The BJP now has a government–or is part of the government–in 16 states, up from seven states in May 24, 2014, when the party came to power at the Centre: Arunachal Pradesh, Assam, Bihar, Goa, Gujarat, Haryana, Himachal Pradesh, Jharkhand, Maharashtra, Manipur, Meghalaya, Nagaland, Tripura, Sikkim, Uttarakhand and Uttar Pradesh.

At its peak, the BJP had governments (or was part of the government) in 21 states.

With yesterday’s election performance, the Congress now has a government or is part of the government in five states–Punjab, Karnataka, MP, Rajasthan and Chhattisgarh–with 21% of the population, up from.two states with 7% population in 2017.

The Congress lost elections in Mizoram, where the Mizo National Front won 26 seats in a 40-member assembly. In Telangana, the incumbent Telangana Rashtra Samithi was voted back to power with 88 seats in the 119-member assembly.

Other parties are in power in seven states–Andhra Pradesh, Kerala, Odisha, Mizoram, Telangana, Tamil Nadu and West Bengal. Jammu & Kashmir is under Governor’s rule.

Of 678 seats in MP, Rajasthan, Chhattisgarh, Telangana and Mizoram–which account for a sixth or 15.2% of India’s population–the Congress won 305 seats, and the BJP won 199 seats, Election Commission data show.

The BJP lost 180 seats that it won in 2013, and the Congress gained 162 across three state assemblies–Rajasthan, MP and Chhattisgarh–as results were declared on December 11, 2018, according to an IndiaSpend analysis of electoral data, as we reported on December 12, 2018.
In 2013, the BJP won 377 seats and the Congress 118 in the three Hindi-heartland states. The BJP had no seats in Mizoram in 2013, and this was the first election for Telangana, which was created in 2014. This means the BJP lost 48% seats it won in 2013, and the Congress gained 137%, we reported.

In MP, the vote shares of the BJP and the Congress were 41% and 40.9%, respectively. In 2013, the comparable vote shares were 45% and 36%, we reported on December 12, 2018.

In Rajasthan, the BJP and Congress vote shares were 38.8% and 39.3%, respectively. In 2013, the BJP vote share was 45% and the Congress 33%.

In Chhattisgarh, the BJP and Congress recorded vote shares of 33% and 43%, respectively. In 2013, this was 41% for the BJP and 40% for the Congress.
 

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The statue’s construction cost is more than double the estimated amount for proposals submitted to the central government by the Gujarat government to include in Pradhanmantri Krishi Sinchai Yojana (Prime Ministers Agriculture-Irrigation Scheme). The construction cost could have been used to irrigate 40,192 hectares of land, cover repair, renovation & restoration of 162 minor irrigation schemes and the construction of 425 small check-dams.

The Statue of Unity–representing the symbolic unification of India post-Independence–will be unveiled by Prime Minister Narendra Modi on October 31, 2018, as tribute to Sardar Vallabhbhai Patel on his 143rd birth anniversary. The statue is now the world’s tallest at 182 metres (597 feet) or nearly 100 times taller than someone 6 feet tall.

Sardar Patel — independent India’s first deputy prime minister and home minister–was popularly known as the ‘Iron Man of India’ for his role in bringing about the merger of the princely states post-independence.

Resentment among farmers and locals
Thousands of tribals and farmers in Gujarat are planning a mass protest against the unveiling of the statue. They are unhappy with the cost of the project and with the lack of adequate rehabilitation efforts and water shortages in the catchment area where the statue is located.
The statue’s construction has affected 75,000 tribals across 72 villages in Gujarat’s Narmada district, NDTV reported on October 20, 2018. Of these villages, 32 have been most affected.  

In 19 villages, rehabilitation has allegedly not been complete while compensation has been paid but further commitments like land and jobs have not been fulfilled in 13 villages.

Farmers have also threatened to drown themselves in the Narmada river as protest during the statue’s unveiling event, The Indian Express reported on October 29, 2018.

Resentment has also been building among more than 1,500 farmers in four districts—Chhota Udepur, Panchmahals, Vadodara and Narmada— who had sold 262,000 tonne sugarcane to the Sardar Sugar Mill in Sankheda, which was shut down due to financial mismanagement by board members. They are still waiting for their dues amounting to Rs 12 crore.

“At a time when Gujarat is facing a water crisis due to lower availability in the Narmada dam, I think the statue project could have been postponed by a year,” according to Ghanshyam Shah, a political expert based in Gujarat  Mint reported on October 30, 2018.

Vijendra Tadvi, a farmer in Gujarat has been finding it difficult to irrigate his three acre farm, the BBC reported on October 28, 2018. “Instead of spending money on a giant statue, the government should have used it for farmers in the district,” he said.

Here’s what Rs 2,989 crore spent on the statue is worth:

• Over eight times the amount (Rs 365 crore) allotted to Gujarat by the central government in 2017-18 under the Rashtriya Krishi Vikas Yojana (National Agriculture Development Scheme) as well as nearly five times the amount (Rs 602 crore) approved by the state government for 56 new schemes and 32 continuous projects under the scheme.
• More than double the estimated cost (Rs 1,090 crore) of two water pipeline projects. Firstly, a project based on the Kadana reservoir that will irrigate 10,000 hectare in Dahod and Mahisagar districts. Second, the Dinod-Boridra lift irrigation project which will provide irrigation to 1,800 hectare within Surat district.
• More than double the estimated amount (Rs 1,114 crore) for proposals submitted to the central government by the Gujarat government to include in Pradhanmantri Krishi Sinchai Yojana (Prime Ministers Agriculture Irrigation Scheme).  The projects will irrigate 40,192 hectares of land, cover the repair, renovation & restoration of 162 minor irrigation schemes and the construction of 425 small check-dams.

The statue construction cost could build:

1. Two new IIT campuses (considering one IIT campus costs Rs 1,167 crore).
2. Two AIIMS campuses (considering one AIIMS cost Rs 1,103 crore).
3. Five new permanent IIM campuses (considering  one IIM campus costs Rs 539 crore).
4. Five new solar power plants, each producing 75 megawatts of power (considering one power plant costs Rs 528 crore).
5. Six Mars missions (considering one mission costs Rs 450 crore) and three Chandrayaan-2 (Moon) missions (considering one mission costs Rs 800 crore) by the Indian Space Research Organisation.

