, intercollegesPupil/teacher ratio, pre-primary/primary/junior 30 42basic schoolPupil/teacher ratio, higher 41 397 National University of Educational Planning and Administration (2012), Elementary Education in India, ProgressTowards UEE, DISE 2010-11.Indicus White Paper Series 3
  5. 5. Bibek Debroy Gujarat – the Social Sectorssecondary schools, intercollegesGER (Classes I-V) 119.95 115.55GER for girls (Classes I-XII) 87.29 84.39GER for SC-s (Classes XI- 39.75 35.60XII)GER for ST-s (Classes IX-X) 53.72 49.41 Table 2: Improvement in School Indicators 2008-09 2010-11% single teacher schools 2.7 0.86% of schools with drinking 90.24 97.89water facilities% of schools with common 73.10 32.79toilets% of schools with 37.69 45.37computersAverage number of teachers 6.1 6.4per schoolGross enrolment ratio, 107.73 110.20primaryGross completion rate, 91.60 96.94primary Second, Gujarat isn’t a homogenous State and there is an inter-regional aspect toeducational deprivation. Table 3 illustrates what one means.9 As with Table 1, the intention isillustrative, not exhaustive. While Table 3 brings out the inter-district variations, because it is asnapshot, it does not bring out the sharp inter-temporal improvements. For example, insecondary education, the drop-out rate for the general category was 28.11 per cent in 2000-01and declined to 23.77 per cent in 2011-12. For SCs, the decline was from 33.42 per cent to 25.06per cent. And for STs, the decline was from 31.25 per cent to 26.63 per cent. On temporalimprovements, here is a quote from Pratham’s ASER report for rural India.10 “Gujarat should bementioned as a state that has also started showing a steady although slow improvement inreading levels over the last three years. One major initiative in the state for the last three years isthat government officers visit randomly chosen schools to assess performance of children9 Statistical Abstract of Gujarat State 2010, Directorate of Economics and Statistics, Government of Gujarat,Gandhinagar.10 Annual Status of Education Report (Rural), 2011, Pratham, January 2012, ASER also has qualitative tests of learning, which we are glossing over somewhat.Indicus White Paper Series 4
  6. 6. Bibek Debroy Gujarat – the Social Sectorsaround November and cross check teachers’ evaluations… In ASER 2011, an average of about87% of all appointed teachers was observed to be in school on the day of the visit. Gujaratstands out with 95.6% teachers attending in primary schools.” There was also a sharp decline inthe number of out-of-school children between 2006 and 2011. Those improvements also comeacross in National University of Educational Planning and Administration’s DISE (DistrictInformation System for Education) dataset.11 For example, the average number of classroomsper school has increased. The student/classroom ratios have also improved. The percentage ofsingle-teacher schools has declined. Pupil/teacher ratios have improved. Physical infrastructureis also far better. Table 3: Drop-out rates in secondary education (Classes VIII-X), 2010-11 District Boys Girls SC boys SC girls ST boys ST girlsKachchh 32.48 24.37 32.18 24.94 35.67 19.67Banaskantha 57.39 54.47 63.40 52.62 54.64 26.63Patan 50.01 28.99 19.57 - 8.14 35.77 - 16.67Mahesana 33.17 19.96 40.06 12.61 71.60 78.40Sabarkantha 7.05 8.71 - 7.32 4.22 7.66 6.45Gandhinagar 25.11 13.51 44.63 67.03 45.45 63.75Ahmedabad - 4.62 - 36.49 4.56 12.09 29.68 18.46Surendranagar 28.45 33.54 25.74 30.28 19.64 - 45.71Rajkot 24.71 18.26 31.68 20.89 80.20 74.75Jamnagar 43.93 52.37 55.62 65.26 63.54 44.90Porbandar 5.10 29.95 13.45 48.44 - 209.68 - 100.00Junagadh - 4.67 0.92 - 76.28 - 67.28 - 15.64 6.10Amreli - 6.33 29.09 17.76 49.31 40.32 50.07Bhavnagar 71.60 64.59 82.97 64.22 78.03 47.45Anand 47.30 38.15 24.63 53.39 4.32 38.36Kheda 24.06 36.46 17.16 - 10.90 - 41.09 - 83.93Panchmahals 15.68 29.04 10.93 74.22 20.60 19.97Dohad 21.02 19.53 26.14 17.97 18.12 14.81Vadodara 18.36 14.68 19.90 - 3.09 46.38 32.3311 Elementary Education in India, Progress towards UEE, DISE 2009-10, September 2009, White Paper Series 5
  7. 7. Bibek Debroy Gujarat – the Social SectorsNarmada 28.83 23.99 16.00 43.75 31.54 25.54Bharuch 23.17 23.88 19.68 17.54 44.06 41.95Surat 36.68 34.31 44.78 51.30 53.07 51.30Dangs 28.35 20.38 27.27 16.67 29.60 19.82Navsari 6.76 16.40 57.43 53.55 41.16 38.11Valsad 25.40 19.12 25.11 24.99 30.06 22.23 Table 4: Drop-out RatesYear Classes I to V Classes I to VII Boys Girls All Boys Girls All2003-04 17.79 17.84 17.83 36.59 31.44 33.732004-05 8.72 11.77 10.16 15.33 22.80 18.792005-06 4.53 5.79 5.13 9.97 14.02 11.822006-07 2.84 3.68 3.24 9.13 11.64 10.292007-08 2.77 3.25 2.98 8.81 11.08 9.872008-09 2.28 2.31 2.29 8.58 9.17 8.872009-10 2.18 2.23 2.20 8.33 8.97 8.652010-11 2.08 2.11 2.09 7.87 8.12 7.952011-12 2.05 2.08 2.07 7.35 7.82 7.56 Consequently, if one has an impression that Gujarat doesn’t do that well on schooleducation, one should check the time-line. Many interventions are of recent vintage and dateddata don’t show the improvements. One such intervention is “Praveshotsava” and “Rathyatra”,targeted at festivals of admission, particularly for girls. Table 4 is symptomatic.12 Theconstruction of classrooms has picked up, after having flagged in the second half of the 1990s.Under the total sanitation programme and a school sanitation programme, toilets have beenconstructed in upper primary schools, with a focus on girls. Several Vidyasahayakas have beenrecruited, the scheme having been introduced in 1998. The numbers are shown in Table 5.13While concerns can be expressed about para-teachers, especially if they aren’t trained, as anincremental improvement, para-teachers have been successfully experimented with in otherStates too. However, in Gujarat, Vidyasahayaks aren’t para-teachers. They are properly trained,12 Ibid.Indicus White Paper Series 6
