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CREDITSEditorial TeamPraveen Jha, Yamini Mishra

AdvocacyBhumika Jhamb, Deepak L. Xavier,Parinita Pandey, Siba ShankarMohanty

ResearchGyana Ranjan Panda, Indranil, JawedAlam Khan, Kaushik Ganguly, PoojaParvati, Ramgati Singh, TrishaAgarwala

Circulation & AdministrationKhwaja Mobeen Ur-Rehman,Ranjeet Singh, Sumita Gupta

AssistanceHarsh Singh Rawat

IllustrationAyan Chatopadhyay

Layout & PrintingKriti Creative Studio

BOARD MEMBERSAmitabh Behar, Anil Singh, Ginny Srivastava, Jagdananda, Jayati Ghosh,John Samuel, Fr. Manu Alphonse, Praveen Jha, Sandeep Dikshit, Shanta Sinha

Volume 5, Track 2, March 2008

A publication by:Centre for Budget and Governance Accountability

for private circulation only

FOR MORE INFORMATION, CONTACT :

Centre for Budget and Governance Accountability

A-11, Second Floor, Niti Bagh, Khel Gaon Marg, New Delhi - 110 049, INDIAPhone: +91-11-4174 1285/86/87 Email: [email protected]

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Foreword

IN THIS ISSUE

Budget and Policy Tracking 2

Inequalities in Access to 9Maternal Health Care inIndia: Some Reflectionsbased on NFHS-3

Implementation of Mid 13Day Meal: Food forThought

How ‘total ’ is Total 16Sanitation Campaign

Budgeting for Human Rights: 19Priti Darooka

Improving access to essential services like healthcare, sanitation, housing, andeducation are crucial to overcome poverty and discrimination. At present, a largesection of our society is still unable to access these basic services mainly due tounaffordability. These are not merely services but bare minimums to one’s right tolive. One of the primary reasons behind such bleak condition is inadequate publicprovisions. Successive governments have taken several initiatives in the form ofprogrammes/schemes so as to enhance the access to such basic services. However,the situation remains the same even today.

The current issue of Budget Track, besides the regular budget and policy tracking,draws attention to two major initiatives of the government — the Mid Day Mealscheme and the Total Sanitation Campaign. Both these initiatives have attractedimmense attention of the media and civil society. The current issue also attemptsto capture a background characteristic namely the wealth index used for the firsttime in the National Family Health Survey (NFHS-3). Since, the data on maternaland child health, reproductive health and utilisation of health care is classifiedinto wealth quintiles; the article underscores several issues pertaining toaccessibility to health services and thus its implications on the health outcomes.Lastly, a write-up on Budgets and Rights by Priti Darooka as Guest Columnemphasizes the mutual functioning of the two domains.

We hope you find the information presented in this issue of Budget Track useful.

[Views expressed in the articles are those of the authors and not necessarily the position of the Organisation]

BudgetTRACKVolume 5, Track 2, March 2008

Budget TRACK Volume 5, Track 2, March 2008

2

Budget and Policy Tracking- Bhumika Jhamb

With the present UPA Government almostcompleting the last year of its term, theUnion Budget 2008-09 assumes specialsignificance. The National Common

Minimum Programme drafted by the UPAGovernment was not just a policy document butunderlines many crucial programmes and initiativeshaving severe implications on every section andsector of the economy. The success of the UPAGovernment largely depends on the realization ofthe promises made in the NCMP. The currentbudget and policy tracking attempts to track twoof these: the issue of food security and theNational Rural Employment Guarantee Act. Also,recently, the National Rehabilitation andResettlement Policy, announced in 2007 attractedcriticism from several spheres. The article makes aneffort to flag some concerns relating to the Policy,

given the government’s intention to give it astatutory backing. With the Union Budget havingbeen released only a fortnight ago, the article alsotracks some of the proposals made by variousstakeholders to the Finance Minister during pre-budget consultations.

Over a month since January, the Finance Ministerhas been pre-occupied with holding pre-budgetconsultations with different stakeholders. Everyonehas a wish list for the Finance Minister, whichthey believe should be integrated in the budget.This year, the consultative process started onJan.7, 2008. For the first time, the FM met withthe financial advisors to various ministries and theEconomic Advisory Council (EAC) to the PrimeMinister headed by C Rangarajan. The followingillustrates the proposals of different stakeholders.

Jan. 7, 2008Meeting with Agriculturists

Achieve 4 percent growth in agriculture - was thecentral theme of the meeting.

Other issues:� Rationalise taxes on agricultural commodities

� Stagnation in production of wheat and rice

Meeting with the EAC

Meeting with Financial Advisors�

�

�

�

Meeting with IndustrialistsJan. 9, 2008

�

�

�

Meeting with Trade UnionistsJan. 10, 2008

�

�

�

�

Budget TRACK Volume 5, Track 2,March 2008

3

THE SECOND BATCH OFSUPPLEMENTARY GRANTS 2007-08A second batch of supplementary grants wassubmitted for the Union Budget 2007-08 whichincludes a total of 42 grants and oneAppropriation. The total grant of Rs. 33, 290.87crore has been sought which comes to approx. 3percent of the total original budget. Uptill now,the two batches of supplementary grants amountto 8 percent of the original budget. Out of thesupplementary grant sought, Rs. 11,869.60 croreinvolves net cash outgo and gross additionalexpenditure matched by savings of the ministries/departments or by enhanced receipts/recoveriessums to Rs. 21,420.82 crore. In addition, a tokenprovision of 1 lakh each has been sought for eachitem of expenditure which sums up to Rs. 45 lakh.

� The Department of Agriculture and Cooperationhas sought an additional funding ofRs. 198.75 crore (a cash outgo) forimplementation of the National Food SecurityMission, a centrally sponsored scheme whichbecame operational in select states in late2007.

� The funding pattern for Sarva Shikha Abhiyan,a flagship scheme of the UPA Governmentwhich seeks to provide universal elementaryeducation has been revised recently. Accordingto the revised pattern, instead from thepresent share of Centre at 50 percent, theCentre-State share will be 65:35 for the initialtwo years of the Eleventh Plan, after whichthe Centre’s share will be subsequentlyreduced to 60 percent in 2009 and further to55 percent in the last year of the EleventhPlan. A further concession was made for theNorth Eastern States. Thus, an additionalexpenditure of Rs. 2,070.00 crore has beensought for in the supplementary grants tomeet the expenditure under the revisedpattern. In addition, in order to meet theadditional expenditure due to revision ofcurrent funding pattern of 50:50 to 90:10, asum of Rs. 230.00 crore has also been sought.

� The District Primary Education Programme(DPEP) was initiated in November, 1994 in 7States (42 districts). It moved into its secondphase in May 1996 and covered 6 additionalStates and a total of 80 districts. Currently,the scheme is operational in Rajasthan andOrissa. A provision of Rs. 20 crore has beensought to meet the additional expenditurewhich will be incurred on extension of DPEPphase II in Rajasthan.

� Many recommendations were made by theSachar Committee Report on Social, Economicand Educational Status of Muslims in India,

released in Nov. 2006. One of them being todisseminate information through a multi-media campaign regarding welfare schemes formonitoring and base line survey in theidentified Muslim concentrated districts. Forthis purpose, a supplementary grant ofRs. 14.98 crore has been sought.

� The National e-Governance Plan initiated in2003 seeks to provide impetus to the growthof e-governance. It does so through settingup the core infrastructure and policies andimplementing a number of Mission ModeProjects at the centre, state and integratedservice levels. As part of this larger plan, theMinistry of Panchayati Raj lately recommendedcomputerization of 2.5 lakh gram panchayatsin the next three years. Thus, this initiativewill kick start the e-governance efforts at thelocal level and as anticipated, will lead togreater transparency and accountability. Also,it seeks to provide technology access topeople who have been deprived of it. For this,an additional grant of Rs. 10 crore has beensought for implementation of Mission Mode one-panchayats.