World’s tallest statue with state of art technology
The Statue of Unity is now 29 metres taller than the Spring Temple Buddha in China– which at 153 metres was previously the tallest statue in the world–and twice the height of the Statue of Liberty (93 metres) in the United States.
The Veera Abhaya Anjaneya Hanuman Swami in Vijayawada, Andhra Pradesh, was previously the tallest statue (41 meters or 135 feet) in India.
“The Statue [Of Unity] will not only remind every individual of our great nation’s freedom struggle but will also inspire the people of our country to inculcate Sardar Vallabhbhai Patel’s visionary ideologies of unity, patriotism, inclusive growth and good governance,” the project portal reads under its objectives.

Courtesy: India Spend
 

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“We have started experimenting with vacuum bio-toilets like those in an aeroplane,” Railway Minister Piyush Goyal told PTI. “Some 500 vacuum bio-toilets have been ordered and once the experiment is successful, I am willing to spend money to replace all the 2.5 lakh toilets in the trains with vacuum bio-toilets.”
 
Vacuum toilets, which cost around Rs 2.5 lakh per unit, will be odour-free, will cut down water use by 1/20th and have fewer chances of getting blocked, he added.
 
This takes the cost to Rs 6,250 crore.
 
In addition, vacuum toilets will need to be emptied and cleaned in rail yards.
 
As of May 31, 136,965 bio-toilets have been fitted in 37,411 coaches, at a cost of around Rs 1 lakh per toilet, according to railway ministry officials quoted by the PTI. This brings the expenditure to about Rs 1,370 crore.
 
There is a plan to install bio-toilets in around 18,750 more coaches by March 2019, when all the coaches of the Indian Railways will be fitted with such toilets, costing the national transporter around Rs 250 crore, the PTI release added.
 
The technology–and the criticism
 
Indian Railways are often described as the world’s biggest toilet: They eject around 3,980 tonnes of faecal matter–the equivalent of 497 truck-loads (at 8 tonnes per truck)–onto rail tracks every day, according to a report released by the Comptroller and Auditor General (CAG) in 2013.
 
Bio-toilets are small-scale sewage-treatment systems beneath the toilet seat: Bacteria in a compost chamber digest human excreta, leaving behind water and methane. Only the water, disinfected later, is let out on the tracks. That’s how they were supposed to work.
 
But, signs of failure came early.
 
In 2007, an experts committee headed by Vinod Tare, a professor at Indian Institute of Technology, Kanpur, had concluded that bio-toilets developed by the Defence Research and Development Organisation (DRDO) were not workable. “Yet, the Indian Railways went ahead with the decision to proliferate this model,” Tare told IndiaSpend in this January 7, 2018, interview.
 
Sanitation experts and various studies–including commissioned by the railways–have pointed out that most of the new “bio-toilets” on Indian trains are ineffective or ill maintained and the water discharged no better than raw sewage, as IndiaSpend reported on November 23, 2017.
 
Lokendra Singh, former director of the Defence Research and Development Establishment (DRDE), had, after an expedition to Antarctica, brought home psychrophilic bacteria that can survive in extremely low temperatures. The bacteria were mixed with cow dung and normal soil, which have methogens (microorganisms that produce methane) capable of breaking down human excreta. This was then supplied to the manufacturers of rail bio-digesters.
 
Singh’s claims of a scientific breakthrough were questioned: The bacterium did not have independent third-party certification, the Defence Research and Development Organisation (DRDO) did not have a patent for the design and manufacture of bio-toilets, and once the tank is filled, human excreta is allowed to drop down onto the tracks.
 
A December 2017 report of the Comptroller and Auditor General on these bio-toilets echoed the findings of our November 2017 investigation into their widespread malfunctioning: The CAG found 199,689 defects in 25,000 toilets. Some major issues were:
 
Highest number of problems/ defects (41,111) found at the Bengaluru coaching depot, followed by Gorakhpur (24,495) and Wadi Bunder (22,521);
Complaints per bio-toilet were highest at the Bengaluru coaching deport (98), followed by Wadi Bunder (32), Rameshwaram (28) and Gwalior (17);
Of the 102,792 instances of choking, 10,098 (10%) cases reported in March 2017;
Of the 102,792 cases of choking in 25,080 bio-toilets, the highest (34%) were reported from Bengaluru. This implied that one bio-toilet got choked 83 times a year;
Choking incidents have risen from 2015-16: One bio-toilet got choked four times a year during 2016-17.
 
Responding to the CAG findings, the railway ministry said its criticism was “not correct” and that “some problems of choking were occurring on account of misuse of toilets by passengers”. An official note from December 20, 2017, said: “These issues are being dealt with promptly.”
 
The denial
 
The railways ministry responded to our November 2017 investigation, pointing out what it calls “factual inaccuracies” and a lack of “technological understanding”. We had published the rejoinder verbatim, with our response:
 
The ministry said the IIT Madras study was conducted “on stationary toilets on selected 15 field installed units and 6 units installed at IIT Madras Campus with bio-digesters based on DRDO technology”, and not on railway coaches. “There is absolutely no difference,” professor Ligy Philip of IIT Madras had told us. “The same technology and the same bacteria is being used for both the land-based and the train bio-digesters.”
“It is not correct to say that bio-toilets in coaches are ineffective or ill-maintained,” the ministry said, adding that periodic tests are conducted to ensure that the discharged water meets specific norms. However, agenda papers of a Railway Board meeting in October 2017 showed that bio-toilets have not passed the performance tests.
“DRDE has more than a dozen national and foreign patents not only on the basic technology but also on the bio-digester fitted in railway coaches,” the ministry said. However, the patent is for engineering and septic tank design. There is no mention on the use of the Antarctica bacteria to aid the bio-digestion process.
The ministry said that a memorandum of understanding (MoU) was signed with the DRDO in March 2010. However, the patent for engineering and septic tank design was awarded in 2015–five years after the MoU for supply of bio-toilets was signed.
 
The policy U-turn
 
As a possible solution, IndiaSpend had offered the ‘zero-discharge toilets’ developed by IIT Kanpur.
 
“IIT Kanpur developed ‘zero-discharge toilets’ which have a separator to segregate the solid matter of human excreta from the liquid portion,” Tare, the professor, told us. “The liquid portion, after treatment, can be used for flushing, while the solid waste can be evacuated at junctions with the aid of assembly suction pumps. Human excreta–mixed with cow dung–could subsequently be used for vermi-composting.”
 
