EU-India Round Table 20-22 September 2007 _____________ "Social Development: Livelihood, Health, Education and Women’s Empowerment — some emerging issues." _____________ India Contribution Rapporteur: Ms CHATTERJEE 1 Social Development: Livelihood, Health, Education and Women’s Empowerment — some emerging issues. by: Mirai Chatterjee Self Employed Women’s Association (SEWA) SEWA Reception Centre, Opposite Victoria Garden, Bhadra, Ahmedabad 380001 Gujarat, India. Phone : 91 – 079 –25506444 / 25506477 Fax : 91 – 079 – 25506446 Email : social@sewass.org Web site : www.sewa.org 2 Social development has been on India’s overall development agenda since before our Independence. The leaders of our freedom movement, led by Mahatma Gandhi promoted the idea of “Swaraj” or holistic and integrated development, respecting the environment and the autonomy of local village communities. Social and economic development were viewed as intertwined, both necessary, if our people were to emerge from grinding poverty. Consequently, development plans from the pre-independence era and after, laid special emphasis on social development. In the health sector, for example, the Sokhey and Bhore Committees prepared blue-prints for the health care system in India. This landmark, and still extremely relevant document, suggested decentralized public health services with a strong emphasis on investing in human resources, including developing local people as primary health care workers. Similar committees and task forces were set up to plan for education, livelihood/employment and equal participation of women in nation-building and in the overall development of free India. The Planning Commission of India was established to provide an overall framework for the social and economic development of the country. Till today it prepares five-year plans for each sector and state. Currently, the eleventh five-year plan is under discussion and preparation. Ten five-year plans later with millions of rupees in outlays, it is important to examine some of the issues emerging in health, education, livelihood/employment and women’s empowerment: where we have reached, where we are headed and some of the issues we face in the ongoing struggle for a society based on social justice and equality for all, as promised in our constitution. This is by no means an exhaustive treatment of the issues at hand, but rather meant to stimulate discussion and debate on the issue of social development in modern India. Each of the above sectors will be discussed separately in this paper. 3 Livelihood/Employment With a large population of working poor, livelihood and employment issues are bound to take centre-stage, because it is work and income that helps our people emerge from poverty and hunger. Time and again, and across the country and in all communities, our people say: “If we work, we can eat and feed our children” or “We work for our stomachs”. Employment and livelihood are the basic requirements of all Indians. India’s huge, economically active population is its greatest strength. Yet to fully utilise this strength, it is critical we recognise its reality. Most of the Indian workforce is engaged in the vast informal economy—that is with no fixed employer-employee relationship or none at all. In fact, 93 % of the work force is informal. If we look at the female workforce, the numbers increase to more than 94%. This translates to about 350 million workers. The informal economy accounts for 64% of GDP. It is the dominant mode of work and livelihood for most Indians. And yet, these workers do not enjoy security of work and income, nor statutory social security benefits. The labour of our hardy, resourceful workers contribute to the economic growth of our country, and yet they remain invisible, unprotected and vulnerable. Some of the main issues that face the working poor, along with steps India is taking, are outlined here. 1. Perhaps the biggest issue is the lack of work and income security faced by the vast informal workforce. Informal workers work long, hard hours for very low wages or income. They are typically engaged in several economic activities at a time so that they can eke out a living. Many of the occupations and trades are hazardous—growing and processing tobacco, construction work and handling chemicals to name a few. Most do not get regular work—in fact, their whole lives centre around the quest for work to make two ends meet. Much of their work is 4 seasonal. Since most informal workers are engaged in agriculture, their work lives are precarious and depend heavily on the monsoons. In the lean season or during drought, migration is common. These workers go to the nearest urban centre for work and sustenance. Further, whenever work is available, income or wage levels are very low. Minimum wage levels set by the government are rarely met, and with a labour surplus and absence of strong unions in most places, the workers are forced to take whatever work and income they can get. The recently enacted Rural Employment Guarantee Act (REGA) is an important step towards the work security of poor, rural households. It is truly a landmark piece of legislation, perhaps among the very few in existence anywhere. Through the REGA, one household member from every family in some of the poorest districts in India will get 100 days of employment, facilitated by the state. Thus, the state is guaranteeing a minimum level of work/employment to its poorest citizens. Soon the REGA will be extended to all districts in the country. And through the National Urban Renewal Mission, such guaranteed work and employment is likely to be extended to the urban poor as well. 2. Social Security—at least health care, child care, insurance, pension and shelter—is