National Rural Health Mission (NRHM)

Introduction

The NRHM aims to provide a fully functional, community-owned, decentralized healthcare delivery system with inter-sectoral convergence at all levels to ensure action on multiple indicators – water, sanitation, education, nutrition, social and gender equality

Features

Main target to provide access to affordable quality healthcare services to rural population
Section Focus: Special focus on vulnerable sections: Women and Children: RMNCH+A – Reproductive, Maternal, New born, Child and Adolescent
Region Focused: Targeted focus on improving primary healthcare services in Empowered Action Group States and North-East
Community Participation: Improved Community level participation through Mahila Arogya Samiti, Rogi Kalyan Samiti and Village Health and Nutrition Council

ASHA – Accredited Social Health Activists

Community Health volunteers called Accredited Social Health Activists (ASHAs) have been engaged under the mission for establishing a link between the community and the health system
ASHA is the first port of call for any health-related demands of deprived sections of the population, especially women and children, who find it difficult to access health services in rural areas.

Rogi Kalyan Samiti (Patient Welfare Committee)

Group of trustees of the hospital to Manage affairs of hospitals

Janani Suraksha Yojana (JSY)

JSY aims to reduce maternal mortality among pregnant women by encouraging institutional delivery.
Under the scheme, cash assistance is provided to eligible pregnant women for giving birth in a government health facility.

National Mobile Medical Units (NMMUs)

Many un-served areas have been covered through National Mobile Medical Units (NMMUs).

National Ambulance Services

Free ambulance services are provided in every nook and corner of the country connected with a toll-free number and reach within 30 minutes of the call.

Janani Shishu Suraksha Karyakram (JSSK)

As part of recent initiatives and further moving in the direction of universal healthcare, Janani Shishu Suraksha Karyakarm (JSSK) was introduced to provide free to and fro transport, free drugs, free diagnosis, free blood, and free diet to pregnant women who come for delivery in public health institutions and sick infants up to one year.

Rashtriya Bal Swasthya Karyakram (RBSK) – In line with Article 45 of DPSP (Early Childhood Care)

A Child Health Screening and Early Intervention Services have been launched in February 2013 to screen diseases specific to childhood, developmental delays, disabilities, birth defects and deficiencies. The initiative will cover about 27 crore children between 0–18 years of age and also provide free treatment including surgery for health problems diagnosed under this initiative.

Mother and Child Health Wings (MCH Wings)

With a focus to reduce maternal and child mortality, dedicated Mother and Child Health Wings with 100/50/30 bed capacity have been sanctioned in high case load district hospitals and CHCs which would create additional beds for mothers and children.

Free Drugs and Free Diagnostic Service

A new initiative is launched under the National Health Mission to provide Free Drugs Service and Free Diagnostic Service with a motive to lower the out of pocket expenditure on health.

District Hospital and Knowledge Centre (DHKC)

As a new initiative District Hospitals are being strengthened to provide Multi-specialty health care including dialysis care, intensive cardiac care, cancer treatment, mental illness, emergency medical and trauma care These hospitals would act as the knowledge support for clinical care in facilities below it through a telemedicine centre located in the district headquarters and also developed as centres for training of paramedics and nurses.

National Iron+ Initiative

The National Iron+ Initiative is an attempt to look at Iron Deficiency Anaemia in which beneficiaries will receive iron and folic acid supplementation irrespective of their Iron/Hb status. This initiative will bring together existing programmes (IFA supplementation for: pregnant and lactating women and; children in the age group of 6–60 months) and introduce new-age groups.

FROM NRHM to NHM

Why NHM?

Integrated Focus on rural and urban areas earlier missing in NRHM
Holistic Focus: Focus expanded from mother and children centric health issues to diverse sections of society
Long Term Vision: NRHM lacked long term vision as it was launched in mission mode
Regional Equity: Highly variable delivery of services across states

NUHM

Envisages to meet healthcare needs of urban population with special focus on urban poor and other vulnerable sections seeking to improve their outreach to primary healthcare services and reducing their out of pocket expenditure in availing healthcare services.