The railway ministry rejected this solution saying the system “involves installation of ground handling facility to evacuate retention tanks at the terminals”.
 
“This involves huge infrastructure cost, man-power, terminals are landlocked, inter- track distance is not uniform everywhere,” the ministry said. “Whereas, in IR-DRDO system, waste is treated on-board itself and thus no ground infrastructure is required. Thus, IR-DRDO bio-toilets being proliferated over IR, is a better solution.”
 
Vacuum toilets, such as those used in aeroplanes, as we said, will need evacuation facilities and treatment plants–which will come at an additional cost to the Rs 6,250 crore likely to be spent on replacing the bio-toilets.

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That defence spotlights the fact that Gujarat–which is ranked second by industries and fifth by per capita income–is ranked 17th among 29 states on infant mortality and 25th by underweight prevalence among under-five children.
 
Up to 33 infants die per 1,000 live births in Gujarat, compared to Kerala (12), Tamil Nadu (19), Maharashtra (21) and Punjab (23), according to the Sample Registration System Statistical Report 2015, the latest available data.
 
Up to 39% of children in Gujarat are underweight–the national average is 35%–compared to 16% in Kerala, 21% in Punjab, 23% in Tamil Nadu and 36% in Maharashtra, according to the National Family Health Survey 2015-16, the latest available data.
 
Among 29 states, Gujarat is India’s second-most industrialised state by gross valued added, its state gross domestic product is fourth-highest in the country, and it is ranked fifth by per capita income, according to government data.
 
On underweight prevalence, Gujarat is ranked, as we said, 25th among 29 states–only ahead of Uttar Pradesh, Madhya Pradesh, Bihar and Jharkhand.
 
Smaller states such as Mizoram (11.9%) and Manipur (13.8%) and bigger states such as Kerala (16%), Punjab (21%) and Tamil Nadu (23%) have lower proportions of underweight children.

Source: National Family Health Survey 2015-16
 
As we said, Gujarat’s infant mortality rate (IMR, or infant deaths per 1,000 live births) is an outlier compared to its economic indicators, as is its under-five mortality rate, by which it ranks 18th, with India’s top five being Goa (13), Kerala (13), Tamil Nadu (20), Maharashtra (24) and Manipur (26).
 

Source: Reserve Bank of India reports here & here; Sample Registration System 2015, National Family Health Survey 2015-16

Note: Domestic product at constant prices and per capita income data are for 2015-16; Economic data for Tripura are for 2014-15, West Bengal for 2010-11
 
Gujarat, which is ranked fourth based on state domestic product, is ranked 17th on infant mortality, behind poorer states such as Manipur (22), Arunachal Pradesh (23) and Tripura (27).
 
Gujarat has a per capita income of Rs 122,502 that is almost close to Maharashtra (Rs 121,514) and Kerala (Rs 119,763). However, its child health indicators lag Maharashtra and Kerala on all three parameters–underweight children under five, infant mortality and under-five mortality.
 
Jammu & Kashmir, with a per capita income of Rs 60,171–50% lower than Gujarat–has lower infant mortality (26) and under-five mortality (28).
 
Nearly 1.08 million Indian children under the age of five years died in 2015–that is 2,959 deaths every day or two each minute–many of them of causes that were preventable and treatable, IndiaSpend reported on August 16, 2017.
 
India has reduced its IMR by 68% in the last 41 years from 130 in 1975 to 41 in 2015-16, data from the National Family Health Survey 2015-16 reveal, IndiaSpend reported on May 3, 2017.
 
India’s IMR of 41 deaths is worse than than poorer neighbours Bangladesh (31) and Nepal (29).
 
The deaths of infants at public hospitals is a nationwide issue, revealing the depth of the crisis in India’s public-health system, IndiaSpend reported on August 29, 2017. This year, 52 infants died over 30 days at Jamshedpur’s Mahatma Gandhi Memorial Medical College hospital in Jharkhand, two weeks after 70 children died at the Baba Raghav Das Medical College Hospital at Gorakhpur, Uttar Pradesh.

Courtesy: India Spend
 

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Last coach (guard coach) of Jammu Rajdhani derailed on arrival at New Delhi Railway Station at 6 am; no injuries or casualties reported.
— ANI (@ANI) September 14, 2017

 
The largest passenger system in the world with 23 million passengers every day, the Indian Railways was hit by 78 derailments in 2016-17 with 193 people dead, the most in 10 years, IndiaSpend reported on August 22, 2017.
 
Although accidents in general have fallen over 10 years, from 194 in 2007-08 to 104 in 2016-17, derailments have risen over this period, an indication that trains are increasingly at peril.
 
The first six months of 2017 reported 29 train accidents, of which 20 were due to derailments, killing 39 people and injuring 54, according to this reply to the Lok Sabha, parliament’s lower house, on July 19, 2017.
 
Over the last decade to 2016-17, 1,394 train accidents were reported in India; 51% or 708 were due to derailments in which 458 people were killed.

 
Source: Rajya Sabha (unstarred question 3473, March 31, 2017; unstarred question 3007, August 11, 2017.)
 
Accidents of consequence in the current financial year ending August 2, 2017, have decreased by 51.2%, from 43 in 2016-17 to 21 in 2017-18, according to this reply (starred question 216) to the Rajya Sabha, parliament’s upper house on August 4, 2017.
 
“Accidents per million train kilometres, an internationally accepted yardstick of safety, has declined from 0.23 in 2006-07 to 0.11 in 2014-15, 0.10 (approximately) in 2015-16 and further declined to 0.09 (approximately) in 2016-17,” former minister of railways Suresh Prabhu told the Rajya Sabha in his reply.
 
Derailment was the second-leading reason for train accidents and casualties between 2003-04 and 2015-16, according to the Twelfth Report of the Standing Committee on Railways on ‘Safety and Security in Railways’ presented in the Lok Sabha on December 14, 2016. The leading reasons for accidents was human error.
 
One of the cause for derailments is the lag in addressing what are technically called “defects in the track or rolling stock”.
 
Only 54% track renewal may have happened in 2016
 
Of 114,907 km railway tracks, 4,500 km, or 4%, should be renewed annually, the committee said. However, of 5,000 km track length due for renewal currently, no more than 2700 km, or 54%, would be renewed, it said.
 