still not enjoyed by the mass of workers. While there are some workers’ welfare funds that provide protection and services and some social assistance programmes, there is work to be done, and models that can be replicated. In some states like Kerala, the workers’ welfare funds do reach significant numbers of workers. Similarly, the old age assistance, though modest, does reach some widows. But the millions of workers in the informal economy, for the most part, remain unprotected. The National Commission of Enterprises in the Unorganised Sector (NCEUS) is attempting to change this situation by proposing a bill and appropriate services. If this is passed in Parliament, it will be a major achievement, as informal workers will by law be entitled to at least health, life and accident insurance, maternity 5 benefits and pension. And states will be free to add on to this floor-level social security. 3. Environmental degradation—of our land, forests and water bodies—pose a direct threat to the most vulnerable of workers in India. With the deteriorating environmental conditions across the country, water has become a burning issue. And the cutting down of our forests, rampant use of pesticides, leasing land and forests for contract farming, mining and other industries, is forcing our people off the land and into penury. Large-scale development projects—whether for mining, irrigation and other purposes—have not only become controversial but also have spawned people’s movements, questioning the development choices and paths that we are taking. Raw materials—like access to bamboo for rural artisans, cotton yarn for handloom weavers, fish and shrimps for traditional fisherfolk—are increasingly hard to come by for these primary producers. Then there is the issue of changing markets due to both domestic and external changes in trade and marketing. Globalization is under close scrutiny both nationally and internationally for what it actually delivers to the majority of our citizens. This is an important subject in and of itself. But it merits at least a mention here. Marketing linkages are required to ensure that workers get fair prices for their products. in our globalized world, stronger direct linkages between producers and buyers are essential to help support families, communities and eventually nations out of poverty. To ensure that this indeed occurs, countries have to ensure that primary producers get all the support they need (access to raw materials, design development, working capital, capacity-building, knowledge of markets, among other inputs) to maximize marketing domestically. 6 At the international level, governments, people’s organisations and NGOs, need to ensure that producers’ interests are safeguarded, and that they get remunerative prices for their products. In particular, direct and indirect subsidies in developed countries for products like agricultural produce, must be removed. It is only then that rural people working on the land, will have a chance to emerge from poverty. 4. Skill development or upgradation, with appropriate technical and design inputs are among the much-needed livelihood and employment-related inputs. While we have excellent higher, professional education institutions, we still lack polytechnics and institutes that serve workers, offering them new skills, exposure to technology and linking them with new employment and livelihood opportunities, as well as market linkages. There are the ITIs, but we need many more such technical training institutes that will make our young people and workers more skilled and employable in the new national and global context. One example of what can be done is that of the Confederation of Indian Industry (CII). It is currently running a programme of skill upgradation, with certification by the ITIs. In sum, while livelihood and employment are the key to poverty reduction, and indeed the very survival of most Indians, we still have very far to go in terms of providing work, income and social security at the household level to our people. While lately this is appearing more on the development agenda, it deserves much more attention, given that it is still the top priority of most Indians—certainly the more than 90% of workers in the informal economy. 7 Health Huge and impressive strides have been made in the health sector since independence. There have been significant changes: a) Reduction of morbidity and mortality across all regions and communities in India. Reduction has been particularly dramatic in communicable diseases, infant and child mortality. Maternal mortality has also declined, and life expectancy has increased markedly for both women and men (See Appendices1,2). The birth rate and fertility levels in India, as a whole, have also fallen, and we are in the process of a demographic transition (See Appendix 3). b) Increases in skilled human resources in health has resulted in greater availability of health care providers in all parts of the country. Indeed, India has now become one of the main exporters of doctors, nurses and other skilled health personnel globally. c) Health has become a major political priority. From new policies to increased media attention, the importance of health is visible on a variety of fronts. As a result of people’s movements, a growing evidence base and an overall recognition of the critical role of health in a nation’s development, the current environment is ripe for even more rapid change and progress. While there is no question that we have moved forward, a number of difficult issues have emerged, ones that we must grapple with squarely, if we are to move towards our ultimate goal of health for all, and with equity. Some of the main issues are highlighted here. 1. The dramatic