The Hindu Editorial Analysis | 2nd July 19 | PDF Download

Miles To Go

• India has some distance to cover before making self-care interventions freely available
• Self-care, which mostly happens outside the formal health system, is nothing new. What has changed is the deluge of new diagnostics, devices and drugs that are transforming the way common people access care, when and where they need them. With the ability to prevent disease, maintain health and cope with illness and disability with or without reliance on health-care workers, self-care interventions are gaining more importance. Millions of people, including in India, face the twin problems of acute shortage of healthcare workers and lack of access to essential health services. According to the World Health Organization, which has released self-help guidelines for sexual and reproductive health, over 400 million across the world already lack access to essential health services and there will be a shortage of about 13 million health-care workers by 2035. Self-help would mean different things for people living in very diverse conditions. While it would mean convenience, privacy and ease for people belonging to the upper strata who have easy access to healthcare facilities anytime, for those living in conditions of vulnerability and lack access to health care, self-help becomes the primary, timely and reliable form of care. Not surprisingly, the WHO recognizes self-care interventions as a means to expand access to health services. Soon, the WHO would expand the guidelines to include other self-care interventions, including for prevention and treatment of non-communicable diseases.
• India has some distance to go before making self-care interventions for sexual and reproductive health freely available to women. Home-based pregnancy testing is the most commonly used self-help diagnostics in this area in India. Interventions include self-managed abortions using approved drugs — morning-after pills taken soon after unprotected sex, and mifepristone and misoprostol taken a few weeks into pregnancy — that can be had without the supervision of a healthcare provider. While the morning-after pills are available over the counter, mifepristone and misoprostol are scheduled drugs and need a prescription from a medical practitioner, thus defeating the very purpose of the drugs. The next commonly consumed drug to prevent illness and disease is the pre-exposure prophylaxis (PrEP) for HIV prevention. India is yet to come up with guidelines for PrEP use and include it in the national HIV prevention programme.
• Despite the WHO approving the HIV self-test to improve access to HIV diagnosis in 2016, the Pune-based National AIDS Research Institute is still in the process of validating it for HIV screening. One of the reasons why people shy away from getting tested for HIV is stigma and discrimination. The home-based testing provides privacy. India has in principle agreed that rapid HIV testing helps to get more people diagnosed and opt for treatment, reducing transmission rates.
• Bhutan’s teachers, doctors and other medical staff will earn more than civil servants of corresponding grades, if a policy recently announced by the country’s government is implemented. The new salary scales will benefit about 13,000 teachers and doctors. This is a novel move. No other country has accorded teachers and doctors such pride of place in its government service, both in terms of remuneration and symbolism. Remarkably, the proposal was announced by Bhutan’s Prime Minister Lotay Tshering, himself a qualified doctor — which suggests that professional experience informs the policy.
• Inspired or fanciful?
• Let us examine the policy’s educational aspect. Is the proposal part of a coherent strategy, or an inspired announcement that is resolute in intent but likely effete in effect?
• The policy’s tonal reference is to be found in Bhutan’s 12th Five Year Plan (2018-23), published by its Gross National Happiness Commission, the country’s highest policymaking body. The commission’s strategy to achieve desired national outcomes through education opens with the notation, “making teaching a profession of choice”. The proposal then is evidently at the core of a larger governmental strategy to achieve the country’s human developmental objectives. The decision also comes in the wake of high levels of teacher attrition, especially the best. Clearly, the government has formulated the policy as a styptic to stop the serious haemorrhage.
• Intuiting the correlation, as Bhutan has, between attracting the best talent to a profession and the renumeration it potentially offers is easy. But importantly, is it possible to demonstrate that improving the status of the teaching profession positively influences educational outcomes?
• The Organisation for Economic Co-operation and Development’s Programme for International Student Assessment (PISA) is a worldwide study that measures and compares student ability in reading, mathematics, science and global competence, with financial literacy an option. Accordingly, it ranks educational systems of countries. An independent study led by the economist, Peter Dolton, has demonstrated a distinct correlation between student outcomes in a country, as measured by PISA scores, and the status that its teachers enjoy. The initiative’s latest report, Global Teacher Status Index 2018, based on its own surveys across 35 countries, goes on to make a strong case for high wages to improve teacher status.
• Policies act as levers that governments use to achieve desired results in focus areas. The results of Bhutan’s policy, if implemented, will take a few years to emerge for critical evaluation. It is, however, based on credible research.
• The fiscal implications
• Bhutan already spends about 7.5% of its GDP on education. The fiscal implications of the new salary structure are unclear now. Generally, teachers constitute a considerable portion of government employees. Therefore, governments looking to emulate Bhutan’s lead will inevitably be asked questions about the financial viability of such a momentous administrative decision. For instance, the Minister concerned in Tamil Nadu, one of India’s better performing States on educational indices, turned down demands of striking teachers for better pension explaining that wages, pensions, administrative costs and interest repayments already amounted to 71% of the State’s expenditure. He asserted it leaves little for other developmental programmes.