“Track renewal covering 5900 km of track have been sanctioned as on March 31, 2016,” said the Fifteenth Report of the parliamentary standing committee on the action taken by government on the recommendations/observations contained in the 12th Report, presented on August 3, 2017. “…Accordingly, physical targets have also been increased from 1500 km to 2668 km.”
 
Track failures and subsequent derailments are caused by twin factors–excessive traffic and underinvestment in rail infrastructure, IndiaSpend reported on April 3, 2017. Up to 40% of Indian Railways’ 1,219 sections are utilised beyond capacity.
 
Here’s all you need to know about the Mumbai-Ahemdabad bullet train.
 

 

 

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This is a common practice in many Indian households, but among the rural poor it makes women and children, some of the weakest in the world, hungrier and sicklier, sparking a cascade of slow development, eventually implicated in holding back national economic progress.

“Particularly among the rural poor, food distribution in households is not based on need,” reads Right to Food in India, a 2003 paper of the Centre for Economic and Social Studies, Hyderabad. “The breadwinner gets sufficient food, the children get the next share, and women take the remains.”

A two-year-old project in Rajasthan used an unusual strategy to break this pattern among poor tribal communities in the southwestern district of Sirohi and eastern district of Banswara. Instead of simply increasing their food supply and access — the standard approach for dealing with malnutrition — it attempted to break the tradition of prioritising men’s needs first.
“We were advised to serve meals only after all the family members are seated so that everyone gets served equally and we discuss food,” said Rukmani (who uses only one name), one of the project beneficiaries.

Behind this strategy of the Rajasthan Nutrition Project, launched in 2015, was a baseline survey of 403 women. It revealed that those with a lesser say in running their household were more likely to have less food for their children and were themselves vulnerable to malnutrition.

Malnutrition is one of the leading causes (about 50%) of all childhood deaths in India, and malnourishment at an early age can lead to long-term consequences, as it affects motor, sensory, cognitive, social and emotional development, IndiaSpend reported in July 2014.

“Stunted children (low height for age) face a lifetime of lost opportunities in education and work,” said a global study called End of Childhood Report 2017. “They are also more likely to succumb to illness and disease, and can die as a result.” Only one child in 10 in India gets adequate nutrition, IndiaSpend reported in May 2017.

So, the Rajasthan campaign, executed by Freedom from Hunger India Trust and Grameen Foundation, both nonprofits, through local partners Pradan and Vaagdhara, made women more health and nutrition-aware and sensitised their husbands to gender equality.

Source: Freedom from Hunger India Trust and Grameen Foundation

“We chose to address intra-household food consumption disparity — the fact that in one household alone, the women and children could be food insecure while the men are food secure,” said Saraswathi Rao, CEO, Freedom From Hunger India Trust.

Over two years, the project has touched the lives of 30,000 people and among the 403 women who were sampled, more than doubled the number of women and children who always have enough to eat.

Before the intervention, 31% women had reported that their husbands alone decided how much food to serve the family. After being told to make decisions jointly, no more than 3% of men continued to take this call alone, while the number of couples making joint decisions increased from 12% to 19%. Also,  53% households reported eating more meals together as a family.

Why better nutrition for women needs a change in attitude

The Rajasthan Nutrition Project’s approach is significant in another respect. Economists have long wrestled with a problem often referred to as the India Enigma: Despite greater economic progress India’s child health indicators fare worse than that of sub-Saharan African nations.

India has more malnourished children than sub-Saharan Africa, IndiaSpend reported in May 2017. Indian babies are more than twice as likely to have lower birth weights than those born in sub-Saharan Africa, 28% to 13%, IndiaSpend reported in November 2016. Low birth weight is the single largest predictor of undernutrition, write S Mahendra Dev and Alakh Sharma in a 2010 Oxfam publication.

The problem, Dev and Sharma said, could be empowerment. “Women in South Asia tend to have lower status and less decision-making power than women in sub-Saharan Africa,” wrote the authors.

So, the solution does not appear to lie in increasing household food supply and access to food—as the government does through the Public Distribution System and Integrated Child Development Services (ICDS), respectively, as a baseline study conducted at the start of the project confirmed. The ICDS is a national programme that provides medical services to preschoolers through a local anganwadi (creche).

Interviews with 403 women revealed who made household decisions about food, mobility and communication. This, in turn, was found to closely correlate with their own and their children’s food security. Nine in 10 were married, of tribal origin and had an average of 3.21 children, including at least one under the age of two, and a third were from families with monthly income Rs 2000-2500.

Among the women who reported having greater autonomy, 39% respondents and 42% of their children had enough to eat. Only 12% women with lower levels of autonomy and 17% of their children reported having enough to eat.
 

Source: Freedom from Hunger India Trust and Grameen Foundation

Women who had a greater say in household decisions were more likely to use government health services, breastfeed their children and enjoyed a better relationship with their husbands.
The study revealed that any effort designed to improve food security and nutrition had to aim at improving women’s autonomy and decision-making within the household, Kathleen Stack, executive vice president of the Grameen Foundation said.

The other benefits of abandoning gender hierarchy

In a one-room tenement in Morthal, with a television blaring in the background, a group of women were talking of what they had learned: How control over nutrition, health and household finance helps their families become healthier.

Zuhra Bano and Meera Gujjar, leaders of local Self Help Groups (SHG), were the most vocal. With 1,250 other mostly illiterate leaders of SHGs, they had signed up for training under the nutrition project.
 

The 1250 trained Self Help Group (SHG) leaders were called Community Nutrition Advisors, and given the job of imparting information to their SHG members and the women’s husbands. They also held rallies to spread the word.

Having qualified as community nutrition advocates, Zuhra, Meera and the other SHG leaders disseminated their new knowledge to their group members—women like Santosh, Hemlata, Rukmani.

One of the project aims was to increase the food available for the sample set of women and children. This was measured by moving them up at least one point on a four-point scale.
 

Source: Freedom from Hunger India Trust and Grameen Foundation

Women were also encouraged to use the food distributed to pregnant and lactating women and young children under the ICDS. Some women had not used this service because they did not know of it, others because their families restricted their movements.

“We never knew that the anganwadi provides children (aged 3 to 6 years) a free daily meal, a variety of meals like daliya (porridge) and khichdi (a rice and lentil preparation), and take home rations for infants,” said Meera, the SHG leader.
 

