Mumbai: India ranked 82nd among 128 countries for generosity over the last 10 years, as per the 10th World Giving Index (WGI). 

Up to a third of Indians helped a stranger, one in four donated money, and one in five gave their time volunteering, the report said, attributing India’s low ranking to its strong culture of unorganised and informal giving to family, community and religion. It recommended more formal mechanisms of donating to charity.

The report, published online in October 2019, was based on surveys of 1.3 million people in 128 countries over the last 9 years (2009-2018). It asked interviewees if they had helped a stranger, donated money to charity or volunteered their time in the past month. The surveys used Gallup World Poll data and were commissioned by Charities Aid Foundation (CAF), a UK charity that provides services and assistance to international charities and their donors.

India’s rank on the Index has yo-yoed vastly, the lowest being 134th in 2010 and the highest being 81st last year. This year’s report aggregated data for each country for the last 10 years. India’s overall WGI score this year was 26%.

Source: World Giving Index 2019 report

India and the World

Of the top 10 countries, seven are among the wealthiest in the world. Yet, global generosity is on the decline, stated the report, highlighting that individual giving is now lower in countries with long histories of philanthropy such as the United States, Canada and the United Kingdom.

“The top ranking countries will usually have a strong culture of giving, or are more developed,” said Meenakshi Batra, who leads CAF India, a non-profit organisation that works to enable effective giving. “Individuals have more resources to give and there is infrastructure for them to give to formal organisations.”

Source: World Giving Index 2019 report

India’s 26% WGI score was less than half of 58% scored by the United States in the top spot. China, with a score of 16%, was at the fag end of the index. The Asian giant also had the lowest score for all three measures considered–helping a stranger, donating money and volunteering.

New Zealand, on the other hand, was the only country to appear in the top 10 on all three counts.

India fails to match Asia’s pace

Five of the 10 countries to have improved their rankings the most on the giving index were in Asia. Indonesia, the country that improved its ranking the most, moved into the top 10 for donating money and volunteering. Sri Lanka achieved the highest score for volunteering in the world; at 46%, its volunteering score was more than double of India’s 19%.

The report attributed this rise in rankings to cultural factors. For example, a majority of people in Myanmar are practising Buddhists, 99% of whom are followers of the Theravada branch that mandates giving. Sri Lanka too has a high population of Theravada Buddhists.

Similarly, in Indonesia, which has the largest Muslim population in the world, giving is closely tied to the religious obligation of giving, zakaat. 

The improved rankings are also an outcome of countries’ economic development. “It is not a surprise that these Asian countries have been increasing [their ranking] due to their rising economic prosperity,” said Ingrid Srinath of the Centre for Social Impact and Philanthropy at Ashoka University in Sonipat, Haryana.

India was the least generous of the seven South Asian countries in the Index, behind neighbours Pakistan, Nepal and Sri Lanka. India’s economic growth in recent decades has been felt by fewer and fewer people, which may explain why its philanthropy is not increasing at a rate similar to that of its Asian counterparts, Srinath said.

Lower-income families are less likely to have donated or sponsored in the last 12 months (69%), than those with a household income of more than Rs 1.7 lakh (~$2,400) per month (82%), the report stated. “The study does not account for the degree of giving from an individual, only whether they are giving or not,” said Batra of CAF India.

“India also has more cleavages than other countries around it in terms of religion, class and caste,” said Srinath. “It is possible that these divides make people less inclined to commit to national philanthropic efforts.”

Under-reported giving

“In India, there is a strong culture of regularly helping and assisting each other,” said Batra. More Indians (64%) said they give money directly to people and families in need or to a church or religious organisation (64%) than to a non-profit or charitable organisation (58%), as per the India Giving Report, a country-specific report by the CAF Global Alliance, a network of organisations working in philanthropy and civil society.