THE UNMET DEMAND: THE ISSUEOF FOOD SECURITYThe issue of food security is inextricably linked toa range of other issues, and thus cannot be seenin isolation. One of the policy thrust areasidentified by the UPA Government (to beimplemented from 2005) under NCMP was tocatalyse new initiatives with a focus on cropyields. The decline in agricultural growth, 77percent of the population with a per capita dailyconsumption of up to Rs. 20 (in 2004-05) whoconstitute the poor and vulnerable and growinginformalisation of labour – constitute both causeand effect of the larger issue of food and nutritionsecurity. The state of under nutrition in Indiahas been reinforced by the findings of NFHS-3,the Global Hunger Index and the recentlyreleased State of the World’s Children Report2008. According to the Global Hunger Report,India has failed to reach the mark of 0.5, whichmeans that it will be unable to fulfil the targetsof halving the proportion of calorie-deficientpeople and underweight children and cuttingunder-five mortality by two-thirds by 2015 set inthe MDGs. Taking the Global Hunger Index figureof 33.3 for India in the base year (1990), thesituation continues to be alarming with the figurepegged at 25. Moreover, Ethiopia has registered abetter hunger situation than India. The percentageof ever-married women in the age group 15-49 yrswho were anaemic has actually increased from51.8 percent to 56.2 percent between the twoNFHS periods (1 and 2). The figure for pregnantwomen who are anaemic in the age group 15-49

Budget andPol icyTracking

“Taking the GlobalHunger Indexfigure of 33.3for India in thebase year(1990), thesituationcontinues to bealarming withthe figurepegged at 25.Moreover,Ethiopia hasregistered abetter hungersituation thanIndia”


4

yrs stands at a high 57.9 percent (2005-06) from49.7 percent as in 1998-99.

One of the most important initiatives taken by thegovernment to meet the needs of food security,especially for the poor and marginalized is thePublic Distribution System. The current system ofTargeted Public Distribution System (TPDS) isplagued with several problems - large scaleexclusion owing to dubious BPL methodology toarrive at the number of beneficiaries, large scalediversion and pilferage – to name a few. Anumber of steps have been taken in the past tostrengthen the PDS including the recentproposals of introduction of food stamps, multi-application of smart cards and web-enabledservices to curb corruption and provide easyaccess to information. However, the governmentis silent on the issue of universalisation of PDS.Instead, the proposal to introduce food stamps asan alternative to the present system will meandilution of the government’s commitment.

Foodgrains productivity deserves a special mentionhere. The NSS 61st round (2004-05) shows that

the per capita intake of calories and proteinhas declined for rural as well as urban areas.The calorie consumption has gone down from2221 to 2047 which is even below the calorienorm for the rural poverty line of 2400 calories.This reinforces the declining availability of thefoodgrains – cereals and pulses and the risingrequirement.

Production of foodgrains since the quantum jumpin 1980s has stagnated in the recent decades andhas not kept pace with the growing population. Asthe Economic Survey 2007-08 also notes, the rateof growth of foodgrains production decelerated to1.2 percent during 1990-2007 which is lower thanthe annual rate of growth of population averaging1.9 percent. It further notes that the target forfoodgrains production set at 217.13 million tonnesfor 2006-07 was lower by 2.7 million tonnes andhighlights that the overall production of foodgrainsin 2007-08 is expected to fall short of the target by2.2 million tonnes.

According to the Department of Agriculture andCooperation, Ministry of Agriculture, the productionof foodgrains is projected to increase from 216.13million tonnes to approx 220 million tonnes by2011-12 and further to 235 million tonnes by2016-17. The corresponding increase in populationis estimated at approx 1200 million and 1300million by 2011-12 and 2016-17 respectively.Therefore, on the one hand, the production offoodgrains will register an increase of 8.7 percent,the population will increase by 26 percent by2016-17.

Recognising the urgent need of augmenting thefoodgrain productivity, a resolution was adopted inthe 53rd NDC meeting, following which theNational Food Security Mission (NFSM), acentrally sponsored scheme was launched on 29th

May, 2007 to operationalise the resolution. Havingthree separate components on rice, wheat andpulses, the scheme aims to increase the productionof each by 10, 8 and 2 million tonnes respectivelyby 2011.

Table Production of Foodgrains

Time Period Agricultural AreaProduction of

Foodgrains(million tonnes) (million ha)

2006-07 216.13 124.07

Source: Agriculture Statistics at a Glance 2006, Departmentof Agriculture and Cooperation, Ministry of Agriculture, Govt.of India

Operation of National Food Security Mission

Budget andPol icy

Tracking

“The currentsystem ofTargeted PublicDistributionSystem (TPDS)is plagued withseveral problems- large scaleexclusion owingto dubious BPLmethodology toarrive at thenumber ofbeneficiaries,large diversionand pilferage –to name a few”

“As the EconomicSurvey 2007-08also notes, therate of growthof foodgrainsproductiondecelerated to1.2 percentduring 1990-2007 which islower than theannual rate ofgrowth ofpopulationaveraging 1.9percent”


5

The scheme intends to meet the requirement offoodgrains by bridging the gap between thepotential of production and current yield offoodgrains. Therefore, out of a total of 35 rice,wheat and pulses producing States/UTs, 16 States/UTs have been selected and from these, 305districts have been identified where the scheme isin operation. As stipulated in the guidelines ofthe scheme, identification of areas andbeneficiaries will be done in a way that themarginalized sections are not excluded. It willbe done in accordance with the implementation ofScheduled Caste Sub Plan and the Tribal Sub Planand further, atleast 33 percent allocations of fundis to be made for small, marginal and womenfarmers.

creation of more job opportunities andenhancement of farm level economy. It is alsounique in the sense that it focuses on threeprimary foodgrains consumed in India, thus makingthe implementation crucial for the availability ofthe three in future. However, as it is clear fromthe present dialogue between the PlanningCommission and the Finance Secretary, the cut inGross Budgetary Support as demanded by variousministries would have implications on functioningof the NFSM. As against the demand of Rs 41,258crore by the Ministry of Rural Development toimplement it’s schemes in 2008-09, GBS has beenreduced by 27 percent (proposed allocations).Since the scheme has become operational onlyrecently, it remains to be seen whether it is ableto achieve the targets by the end of the EleventhFive Year Plan. Also, the targets set by the Missionmay not be adequate to meet the growing demandfor food grains and thus may require revision.

NREGS – WHAT DO THE DRAFTCAG REPORT FINDINGS MEAN?1

The findings of the draft CAG six-monthperformance audit of the National RuralEmployment Guarantee Scheme can be said to beresponsible for the recent furor in the media. Theissue was covered in almost all national dallies.The six month performance audit of the NREGSwas conducted in 513 gram panchayats spreadacross 68 randomly selected districts from 26States. Consequently, a series of articles spanningfour days from Jan. 7 to Jan. 10 reported on thefindings. The findings primarily report the non-conformity to the guidelines of the Act at theNational level since out of a total of 1,460irregularities pointed by the report, 61 percentaccount for deviations from the guidelines,whereas fund utilization and manipulation accountfor 2 percent and 1 percent respectively.

Therefore, explanations are being sought fromdifferent States where the scheme is in operationwhich will be then incorporated in the draftreport. The report points to alleged corruption,inefficiency, diversion and misutilisation of fundsand unreliable figures. The reasons identified forthe same include, deficient financialmanagement and tracking system, inadequateand delayed planning of the works, absence ofauthenticated books for records (in as many as14 States), and workers being paid wages lowerthan the minimum wage rate (11 States). Lackof adequate administrative and technical humanresources at the local level has been also markedas one of the main deficiencies affectingimplementation of the programme.

NREGS, which was initially implemented in 200

The funds will be directly released in installmentsto the autonomous agency in the State. A total ofRs. 4,882.48 crore is estimated for the scheme.

The Integrated Cereal Development Programme(ICDP), a centrally sponsored scheme would thusbe stopped subsequently with theoperationalisation of NFSM in the identifieddistricts. In addition, under the Integrated Schemeon Pulses, Oilseeds and Maize (ISOPOM) which hasbeen in operation since 2004, the pulseprogramme specifically will also be discontinued inthe identified pulse-producing districts. Ascaptured from the Outcome Budget 2007-08 of theDepartment of Agriculture and Cooperation,majority of the targets under specific componentsof the pulse programme have not been achieved.Two primary reasons mentioned include (a) theprojection of targets under various componentswere made based on the approved action plan ofthe implementing States wherein the requirementof funds for implementation was also projected,which was more than the allocation made to theState and (b) there was diversion of allotted fundsto other approved components.

Thus, from the past performance, the success ofNFSM is contingent upon effective coordination atvarious levels and preparation of State ActionPlans. This is perhaps the first scheme of itskind that apart from the primary aim ofincreasing the production of rice, wheat andpulses in a sustainable manner, also anticipates

1 Pls note that the figures referred here are drawn from the News Reports published by various dallies with regard to theDraft CAG Report which is not in the public domain.