Focus on meeting healthcare needs of slum population with convergence with schemes of other ministries engaged in enhancing related health determinants- water, sanitation, education, housing etc – Ministry of Urban Development, Housing and Urban Poverty Alleviation, MHRD and MWCD

Pathway to achieving NUHM goals

Need-based healthcare delivery system to meet diverse healthcare needs of urban poor and other vulnerable sections like street vendors, rickshaw pullers, coolies, construction workers
Availability of resources for providing primary healthcare to urban poor
Institutional mechanism and management system to deal with rapidly growing urban population (multi-sector convergence – water, housing, sanitation)
Partnership with the community and local bodies for proactive involvement in planning, implementation and monitoring of health activities
Partnerships with NGOs, health service providers and other stakeholders

Projects under NHM

Kayakalp

Award scheme that recognizes excellence in the cleanliness of public health facilities

Objectives

Inculcate a culture of cleanliness in public health facilities in a structural manner with bio-waste disposals and protocol creation and concurrence
Promote cleanliness, hygiene and infection control practices in healthcare facilities
Create and share sustainable practices related to improved cleanliness in public health care facilities
Build confidence of users in public health facilities
Introduce a culture of peer review and assessment of performance related to hygiene, cleanliness and sanitation

Indradhanush (Will be covered under Immunization)

Preventive Health Care

Poverty

World Bank defines poverty as a social phenomenon in which a particular section of the society is unable to fulfil their basic needs

Measuring Poverty- Absolute and Relative scales – Tendulkar and Rangarajan

Absolute Poverty: The deprivation of an individual or household with respect to objective levels of living standard is referred to as absolute poverty.

Eg: India has 26.9 crores as of 2011-12 below its poverty line

India has been successful in reducing its absolute poverty. The number of poor has come down from 40crore in 2004 to 26 crore in 2011. Such a rapid reduction in poverty levels are a result of key government interventions in education, skill development, land reforms and affirmative action.

Relative Poverty: The deprivation of an individual or household relative to another is referred to as relative poverty. The measure of income inequality is significant in relative poverty and is mainly used in rich countries.

Eg: the U.K uses a median income level to measure how many individuals are earning less than the average workforce

With growing income inequality and inter-state disparities, relative poverty in India remains stark. While the Southern states show a higher level of human development, the northern states in the EAG belt suffer from acute poverty. A recent Oxfam report shows how 1% in India capture 73% of the wealth. The increasing role of the state as a facilitator of the market has increased such disparities. The role of the market in providing social services of education, health and skill development has continued to class polarise Indian society.

Tendulkar Committee Recommendations

Shift from Calorie based Estimation: Tendulkar committee advocated to replace calorie based estimations of Alagh and Lakdhawala committees. Thus, it widened the scope of poverty from merely food security
Uniform Poverty Line Basket: The committee advocated to fix a uniform poverty line basket for rural and urban India based on Purchasing Power Parity model. This basket was made up of food, fuel, footwear, education, medical, sanitation and several other services and durables
Price Adjustment: Spatial and temporal variations in prices were to be accounted for in estimating poverty
Social Determinants: Tendulkar incorporated dimensions of health and education expenses into poverty

Criticism

Too low a poverty line: At 33 Rs a day, many would argue that the Tendulkar poverty line is set too low. Even an individual with 34 Rs as his or her remuneration would struggle to eke out a living

Outcome

According to the Tendulkar Poverty line, 37% of India is classified as poor (Rural: 41% and Urban: 25%). The think tank NITI Aayog has backed the Tendulkar line as a reference point for tracking progress in combating poverty. The poverty estimate would not be used in assessing beneficiaries.

Multi-Dimensional Poverty Index (By Oxford Poverty and Human Development Initiative + UNDP)

Parameters used:

Health – Nutrition, Child Mortality
Education – Mean Schooling Years, Net Attendance Ratio
Standard of living- Drinking water, Sanitation, Electricity, Assets(Housing), Cooking Fuel

Socio-Economic Caste Census

Used for identifying beneficiaries for MGNREGA and other social security schemes
Used the term ‘excluded households’ depending on ownership and nature of land and assets, head of the family’s caste, gender and disability, education of family members
Automatic exclusion and inclusion parameters were used
Example: Household paying income tax automatically excluded
Manual Scavenger families are automatically included

Why SECC

Earlier method used to identify those suffering from poverty – Tendulkar or Rangarajan- by identifying a basket of basic necessities and computing corresponding monetary requirements pegged minimal income requirement too low
Helps to move to a principle of program specific indicators for program specific entitlements
A more dynamic approach was hence deemed necessary for identifying deprived sections of society and thus SECC came into being