Besides, India has over over 500 forms of traditional religious giving, such as Hindu daan and utsarg, Islamic zakaat, kums and sadaqa. “This form of giving may not show up on the Index because Indians consider this a family or a religious obligation,” said Batra. “For instance, it is commonplace for Indians to feed poor people outside places of worship, or serve a meal to pious and holy men. Those responding to the survey would not have counted this as giving, because they consider this to be their duty.”

Incidentally, upto 38% Indians said they would donate more if they knew how their money would be spent, and 32% would donate more if there was more transparency. “There is potential for organised non-profit organisations to provide more formal options of giving,” said Ben Russel of CAF.

Billionaires show little giving spirit

In 2017, the wealth held by India’s wealthiest 1% increased by Rs 20,913 billion ($303 billion). This was equivalent to the central government’s total budget that year, as per this report by Oxfam India.

The contribution of India’s richest to philanthropic activities has grown at a slower pace than the increase in their wealth, as reported by IndiaSpend earlier this year. Large contributions (more than Rs 10 crore) by ultra-high net worth individuals (individuals who have a net worth of more than Rs 25 crore) have decreased 4% since 2014.

India’s lowest WGI score in the last six years (22% in 2018) coincided with its reporting a record number of 121 billionaires–the third highest number of ultra-rich individuals in any country, behind China and the United States.

(Habershon, a graduate from the University of Manchester, is an intern with IndiaSpend.)

Courtesy: India Spend

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Uttar Pradesh reported better availability–66% of the pharmacists interviewed said they stock the drugs–as did Bihar at 37.8%.

These prescription drugs, mifespristone and misoprostol, commonly referred to as medical methods of abortion (MMA), account for four out of five abortions in India undertaken by 10 million women every year, as reported by IndiaSpend in 2016. This implies a clandestine market in MMA, activists working in the field of women’s reproductive health alleged.

When asked why they did not stock MMA, 69.4% pharmacists cited “legal barriers”, said the study conducted by Pratigya, a network dedicated to women’s rights and their access to safe abortion care. This reason was quoted by 90.4% of those surveyed in Maharashtra and 75.6% in Rajasthan.

These “legal barriers” refer to concerns about sex-selective abortions that ensure the birth of only a male child, a practice common in countries such as India and China with a marked son preference in families. But, as we explain later, these fears about MMA’s misuse are misplaced–it cannot be used for sex selection because it is effective only in early pregnancy when the foetus’ gender cannot be determined.

“For women in India, access to abortion has been marred by extreme stigma, lack of awareness about its legality, unavailability of safe services near the community, and high costs charged by providers,” said Vinoj Manning, CEO Ipas Development Foundation, a not-for-profit organisation that works for safe abortion and contraception.

Abortion was legalised in India almost half a century ago, yet unsafe abortions–performed in unhygienic conditions by untrained providers–are the third largest cause of maternal death. An estimated 56% of abortions in India are unsafe, IndiaSpend reported in 2017.

MMA has a success rate of 95%-98% if administered properly, but the lack of medical supervision has resulted in a significant number of botched abortions in India.

The study surveyed 1,008 retail chemists across four states, interviewing at least 250 in each. The cities included were Bhagalpur, Darbhanga, Gaya, Muzaffarpur, and Patna in Bihar; Aurangabad, Mumbai, Nagpur, Pune, and Solapur in Maharashtra; Ajmer, Bikaner, Jaipur, Jodhpur, and Kota in Rajasthan and Agra, Ghaziabad, Kanpur, Lucknow, and Varanasi in Uttar Pradesh.

Rajasthan and Maharashtra were chosen for the study because there were reports of shortage of MMA in the market, VS Chandrashekar, CEO of Foundation for Reproductive Health Services, and Pratigya Campaign for Gender Equality and Safe Abortion, and writer of the study. Bihar and UP were chosen because they are highly populated and have poor socio-economic and health indicators, he added.