declines in morbidity and mortality levels are unevenly spread across the country. There are marked regional differences, disparities by gender, community and income level. In sum, the improvements in levels of health are unequally distributed. There is a gradient, with some states, communities and males at the top 8 and others, including women, tribals, dalits, remote mountain and desert communities at the bottom. The above inequitable trend in health is best illustrated by the now celebrated case of Kerala. For a number of socio-economic, cultural and structural reasons, Kerala has among the best health and education indicators in the country: 16.4 per 1000 live births for infant mortality compare to 43.8 as per the national census. Literacy rate is over 90% in Kerala, compared tot he national average of 65%. This is in sharp contrast to Bihar, Orissa and some of the other “weaker” states (Uttar Pradesh, Madhya Pradesh, Jharkhand, Chhatisgarh, Rajasthan and parts of the North-East and Uttaranchal). 2. There is uneven distribution of skilled health personnel in the country, with 80 per cent of doctors providing their services in the urban areas, and especially the large metropolitan ones. Most of rural India does not receive the benefits of a functioning public health system with life-saving services. To counter this, the government has recently instituted a National Rural Health Mission – a programme to ensure integrated services at the village level, with significant financial outlays for infrastructure and personnel, including a village-level female social health activist called ASHA. This mission is also promoting public-private partnerships, especially in the poorest states, to ensure that services actually reach people. 3. Resource allocation in the health sector has on the whole been inadequate and skewed, favouring curative care through large tertiary hospitals, mainly in urban areas. Public health, preventive medicine and health education have received much fewer resource allocations. In fact, family planning as a sector has obtained a huge chunk of resources, as if fertility can be dealt with in isolation from other social inputs. 4. Implementation or actual delivery of services has been mediocre at best, and very poor in many states, especially for our rural citizens. While Kerala, Goa, Tamil Nadu and some regions of other states have shown marked improvement in both health status and services, other areas are still causes of concern. 9 The main problem is that the system does not deliver—doctors do not go to the villages or even to the district-level, their and others’ non-performance is not dealt with because of their economic and political clout, medicines and other equipment do not reach or are under- and unutilized and life-saving supplies of blood and other essentials are just not available for the mass of Indians. In many areas, corruption is an issue. Medical supplies never reach where they should and instead end up on the black market, transfers of health personnel in government occur frequently, and there are irregularities in procedures which accompany the ordering of goods and public tenders. In Karnataka state, a whole commission has been set up to detect and stem corruption in the public health system. 5. There is a huge and totally unregulated private health care system in India. Today 80 per cent of all Indians go to private health providers, spending vast sums out of pocket. In fact, health-related expenditure is the number one cause of indebtedness and assetlessnes among the poor. The private health sector does provide timely, much-needed care, and in situations where often the public health system functions poorly or not at all. However, the care is not always rational and of acceptable quality. And it is always more expensive than public services. In our experience of organizing health insurance for the poor, we have seen that private providers cost three to five times more than the same health public services. Moreover, there is a strong tendency to over-prescribe medicines, promote unnecessary diagnostic tests and hospital admissions. In fact our experience has prompted us to develop tie-ups with local hospitals— government, trust and private—in order to ensure high quality, appropriate care and at low cost. 6. Health insurance is almost non-existent in India, especially for the working poor. As mentioned above, with spiraling medical costs, sickness has become the number 10 one cause of indebtedness amongst poor families, pushing them deeper into poverty. Education This is a sector that has been given prime importance by all governments since Independence. Gandhiji himself advocated a holistic and value-based education, rooted in our culture and in our ground realities. He called this “Nai Taleem” or “ New Education/Training”. This type of education was designed to open the mind, encourage questioning and also prepare young people for a life of service to India and Indians, especially the poor. India has undoubtedly made several important gains in education. Literacy levels for both women and men have increased since Independence and basic infrastructure like schools and colleges exist in most states. There have been recent serious efforts to revamp our school curriculum to one which is both holistic, culturally sensitive to our plural society. Our specialized and professional education institutes—the IIMs, the IITs, architecture, design, engineering and medical schools and colleges—are among the best in the world. Professionals graduating from these and other educational institutions in India are among the most coveted and highly paid. A case in point is the famed Silicon Valley in the U.S. where a high proportion of successful “techies” are Indians. Bangalore’s growing IT sector has also attracted world attention as a centre of excellence. Despite these gains, we have moved away from the path that Gandhiji had charted. Today, we have an education system that has little to do with our reality—the fact that we are still a largely agrarian society, steeped in poverty. 