Objectives of SECC

Targeting of Beneficiaries: Enable ranking of households in terms of socio-economic status which can then be utilised for state governments to prepare a list of BPL families where social benefit schemes can be targeted at.
- MGNREGA and NHPS are targeted at beneficiaries according to SECC
Caste wise Enumeration: Make available authentic information for caste wise enumeration of population and education status of caste sections of the population

Criticisms

Incorrect Data: Non-confidentiality of census means respondents may have wilfully provided wrong data for entitlement of benefits
Unequal coverage across various districts and states
Number of manual scavengers grossly underestimated

Causes of Poverty in India

Social Causes

Casteism – Occupational Stagnation

Eg: Manual Scavengers

Patriarchal Mindset- Women are confined to their chores within households affecting economic productivity of the family
Health and Sanitation- Highest out of pocket expenditure of households which are largely vulnerable to diseases brewing out of lack of hygiene, access to clean drinking water and sanitation
Large Population – Greater stress on resources which widen chasm of inequitable benefit attainment

Economic Causes

Education and Skilling– Lack of schooling and higher education resulting in lower employability in jobs that pay sufficiently. Hence they are confined to low earning jobs like agriculture, construction workers, coolies, street vendors etc.
Disguised Unemployment- Low productivity in agriculture
Fragmented Landholdings
Poverty itself being a cause transmitted from one generation to another as the next generation are not able to draw on opportunities due to financial restrictions imposed on them

Political Causes

Lack of political will
Inequitable distribution of benefits and entitlements in proportion to need of sections
Colonial Legacy
Slow and ineffective implementation of land reforms

Cultural Causes: Many of the tribal population like the Jarawas withdraw themselves from the mainstream. They continue to live an aboriginal life isolated from modern technology and production. This perpetuates low incomes and lack of access to education and health.

Addressing Poverty through Government Interventions

Assistive Development

The government plays the role of a welfare state and assists the vulnerable population by providing them financial and other means of support. In this mode of development, the beneficiary itself is not involved in the process as she is only a receiver of government aid in the form of cash or kind

Entitlements through Financial Support

National Social Assistance Programme – Ministry of Rural Development

Provides social pensions to the elderly, destitute and citizens with disabilities.
Depends on an income of the citizen – any citizen lacking regular funds in the form of regular income or assistance from family members.
Concurrent with Article 41- DPSP- Public Assistance in case of unemployment due to old age, sickness and disablement.

Constitutional Inspiration

Article 41- State shall within the limits of its economic capacity and development, endeavour to recognize the right to work, education and public assistance in case of old age, sickness, disability and unemployment.

The NSAP includes three components:

National Old Age Pension Scheme (NOAPS);

National Family Benefit Scheme (NFBS);

National Maternity Benefit Scheme (NMBS).

Launched in 1995; later on Indira Gandhi Widow Pension Scheme and Indira Gandhi National Disability Pension were merged with this programme.

The NSAP is extended to cover all individuals living below the poverty line.

IGNOAPS

Above 60 years, below the poverty line

IGNWPS

Above 40 years, widow, below the poverty line

IGNDPS

Above 18, >80% disability, above the poverty line

National Family Benefit Scheme

Breadwinner dies between ages of 18-60; ‘lump sum’ assistance of Rs20000 is provided.

Annapurna Scheme

10kg of rice for beneficiaries per month who are senior citizens not covered under IGNOAPS.

Public Distribution System- Ministry of Consumer Affairs, Food and Public Distribution

PDS is an institutional framework or supply chain consisting of distribution of food grains and other basic necessities like kerosene and sugar to deprived sections at affordable prices through fair price shops

Till 1992, PDS was universal and later shifted to Targeted PDS for streamlining distribution so that deserving beneficiaries are benefited more.

The Supply Chain

The farmer produces—à Government procures the grains—à Stores in FCI——à Transportation to States—-à Distributed to Fair price shops—-à Beneficiary

Allocation of food grains according to 1. Number of BPL beneficiaries 2. Agricultural production

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

Electricity – DDUGJY

Deen Dayal Upadhyaya Gram Jyoti Yojana (Ministry of Power)

Provide a continuous power supply to rural India
GARV-II app to provide real-time data of all six lakh villages of the country
Village-wise works sanctioned under Deen Dayal Upadhyaya Gram Jyoti Yojana (DDUGJY) has been mapped to scrutinize the progress of work
Feeder separation to ensure sufficient power to farmers for irrigation and regular supply to other consumers. It is also a pre-requisite for introducing water pricing.

PURA (Providing Urban Amenities to Rural Areas) – MoRD

Aims to provide amenities similar to urban areas by four-thronged process of rural development.

