ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

Articles By Reetika Khera

Health Checkup

The findings of a recent survey of public health centres in five north Indian states (Bihar, Chhattisgarh, Himachal Pradesh, Jharkhand and Rajasthan) are presented, in light of earlier surveys in the same areas from 2002 onwards. Contrary to a common narrative whereby public health services in India have “collapsed,” there is a general pattern of improving quality and utilisation over time. The pace of improvement, however, is far from adequate. The recent conversion of many health centres into health and wellness centres, in particular, has been largely cosmetic so far. In states like Bihar and Jharkhand, the standards of healthcare in public facilities remain abysmal. Hope lies in the experiences of states that have shown how decent standards of healthcare can be achieved in the public sector, notably Himachal Pradesh. Even in Chhattisgarh and Rajasthan, there have been valuable initiatives in recent years.

Maternity Entitlements

Maternity benefits of at least `6,000 per child are a legal right of all Indian women under the National Food Security Act, 2013. In practice, a large majority are still deprived of maternity benefits. A recent survey, conducted in six states of North India, reveals that pregnant women’s basic needs for nutritious food, proper rest, and healthcare are rarely satisfied. Among the women who had recently delivered a child, about half had eaten less than the usual during pregnancy and nearly 40% complained of a lack of rest at that time. The average weight gain during pregnancy was just 7 kg. There is, thus, an urgent need for better recognition of the special needs of pregnancy, provision of maternity benefits in accordance with the law, and better support for pregnant women, including quality healthcare.

Information Technology and Welfare

The use of information technology in public administration is seen as a significant tool for improving efficiency, transparency and accountability in governance. We study the use of various forms of IT, such as computerisation, public management information systems, digital ID and biometrics in the social security pension programme in Andhra Pradesh. IT interventions need to be unbundled in their evaluations since our analysis concludes that there is no automatic link between the use of IT and enhanced transparency or accountability, and the use of IT may reinforce existing power imbalances.

Aadhaar Failures: A Tragedy of Errors

Several instances of practical difficulties that people across India have faced in accessing welfare schemes show the magnitude of the problems inherent in the Aadhaar project. 

Casting the Net

A broad-brush assessment of the public distribution system is presented in six of India’s poorest states—Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, and West Bengal—soon after the National Food Security Act, 2013 came into force. Important gains have been made, including broader coverage, lower targeting errors, accelerated PDS reforms, and a greater political commitment to food security. In four of the six reference states, the PDS seems to be doing reasonably well, but Bihar and Jharkhand still have a long way to go. Even in the leading states, much remains to be done to achieve the purpose of the NFSA: ending food insecurity.

Impact of Aadhaar on Welfare Programmes

India’s ambitious biometric identity documents project, Aadhaar, was portrayed as one that would enhance India’s welfare efforts by promoting inclusion and reducing corruption. From being a voluntary ID, it has become de facto compulsory for most welfare programmes. Despite early warnings of its limited role in achieving its stated objectives, successive governments have ramped up its use. Using a variety of sources, a review of the impact of Aadhaar on welfare programmes is presented. It is found that far from being inclusive and reducing corruption, Aadhaar is becoming a tool of exclusion. The government’s estimates of savings also do not stand up to scrutiny, and whatever is termed as savings is often the result of a denial of legal entitlements. In its current form, the Aadhaar project undermines the right to life.