  8. 8. Bibek Debroy Gujarat – the Social Sectorsthe difference with regular teachers being that they are on fixed probationary contracts for fiveyears. In 2002-03, a Vidya Laxmi Bond scheme was started, for girls, initially in rural areas, butalso extended to urban BPL families. A sum of money is deposited at the time of admission (inClass I) and this is repaid with interest when the girl passes out of Class VII. Apart from this,there have been improvements in physical infrastructure, some of this under the Van Bandhuscheme for tribal talukas and the Sagar Khedu scheme for coastal talukas, planning facilitated bythe BISAG mapping mentioned earlier. Biometric monitoring of attendance has also beenintroduced. While more examples are unnecessary, because this is not a book on education, orschool education, alone, one should mention the Gunotsav programme, designed to improvequality in 34,000 primary government schools. Table 5: Vidyasahayaks appointed 1998-99 15,404 1999-2000 20,756 2000-01 13,181 2001-02 6,900 2002-03 6,591 2003-04 3,848 2004-05 15,468 2005-06 0 2006-07 12,691 2007-08 0 2008-09 10,225 2009-10 6,294 2010-11 10,000 2011-12 11,625 The Gunotsav programme was started in 2009-10. So at one level, it is a bit too early tojudge its success, at least in quantitative terms. Its novelty lies elsewhere. Ministers, includingthe Chief Minister, and senior civil servants spend an entire day at the school, evaluating itsphysical and educational facilities. The students are also tested and the school is gradedaccording to the qualities (guna). The grades are from A to F and the grading is done externally,as well as through a self-assessment by teachers. That is, there are two parallel grading exercises.Take Junagadh district as an example. Data are available for 2009-10 and 2010-11. In theIndicus White Paper Series 7
  9. 9. Bibek Debroy Gujarat – the Social Sectorsexternal grading, in 2009-10, 0% of schools in Junagadh were “A”, 2.4% were “B”, 8.3% were“C”, 70% were “D”, 20% were “E” and 1.4% were “F”.14 In 2010-11, these ratios changed to0% for “A”, 0.15% for “B”, 19.3% for “C”, 71.9% for “D”, 7.5% for “E” and 1.2% for “F”.The ratings by teachers followed a similar pattern. With just two years, it is difficult to detectrobust statistical trends. Nevertheless, there is a suggestion that while the movement towards“A” or “B” is not that marked, there has been a slight nudging upwards from “D”, “E” and “F”towards “C”. The utility of the exercise is however different. It decentralizes educationalplanning by taking administrators down to the grassroots and it also subjects schools to externalscrutiny, providing feedback loops in either direction. In sum, on school education, in the lastfew years, there has been an additional focus and this has also been reflected in improvements inoutcome indicators. Let us now move on to the somewhat different issue of skills, often equated withvocational or technical education, though there is a low end (ITI) and a high end (IIT) to thistype of education. The skills deficit in India has been flagged several times. The following drivehome the point.15 80% of new entrants into the work force have no opportunities fordevelopment of skills. While there are 12.8 million new entrants into the work force every year,the existing training capacity is 3.1 million per year. In both rural and urban India, and for bothmales and females, attendance rates in educational institutions drop by around 50% in the agegroup of 15-19 years.16 Simultaneously, labour force participation rates begin to increase in theage group of 15-19 years and by the time it comes to the age group of 25-29 years, it is 95.0% forrural males and 94.4% for urban males. The figures for females are lower at 36.5% in rural Indiaand 22.1% in urban India. The 15-29 age-group can be used as an illustration. Since post-educational institution training opportunities are limited, 87.8% of the population in this brackethas had no vocational training.17 Of the 11.3% who received vocational training, only 1.3%received formal vocational training.18 Most of the skills deficit is a problem that plagues theunorganized/informal sector. While there are alternative definitions of unorganized or informal,it is unnecessary to go into those definitional problems here.19 But it is necessary to rememberthat there can be workers apparently employed in the organized/formal sector, who are oninformal contracts. They too are therefore unorganized/informal. In general, the organized14 Figures from Junagadh district sources.15 Eleventh Five Year Plan, 2007-2012, Vol. I, Inclusive Growth, Planning Commission, Government of India and OxfordUniversity Press, 2008.These numbers are based on the 61st round (2004-05) of the NSS.16 The drop is sharper for rural females and is higher in rural than in urban India.17 85.5% for males and 90.2% for females. Understandably, the numbers without training are higher in rural areas.18 The number is higher for males and higher in urban than in rural areas.19 See, Report on Conditions of Work and Promotion of Livelihoods in the Unorganized Sector, National Commission forEnterprises in the Unorganized Sector (NCEUS), August 2007.Indicus White Paper Series 8
  10. 10. Bibek Debroy Gujarat – the Social Sectorssector has higher levels of skills than the unorganized sector and regular workers perform betterthan casual workers. It is worth making the point that education is not the same as skillsformation, with the latter developed through some form of vocational education (VE).Education does not necessarily lead to the development of marketable skills. However,education does provide a general template and makes it easier to access both formal andinformal VE. In 2004-05, NSSO (National Sample Survey Organization) asked a question about theskill profile of the youth, defined as those between 15 and 29 years. Skills were defined asinformal (both hereditary and others) and formal, formal vocational training interpreted as onewhere there was a structured training programme leading to a recognized certificate, diploma ordegree. Understandably, formal training was higher in urban than in rural areas. However,informal skill acquisition was evenly spread across urban and rural areas. For youth, the 2004-05survey brings out inter-State differences starkly. This is shown in Table 6.6. Amongst the youth,most of those with formal training are in Uttar Pradesh, West Bengal, Gujarat, Maharashtra,Kerala, Andhra Pradesh, Kerala and Tamil Nadu. A better indicator of the State’s performanceis the share of the young population that has some variety of formal training. In this, HimachalPradesh, Gujarat, Maharashtra, Tamil Nadu and Kerala perform relatively better, excluding theUTs. Is this because there is better training capacity and infrastructure? Is it because industrialactivity exists in these States? Is it because there is a positive correlation between someminimum level of educational attainment and acquisition of formal training? The answer isprobably a combination of various factors. However, the dated nature of the data apart, clearlyGujarat needs to do better.Table 6: Inter-State variations in skill formation among youth, 15-24State Share of State in those % youth in State with with formal training (%) formal trainingJammu & Kashmir 0.4 2.0Himachal Pradesh 1.0 5.6Punjab 2.8 4.1Uttarakhand 0.8 3.9Haryana 2.8 4.5Delhi 1.7 4.1Rajasthan 2.5 1.7Indicus White Paper Series 9