Most sales without prescription, study

Medical abortion pills are currently classified as Schedule H drugs, and therefore are legally available at pharamacists with prescription. But most clients come to ask for medical abortion drugs without a prescription, the study found, and therefore without information about the drugs.
“In this case, the obligation to give clients the right information about dosage and side-effects lies with the doctor and the chemists,” said Chandrashekar. “Many chemists also sell the medicine out of packs, in that case it is difficult for women or men to read the inserts.”

This form of abortion has prompted a new classification of “less safe” abortion by the World Health Organization. It is seen as better than “least safe” abortion, because it uses prescribed medication, rather than the introduction of foreign objects and use of herbal concoctions. But it is still not safe due to the absence of a trained provider.

‘Secret sales because of overregulation’

Why do authorities warn pharmacists against supplying MMA? The answer lies in the practice of sex-selective abortions in India.

From 2001 to 2011, India’s child sex ratio declined from 927 to 919 females per 1,000 males. In Rajasthan, it fell to 888 per 1,000, spurring the state into setting a target sex ratio of 940 by 2021, as reported by The Times of India in 2018. The Pre Conception and Pre Natal Diagnostics Techniques Act (PCPNDT), 1994, was brought in to tackle gender-biased sex selection in India, and raids and crackdowns were conducted on retail pharmacists and provider sites stocking MMA.

This conflict between providing abortions and fighting the declining sex ratio in Rajasthan and Maharshtra has “created barriers and roadblocks to women’s access to abortion care”, the study said.

Whilst 31.8% of pharmacists were told by drug authorities to sell them on prescription, 45% (and as much as 73.3% in Rajasthan) were told to not sell or keep the drug, the study found.  Most (56%) retail pharmacists interviewed for the study considered MMA to be overregulated compared to other Schedule H drugs. In Maharashtra, this response came from nearly all pharmacists (91.7%).

“As a result, medical abortion drugs are often secretely sold at chemists in Rajasthan off-record, for five or six times the price,” said Rajan Chowdhury, a Jaipur-based social activist who works in the field of women’s rights.

But the regulatory pressure on pharmacists stocking MMA is misplaced, said Chandrashekar. MMA cannot be used to facilitate sex selection because foetus’ sex can only be determined after the 13th-14th week of pregnancy while MMA has to be used within nine weeks.

Sex selection makes up 9% of abortions in India, it was found in 2015.

Ill-informed pharmacists

The overregulation of MMA not only prevents access to abortions, but also results in low knowledge about the pills as well as the legality of abortions among pharmacists. “The Pratigya Campaign is very concerned about this,” said Chandrashekhar.

The number of retail druggists who reported being trained on MMA was low–15% in Bihar and 9% in Uttar Pradesh, for example. Upto 64.5% reported getting information on the drugs from brochures and booklets. When asked, 35% of pharmacists could not recall the name of the drugs used for medical abortion. More than half of retail chemists thought that abortion medication is not useful for women.

There were signifacant gaps in awareness about abortion among pharmacists–43% thought that they are illegal in India despite its legalisation through The Medical Termination Of Preganancy Act in 1971. In Rajasthan, upto 60.7% thought abortion is illegal.

Three of four who stocked MMA were not aware that abortion is legal up to 20 weeks of gestation. A higher proportion of them (40%) considered abortion to be legal only upto 12 weeks of gestation. Awareness of this detail was the least in Uttar Pradesh at 9.5% though the state had the highest number of pharmacists stocking MMA (66%).

Less than a third (30%) of pharmacists were aware that the MMA drugs have to be taken within the nine-week limit. Just as many retail chemists misunderstood this period to be seven weeks.

No awareness among users

Since the providers are untrained, few women who buy MMA without a prescription get necessary counselling about the drug, its usage and side-effects. This is the “biggest problem women are facing”, said Kalpana Apte, secretary general, Family Planning Association of India and a member of the technical advisory group at the Pratigya Campaign.

