Health Sector In India- Holistic Study Part 3

Issues in Each stage of Supply Chain

Procurement: Timely procurement not performed and farmers are forced to sell through middlemen and markets. Grains procured are low in quality and faulty MSP policy means there is an asymmetrical expansion in production of wheat and rice
Storage: Cold Storage mechanisms are absent in FCI and hence grains are vulnerable to going stale quickly
Transportation: Leakages during transportation and time consuming as production and distribution areas are far away from each other
Distribution to Fair Price Shops: Truck diversions leading to lesser quantity for sale through fair price shops.
At Fair Price Shops: Issue of hoarding and sale through black market. Problem of ghost beneficiaries

General Issues with PDS

Reduced Coverage: Less density of fair price shops that hinders coverage and access to entitlements at remote places
Incorrect Beneficiary Allocation: 16% of BPL population still not covered by PDS due to want of ration cards. Homeless, destitute and disabled portions are not covered under the PDS system
Nutrient Deficiency: PDS is mainly cereal centric while supplementary micronutrients and vitamins are not supplied to beneficiaries triggering the issue of hidden hunger
Exclusion Errors: The advent of Aadhaar Assisted Biometric Authentication (AABA) system has led to exclusion of PDS services for deserving beneficiaries in lieu of biometric authentication failure. Such a failure may happen due to interrupted power supply, inadequate mobile or internet connectivity and problem with data repository servers – issues very alive in villages of India.
- Starvation deaths in Jharkhand due to deprivation of PDS services on account of authentication failures

Suggestions to Resolve Issues

Correct faulty MSP policy to address problem of skewed production of wheat and rice. Provide farmers with input subsidy on requisite fertilisers integrated through soil health card scheme and recommend scientific practices to improve quality of grains
Forge partnerships with private sector entities to bring in efficient cold storage mechanisms for food grains in FCI.
1. Cold chain programme of the Food Processing ministry can be utilized for the same
2. PDP system can be implemented to reduce the burden of storage in FCI
A dedicated freight corridor can be constructed and used for fast transportation to minimize leakages
GPS enabled tracking systems and SMS based monitoring can be used for monitoring truck movement and preventing its diversion
E-PDS: States may emulate Odisha in Electronic Record keeping can enhance transparency in sale of basic items thus discouraging practices of hoarding and black marketing.
Bio-metric Identification systems can be brought in to eliminate the problem of ghost beneficiaries
Other technological reforms- Digital Ration Card, SMS alerts to beneficiaries and Citizen’s web portal for grievance redressal
Increase coverage by improved physical connectivity and setting up fair price shops in remote areas of states
Bio-fortification and inclusion of micro-nutrient rich entitlements in PDS network to address issue of hidden hunger – Iodised salt, Black gram as practiced in Chhattisgarh
Ensure access of food grains to remaining BPL population and bring homeless, destitute and disabled persons under ambit of PDS
MP government devised a scheme whereby biometric authentication was done only once a year for households. The beneficiaries would be provided with bar-coded coupons that they can use to collect their entitlements

Odisha Case Study – What Odisha did to revamp and strengthen PDS?

E-PDS: Entire distribution system at all stages of procurement, transportation and distribution were computerised to increase transparency
Community management of PDS: Outlets were managed by SHGs, NGOs and gram panchayats thus directly devolving implementation power with a grass-root level population including beneficiaries
Mobile PDSàIncreased Coverage: Vans were mobilised to bring distant and unconnected parts under coverage thus enhancing coverage of PDS
Digitization of weighing scales to reduce avenues for corruption exploiting ignorance of beneficiaries
GPS enabled tracking facilities: Transportation of food grains to fair price shops monitored and regulated using GPS
A grievance redressal mechanism was put in place

Replacing PDS with DBT – The Pros and Cons

There have been suggestions to replace PDS with DBT to empower consumers to purchase their own food grains. Pilot DBT projects have been carried out in Haryana and Pudhucherry which have been largely successful. The usage of Aadhar linked DBT would minimize leakage of subsidies as it is directly provided to benefactors account.

How DBT can be helpful?

Varying food cultures, dietary needs and social norms of people are not taken into account in case of PDS system as it is generally a one-size fits all approach. DBT empowers a citizen to choose for himself and affords greater flexibility
Reduces leakage of subsidies
Narrows down opportunities for corrupt practices and manipulation
Facilitates maintenance of electronic database assuring better transparency with regard to distribution process

Challenges to DBT implementation

Incomplete financial inclusion: People in rural areas do not have access to banking services and many are unfamiliar and do not prefer to use bank accounts
A ‘cash over kind scheme’ puts the onus on the beneficiary to make productive use of money. Hence it is widely feared among several families that such money would not be expedited on urgent requirements like food grains but might be squandered on other non-essential items.
A regional disparity can exist where the scheme of DBT may be successful in certain regions of the country where people desire the DBT system. In other regions where individuals desire a better PDS rather than DBT, it may not be successful. Hence there is a need for demand assessment before reaching a decision.
PDS itself suffers from a problem of not addressing the nutritional security of individuals although it suffices for the adequate calorie intake. In case of DBT, citizens themselves have to make well informed choices of nutrition. Such a knowledge of a balanced diet would not be present in many individuals which can have consequences of nutritional deficiencies particularly in women and children
Some opine that PDS insures better against inflation compared to the DBT

Infrastructural Assistive Development

Bharat Nirman – Launched in 2005

Holistic Scheme covering multiple dimensions of basic necessities – Water, irrigation, Housing, Electricity

Current Administration has broken up the holistic approach into individual schemes

PM Krishi Sinchai Yojana – Ministry of Agriculture and Farmers’ Welfare

National mission to improve farm productivity and ensure better utilization of the resources
Focus on water resources and precise irrigation
Irrigation investments at field level is enhanced
Crop per drop is the motto with ranch water reuse advocated
Develop and expand cultivable land in the country

Housing Sector

The social consultancy, FSG, says that up to 37 million households — a quarter of India’s urban population — live in informal housing, including slums. It recommends giving them basic property rights

Why Housing is important?

