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Blog #4: 1 in 3 has piped water, 2 of 5 kids stunted

India is home to the largest number of poor people in the world, as well as the largest number of people who have recently escaped poverty. Over the next few weeks, this blog series will highlight recent research from the World Bank and its partners on what has driven poverty reduction, what still stands in the way of progress, and the road to a more prosperous India.

We hope this will spark a conversation around #WhatWillItTake to #EndPoverty in India. Read all the blogs in this series, we look forward to your comments.

The rapid decline in consumption poverty over the past two decades was accompanied by improvements in other dimensions of welfare. But progress has been mixed and much still remains to be done. India’s performance on key indicators of well-being lags behind countries at similar stages of development. And country-level estimates mask wide disparities between states.

India has made great strides in reducing consumption poverty over the past two decades. Between 1994 and 2012, some 133 million people were lifted out of poverty. While this represents significant improvement in the well-being of India’s people, the country’s progress on other important indicators such as health, nutrition, and sanitation has been less encouraging. This highlights a multidimensional development challenge that will need urgent attention if poverty in all its forms is to be alleviated and the people’s aspirations for a better standard of living are to be fulfilled.

On a positive note, India has made appreciable gains on several fronts. Infant and child mortality rates were more than halved between 1994 and 2014, and the maternal mortality ratio fell by over 60 percent. Students are now staying longer in school, as evidenced by an increase in secondary school completion rates. And children are 34 percent less likely to be underweight in 2014 than they were in 2005.

 Select indicators of human development – 2005/06 versus 2012/15, India
Fig. 1: Select indicators of human development – 2005/06 versus 2012/15, India

However, these bright spots coexist with slow progress on other important fronts. For instance, less than a third of India’s households have convenient access to piped water, showing very little improvement since 2005. Only 2 out of 5 households have access to improved sanitation facilities and an overwhelming 44 percent of the population practices open defecation. In fact, India lags behind neighboring countries like Bangladesh, Nepal and Pakistan in improving access to sanitation and eradicating open defecation. The Swachh Bharat Mission is thus a timely initiative to improve an aspect of well-being in which India has not only fallen behind its neighbors, but has also not kept pace with its own record of progress in other dimensions. 

Importantly, child under-nutrition remains high and endemic. Roughly 2 in 5 children under the age of 5 are ‘stunted’ - that is they are shorter than the desired height for their age. While child under-nutrition in India is similar to comparable countries in South Asia, nationwide estimates hide wide disparities between states. In Bihar, Jharkhand, and Uttar Pradesh for instance, roughly half of all children under 5 are stunted. Even relatively prosperous states like Andhra Pradesh, Gujarat, Haryana, and Maharashtra fare poorly in this regard.

Notably, malnutrition and poor standards of living are not just confined the poor. Apart from the incidence of stunting, the share of the population that lacks access to piped water and improved sanitation is higher than the poverty rate, indicating the wider extent of the challenge.

India’s progress on these non-monetary dimensions of well-being is also disappointing when compared to countries at similar stages of development. For example, India’s infant and child mortality rates are higher than countries at comparable, or even lower, levels of per capita income. In fact, not only do Cambodia, Nicaragua and Vietnam perform better on infant and child mortality than India, but neighboring Bangladesh and Nepal do so too. This is the case despite starting out at roughly similar levels as Cambodia, Bangladesh and Nepal on both metrics two decades ago. And when we compare India’s infant, child, and maternal mortality rates to the other BRICS nations, we find that the country has a lot of catching up to do.

 graphs on infant and child mortality in India

In sum, India’s progress on reducing consumption poverty is certainly cause for celebration. However, the persistence of a range of other deprivations presents important development challenges. Apart from their intrinsic value as markers of welfare and equity, progress on stunting, nutrition, sanitation, and other key aspects of well-being will enable households to chart a path out of poverty. Better health, sanitation and education will not only help raise the productivity of millions, they will also empower the people to meet their aspirations, and provide the country with new drivers of economic growth.

data sources and notes
                                                   Data sources and notes

Reference: Ambar Narayan and Rinku Murgai: “Looking Back on Two Decades of Poverty and Well-Being in India”, WPS 7626.
 This blog was originally published in the Indian Express on 27th May, 2016.