1. Despite significant improvement in basic infrastructure, the quality and suitability of Indian education, especially at the school level continues to be a difficult issue for various reasons. These include non-availability of teachers, lack of commitment on the part of teachers and others to poor, rural children and their needs (not unlike the situation in the health sector where doctors and others are unwilling to serve village communities and prefer to work in the urban centers), inappropriate curricula, and lack of proper textbooks and educational equipment among others. While school- 11 going has improved appreciably at the primary level, retaining pupils is an ongoing problem. 2. The poor conditions and education given in our school has resulted in a proliferation of private schools and colleges. These are again of varying quality and always expensive relative to the average incomes of Indians. They are not always regulated properly, either for quality, fees charged and even safety standards. 3. There are marked regional and state-wide differences in literacy and educational levels in India. Again, like in the health sector, Kerala, and some other states are on one end of the spectrum and the northern states like Bihar, Uttar Pradesh, Madhya Pradesh, are at the other end (See appendix 4). Within states, certain districts and then some communities, again dalits, tribals, working-class castes, minorities and women, bring up the rear. In fact, there are marked differentials in male-female literacy levels, and also by community—yet another parallel with the health sector. 4. Allocations at central and state government level have been somewhat better than those for health, but still far behind the levels required for a well-educated population. 5. Like in the health sector, the implementation of basic educational programmes is an ongoing challenge. Lack of accountability in our rural schools and colleges is a major issue. We have witnessed teachers coming in on one bus, signing the attendance register and leaving on the same bus. And these are not isolated anecdotes. In some states, teachers don’t even bother to come to school at all. In fact, as far as quality, costs and human resources are concerned, there are marked parallels between the issues facing the health and education sectors. 6. Corruption in the education sector may not be as endemic as in health, but it does exist. Further, the issue of transfers—moving teachers around to suit their rather than the pupils’ convenience—is commonplace and also breeds corruption. In some 12 states, just to get a teacher’s job with secure remuneration and tenure requires money changing hands. Despite the challenges, we see a remarkable change today in the importance given to education, compared to earlier decades. Today, most Indians across all communities and income levels view education as a means to social and economic advancement. In our own work at the Self-Employed Women’s Association (SEWA), we see a major shift in poor women’s priorities with regard to education. In a large gathering of grassroot leaders five years ago, education for themselves and their children was listed as their top priority for the future. Earlier women favoured work security above all else. And education was not viewed favourably as they said that their children did not get secure jobs (“naukri”) anyway, and then refused to follow the traditional economic activity of their parents once they were educated. Today, women still struggle for work security. But increasingly they are of the view that education defines the future ahead. The government’s clear emphasis on education—the Sarva Shiksha Abhiyan and other education-for-all campaigns--no doubt has created a demand for education everywhere. The mid-day meal programme in schools in many states has also drawn more of our children to school, and seems to also ensure that they remain there. The mid-day meal is arguably one of the more successful interventions to ensure education for all in our country. In sum, the greater demand for education is likely to translate into a push for better services and infrastructure for future generations of our children, in village schools all across our vast country. Women’s Empowerment Women have been active in nation-building well before our Independence. There are well-documented examples of women throughout our history who defied traditional boundaries and struggled for their beliefs, and for greater space and leadership in Indian society. 13 But it was perhaps the Freedom Movement which saw large numbers of women take to the streets for the first time. They heeded Gandhiji’s call and fought shoulder-toshoulder, non-violently, for our independence and for a new society based on justice and equality between women and men. Our nationalist leaders not only recognized women’s contribution, the need for their empowerment and equal participation in all aspects of public life, but also enshrined equal rights for all in our constitution. Laws protecting women and promoting their rights have been enacted. There is no doubt that much ground, here too, has been covered. A few examples of recent legislation to protect and promote the rights of women include the bill against domestic violence, and also the mandatory reservation of one-third of all elected seats for women in the village councils or panchayats. This reservation is assured