  11. 11. Bibek Debroy Gujarat – the Social SectorsUttar Pradesh 6.9 1.7Bihar 0.8 0.5Assam 0.8 1.4West Bengal 6.9 3.2Jharkhand 0.8 1.3Orissa 1.9 1.9Chhattisgarh 2.0 3.5Madhya Pradesh 3.4 2.2Gujarat 6.6 4.7Maharashtra 21.7 8.3Andhra Pradesh 6.6 3.2Karnataka 4.6 3.1Kerala 12.2 15.5Tamil Nadu 11.3 7.6North-East 0.4 1.3Union Territories 1.3 12.6 Where will these skills be needed? At an all-India level, there is some tentativeidentification of where these skill needs are going to be. For instance, within the servicescategory, Planning Commission20 identifies the following for high growth and employment – IT-enabled services, telecom services, tourism, transport services, health-care, education andtraining, real estate and ownership of dwellings, banking and financial services, insurance, retailservices and media and entertainment services. Other sectors mentioned are energy production,distribution and consumption, floriculture, construction of buildings and construction ofinfrastructure projects. Within industry groups are automotives, food, chemicals, basic metals,non-metallic minerals, plastic and plastic processing, leather, rubber, wood and bamboo, gemsand jewellery and handicrafts, handlooms and khadi and village industries. In a separateidentification from the point of view of demand for skills, there is mention of 20 sectors –automobiles and auto-components, banking/insurance and financial services, building andconstruction, chemicals and pharmaceuticals, construction materials/building hardware,educational and skill development services, electronics hardware, food processing/coldchain/refrigeration, furniture and furnishings, gems and jewellery, health-care services, ITES orBPO, ITS or software services, leather and leather goods, media, entertainment, broadcasting,20 Ibid.Indicus White Paper Series 10
  12. 12. Bibek Debroy Gujarat – the Social Sectorscontent creation and animation, organized retail, real estate services, textiles and garments,tourism, hospitality and travel trade and transportation, logistics, warehousing and packaging.Quality issues apart, these are not necessarily the skills being imparted today. And this also has abearing on the modes through which skill development will take place. Certain elements areobvious enough. For example, one should introduce vocational education in schools, especiallybeyond Classes VIII. ITI-s should be upgraded and extended to areas where they are absent.There should be some kind of Skill Development Centre (SDC), if not in every block, at least inevery district. However, to ensure placement, these should be done with the involvement of theprivate sector, such as in the PPP mode, and not by the government alone. However, it must also be recognized that there are several layers in the skills problem.Nor are there clear answers as to the superiority, or otherwise, of public-delivery vis-à-vis privatedelivery.21 There are public-private partnership models in several countries in Europe. In Japan,training is essentially provided through the enterprise, whereas in East Asia, delivery isfundamentally public. At the other end, in Britain and USA, delivery is primarily private.Vocational education through schools works well in USA, Sweden, France, South Korea andTaiwan. Formal employment is low in India and several parallel systems co-exist - the formalpublic (government) training system, public training that caters to the informal sector, the non-government (both private and NGO) network of formal training institutions and the non-government (primarily NGO-driven) system of informal training. In the first category one hasvocational education through schools22, polytechnics through the Ministry of Human ResourceDevelopment, the Craftsmen Training Scheme and the Apprenticeship Training Scheme throughthe Directorate General for Employment and Training under the Ministry of Labour andEmployment. The plans to expand public capacity under the “National Skill DevelopmentPolicy” are essentially under this segment. In the second segment of public training that catersto the informal sector, one has community polytechnics run by the Ministry of Human ResourceDevelopment, the Jan Shikshan Sansthan (JSS) for disadvantaged adults,23 the National Instituteof Open Schooling (NIOS), Ministry of Labour and Employment’s Skill DevelopmentInitiative,24 Ministry of Micro, Small and Medium Enterprises’ entrepreneurship developmentprogrammes and entrepreneurship skill development programmes, Prime Minister’s Rozgar21 See the discussion in, Improving Technical Education and Vocational Training, Strategies for Asia, Asian DevelopmentBank, 2004.22 Especially +2 in secondary schools. A centrally sponsored scheme has existed since 1988. Such training isfollowed by apprentice training under the Apprenticeship Act.23 This can be implemented by NGOs.24 This was started in 2007.Indicus White Paper Series 11
