STATUS OF BIHAR ACROSS SOCIAL PARAMETERS OF THE SDGs

The 2030 Agenda for Sustainable Development adopted in 2015 provides a shared blueprint for peace and prosperity for people and the planet, now and into the future.  At its heart are the 17 Sustainable Development Goals (SDGs), that recognize that ending poverty and other deprivations must go hand-in-hand with strategies that improve health and education, reduce inequality, and spur economic growth – all while tackling climate change and working to preserve our oceans and forests.

India, having 17 per cent of the world’s population, holds the key to global SDG achievement. Today, the country faces multiple challenges in several sectors of development, be it health, nutrition, education, sanitation and infrastructure. But it also provides opportunities to come out with innovative solutions to such problems.

Given the federal structure of India, States and local governments are crucial to India’s progress, as they play a pivotal role in implementing development programmes and are therefore essential stakeholders in realising SDG.

This document studies the 4 social parameters of SDG related to poverty, hunger, healthcare and education. It uses data from the NITI Aayog SDG Index report 2019-20 and the Economic Survey of Bihar 2019-20 and reflects upon the status of Bihar across these social parameters and compares it with other states of India.

Bihar has been chosen as subject of study owing to its large geographic area, huge  population, high population density and backward socio-economic parameters making it key to overall performance of India in achieving SDG targets.

SDG 1: NO POVERTY

End Poverty in All its Forms Everywhere

Equitable & inclusive development requires improving human capital which can be achieved by breaking out from the vicious cycle of intergenerational poverty.

Bihar ranks Second Last at 27^th position only above Jharkhand. The best states are Tamil Nadu, Tripura and Andhra Pradesh which has more than double the SDG index score of Bihar. Analysing sub-parameters of Poverty following were the findings:

1. BPL POPULATION:
   • The poverty ratios using the Tendulkar Committee methodology, for Bihar was 34.1 % for rural and 31.2 % for urban areas in 2011-12. The overall poverty ratio was 33.7 %.
   • These poverty ratios are much higher than Kerala which has only 7% BPL population, Himachal Pradesh (8%), Sikkim (8%) and Punjab (8%) and even substantially higher than the all-India level of 21.92 %.
2. MGNREGA COVERAGE:
   • MGNREGA ensures 100 days of employment to the people in need of work and is key to ensure minimum income to poor.
   • In Bihar coverage under MGNREGA stands at 77% while Mizoram, Meghalaya, Arunachal Pradesh and Nagaland have over 95% population who demanded and got employment under MGNREGA.
   • Bihar delivered only 108.4 million person days out of a target of 140 million, completed only a third of its target of rural roads, resulting in 2,095 habitations still being unconnected and built just around 388,000 rural houses out of a target of 1.17 million houses by March 2019.

A multipronged strategy to eliminate poverty lies at the core of India’s national development agenda. Targeted programmes to facilitate income growth for the economically disadvantaged, social protection measures and access to basic services are key to achieve goal of No Poverty.

SDG 2: ZERO HUNGER

End Hunger, Achieve Food Security & Improved Nutrition and Promote Sustainable Agriculture

With a nearly six-fold increase in food grain production from 50 million tonnes in 1950-51 to more than 283.37 million tonnes in 2018-19, India has done well to expand food production and build up stocks of food grains. However, there is inequality among performance of states.

In achieving goal of zero hunger, Bihar ranks Third Last at 26th position. Only Madhya Pradesh and Jharkhand are placed below Bihar. The top states working progressively for food security and improved nutrition to end hunger are Goa, Mizoram and Kerala which has SDG Index score thrice that of Bihar.

