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Sex Work and the Law: A Case for Nuanced Debate

23 Dec

The debate over legalization vs decriminalization of prostitution is in the public domain with reports that the National Commission for Women has recommended legalization to the Supreme Court appointed panel for rehabilitation of sex workers. The panel, formed in 2011 when the Supreme Court suo motu converted a criminal appeal relating to a murder of a sex worker into a PIL, is in the process of consulting various stakeholders.

The mandate of this panel was to recommend measures for the rehabilitation of sex workers who wished to leave sex work, and conducive conditions for sex workers who wish to continue working in the profession.

Magnitude of the issue

Estimates of the number of women engaged in prostitution have increased over the years. In 1997, a report of the National Commission of Women put it at 2 million, in 2004, a study sponsored by the Ministry of Women and Child Development estimated it to be 3 million of which 36% were children and a 2013 report on sex trafficking by Dasra, a philanthropic foundation estimated that about 20 million women were engaged in the profession. The 2013 report showed that 80% of these women are victims of sex trafficking. Most disturbingly, out of the estimated 16 million women who are trafficked, 6 million are children under 18 years of age. There is however no official estimates available since 2004 of the prevalence of prostitution.

According to the 2013 report, the prevalence of prostitution is highest in states such as Arunachal Pradesh, Andhra Pradesh, Gujarat, Karnataka, Goa, Madhya Pradesh, Maharashtra, Nagaland, Rajasthan, Tamil Nadu and West Bengal as well Union Territories like Chandigarh and Daman and Diu.

Multiple factors lead to women becoming prostitutes, the most common of which are illiteracy, lack of vocational skills, economic distress, migration, desertion by spouse, ill-treatment by parents and family tradition. Most work in miserable conditions leading to different types of diseases, depression and hopelessness. They are also faced with daily violence, constant police harassment and societal ostracisation. Given the informal economy in which they work, they also find it difficult to open bank accounts, get insurance or identification cards.

The threat of HIV/AIDS also looms large –  reports say prevalence of HIV/AIDS among this category ranged between 2% and 38% in India (globally it is about 12%). However, due to their ambiguous legal status, they are unable to get access to basic services including healthcare, education and bank accounts.

Not prohibited, but is it permitted?

According to the Immoral Trafficking Prevention Act, 1956 (ITP Act), “prostitution” is defined as the sexual exploitation of persons for commercial purposes. While it does not prohibit sex work per se, it imposes penalty for keeping a brothel, soliciting, pimping and plying the trade near a public place such as places of worship, schools and hospitals.

In 2006, India moved towards decriminalization of prostitution when it attempted to amend the ITP Act by deleting the provision that penalized soliciting and adding a provision that penalized clients of sex workers who were trafficked victims. However the Bill lapsed with the dissolution of the 14th Lok Sabha. These provisions were not well thought through given that it did not clarify the confusion about the profession’s basic legal status since provisions such as penalizing clients, prostitution in brothels and public places made it difficult for prostitutes to practice their trade legitimately.

What works?

In most of Asia, Africa and parts of the US, prostitution is illegal. Some states in Australia and New Zealand have decriminalized prostitution (no penalty for prostitutes) while Sweden, Norway, Iceland and Nepal penalize the client on the ground that prostitution is an aspect of male violence towards women. Prostitution is legal in most countries in Latin America and Europe and in some parts of the US.

The evidence however is not clear either ways. Some studies do show a correlation between legitimizing sex work and a drop in violence targeting sex workers while others show that it has resulted in increase in human trafficking.

Decriminalising – the way forward

As we re-open the debate about prostitution, Legalization in India may not improve matters given India’s lax law enforcement mechanism as well as cultural milieu. The safest option at this point may be decriminalizing the trade so that sex work per se is not legalised but sex workers are not harassed and exploited by the police, brothel owners and pimps (middlemen).   It would also reduce barriers to essential health services, education, bank accounts, insurance, voter identity cards. The government needs to play a crucial role by providing credible rehabilitation options if any of them want to opt out.

The recently enacted Criminal Laws (Amendment) Act, 2013 includes provision to penalize trafficking for any purpose. However, the government needs to strengthen its efforts to combat trafficking by dedicating resources, strengthening capacity of existing institutions and encouraging other stakeholders to leverage their own resources and expertise to address this serious problem. Considering the cross-regional and interdisciplinary nature of trafficking, there is a need to build and provide sustainable support to networks that bring together various stakeholders linking source and destination areas, frame common objectives and ensure accountability and effective delivery on the ground. 

The piece was first published on the Bharti Institute of Public Policy, ISB’s blog.

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A parliamentary budget office for India

22 Nov

By Kaushiki Sanyal and Sruti Bandyopadhyay
This article was first published in Mint on Nov 20,2013
At a time when India is going through an economic slow down, it seems counter-intuitive to enact legislation such as the National Food Security Law or continue to dole out subsidies that end up benefiting rich farmers. One reason for these economically questionable actions is the political dividend that parties hope to reap. However, there may be other reasons at work—the lack of understanding among parliamentarians of far-reaching economic impact of government policies. This has grave consequences for a parliamentary democracy where financial oversight is one of the key functions of a legislator. It may also explain to some extent the relative lack of debate on fiscal matters in Parliament.
Data released by PRS Legislative Research since 2000 shows that Lok Sabha has not spent more than 45% of its time discussing the budget. In 2013, Parliament did not discuss the budgetary proposals of any ministry (demand for grants). All were “guillotined” i.e., put to vote without any discussion. In case of Bills, the debate hardly ever goes into their fiscal implications. Financial memoranda of Bills only provide the estimated expenditure at the Union level. For example, the Right to Education Bill, 2008, which required the government to reimburse unaided schools for expenditure on every child, did not provide any estimate for this purpose. The Food Safety and Standards Bill, 2005, only budgeted for setting up the Food Safety and Standards Authority of India. It did not specify whether the cost of implementing this law would be different from the existing system, nor did it account for the enforcement costs to be borne by state governments.
What is holding back members of Parliament (MP) from questioning the executive on fiscal matters? The problem may be lack of expertise among MPs and lack of access to objective and high-quality research that is independent of the executive. Unfortunately, MPs in India do not have a staff of high quality researchers (unlike in other developed democracies) to help them gain expertise in budgetary matters. The institutional research support within Parliament such as a library and reference service is limited due to resource constraints, nor are their research products available readily in the public domain.
A remedy for this may be the establishment of a parliamentary budget office (PBO) in India—a common feature across many countries ranging from developed democracies such as the US, the UK, Canada, Australia, Korea, to Hungary, Uganda, Kenya, Thailand and Bangladesh. PBOs provide legislators with high-quality analysis that is independent of the executive. They specialize in objective and policy neutral analysis on the full budget cycle, the broad fiscal challenges facing the government, budgetary trade-offs and the financial implications of legislative proposals. Such research can raise the quality of debate and scrutiny in Parliament as well as enhance fiscal discipline. Most importantly, it strengthens the role of Parliament in financial oversight.
The key challenges faced by any country that establishes a PBO are threefold—guaranteeing independence and viability of the office in the long-run; ability to carry out truly independent analysis; and demonstrating impact. Countries have adopted different models to suit their specific needs.
The degree of independence of the PBOs varies across countries—in the US, Korea, Uganda, Kenya, Canada and Australia, PBOs fall within the jurisdiction of the parliament, while in Sweden and the UK, it is under the executive. India will need to ensure the independence and non-partisanship of such a body for it to have credibility with legislators. This may best be done if it is established as a statutory body reporting directly to Parliament. A clear set of deliverables may be desirable.
The functions of the PBOs may differ too. For example, the US Congressional Budget Office (CBO) provides information on economic outlook, cost estimates of specific legislative proposals, long-term budget outlook etc. The Canadian PBO provides independent budget projections, fiscal sustainability report, and financial analysis of Bills. In Uganda and Kenya, PBOs exclusively cater to requests from committees while Canada carries out service requests from individual MPs but ranks them below committee requests in terms of importance. The US services requests from committees as well as individual legislators. The UK also caters to individual MPs. It may be worth it in terms of strengthening the legislature if the Indian Parliament were to invest in a well-funded, professionally-run PBO that would cater to both individual MPs and committees.
Has there been any discernable improvement in fiscal oversight in countries which have established PBOs? This is a difficult question to answer given the complexity of policy-making. However, there are some encouraging results. The Canadian PBO contested the true cost of the war in Afghanistan and most famously, exposed the real cost of the government’s proposed F-35 fighter jet procurement. In the US, the CBO focuses on costing or scoring legislative proposals relative to the baseline. This has helped discourage Congress from making unaffordable proposals. In Australia, the PBO does a costing of different political parties’ electoral manifestos, which can discourage unaffordable election commitments.
India will surely benefit from an institutional mechanism that strengthens the capacity of the legislature to hold the executive responsible in financial matters.
It is important to understand that a PBO can only provide independent research; it certainly cannot prevent executives from taking bad fiscal decisions.