through the 73rd and 74th Amendments to the Constitution of India. As a result of this, 1.2 million women have been elected as representatives in local bodies. These women can now push for various pro-women and pro-poor policies. The amendments to the Hindu Succession Act 1956, passed by the Parliament in 2004 is another landmark legislation. Through this, Hindu women, and also Jains, Buddhists and Sikhs, get joint ownership rights in ancestral property, including equal rights to agricultural land. The government has also set up a National Commission for Women to promote women’s empowerment and safeguard their rights. It undertakes awareness and skill development related training activities all over the country. Several states – Madhya Pradesh, Maharashtra, Haryana, Tamil Nadu, Kerala and Gujarat to name a few – have undertaken special programmes for women. The women’s movement picked up momentum in the seventies, with campaigns against violence, dowry, for equal property rights and inheritance and for employment with equal remuneration. Women in large numbers organized on a number of issues, including the struggle against alcohol and its effect on both violence against women and on poverty. The anti-arrack movement in South India reminded policy-makers that women, when organized, can be a powerful force for change. Doors in non-traditional sectors— 14 engineering, science, management, finance and other fields—have increasingly opened up for women. Yet, for the mass of women who are poor, rural but very economically active, equal rights and status—within the home, the community, the village and beyond—is still a distant dream. There is a greater awareness of injustice, exploitation and discrimination, but still too few strong women’s organizations and others to support their efforts to overcome the many layers of inequality they face. Where they organize into their own membership-based organizations, they are strong, articulate and develop into capable leaders. There are indeed several examples of big and small organizations and movements which result in their empowerment. They are leading the microfinance movement—mainstream banks are now eager to provide financial services to women. They are considered dependable and thus bankable. But we still have a long and obstacle-strewn path to traverse before Indian women will be at par in every village and urban community. The issues are numerous and perhaps more than any other, touch upon our most sensitive and basic social unit—our families themselves. 1. Women constitute about 50% of the population in India. Their contribution in the country’s economic activities has been very significant. However, this contribution is acknowledged neither in the National Accounts Statistics of the country nor in the sphere of household activities. 2. Equal access to and opportunities for work, employment, education and health, among other sectors, is still not available to most Indian women for a whole host of reasons—socio-cultural, economic and political. We cannot possibly go into the reasons for their continued social exclusion in this paper. But it is a reality, and a very sobering one at that. 3. Equal remuneration at the workplace and equal sharing of household responsibilities are also issues that face most women. If she is struggling to eke out a living and unable to emerge from the double and triple burdens of household responsibilities 15 and chores, then how is she to be an equal participant in development—her own, her children’s and of her community? 4. Universal male preference across virtually all communities and socio-economic classes is still the norm. It has resulted in the dramatic skewing of the male-female sex ratio, as female fetuses are aborted. Even after birth, unequal and unfavourable treatment of girl children results in higher female mortality and morbidity in many states. In some states, notable the richest ones in the country like Punjab, Haryana, Maharashtra and Gujarat, female feticide and consequent skewed sex ratios have reached alarming proportions, warranting state and nation-wide campaigns. 5. Violence against women, especially rape and assault, like in most other countries, is a major women’s rights and public health issue. Laws have been enacted to punish the perpetrators, but as mentioned earlier, if there are few organisations to support them, women are unable to resist or speak out. And so the culture of silence and subjugation, as opposed to empowerment, continues. 6. Trafficking in women, both internally between states and from our neighboring countries, is another difficult issue. Needless to say it is perpetuated by the low status of women and the lack of employment opportunities in many areas. There are so many other issues—many of them common to poor men and women, but affecting women more acutely as has been mentioned above. What is especially noteworthy is that at the policy level, there is an active commitment to women’s empowerment and to equality. The media has also played its part in spreading awareness on women’s rights. It is certainly less possible to get away with blatant discriminatory acts or atrocities on women than it was a few decades earlier. But because it hits at the very structures and social fabric of our country, it will still take some time to effect the changes we need for equality and women’s empowerment. 