Mystery surrounds India health survey (clue: unflattering for Gujarat under Modi)
Good health data is rare in India. The last time the
country published a comprehensive, state-wide survey was back in 2007. So why hasn't a vast survey of women and children carried
out by the Indian government with the UN agency for children, Unicef, been
released?
India's so-called Rapid Survey of Children was a huge
undertaking. Almost 100,000 children were measured and weighed and more than
200,000 people interviewed across the country's 29 states. The final report was
due for publication in October last year, the BBC understands. Yet, more than
half a year later, the important body of data remains secret.
Leading development economist Jean Dreze describes the delay
in publication as "an absolute scandal". "All the neighbouring
countries including Bangladesh, Nepal, Sri Lanka, Bhutan, Pakistan and even
Afghanistan have up to date nutritional surveys," he says. "It is
hard to account for a 10-year gap without attributing some sort of political
reluctance." Unicef says it understands that the government is "reviewing
the survey methodology" - but the agency is looking forward to the release
of the data.
"Data is crucial for making sound evidence-based
plans," explains Saba Mebrahtu, Unicef's head of nutrition in India.
"It helps us understand what is causing under-nutrition so that
interventions can be focused in those areas."
Poor performance: The BBC has asked the Indian
government why it hasn't been released and when it expects to - but we haven't
received a response. We have, however, managed to get hold of a copy of the
report. Looking just at the overall figures, India's reluctance to publish the
survey is rather surprising. It shows the country has an encouraging story to
tell. Indicators of malnutrition are still very high, far higher than most
African nations, but they are improving.
Ten years ago, two-fifths of children under five were
underweight, now it is more like a third. However, the survey confirms large
and enduring discrepancies between states, including the continuing strikingly
poor performance of the Indian prime minister's home state, Gujarat. As chief
minister, Narendra Modi ran the state for more than a decade.
His general election campaign was based on the promise that
he would do for India what he had done for Gujarat. The results of the survey
might lead some people to question whether - in terms of health - it is really
a model the nation should seek to emulate. It shows that despite impressive
economic growth, the state continues to have some of the worst health outcomes
in India. It says 41.8% of children in Gujarat are stunted while 43.8% don't
have the all the vaccinations they need, for example.
'Encouraging trends': Gujarat's poor results have led
to speculation that one reason the government has been holding back the report
is to spare the prime minister embarrassment. It certainly appears that
Gujarat's shortcomings are, at least in part, a result of policy. A decade ago
a survey found the neighbouring state of Maharashtra had malnutrition figures
almost as woeful as Gujarat does now. Maharashtra decided to take action. Sujata Saunik, the head
of the state's health department, says it used the data from that earlier
survey to design a programme to improve child health.
It has been a great success. She says stunting has been cut
by almost 41% and in the number of underweight babies is down by 24%. "These
are encouraging trends," she says, rather modestly. India, however, is unlikely to see similarly dramatic
changes in the national picture. The Indian government spends just 1% of GDP on
healthcare - one of the lowest figures in the world. And since Mr Modi came to
power, he has cut central government spending back.