India – No country for women?

17 Sep

A fast track sessions court in Delhi awarded the death penalty to the four adult rapists in the December 16 gang-rape case where a young woman was raped and brutalized by six men.  One of the culprits was a juvenile who was sentenced to three years in a remand home (the highest punishment under the Juvenile Justice Act) and the fifth died in custody.  Ironically, according to a newspaper report, of the 23 rape cases Additional Sessions Judge Yogesh Khanna (the presiding judge) heard this year, 20 of them resulted in acquittal, primarily because the evidence against them was not strong.

In another recent incident, a photo-journalist was gang-raped at the Shakti Mills compound in Mumbai giving a blow to its reputation as one of the safest cities in India for women.  It has now come to light that these men were repeat offenders having raped around 10 women including a rag picker and a sex-worker in the last six months.

And this brings us to the core of the problem – the impunity with which the men feel they can get away with sexual crimes in India.  A toxic mix of patriarchal and regressive values about women’s honour and purity, inert judiciary and an unresponsive and ill-trained police force combines to ensure that women rarely report sexual crimes.  If they do report, they are often subjected to further trauma by the police force who may refuse to file FIRs, blame the victim, and make her undergo degrading medical tests.  While collection of forensic evidence is crucial for investigating a rape, the police are hardly trained in new and scientific investigating techniques nor are there sufficient laboratories to process forensic evidence in a timely manner (see here and here).  The judiciary is also no less to blame for causing trauma to a rape survivor – whether through delays or allowing the moral character of the woman to be called into question.

In India, women are subjected to milder forms of street sexual harassment such as groping, stalking, flashing, passing lewd remarks almost on a daily basis.  In fact, such harassment is so rampant in public places that it is taken as normal.  Often women themselves are blamed for such actions.  Therefore, few women even bother to complain and treat it as something that is upto them to avoid.

The public outrage triggered by the brutal rape of December 16 in Delhi finally broke the silence and apathy surrounding these issues.  It also forced the government to set up a committee under the chairmanship of Justice J.S. Verma to recommend changes to the rape laws.   It made wide-ranging recommendations on laws related to rape, sexual harassment, trafficking, child sexual abuse, medical examination of victims, police, electoral and educational reforms.  Based on some of these recommendations, the government promulgated the Criminal Laws (Amendment) Ordinance amending the Indian Penal Code.  The Ordinance became an Act of Parliament when it was passed in the Budget Session of 2013.

However, a lot of the public debate is focussed on the type of punishment that should be meted out to rapists – castration, death penalty or life-imprisonment.  High penalty may be a deterrent only if there is certainty of prosecution, which is sorely lacking given the condition of the police and judiciary.  The data from the National Crime Records Bureau show that while registration of cases has been rising, the conviction rate remains at a low 13%-14%.  The high number of pending cases is also a cause for concern.

Table 1 provides a snapshot of the penalty levied for certain sexual crimes against women and the number of cases registered each year since 2008.  It may be noted that the new Criminal Laws (Amendment) Act, 2013 which amended the Indian Penal Code among other Acts have added new offences such as acid attack and stalking and changed the quantum of punishment in existing offences.  The data for these offences would be available from next year.

Table 1: Penalty for sexual crimes and number of cases registered

Sexual Crimes Penalty 2009 2010 2011 2012
Rape (Sec 376 IPC) 7 years to life (lower for marital rape) 21,397 22,172 24,206 24,923
Molestation (Sec 354 IPC) Upto 2 years & fine 38,711 40,613 42,968 45,351
Sexual harassment (Sec 509 IPC) Upto 1 year & fine 11,009 9,961 8,570 9,173
Indecent Prohibition of Women (Prohibition) Act, 1986 Upto 2 years & fine of Rs 2000 (increases on second offence) 845 895 453 141
Immoral Traffic (Prevention) Act, 1956 Varies between 3 months to 14 years 2,474 2,499 2,435 2,563
Total crimes 74,436 76,140 78,632 82,151
Sources: Indian Penal Code; Indecent Representation of Women Act,1986; Immoral Traffic (Prevention) Act, 1956; “Crime in India -2012,” National Crime Records Bureau.

Table 2 provides the data for the cases of crimes against women that were tried, convicted and acquitted since 2009.  Crimes against women include rape, kidnapping & abduction of women and girls, dowry deaths, molestation, sexual harassment, cruelty by husband and relatives, importation of girls, Immoral Traffic (Prevention) Act, 1956, Dowry Prohibition Act, 1961, Indecent Representation of Women Act, 1986, and Sati Act,1987.

Table 2: Cases of crimes against women that were tried, convicted, acquitted and pending

 

Status of Cases

Year Registered Trials completed Conviction Acquittal % of convictions
2009 203,804 100,611 27,977 72,634 13.7%
2010 213,585 108,933 30,270 78,663 14%
2011 228,650 112,368 30,266 82,102 13%
Sources: “Crime in India – 2012”; National Crime Records Bureau.