16 Where Do We Go From Here India has made considerable progress in regard to progress in health, education and women’s empowerment. Poverty levels have fallen—officially now 26% of our people are below the poverty line—and in many regions, standards of living have improved appreciably. The main issue seems to be the persistence of inequality and inequity. Indeed, even as economic growth continues, the question remains as to whom and how benefits are divided. And the second generic issue seems to be the acute difficulty we have in implementing our laws, policies and programmes in a clean, accountable and efficient manner. We have decentralized, local self-government by way of panchayati raj in many states, and yet we struggle to provide the basics to the mass of Indians. While the issues are many and complex, requiring deep-rooted changes in structures, mind-sets and even changes of heart, there are also causes for some optimism. This paper points to some of these, as we believe that these are truly pointers for the way forward. The question that faces us, those of us engaged with the issues of poverty, social development, equality and social justice at the policy, legislation, research and grass root level is: what is the way forward? How can we move in the direction and with renewed commitment to the paths already laid out for us so many years ago? Or are those paths simply irrelevant in the modern, globalised world? The context has irreversibly changed, and we cannot turn back clocks. But the reality for most of our people, their needs and concerns—to live a life of dignity in which their basic needs are taken care of and one that frees them from grinding poverty—still remains. Hence, the pre-independence emphasis on social development, linked to overall economic growth and development for all, especially the poorest, is still relevant. 17 What has changed now is that we have more tools—of science, technology and management—and the benefit of some hindsight and of concrete, tested out experiences. Some of the latter will be outlined here. 1. Policy and legislation at the national, state and even district levels have a very major role to play in shaping the social and economic development in our country. Even those who are frustrated with the pace of change would agree that strong pro-poor, pro-social development policies have a huge impact on the ground. Even if implementation falls short, such policies set standards and are benchmarks. They give those of us who organize on the ground causes for hope and optimism, because we can disseminate information on these laws and policies and organise the poor to ensure that the fruits of these policies reach them. One such benchmark is the Common Minimum Programme of the government. Comprehensive and holistic in nature, it lays out the vision of a just and equitable society. Every aspect of our socioeconomic development has been addressed, and broad plans for what is to be done, have been outlined. In addition, there are several policies and documents emerging from the CMP which elaborate on and resonate with this vision and basic commitment—The National Rural Health Mission, the National Urban Renewal Mission, new education policies, the already mentioned REGA, the Right to Information Act and the proposed law for the social security for unorganized sector workers. In a world where it is no longer popular to talk about increased public spending, our government has indeed increased the social sector spending in health and education, and has promised to do more in this direction. There is a recognition at the highest levels of policy-making that economic growth must be accompanied by social development and equitable policies. There is no doubt that such clear policy-level directives for social development are critical if we are to tackle some of the issues discussed above. 18 2. Decentralising the implementation of social development programmes, so that they are as close to people’s doorsteps as possible, leads to better implementation of programmes and services. There have been several important experiences across all states. We need to pay attention to this as there is a major problem of implementation of otherwise well-conceived programmes. In a country of our size and diversity, the centrally controlled, “one size fits all” type of programmes rarely work. What do seem to work better, whether in health or education, are social development programmes conceived in a manner that involves local people from the drawing board stage. There are enough examples of this from every state in the country. 3. Putting social and other development programmes in people’s control works best of all. Numerous examples from both civil society and government, point to the fact that when programmes are owned, managed and controlled by local people, and especially women, we really do see changes on the ground. This means putting one’s faith in local people and their abilities, supporting them with capacity-building and other inputs, entrusting them with resources—even government monies, building up their assets and resources, and ensuring that they have voice and representation in all decision-making, including at the highest levels of policy-making. The approach of entrusting implementation to bona fide people’s groups which has proved successful in a number of cases, needs to be upscaled and documented more carefully. We are not suggesting abdication of governmental responsibilities, but rather strategic partnerships which will deliver. And transparency all along the chain of implementation, proper audits and accountability. Further, we have seen that when people take care of their own development programmes and processes, they feel empowered and strong. Their leadership develops and often the face of the whole region changes. 