  13. 13. Bibek Debroy Gujarat – the Social SectorsYojana (PMRY),25 the Swarna Jayanti Shahari Rojgar Yojana (SJSRY),26 the Swarnajayanti GramSwarozgar Yojana (SGSY)27 and Department of Rural Development’s RUDSETIs (RuralDevelopment and Self-Employment Training Institutes).28 Ministry of Textiles, DevelopmentCommissioner (Handicrafts), Ministry of Youth Affairs and Sports, Ministry of Women andChild Development, Department of Science and Technology, Ministry of Agriculture, Ministryof Health and Family Welfare, Ministry of Tourism, Ministry of Food Processing, Ministry ofSocial Justice and Empowerment and Ministry of Minority Affairs also have small programmeswith some skill development components. There can be skills deficits that are structural innature. These require candidates to go through longer-duration training. In other instances,shorter-duration interventions will work. And in the last category, all that is required is last-mileunemployability. Against this background, unlike school education, there is no demonstrated marketfailure for technical or higher education, though one can empathize with the State government’sintent to increase capacity in ITI-s and polytechnics and also towards the higher end of thetechnical training ladder (engineering, pharmacy). This is also understandable, since some of thisupgradation is linked to external funding (Union government, World Bank). Interpreted thus,the experiment of switching 72 of the 253 ITI-s to a PPP mode is more interesting. Perhaps theonly exception to that general statement about market failure is for State intervention for specificbackward segments, such as the Kaushalya Vardhan Kendras (KVKs) (launched in 2010-11)targeted at women or special vocational training programmes targeted at tribal youth. But in allfairness, it is not that the principle of private sector involvement is not recognized. For example,some vocational training centres (VTCs) for tribal youth are in the PPP mode. But it is also fairto say that this hasn’t picked up that much steam yet. Having said this, there are few initiatives one should flag. First, the Gujarat KnowledgeSociety, in PPP mode, offers short-duration training. Second, there is SCOPE (Society forCreation of Opportunity through Proficiency in English). Third, there are mini ITI-s andpolytechnics. Fourth, the open school system apart, Gujarat is the only State which hasintegrated ITI education with mainstream education. That is, depending on exit (Standard VIIIor X), one takes a language exam, and after having completed ITI training, is eligible for collegeadmission.25 This was started in 1993 and has an element of training for self-employed entrepreneurs.26 This was started in 1997 and has an element of training in urban areas. It has two separate components for self-employment and wage employment.27 This also has a training component.28 The first RUDSETI was set up in Karnataka in 1982. Ministry of Rural Development also has pilots inpartnership with IL&FS.Indicus White Paper Series 12
  14. 14. Bibek Debroy Gujarat – the Social Sectors We should also mention the question of matching labour supply to labour demand,something that employment exchanges were supposed to do. Unorganized sector male wageemployment is primarily in manufacturing, construction, trading and transport. For women,trading and transport can be replaced by domestic services. How do these workers find out jobsare available and decide on temporary or permanent migration? The answer is simple. Barringlimited instances of job offers at factory gates, there are only two channels: informal (family,caste, community) networks and labour contractors. This kind of information disseminationcannot be efficient, apart from commissions, exploitative or otherwise, paid to agents. Otherthan such dis-intermediation and information dissemination being inefficient, there can be noquestion of skill formation if recruitment is through such informal channels. Clearly, one needsefficient clearing houses that match supply and demand. Employment exchanges have failed todo this successfully in most States, Gujarat being an exception. They have succeeded in a verylimited way with jobs for the private sector and increasingly less with jobs for the public sector.For the private sector, the mandatory requirement of recruitment through employmentexchanges only applies below a threshold level of wages and these have not been revised foryears. Whatever the law may say de jure, there is nothing mandatory about employment exchangesde facto. For the public sector, a Supreme Court judgement in 1996 said that appointments nolonger had to be from the pool that was registered with employment exchanges, as long as jobvacancies were suitably publicized. The public sector also set up channels like Staff SelectionCommissions, Banking Service Commissions and Railway Recruitment Boards. Administrationand expenditure on employment exchanges are now State subjects, an earlier matching grantfrom the Centre having run its course in 1969. So there should be a cost-benefit analysis of theemployment exchanges. Do placements justify the expenditure on them? Gujarat is an exampleof a State that has tried to reform the 41 employment exchanges, with some PPP kind ofinvolvement Gujarat.29 Job fairs have also been held to perform the matching function. UnderUDISHA, there are placement cells in colleges. While there is no denying these positives, including the idea of the KnowledgeConsortium of Gujarat for higher education, for technical and higher education, one can’t avoidthe sense that there is greater scope for the government to step back. Including agriculturaluniversities, there are 21 State universities in Gujarat, 3 Central universities, 16 privateuniversities and 6 institutes of national importance. However, the private ones still tend to be29These are called Rozgar Sahay Kendras in Gujarat, labeled as public-private partnerships. The public employmentexchange provides a database of people on the register (the supply of labour, so to speak) and the private agencymatches it with demand.Indicus White Paper Series 13
  15. 15. Bibek Debroy Gujarat – the Social Sectorsspecialized, with a professional focus. Is there scope for these to expand and for the State towithdraw? The large number of private universities set up in the last 10 years suggests that theanswer is in the affirmative. Such changes can be supply-driven, or react to demand. Theincreases in enrolment in school education imply that the demand for change will come, perhaps10 years down the line, and drive a clear focus in government delivery, away from technical andhigher education, towards school education. Subsidizing the poor and the disadvantagedthrough government financing is a different proposition altogether. From education, let us move on to health. The case for market failure is generally greaterfor health than it is for education. If there is a perception that Gujarat doesn’t do that well insocial sectors, that’s truer of health than of education. However, before turning to Gujarat-specific issues, some general comments are in order. In September 2010, India’s Ministry of Health and Family Welfare presented an annualreport on the state of India’s health, presumably the first of several such status reports.30 Thereis a self-congratulatory