Following results were obtained on studying the performance of Bihar:

1. STUNTING & MALNUTRITION:
   • In Bihar, NFHS-4 (2015-16) estimates that 48.3 percent of children under 5 years are stunted (too short for their age), which signifies chronic undernutrition.
   • The stunting is observed to be 9.5 percentage points higher among the children in rural areas (49.3 percent), compared to urban areas (39.8 percent). Among the districts of Bihar, the prevalence of stunting is the highest in Sitamarhi (57.3 percent) and Nalanda (54.1 percent).
   • The percentage of children under 5 years of age who are stunted is the highest in Bihar at 48 per cent whereas Jammu & Kashmir (12%), Goa (19.6 per cent), Tamil Nadu (19.7 per cent) and Kerala (20.5 per cent) has much lower number of children who are stunted.
2. UNDERWEIGHT:  
   • As per NFHS-4 results, in Bihar about 43.9 percent of children under 5 years are underweight in Bihar.
   • There is a difference of 7.1 percentage points between rural and urban areas, standing at 44.6 percent and 37.5 percent respectively.
   • Among the 38 districts, Arwal records the highest share of underweight children at 54.0 percent, followed by Gaya (53.1 percent) and Sheikhpura (51.7 percent).
3. WASTING:
   • 20.8 percent of children under 5 years of age in the state are wasted (too thin for their height), which signify acute undernutrition as a consequence of malnourishment. (NFHS-4)
   • Among the districts, Arwal (30.7 percent), Jamui (29.4 percent) and Sheikhpura (28.9 percent) are worst performing districts. Bihar has 44% children under 5 who are underweight while Sikkim and Mizoram have 11% underweight children.
4. ANAEMIC POPULATION:
   • Bihar has 58% pregnant women and 43% under age of 5 children who suffer from Anaemia while Kerala has 22% and 12% respectively.

The solution to Zero Hunger lies in food & nutritional security, agricultural income & productivity and promoting climate adaptive agriculture and sustainability.

SDG GOAL 3: GOOD HEALTH AND WELL BEING

Ensure Healthy Lives & Promote Well Being for all at all Ages

The Goal addresses all major health priorities, including reproductive, maternal and child health; communicable, non-communicable and environmental diseases; universal health coverage; and access for all to safe, effective, quality and affordable medicines and vaccines.

It also calls for more research and development, increased health financing, and strengthening the capacity in health risk reduction and management.

Bihar stands at Third last position at 26th in providing health services to its people both in terms of quality and quantity of health infrastructure. The top positions in good health are occupied by mostly southern states of Kerala, Andhra Pradesh, Tamil Nadu and Maharashtra.

RANKING ACROSS VARIOUS HEALTH PARAMENTERS

• MMR (Mother Mortality Rate): Bihar has high MMR of 165 whereas 3 States – Kerala, Maharashtra, and Tamil Nadu, have already reached the SDG-3 target of MMR of less than 70 per 1,00,000 live births. (National Average is 122).
• Institutional Deliveries: Bihar has 42% women undergoing institutional deliveries while Kerala, Mizoram and Telangana have over 70% institutional deliveries.
• Under 5 Mortality Rate: Bihar has very high U5MR of 58 while Kerala stands first at 7 and Tamil Nadu at 27.
• Full Immunisation of Children Under 5: Only 48% of children under 5 are fully immunised while Andhra Pradesh, Haryana, Himachal Pradesh, Manipur, Mizoram, Telangana and Uttarakhand has over 70% immunisation.
• Total Physicians, Nurses and midwives: Bihar has 19 per 10,000 Population while Kerala has 112 and Tamil Nadu has 71 per 10000. The National Average is 38 and target being 45.

POOR HEALTH INFRASTRUCTURE IN BIHAR:

The poor status of health in Bihar is not only due to its quality of healthcare but also due to lack of sufficient healthcare workforce. This has been reflected in the following study:

• Doctor’s Vacancy: As regards doctors, in 2018-19, there were 3821 regular doctors in Bihar, against 6261 sanctioned posts, indicating a high vacancy ratio of 39 %. In addition, there were also sanctioned posts for 2314 contractual doctors, of which only 533 posts were filled up, representing vacancy of 77 percent.
• Nurses Vacancy: there were 4704 sanctioned posts, but the number of working nurses were lesser at 1994, indicating a high vacancy ratio of 58 percent. Similarly, in case of contractual nurses, against the sanctioned strength of 1719, only 308 were working, implying a high vacancy ratio of 82 percent.
• ANMs Vacancy: In 2018-19, the actual strength of regular ANM was 11,830, against the sanctioned posts of 21,859, indicating a vacancy ratio of 46 percent. Likewise, the working strength of contractual ANMs was 5889, against 12,587 sanctioned posts, indicating a vacancy ratio of 53 percent.
• Dilapidated Health Condition: In Bihar, there are as many as 7 districts (Sheikhpura, Jahanabad, Arwal, Sheohar, Nalanda, Bhagalpur and Patna), in each of which a government doctor has to serve more than 5 lakh people.
• Health Institution/Lakh Population: The best three districts in terms of availability of health infrastructure/lakh population are — Jamui (179), Sheikhpura (173) and Sheohar (169). At the other end, three most disadvantaged districts are — Patna (62), Sitamarhi (78) and Darbhanga (83).