Less than half the respondents (45.7%) were able to recommend the correct dosage of MMA to clients, 29.8% knew nothing of how it was to be taken, and 43.4% when. Upto 80.8% reported that they gave no information about the side-effects associated with the drug and this was despite the fact that 29.5% of clients returned to complain about side-effects. To those who complained, nine out of 10 druggists suggested that they consult a doctor.

“Currently, there is no training for Rajasthan chemists and when they give the pills it is without any guidance or instructions,” social activist Chowdhury said. “Going forward chemists must become more responsible for the sale of MMA, and give adequate warnings about its use.”

Upon purchase, 63.8% of pharmacists did not ask clients about their last menstrual period–necessary for calculating the term of the pregnancy–43% did not ask about the duration of the pregnancy, 54.2% did not ask for a doctor’s prescription. On average, 60% of clients who came to purchase the pills were men.

Apte and Chandrashekar both recommended increasing the base of doctors and nurses who can prescribe medical abortions, in line with recomendations from the World Health Organization.

“At present, only 60,000/70,000 doctors can prescribe MMA drug in the whole of India,” said Chandrashekar. “Widening the pool of providers to all doctors can increase doctors in India able to prescribe this drug to 800,000-1 million.”

This story was first published here on Healthcheck.

(Habershon, a graduate from the University of Manchester, is an intern with IndiaSpend.)
 

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“I am quite concerned about MGNREGS being hollowed out,” says Thiemo Fetzer, associate professor in the department of economics at the University of Warwick, “It is a policy that– far from being perfect–is delivering something that has been missing in India’s social policy.”

The Warwick university study, based on events between 2005 and 2014, focused on the links between MGNREGS and conflict in 10 states that have a history of Maoist insurgency. This conflict resulted in 5,235 casualties between 2007 and 2013, including around 3,000 civilians, 1,000 security personnel and 900 Naxals, IndiaSpend reported in 2013.

“The districts where agricultural labour markets and output depend the most on monsoon rainfall benefited the most from MGNREGS providing insurance, seeing drops in conflict of up to 50%,” said Thiemo Fetzer, the author of the study, and associate professor in the department of economics at the University of Warwick.

Shock events such as droughts that affect income stability in rural areas are being increasingly pegged to climate change, and the impacts of climate change on rural areas are being increasingly viewed as global security risks. India is located in the world’s most disaster-prone region. Almost half its land area faced drought last year with rainfall reduced to a third of the annual average.

But in 2019, MGNREGS, the world’s largest rural workers programme, had its budget cut for the first time in five years–from Rs 61,084 crore in 2018-19 to Rs 60,000 crore in 2019-20. The scheme has been criticised for failing to provide the work promised, not paying wages on time, and not being viably implementable in India’s weaker states.
None of these shortcomings take away from the programme’s vital social value, Fetzer said.

Fetzer is an Associate Professor of Economics at the University of Warwick, a visiting fellow at the London School of Economics, and is also affiliated with the Pears on Institute at the University of Chicago and the Centre for Economic Policy Research in London.

The rise in demand for MGNREGS during poor monsoons coincided with a reduction in conflict levels in around 60% of villages located in Naxalism-prone areas, or the ‘red corridor’ as it is called, your study has found. Can you explain the link?
Yes, what the paper does is study the patterns between conflict in the red corridor and monsoon season rainfall. I observe that prior to the introduction of MGNREGS, droughts were associated with significantly more conflict and insurgent activities in the year after a bad harvest. This relationship seems to have become much weaker since the introduction of MGNREGS. This raises the question–is this due to MGNREGS or not?

To answer this question, I study in detail how MGNREGS participation indeed follows this seasonal pattern–with significant increases in participation in the programme following a bad monsoon. This observation–that MGNREGS participation is strong in areas that are experiencing periods of drought–is particularly pronounced in districts where agricultural labour markets and production rely heavily on the monsoon. It is those districts, where the value of insurance is the biggest, that see the biggest drops in conflict.