under-current in this report. Life expectancy has increased to 63.5 years.Infant and under-5 mortality rates have declined, with the IMR (infant mortality rate) at 53 per1000 live births. Subject to data problems about maternal mortality ratio (MMR), that too hasdropped to 254 per 100,000 live births. All these are 2009 figures. For Gujarat, this reports alife expectancy of 64.1 years, infant mortality rate of 50 and a maternal mortality ratio of 160.However, Gujarat’s IMR has dropped to 44 in 2010. The respective all-India figures are 63.5years, 53 and 254. If Gujarat’s benchmark is better performing States, as it should be, and notall-India averages, obviously Gujarat needs to do better. The Mid-Term Appraisal of theEleventh Five Year Plan reports that 54.0% of Gujarat’s children were immunized in 2002-04and the figure went up to 54.9% in 2007-08.31 For all-India, the respective numbers were 45.9%and 54.1%. To state the obvious, the numbers are dated, not just for Gujarat, but for all States.A National Rural Health Mission (NRHM) was launched in 2005 and for Gujarat, the NHRMsite also mentions that the sex ratio is 920, compared to 933 for India.32 There are several problems with any self-congratulatory under-current. First, dependingon the country with which one is making comparisons, India is still an under-performer inhealth. Second, there is a 2009 country report on India’s progress towards the Millennium30 Annual Report to the People on Health, Ministry of Health and Family Welfare, India, September 2010, White Paper Series 14
  16. 16. Bibek Debroy Gujarat – the Social SectorsDevelopment Goals (MDGs).33 The MDG system has a hierarchy of goals, targets andindicators and several are on health. Stated simply, in terms of progress towards 2015, Indiaperforms far better on poverty reduction and education than it does on any of the health-relatedindicators. While lauding Gujarat on achieving the poverty reduction MDG targets, this MDGreport also states, “The rural‐urban divide in incidence of infant mortality is quite glaring,” andmentions a Gujarat differential of 24. Third, progress has to be benchmarked against what wasexpected or projected. The Eleventh Five Year Plan (2007-12) had projected that by 2012, theMMR would be 100 and the IMR would be 28. On the assumption that these were thenbelieved to be deliverable targets, there has been slippage. Since the Bhore Committee of 1946, there have been 21 committees and commissionswith a direct focus on health, not counting the ones that deal with pharmaceuticals or relatedareas.34 The recommendations of these committees and commissions helped to shape India’shealth-care infrastructure, policy and legislation. Let’s highlight two of these recommendations,because they did argue for choice, competition and efficiency on the supply-side and an end topublic sector monopolies, with suggestions on financing health-care. It’s a different matter thatthese recommendations weren’t implemented and also that those recommendations were madein 1946 and 1948. In 1946, there was the Health Survey and Development (Bhore) Committee, whichrecommended a public health service and the present PHC and CHC system. But the committeealso stated, “The following questions seem, at the outset, to require an answer: (1) Whether theservice should be free or paid for by the recipient: if the latter, whether it should be a gradedscale of payment so as to suit the level of the patient’s income and whether such payment shouldbe made for each occasion when service is rendered or through some form of sicknessinsurance; (2) Whether our scheme should be based on a full-time salaried service of doctors oron private practitioners resident in each local area or settled there on a subsidy basis; (3)Whether, in either case, some measure of choice can be given to the patient as regards hisdoctor” (Vol. II, p. 21). In 1948, the Sub-Committee on National Health (Sokhey Committee)of the National Planning Committee stated, “The availability of medical benefits or nursingservice should not depend upon an individual’s ability to pay for them but that they should bemade available equally irrespective of that ability, as a matter of common obligation of the state33 There have been two earlier reports too. But this 2009 is the latest. Millennium Development Goals, India CountryReport 2009, Mid-Term Statistical Appraisal, Central Statistical Organization, Ministry of Statistics and ProgrammeImplementation, In a collaborative exercise between the Ministry of Health and Family Welfare (MoHFW) and the World HealthOrganization (WHO, India), the reports of most of these committees/commissions are available at White Paper Series 15
  17. 17. Bibek Debroy Gujarat – the Social Sectorstowards its members. Those members themselves may indeed, quite legitimately, be required tocontribute according to their ability, in one form, or another, to the improvement in their healthand living conditions. But irrespective of that contribution, the state must accept the obligationto provide at least a standard minimum of organized health service, including advice andtreatment to every suffering member of the community. … But in so far as active assistance, inthe shape of direct financial provision from the public purse is concerned on hospitals,dispensaries, professional advice, technical apparatus or even sanatoria, nursing homes, asylumsfor mentally defective, this should be as far as possible derived from the contribution of theindividuals insured. It is a healthy principle not only because it teaches people to attendthemselves to avoidable causes or conditions of disease; it is psychologically still more valuablebecause it teaches self-help, eliminates any taint of charity or unearned dole not specificallycontributed to by the individual concerned is apt to engender.” The National Rural Health Mission (NRHM) has already been mentioned. While itsfocus was on improving the health-care infrastructure in rural India, the emphasis was primarilyon child-birth and pre-natal care. For example, the specific targets are about IMR (this includesvaccination), MMR, TFR (total fertility rate), under-nutrition among children, anemia amongwomen and girls (this includes the provision of nutritional supplements), provision of cleandrinking water and raising the sex ratio in the 0-6 age-group. That’s because the reproductiveand