“The success ofNFSM iscontingent uponeffectivecoordination atvarious levelsand preparationof State ActionPlans”

“The report pointsto allegedcorruption,inefficiency,diversion andmisutilisation offunds andunreliablefigures”


6

poorest districts, was gradually extended to 130additional districts. Soon, the scheme would beoperationalised in 596 districts of the countryleaving roughly 7-8 urban districts. As it standstoday, 2.58 crore households have been providedemployment and number of persondays totals to85.54 crore. The proportion of SCs, STs and womenin the scheme is 27 percent, 31 percent and 44percent respectively. (NREGA website). However, onthe other hand, the CAG report highlights that only3.2 percent of the registered households could getthe 100 days employment between Feb. 2006 andMarch 2007 and the average employment generatedcomes to just 18 days. This can be understood bythe fact that as soon as the scheme was announced,many households got themselves registered andthus the percentage of those provided employmentin proportion to the households registered wouldbe a very low figure and thus an underestimationas shown by CAG findings.

Clearly, the CAG findings reveal that the Statesare finding it very difficult to comprehend andfollow the guidelines set at the National level.This is reflected by 61 percent of the irregularitiesaccounting to deviations from the National levelguidelines.

Thirdly, as also noted by many surveys, theperformance of some States on NREGS such asRajasthan, Chattisgarh and Andhra Pradesh hasbeen much better than states such as UP, Orissaand others. The success of the scheme is largelydue to strong Panchayati Raj systems in place.However, places such as Jharkhand where suchsystems do not exist, the functioning of thebureaucratic administration has ushered theprocess.

The transparency safeguards such as regular socialaudits have been built in the Act and the role ofgram sabha in conducting them is clearly definedin the guidelines. However, on the ground, the roleis not being exercised by the gram sabha but bythe NGOs who were to build capacities of the gramsabhas to conduct social audits.

Another crucial aspect of the Act is payment ofthe unemployment allowance in case of delay inproviding employment by the State concerned.At present, payment of this allowance is solely theresponsibility of the State and thus acts as adisincentive for the State. The underlying aim ofthe States to provide such allowance was toprovide employment at the earliest. However, oneof the CAG’s recommendations includes partialreimbursement of the allowance by the Centre.This might not work in favour of the inherentobjective. However, taking cognizance of thefinancial crunch of the States, such sharing by theCentre and the States in payment of the allowancewould be a welcome step for the States.

A crucial bottleneck in the functioning of theNREGS is the paucity of technical staff at the

panchayat level as is also clearly noted by theCAG report and is also included as one of therecommendations. As required, a gram rozgarsevak or an Employment Guarantee Assistant(EGA) needs to be appointed in every panchayatand junior engineers have to be appointed totake note of the work measurements at thesites. According to the report, 52 percent of the513 gram panchayats had not appointed EGAs. Inaddition, the panel of accredited engineers at thedistrict and block levels were found to be absentin 23 states.

An important recommendation of the report is toexplore a nationwide agreement with theDepartment of Posts for all NREGS payments –seen as a way of plugging the leakage in thesystem. It is a welcome step by the Governmentto use technology in increasing the efficiency ofthe programme. The Government has started theprocess of linking with PSUs to handledisbursements of funds for the NREGS workers.At the same time it is important to be cautiousof the misappropriation of money by the postaldepartment which is actually intended for thelabour.

Finally, there is sufficient evidence that indicatesmore likelihood of women’s participation in thescheme wherever SHGs are functional. This requiresMinistry of Rural Development to encourageconvergence of schemes and programmes run byother ministries.

Again, with the proposed allocations being muchlower than the GBS demanded, as stated earlier,the expansion of NREGA from April 2008 will poseproblems. NREGA, a historic Act, enforced in2006 faced extreme skepticism by corporategiants and the Finance Ministry. Although varioussurveys and CAG’s audit point to variousirregularities in its implementation and recommendenormous scope for improvement, there is nodenying the fact that NREGA carries immensepotential in creating employment throughgeneration of productive assets.

WOMEN AND THE NATIONALPOLICY FOR FARMERSThe feminization of agriculture is clearly evidentfrom the NSS 61st round. The share of agriculturalworkers in the female workforce is as high as72.8 percent in 2004-05, primarily due toincreasing male out migration. According to thedata compiled by the National Commission onEnterprises in the Unorganised Sector (NCEUS)from the NSS 61st Round (2004-05), the share offemale agricultural workers after remaining almoststable during 1983 and 1993-94 and prior todeclining to 38.8 percent in 1990-00, registeredan increase of up to 41.6 percent in 2004-05.The share of women farmers in 2004-05 stoodalmost equal i.e. 64.4 percent for women and 64

Budget andPol icy

Tracking

“According to thereport, 52percent of the513 grampanchayats hadnot appointedEGAs. Inaddition, thepanel ofaccreditedengineers at thedistrict andblock levelswere found tobe absent in 23states”

“There is nodenying the factthat NREGAcarries immensepotential increatingemploymentthroughgeneration ofproductiveassets”


7

percent for men. This trend indicates a declinein casualisation of female workforce in agriculture.The report also notes that amongst smallfarmers who are women, 85 percent have highlevels of illiteracy or education only up toprimary level and 6 percent with educationabove secondary level against 62 percent and20 percent respectively for the malecounterparts. In addition, it notes a highincidence of poverty for landless and sub marginalfarmers. Among the farmer households, nearly15 percent had sub marginal land holdings and30 percent possessed marginal holdings.

Thus, as it follows from the report, it is importantto look at the National Policy for Farmers, 2007from the lens of women to see as to how far itaddresses the concerns of women farmers.

WOMEN’S ASSET BASE:OWNERSHIP ISSUESOne of the crucial aspects that forces individualsto work as labourers is lack of assets andlandlessness. This is particularly true for womenfarmers since land is largely in the name of menof the family. The Hindu Succession AmendmentAct (2005) needs to be considered here since itseeks to provide ownership to females as well. Therevenue records in the name of women farmers areespecially important for them to access credit. Thepolicy for farmers recognizes the urgent need ofempowering women to access credit servicesthrough joint pattas for homestead as well asagricultural land. A vital asset on whichproductivity depends is the availability of water/irrigation. The policy acknowledges women’s roleas managers of water resources as well as theiraccess to the same.

WOMEN’S LOCAL KNOWLEDGE ANDPRACTICEWomen’s possession of local knowledge andpractice is widely recognized and so does theNational Policy for Farmers. With the aim ofconserving and developing bio resources, one ofthe ways promoted by the policy includesinvolvement of women while documenting thetraditional knowledge through community bio-diversity registers. It recognizes women’s role inseed technology training centres and communitymanaged seed villages.

SUPPORT SERVICES FOR WOMENAs noted by the NCEUS Report, women areprimarily engaged in transplanting, sowing,weeding and harvesting which involve use ofimplements. The policy promotes use of women-friendly implements, which aim to reduce drudgery,save time, enhance output and provide comfortwhile handling. Further, it also seeks to address

concerns of women farmers through provision ofsupport services such as crèches, child carecentres, nutrition, health and training etc., forwhich funds will be routed through schemes ofMinistry of Panchayati Raj, Rural Developmentand Agriculture.

ACCESS TO CREDITRecognising the urgent need of access to credit forwomen cultivators owing to lack of ownership ofland, the policy seeks to address this throughissuance of kisan credit cards for women with jointpattas for homestead/agricultural land, andindemnity bonds/guarantees from husband andrelatives for those women who do not have jointpattas.

GROUP APPROACHThe policy especially purports a group approachwhere cooperatives and SHGs will play a majorrole. This approach has two purposes –dissemination of agricultural technology andinputs and secondly, encouraging investment andproduction among small scale women farmerswherever possible. Also, for access to informationregarding market produce, group approach hasbeen promoted.

On the whole, access to credit, a key concern forfarmers and for women farmers in particular, wherethe issue of land ownership is implicit, seems tobe taken care of by the policy. However, there isno mention of women farmers when the policyseeks to address the concerns of special categoryof farmers such as tribals. Also, integration ofexisting schemes is vital for provision of supportservices which will largely depend on theoperationalisation of the policy. Such convergencecould also be utilized to address the issue ofilliteracy amongst women farmers.

NATIONAL REHABILITATION ANDRESETTLEMENT POLICY, 2007Involuntary displacement of people, especially themarginalized groups such as SCs, STs, farmers andwomen is rather a norm following the impositionof the neo-liberal policies. Although acomprehensive policy for rehabilitation andresettlement was not identified as one of thethrust areas of the National Common MinimumProgramme, it was included as key instruments inthe NAC headed by the UPA Government. However,after it became defunct in 2005, the things stoodstill. The urgency of such a policy in recent timesis as a result of large-scale protests against settingup SEZs, especially in Singur and Nandigram.