Can India afford a similar policy?

• India currently spends about 3% of its GDP on education, accounting for about 10% of the Centre’s and States’ budgetary expenses. Salaries constitute a large portion of this expenditure. The NITI Aayog in its report last year recommended that India raise this to 6% of GDP by 2022. Paying teachers (and doctors) significantly higher salaries may seem like a tall order, but the Central and State governments could consider rationalizing both teacher recruitment and allocation of funds to existing programmes. Some programmes may have outlived their purpose, while others could be pared down or better directed. In fact, improving accountability in the system could free up huge savings.
• A World Bank study found that teacher absenteeism in India was nearly 24%, which costs the country about $1.5 billion annually. Absenteeism could be the result of many factors, including teachers taking up a second job or farming to boost incomes, providing parental or nursing care in the absence of support systems, or lacking motivation. The incentive of an enviable income which is girded with unsparing accountability could mitigate many ills that plague the system, free fiscal space and help meet important national developmental objectives.
• Piloting a policy of such consequence may also be easier in a smaller State, say Delhi. Education is a key focus area for the Delhi government; the State invests 26% of its annual budget in the sector (much more than the national average). The administration has also worked on improving teacher motivation as a strategy for better educational outcomes. The base has been set. The political leadership in the State, which is unafraid of the bold and big in the social sector, could build on this. Moreover, since the State is highly urban and well-connected, it would be easier to enforce accountability measures, which must underpin so heavy an expenditure.
• Ultimately, no investment that enables an educated, healthy, responsible and happy community can be deemed too high by any society. The short-term GDP-minded would do well to consider these words in OECD’s ‘Education at a Glance 2018’ report: “The quality of education can be a strong predictor of a country’s economic prosperity. Shortfalls in academic achievement are extremely costly, as governments must then find ways to compensate for them, and ensure the social and economic welfare of all.” Governments intent on improving the quality of education they offer must step out of incrementalism in policy-making. Improving teacher status by offering top notch salaries to attract the best to the profession could be that revolutionary policy-step forward, which Bhutan has shown a willingness to take.
• The introduction of the Central Educational Institutions (Reservation in Teachers’ Cadre) Ordinance, 2019, which is meant to “provide for the reservation of posts in appointments by direct recruitment of persons belonging to the Scheduled Castes, the Scheduled Tribes and the socially and educationally backward classes, to teachers’ cadre in certain Central Educational Institutions established, maintained or aided by the Central Government”, redresses the anomaly found in the recruitment of Other Backward Class (OBC) candidates at higher levels of teaching positions.
• The ordinance indicates that reservation to OBCs shall be provided at all levels of teaching, leaving no space of misinterpretation by some universities that had arbitrarily restricted reservation for OBCs to the level of ‘Assistant Professor’.
• However, recent advertisements by 13 central universities are in clear violation of the ordinance. Of these, only Allahabad University and Dr. Harisingh Gour University have followed fully the reservation policy by earmarking positions for OBCs at all levels, while the Central University of Kashmir has reservation at all levels except that of ‘Professor’.