As the data shows, there has certainly been an increase in registration of rape cases.  On the one hand this is a cause for concern, on the other it may be a sign that more people are coming forward to register rape cases.  Therefore, it is difficult to conclude whether the number of incidents of rape has gone up or the registration of cases has improved.  However, the high pendency in courts and the low rate of conviction point to the dire need for police and judicial reforms.  Various commissions such as the National Police Commission, the Law Commission, the Gore Committee, the Ribeiro Committee, the Padmanabhaiah Committee and the Malimath Committee have made extensive suggestions to reform the police.  However, hardly any far-reaching reforms have been undertaken to overhaul the law enforcement machinery in the country.

In order to ensure that women not only feel safe to venture unaccompanied in public places but also report crimes, the government, judiciary and civil society need to change their approaches drastically.  The government needs to muster the political will to ensure an independent, well-trained and well-equipped police force.  It also needs to legislate judiciously and ensure that the laws are implemented.  The judiciary needs to tackle pendency, fine-tune the process of selection of judges and ensure that there is better quality of judicial infrastructure and manpower.  Last but not the least, civil society is crucial for not only pressurizing the government to act but also to initiate far-reaching changes in the way women are treated in the country.

Let the public participate

5 Aug

This post was first published in Takshashila’s Pragati – The Indian National Interest Review on May 3, 2013.  The article can be accessed here.

Given the failure of many government legislations in achieving the objectives for which they were formulated, a case for institutionalising deeper public consultations in the legislative process has been made in the recent past. Currently, there are four entry points where citizens can participate in the legislative process: first, the identifying stage; second, the drafting stage; third, the legislative stage; and fourth, the post-legislative stage.

Civil society organisations can alert the government to the need for a particular legislation or changes in an existing law. The Mazdoor Kisan Shakti Sangathan, a farmers and workers group, ran a successful campaign for a Right to Information law, which was finally enacted in 2005. The recent anti-corruption agitation led to the introduction of a Lokpal Bill currently pending in the Rajya Sabha. The long-running Right to Food campaign by a network of NGOs has been instrumental in raising awareness about chronic hunger and the eventual introduction of the National Food Security Bill in 2011.

The government can also suo moto decide that a law is required in a particular sector. It may get inputs from specialised bodies such as the National Human Rights Commission and the Law Commission or appoint a group to study a sector and draft a law. These groups or bodies may hold consultations with independent experts and stakeholders. Furthermore, an individual Member of Parliament (MP) can also introduce a Bill in either House. This is known as a Private Member’s Bill (for example, Lok Sabha MP, Kalikesh Singh Deo introduced the Disclosure of Lobbying Activities Bill in 2013 to regulate lobbying activities). Although these are generally never passed, they act as signalling devices to the government, which may introduce its own legislation on the subject. It is possible for the public to approach their constituency representatives to advocate for a particular law.

Government Bills are drafted by the concerned ministry, which is then vetted by other ministries. There are also times when the government approaches an independent expert to draft a law. Recently, it appointed the Financial Sector Legislative Reforms Commission, under the chairmanship of Justice BN Srikrishna to reform the financial sector laws.

The government may publish the draft legislation in the public domain for feedback. Drafts of the Electronic Service Delivery Bill, the National Sports Bill and the Land Acquisition and Resettlement Bill were published for a specified time period (generally 20-30 days). It may also circulate the draft among a select set of stakeholders for comments.  An individual MP may solicit public feedback on his Private Member Legislation. For example, Biju Janata Dal, MP Baijayant Panda uses his personal website and social media tools such as Facebook to publicise the draft of his private member bills.

There are few avenues of public engagement once the Bill is introduced in the Parliament. Since 1993, 24 Department-related Standing Committees (DRSCs) were formed to scrutinise Bills and other policies of the Government (before 1993 Bills were sometimes referred to ad-hoc committees for scrutiny). Generally most Bills are referred to these DRSCs, however, the presiding officer of the House has the discretion not to do so. For instance, key Bills such as the Special Economic Zones Bill, 2005 and the National Investigation Agency Bill, 2008 were not referred to a DRSC. In contrast, the Lokpal Bill passed by the Lok Sabha was sent to a Select Committee by the Rajya Sabha although it had been examined by the DRSC.

These DRSCs may solicit feedback from the public by issuing notices in key newspapers and the Gazette of India. The public comments are also tabled in the form of a report. However, the level of public engagement varies with different Bills. For instance, the DRSC scrutinising the Companies Bill, 2009 received 101 comments while only 10 submissions were received for the Armed Forces Tribunal (Amendment) Bill, 2012.

The government is not bound to accept the recommendations of the DRSC but individual MPs may introduce amendments to the Bill when it is being considered by the House. The MP may suggest amendments based on the DRSC’s suggestions or any public feedback.

Once Bills are enacted, ministries draft and notify Rules (also known as subordinate legislation) to enable their implementation. These Rules may be scrutinised by the Subordinate Legislation Committee, which is empowered to seek public feedback.

Post legislative scrutiny of laws is not mandatory in India. It may however be undertaken by bodies such as the Law Commission of India, the DRSCs or a specific commission appointed for the purpose who may hold public consultations. Recently, rape laws were reviewed by the Justice Verma Committee before an Ordinance was promulgated on the matter.

Many other democracies have devised meaningful ways to encourage public participation in the legislative process. In countries such as the UK, Australia and South Africa, it is mandatory to hold public consultations or publish draft Bills for comments. In fact, in South Africa it is a constitutionally mandated provision. In the UK, the Government publishes Green Paper and White Paper, which sets out its central ideas on the Bill. After introduction, it is compulsory to refer a Bill to a committee in the UK and the US. However, there is no such requirement in Australia, Canada and South Africa. Unlike in India and South Africa, it is mandatory for the Government in countries such as the UK, Australia and Canada to respond to the recommendations of the committee. While post legislative scrutiny in India is largely a matter of discretion of the Government, in the UK it is compulsory to do so within three to five years. In the US, legislative oversight committees review laws on a continuous basis. In Australia, most laws have to be reviewed within three years.  Public comments are also solicited during the post-legislative scrutiny.

India can learn from the experience of these countries and tailor them to suit our requirements. There are many ways in which the government can deepen public engagement in the legislative process.

First, ministries can be mandatorily required to publish the draft Bill for a reasonable time and publicise it through different media. Along with the draft Bill, the ministry may be required to include available background information on the subject and facilitate access to legal and legislative record on the matter.

Second, it should be compulsory to refer a Bill to a DRSC or select committee for scrutiny. This could be at both the pre-legislative stage and the legislative stage.  These committees should be required to hold wide consultations with a variety of stakeholders (NGOs, state and local governments, special interest groups, academics and legal experts). Public participation may be facilitated by increasing access to constituency offices, using a variety of media outlets to publicise the Bill and creating public participation offices that can interface with the public.

Third, in order to increase transparency in the feedback process, the government could be required to publish a report demonstrating how the inputs from stakeholders have been considered while formulating the law.