The prime focus area should be reducing MMR, under 5 Mortality Rate, addressing burden of Communicable disease & focussed approach on NCD. This can be achieved by providing for sanctioned number of doctors, specialists, ANMs and nurses and a dedicated scheme for mother and new-born with proper monitoring. A bold approach can be shifting the focus to Universal Health Coverage.

SDG GOAL 4: QUALITY EDUCATION

Ensure Equitable & Equitable Quality Education and Promote Life Long Learning Opportunities for All

Investing in human development requires a heavy focus on education. While the Millennium Development Goals focused on increasing student enrolment, the SDGs placed particular emphasis on improving the quality of education and learning outcomes.

While SDG 4 focuses on equity, inclusion and quality of education, it also aims to build and upgrade education facilities that are sensitive to the needs of children and person with disabilities.

Bihar is positioned Last in Quality and inclusive and equitable Education. Himachal Pradesh, Kerala, Goa and Tamil Nadu have outperformed in providing education to students. Following analysis highlight the position Bihar in contrast to other states on various educational parameters:

1. Literacy Rate: The literacy rate in Bihar was 61.8 percent in 2011 as compared to a national average of 72.9 percent. Kerala has highest literacy rate of 94%.
2. Proportion of Trained Teacher: The National Average of trained teacher is 79% while that in Bihar is 24% while Kerala, Punjab, Arunachal, Himachal, Haryana, Delhi, Karnataka, MP have over 95% trained teachers.
3. Average Annual Dropout Rate at Secondary Level: The dropout rates at secondary level are much higher than that at the elementary level. The dropout rate was 56.1 percent in 2017-18 at the secondary level. Thus, only 44 percent of students enrolled in Standard I presently complete their secondary level education in Bihar. While dropout rate for Himachal Pradesh (7%), Uttarakhand (9%), Delhi (11%) and Kerala (12%) stood much lower.
4. GER in Higher Education: Bihar has Gross Enrolment Ratio of only 13.6% in higher education whereas Kerala tops the list with GER of 37 percent.
5. Scheduled Caste Dropout Rate: As per Bihar’s Economic Survey, the dropout rates for Secondary Education in 2017-18 was 58% and gender-wise dropout was 62% for Boys and 53% for girls and for the Upper Primary level it was 48% (combined) and 52% for boys and 43% for girls.

The solution lies in providing free, equitable and quality primary and secondary education, Access to quality early childhood development, care and pre-primary education and Accessible, Affordable and Quality Higher Education along with Skill Development courses. This will build a cadre of quality workforce and help realise the true benefits of demographic dividend.

CONCLUSION:

Overall, in NITI Aayog’s SDG Index, Bihar is positioned last with Index score of 50, while Kerala (70) stands at top followed by Himachal Pradesh (69) and Andhra Pradesh (67), with India’s average index score being 60. This is also supported by above report findings where we observe that Bihar has ranked poorly on parameters of poverty alleviation, zero hunger, food security, health and education.

The present scenario demands the State government to take responsibility for the same and align the budgetary allocation to these human development parameters. Moreover, a proper monitoring mechanism needs to be setup to evaluate the progress of steps taken to achieve these goals.  Interventions in Poverty Alleviation by targeted schemes & access to basic services; Fighting Hunger by providing food and nutritional security; provision of Good Health for All via better healthcare facilities and universal health coverage and providing Quality Education which is accessible, affordable and inclusive at all levels holds the key to achieve the Sustainable Development Goals.