Ambar Narayan

Lead Economist, Poverty Global Practice, World Bank

Join the Conversation

K Jude Sekar
May 27, 2016

Interesting pointers and insights have been provided. The spider's web-like representation is imaginative and appealing.
Sanitation is key to good living. Good health is largely dependent on it. Lack of nutrition may be largely due to poor sanitation, leading to poor health, especially in rural children where we have the manifestations as stunted growth, gastro-intestinal disorders and even impacting education and mental growth in the long run.
The comparison with other similar countries is quite revealing. However, a comparison within India, like rural-urban, and also between the better-performing states and the laggards would perhaps throw more light on the path to prosperity on the whole.

R C Rath
May 27, 2016

There is a marked improvement in the rural poverty in India. Education, drinking water and rural health are the areas of concern for the rural areas. Transparency in governance will reduce the poverty further

June 06, 2016

Nice article

ram niwas sharma
July 14, 2016

Role of bureaucracy and political system :
1) the country is governed by bureaucracy and politicians.Issue is how to awaken them , make efficient and productive.There are 68 years of Independence. Condition of JAPAN , SINGAPORE , CHINA, TAIWAN , SOUTH KOREA in comparison to India around 1950 and present 2016 need to be also checked and causes have to be found out how it can improve.
Most things in India are still looked after by government and government sector. Billions of dollars are being spent in various 5 year plans by government on above issues , where the is the money going and how can it be utilised properly?
Is political and administrative system in INDIA PROPER or IT NEEDS REFORMS?

Akwasi Appiah
July 15, 2016

Great. Thank You...

Angapat Raghu Menon
July 15, 2016

India is a Fast growing country in the past two decades, but prosperity is very slow. In the case of health it is very poor where it is not reaching the people. Sanitation is very poor. The world Bank has already financed by the Excellency the President of World Banks visit to India. Nutritions are lacking to the children which is given through the Angenvadies. We must give more attention to the poor children those coming to the Anganvadies and a Doctor should make visits to the children. In the case of Pakistan and Bangladesh they are highly populated and their living standard are very poor,Childrens mortality is higher than the percentage calculating India. In Pakistan childrens health and the food are in poor supply and the nutritions are poor. In some areas childrens are starving for food. In Pakistan the govt: is more money spending for the terrorism rather than Economic growth. Agriculture out put is poor,lack of Education and the medical aid is poor. In Bangladesh the result is not so good growing tentions inside the country is much higher,poor food supply and the economic growth is not so good. Medical aid and the education sector is poor all around it will take time to eliminate. Poverty is the main agenda for the countries of Pakistan and Bangladesh.
Nepal is in need of Foreign aid since the Earth quake destroyed most of the villages. Reconstruction, water and sanitation will take years. They need financial aid and development to restore the city and the roads. Medical care and Education compared to India is Poor and children are mostely not going to school because of their schools were destroyed. Food and Medical aid is necessary to restore the country to the normal. Srilanka is much better because of tourism and the economic growth is better than Pak and Bangla. Exports of commodities are much better than India. They are selling tourism and the economic growth is in right path way. Tamil area is upcoming after the Tiger is eliminated after the civil war against the Tamil Militent groups , Northern Lanka is developing slowly and the economic growth is better. Children are going to school,no scarcity of food for the children and the medical aid is better. Before 2030 South Asia will be eliminated poverty.

Clement Gavi
July 15, 2016

'India has made great strides in reducing consumption poverty over the past two decades.Between 1994 and 2012, some 133 million people were lifted out of poverty. While this represents significant improvement in the well-being of India’s people, the country’s progress on other important indicators such as health, nutrition, and sanitation has been less encouraging.'
In reading the above and searching to understand why one can come to the conclusion that it might be an issue of a definition. definition that determines. E.g what would have been the case if 'health, sanitation and nutrition' were considered as contents of consumption? Likelly they would have been targeted as necessities as the other consumption.

C G Pandya
July 22, 2016

It is true that the country has made a lot of progress but much more is needed to be accomplished. Some of the major weaknesses in the system are :
- Population is bursting out and there seems to be no control. Unless drastic "surgery" is done immediately, the rate of growth will go down rapidly.
- There is , unfortunately, a lot of indiscipline everywhere except of course in the military services.From politics down to bureaucracy and in business there is not just lack of discipline but positive indiscipline.
- Legal systems take years and even decades to get cleared. So many scams have been reported but hardly any action seems to have been taken resulting in culprits being let loose.
- Corruption in almost every form is yet another big problem.
These are some of the problems. As against that there are many individuals in the country who are hard working , sincere and honest and the country is progressing only because of such people.
We do hope, all such weaknesses will reduced and the country will become strong.