19 Implementation by people’s organizations—unions, cooperatives, self-help groups, economic associations—and NGOs may be a slow process, because the people themselves have to learn the ropes. But once they do, the speed of change may exceed all expectations. At SEWA we have been fortunate to witness such changes. Women who barely came out of their homes, leave alone to meetings, negotiate with middlemen, confront corrupt officials and are unanimously chosen as the sarpanches or village leaders. They become barefoot doctors, managers of their village-based mini-banks or embroidery cooperatives and handpump technicians. These are just three among many possible ways forward. There are no easy answers or prescriptions. All three of the ideas enunciated above will have to be put into place simultaneously. And there will be other interventions and action required as well. What is clear, however, is that for social development policies and programmes to be effective and result in significant changes in people’s lives, people and the poorest— women, tribals, dalits, minorities and others—will have to be central. And wherever possible, they should lead, manage and control the programmes and processes for their own social development. India-EU Partnerships for Social Development – Possibilities for Joint Action As two large, and vibrant democracies, both India and the EU have much to learn and share with each other on social development. Both are multicultural and diverse societies, committed to the ideas of equality and social justice for all. In this context, some possible routes for joint action are suggested here. 1. The ideas suggested in the section “the Way Forward “ in this paper could provide a framework for the planning of future collaboration, including on specific projects and programmes with India and the EU. In particular, the active involvement of people’s organizations and NGOs in the actual implementation of these programmes should be considered. This approach could be built in into the bilateral agreements between our two countries. 20 2. In ongoing partnerships between India and the EU, like the State Partnership Agreements with Rajasthan and Chhatisgarh states, the suggested action on sectors discussed in this paper could be integrated into the projects selected under these state partnerships. 3. Forums for discussion on common issues may be developed, and must include both government and civil society organizations. These would be used to share ideas, experiences and activities. One such area for consideration could be how countries have measured the equity impact of a particular sector, for example, health. Specifically, one could look at whether the poor and the poorest of citizens are actually obtaining the health services, how one measures this and monitors this on an ongoing basis. Both countries have experience in this area, and are committed to equity. Hence, this could develop as an area of actionresearch leading to concrete interventions. 4.There may also be specific areas in the social sector that are of special interest to both countries. A few examples are outlined below. a) Employment : The Indo-EU Round Table(RT) could suggest that a partnership programme be developed for massive skill upgradation linked to employment opportunities in some states. This would include new sectors like IT and focus especially on training women and other poorest members of our society. b) Education: Support efforts to educate children in the poorest districts of the country, including ensuring that text-books and other supplies reach them. Education should start with crèches and child care for every child. There is much scope for mutual learning and experience-sharing leading to action. c) Women’s Empowerment: Promoting organizing of women and their capacity-building, including leadership training, deepening their understanding on local self-government and more broadly encouraging greater education and literacy. d) Health: Examining partnerships that promote better outreach and quality of services, especially in rural areas. The British example of such 21 approaches in the National Health Services (NHS) could be one useful point for discussion and study. Another area could be the increasing focus on public health that is gaining some ground in India, a subject on which the EU has much experience. In sum, the India-EU Round Table may be used as a forum to share and test out new ideas and approaches, focusing on what works and is workable, so that these ideas may be put into action for improving the well-being and indeed, the lives of people. 22 Appendix 1 Health and Education Data for India Reductions in Infant and Under 5 Mortality Rates Mortality Rate (per 1,000 live births) 300 250 200 1960 150 2003 100 50 0 Infant Under 5 Source: UNICEF Age Life Expectancy at Birth 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0 Female Male All 1955 1960 1970 1980 1990 2000 Year Source: UN Common Database 23 Appendix 2 Maternal Mortality Rate (per 100,000 live births) Maternal Mortality Decline 700 600 500 400 300 200 100 0 1982-86 1987-91 1992-96 Year Source: Bhat, P.N. Mari. Institute of Economic Growth, Delhi. Note: There is a paucity of MMR data over time in India and MMR estimates vary by source. These data are based on indirect estimates from the national census. The overall trend is downward, based on all sources. Appendix 3 Decrease in Total Fertility Rate Total Fertility Rate 7 6 5.97 5.92 5.69 5 4.83 4.15 4 3.45 3 2 1 0 1955 1960 1970 1980 1990 2000 Year Source: UN Common Database 24 Appendix 4 Percent Literacy Rate Improvements 80 70 60 50 40 30 20 10 0 Male Female All 1951 1961 1971 1981 1991 2001 Year Source: Population Census 2001. 120 100 80 60 40 20 0 Adult literacy 2001 Bi ha r G uj ar W at es t Be M ad ng hy al a Pr ad U es tta h rP ra de sh M ah ar a Ke ra sh tra % attending school (6-14 yrs) 1999-00 la Percent State wise literacy and school attendance State Source: Adult literacy: Population Census, 2001. % attending school: NSS 5 th round. 25