Despite the introduction of the MGNREGS programme, the total number of conflict events has increased over time across Maoist areas between 2005 and 2014. How significant was MGNREGS to the Maoist conflict overall?
From the aggregate trends, we do not really learn much about what is happening on the ground in places and how MGNREGS affected places. The aggregate trend could be driven by a whole lot of factors and changes, for example, improved reporting on the conflict–which is definitely a factor.

My study focuses on detailed micro data and suggests that had MGNREGS not been introduced, the overall increase in conflict would likely have been significantly higher. The parts of the country that benefited most from the scheme–specifically districts where agricultural labour markets and output depend strongly on monsoon rainfall–saw drops in conflict of up to 50%. This is sizeable and, of course, while aggregating back up from the micro evidence is difficult, would nevertheless suggest sizeable impacts at the aggregate level.

In 2017, it was estimated for 89 countries that natural disasters would put an additional 26 million people into extreme poverty (living on less than $1.90 a day) in the next year. Studies (such as this) have shown that climate-related natural disasters such as storms, floods and droughts have also affected the risk of civil war. Could programmes such as MGNREGS offer preventive and post-disaster reconstruction solutions?
This is a very important question. Countries around the world struggle with the climate emergency. It is a dramatic challenge especially for developing countries as they are set to bear most of the cost and have the least state capacity to mitigate the climate crisis. I think MGNREGS provides an interesting example of a potential policy that can work in reducing the experienced volatility of incomes among people in rural areas.

A basic form of social insurance can encourage productive investments, increase growth and development more broadly. It is a myth to say that a welfare state is undermining development–a basic social security net is absolutely crucial.

And this is where the problem is: How to design such an insurance programme in a context with weak state capacity? You want to ensure that insurance is well-targeted, i.e. only people in need actually benefit. You also want to make it easy for central governments and civil society to monitor programme implementation to reduce corruption.

MGNREGS does a fairly decent job at delivering on these two fronts. First, the fact that MGNREGS pays wages at the state minimum wage-level means that it is only attractive when wages in labour markets are low (for example, following a bad monsoon). Also, in order to get an income from the scheme people need to actually work–this ensures that people with good outside options or high incomes are not skimming the system as is for example the case with the PDS (public distribution system). In the PDS, it is well known that lots of households benefiting from the system are not needy by any reasonable definition.

And lastly, the requirement that MGNREGS produces physical assets and infrastructure makes monitoring and enforcement easier as civil society, the press and higher levels of government can always check on whether infrastructure actually gets built.

Of course, it would be great if one would not have to rely on these indirect mechanisms to ensure that social insurance becomes targeted–I am a bit doubtful about the quality and the social value of some of the infrastructure that ends up being built. But if a state is not able to provide directed targeted transfers to people affected by a shock that is none of their own making–such as a bad monsoon–MGNREGS does represent a valuable and important policy tool.

The programme, in that sense, serves as a significant inter-Indian transfer that helps stabilise rural economies following a shock and thereby, actually reduces the impact of the monsoon on the economic cycle.

At the end of April 2018, 57% of MGNREGS wages remained unpaid. In 2014-15, only 6% of households were able to hit 100 days of work, with the average being 40 days. Can it still play an effective role in providing income security and stemming conflict?
It is clear that there are many problems–after all the programme is just gigantic in scale. Regarding the two figures you mention, there is an evident erosion in the quality of MGNREGS in recent years and that really needs to be tackled. After all, its value is that it does provide for a stable wage floor and assured alternative for rural households in distress. This in and of itself has an effect on rural labour markets, helping stabilise wages following a bad shock. So the programme also indirectly has some benefits even for people not participating in it. But this indirect benefit is only maintained if those who do opt for MGNREGS actually end up getting paid.

