* Up to 43% of women in the working age (about 153 million) in India only do domestic work, indicating the scale of their exclusion from the workforce.
* A quarter of Indians (300 million) are illiterate, with 10% of those aged six to 14 dropping out of school.
* Nearly half of all homes (47%) lack piped drinking water and sanitation.
* About 88% of diarrhoeal deaths are caused by poor sanitation.
These are some reminders of the scale of India's continuing backwardness--despite economic progress--and the linkages between poverty, health and access to a better quality of life, explained in the India Exclusion Report (IXR) 2015, released on Saturday, March 5, by New Delhi's Centre for Equity Studies.
IndiaSpend was associated with the report's data research.
How India struggles to get the basics right
A quick glance at the 283-page report reveals that the result of poor maternal and infant healthcare is a life expectancy of 66 years (lower than the global average of 71, just a year more than Ethiopia's 65 and seven years behind poorer Cambodia's 73).
However, while the 2011 Census put India's life expectancy at 66 years, the latest government data for 2014 puts the figure at 71.5, on par with the world average.
These indices are particularly related to a lack of piped water for drinking, and sanitation--absent in 47% of Indian homes--emphasising governmental failures in providing basic infrastructure to the poor and vulnerable.
The IXR also discusses practices that can help overcome such lack of access.
It explains free, clean primary health services in Pimpri Chinchwad, Maharashtra, for the poor. In Chennai, it analyses a surveillance, disease prevention and outbreak response; in Raipur, Chattisgarh, strong community outreach practices.
Rather than ruthlessly evacuating slums, the parivartan (transformation) programme in Ahmedabad started in 1996, assured slum dwellers that they would not be evicted for the next 10 years. The assurance was not legally binding, but it helped ensure community participation to upgrade physical infrastructure (water supply, sanitation, drainage, roads) with financial assistance from the corporation.
In Bangalore, the Bangalore Water Supply and Sewerage Board considers the urban poor as potential customers. In 2000, procedures to get a water connection were simplified: “The requirement of formal tenure documents for new connections was replaced with simple occupancy proof (to address concerns of land tenure), connection fees were reduced and tariff structure for domestic water was revised to introduce lower minimum monthly charge (to address concerns of affordability), and shared connections were offered as an alternative”, said the report.
Exclusion from public goods particularly affects women, children
Exclusion is viewed as lack of access to key public goods, provided and maintained by governments and civil society--such as health infrastructure, sanitation, drinking water and work opportunities, especially for women.
Poor health and education infrastructure adversely affects women. Maternal health benefits don’t reach women easily and lack of access to education limits employment opportunity among them; 43% of women in the working age-group of 15-59 years only do domestic work, according to the report.
India has 71 million single women, according to data from Census 2011, and an IndiaSpend analysis had observed a 39% rise in about a decade. Single women include widowed and divorced women; the social stigma associated with their status excludes them from participating equally in economic activities, the IXR report said.
An estimated 44 million children in India work, the report said. Other than lack of access to education, these children also suffer from poor health.
“Disaggregated data for urban child workers are unavailable, although some reference is made to occupations such as construction, work in factories, the service sector," said the report. "Poverty and lack of social security are the main causes of child labour." Child workers typically suffer from a variety of health effects, including orthopaedic ailments, injuries, stunting of gastro-intestinal, endocrinal and reproductive systems because of strain and exposure, and greater preponderance of substance abuse as compared to children who are not in labour.
Disadvantaged groups: Victims of violence
“52 persons lay dead, over 60 had been grievously injured, and scores of houses destroyed in fires, across 14 villages (the effects radiating to 74 adjoining villages) in (the) two districts” of Muzaffarnagar and Shamli in western Uttar Pradesh in September 2013.
Violence spread to about 74 villages in the adjoining districts of Muzaffarnagar and Shamli. The largest violence-induced migration in recent times--mainly of Muslim families--is part of a continuing phenomenon, the report said, warning that “many instances of deaths, injuries, sexual violence, and destruction of property remain uncounted to this day”. Indeed, official figures themselves vary greatly, as this IndiaSpend report explained.
Will a new tax make life more difficult for the poor?
The implementation of Goods and Services Tax (GST) can increase the Gross Domestic Product by 2%, according to the IXR. This will, in turn, increase the government's tax income, possibly enabling it to provide better services.
But tax, the report said, “is inevitably a burden on every person who has to pay it". Indirect taxes on consumer goods are high, and this means everyone--the rich and the poor--must pay equally.
“... indirect taxes (i.e., the taxes imposed on the production, trade and sales of goods and services), which are regressive in nature as they do not distinguish potential tax payers on the basis of their ability to pay or, in other words, on the basis of their incomes… By virtue of being included as a part of the price of a good, an indirect tax also generates socio-economic exclusion, especially for the poor consumer,” said the report.
“GST continues to be on the drawing board with a consensus between the centre and state governments proving elusive. Depending on the actual format of its implementation, as and when that happens, including the rates of taxation and the list of commodities exempted from taxation, the implications of the GST burden on the poor household would have to be reassessed.”
(Tewari is an analyst with IndiaSpend.)
This story has been updated to include the latest government data on India's life expectancy.
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