“The public investment in social infrastructure like education and health is critical in the development of an economy,” the report said.
While India has had a target of increasing public spending in education and health (as a percentage of GDP) for years, in reality expenditure has remained stagnant and in some cases even reduced.
“As a percentage of GDP, the expenditure on education which remained stagnant around 3.1 per cent during the period 2009-10 to 2013-14, however, declined to 2.8 per cent in 2014-15,” the Survey said.
Right to Education has improved enrolment of children in school but has not had a commensurate increase in learning outcomes, it pointed out.
The Survey suggested that salaries of teachers, scholarships and other payments to children should be done in the form of direct transfers as in Direct Benefit Transfer (DBT) to ensure funds are transferred in full and to encourage more engagement.
Drop out trend
What is telling is the reasons for dropping out of school. While boys drop out to start earning, girls mostly leave schools to help out at home, as well as financial constraints. “This suggests that the cost of education is a key determinant in the completion of education,” the survey noted. According to data from the National Sample Survey Office (NSSO), the average annual private expenditure on general education per student (primary and above) has increased from ₹2,461 in 2007-08 to ₹6,788 in 2014.
“It is imperative that the government take appropriate measures to maintain quality of education and impart skills through education which ensure employability and returns to their investments,” the Survey noted.
The current metrics to measure skill training outcomes, too, are inefficient as they look only at the number of people ‘trained’ ignoring parameters such as level of training, person days, person hours and duration of training, the report points out.
The figures on health parameters, too, are dismal. While India has improved, significantly, on the primary measures of health — infant mortality, maternal mortality and life expectancy — a simple comparison with other countries at similar level of economic development shows it is far behind.
Not only is the country’s private out-of-pocket expenditure higher than any other BRICS nation, but it is lagging in nearly all these parameters of health as well.
“The higher out-of-pocket expenditure on health leads to the impoverishment of poorer sections of society and widens inequalities,” the Survey said, adding, “It is necessary to expand provision of quality public health services to low income groups to prevent impoverishment of large sections of population owing to ill health.”
The Survey has also recommended a push to cheaper generic medicines and reduce dependence on patent drugs, makers of which “make excess profits at the cost of the consumer.”