There were many issues which remainedunaddressed in the former policy, National Policyon Resettlement and Rehabilitation for Project


“The policy forfarmersrecognizes theurgent need ofempoweringwomen toaccess creditservices throughjoint pattas forhomestead aswell asagriculturalland”

“Integration ofexisting schemesis vital forprovision ofsupport serviceswhich willlargely dependon theoperationalisationof the policy”


8

Budget andPol icy

Tracking

“The NationalR&R Policy,2007 aims tominimizelarge scaledisplacementand promotenon-displacingand leastdisplacingalternatives”

Affected Families, 2003 and thus a need was felt,especially after the SEZs episode, to draft acomprehensive policy. Therefore, a NationalRehabilitation and Resettlement Policy was draftedand approved lately in October 2007. Alsoconsequently, to give it a statutory backing, twobills - Rehabilitation and Resettlement Bill – 2007and Land Acquisition (Amendment) Bill – 2007were raised in the Winter Session of theParliament.

The National R&R Policy, 2007 sets minimumrequirements to be integrated by the stategovernments, PSUs or agencies which have eitheran R&R policy or are in the process of formulatingone. It aims to minimize large scale displacementand promote non-displacing and least displacingalternatives.

In terms of sharing of benefits accruing from theorganization/individual acquiring the land, thepolicy states that if the land acquired for a publicpurpose is transferred to an individual/organization, eighty percent of any net unearnedincome accruing to the transferor (individual/organization), it shall be shared amongst thepersons from whom the lands were acquired ortheir heirs. This sharing will be in proportion tothe value at which the lands were acquired.

Although, prima facie the National R&R Policylooks comprehensive and appears to have pluggedthe loopholes in the former policy, a closer look atthe policy reveals some very crucial unaddressedissues.

1. At the very outset, the Preamble of the policystates that the adverse impact on affectedfamilies needs to be assessed in a participatoryand transparent manner. The reflection to doso is absent in the whole policy documentbarring a provision for consultation withthe affected families during the finalpreparation of the Social ImpactAssessment and Environment ImpactAssessment reports which will be furtherexamined by an expert group comprisingmembers nominated by the appropriategovernment. Even while conducting thecensus of the affected families, thecompulsion of such families is absent in thePolicy.

2. The Policy exempts the Ministry of Defencewith regard to conducting SIA report for thepurpose of land acquisition for nationalsecurity.

3. The Land Acquisition Act has been contestedseveral times and thus has remained a sourceof conflict. The Policy defines land acquisitionor acquisition of land as acquisition of landunder the Land Acquisition Act, 1894 asamended from time to time, or any other law

of the Union or a State for the time being inforce. Thus, such a definition providesautonomy to the Government to acquire anyland in the name of public purpose.

4. Another source of concern is the fact that thePolicy states declaration of any area (or areas)as a resettlement area (or areas) forrehabilitation and resettlement of the affectedfamilies. The displacement of non-projectaffected families in such a case cannot beignored and needs attention.

5. There are far too many ifs and buts in thewhole policy when it comes to provision ofrehabilitation and resettlement benefits. Forinstance, the policy states that each affectedfamily owning agricultural land in the affectedarea and whose entire land has been acquiredor lost, agricultural land or cultivablewasteland may be allotted only if Governmentland is available in the resettlement area.Similarly, the policy states that in case ofland acquisition, the requiring body shall givepreference to the affected families ……subjectto the availability of vacancies and suitabilityof the affected person for the employment.Also, with regard to provision of scholarships,it states that the requiring body will offerthem as per the criteria as may be fixed by theappropriate government.

6. One of the definitions of the affected familyas provided by the policy is – any agriculturalor non-agricultural labourer, landless person,rural artisan, small trader or self-employed,who has been residing or engaged in trade,business, occupation or vocation continuouslyfor a period of not less than three years. Thepolicy fails to acknowledge that tribals mayget excluded if restricted to such a definitionsince the kind of cultivation carried out bytribals and other nomadic tribes requiresconstant moving in and out which thereforemay not mean constant engagement at aplace for a period of three years.

7. The policy clearly states that if the landacquired remains unutilized for a period offive years, it will revert back to the possessionand ownership of the appropriate government.However, the policy is mute on the concernedgovernment’s action after getting the land.

Thus, on the whole, the National R & R Policy2007, which was expected to plug the loopholesand suggest a comprehensive framework foraddressing rehabilitation and resettlement, failsto do so on many counts. There is a lack ofconcrete commitment on part of the appropriategovernments to provide adequate protection to theaffected families. With the ongoing Budgetsession, and the related speculation on the Billspassed, the concerns raised above merit attention.


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The National Family Health Survey (NFHS)provides state and national levelinformation for India on crucial healthindicators such as Fertility, Infant and

Inequalit ies in Access toMaternal Health Care inIndia: Some Reflectionsbased on NFHS-3 - Indrani l

Child Mortality, Practice of Family Planning,Maternal and Child Health, Reproductive Health,Nutrition, Anaemia, Utilization and Quality ofHealth and Family Planning Services. As of now,three rounds of household surveys have beenconducted, the first round (NFHS-1) was conductedin 1992-93, followed by NFHS-2 in 1998-99; andthe third round has been recently conducted in2005-06. NFHS-3 interviewed around 89,777 evermarried women; NFHS-2 also covered around90,000 ever married women of the age group 15-49 yrs, whereas for NFHS-3, 1,24,385 ever marriedwomen were interviewed. The third round of NFHScovered all 29 states and provides information ona total of 29 indicators of which 12 were onmaternity and child care.

do not receive antenatal care, whereas almostevery pregnant woman (97.4%) from the highestincome quintile receives antenatal care. Womenfrom upper wealth quintiles have greater access todoctors while seeking antenatal care, whereaswomen from the lowest income quintiles dependmore on ANMs, Nurses, LHVs or Midwifes. Amongthose women in the lowest income quintile whocould access any form of antenatal care, only onein every five could seek care from a doctor. Morethan four out of every five pregnant women inhighest income quintile visited a doctor. This

ACCESS TO ANTENATAL CAREAntenatal care (ANC) refers to pregnancy relatedhealth care, which is usually provided by a doctor,an Auxiliary Nurse Midwife (ANM) or any otherhealth professional. Reproductive and Child HealthProgramme aims at providing at least threeantenatal check-ups which should include weightand blood pressure check, abdominal examination,immunization against tetanus, iron and folic acidprophylaxis, as well as anaemia management.Almost one out of every five women in India didnot receive any antenatal care for their last birthin the five years preceding the survey. Women notreceiving antenatal care tend disproportionatelyto be older women, women having children withhigher birth orders, scheduled tribe women,women with no education and women withhouseholds with a low wealth index. In thelowest wealth quintile, 41 percent pregnant women

One of the background characteristics used for thefirst time in NFHS-3 Report is an index of theeconomic status of households called the wealthindex. The wealth index has been developed andtested in a large number of countries in relationto inequalities in household income, use of healthservices, and health outcomes. It is an indicatorof the level of wealth that is consistent withexpenditure and income measures. The economicindex was constructed using household data for 33assets and household characteristics. The samplehouseholds have been divided into quintiles i.e.five groups with an equal number of households ineach group.

The NFHS-3 data based on wealth index can be avery important source of research on healthinequalities. It is for the first time that data onmaternal and child health, reproductive health andutilisation of health care is classified into wealthquintiles making it possible for assessing the levelof inequality. It would be worthwhile to assess thelevel of inequalities in maternal health using someof the indicators provided in the Report.


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clearly reveals that poorer sections of the societyhave lesser access to trained professionals orbetter quality of care.

Important elements of antenatal care include theprovision of iron supplementation for pregnantmothers, two doses of tetanus toxoid vaccine anda drug to get rid of intestinal worms. There existsclear class gradient in each of these indicators.Half the pregnant women in the poorest incomequintile receive IFA, but only one in ten takeIFA tablets or syrups for full ninety days.Compared to this, 85 percent of pregnant womenin the highest strata receive IFA tablets but halfof them take it for full 90 days. More than threequarter of pregnant women receive two shots oftetanus toxoid injection. Though there exists classgradient in the access to TT injection, the gradientis not very steep. Overall, only 3.8 percentpregnant women receive any intestinal parasitedrug and access to it for women in better offsections is much higher than those in the lowerstrata.

undergoing ultrasound tests, almost 62 percentwomen in the richest strata access it. This clearlyshows poorer women’s inaccessibility towardsmodern technologies.