Fourth, most Acts should be subject to a post legislative scrutiny through public engagement every three to five years.  This could be carried out if each Bill includes an Explanatory Note giving the criteria or outcomes by which the Bill could be judged for effectiveness.  This responsibility could be given to a specialised committee.

Such measures will result in robust legislations, which shall need lesser amendments and will be successful in achieving the objective with which that legislation was enacted.

This shortcut weakens democracy

25 Jul

By Harsimran Kalra and Kaushiki Sanyal

This article was first published in the Hindustan Times on July 23, 2013 (see here)

The promulgation of the National Food Security Ordinance on July 5, shortly before the Parliament session, has raised many eyebrows. Political pundits are speculating that it is a last ditch attempt by the UPA to garner votes before the 2014 general elections. The UPA 2, on its part, has blamed the repeated disruptions in Parliament for this executive intervention.

Leaving political motives aside, the circumstances in which this ordinance was promulgated also raise the issue of propriety. An ordinance can be promulgated by the president only when Parliament is not in session and ‘immediate action’ is required. Therefore, it is in the nature of an emergency power, rather than a means to bypass the legislature. Given that Parliament is going to reconvene in a few weeks and there is already a similar Bill pending in Parliament, has the government acted within the lakshman rekha crafted by the Constitution over the executive’s law making capacity?

The power of ordinance was devised to overcome extraordinary circumstances, however, this power has not been used sparingly. Over 600 ordinances have been promulgated in India. Except, 1963, not a single year has gone by without the government resorting to the ordinance-making power. In fact, in 1994, 34 ordinances were promulgated, the highest in a year till date. Also, in this year itself, the government has promulgated four more ordinances, including the Criminal Laws (Amendment) Ordinance, which amended India’s rape laws.

Successive governments have given short shrift to the ’emergency’ test. Right from the inception of the Constitution, reliance was often placed on ordinance powers to deal, not with emergencies, but failures in negotiating the legislative process. Within the first 20 years after the Constitution was adopted, over 30 ordinances were promulgated a few days before Parliament began or after it ended. The two recent ordinances – Criminal Law (Amendment) Ordinance and the Food Security Ordinance – also hardly meet the emergency criteria. Both these ordinances seek to address deep-rooted problems of the country, which have been raised by many experts and activists over the years. The government has not shown any urgency in taking action over the years so it is not clear what recent emergency triggered their promulgation. Moreover, both these ordinances replaced related Bills that were already at an advanced stage in the legislative process. The Criminal Laws (Amendment) Bill was pending with the standing committee while the discussion on the food security Bill had already been initiated in the Budget session of Parliament.

Parliamentary process and democratic checks are circumvented when an ordinance is issued while a related Bill is pending in Parliament. Instances of this disregard for the spirit of the Constitution are many, right from 1954 when the Press (Objectionable Matters) Amendment Ordinance was promulgated. Other instances include the Essential Commodities (Special Provision) Ordinance, 1997 and the Indian Telegraph (Amendment) Ordinance, 2003.

In light of the public debate that raged around both the recent ordinances, due opportunity ought to have been secured to discuss the issues in Parliament. Although the ordinance has to stand the test of Parliament and be passed within six weeks of the session, this is more in the nature of a check in the political plan of the government. Passage of the ordinance on the floor of the House within the stipulated time becomes a face saving exercise instead of a deliberative, consensus building effort. What does the repeated use of ordinance-making power mean for a democratic nation with a robust parliamentary system? Are there structural weaknesses that need to be addressed so that governments are not allowed to rely excessively on ordinances? The time is ripe to devise measures that would deepen our democratic credentials such as allowing for wider public consultations; encouraging governments to engage with the Opposition to break the legislative log-jam and a stricter test of ’emergency’ for issuing an ordinance that would be open to assessment by the legislature.

Is the Food Security Ordinance a game-changer for India’s poor?

23 Jul

Citing the disruptions in Parliament, the UPA government decided to promulgate the National Food Security Ordinance on July 5. Under Article 123 of the Constitution, the President can promulgate an Ordinance when Parliament is not in session and there is need for ‘immediate action’. It is possible that the government has crossed a line of Constitutional propriety by promulgating this Ordinance since Parliament is about to convene in a few weeks and there is a similar Bill already pending in Parliament. This issue will be explored more fully in my next blog post. In this post, I propose to examine the key highlights of the Food Security Ordinance and whether it would deliver food security to the citizens of this country.

Highlights of the National Food Security Ordinance

  • It entitles upto 75% of the rural population and 50% of the urban population to 5 kg food grains per month at a subsidized rate.
  • Rice, wheat and coarse grains will be sold at Rs 3, Rs 2 and Rs 1 per kg respectively.
  • Central government shall decide the proportion of the population to be covered in each state.
  • State governments shall identify the eligible households in the states.
  • Food grains shall be distributed to the eligible persons through the network of fair price shops under the PDS.
  • In case the central government is unable to supply food grains to the state, it shall compensate the state governments who have to give a food security allowance to each entitled person.

Key milestones in India’s food security policy

The notion that access to food should be a right has its origin within the UN’s 1966 International Covenant on Economic, Social and Cultural Rights. Food security exists when all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life.

India’s tryst with food security can be traced back to 1996 when the Supreme Court declared that the “right to live guaranteed in any civilized society implies the right to food”. This was followed by a writ petition filed in the Supreme Court by the People’s Union for Civil Liberties (PUCL) Rajasthan in April 2001 against the central government, Food Corporation of India (FCI), and six state governments. The petition contended that the right to food was a fundamental right under “the right to life” provided by Article 21 of the Constitution of India.

Although no final judgment has been given, the Supreme Court has issued several interim orders in the case. On May 8, 2002, the Supreme Court appointed two Commissioners for the purpose of monitoring the implementation of the interim orders (see reports).

Both UPA I and II made food security an electoral promise and entrusted the task of drafting a legislation to the Sonia Gandhi led National Advisory Council (NAC). On October 23, 2010, the NAC made certain recommendations about the basic framework of the Food Security Bill. In response, the Prime Minister set up an Expert Committee under Dr C. Rangarajan to examine the Bill, which submitted its report in January 2011. It stated that it would not be possible to implement the NAC recommendations because of lack of availability of food grains and huge subsidy implications. The NAC however disagreed with it and prepared a draft Bill in June 2011.

The government finally introduced the National Food Security Bill, 2011 in the Lok Sabha on December 22, 2011. It was referred to the Standing Committee on Food, Consumer Affairs and Public Distribution, which submitted its report in January 2013. The discussion on the Bill had been initiated during the Budget session of 2013. The government also introduced a set of official amendments to the Bill, which have been incorporated in the Ordinance that was promulgated recently.

Ordinance: A hit or miss?