child-care programme (RCH) was a key building block of NRHM. The National Commission on Macroeconomics and Health (NCMH) had some reliabledata on major health conditions in terms of their contribution to India’s disease burden, thoughit did not disaggregate this State-wise.35 This is shown in Table 7.36 Category I health conditionsaccounted for almost half the disease burden in Table 7. Some of these pre-transition diseasesare declining in importance. However, there are question marks about HIV/AIDS, somevariants of TB and drug-resistant malaria. Correspondingly, Category II health conditions likecardio vascular disease, diabetes, respiratory conditions like asthma and COPD and mentalhealth disorders are increasing in importance. Category III (accidents and injuries) have alsobeen increasing. The problem is that a heterogeneous country like India, marked by disparities,is both in pre-transition and post-transition stages.35 Disease burden in India, Estimations and causal analysis, Though use was made of National Sample Survey (NSS) data from 1995-96, and NSS data from 2004-05 (but notlater) are now available, there are unlikely to be major changes to Table 1.Indicus White Paper Series 16
  18. 18. Bibek Debroy Gujarat – the Social Sectors Table 7: Health conditions and disability-adjusted life-years (DALYs) lostDisease/health condition DALYs lost (X Share in total burden of 1000) disease (%)Tuberculosis 7,577 2.8HIV/AIDS 5,611 2.11Diarrheal diseases 22,005 8.2Malaria & other vector-borne conditions 4,200 1.6Leprosy 208 0.1Childhood diseases 14,463 5.4Otitis media 475 0.1Maternal & peri-natal conditions 31,207 11.6Other communicable, maternal & peri- 49,517 18.4natal diseasesCancer 8,992 3.4Diabetes 1,981 0.7Mental illness 22,944 8.5Blindness 3,699 1.4Cardiovascular diseases 26,932 10.0Chronic obstructive pulmonary disease 4,061 1.5(COPD) & asthmaOral disease 1,247 0.5Other non-communicable diseases 18,801 7.0Injuries 45,032 16.7Unlisted conditions 68,319 25.4 The core of the delivery problem is in rural India, where primary health-care is providedthrough a network of sub-centres (SCs), primary health centres (PHCs) and community healthcentres (CHCs). Table 8 is based on Central data.37 There are population norms for such SCs,PHCs and CHCs. For instance, a population size of 5,000 must have a sub-centre, a populationsize of 30,000 must have a PHC and a population size of 120,000 must have a CHC.38 A sub-centre has a lady ANM (auxiliary nurse mid-wife) and a male health worker (MHW). There is alady health visitor (LHV) for six such SCs. The PHC is a referral unit for six SCs and has a37 These have been the norms since 2009. However, there are lower population thresholds for hilly and tribal areas.Indicus White Paper Series 17
  19. 19. Bibek Debroy Gujarat – the Social Sectorsmedical officer (MO) and other staff. The CHCs are supposed to have four medical specialists(surgeon, physician, gynecologist, pediatrician), with an anesthetist and eye surgeon eventuallymade mandatory. In parallel with the NRHM, a National Urban Health Mission (NUHM) hasnow been proposed. The Ministry of Health’s Annual Report succinctly states the problem inurban India.39 “However, while there is somewhat a uniform public health infrastructure in therural areas, it is largely non-existent in urban areas except in some large urban centres andmetropolitan cities that too mostly focused on reproductive and child health services.Approximately three-quarters of urban healthcare is accounted for by private health facilities andtherefore, result in substantial out of pocket expenses. The health indicators for the urban poorare as bad as their rural counterparts and much worse than the urban average. Poorenvironmental condition in the slums along with high population density makes them vulnerableto various communicable and vector borne diseases….The poor health outcomes can partially betraced to the inadequate services, like water supply and sanitation, and housing facilities.” Table 8: Gujarat’s Health InfrastructureParticulars Required In position shortfallSub-centre 7263 7274 -Primary Health 1172 1073 99CentreCommunity Health 293 273 20CentreMultipurpose worker(Female)/ANM at 8347 7060 1287Sub Centres &PHCsHealth Worker(Male) MPW(M) at 7274 4456 2818Sub CentresHealth Assistant(Female)/LHV at 1073 267 806PHCsHealth Assistant 1073 2421 -39 Ibid.Indicus White Paper Series 18
  20. 20. Bibek Debroy Gujarat – the Social Sectors(Male) at PHCsDoctor at PHCs 1073 1019 54Obstetricians &Gynaecologists at 273 6 267CHCsPhysicians at CHCs 273 0 273Paediatricians at 273 6 267CHCsTotal specialists at 1092 81 1011CHCsRadiographers 273 124 149Pharmacist 1346 781 565Laboratory 1346 897 449TechniciansNurse/Midwife 2984 1585 1399 The focus thus is on public sector delivery, both in rural and in urban India, despite thestatement that three-quarters of urban healthcare is accounted for by the private sector.However, some empirical work by Jishnu Das shows that even in rural India, access is primarilythrough the private sector. “Typically, households can access multiple providers, ranging fromfully qualified public and private sector providers to those without any formal medical training inthe private sector....According to a recent report, across rural India, the average household canaccess 3.2 private, 0.3 public, and 2.3 public paramedical staff within their village. ..Of thoseidentified as doctors, 65% had no formal medical training and, of every 100 visits to health careproviders, eight were to the public sector and 70 to untrained private sector providers.”40 Forexample, in rural Gujarat, on an average, 1.19 private providers are available within a village, with0.25 public doctors and 3.49 non-doctor public providers. The report in question is animportant one, because it demolishes the proposition that there is a market failure of healthworkers in rural India and that the public sector must fill the void.41 Contrary to a prioriexpectations, the key trends are the following. First, the availability of medical providers in ruralIndia is quite high, nearly 6 available per rural village. Second, more than 50% of medical40 Jishnu Das, “The Quality of Medical-Care in Low Income Countries: From Providers to Markets,” PLOS (PublicLibrary of Science) Medicine, April 2011.41 Mapping Medical Providers in Rural India: Four Key Trends, the MAQARI (Medical Advice, Quality, and Availability inRural India) Team, CPR Policy Brief, February 2011, White Paper Series 19