DELIVERY CARE:Place of Delivery: Deliveries in safe hygieniccondition and under the supervision of trainedpersonnel are very critical to ensure safemotherhood. In India, 61 percent deliveries takeplace at home (fig 4). For the lowest wealthquintile, 87 percent of deliveries take place athome - as we go up the wealth quintiles, wefind lesser home deliveries. For the richestquintile, only 11.4 percent deliveries take place athome. Nearly 39 percent of pregnant womendeliver in some facilities. But if we compare theplace of delivery, we find that only 18 percent ofall deliveries take place in public institutions,whereas 20.6 percent of deliveries take placeeither in private hospitals or NGO or Trusthospitals. Dependence of the poorer sections onpublic institutions is relatively more as comparedto those in the rich wealth quintiles (Fig 5).Correspondingly, as income increases relativedependence on private services increases. It is tobe noted that one in every three institutionaldeliveries for the poorest wealth quintile takesplace in private facilities. This is despite the factthat private deliveries are costly. The reason maybe that they are forced to access privateinstitutions to a great extent in the absence offunctional public facilities. It is to be notedhowever that inequalities in access are much lessin terms of public facilities than private or NGO orTrust hospitals.

The effectiveness of antenatal care in ensuringsafe motherhood partially depends on the testsand measurements done. Tests and measurementslike taking weight, measuring blood pressure, urineand blood tests are very important to monitorhigh risk pregnancies. For every service thereexists class gradients, but gradients get steeper asthe tests get more complicated. Ultrasound testhas become very popular for detecting andmonitoring pregnancies, especially among younger,well-off women in urban localities. Ultrasoundtests, being very sophisticated and hence costly- women from the poorer strata have verylimited access to it. Compared to only 4 percentpregnant women from lowest wealth quintile

Inequal i t iesin Access to

MaternalHealth Care

in India:Some

Ref lect ionsfrom NFHS-III

“For every servicethere existsclass gradients,but gradientsget steeper asthe tests getmorecomplicated”

“One in everythreeinstitutionaldeliveries forthe poorestwealth quintiletakes place inprivatefacilities”


11

Use of caesarean section has become almost anepidemic for the women in richest wealthquintiles. More than one fourth of the deliveries(25.7%) in the richest quintile are done bycaesarean section. Compared to this, only 1.5percent of deliveries in the poorest quintile aredone by caesarean section. Twenty eight percentof deliveries conducted in private sector aredone through caesarean sections; whereas only15 percent of such deliveries are carried out inpublic sector. This clearly shows that access tomodern technologies is always very limited forwomen in the poorer sections of the society;moreover these technologies are only accessible torichest sections.

friends and relatives for assistance duringdelivery, whereas in better-off sections servicesof TBAs and relatives/friends are scarcelyavailed.

ACCESS TO EDUCATION:As we have clearly seen, wide range of inequalitiesexist in almost every indicator of access to healthcare. Women in poorer quintiles have lesser accessto antenatal care, institutional deliveries, skilledproviders, and modern technologies. Clearly, thesefactors affect their health. However, apart fromaccess to better health care, there are certainfactors which affect women’s health, but they arenot part of health system per se. For instance,level of education, age of marriage, employmentstatus, and power of decision making play a verycrucial role in women’s health.

Level of education affects women’s health seekingbehavior, their access to information, and theiroverall entitlement to resources very positively.These collectively affect their health outcomes.But level of education is also subject to women’sclass position. As income level increases, level ofilliteracy goes down. Women at the lowestincome quintile are nine times more illiteratethan those at the highest income quintile.Women attaining ten or more years of educationare mostly from the upper two quintiles (84%).Only 1.7 percent of women from the lowest incomequintile are able to access education. Probabilityof attaining ten or more years of education for thewomen in highest quintile is 35 times higher thanthose at the lowest quintile.

ASSISTANCE DURING DELIVERY:Obstetric care from a trained professional is verycritical in reducing maternal and neonatalmortality. Most of the home deliveries take placewithout assistance from trained professionalswhereas most of the institutional deliveries areassisted by health professionals. Forty-sevenpercent of births in the five years preceding thesurvey were assisted by health personnel, including35 percent by a doctor and 10 percent by an ANM,nurse, midwife, or LHV. More than one-third ofbirths (37 percent) were assisted by a traditionalbirth attendant (TBA), while 16 percent wereassisted by only friends, relatives or other persons.Very strong class gradient exists in accessingassistance from skilled providers during deliveries.Less than one in five deliveries in the poorestsection are assisted by skilled providers; whereasnine in ten deliveries in the richest section areassisted by skilled personnel. The two bottomincome classes mainly depend on TBAs or Gender differentials in educational attainment and

illiteracy are quite high in India. Compared to 18percent illiteracy among men in the age group of15-49 yrs, illiteracy is as high as 40.6 percentamong women. Among all classes, 34.6 percent ofmen attain ten or more years of education,whereas only 22.4 percent women reach that level.Gender differentials in illiteracy, measured in termsof ratio of percent of illiterate women to percentof illiterate men, increases with increase inincome. For the lowest wealth quintile genderdifferential is 1.6, which means that for everyman, 1.6 women are illiterate. For the highestincome quintile, the differential increases to 4.1.

Inequal i t iesin Access toMaternalHealth Carein India:SomeRef lect ionsfrom NFHS-III

“More than onefourth of thedeliveries(25.7%) in therichest quintileare done bycaesareansection”

“Probability ofattaining ten ormore years ofeducation forthe women inhighest quintile”


12

The trend of gender differential reverses whenwe consider educational attainment of ten ormore years - from 0.26 for lowest quintile theratio reaches 0.85 for highest quintile.

slightly longer to marry than earlier. Rural womenmarry earlier than those in urban areas. Themedian age of marriage among rural women in theage group 20-49 yrs is 16.4 yrs compared with18.8 yrs among their urban counterparts.Differentials in wealth affect age of first marriageto a great extent. The average age of firstmarriage for women of age 25-49 yrs in thehighest wealth quintile is 19.7 yrs, which ismore than four years higher than those in thelowest wealth quintile. The implication of ahigher age of marriage can be seen in thehealth outcomes very clearly.

The above discussion clearly suggests that thereexists enormous amount of inequalities inaccessing maternal health care. Almost all theindicators we have used show that women in thericher income quintiles have much greater accessto services- be it antenatal care, institutionaldelivery etc. The data also reveals that access toskilled providers is also very limited for women inthe poorer sections and they have to depend onsemi-skilled or unskilled personnel in accessingantenatal care or birth deliveries. We have alsonoted that for those services where there isconsiderable presence of public provisioning,inequality in access is little less compared toservices where private providers dominate. Anothervery interesting result that comes out of thediscussion is that access to modern technologieslike ultrasound and caesarean section are restrictedto women in the top income quintile and poorersections have very limited access to such services.We also find that women in the poorer sectionshave very limited access to institutional deliveries,which remain a major impediment to safemotherhood. In the brief analysis of factorsextraneous to health services but critical toaccessing maternal health like mothers’ educationalattainment or age of first marriage, strongcorrelation with wealth quintile could also befound. In a situation where women in the poorersections have very limited access to servicesrelated to maternal health, their health outcomeswill definitely be affected. Unfortunately, there isnot much emphasis on morbidity and mortalitydata in NFHS, which restricted our analysis onservices delivery. To get a complete picture ofhealth inequalities, there is an urgent need togenerate data on mortality and morbidityoutcomes based on income classes.

AGE AT FIRST MARRIAGE:Marriage of women before reaching 18 years of ageincreases the risks related to pregnancy. In India,most of the women get married before they reachthe legal age of marriage. The median age of firstmarriage for women in the age group 25-49 yrs is16.8 yrs. The median age of first marriage isalmost two times higher for women in the agegroup 20-24 yrs than for women in the age group40-49 yrs, which means that women are waiting

Inequal i t iesin Access to

MaternalHealth Care

in India:Some

Ref lect ionsfrom NFHS-III

“Differentials inwealth affectage of firstmarriage to agreat extent”


13

M

Implementation of MidDay Meal: Food forThought - Pooja Parvati

Madras Municipal Corporation. By the mid 1980s,Gujarat, Kerala, Tamil Nadu and Pondicherry haduniversalized a cooked Mid Day Meal Programmewith their own resources for children studying atthe primary stage. Mid Day Meal was also beingprovided to children in Tribal Areas in some Stateslike Madhya Pradesh and Orissa. By 1990-91, thenumber of States implementing the Mid Day Mealprogramme with their own resources on a universalor a large scale had increased to twelve, namely,Goa, Gujarat, Kerala, Madhya Pradesh, Maharashtra,Meghalaya, Mizoram, Nagaland, Sikkim, Tamil Nadu,Tripura and Uttar Pradesh. In another three States,namely Karnataka, Orissa and West Bengal, the

(c) Rs. 1.50 per child per school day payable topersonnel/agency viz. SHG, VEC, SMC by theCentre (with the State/UT contributing aminimum of 50 paise) at the primary stage. InStates in the NER, the Centre will provide @Rs. 1.80 per child per school day (provided theState/UT contributes a minimum of 20 paise).While at the upper primary stage, the Centreprovides @ Rs. 2/child/school day with aminimum contribution of 50 paisa by theState. In the case of NER states, at upperprimary stage, the Centre provides @ Rs. 2.30/child/school day with the State contribution of20 paisa.