Representation of OBCs

• Further, even after a clarification issued by the Ministry of Human Resource Development last month, only the Central University of Himachal Pradesh issued a revised notification providing OBC reservation at all levels of teaching.
• Curiously, while the Indira Gandhi National Tribal University — Amarkantak has reserved positions for ‘Economically Weaker Sections’ (EWS) at the levels of ‘Associate Professor’ and ‘Professor’, it has no reserved positions for OBCs. The Tata Institute of Social Sciences, which is known for its commitment to issues related to social justice, too has no reservation at higher levels of teaching positions. The rapidity with which the Central University of Rajasthan has almost reached the last step of recruitment is questionable.
• Though OBCs account for about 50% of the country’s population, their representation in all faculty positions in all central educational institutions is only 9.8%.
• According to a recent report by the University Grants Commission, only 13.87% of positions at the Assistant Professor-level in central universities were occupied by OBCs. The representation became almost negligible at higher levels, i.e. those of Associate Professor and Professor, accounting for just 1.22% and 1.14%, respectively.
• Noticeably, the representation of OBCs was less than that of Muslims at higher levels of teaching. Certain communities of Muslims are recognized as OBCs, and if we exclude them, the representation of non-Muslim OBCs in the institutions would become negligible.
• In case of violations
• Generally, the decision-making power at universities rest upon the Professors and Associate Professors. Professors, who play a significant role in the recruitment process, at times misinterpret the constitutional provisions.
• Even if a violation is found, the maximum a court does is to order a correction to the institution’s advertisement, without awarding any compensation to the petitioner or punishment to the violators. Moreover, legal procedure is tedious and hence is generally avoided.
• Noticeably, implementation of reservation for SCs, STs and OBCs in higher educational institutions funded by the Centre was delayed for more than 15 years after the announcement, while the same for EWS was done within a month of the announcement.
• Such differential treatment results in imbalanced representation of a social group at higher levels of teaching and decision-making. Women may soon get to travel for free on buses and Metro trains in Delhi. This gender-based public transport fare subsidy programme, announced by the Aam Aadmi Party government, has not been tested anywhere in India in the past. Proponents claim that the policy will protect and liberate women. Critics argue that it is financially unviable and unfair. As polarized debates over the intent and impact of the policy continue, it is useful to assess whether this idea, in principle, has any merit.
• Subsidies to the disadvantaged
• Cities often provide public transport fare subsidies to all or some citizens to encourage them to use public transport, or for easing their travel cost burdens. Singapore, for example, offers a discount to rail commuters who are willing to travel before the morning rush-hour. Public transport is free for residents in Estonia. Luxembourg, with a population of about 600,000, has made public transport free for those under the age of 20. Paris, with a population of over 2 million, has announced a comparable plan. Hong Kong has implemented a public transport fare concession scheme for people aged 65 years or more. Berlin offered women a 21% ticket discount for one day in March this year to highlight the gender wage gap. In India, however, urban transport fare discounts are less common, although concessions for seniors, students, and other socioeconomic groups are available for government-operated flights and longdistance railway services.
• Fare discounts intend to make public transport truly public as some people are at a relative disadvantage in urban transportation markets due to their unique social, economic, and health circumstances. Article 13 in the United Nations’ Universal Declaration of Human Rights recognizes freedom of movement as a basic human right. If we consider transportation as a fundamental social need and providing mobility for the transportation-disadvantaged as our collective responsibility, then any urban transport policy should include subsidies targeted at the disadvantaged. Specific supply-side investments or fare price discounts to help the disadvantaged travel, conduct activities and prosper are therefore justified. Public transport may even need to be free for some. In this context, let’s take the case of women.
• Women in India travel far less than men, and this has significant impacts on their education, employment, and enjoyment. A study in Delhi found that college girls, compared to boys, chose lower ranked colleges with safe and reliable transport access. Similarly, an estimated 60% of women workers in India choose to work from home or at a place which is less than a km from home, according to the 2011 Census. The remaining working women tend to rely excessively on public transport, according to a World Bank Study conducted in Delhi. An RTI application revealed that, in 2013, only 13% of Delhi driving licences were issued to women. These findings are suggestive of gender differences in travel choices and patterns.
• Wage discrimination, gender segregation in employment, and household labour divisions contribute to gender inequality in transportation. Because men’s jobs are considered to be more valuable, they tend to own the household vehicles and commute privately. This lopsided rationing of household transport budgets also results in women taking slower commute options to save on expenses. When Delhi Metro hiked fares last year, around 70% of women surveyed in a study suggested that they would have to choose a less safe travel option for work, or travel less. Compromises on education and jobs for travel purposes is one of the reasons for women earning less than men, leaving the workforce, and consequently being more cash-poor than men. Finally, limited money to travel also means that women are willing to forgo hospital visits, significantly affecting their health.
• There may be a case for free or discounted public transport for women. A subsidy like this is most likely to benefit women who might consider taking up jobs for which they are better suited but are further away from home. Women can engage in a range of activities that promote their well being. Free public transport can therefore bring more women to public spaces, and, consequently, make those spaces safer for women.