  21. 21. Bibek Debroy Gujarat – the Social Sectorsproviders are private providers. However, third, the majority of medical providers have nomedical qualifications. 65% have no formal medical training. Fourth, most households visitprivate doctors and doctors with no medical qualifications.42 92% go to private providers and79% go to unqualified providers. A private market thus exists. The problem is with its quality and lack of regulation. Incontrast, the public sector provisioning may not have problems of regulation, but it continues tohave problems of access and quality. It is because of this lack of service quality in public sectordelivery, spliced with the non-availability of drugs, that patients resort to the private sector. With those kinds of problems with public delivery, In ad hoc fashion, several States have also experimented with PPP models in deliveringhealth-care, outsourcing and levy of appropriate user charges. The Ministry of Health and FamilyWelfare has a database that collated these and other reform attempts.43 Gujarat itself hasexperimented with user charges. Typically, such charges are imposed for diagnostic and curativeservices on patients above the poverty line, while those below the poverty line are exempted andcontinue to receive free and subsidized services. Gujarat’s government hospitals and CHCs haveRogi Kalyan Samitis, which are explicitly expected to outsource non-core activities.Simultaneously, the Gujarat Medica Service Corporation Limited was set up to procure bulkgeneric drugs. In the course of formulating the 11th Five Year Plan (2007–12), the PlanningCommission constituted a Task Force on Public–Private Partnerships (PPP) to improve health-care delivery.44 Instead of the classic obsession with increasing public expenditure and assumingthat it must be equated with public provisioning, the task force’s report indicates how choice andcompetition can be introduced. The report begins by accepting the inevitable, instead ofquestioning it, namely, the importance of the private sector, both for profit and non-profit. Thisdoes not negate the point about lack of regulation, since the quality of health-care provided bythe private sector varies. In general, private health-care services are also more expensive thanpublic ones, more so for in-patient services. Services can also be contracted out on a temporarybasis to the private sector. The government can pay an outside agency to manage a specificfunction, or government facilities can be leased to private entities. Subsidies meant for the poorcan be routed through private entities. While there can be no universal template, there are twopropositions that are clearly myths – first, everything has to be delivered by the public sector;42 The word “doctor” is being used in loose fashion. It does not imply the possession of a MBBS degree.43 Ministry of Health and Family Welfare (MoHFW), 2007, “Health Sector Policy Reform Options Database ofIndia(HS-PROD)”.44 Government of India, 2007, Draft Report on Recommendations of Task Force on Public Private Partnership for the 11th Plan,Planning Commission, White Paper Series 20
  22. 22. Bibek Debroy Gujarat – the Social Sectorssecond, the poor are unwilling to pay. The usual approach to addressing health problems is oneof increasing public expenditure on health, the argument being that out-of-pocket (OOP)expenditure on health-care is too high. While this is true, this is more of an insurance issue andits delivery. Since insurance has been mentioned, let’s flag this first. The Rashtriya Swasthya BimaYojana (RSBY) is a Centrally sponsored health insurance scheme, meant for BPL households,with a matching contribution by the State government. The BPL data have to conform toPlanning Commission specifications. Started on a pilot basis in 5 districts in 2008-09, this nowcovers 1.9 million rural BPL families and in 2011-12, was extended to 1 million urban BPLfamilies too. Through smart cards, this ensures cashless treatment in recognized hospitals, notjust public, but private too. Since the public health-care infrastructure is weak, as has beenmentioned earlier, the Chiranjivi Yojana also taps the private sector, to employ private sectorspecialists in safe delivery. While the poor household doesn’t have to pay, the government paysthe private sector specialist. The Chiranjivi Yojana was first introduced on pilot basis in 2005and has picked up since then. For example, there were 7,793 beneficiaries in 2005-06 and150,979 in 2010-11. The Chiranjivi Yojana has won several awards. The Bal Sakha Yojana has asimilar PPP idea. It was launched in 2009 and covers all BPL households and tribal households,even if they happen to be APL. Neo-natal care is provided by private enrolled pediatricians, whoare then reimbursed by the State. Finally, there is the recently launched Mukhyamantri AmrutamYojana, to cover some categories of hospitalization and surgery for BPL households, throughempanelled healthcare providers, public or private. Health-care has several dimensions. There is the preventive part, interpreted as cleandrinking water, sanitation, sewage treatment and nutrition, be it through MDMS, ICDS, vitaminsupplements or otherwise. Incidentally, in ULBs, Gujarat has several pay and use toilets in BOTmode. There is a KPSY (Kasturba Poshan Sahay Yojana) for nutrition during pregnancy. Thereis also the preventive part, interpreted as immunization. The State government’s focus hasclearly been on reducing neo-natal deaths and bringing down the IMR and MMR. That’s wherethe Janani Suraksha Yojana (JSY) comes in, designed to shift poor women to institutionaldelivery. The number of JSY beneficiaries went up from 12,573 in 2005-06 to 342,211 in 2011-12.45 Simultaneously, the percentage of institutional deliveries has sharply gone up from 55.87%in 2003-04 to 93.5% in 2011-12. Immunization coverage has also increased. Obviously, thisisn’t because of JSY alone. JSY should be considered in conjunction with the JSSK (JananiShishu Suraksha Karyakram), a CSS for subsidized delivery and treatment for infants. There has45 White Paper Series 21