(d) Contruction of kitchen sheds @ Rs. 60,000/unit and for procurement of kitchen devices @Rs. 5,000 per school.

(e) Management, monitoring and evaluation costs@ 1.8 percent of the cost of food grains andcooking cost.

(f) Central assistance is also given for providingcooked Mid Day Meal during summer vacationsto children in areas declared by stategovernments as drought-affected areas.

(g) As per the latest notification by the Ministry,(in addition to extending the scheme to upperprimary stage), central assistance towards

• Addressing malnutrition, and

• Social empowerment through provision ofemployment to women.

COMPONENTS OF CENTRALASSISTANCECentral Assistance under the scheme consisted ofthe following:

(a) Free supply of food grains@100 gm/child/school day for primary stage and 150 gramfood will be allotted at the upper primarystage.

(b) Subsidized transportation of foodgrains fromnearest FCI up to Rs.125 per quintal for 11Special Category States including the NER andRs.100 per quintal for other States and UTs.

programme was being implemented with Stateresources in combination with internationalassistance. Another two States, namely AndhraPradesh and Rajasthan were implementing theprogramme entirely with international assistance.

With a view to enhancing enrollment, retentionand attendance and simultaneously improvingnutritional levels among children, the NationalProgramme of Nutritional Support to PrimaryEducation (NP-NSPE) was launched as a centrallysponsored scheme on 15th August 1995, initiallyin 2,408 blocks in the country. By the year 1997-98, the NP-NSPE was introduced in all blocks ofthe country. It was further extended in 2002 tocover not only children in classes I-V ofgovernment, government aided and local bodyschools, but also children studying in centres rununder the Education Guarantee Scheme (EGS) andAlternative and Innovative Education (AIE)Scheme.

The key objectives of the programme are:

• Protecting children from classroom hunger,

• Increasing school enrolment, retention andattendance rate,

• Improved socialization among childrenbelonging to all castes,

id Day Meal in schools has beenoperational in India since a long time. In1925, a Mid Day Meal Programme wasintroduced for disadvantaged children in


14

cooking cost based on Inflation Adjusted Index(Consumer Price Index) every two years will beavailable beginning 2008-09 for Mid Day Mealboth for primary and upper primary stages.

(h) Information, Education and Communication(IEC) activities have been incorporated as acomponent of Management, Monitoring andEvaluation costs.

NUTRITIONAL CONTENTThe Central Government has fixed 450 calories, 12gm protein, and adequate quantities ofmicronutrients (Fe, Folic Acid, and Vitamin A) ofmeal for a primary class student. While for anupper primary student, the calorific value of themeal has been fixed at 700 calories and 20 gramprotein for a child a day.

The table provides the amount allocated by theCentre towards the Scheme since it was launchedas a centrally sponsored scheme in 1995.

CONVERGENCE OF MDM WITHOTHER DEVELOPMENTALPROGRAMMESAnother significant aspect about the Schemeimplementation is the nature of interlinkages withother departments/ministries. Several facilities/provisions under the Scheme have been designedto enhance convergence and implement (theScheme) in a cost-effective manner. However, theactual situation vis-à-vis the potential design willalso be taken up in the last section of the paper.

The Scheme is implemented by the Department ofSchool Education & Literacy, Ministry of HumanResource Development, the State Nodal Departmentfor MDM (this may vary from one State to the

Table showing Central Government Outlays toMid Day Meal Scheme in Rs. Crore (1995-96 to2008-09)

Year Allocation Amount Totalmade met Alloca-

towards through tionMid Day Prarambhik

Meal Shikshain the KoshUnionBudgetScheme

1995-96 RE 612 612

1997-98 RE 960 960

1998-99 RE 1400.15 1400.15

1999-2000 RE 1500 1500

2000-01 RE 1300 1300

2001-02 RE 1031.24 1031.24

2002-03 RE 1021.5 1021.5

2003-04 RE 1375 1375

2004-05 RE 1507.5 1507.5

2005-06 RE 3010.76 3010.76

2006-07 RE 1898.2 2915 4813.2

2007-08 RE 3191.6 2812.4 6004

2008-09 BE 2073 5127 7200

Source: Expenditure Budget, Volume II, Union Budget forseveral years

Kitchen-cum-shed Sampoorna Grameen Rozgar Yojana (Ministry of Rural Development)Basic Services for Urban Poor, Slum Development Programme (IntegratedHousing and Slum Development Programme), Urban Wage EmploymentProgramme /Swarna Jayanti Shahari Rozgar Yojana (Ministry of Hosing andUrban Poverty Alleviation)Backward Region Grants Fund (Ministry of Panchayat Raj)Sarva Shiksha Abhiyan (Ministry of Human Resource Development)

Water supply Accelerated Rural Water Supply Programme, Swajaldhara (Ministry of RuralDevelopment – Department of Drinking Water Supply)Backward Region Grant Funds Panchayats under 12th Finance Commission,Backward Region Grant Funds (Ministry of Panchayat Raj)Sarva Shiksha Abhiyan (Ministry of Human Resource Development)

Kitchen devices Sarva Shiksha Abhiyan (Ministry of Human Resource Development)

School health programme National Rural Health Mission (Ministry of Health and Family Welfare)

other) & Food Corporation of India (FCI). At thedistrict level, District Nodal Agencies for MDM andat the sub-district level, the schools (through PRIsand municipalities) along with the nearest FCIgodown comprise the key implementing agenciesfor the Scheme.

Implementationof Mid DayMeal: Food

for Thought

“Severalfacilities/provisions underthe Schemehave beendesigned toenhanceconvergence andimplement (theScheme) in acost-effectivemanner”


15

PROBLEMS IN SCHEMEIMPLEMENTATION: THE ESSENCEMoving on to some critical aspects with regard tothe Scheme implementation, while the overallbenefits of the Scheme cannot be overstated, gapsremain. Relevant literature and surveys pointtowards critical shortcomings, mostly pertaining tooperational aspects of the Scheme implementation.

• In 2003, Centre for Equity Studies, New Delhiconducted a survey in three States ofChhattisgarh, Rajasthan and Karnataka toexamine various aspects relating to theperformance of the Scheme and, among otherissues, noted that the meals were not beingprepared in hygienic conditions. Pupils fallingunwell and the nature of the menu illustratethis. The recent incident in Kumbakonam, TamilNadu amplifies this concern. A related problemwas the disruption of classroom activity due tocooking the meal in the same space meant forstudying. Given the inadequate infrastructure,the only room that might be the classroomwould double as the cooking space, distractingthe students from studying.

• Substantiating the above, available literaturepoints to lack of infrastructure as a keyconstraint to effective implementation.Availability of clean water for cooking andhygiene, kitchen sheds or kitchens to ensureteaching and learning are not obstructed,maintenance of existing sheds to preventaccess of animals, provision of adequatestorage for foodgrains to avoid decay,contamination and corruption (storing grainsin the house of president of the VillageEducation Committee, a common fix to theproblem, makes monitoring the availablequantity difficult), and adequate staff formanaging the MDM (recruiting cooks instead ofteachers having to do the cooking as well andproviding helpers to assist the cook) are thekey aspects related to infrastructure.

• Other relevant studies reveal gaps inmanagement of the Scheme that are alsolinked to issues of financing. These includeirregular supplies of foodgrains, poormonitoring, partial payment of fuel ortransport costs, low and delayed

remuneration of cooks and helpers. Not onlydo these bottlenecks hamper the functioningof the Scheme but also leave scope forcorruption, e.g. partial payment of transportcosts induces the need to recover costs byselling some of the rice.

• A growing trend of public private partnershipsin managing the Scheme leaves room forcommercial interests to use it as a platform topromote their agenda.

• Focusing on socialization, research suggestsevidence of caste discrimination in MDM. InRajasthan, Bihar and Tamil Nadu, access toDalit students is either denied completely orlimited (with segregated seating, differentfood, labeled plates, lower caste children givenwater by others, etc.). Appointment of Dalit(and other minorities) cooks is anotherfacet of the same problem.