Infrastructural/Physical Development – Increasing road connectivity to rural areas

Knowledge Connectivity- Setting up Educational institutions

Communication Accessibility- Telecom and other networks

Economic Enhancement- Providing livelihood opportunities on the background of other 3 pillars.

Employment opportunities are provided to villages under the MNREGA scheme providing 100 days of assured employment.

Increased focus given to sanitation, provision of clean drinking water on re-launch of the scheme compared to knowledge connectivity.

Technical Assistance is provided by ASEAN Bank of Development.

Launched as a PPP model with private sector organizations coordinating with Gram Panchayats implementing developmental plans of MoRD plans of Central and State governments.

S.P Mukherjee Rurban Mission

The mission recognizes that villages are not stand alone settlements but clusters of them that are proximate providing opportunities to derive geographical and demographic advantages. These clusters once developed can be classified as ‘Rurban’ and the mission aims to provide them with physical, social and economic infrastructural facilities.

Vision: Development of clusters of villages with focus on inclusivity and equity and provision of basic facilities essentially considered urban in nature, thus creating a cluster of smart Rurban villages

Objective: Local Economic Development, Enhance basic services and create well planned Rurban clusters

Components:

Digital Connectivity – Bridging the digital divide with rural areas by leveraging Digital India Mission. Enhances online access to government services aiming to digitally empower citizens. Digital literacy is a key part of capacity building and skill development initiatives hence enabling livelihood generation reducing unemployment in rurban clusters – (DDUAY can be leveraged for the same)
Skill Development
Integrated Planned Villages – Creating a smart culture of villages , inter-village road connectivity, village streets and drains, Fully equipped mobile health unit (NRHM), Sanitation, Water supply, Solid and Liquid Waste Management
Traditional Knowledge – Upgrading school/ higher education facilities

Desired outcomes of the Mission

Local economic development generating livelihoods for rural poor hence reducing unemployment and poverty by provision of economic activities, developing skills and local entrepreneurship providing infrastructural facilities
Attracting investment in rural areas and spreading development in the region
Bridging divide between rural and urban areas – economic, technological and those related to facilities or services

Structure of Implementation – The Polity Takeaway of Rurban Mission

State governments would identify clusters geographically contiguous with gram panchayats in accordance with the framework of implementation as directed by MoRD. Hence Rurban mission is a continuation of the government’s policy of encouraging the bottom-up approach.

Funding is through various other schemes integrated into the cluster and additional 30% Critical Gap Funding as Central share to enable development of such Rurban clusters – Cooperative Federalism

States would prepare detailed Integrated Cluster Action Plans – Detailing strategy for the cluster, desired outcomes for the cluster under the mission and resource convergence under various schemes and CGF required for the cluster

Participative Model of Development

In this mode of development, citizens are provided opportunities to empower themselves and hence ride over poverty. Hence beneficiaries are active participants in this model of development and it is a more sustainable solution as it involves creation of livelihoods enabling citizens to be self-reliant

MGNREGA – Ministry of Rural Development

Under this programme, the government guarantees 100 days of assured employment to beneficiaries in rural areas (1 member of household). In case of regions affected by natural disasters, days of employment shall stretch to 150 days.

Even in cases where the government is not able to provide the guaranteed work hours, the beneficiaries shall earn wages of 100 days of employment.

Objectives of MGNREGA

Livelihood Creation: Providing livelihoods to rural poor enabling them to come out of poverty
Rural Infrastructure Development: Build up rural infrastructure with active participation of villagers
Demand-driven rural development: The planning and implementation of the MGNREGS is vested with the Panchayats. This ensures that the demand of the population evokes development rather than a top-down approach followed in earlier CDPs.
Bottom-up Approach with greater accountability in grass-root governance

Constitutional Background

Article 38 – Promote the welfare of people securing economic (social, political) justice

Article 39 (A) – All citizens men and women shall have adequate means of livelihood

Article 41- State shall within the limits of its economic capacity and development, make effective provision for securing the right to work, to education and public assistance.