  23. 23. Bibek Debroy Gujarat – the Social Sectorsbeen an IMNCI (Integrated Management of New Born and Childhood Illness), launched in2005, combined with Mamta (Malnutrition Assessment and Monitoring to Act) initiatives, whicheffectively register a mother and child and track post-natal nutrition, health and immunizationstatus. E-Mamta computerizes this tracking. The Mamta Abhiyan has four separatecomponents – Mamta Divas (Health and Nutrition Day), Mamta Mulakat (post-natal care visits),Mamta Sandarbh (referral services) and Mamta Nondh (recording and reporting). Perhaps themost interesting of all these experiments is the emergency 108 number, which is not just formedical emergencies, but for police and fire emergencies too. This was launched in 2007 and isoperated by GVK Emergency Management and Research Institute (EMRI). There are now 506ambulances and all districts have been covered. On an average, there are between 2000 and2,200 108 calls every day. Data are dated. When more current data come in, these interventionsshould logically show declines in both IMR and MMR. It is undeniable that Gujarat’s base inhealthcare outcomes was low. It is also true that dated data reveal this. But as more recent datacome in, these interventions should show improvements. There remains the matter of the sex ratio and the Pre-conception and Pre-NatalDiagnostics Techniques (PC & PNDT) Act and its enforcement, or lack. Table 9 shows the sexratios. Gujarat’s sex ratios are well below national averages, though the decline has been lesssharp between 2001 and 2011. What’s important is not the overall sex ratio, as in Table 9, butthe child sex ratio, which is worst in districts like Surat, Gandhinagar and Mahesana. These arerelatively more prosperous districts and as with elsewhere in India, there is a positive correlationbetween female feticide and income, infanticide being a slightly different issue. However,beyond awareness and stronger enforcement of the PC & PNDT Act, it is difficult to see whatcan be done. This is essentially what the Beti Bachavo Abhiyan is about. After all, one is talkingabout complicated socio-economic and cultural phenomena, reflective of the status of women. Table 9: Sex ratios 1951 1961 1971 1981 1991 2001 2011Gujarat 952 940 934 942 934 920 918Kachchh 1079 1041 1012 999 964 942 907Banaskantha 951 947 941 947 934 930 936Patan 971 956 957 963 944 932 935Mahesana 1003 974 961 974 951 927 925Sabarkantha 973 954 965 976 965 947 950Gandhinagar 992 961 936 943 935 913 920Indicus White Paper Series 22
  24. 24. Bibek Debroy Gujarat – the Social SectorsAhmedabad 836 852 863 888 897 892 903Surendranagar 958 943 941 934 921 924 929Rajkot 988 963 947 947 946 930 924Jamnagar 986 952 942 949 949 941 938Porbandar 1001 962 952 967 960 946 947Junagadh 976 949 933 954 960 955 952Amreli 974 959 957 980 985 987 964Bhavnagar 955 936 944 954 944 937 931Anand 906 890 880 905 912 910 921Kheda 918 914 907 924 924 923 937PanchMahals 922 925 930 942 934 938 945Dohad 954 954 964 984 976 985 986Vadodara 914 906 900 915 913 919 934Narmada 938 952 961 954 947 949 960Bharuch 946 945 944 938 925 921 924The Dangs 877 913 946 970 983 987 1007Navsari 1041 1030 1002 975 958 955 961Valsad 1001 1005 992 989 957 920 926Surat 973 967 943 908 882 810 788Tapi 959 972 957 989 987 996 1004Indicus White Paper Series 23
  25. 25. Bibek Debroy Gujarat – the Social SectorsAbout the Author:Bibek Debroy (born 25 January, 1954) is an Indianeconomist, who is currently a Research Professor at theCentre for Policy Research, New Delhi. He was educatedat Presidency College, Calcutta, Delhi School ofEconomics and Trinity College, Cambridge. Prof. Debroyhas taught at Presidency College, Calcutta, the GokhaleInstitute of Politics and Economics, Indian Institute ofForeign Trade and National Council of Applied EconomicResearch.His past positions include the Director of the Rajiv GandhiInstitute for Contemporary Studies at Rajiv Gandhi Foundation, Consultant to the Departmentof Economic Affairs of Finance Ministry (Government of India), Secretary General of PHDChamber of Commerce and Industry and Director of the Project LARGE (Legal Adjustmentsand Reforms for Globalising the Economy), set up by the Finance Ministry and UNDP forexamining legal reforms in India. Between December 2006 and July 2007, he was the rapporteurfor implementation in the UN Commission on Legal Empowerment for the Poor. Prof. Debroyhas authored several books, papers and popular articles, has been the Consulting Editor of someof the most prominent financial newspapers in the country and is now Contributing Editor withIndian Express. He is a member of the National Manufacturing Competitive Council. He is alsoa member of the Mont Pelerin Society.Indicus White Paper Series 24
  26. 26. About IndicusIndicus Analytics is an economics research and data analysis firm based in New Delhi. Indicus follows the progress of themany facets of the Indian economy at a sub-national and sub-state level on a real time basis. It conducts monitoring andevaluation studies, indexation and ratings, as well as policy analysis. Simply put, Indicus is Indias leading economicsresearch firm.Indicus provides research inputs to governments, research organizations, civil society, media, international institutions andcorporates. Some examples of Indicus study sponsors include academic institutions such as Harvard, Cambridge, StanfordUniversities; national and international government organizations such as DFID,USAID,RBI,Finance Commission apartfrom various ministries; international organizations such as World Bank, UNICEF, UNDP; media groups such as IndiaToday, Outlook, Indian Express; corporates such as IKEA, Microsoft, VISA; consulting firms such as McKinsey, BCG,E&Y; NGOs and civil society organizations such as National Foundation of India, Liberty Institute; to name a few.DisclaimerThe information contained in this document represents the current views of the author(s) as of the date of publication. ThisWhite Paper is for informational purposes only. The author(s) and Indicus makes no warranties, express, implied orstatutory, as to the information in this document. No part of this document may be reproduced, stored in or introduced intoa retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, recording, orotherwise),or for any purpose,without the express written permission of the author(s). iNDICUS Indicus Analytics Pvt. Ltd. 2nd Floor, Nehru House, 4 Bahadur Shah Zafar Marg, New Delhi-110002, INDIA. Phone : 91-11-425 12400, e-mail : Web :