The Rajasthan Nutrition Project, an initiative in Rajasthan’s Sirohi and Banswara districts involved training 1250 mostly illiterate Self Help Group (SHG) leaders in health, nutrition and managing household finances. Here, Meera (in green), a SHG leader, is seen with a few members of her SHG, with who she shared her learning. The 1250 SHG leaders reached out to over 8000 women, and through them, touched the lives of 30,000 people.

Having learned of what was available, the women of Morthala wondered if they would be permitted to walk to the nearest anganwadi, a couple of kilometres away, in the neighbouring village.

To address this social constraint, community facilitators like Baldev Kumar, also trained under the project, and community nutrition advocates conducted gender dialogues to explain to husbands why it was important for couples to make decisions jointly.

After these conversations, more than  twice the number of women were permitted to visit a market or healthcare centre than before, increasing the use of anganwadi services by 32%. The number of couples taking joint decisions about buying food also doubled.

Ensuring dietary diversity in a few, cost-effective steps

To improve their family’s nutrient intake, women were advised dietary diversity, especially to eat more fruit and vegetables. This was unthinkable for many of the tribal women, who had no money to buy extra food.

“So, we sourced seeds from local government agencies and helped them create kitchen gardens, even those with limited water supply started using waste wash water to grow a few vegetables,” said Baldev.

Women now reported consuming an average of three additional foods a day. Their intake of green leafy vegetables increased 344%, their consumption of yellow/orange coloured veggies rose 940% and their milk intake rose 70%.

Nutrition tips the women took to implementing included guidelines such as “cook in an iron pot” and “make more nourishing rotis (Indian flat bread) by mixing a couple of grains like wheat, corn and pearl millet instead of using only wheat” and “breastfeed your children in the first hour after birth”, reported Zuhra and Meera.

Among the 403 study participants were 21 pregnant women, an intentional inclusion to gauge how women’s autonomy affected breastfeeding.

When the women were first interviewed, it turned out that those with a say in their household finances were more likely to report exclusively breastfeeding their child for six months.
Over the course of the engagement, the percentage of new mothers who breastfed infants within the first hour of birth increased from 47% to 83%.

Autonomy empowers rural women to deal with illness more promptly

Having been shown how to make Oral Rehydration Solution (ORS) and to keep a child with diarrhoea well hydrated, the number of women who had treated a child with diarrhoea with ORS increased by 140%—from 34% to 84%.

“Now we take care of diarrhoea ourselves by making ORS,” said Meera, the SHG leader

Better knowledge of health services at the anganwadi encouraged more women to promptly seek healthcare for themselves as well as their children.

Savings on health increased from 65% to 80% while 52% women reported an overall increase in savings.

“Now we put aside a little money every month for our health, just in case we need it,” said Zuhra.
 

Zuhra Bano (in orange), a Self Help Group (SHG) leader, signed up to be trained as a Community Nutrition Advisor, which meant she would share health, nutrition and household finance information with members of her SHG and interact with the women’s husbands to tell them how important is it to make decisions about health and food jointly.

Make the community a part of the solution

“We found the methodology effective because it involves the community; making local women a part of the solution always works better than advocacy by an external agent,” Roli Singh, secretary of Rajasthan’s department of women and child development told IndiaSpend.

“Also, the initiative is cost-effective, and the kitchen garden component to enhance the supply of fresh and nutritious food can be made more effective by synergising it with a livelihoods initiative and agriculture extension schemes,” said Singh.

To involve the community even more closely, Singh would also like the manufacturing, packaging and supply of supplementary nutrition to be outsourced to SHG clusters with experience in health and nutrition advocacy.

At recent national and state level consultations in Delhi and Jaipur, Arun Panda, (then) additional secretary and mission director, National Rural Health Mission, released a policy brief and a technical guide based on the Rajasthan project.

Prepare nutritional dos and don’ts in simple language, including Hindi, and share these with the ministry of health and family welfare to be disseminated in other states, Panda requested the Freedom From Hunger India Trust. “Simple and cost-effective solutions can easily be understood, adopted and sustained,” he said.

Back in Morthala, Meera and others’ lives are changed forever. Thanks to a small change in their mealtime routine.

(Bahri is a freelance writer and editor based in Mount Abu, Rajasthan.)
 

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Accredited Social Health Activists (ASHAs) – considered to be voluntary workers – are paid a honorarium by the government and most make about Rs 1,000 a month–less than the cost of a bottle of single malt or a branded shirt.

Rekha Rewat, an accredited social health activist (ASHA), in Madhya Pradesh. An ASHA serves as a healthcare facilitator, and goes door to door visiting the poorest and most vulnerable sections of the society–nearly 22% or 269 million Indians still live under the poverty line.

Nearly a million workers–forming the frontline of India’s faltering public health system–are inadequately trained and are underpaid, according to an IndiaSpend analysis of health ministry data, imperiling the country’s progress in healthcare efforts.

Accredited Social Health Activists (ASHAs)–considered to be voluntary workers–are paid a honorarium by the government and most make about Rs 1,000 a month–less than the cost of a bottle of single malt or a branded shirt. ASHAs are required to undergo a 23-day training spread across 12 months, but a third of the ASHAs in a block in north Bihar were not trained at induction, and the rest received seven days of training and learnt the rest by reading the manual, according to this 2015 study conducted in 187 villages.

An ASHA serves as a healthcare facilitator, and goes door to door visiting the poorest and most vulnerable sections of the society–nearly 22% or 269 million Indians still live under the poverty line. Her responsibilities are related to reproductive and child health, immunisation, family planning and community health. This includes home visits and counselling of pregnant women, helping with village health plans, providing medical care for minor ailments, such as diarrhoea, fever and first aid for minor injuries.

India accounted for close to a fifth of 303,000 maternal deaths and 26% of the neonatal deaths globally, IndiaSpend reported in September 2016. Only 62% of Indian children between the ages of 12 and 23 months were fully immunised—for BCG, measles, and three doses each for polio and diphtheria and tetanus IndiaSpend reported in March 2017.

More than seven in 10 ASHAs said they need better training

As many as 70-90% ASHAs said they needed better training, monetary support and timely replenishment of the drug kit to perform better. ASHAs also said they received no assistance from the panchayat and limited support from auxiliary nurse midwives and anganwadi workers.

