Economic Survey Volume 2 Chapter 10 (Latest)






The chapter identifies investment in human capital as a prerequisite for a healthy and productive population for nation-building. It describes how The Government has been enhancing the expenditure on human capital along with adopting measures to improve the efficiency of expenditure by convergence of schemes.



The expenditure on social services by the Centre and States as a proportion of GDP has remained in the range of 6% over the past few years. It has further moved up to 6.6% in 2017-18 (BE).



The Government of India is committed to achieving the Sustainable Development Goal (SDG- 4) for education – “Ensure inclusive and quality education for all and promote lifelong learning” by 2030.

India has made significant progress in quantitative indicators such as enrolment levels, completion rates, etc. However, the quality of education also needs to be monitored and assessed.

The RTE Act, 2009 lays down the guidelines for maintaining the norms and standards such as SCR, PTR and GPI for effectiveness of the schooling system.


Certain indicators to assess inclusiveness of schooling system:

  1. Student Classroom Ratio (SCR) – average number of pupils (students) per classroom in a school in a given school-year. The ideal size should be at 30 students per classroom.

Percentage of schools with SCR>30 students declined from 43% in 2009-10 to 25.7% in 2015-16.

  1. Pupil Teacher Ratio (PTR) – At primary level and upper primary level, the PTR should be 30:1 and 35:1 respectively.

PTR>30 might be due to shortage of teachers or deployment issue of teachers.

  1. Gender Parity Index (GPI) – reflects the discrimination against girls in access to educational opportunities.

With efforts like Beti Padhao, Beti Bachao, the GPI has improved substantially at the primary and secondary levels of enrolment.



In order to ensure welfare of labour in the country, various steps have been taken which include the following:

  • Codification of labour laws – to remove the multiplicity of definitions and authorities leading to ease of compliance without compromising wage security and social security to the workers. (4 labour codes- Code on Wages, Code on Safety and Working Conditions, Code on Industrial Relations, and Code on Social Security and Welfare)
  • Technology enabled transformative initiatives – Shram Suvidha Portal, Ease of Compliance, Universal Account Number, National Career Service portal.
  • Extension of Employee’s State Insurance (ESI), Act: to all 325 complete districts as well as 93 district headquarters area.

Gender gap in Labour Force Participation Rate and Earnings: Global Comparison


The gender gap in labour force participation rate is more than 50 percentage points in India.

Women workers are the most disadvantaged in the labour market as they constitute a very high proportion among the low skilled informal worker category, and are engaged in low-productivity and low paying work. Owing to this, women earn very low wages.


Measures undertaken to promote women participation in economic activities:

  1. MGNREGA- ensures participation by women in the economic activity by stipulating minimum 33% participation by women.
  2. Mahila E-Haat – for meeting aspirations and needs of women entrepreneurs.
  3. Maternity Benefit (Amendment)Act, 2017– women are entitled to enhanced maternity leave for a period of 26 weeks (6 months) working in registered establishment under any Central or State law.
  4. Creche facility– mandatory for the establishments employing 50 or more employees to provide crèche facility.


Although there are 49% of women in the population yet the political participation of women has been low.

As per the report ‘Women in Politics 2017 (IPU & UN)’ Lok Sabha had 64 (11.8% of 542 MPs) and Rajya Sabha had 27 (11% of 245 MPs) women MPs.Among the State assemblies, the highest percentage of women MLAs were from Bihar, Haryana and Rajasthan with 14% followed by Madhya Pradesh and West Bengal with 13% and Punjab with 12%

There are developing countries like Rwanda which has more than 60% women representatives in Parliament in 2017 while countries like Egypt, India, Brazil, Malaysia, Japan, Sri Lanka and Thailand have less than 15% representation of women in Parliament.


To promote women’s political participation and leadership roles:

  • Article 243D (3) of the Constitution of India provides that not less than one third of the total number of seats be reserved for women.
  • Article 243 D (4) of the Constitution of India provides that not less than one third of the total offices of Chairpersons in Panchayats at each level shall be reserved for women.
  • Mahila Shakti Kendra scheme for leadership development and to address women’s issues at village levels.
  • Nai Roshni a leadership development programme for benefiting the women belonging to minority communities.


  • Ensuring healthy lives and promoting the well-being for all at all ages is essential to sustainable development (SDG-3).
  • Expenditure by the Government healthcare providers accounted for about 23% of the Current Health Expenditure (CHE) as per National Health Accounts 2014-15 that reflects the prominence of private hospitals and clinics among health care providers.
  • Incurring higher levels of Out of Pocket Expenditure (OoPE) on health adversely impacts the poorer sections and widens inequalities in developing economies.
  • Diagnostics– Limited affordability and access to quality medical services contribute to delayed or inappropriate responses to disease control and patient management. There are not only wide differences in average prices of diagnostic tests but also range in the prices is substantial.


Steps taken by the Government to regulate prices of Drugs and Diagnostics:

  • National Free Diagnostic Service Initiative which under National Health Mission (NHM), provides essential diagnostic services in public health facilities.
  • National Free Drug Initiative under NHM aims at expanding the availability of free drug provision in all public health facilities.
  • Under Clinical Establishments (Registration and Regulation) Act, 2010 and Clinical Establishments (Central Government) Rules, 2012, the clinical establishments shall charge the rates for each type of procedure and services within the range of rates determined by the Central Government from time to time in consultation with the State Governments.
  • Amendment of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 stipulating that ‘every physician should prescribe drugs with generic names legibly and preferably in capital letters and he/she shall ensure that there is a rational prescription and use of drugs’.