Basic necessity of all human beings and individuals
Bedrock of several other socio-economic parameters: health, hygiene, gender equality, education, security
Enables living together of families – basic unit of every society
Social Capital in society

Reasons to Worry

Growing slum population: Shrinking land space and greater demand means acquiring land has become extremely expensive. This coupled with high construction costs have led to a growing slum population in urban areas. The displacement of people from remote areas and rural-urban migration further aggravate the slum crisis.
Ghettoization: Marginal communities in urban areas live together in urban sprawls where they have lesser access to basic civic amenities like clean drinking water, sanitation (lack of toilets), electricity (power outages), drainage (open) etc. World Bank has used the term hidden urbanization to refer to such urban communities.
Evictions and Demolitions: Forced eviction from slums and their demolitions from cities have risen to make way for infrastructure development in cities and slum dwellers do not wish to relocate to city’s fringes where they are worried that their location would restrict employment, education and other amenities
Thatched Houses in Rural Areas: Houses in rural areas are made of non-conventional sources like thatch, wood and so on. These are highly vulnerable to natural disasters like cyclones and fires

Pradhan Mantri Awas Yojana (Housing for all) – Ministry of Housing and Urban Poverty Alleviation

The scheme reflects the commitment of the government to ensure Affordable Housing for all by 2022 in accordance with the SDG 11 of making human settlements inclusive, safe, resilient and sustainable

4 schemes within PMAY

In-situ Slum Redevelopment with private sector participation using land as resource
Affordable Housing through Credit Linked Subsidy
Affordable Housing in Partnership with private and public sector
Beneficiary led house construction

Owned by females or jointly with males

Features of PMAY

eco-friendly construction technology
Allotting ground floors preference will be given to differently-abled and older persons – (Rashtriya Sugamya Yojana)

Site selection was to be made by the states in consultation with the Centre giving priority to district headquarters, cities of religious heritage and tourist importance, with due consideration to the criterion of the pace of growth of the city, of slums within the city and predominance ofScheduled Caste, Scheduled Tribe and minority population and other weaker and vulnerable section of the society

Pradhan Mantri Awas Yojana Gramin -MoRD

Aims to provide environmentally safe and secure pucca houses for all households in rural areas by 2022
Provides a loan of Rs 70k for the beneficiary selected on basis of Socio Economic Census 2011 and verified by Gram Sabha.
Aims to integrate skill India and Make in India project with several lakh masons trained in rural areas for building the required houses.
Payment process will be done through Aadhar linked DBT to Jan Dhan accounts of beneficiaries to ensure transparency

Benefits of PMAY

Affordable Housing: PMAY has commissioned according to the MoH&UD 51 lakh dwelling units rapidly upscaling from previous housing schemes
Job Creation Potential: PMAY with its ambitious targets of building 2 crore houses by 2022 has immense job creation potential in construction and associated sectors
Boosting Investment: Infrastructural development is bound to offshoot investments in other areas as economic opportunities trickle down in various forms to prospective investors thus triggering a virtuoso economic cycle
Growth of Associate Sectors: The construction sector’s growth provides fillip to cement and steel by inadvertently raising the demand for the same

Evaluation of PMAY

High Occupancy: Most of the constructed houses have been in regions where there has been a great need for housing facilities and hence have high occupancy.
Slow Pace of Construction: Attributed to the slowdown in credit flow to the housing sector owing to the Twin Balance Sheet Problem

Way Forward

Speed up Credit: Long term bonds can be issued by housing and infrastructure financing companies for domestic investors, foreign pension and sovereign funds. Foreign investment can be incentivized as it brings superior technology and cost-effective construction techniques
Strengthening PPP: Government may take over stalled projects and also pursue time-bound and outcome-bound credit to developers to assist them in completion of the projects.
Productive Use of Land: Availability of land at premium rates in urban areas mean that vertical construction needs to take precedence to ensure efficient usage of urban land. Floor space index can hence be re-examined to facilitate greater number of floors per

Suggestions

Increase Supply of Shelter and Basic Amenities:The Government should improve the legal and regulatory environment and increase the supply of affordable, legal shelter with tenure security and access to basic services and amenities. The Government should undertake physical up-gradation of informal settlements sometimes accompanied by the provision of public services, such as access to roads, electricity, water supply and sanitation. These services create a high level of perceived tenure security without a formal change of legal status and have encouraged local improvements and investment
In-Situ Slum Redevelopment: Slum dwellers often do not wish to relocate wary of gaining access to employment and education, hence the government can focus to provide housing facilities in the slum area itself. This would help in expeditious spending of money for targeted emancipation of slum dwellers
Rural Employment: The government can provide impetus to its livelihood generation programmes in rural areas to generate jobs. This can help arrest migration into urban areas and relieve some of the pressure on civic amenities and urban resources.
Giving Property Rights: Recognizing property rights of informal house dwellers might encourage home improvement and also incentivize municipalities to invest infrastructure development and amenities provision. Property rights can be of various types for informal dwellers like the following:
- Right to use and access to basic services
- Mortgageable rights to incentivize home improvement. Endowing slum dwellers with mortgageable titles can open the gates to many opportunities for improving health, education, employment and providing entitlements to social programmes
- Non-transferable heritable right (As provided by Odisha government)
- Exchange among only low-income groups