Only 22% of the ASHAs surveyed had some understanding of their role, according to the 2015 study in north Bihar; most ASHAs were involved in maternal and child care but did not work in local health planning or other duties related to health activism.

An ASHA is between 25 and 45 years of age, educated up to grade VIII or higher, and is currently married/divorced/widowed. Typically, one ASHA caters to a population of 1,000 people, but the average has since dropped to one ASHA per 910 population.

An ASHA is selected through a process involving community groups, self-help groups, anganwadi (courtyard shelters), block nodal officers, district nodal officer and gram sabha (village councils).

At least 65% ASHAs were being consulted during illness of a sick child but their effectiveness was lower due to “lack of skills, supplies, or limited support”, according to this 2015 report by the National ASHA Mentoring Group in 16 states.

For instance, ASHAs were able to supply oral rehydration solution from their kit in 27% of diarrhoea cases in Bihar, 37% in Jharkhand, 56% in Rajasthan and 54% in Assam.

ASHAs were found to be satisfactory in 52% cases for temperature measurement, 61% cases for handwashing (before handling patients), 43% cases for weight measurement and 68% cases for skin-to-skin care, according to this 2016 study published in Indian Pediatrics.

“The study demonstrates that the knowledge and skills of ASHAs regarding newborn care is sub-optimal,” the authors said.

‘Saved lives, always on call for emergencies. Earned Rs 1,000-Rs 1,200 a month’

Sandhya Vaidya, 32, became an ASHA in 2010 because she wanted to work outside her home and help other women in her village of Wansadi in Naxal-affected Korpana taluka (administrative block) in Chandrapur district, Maharashtra.

The work was gratifying: Vaidya remembered saving a baby’s life–as she was stuck in half inside the birth canal as her mother had seizures–among her achievements. But the pay was paltry, she told IndiaSpend.

She was paid Rs 2 for each household visited, Rs 3 for each malaria test, Rs 150 for a session to create awareness on mothers’ nutrition needs and Rs 600 for escorting women to the sub-centre for delivery if the woman is from below poverty line. (The rates have been revised since.)

ASHAs, as we said, are considered to be voluntary workers and paid honorariums; for Vaidya, it used to be Rs 1,000-Rs 1,200 per month, given lump sum once every two or three months.

It took two full years before she received the drug kit she was supposed to carry around to the households, she added. The drug kit consisted medicines for simple ailments.

While they were given training every year, Vaidya said, most times they were asked to read from the manual.
 

Sandhya Vaidya, 32, became an accredited social health activist in 2010. She was paid Rs 2 for each household visited, Rs 3 for each malaria test and Rs 600 for escorting women to the sub-centre for delivery if the woman is from below poverty line. In 2015, tired of the low pay, Vaidya applied and was selected for the position of police patil (constable).

Before the launch of the 108 ambulance service that reaches a patient within 20 minutes in urban and 40 minutes in rural area, Vaidya spent her own money to escort mothers to healthcare centres. “I have helped many women during their pregnancies with food, medicines and clothes for their kids for the first month.”

In 2015, tired of the low pay, she applied and was selected for the position of police patil (constable). “I now make Rs 3,000 a month and there isn’t much work. As an ASHA, I had to attend emergency calls at night, and do surveys for pulse polio and elephantiasis where I roamed the whole day to get just Rs 50,” Vaidya said.

There have been frequent agitations by associations of ASHAs demanding minimum wages and asking to be made government employees.

“….the issue of payment of fixed monthly honorarium has been examined on many occasions and it was decided to continue with the existing system,” this 2016 reply to the Lok Sabha by the ministry of women and child development stated.

“The ministry has not only enhanced the rates of certain existing ASHA incentives but has also introduced new incentives including those for routine activities which coupled with other existing routine activities would enable each ASHA to earn at least Rs 1,000 per month subject to her carrying out the routine activities.”

Rural India short of ASHAs by 8.3%, slow training delays certification

There are 873,759 ASHAs working in rural India against the target of 952,533 (91.7%), under the National Rural Health Mission.

High focus states, which have weak public health indicators and weak infrastructure–Bihar, Chhattisgarh, Odisha, Jharkhand, Madhya Pradesh, Rajasthan, Uttar Pradesh and Uttarakhand–had about 90% of the targeted number of ASHAs. While the northeastern states had nearly 99% of the targeted number, in states such as Uttar Pradesh, West Bengal, Karnataka and Kerala, the shortage was over 15%.

Source: National Health Systems Resource Centre
Note: Delhi has selected ASHAs only in certain identified clusters, at the level of 1 for 2,000 population. Chhattisgarh has selected ASHAs at habitation level. Tamil Nadu has selected ASHAs only in tribal areas.

Goa opted out of the ASHA programme.

ASHAs are also an integral part of the National Urban Health Mission launched in 2013–42,769 ASHAs are active in urban areas against the target of 70,721 (60%).

Given urbanisation and the expansion of slums and slum-like areas, the target for ASHAs is likely to increase across all cities and towns, the update said.

The programme to recruit more ASHAs is also stuck at inadequate training: The sluggish pace of training leads to attrition of knowledge and skills, and affects the state’s readiness to register ASHAs for certification, according to this July 2016 update, the latest available, by the National Health Systems Resource Centre, a part of the ministry of health and family welfare.

“The stagnation in training at the ASHA levels implies lack of resources: both financial and human,” the update said.

(Salve is an analyst and Yadavar is principal correspondent with IndiaSpend.)

This story was first published on IndiaSpend.
 

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The data, however, suggest a more nuanced picture. In various assembly elections since its defeat in the 2014 general elections, the Congress has actually improved its strike rate in terms of number of seats won per seats contested, although it has contested fewer seats. Not only that, it has also improved its vote share.
 
What the statistics say
 
The most appropriate metric for evaluating the performance of a political party and its “CEO” is its win percentage and vote share. Ten states–Maharashtra, Jharkhand, Bihar, Delhi, Bengal, Tamil Nadu, Kerala, Assam, UP and Punjab–have had a state election since the 2014 general election, not including the smaller ones such as Goa and Manipur.
 
These 10 states account for nearly 60% (317/543) of all Lok Sabha seats.
 
During the 2014 general election, the Congress party effectively contested in 1,544 assembly segments–parts of Lok Sabha constituencies equivalent to assembly constituencies–across these 10 states and won a mere 194, a winning percentage of 13%.
 