Opinion is divided about the need and desirability of the Food Security Ordinance. Some experts such as Jean Dreze and Amartya Sen are staunch supporters of the Bill given India’s malnutrition rates. Others such as Arvind Panagariya, Surjit Bhalla and Abhijit Banerjee have raised certain key issues regarding the need and impact of such a legislation. In fact, the debate on food security has dove-tailed with a larger debate about India’s governance priorities between two renowned economists – Amartya Sen and Jagdish Bhagwati (see here and here for the Sen-Bhagwati debate on re-distribution vs growth).

The criticism of the Ordinance mainly falls into the following categories: (a) purpose of the Ordinance; (b) identification of beneficiaries; (c) mechanism for delivering food security; and (d) the impact on the food subsidy burden.

Purpose of the Ordinance: The basic premise of the Ordinance is that India has a problem of persistent hunger which has led to high rate of malnutrition. Therefore, the government needs to provide the population with subsidized food grains. These premises have been challenged by various experts. Prof Arvind Panagariya, an economist at Columbia University, has recently attacked the notion that India’s child malnutrition rates are higher than that of Sub-Saharan Africa. Blaming the flawed measurement methodology of WHO, he makes a persuasive case that it is improbable that India is ahead of Sub-Saharan Africa in all other health indicators except malnutrition.

Other experts such as Arvind Virmani point out that persistent hunger is a much lesser problem than malnutrition. According to NSSO, in 2004-05, about 2% of households suffered from hunger at some point during the year. This Ordinance only addresses hunger while the focus needs to be on malnutrition which is a problem of a higher magnitude. Given the data on hunger, it is clear that malnutrition exists not so much because of lack of access to food but because of faulty diet. However, the Ordinance only focuses on providing cereals rather than nutrition rich food like vegetable, pulses and fruits. In fact, it may even have the unintended consequence of forcing farmers to grow cereals rather than fruits, pulses and vegetables.

Some experts have also pointed out that one of the major causes of malnutrition is the lack of sanitation. Unless policies focus on addressing this, malnutrition will remain a severe problem (see here, here and here). Others such as Prof Kaushik Basu have suggested that there is need to redesign how the government acquires and releases food on the market.

Identification of beneficiaries: While the Bill had divided the population into three groups (priority, general and excluded), the Ordinance only has two categories (those entitled to subsidized food grains and those who are not). However, this does not do away with the need to identify beneficiaries and thus can lead to inclusion and exclusion errors. According to some estimates, 61% of the eligible population is excluded from the BPL list while 25% of non-poor households are included in the list. The only way to completely eliminate inclusion-exclusion errors is by universalizing the scheme or by having a clear-cut exclusion criteria (see here). However, given the issue of financial burden, the problem of identification may be tackled through the biometric-linked Aadhaar number (see here and here). Basically, Aadhaar will enable the government to authenticate the identity of a person. It may reduce duplicate and ghost beneficiaries (non-existent beneficiaries). However, the success of Aadhaar in weeding out ghost beneficiaries depends on mandatory enrolment. If enrolment is not mandatory, both authentication systems can co-exist. In such a scenario, people will be able to opt out of the Aadhaar system (see here).

Mechanism for delivering food security: The Ordinance legalizes the PDS even though there is a large body of evidence about the inefficiency of the system (see Wadhwa Committee reports, Planning Commission report). These committees have pointed out issues such as targeting errors, low off-take of foodgrains by households, leakages and diversions of food grains to the open market, adulteration of food grains and lack of viability of Fair Price Shops.

Many experts have suggested other alternatives to the PDS such as cash transfer (see here, here and here) and food coupons. There is evidence that these methods have worked in countries such as Brazil (see here and here). Some advantages of these are: reduced administrative costs, expanded choices for beneficiaries, and more competitive pricing among shops. Also, allowing alternate methods could give more flexibility to the states to adopt the mechanism that suits their needs (see here).

Impact on food subsidy burden: According to the government’s calculations, the Ordinance will take the total food subsidy bill to Rs 124, 747 crore in 2013-14. However, there are other costs related to the implementation of the scheme that may not have been factored in such as cost of procurement, storage and transport of food grains. The Bill had given an annual estimate of Rs 95,000 crore as the cost to the exchequer. However, various experts refuted this figure. Their estimations vary from Rs 2 lakh crore to Rs 3.5 lakh crore (see here and here). The basic problem of having a high food subsidy bill is the effect on the fiscal deficit and inflation. Also, given the limited resources available, if the government prioritises one policy, it adversely impacts resource allocation for other policy goals. Therefore, policy choices need to be made based on what would give the most bang for the buck (see here) rather than on populist rhetoric.

It is imperative that the government considers these critiques while framing its food security policy; otherwise the Ordinance would be another lost opportunity to address a key problem faced by the poor.

Where angels fear to tread

1 Jul

This article was published in the Crest edition of the Times of India on June 29, 2013.

It’s rather strange that while the debate over allowing foreign universities to set up campuses in India remains as yet unresolved, the University Grants Commission (UGC), our apex education regulator, is about to notify rules regarding their entry in the country. The government, it seems, is in a bit of a hurry. Presently, Indian institutions can grant degrees and diplomas in collaboration with foreign institutions; but, foreign universities cannot set up branch campuses here without an Indian partner.

There are broadly three perspectives in the debate over the entry of foreign institutions. One, the opponents of the move argue that it would lead to commercialisation of higher education, and restrict access to quality education only to the rich. In response, the move’s proponents argue that it would increase choices for students, enhance competition in the sector – with potential for qualitative improvement in the Indian institutions – and provide technical skills for the job market. They suggest that the government can provide easy loans and scholarships to economically disadvantaged students to ensure that they do not lose out. Three, some experts have taken a middle view. They favour allowing foreign institutions so long as there are appropriate regulations in place to ensure that only good quality institutions are allowed entry.

The proposed UGC regulations have also taken the middle path, it appears, by restricting entry to only institutions that are placed in the top 400 as per ‘world university rankings’ put out by groups such as the Times Higher Education or Quacquarelli Symonds. In addition, only institutions which are accredited and have a track record of a minimum of 20 years in the parent country would be considered. While the purpose for such high entry barriers is to ensure that only quality institutions are allowed to enter, it is an open question whether top institutions would choose to come to India. Till date, hardly any high quality institution has entered India although the regulations notified by the All India Council of Technical Education (AICTE) allow foreign technical institutions to offer degree or diploma courses either directly or through collaboration with an Indian partner.

It is noteworthy that countries such as South Korea, Singapore, and UAE offer incentives that reduce the costs and the risks associated with establishing a campus in a different country. However, the proposed regulations take it for granted that institutions are willing to come to India and appear to focus on increasing the constraints to entry. These include requiring the foreign institution to operate as a non-profit legal entity; insisting that they maintain a corpus of at least Rs 25 crore for each campus they propose to establish and disallowing any repatriation of surplus income. In fact, it allows foreign institutions to utilise only up to 75 per cent of the surplus income for developing the campus.

