From Jacob Levich on India indicators

[Louis Proyect <lnp3@xxxxxxxxx>]

reply to Louis's query about the LBO list's debate on Indian infant
mortality, a comrade writes from India:

In the first place one should question the connection made between
reduction in IMRs and a "dynamic capitalist economy". According to official
data, Kerala has the lowest IMRs in India (10 per 1,000 live births) but
has a stagnant economy with little industry and high unemployment. By
contrast, Gujarat, considered one of the most "dynamic" states in India,
attracting large investments over the last decade, has an IMR of 60. The
reason appears to be Kerala's relatively high social expenditures on public
health, education, and most of all universally available subsidised rations.

Indeed, India's infant mortality rate began to decline from the 1920s,
under the British, despite per capita agricultural output actually falling.
It is argued by some scholars that the overall improvement in India's
health indices in this period was the result of measures by the British to
control (politically embarrassing) famine deaths, even as endemic hunger
remained or worsened. Post-transfer of power India has continued this
policy. IMRs have continued to fall; but endemic hunger has persisted. A
number of economists (Utsa Patnaik, M.H. Suryanarayana, Jaya Mehta, and
others) have pointed out that nearly three-fourths of the rural population
and half of the urban population are unable to obtain minimum calorie
needs. Patnaik points out that half the rural population in India, or 350
million people, are below the average energy intake of sub-Saharan Africa.
Nutritional outcomes bear this out: the National Family Health Survey and
the National Nutrition Monitoring Board have concluded that roughly half of
all children in India are malnourished, more than half of all women are
anemic, and two-fifths of all adults suffer from chronic energy deficiency.
An official committee on long-term grain policy documented the worsening
consumption of the poor during the 1990s (the present round of economic
`reform' was initiated in 1991). Improvement in IMRs, then, does not
necessarily tell us of the quality of life of those who survive.

India's improvement in health indicators, of course, lags far behind that
of China (most of the latter's improvement took place in the pre-1980
period, after which there has been a marked slowdown). But according to
UNDP data, India also lags behind some of its other neighbours, barring
Pakistan:

Infant mortality rate (per 1,000 live births):

                       1990                2002

China                 38                     31

India                 80                     67

Nepal               100                   66

Pakistan            96                     83

Sri Lanka          19                     17

Bangladesh       96                     51

-- UN Human Development Report 2004

Let us leave aside Sri Lanka, whose excellent indicators are the legacy of
an earlier universal public distribution system. What of Bangladesh and
Nepal: their IMRs have improved faster than, and are now lower than,
India's. Are Bangladesh and Nepal thriving, dynamic economies?

Finally, there may be a problem with the Indian data. Infant mortality data
is based on official registration of such deaths. A recent study by Dr
Abhay Bang concludes that nearly 70 per cent of infant deaths in the state
of Maharashtra go unrecorded. He has also recently headed an official
committee to check the deaths of tribal children from malnutrition; the
committee's tabulation of such deaths is more than double the official figure.

It is also puzzling that Bihar, one of the two poorest states in the
country, and ranked at the bottom of all human development indicators,
reports IMRs below the national average.