In subsequent state elections in these 10 states, the Congress party contested in 1,032 assembly constituencies across these states and won 258–a winning percentage of 25%.
 
Put simply, the Congress doubled its win rate between the 2014 general election and the subsequent state elections.
 
In the 2014 election, 20 of every 100 voters (weighted by size of the state) in these 10 states voted for the Congress. Post-2014, 30 out of every 100 voters voted for the Congress, an increase of 10 percentage points in vote share.
 

Source: IndiaSpend analysis of Election Commission of India data
*Weighted average vote share by size of state
 
In eight out of these 10 states, the Congress has won more assembly segments post-2014 than it did in the 2014 elections (when considering parliamentary performance in assembly segments to break down voting patterns). Its vote share increased in six out of these 10.
 
The charts below show the Congress’ vote share and seats won in the 2014 general election and the subsequent assembly election in each state. A triangle inside the box indicates that the Congress improved its performance post-2014 in that state.
 
Source: IndiaSpend analysis of Election Commission of India data
 
Arithmetically, it is hard to make the case that the Congress is in worse shape today than it was in 2014. The numbers clearly show that the Congress has doubled its win percentage and improved its vote share by 50% since 2014.
 
To be sure, the Congress’ improved electoral performance is largely on the back of opportune alliances. But a decision to swallow pride and ally with another party is also a political strategy.
 
It can also be argued that the party’s performance in 2014 was so miserable that the only way from there was up.
 
Either way, only time will tell if the Congress needs a new life or a coffin, but arguments on either side should not lose sight of the data.
 

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Punjab Congress chief Captain Amarinder Singh addresses a press conference after his party won the assembly elections with 77 out of 117 seats, up from 46 in 2012.

On March 11, 2017, the Congress party led by Captain Amarinder Singh won the Punjab elections with 77 out of 117 seats, up from 46 in 2012. Seats won by the Shiromani Akali Dal (SAD), the party in power from 2012-17, reduced from 56 to 15.
 
In 2014-15, Punjab had a per capita income of Rs 96,638, which is likely to increase 5% to Rs 101,498 in 2015-16, according to advance estimates, but this rise does not reflect a host of economic and social problems, as IndiaSpend reported in January 2017.  
 
As the new Congress government takes charge, here is a look at some of the major issues in Punjab, India’s 11th richest state, and the solutions laid out by the Congress in its election manifesto.

 
Slow agricultural growth
 
The rate of agriculture growth in the state declined over nine years, from 0.95% in 2005-06 to -3.4% in 2014-15, according to Punjab government data, affecting 6.3 million people of the working population engaged in agriculture, according to the 2011 Census.
 

Although Punjab is likely to have recorded a higher agricultural growth rate in 2015-16 than the national agricultural growth rate, average farm sizes have fallen from 3.9 hectares to 3.7 hectares over five years from 2005-06 to 2010-11, according to 2010-11 Agricultural Census data. Many youth are no longer interested in farming, as this 2016 study in the Asia Pacific Journal of Research observed.
 
Lack of research and development and the inability to exploit irrigation facilities and boost yields are issues that lead to agriculture to grow slower than it could, according to the Economic Survey 2015-16 of Punjab.
 
What the manifesto said” For higher agricultural growth, the Congress manifesto said it would continue to provide free power to farmers, improve agricultural product markets, support the development of new high-yielding varieties of seeds, improve the canal irrigation system, incentivise farmers to invest in crop diversification, promote food processing industries, set up modern warehouses for produce, cold storage and better transport infrastructure for agricultural produce.
 
The manifesto also proposes several other programs, including a direct transfer of agricultural subsidies to reduce leakage, and increasing compensation for crop failure to Rs 20,000 per acre.

High youth unemployment
 
In Punjab, the unemployment rate among youth–the proportion of the labour force between 18 and 29 years that is unemployed–is 16.6% while the Indian average is 10.2%. Punjab also has India’s eighth-highest rural youth unemployment rate.

 
Increasing mechanisation of agriculture and the lack of required skills to work in information technology firms have left Punjab’s rural educated youth in a limbo, according to this 2014 paper by the Economic and Political Weekly.
 
As many as 18,770 factories closed between 2007 and 2014, when the SAD was in power, the Hindustan Times reported on February 3, 2014, quoting right-to-information data obtained by the Punjab Pradesh Congress Samiti (Punjab state congress committee): 8,053 factories closed in Amritsar, and no new industries were started in Tarn Taran, Moga, Rupar and Mansa districts, according to the data.
 
Increasing subsidies–and hence a shortage of money for government investment–has been cited as a key reason for Punjab’s declining growth rate, according to this 2012 commentary by the CATO Institute, an American think tank based in Washington DC.
 
Populist policies, such as free electricity to farmers, could also be responsible for slowdowns, the Wall Street Journal reported in May 2011. The Congress manifesto said it would continue to provide free electricity to farmers.
 
Inflated land prices due to restrictive laws, neglect of higher education due to emphasis on agriculture, investment rates below the national average since the 1990s and corruption are other reasons for slow industrial growth in Punjab, according to this 2012 paper by the CATO Institute.
 
What the manifesto said: The Congress manifesto said the government will provide ‘Ghar Ghar Rozgaar’, a job in every household. For this, it proposes to revive small and medium scale industrial clusters such as hosiery, textiles, sports goods, electronics, wood work, electrical, hand-tools, light machinery parts, while aggressively pursuing global and domestic investors to set up units in Punjab. The manifesto said the government would select companies based on the employment opportunities for the youth of Punjab.
 
It also promises an unemployment allowance of Rs 2,500 per month to all unemployed, until these jobs can be created.
 
To attract industry, the manifesto promises electricity at Rs 5 per unit, subsidised water and a sewerage facility. It also suggests a revamp of the excise, taxation policy, and administration to check corruption.  

Deep and spiralling drug problem
 
There are nearly 230,000 opioid dependent and 860,000 opioid users in Punjab, according to the 2015 Punjab Opioid Dependence Survey, conducted by researchers from the All India Institute of Medical Sciences and Society of Promotion of Youth and Masses, a non-profit working towards prevention of drug abuse.
 
While 80% of addicts tried to quit, no more than 35% received professional help. Opioid dependents spent Rs 1,400 per day on drugs or an estimated Rs 7,575 crore state-wide every year, and drug use is linked with poverty, unemployment and illiteracy, as IndiaSpend reported in February 2017.
 
