Apart from investing far more in health and education, says the Survey, policies need much change in both.
Such as designing around learning outcomes in education and punishing hospitals for raising false claims on treatment. The proportion of gross domestic product on education was 3.2 per cent in 2011-12; it remained so in 2016-17. Some schemes have helped primary enrolment of children — mid-day meals, Right to Education Act, Sarva Shiksha Abhiyan. Others such as providing of stationery or computers or infrastructure have not. “Such interventions created leakages in delivery, owing to governance issues... Education policies need to be designed with ultimate focus on learning outcomes and remedial education, with interventions which work and maximise the efficiency of expenditure..quality of education at all levels should be maintained and monitored on a continuous basis across schools.”
It suggests direct transfer of teacher pay into bank accounts. And, a biometric attendance system for teachers, other staff and students. “Based on the feedback of this pilot (scheme), the same should be modified and extended to all schools before the end of 2021-22.” It says the dropout rate in Odisha was as much as 30 per cent. The retention rate is less than 50 per cent in secondary schools in Bihar, Rajasthan, Madhya Pradesh, Jharkhand and the northeast.
The government expenditure to GDP ratio on health has hovered around 1.5 per cent, whereas the National Health Policy advocates 2.5 per cent. The Survey also notes that India has emerged as the country with the largest out-of-pocket spending on health among the BRICS economies, consistently higher at more than 60 per cent since 2008. “There has to be concerted effort to reform the sector, by addressing quality issues, standardising rates for diagnostic tests, generating awareness about alternative health systems and introduction of punitive measures like fines on hospitals and private health providers for false claims through surgery and medicines,” it said. “For more equitable access to health services, government should provide health benefits and risk cover to poorer sections.”
The Survey quoted data from the National Crime Records Bureau (NCRB) that the conviction rate had fallen in crime against women. “NCRB 2015 reports a less than 22 per cent conviction rate in such cases, a failure of governance. The proportion of IPC crimes committed against women with respect to total IPC crimes increased from 9.4 per cent in 2011 to 10.7 per cent during 2015.”