UPSC MainsESSAY2019125 Marks1200 Words
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Q6.

Neglect of primary health care and education in India are reasons for its backwardness

How to Approach

This essay requires a nuanced understanding of the interplay between primary healthcare, education, and socio-economic development in India. The approach should be to first define 'backwardness' in the Indian context, then demonstrate how deficiencies in primary healthcare and education contribute to it. The answer should explore historical context, current challenges, and potential solutions, incorporating data and examples. A balanced structure, acknowledging complexities and counterarguments, is crucial. The essay should adopt a multi-disciplinary approach, drawing from economics, sociology, and political science.

Model Answer

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Introduction

India’s development trajectory, despite significant economic growth in recent decades, remains unevenly distributed and plagued by persistent socio-economic disparities. ‘Backwardness’ in the Indian context isn’t merely economic; it encompasses social indicators like health, education, and opportunity, creating a cycle of disadvantage. The neglect of primary healthcare and education, foundational pillars of human capital formation, has historically exacerbated these inequalities, hindering inclusive growth and perpetuating a state of relative underdevelopment. The National Education Policy 2020 and initiatives like Ayushman Bharat aim to address these gaps, but systemic challenges remain, demanding a critical examination of the historical and contemporary factors at play.

Historical Context and the Colonial Legacy

The roots of the neglect can be traced back to the colonial era, where investment in education and healthcare was minimal, primarily serving the interests of the ruling elite. Post-independence, while significant strides were made, the focus remained largely on higher education and tertiary healthcare, often at the expense of primary levels. The Bhore Committee (1946) advocated for a comprehensive primary healthcare system, but its recommendations were only partially implemented. The emphasis on centrally planned economic development prioritized industrialization, often overlooking the crucial role of a healthy and educated populace.

The State of Primary Healthcare in India

India’s primary healthcare system, the first point of contact for most citizens, faces numerous challenges:

  • Infrastructure Deficit: Shortage of Primary Health Centres (PHCs), Sub-Centres (SCs), and qualified healthcare personnel, particularly in rural and remote areas. According to the Rural Health Statistics 2021-22, there is a significant shortfall of doctors and nurses at the PHC level.
  • Funding Constraints: Public health expenditure in India remains low, at around 1.3% of GDP (National Health Profile 2019-20), significantly lower than the global average.
  • Accessibility Issues: Geographical barriers, lack of transportation, and socio-cultural factors hinder access to healthcare services for marginalized communities.
  • Quality Concerns: Limited availability of essential medicines, diagnostic facilities, and skilled birth attendants compromise the quality of care.

The Ayushman Bharat – Health and Wellness Centres (HWCs) scheme aims to transform PHCs into HWCs, providing comprehensive primary healthcare services. However, its success hinges on addressing the existing infrastructure and human resource gaps.

The Crisis in Primary Education

Similar to healthcare, primary education in India suffers from systemic issues:

  • Access Disparities: Despite initiatives like Sarva Shiksha Abhiyan (SSA) and Right to Education (RTE) Act, 2009, significant disparities persist in enrollment and retention rates, particularly among girls, Scheduled Castes (SCs), Scheduled Tribes (STs), and other marginalized groups.
  • Quality of Education: Poor infrastructure, inadequate teacher training, and a rote-learning based curriculum contribute to low learning outcomes. The Annual Status of Education Report (ASER) consistently highlights the learning crisis in Indian schools.
  • Teacher Shortages: A chronic shortage of qualified teachers, especially in rural areas, impacts the quality of education.
  • Dropout Rates: High dropout rates, particularly at the upper primary level, indicate systemic failures in providing relevant and engaging education.

The New Education Policy (NEP) 2020 proposes significant reforms, including a focus on foundational literacy and numeracy, teacher training, and vocational education. However, effective implementation will require substantial investment and political will.

The Interlinkage between Health and Education

The neglect of primary healthcare and education are not isolated issues; they are deeply interconnected. Poor health impacts educational attainment, as sick children are less likely to attend school and perform well. Conversely, lack of education limits health literacy, leading to poor health choices and increased vulnerability to diseases. This creates a vicious cycle of poverty and underdevelopment.

Economic Consequences of Neglect

The consequences of neglecting these sectors are far-reaching:

  • Reduced Productivity: A sick and uneducated workforce is less productive, hindering economic growth.
  • Increased Healthcare Costs: Preventable diseases and complications due to lack of healthcare access lead to higher healthcare costs in the long run.
  • Widening Inequality: Disparities in health and education exacerbate income inequality, creating social unrest.
  • Demographic Dividend Unrealized: India’s demographic dividend can only be fully realized if the population is healthy and educated.

Governance and Policy Failures

Several governance and policy failures contribute to the problem:

  • Fragmented Approach: Lack of coordination between different government departments and agencies.
  • Corruption and Leakages: Funds allocated for healthcare and education often get diverted due to corruption and inefficiencies.
  • Lack of Accountability: Weak monitoring and evaluation mechanisms hinder accountability.
  • Political Prioritization: Insufficient political prioritization of primary healthcare and education.

Conclusion

The neglect of primary healthcare and education in India is undeniably a significant factor contributing to its relative backwardness. Addressing this requires a paradigm shift towards prioritizing these foundational sectors, increasing public investment, improving governance, and ensuring equitable access to quality services. The success of initiatives like Ayushman Bharat and NEP 2020 depends on overcoming systemic challenges and fostering a holistic approach to human capital development. Investing in the health and education of its citizens is not merely a social imperative but a crucial prerequisite for India to achieve its full economic and social potential.

Answer Length

This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.

Additional Resources

Key Definitions

Human Capital
The stock of knowledge, skills, habits, and social and personality attributes, including creativity, embodied in the ability to perform labor so as to produce economic value.
Right to Education (RTE)
The Right of Children to Free and Compulsory Education Act, 2009, mandates free and compulsory education for all children aged 6-14 years.

Key Statistics

India’s public health expenditure was 1.3% of GDP in 2019-20, compared to 3.3% in the UK and 8.3% in Germany.

Source: National Health Profile 2019-20

As of 2022, approximately 20% of Indian children aged 6-14 years were not enrolled in school.

Source: UNESCO Institute for Statistics (Data as of knowledge cutoff)

Examples

Kerala Model of Development

Kerala’s success in achieving high levels of human development, despite limited economic resources, is often attributed to its early and sustained investment in education and healthcare.

Frequently Asked Questions

Why is primary healthcare more important than tertiary healthcare?

Primary healthcare is the first point of contact and focuses on prevention and early detection, reducing the burden on tertiary healthcare facilities and improving overall health outcomes. It is also more cost-effective.

Topics Covered

Social IssuesEconomyGovernanceHuman Development IndexPublic HealthEducation Policy