• CBGA, as part of its Monitoring Right toEducation study in 2007, conducted a primarysurvey in three States of Andhra Pradesh, Biharand Orissa and examined MDM as one of thecritical components. The findings (as shared inthe previous Budget Track) noted that whileMDM was operational in most of the schoolssurveyed, the prescribed menu was notfollowed in many cases. Several instances ofcooks not being paid since a long time andoverburdened teachers, thrust with the taskof managing the meals, were reported. Poorinfrastructure and lack of adequatemonitoring were the usual suspects.

Having made a summary scan of the Scheme, itbecomes clear that while some progress has beenmade, there is a long way to go. While the Centrehas extended the Scheme to upper primary levelin 2007, a welcome step in itself, this needs tobe substantiated by overhauling themanagement, functioning and monitoring of theprogramme. Allocations need to be raised,especially for poorer States, to ensure that thequality and intent of the Scheme is met.Infrastructure is a major determinant in thesuccess of the Scheme. Streamlining the guidelinesfor classroom and mealtime conduct, the selectionof cooks can enhance the perceived social benefitsof the MDM Scheme.

Implementationof Mid DayMeal: Foodfor Thought

“A relatedproblem was thedisruption ofclassroomactivity due tocooking themeal in thesame spacemeant forstudying”

“Other relevantstudies revealgaps inmanagement ofthe Scheme thatare also linkedto issues offinancing”


16

IIn the International Year of Sanitation(2008), the Government of India is claimedto have implemented the Total SanitationCampaign (TSC) in most of the districts

successfully; it is being implemented in 583districts from a total 610 districts. Those districtswhich remained outside of the TSC coverage areprimarily urban, while some are unapproachabledistricts. This scheme is considered to be one ofthe flagship schemes, which is undertaken bythe United Progressive Alliances (UPAGovernment), in the perspective of ruraldevelopment as well as in honoring India’scommitment to meet the MillenniumDevelopment Goals (MDGs) to halve theproportion of people without sustainable accessto safe drinking water and basic sanitation by2015. Besides, the TSC has set a target toachieve 100 percent rural sanitation by the endof the Eleventh Plan (i.e., by 2012). The 100percent sanitation coverage is in terms ofHousehold Toilets, Schools and Anganwadi Toilets,and also providing hygiene education to thepeople.

INTRODUCING TSCIn its endeavor to providing basic sanitation to allrural habitations, India launched its firstnationwide programme for rural sanitation in 1986in the form of the Central Rural SanitationProgramme (CRSP) under the Ministry of RuralDevelopment with the objective of improving thequality of life of rural people and to provideprivacy and dignity to women. It was supplydriven, highly subsidized and gave emphasis on asingle construction model. It’s feature alsoincluded a pattern of centralization in its planningand implementation at State and Districts level forthe purpose of selecting villages and beneficiariesand also fixing targets for each village. It hardlyhad any focus on building awareness and changein behavior for relevant hygiene practices. Thebeneficiaries had very limited choice in designingthe toilets. Rural Welfare Officers/NGOs wereauthorized to construct latrines by engaging localcontractors in the CRSP scheme. The deliverableoutcome of the CRSP in the 1990s, as per theUNICEF’s report on Progress for Children, is 14percent which was far less than the World average

and Hardware. While the Software components arethe start-up activities, IEC activities andadministrative charges which are primarilyessential to run the programme; the Hardwarecomponents are tangible outcomes that need to berealized through the construction of Rural SanitaryMart (RSM) and Production Centres (PC), IndividualHouseholds Latrines (IHHL), Community SanitaryComplex, and above all, Institutional Sanitationwhich includes both school sanitation andAnganwadi sanitation, etc.

But the current statistics of physical andfinancial performance of TSC components defiesthe Union Government’s claims andcommitments and looks far behind the timelineto fulfil universal or total coverage target set bythe Planning Commission by 2012 andMillennium Development Goals by 2015.

PHYSICAL PERFORMANCE:• The TSC programme is in its ninth year of

implementation with a total outlay ofRs. 1,355,268.71 lakh and its aims to build

of 49 percent. Therefore, the need was felt torevamp the scheme. Based on therecommendations of the National Seminar on RuralSanitation in September 1992, the CRSPprogramme was revised and renamed as TotalSanitation Campaign (TSC), which followed anintegrated approach to rural sanitation. TSC hassome distinct features such as the role ofPanchayati Raj Institutions (PRIs) as pivotal pointin decentralized planning and implementation;considerable reliance on Information Education andCommunication (IEC) and social mobilization forcreating awareness and demand generation; andfocus on hygiene education through communityled and people centered approach. Besides, it alsoprovides a range of technological options tobeneficiaries, and empowers them to constructlatrines by using locally trained masons.

The scheme claims to be ‘total’ because it hasall components that are inevitable for a holisticcoverage of rural sanitation. There are two maintypes of the components of the TSC: Software

How ‘total ’ is TotalSanitation Campaign?

-Gyana Ranjan Panda


17

11.89 crore Individual Household Latrines(IHHL) units; 11.39 lakh Schools Toilets; 4.14lakh Anganwadi Toilets; and 27,796 SanitaryComplexes. However, the total achievedperformance so far on the above componentsstands at 4.93 crore IHHL (34%); 5.31 lakhSchools Toilets (46%); 1.70 lakh AnganwadiToilets (41%); and 12,303 Sanitary Complexes(46%).

• Among all States, only Sikkim has attained100 percent target and Andhra Pradesh,Haryana, Kerala, Mizoram Tamil Nadu and WestBengal have done farely well in theperformances indices.

• Poor performing States include Bihar,Chattisgarh, Jharkhand, Karnataka, Orissa,Punjab, Uttar Pradesh and others.

FINANCIAL PERFORMANCE:• With regard to financial progress in the TSC

project, out of 583 projects districts with anoutlay of 1,355,268.71 lakh, the totalexpenditure reported is 389,551.84 lakh whichis only 29 percent of the total outlay.

• In the total approved share, Center, Statesand Beneficiary shares are 63 percent, 22percent, and 15 percent respectively. In therelease of funds, their respective proportionsare 36 percent, 49 percent and 51 percent. Inthe expenditure reported, State’s share is mostwith 76 percent; Center’s share is 67 percent;

Sanitation Coverage in South Asia (%) Against Millennium Development Goals (MDG)

1990 2004 MDG targets* Progress towards theCountries Urban Rural Total Urban Rural Total 2015 MDG targets

*

On tracksInsufficient progress—

No Progress—

How ‘total ’ isTotalSanitat ionCampaign?

Source : www.ddws.nic.in


18

and beneficiary share with 65 percent to theirrespective released share.

• As the financial norms and guidelines of theTSC requires, all project districts (583) need toavail four installments of the Central andState shares; however after Ist installment,there are only 250 project districts so farwhich have availed the second installment, 66districts sought the third installment and only2 districts claimed the fourth installment.Those two districts which have opted fourthor last installment belong to Sikkim only.

SANITATION AND MDGsUNICEF Report on “Progress For Children”(December 2007) considers the South Asia’ssanitation coverage among the lowest in theworld at 37 percent, about the same as that inSub-Saharan Africa. Roughly, around a third ofthe world’s total live in this region without anytoilets. Though the region has boosted in itsefforts regarding access to improved drinking-watersources from 71 percent in 1990 to 85 percent in2004 and has virtually met its MDG targets of 86percent; it is lagging far behind from other regionsin the sanitation front. The sanitation coveragehas been more than doubled from 17 percent in1990 to 37 percent in 2004, but given the poorstart, the pace will have to be considerablyaccelerated if the region is to meet its target of59 percent. A further 478 million people, around48 million a year, will need to gain access by2015. However, an important reference of thereport is that the region has severe urban-ruraldisparities in sanitation coverage. While thenumber of people in urban areas without access tosanitation increased from 139 million in 1990 to153 million in 2004, urban sanitation coverage ismore than twice of the rural sanitation coverage.This rural and urban divide is more or less uniformin all the eight countries of the South Asia region.