Foreign educational institutions would also have to mandatorily publish a prospectus with details of course, fees and other charges and money to be refunded. The institutions would be penalised with a minimum fine of Rs 50 lakh which may be extended to Rs 1 crore if they do not conform to the norms of UGC. However, it is not clear what procedure would be followed to penalise such institutions or whether UGC would have the power to close down these institutions.

According to the National Knowledge Commission and the Yash Pal Committee, the regulations should focus on ‘incentivising quality institutions’ to enter India while disincentivising sub-standard institutions from entering the country. But why would quality institutions be interested in entering the Indian market if they have to operate under such constraints? It is also not clear if these institutions would have the autonomy to setup their own courses and charge their own fees. Sadly, this is not the government’s first misguided attempt to facilitate entry of foreign universities. In May 2010, it introduced the Foreign Educational Institutions (Regulation of Entry and Operations) Bill, which is still pending in the Lok Sabha. This Bill had been examined by the Parliamentary Standing Committee on HRD, which recommended that there be adequate safeguards for stakeholders. It suggested that an independent regulator should monitor fee, curriculum and salary;approvals should be given on a short-term basis first before being extended and the government should devise incentives for foreign institutions to utilise their surplus funds in India.

These current UGC notifications, which do not need legislative approval, are an attempt to bypass the legislative logjam. Besides, there is also a basic lack of clarity in purpose. Does the government want to woo good quality foreign universities or does it only seek to regulate the ones who are interested in coming to India? We can’t assume that the two go together. And these regulations fail to serve either purpose fully since they do not provide incentives for quality institutions to enter India but create high entry barriers for other institutions.

Foreign universities are certainly not the panacea for all the ills of the higher education system in India. They would at best bring in some much needed competition into the sector filled with mediocre institutions. Before framing any policy for foreign institutions, our policy-makers need to have a clear understanding on the fundamental question of whether foreign universities need us or do we need them more.

Disaster management: How prepared are we?

25 Jun

The flash floods and landslides caused by sudden heavy rains in Uttarakhand and Himachal Pradesh on June 15 have resulted in heavy casualty and loss of property.  The death toll is likely to be about 1000 while over 20,000 people still need to be evacuated.  Currently, rescue operations are being carried out by several agencies such as the Army, Indo-Tibetan Border Police (ITBP), Border Security Forces (BSF), and the National Disaster Response Force (NDRF) (see here for latest updates).

However, various news reports (see here, here and here) have highlighted the lack of disaster preparedness of the authorities in the state and the centre.  In fact, news reports suggest that the Indian Meteorological Department had warned Uttarakhand government of the likelyhood of heavy rainfall within 48 hours.  However, the local authorities failed to issue any warning or analyse the likely effect of such rainfall.  Given the size of its population and the high risk it faces from natural disasters, it would be absolutely criminal for India to be lackadaisical about its disaster preparedness.

In this blog post, I provide a quick analysis of where India stands in disaster management preparedness.

A blue-print for disaster management

India first woke up to the need for a holistic approach to disaster management (and not relief centric) after the devastation caused by the Indian Ocean tsunami, the super cyclone in Orissa and the earthquake in Gujarat.  Disaster management was recognized as a development issue for the first time during the 10th Five Year Plan (2002-2007).  In 2005, the government passed the Disaster Management Act, to provide for effective management of disasters.  It defined disaster as a catastrophe, calamity or grave occurrence in any area due to man-made or natural causes or by accident where there has been substantial loss of life and property.  The Disaster Management Policy was framed in 2009.

The Ministry of Home Affairs is the nodal ministry for disaster management.  The National Disaster Management Authority (NDMA) is mandated to deal with all types of disasters, natural or manmade with certain exceptions (such as terrorism, counter-insurgency, serial bomb blasts, and hijacking, mine disasters and forest fires).  The National Crisis Management Committee (NCMC), headed by the Cabinet Secretary handles these issues.  NCMC gives directions to the Crisis Management Group, which actually deals with all the matters related to relief activities in the case of any major disasters.

National level authorities under 2005 Act

  • The Act established the NDMA and provided for setting up advisory committees and a National Executive Committee to aid the NDMA in performing its functions.
  • NDMA’s functions include (a) laying down the policies, plans and guidelines for disaster management; (b) approving the National Plan and the plans of various ministries; and (c) laying guidelines for state authorities.  It shall also recommend guidelines for the minimum standard of relief to be provided to persons affected by the disaster (relief camps, ex-gratia assistance).
  • The National Executive Committee would prepare a National Plan for disaster management of the country.
  • The National Disaster Response Force (NDRF) would be under the general superintendence of NDMA but the command of the force shall be with the Director General of NDRF to be appointed by the central government.

State and district level authorities under 2005 Act

  • Every state government has to set up a State Disaster Management Authority, which would be assisted by advisory committees and State Executive Committee.  In addition, it has to set up District Disaster Management Authorities in every district of the state.  The State Executive Committee is responsible for implementing the national and state plans and act as the coordinating and monitoring body for management of disaster in the state.

Penalties

  • The Act also lays down penalties ranging from one to two years imprisonment and fine for offences related to obstruction of any officer in the performance of his duties, false claims, misappropriation of money or material and for making false warning (relevant government officials have been given blanket immunity from this provision).

On-ground status on implementation

By the end of the 10th Plan, a skeletal structure for disaster management had been put in place.  A central law on disaster management was enacted in 2005 and the National Disaster Management Authority was set up.  However, the Act itself had certain shortcomings which contributed to its poor implementation record.

Shortcomings in the Act

The Standing Committee on Home Affairs had examined the Disaster Management Bill and made certain recommendations, most of which were not incorporated in the 2005 Act.  It suggested that at each level, the respective authority should include elected representatives from the Parliament, State Legislatures and local government bodies.  At the district level, there should be a Relief Commissioner (other than the District Collector/Magistrate) to ensure that affected population in disaster hit areas get relief.  Although the Act included penalties for giving false warning and causing obstruction, it is not clear who would be the complainant in such cases.

Other experts (see here and here) also pointed out loopholes in the Act, which might make it less effective.  They include (a) lack of clear guidelines on who shall be entitled to relief and compensation under the Act; (b) lack of clarity on who shall be monitoring the performance of the various agencies set up under the Act; (c) lack of clarity about coordination between the different agencies; (d) no guideline on how to differentiate between a disaster and a disaster of severe magnitude; and (e) no provision for declaring a disaster prone zone or classifying disasters in various categories.

Poor implementation record

The level of preparedness for disaster management at the centre and the states is very uneven.  According to a 2012 report by the Institute of Defence Studies and Analyses, even after six years of the enactment of the Disaster Management Act, many states have not yet established the state-level authorities.  The report concludes that the present capability of civil administration for combating disasters remains inadequate and they rely on the armed forces for major emergency responses.

In 2013, the Comptroller and Auditor General (CAG) released a performance report on India’s disaster preparedness.  It found critical gaps in the preparedness level for various disasters.  It found NDMA to be ineffective in most of the core areas since it neither had information and control over the progress of the work at the state level nor could it successfully implement various projects.  The report stated that the National Executive Committee had not met after May 2008; the National Plan for Disaster Management has not yet been formulated and there were delays and mismanagement in respect of State Disaster Response Fund.