The high cost of free rides

• Two questions remain.

1. Who will pay for the subsidies aimed at the transportation-disadvantaged?
2. And will such subsidies make it difficult for public transport to achieve its other major goal — reducing car use and cleaning up the air?

• To address these questions, we must first recognize that personal motorised vehicle travel is highly subsidised globally, including in India. Believe it or not, driving is cheap. Car and motorised two-wheeler users are not required to pay for the full costs their travel choices inflict on society in the form of traffic congestion, environmental pollution, and distortions in urban form.
• Promotion of cleaner fuels and vehicle-sharing can reduce but not eliminate the costs.
• Indian cities must consider pricing interventions such as congestion charges, mileage-based road use charges, parking charges, and higher petrol taxes so that private driving costs better reflect full social costs. London and Stockholm, for example, have been charging for congestion for over a decade. Such measures, in addition to discouraging driving, can help governments generate funds for expanding, improving, and operating relatively cleaner transportation alternatives such as public transport. Better public transport service is key to getting people out of cars, reducing air pollution, and making cities more liveable. It is possible that revenues from appropriately charging personal motorised travel will be sufficient to make travel by public transport cheap or free for the transportation-disadvantaged, without any additional public subsidy requirement.
• Even if free public transport for women makes economic sense and seems fair, would all women support the policy? Informal surveys conducted after the Delhi government’s announcement suggests that women are divided in their preference for the policy. Women who feel this policy treats them as lesser citizens should have the choice to opt out. Whether a free public transport pass for women should be income-based is unclear; meanstesting for a public transport fare concession programme may not be worth the effort.
• Finally, this debate is not for Delhi alone. It’s time that all Indian cities crafted efficient, effective, fair, and context-specific public transport policies. Men and women do not enjoy equal freedom to move in India, and policymakers should act.

Will provide citizenship to Hindus: Shah

• Home Minister Amit Shah said on Monday that the government would bring a Bill in Parliament to provide citizenship to “Hindu refugees” left out of the National Register of Citizens (NRC).
• Mr. Shah made the remark in the Rajya Sabha after Trinamool member Derek O’Brien raised the issue of the probability of 23 lakh Bengali Hindus losing citizenship when the final NRC is published by July 31 in Assam. Nearly 41 lakh people have been excluded from the final draft NRC, of which 36 lakh have filed claims against the exclusion.
• “I want to repeat our stand on NRC. We want to stop infiltration and also push every single infiltrator out of the country. As far as Hindu refugees are concerned, we are bringing the Citizenship Amendment Bill to give them Indian citizenship,” Mr. Shah said. In its 2019 election manifesto, the BJP said it would compile NRCs across the country. President Ram Nath Kovind’s speech this month also mentioned that NRC would be implemented on “priority basis in areas affected by infiltration”. • At present, on Supreme Court directions, the Registrar-General of India (RGI) published the final draft of the NRC on July 30 last year to exclude those who had illegally entered the State from Bangladesh after March 25, 1971. The RGI on Monday a month’s extension to complete the enumeration process for updating the NRC in Assam.

 

 

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