Positive Outcomes of MGNREGA

Provision of livelihoods enabling several villagers to be alleviated from poverty increasing their purchasing power
Rural infrastructure development with particularly goods results seen in ancillary agrarian infrastructure of canals and reservoirs
Enabled government to implement several other programmes linked with rural development by leveraging available demographic dividend in a win-win situation for both stakeholders
Women empowerment: MGNREGA witnessed large scale participation of women hence empowering them economically enabling them to find voice within their households
Tackled the issue of seasonal unemployment and disguised unemployment in agriculture by diversifying employability opportunities enabling better productivity
Increased bargaining power of agricultural labourers enabling them to thrive overexploitation of landlords
MGNREGS helped arrest rural to urban migration and some studies point to a reverse migration to rural areas in search of work
Social Audit component empowering citizens and enforcing accountability on governance systems

Critical Analysis of MGNREGA

Inadequate Productivity: MGNREGA has not witnessed the building of productive assets in proportion to the employment opportunities it generates and the wages the government commits. Hence the very objective of introducing a participative form of development has been compromised
Lack of focus on skill development: Although MGNREGA witnessed large participation of rural workforce, the characteristics of the population and the work assigned was largely non-skilled or semi-skilled works generating a pool of low skilled workforce. Hence there was a lack of focus on skill development and employability in skilled jobs.
Wages not disbursed timely have been a violation of socio-economic justice that a welfare state stands for which is also a part of the basic structure of the constitution.
State-wise wage disparity
Insufficient wages: Many states have fixed wages that are below minimum wages stipulated by legislations effectively violating Article 23 of the constitution which eliminates forced labour and the spirit of living wage guaranteed under Article 43(DPSP).
- The Mahendra Dev committee unequivocally stated that ‘the baseline for all MGNREGA workers wage shall be fixed at minimum wage for agricultural labourers fixed by the state under the Minimum wages Act
Beneficiary Identification: Gram panchayats tasked with beneficiary identification have suffered from issues of nepotism, corruption and favouritism which has led to exclusion errors
Reduced available employment for agriculture: The increased wages and alternate avenues provided by NREGS has increased the cost of obtaining labour for farmers which have affected their profitability

Recommendations for Improving MGNREGA

Increasing Productivity Leveraging Technology: Geo-Tagging and leveraging satellite-based technology to identify prospective areas of development, monitoring and ensure its fulfilment
Diversify to avoid Exclusion: Workforce must be chosen from different sections of society to avoid exclusion errors
Integration with other rural development programmes to achieve greater convergence of outcomes. Eg: PMGSY can be integrated with MGNREGS
Introduce a skill development component and enhance aptitude of citizens towards skilled jobs —à PROJECT LIFE
DBT to increase transparency and ensure timely disbursement of wages
Including labour on Private farmland in subset of activities: Recognizing farm labour under NREGS and providing subsidy on labourer’s wages to farmers can ensure that rural agriculture is not hit by reduced availability of labour

Deen Dayal Upadhyaya Antyodaya Yojana – NRLM – MoRD

Aided in part by investment from the world bank, the mission aims to create efficient and effective institutional platforms for rural poor enabling them to increase household income through sustainable livelihood enhancements and improved access to financial services.

Features of DDUAY

Universal Social Mobilization of Poor: Formation of SHGs to mobilize poor population into groups and leverage their strength as a group to attain means of livelihood. Special efforts are made to ensure participation of vulnerable and marginalized households – women-headed households, SC/ST , disabled, landless, migrant labourers
Financial Inclusion: By grouping into SHGs, it eases the difficulty in receiving micro credit from rural credit institutions making rural poor preferred clients of the banking system. NRLM facilitates universal access to cost-effective financial services to the poor including financial literacy, bank accounts, credit, insurance, remittance, pension and counselling on financial services.
Social Capital: Brings like-minded people together and provides opportunities to alleviate participants from poverty leveraging their collective strength
Capacity Building: Poor are provided with requisite skills for managing their institutions, linking up with markets, managing existing livelihoods, enhancing credit absorption capability and creditworthiness. ICT is used as an important tool in knowledge dissemination for more effective capacity building
Facilitating Market Linkages: SHGs enable to find efficient linkages to market in terms of finished goods distribution (forward linkage) as well as raw material procurement (backward linkage). Hence it enables handicraft and traditional village industries to thrive driven by demand

Challenges of DDUAY

Market linkages are not sufficient affecting profitability of MSMEs under rural entrepreneurs backed by DDUAY
Lack of Aptitude towards skill development and skilled jobs
Cultural impediments of patriarchy and caste affecting participation of women and occupational mobility of historically disadvantaged sections
Political Interventions affecting the smooth functioning of DDUAY

Regional Disparity with South India mainly gaining employability as opposed to the North

Health Sector In India- Holistic Study Part 3