Response to a specific disaster is the best test of the level of disaster preparedness.  However, the response to the Uttarakhand floods has exposed the lack of preparedness of administrative machinery.  While natural disasters may be unpredictable, India cannot afford to wait for the next disaster to strike before getting its act together.

What ails India’s public health delivery system

17 Jun

Recently, the Cabinet approved the Ministry of Health and Family Welfare’s new programme, the National Urban Health Mission (NUHM), which seeks to focus on the public health needs of the urban poor. NUHM is the new scheme under the government’s overarching National Health Mission (NHM) programme.

The existing National Rural Health Mission (NRHM) is the other scheme under the NHM. NRHM was launched in April 2005 to provide comprehensive healthcare in rural areas. The programme focuses on 18 states. Each village with a population of 1,000 in these states are to have an Accredited Social Health Activist. NRHM proposes to (a) strengthen existing infrastructure; (b) prepare district health plans; (c) guide sanitation and hygiene projects; (d) strengthen disease control programmes; (e) foster public-private partnerships in healthcare; and (f) implement new finance mechanisms.

Although providing the urban poor with a well-functioning public health system is a dire necessity, it is unclear whether NUHM would succeed in doing so given the government’s poor track record in establishing a public health system in the country. Having said that, it is also true that India has come a long way from the time of independence in terms of providing health facilities to its citizens.

This post focusses on India’s present status in terms of health indicators and public health infrastructure based on the performance of NRHM. Since the NUHM would follow a similar model as NRHM, its chances of success may depend on addressing the bottlenecks in the NRHM.

India’s track-record so far…

Health indicators

India’s dysfunctional public health system has taken a toll on its citizens, especially the poor. Table 1 comparing India’s status with other countries on key health indicators shows that it lags behind many countries. However, public spending on health in India is among the lowest in the world at about 1.4% of the Gross Domestic Product (GDP). Also, households in India spend about 5-6% of their consumption expenditure on health.

Table 1: Health indicators of some countries

Country IMR MMR Life expectancy at birth Total Health Exp (as % of GDP)

M

F

India

44

212

62.6

64.2

4.6

Pakistan

71

320

66.9

67.5

2.6

Ghana

50

350

61.8

63.6

6.9

Bangladesh

49

570

65.8

68.1

3.4

China

22

45

71.8

75.3

4.6

Sri Lanka

12

58

70.8

78.2

4

Malaysia

8

62

72.5

77.2

4.8

USA

7

24

75.4

80.5

16.2

UK

5

12

77.4

81.7

9.3

Sweden

3

5

78.8

82.9

9.9

Sources:All India Progress under NRHM as on 31 Dec, 2012,” NRHM website; “World Population Prospects: the 2010 Revision,” UN, Dept of Economic and Social Affairs, 2011; “MDG Indicators,” UN; Databank of World Bank; 11th Five Year Plan, Planning Commission.

*Note: Infant Mortality Rate (IMR): Deaths per 1000 live births; Maternal Mortality Rate (MMR): Deaths per 100,000 live birth; Total Health Expenditure: Includes public and private expenditure.

Infrastructure

India has an elaborate public health infrastructure but it is mostly dysfunctional with neither proper infrastructure nor trained man-power. According to government norms, urban areas are supposed to have a two-tier system with Urban Health Centres for every 100,000 population, followed by general hospital. There are similar norms for rural areas. Table 2 gives an overview of the multi-tier network through which government health services are supposed to be delivered in rural areas.

Table 2: Norms for public health institutions in rural areas and the shortfall

Tiers Population and staff norms Services Status as of 2012
Sub-Health Centre Level(Gram Panchayat level) 1 Sub-Centre for a population of 5,000 in the plains and 3,000 in hilly areas.Staffed with Auxiliary Nurse Midwife and a male health worker. Perform tasks related to maternal and child health, nutrition, immunisation, diarrhoea control etc. Provided with basic drugs for minor ailments. 1,48,124 (shortfall of 35,762 Sub Centres)
Primary Health Centres (PHCs)(Cluster of Gram Panchayats) 1 PHC for a population of 30,000 in the plains and 20,000 in the hilly areas.Staffed with one Medical Officer and 14 other workers. Acts as a referral unit for 6 sub-centres and has 4-6 beds for patients. Provides a package of essential public health programmes. 23,887 (shortfall of 7,048 PHCs)
Community Health Centres (CHCs)(Block level) 1 CHC for a population of 1,20,000 in the plains and 80,000 in hilly areas.Staffed with 4 Medical Specialists and 21 paramedical and other staff. Has 30 in-door beds and serves as a referral centre for 4 PHCs. Provides facilities for emergency obstetrics care and specialist consultations. 4,809 (shortfall of 2766 CHCs)
District and Sub-District Hospitals(District level) 1 hospital for each district, which is linked to sub-district hospitals, CHCs, PHCs and Sub-Centres.Staff norms vary based on the size of the hospitals i.e. the number of beds. District hospitals generally have 75 to 500 beds. Sub-District hospitals have 31 to 50 beds. Services include OPD, indoor and emergency services. Provides consultation services with specialists. District hospitals provide secondary level referral services for institutions below district level. 627 district hospitals and 305 health facilities

Sources: Annual Report 2010-2011, Ministry of Health and Family Welfare; “Indian Public Health Standards for 201-300 Bedded District Hospitals: Guidelines,” January 2007, MoHFW; “All India Progress under NRHM as on 31 Dec, 2012,” NRHM website; NRHM MIS.

Availability of doctors

Even in places where the infrastructure is in place, there is a shortfall in trained doctors and support staff. Qualified doctors do not want to be posted to rural areas because of lack of educational facilities, irregular electricity supply, lack of potable water, safety issues and lack of well-equipped laboratories. Table 3 shows the percentage of vacancies of doctors at both the PHC and CHC level.

Table 3: Vacancies of doctors in PHCs and CHCs

State

% of vacancy in PHCs

% of vacancy in CHCs

ChhattisgarhWest BengalMaharashtraUttar PradeshMizoram

Madhya Pradesh

Gujarat

Andaman & Nicobar Islands

Odisha

Tamil Nadu

Himachal Pradesh

Uttarakhand

Manipur

Haryana

Sikkim

Meghalaya

Delhi

Goa

Karnataka

Kerala

Andhra Pradesh

Rajasthan

Arunachal Pradesh

Assam

Bihar

Chandigarh

Dadra & Nagar Haveli

Daman & Diu

Jammu & Kashmir

Jharkhand

Lakshadweep

Nagaland

Puducherry

Punjab

Tripura

India

71

44

37

36

35

34

31

30

28

27

22

22

20

19

19

18

14

11

10

7

3

0.4

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

24

90

0

34

NA

NA

88

0

100

62

0

NA

74

94

94

NA

0

0

67

NA

NA

27

49

NA

NA

60

50

0

0

53

81

0

NA

0

40

NA

59

Sources: National Rural Health Mission (available at http://nrhm-mis.nic.in/UI/RHS/RHS%202011/RHS%20-March%202011-%20Tables-%20Final%209.4.2012.pdf). The data for all states is as of March 2011 except Bihar, UP, Mizoram and Delhi where data is as of 2010

Food for thought for policy-makers…

The existing system does not approach the task of providing healthcare in a comprehensive manner. It takes a fragmented disease specific approach with limited scope for innovations. In addition to dysfunctional health infrastructure, there is lack of accountability and discipline in the whole system. Over the years various committees such as the Bhore Committee 1946, Jungalwalla Committee 1967, Bajaj Committee 1996, Mashelkar Committee 2003 and the National Commission on Macroeconomics and Health 2005 have suggested ways to strengthen the health sector. Based on the recommendations of these committees and other experts, below are some policy options the government can consider.