Burden of Diseases: India and States

The report ‘India: Health of the Nation’s States’, 2017 provides the first comprehensive set of findings for the distribution of diseases and risk factors across all States from 1990 to 2016.


  • DALYs is the sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability.
  • One DALY represents the loss of the equivalent of one year of full health.
  • Using DALYs, the burden of diseases that cause premature death but little disability can be compared to that of diseases that do not cause death but do cause disability.

Of the total disease burden in India measured as DALYs, 61% was due to communicable, maternal, neonatal, and nutritional diseases (CMNNDs) in 1990, which dropped to 33% in 2016. There was a corresponding increase in the contribution of non-communicable diseases (NCDs) from 30% of the total disease burden in 1990 to 55 per cent in 2016.


Leading risk factors for health loss:



DALYs: A State level analysis


There exists an inverse relationship between life expectancy and DALY rates. States with higher life expectancy reflect lower DALYs rates means lower incidence of diseases and vice-versa. States with high DALYs rates are indicate relatively greater increase in NCDs.

Inequalities in life expectancies still persist among states with a range of 64.5 years in UP to 75.2 years in Kerala in 2015.

Government Programmes for Women & Children:


  • Integrated Child Development Scheme- aims at holistic development of children upto 6 years and pregnant & lactating women. The fortification of food items with essential micro nutrients has been made mandatory in government funded nutrition related schemes.
  • Pradhan Mantri Matru Vandana Yojana- provides for partial compensation for the wage loss in terms of cash incentive so that the woman can take adequate rest before and after delivery of the first child.
  • National Nutrition Mission- as an apex body will monitor, supervise, fix targets and guide the nutrition related interventions across ministries. It will create synergy, ensure better monitoring, issue alerts for timely action to achieve the targeted goals.
  • Pradhan Mantri Ujjawala Yojana- to provide LPG connection to 5 crore women belonging to BPL families to safeguard health by providing clean cooking fuel.

Public Health Expenditure by States and DALYs


  • The National Health Policy, 2017 – recommended increasing State sector health spending to more than 8% of the State government budget by 2020.
  • States with lowest per capita public health expenditure have higher DALYs rate as compared to the States with greater public health spending. However, the States of Assam, Uttarakhand, Delhi, and J& K have higher DALY rate despite having higher per capita public spending.
  • The efficiency in the use of resources along with measures for preventive and curative health care is necessary to translate enhanced expenditure into improved health outcomes.
  • Increase in use of antibiotics in developing countries like India where health care spending is low, is a cause for concern.




AMR – microorganisms change in ways that render the medications used to cure the infections they cause ineffective.

Reasons– inappropriate use of medicines, low-quality medicines, wrong prescriptions and poor infection prevention and control also encourage development and spread of drug resistance.

AMR is of particular concern in developing nations where the burden of infectious diseases is high and healthcare spending is low. Thus, judicious use of antibiotics is required.

Steps taken– India has finalized a comprehensive and multi-sectoral National Action Plan aligning to the Global Action Plan and adopted a holistic and collaborative approach involving all stakeholders towards prevention and containment of AMR.

The Government of India has initiated series of actions including setting up a National Surveillance System for AMR, enacted regulations (Schedule-H-1) to regulate sale of antibiotics, brought out National Guidelines for use of antibiotics etc.

 Challenge– efficient implementation through a coordinated approach at all levels of use of antibiotics for which all State Governments need to develop state-specific action plans.


  • The number of persons defecating in open in rural areas, which were 55 crore in October, 2014 declined to 25 crore in January, 2018, at a much faster pace compared to the trend observed before 2014.
  • 296 districts and 307,349 villages all over the India have been declared as Open Defecation Free (ODF).
  • Eight States and two UTs i.e. Sikkim, Himachal Pradesh, Kerala, Haryana, Uttarakhand, Chhattisgarh, Arunachal Pradesh, Gujarat, Daman & Diu and Chandigarh have been declared as ODF completely.


Health and Economic Impact of Sanitation

According to UNICEF, the lack of sanitation is responsible for the deaths of over 100,000 children in India annually and for stunting of 48% children.

As per the results of pilot study undertaken by the Bill & Melinda Gates Foundation (BMGF) in selected ODF and non-ODF districts:

  • The non-ODF districts have lower percentage of population with secondary education
  • In ODF areas: behavioral shift of the individuals due to larger presence and proactive work undertaken by village health and sanitation committees (VHSC).
  • Higher proportion of mothers of ODF areas in the ‘normal’ BMI category (62.9%) as compared to that of non-ODF areas (57.50%) showed that not only children but mothers were also healthier in the ODF areas.

The World Bank estimates, the lack of sanitation facilities costs India over 6 per cent of GDP.

In a report The Financial and Economic Impact of SBM in India (2017)’ UNICEF estimated that a household in an ODF village in rural India saves Rs. 50,000/- ($800) every year.