Regarding the 100 days–it is true that there are cases of rationing. This can have many reasons. For example, panchayats may be unwilling to provide employment if only a small number of people request employment because there is an actual cost to panchayats to come up with public works projects. There are also likely conflicts of interest if village officials are also agricultural land owners who have an incentive in not providing MGNREGS work during the agricultural season. These all contribute to a problem whereby the scheme is not really effective in providing insurance against household idiosyncratic shocks that affect individual households, but not whole villages. This highlights that MGNREGS is not a genuine social insurance because it predominantly provides insurance against shocks that affect whole districts of villages at the same time.

This is, in fact, what I show in my paper. While there is rationing of MGNREGS work, participation for the programme is high following district-level shocks, for example following a bad monsoon.

In its first term, the ruling National Democratic Alliance put emphasis on promoting entrepreneurship through the Skill India Initiative and Make in India programme. Budget allocation to the Ministry of Skill Development and Entrepreneurship (MSDE) has increased 237% over the last four years, according to government data. But, for the first time since 2013, MGNREGS funding will drop by 1.8% in the 2019-20 budget. Are other programmes likely to work better than MGNREGS? In its second term, what should the NDA government’s approach be?
I am quite concerned about MGNREGS being hollowed out. It is a policy that–(though) far from being perfect–is delivering something that has been missing in India’s social policy: An effective form of social insurance particularly benefiting the rural parts of India. Rather than hollowing it out by depriving it of the funds it needs, focus should be on investing in the programme to ensure even less leakage to allow it to function.

Upskilling is definitely important but I have yet to see evidence that these programmes actually work. It is very important that MSDE engages with academics to evaluate the initiatives against their effectiveness.

The Make in India initiative is interesting but again, it does raise important questions as to what policy instruments are being used. Manufacturing of tradable goods is likely to be an important source of private sector employment that can absorb workforce from rural areas but I worry that the policy tools used focus around the government picking select industries or even companies, rather than focus on building the right institutional support to facilitate private initiative. It is important for any such policy for the government to transparently engage with all stakeholders–the focus should be on developing an enabling and supportive institutional environment to foster private initiative.

India ranked amongst the highest religion-related social hostilities index, at 9.6 compared to the world average of 1.8 in 2016, according to a Pew Research Center study. The motivations for this kind of conflict are identity-based, whereas the Maoist conflict is to a significant extent motivated by land rights and other development factors. Do you believe rural income guarantee programmes such as MGNREGS could mitigate conflict motivated by religion/ethnicity?
This is an interesting question. The focus of my study was indeed on the Maoist conflict. But I do think that the scheme may have some positive features as well that may be of relevance to other conflicts. The fact that people participating in MGNREGS work side by side is something that may actually foster and improve social cohesion. Of course, if at the local level implementation and access to work becomes co-opted then just as any other government programme it can become a tool fostering exclusion and producing grievances. So again, it depends on the specific design and the realities on the ground.

By 2030, the share of the global poor living in fragile and conflict-affected areas is projected to reach nearly 50%. How do we prepare for this?
As indicated, I sincerely think that developing countries more broadly should consider programmes like MGNREGS–not because they are perfect, but because they can actually work vis-à-vis other initiatives that may end up providing un-targeted transfers to households that do not actually need them. It is absolutely important that the organisation of these programmes is sufficiently decentralised to ensure that they do not become a tool to be co-opted for political gain. MGNREGS is a good example because since its introduction we have learned quite a few things already as to how we can make it work better. So other countries can really learn from the Indian experience here.

It is also important to not confound MGNREGS with other types of cash-for-work programmes–some of which have been studied, for example in Tunisia. The key value of MGNREGS is the fact that it is there to fall back on. Most cash-for-work programmes are temporary by nature and hence, do fail to provide social insurance simply because they are not guaranteed to be available in the future when demand may be there.

So MGNREGS has a social value. Even if nobody is doing any work, the certainty that there is a fall-back has a significant positive effect by itself.

(Habershon, a graduate from the University of Manchester, is an intern with IndiaSpend.)

Courtesy: India Spend
 

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