WHY NOT ‘TOTAL’?The poor financial and physical performance of theTSC are highlighted by many studies commissionedby the Government of India. The AgriculturalFinancial Corporation Ltd. (AFCL) conducted the

mid-term review of the TSC programme in 2005.It’s coverage was quite selective (20 districts of 14states viz., Andhra Pradesh, Assam, Bihar,Maharashtra, Gujarat, Rajasthan, West Bengal,Jharkhand, Tamil Nadu, Kerala, Tripura, Karnataka,Uttar Pradesh and Madhya Pradesh). The chiefnodal TSC implementing authority, the Departmentof Drinking Water and Sanitation (DDWS), in itsAnnual Report and Outcome Budget underlinedmany challenges faced by the Total SanitationCampaign (TSC). Some of the important findingsare the moribund state of the PRIs in manyStates along with the low level of priorityattached by political as well as administrativemachinery causing poor implementation of theTSC programme; the low motivation level inmany grassroots implementing machinery; non-release of share by some States; lack ofemphasis on inter-personal communication atvillage level; inadequate capacity building andhuman resources at implementation level, etc.

However, the most important problem is the delayin the fund flow with regard to States’ share alongwith that of the Centre’s to the district. Thiscauses delay in the utilization of the first orsecond installments in many districts. To illustrate,the financial norms of TSC requires the submissionof Utilization Certificate (UC) of 60 percent ofboth Center and State’s share along with the auditreport before claiming the next installment of TSCprogramme. The record of claiming secondinstallment is very poor as data suggests, only250 project districts have so far claimed thesecond installment, 66 project districts haveclaimed the third installment and only 2 projectdistricts have availed the fourth or lastinstallment.

In sum, the TSC is a well-targeted scheme toprovide hygienic and sanitized rural environmentto the individual, community as well as to theinstitutional level. It has all requiredcomponents that can be claimed to be as ‘total’in its coverage and can lead to both tangibletargets and intangible outcomes. However, thepresent position of the TSC coverage negateswhat could have been ‘total’ in the TotalSanitation Campaign.

How ‘total ’ isTotal

Sanitat ionCampaign?

“After Istinstallment,there are only250 projectdistricts so farwhich haveavailed thesecondinstallment, 66districts soughtthe thirdinstallment andonly 2 districtsclaimed thefourthinstallment”

“The mostimportantproblem is thedelay in thefund flow withregard to States’share along withthat of theCentre’s to thedistrict”


19

Budgeting for Human Rights- Prit i Darooka

In recent years, there are growingcollaborations between groups working onhuman rights, especially economic, socialand cultural rights (ESCR) and those

working on budget analysis. Although the twoframeworks are very different in theory andpractice, they both share a common goal—a goalto promote human well being for all. Budgetanalysis and human rights are interconnected.Promoting human rights have economicconsequences as they require resources, similarlyeconomic policies do impact how people enjoyhuman rights. A better understanding ofgovernment budget seems particularly relevant tostruggles for human rights. Budget analysis,especially in context of ESCR can provide muchneeded teeth to measure progress in a concreteway and advocate for government compliance.Budget analysis can help identify and clarifythe sites of negotiations and struggle needed tobring about improvements in human rightssituations.

International human rights framework is at timesperceived as overly individualistic and ‘Western’.Such criticism might have validity in some cases,however, internationally accepted, the richnormative content of human rights framework ofindividual dignity and entitlements provides usefulethical and political supplements to economicpolicies. Human rights standards as outlined invarious international treaties are part of domesticlegislation and policies, hence can facilitate arights based approach to government budgets andcan ensure no one is left behind. Rights andobligations demand state accountability. Humanrights obligations must take priority as humanrights are end in themselves whereas budgets areonly means to achieve various ends. This alsomeans that financial objective must not beachieved in a way that violates human rights and/or fail to fulfill them.

Budgets are not just instruments of economicpolicies but are political documents. Budgets revealvalues and priorities of a country. It is thefinancial statement of all government activities.Therefore, a detailed analysis of budgets interms of how budget resources are raised andallotted; who benefits from them and who areleft behind, what are the cost implications tofulfill human rights obligations, can all beuseful tools for human rights advocacy.

Human rights instruments, especially treaties setclear guidelines that are binding on States in

budget decisions. For example, InternationalCovenant on Economic, Social and Cultural Rights(ICESCR) states that

Each State Party to the presentCovenant undertakes to take stepsindividually and through internationalassistance and cooperation, especiallyeconomic and technical, to themaximum of its available resources,with a view to achieving progressivelythe full realization of the rightsrecognized in the present Covenant byall appropriate means, includingparticularly the adoption of legislativemeasures.

Article 2 (1)

The Article recognizes that the resources availableto States are limited and full realization of rightstakes time. Concept of ‘progressive realization’imposes a specific and continuing obligation to

move as expeditious and effectively as possibletowards full realization of rights. The concept of‘maximum available resources’ under the article hasdirect budget implication. Progressive realizationdoes not provide the state with an excuse tomanage public finance in disregard of humanrights. Under ICESCR, States are required to ensurefulfillment of ‘minimum core’ obligation of eachright. States can never justify non compliance tocore obligations as these obligations areimmediate in nature. Any retrogressive measuresthat affect enjoyment of any ESCR require Statesto show that such measures were introduced onlyafter consideration of all alternatives.

International human rights reporting mechanismsincluding various treaty bodies provide anopportunity for civil society groups to haveconstructive dialogue with their governments.Besides highlighting good practices, the processalso allows ‘naming and shaming’. India isscheduled to report to the UN Committee onEconomic, Social and Cultural Rights (CESCR) inMay, 2008. CESCR monitors implementation ofInternational Covenant on Economic, Social andCultural Rights (ICESCR). Once a country ratifiesa treaty, it is expected to submitted periodicreports every 5 years on how it is fulfilling itsobligations under that treaty. India ratified ICESCRin 1979 and submitted initial report in 80s andthen never reported. India is reporting to CESCRafter almost 20+ years.


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India’s compliance to ICESCR obligations beingreviewed by CESCR provides an opportunity for civilsociety groups in India to provide CESCR with aparallel NGO report. The official state report usuallyprovides an incomplete picture and the Committeeencourages civil society to also submit a report togive a complete picture. PWESCR (Programme onWomen’s Economic, Social and Cultural Rights)has initiated a collective process in India todevelop a collaborative NGO report for CESCR.There are about 40+ organizations part of thiscollective, including Center for Budget andGovernance Accountability. Budget analysis wasidentified by the Collective as one of the crosscutting issue for the NGO report. Attempts will bemade to bring budget analysis to all issues coveredwithin the report.

Using budget analysis to monitor ESCR in Indiawill provide the following:

• Combining the moral and legal power ofhuman rights with the technical power ofbudget analysis can help the NGO report to

CESCR present some very persuasive evidenceand arguments.

• Human rights advocates like us at times failto provide clear recommendations needed torectify and fulfill human rights obligationsespecially in terms of ESCR. Budget analysiscan highlight inadequacies in expenditure,misdirection of funds and/or disregards tohuman rights commitments.

• Resources are always limited. Inadequacy offunds is typically and at times justifiablyclaimed by governments as the main reasonfor not fulfilling rights obligations. Budgetanalysis can reveal ‘lost funds’ by corruptionin government spending and in administrationof funds.

• Besides highlighting various issues, the NGOreport will also provide recommendations forIndian government to rectify these issues.These recommendations will require resources.Budget analysis can reveal how to findadditional funds.

Budgeting forHuman Rights

Priti Darooka is the Founder and Coordinator of the Programme on Women’s Economic,Social and Cultural Rights (PWESCR)

Dear Readers,

We are glad to inform you all that we areintroducing a Reader’s Column in the BudgetTrack.

We request you to send your responses tothe issues comprised in the Budget Track [email protected]. You may alsomail us your comments at our postal address.

CREDITSEditorial TeamPraveen Jha, Yamini Mishra

AdvocacyBhumika Jhamb, Deepak L. Xavier,Parinita Pandey, Siba ShankarMohanty

ResearchGyana Ranjan Panda, Indranil, JawedAlam Khan, Kaushik Ganguly, PoojaParvati, Ramgati Singh, TrishaAgarwala

Circulation & AdministrationKhwaja Mobeen Ur-Rehman,Ranjeet Singh, Sumita Gupta

AssistanceHarsh Singh Rawat

IllustrationAyan Chatopadhyay

Layout & PrintingKriti Creative Studio

BOARD MEMBERSAmitabh Behar, Anil Singh, Ginny Srivastava, Jagdananda, Jayati Ghosh,John Samuel, Fr. Manu Alphonse, Praveen Jha, Sandeep Dikshit, Shanta Sinha

Volume 5, Track 2, March 2008

A publication by:Centre for Budget and Governance Accountability

for private circulation only

FOR MORE INFORMATION, CONTACT :

Centre for Budget and Governance Accountability

A-11, Second Floor, Niti Bagh, Khel Gaon Marg, New Delhi - 110 049, INDIAPhone: +91-11-4174 1285/86/87 Email: [email protected]

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