What the manifesto said: The Congress manifesto suggests a ‘Zero tolerance policy’. It proposes ‘permanent cure, perfect rehabilitation’ through a new legislation for the speedy trial of those who engage in the drug trade, and confiscation of their property, along with a policy of rehabilitation for those who ‘have been wrecked by this evil’. Anyone who registers themselves at a district de-addiction centre will be treated free of cost, and receive training so that they can earn their livelihood.
 
It also proposes to increase economic productivity with higher investment to create large-scale employment for youngsters. Finally, it proposes an overhaul of the education policy so that the youth can benefit from India’s growing economy.

The neglect of primary education, and Punjab’s drop-out problem
 
Female literacy rate increased 11 percentage points from 70.7% in 2011 to 81.4% in 2015-16, according to data from the National Family Health Survey, 2015-16. The male literacy rate saw a slower growth of seven percentage points, from 80.4% in 2011 to 87.5% in 2015-16.
 
But even though literacy and the general education budget rose, the average annual dropout rate at the primary level increased, from 1.3% in 2014-15 to 3.1% in 2015-16, according to District Information for System Education (DISE) data.
 
In Punjab, 84% of primary-age students were enrolled in primary school in 2015-16, but only half (51.6%) of secondary-age school students were enrolled in secondary school, according to the DISE data.
 
Though learning levels in the state are higher than many other Indian states, many students are left behind, and others don’t learn at the grade level. For instance, in 2016, in rural Punjab, less than half (48.7%) of grade III children surveyed in households could subtract, while as few as 35.2% could read a grade II level text.
 
Lack of classrooms, over-congestion of present ones and unavailability of basic electricity or drinking water are some reasons as to why students dropped out or cut classes, the Indian Express reported in May 2016.
 
What the manifesto said: The Congress manifesto lays out several provisions for improving education in the state, including spending 6% of the state’s gross domestic product on education, emphasis on early childhood care and education, promoting quality education, a digital education program, recruiting teachers in sufficient numbers, reducing their time spent on non-teaching related tasks, and providing free transportation to school for all students.
 

Weak healthcare system, low coverage of health insurance
 
Punjab faces a double burden of obesity and poor nutrition. Obesity among men (27.8%) and women (31.3%) increased by 5.6 and 1.4 percentage points, respectively, in the decade to 2015, putting more people than ever at risk of different non-communicable diseases, a situation the state’s healthcare system appears unprepared to deal with.
 
Simultaneously, the proportion of anaemic men doubled between 2005 (13.6%) and 2015 (25.9%), and anaemic women went up from 38% to 53.5%.
 
Wasting (low weight-for-height) among children has increased from 9.2% in 2005 to 15.6% in 2015, and one in four children is still stunted (low height-for-age), according to an analysis of the latest government data, by the Observer Research Foundation in February 2017.
 
Vacancies and absenteeism at Punjab’s public-health facilities make it difficult to improve health status through publicly provided healthcare, according to this 2014 Princeton University study. As a result, dependence on private healthcare facilities is high–83% for outpatient and 66% for inpatient–leading to Punjab having the highest average medical expenditure per episode of hospital admission in India.   
 
Punjab also has among the lowest proportions of population covered by health insurance–5.6%, compared to the all-India average of 15.2%.
 
What the manifesto said: The Congress manifesto promises compulsory health insurance for all, with premiums borne by the state government for those below 18 years and those above 60 years.
 
It also promises that primary and community health centres would be developed as multi-speciality hospitals with adequate medical and non-medical staff, while proposing to hire doctors every year to avoid a shortfall.
 
We welcome feedback. Please write to respond@indiaspend.org. We reserve the right to edit responses for language and grammar.
 

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People queue up outside an ATM kiosk to withdraw cash in Hyderabad on December 21, 2016. The government accepted that the demonetisation exercise reduced economic activity–represented by growth in gross domestic product–by 0.25%-0.5% relative to the baseline of 7%
 
The forecast corroborates the growth estimate of 7.1% by the Reserve Bank of India, and is close to the estimate of 6.6% by International Monetary Fund.
 
GDP growth is expected to remain fairly stable at 6.75%-7.5% in 2017-18. “Even under this forecast, India would remain the fastest growing major economy in the world,” the Survey said.
 
“There have been reports of job losses, declines in farm incomes, and social disruption, especially in the informal, cash-intensive parts of the economy, but a systematic analysis cannot be included here due to paucity of macro-economic data,” the Survey admitted.
 
Finance Minister Arun Jaitley presented the survey to both houses of Parliament on the first day of the Budget Session 2017.
 
The survey highlighted three major risks to growth:
 
1) How far the effects of demonetisation could linger into the next financial year (2017-18), especially if uncertainty remains on the policy response;
 
2) Geopolitics could increase oil prices more than forecast; and
 
3) Trade tensions among major countries, triggered by geo-politics or currency movement.
 
“The one significant upside possibility is a strong rebound in global demand and hence in India’s exports,” the Survey said. “There are some nascent signs of that in the last two quarters. A strong export recovery would have broader spillover effects to investment.”
 
The Survey also highlighted the need for the formation of a public asset rehabilitation agency to resolve big and complex debt cases, Business Standard reported on January 31, 2017.
 
Divided into 14 chapters, the Survey discussed other issues, such as job creation, migration, health and fertility indicators and goods and services tax–an indirect tax that will replace octroi and other local taxes–expected to come into force in July 2017.
 
The first-ever estimates of internal work-related migration, using railway passenger data for the period 2011-2016, indicate that 9 million people migrated between states every year, the Survey said, highlighting the increased migration across the country.
 
The Survey devoted an entire chapter to the idea of universal basic income (UBI): “It is premised on the idea that a just society needs to guarantee to each individual a minimum income which they can count on, and which provides the necessary material foundation for a life with access to basic goods and a life of dignity.”
 
A UBI that reduces poverty to 0.5% would cost between 4-5% of GDP, assuming that households in the top 25% income bracket do not participate in the programme, the Survey said. “On the other hand, the existing middle class subsidies and food, petroleum and fertilizer subsidies cost about 3% of GDP,” an official release said.
 
“Time is ripe for discussion, and not implementation of Universal Basic Income (UBI)”, chief economic advisor Arvind Subramanian said at a press conference.

Courtesy: India Spend
 

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