  • Given that out of pocket expenditure on health is very high for Indians, the government needs to focus on reducing household expenditure of the poor by financing comprehensive healthcare package. The Planning Commission’s report on Universal Health Coverage can be a starting point for framing a suitable package that has the most impact on the poor.
  • One of key reasons why the public healthcare system is dysfunctional is the lack of accountability and discipline among the stakeholders. Since government functionaries have security of tenure, there is very little incentive to perform on the job. Therefore, it is essential to establish institutional mechanisms for oversight functions as well as incentivize health personnel to perform well. Some experts have suggested that the community and locally elected bodies through Village Health Committees and empowered management committees be involved in overseeing the functioning of PHCs and CHCs. Similarly, a District Health Authority may be constituted with public representatives. Also, there needs to be performance based monitoring of health personnel.
  • The role of the private sector in providing health care is already well-established. The private sector includes a range of providers addressing different market segments (voluntary, not-for-profit, corporate, for-profit, trusts, and stand-alone specialist services). While there are a number of super-specialty hospitals such as Medinova, Max, Escorts, and Apollo, most providers are sole practitioners or small nursing homes with 1-20 beds. They serve urban or semi-urban clientele. According to some experts, there is need to enforce sufficient regulations on the private sector to ensure that the unqualified health providers or quacks are not able to harm the patients.
  • The focus of any health policy should be the quality of care provided to a patient. A recent study by experts at the World Bank has comprehensively shown that the problem lies not so much in access to public health care but of the quality of care being provided. According to these experts, so far, government policy has focussed primarily on increasing access to public health rather than devising ways to ensure that everyone gets access to quality care. The study suggests some solutions: (a) fundamentally reforming the way medical degrees are awarded and requiring doctors to go for re-certification periodically; (b) doctors may perform better if there is some performance based pay, better monitoring and a denser peer network; and (c) educating people about issues such as over-medication, sanitation, hygiene and waste management.

How good is the data for monitoring government schemes?

3 Jun

Recently, a news item brought to attention a crucial but not often discussed matter on the quality of data collected at various levels of the government. It quoted a report from the Planning Commission’s think tank, Institute of Applied Manpower Research (IAMR) which found that the data on the government’s many flagship schemes was either incomplete or inconsistent.

Here’s a quick summary of the report.

The report examined the Management Information System (MIS) of 13 flagship central government schemes. MIS is a tool to collect data for a particular scheme or organization to help evidence-based programme management. The 13 schemes this report focused on are:

Total budgetary allocation for all these schemes is Rs 1,71, 582 crores.

Findings

  • The study ranked PMGSY and MNREGA in the top bracket in the design of MIS. NRHM, NRDWP, RGVY and TSC were ranked in the next category because they have recently started designing a more effective MIS. However, key schemes such as SSA, MDM, JNNURM and ICDS had poorly designed MIS and needed to take steps to strengthen the process.
  • A very important criteria is the reliability of data. Therefore, reliability and validity checks of data should be done at the district level. However, RGGVY, JNNURM, rural telephony and irrigation checked the data at the state level. Also, many of the data was not up to date.
  • The connection between implementation and outcome was weak for most schemes except MNREGS and PMGSY. There was also inconsistency in data. For example, ICDS and the National Family Health Survey are inconsistent with respect to data on level of malnutrition for each state. Since there was no effort to conduct an independent external verification or authentication of the data, there were discrepancies with the outcome/output data in the MIS and the sample survey data carried out by independent organizations.
  • Lack of use of data was a key weakness of the MIS of flagship programmes. Each scheme used the MIS data to get approval for next year’s budget and action plans but not for course correction.

New initiatives

Under the 12th Five Year Plan, the government has proposed new initiatives for effective management of centrally sponsored schemes. It proposed use of real-time technologies to monitor schemes. Furthermore, it planned to provide each beneficiary with a Unique Identity Number (Aadhaar) linked to his biometric data. This would make it easier to monitor whether the targeted beneficiaries actually receive the benefits. By 2014, about 600 million citizens are likely to have Aadhaar. Currently, there is no information on whether MIS data has been used to achieve the desired outcomes or if the implementation strategy has been modified with the help of MIS data. The 12th Plan intends to change this by focusing on outcome sustainability.

Implications for India

While statistics may not tell the whole story, it is well established that governments need timely and reliable facts to design effective policies. If the database is weak, resource allocation may get distorted and policies may not respond to the real needs of the community. Therefore, India’s lack of robustly designed data collection systems may be one of the reasons why innumerable government schemes fail to actually achieve the stated objectives.

Some experts have raised alarm bells about the lack of reliable data (see here, here and here) in various sectors and how it has hampered policy making. However, the government has not displayed major signs of urgency about tackling this problem. If concerned stakeholders are able to convince the government that designing a robust data collection system is going to give the government more bang for their buck it may actually take steps to address the problem.

Law to regulate lobbying in India

29 May

Recent news reports suggest that the committee investigating the case of Walmart lobbying the Indian government to allow FDI in the retail sector is going to submit its report shortly.  It is reported that the committee could not find evidence of Walmart bribing any government official or indulging in any unlawful activity.  However, the committee may recommend that the government frame rules to regulate lobbying in India.

In this context, Harsimran Kalra and I published an article in the Oxford India Policy Blog that made a case for regulating lobbying in India.  It also flagged some issues that needs to be debated widely before a law on lobbying is drafted.

The full article can be accessed here.

An excerpt from the article is given below

At present, a few countries have laws to regulate lobbying.  These include Australia, Canada, US, Germany, Hungary, Poland, Lithuania, Slovenia, Israel and Taiwan.  Other countries such as France, Spain, Portugal, India and Japan do not have any such law while UK and Ireland regulate the lobbied.

Although India currently does not regulate lobbying, it is likely to move toward that direction.  Before the government drafts a law, it is essential to get clarity on the activities sought to be regulated and sanctioned.  In this article, we explore how other countries have defined lobbying, the mechanism they adopted to regulate these activities and the lessons India could learn from their experience.

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