Getting down to ground level

In India, although the IMR has declined from 140 to 80 per thousand, the slowness of this process should be a matter of concern. More importantly, noteworthy interstate differences in the pace of reduction in IMR merit careful examination.

The government cannot embark on a policy of lowering the death rate unless they have reliable knowledge of its causes. This is where micro-level studies come in. The pattern of development over the past few decades has accentuated differences among subgroups of populations making any aggregate analysis almost meaningless. Maharashtra with the highest per capita income will have regions like Marathwada, which will be almost on a par with Bihar and UP in terms of human development. So micro level attempts or qualitative studies need to be welcomed.

In this context, two painstaking studies done recently in Maharashtra deserve comment. The findings reported by eminent social worker, Dr Abhay Bang, of Search, after surveying eight districts, are startling. He concluded that there is a gross under-reporting of infant deaths and placed the figure at 80 per cent.

It appears that the tribal terrain is just not covered by the government. This gets further support from Arun Bhatia, well-known administrator and presently, commissioner, Tribal Research Institute. He not only confirms Bang’s observation, but adds that these deaths were mainly due to malnourishment.

Recent studies clearly attribute the high rate of IMR to malnutrition. But probably, in most cases, it may be even due to undernutrition, or starvation. While malnutrition refers to the lack of quality, undernutrition refers to lack of quantity. And this despite bumper food stocks.

To find the reasons for infant mortality, we must zero in on two factors: poverty and lack of adequate food, safe drinking water and hygienic living conditions. Clearly, the PDS is of pivotal concern here.

We need to go deeper into why the PDS has not delivered; why programmes like Food For Work and the Employment Guarantee Scheme do not seem to have worked well. The least these programmes should do is to ensure that there is no starvation. The findings of Bang and Bhatia should arouse social concern and pressurise the government into intervening in this issue on a war footing.

Rao is head, biometry and nutrition group, Aagharkar Research Institute, Pune, while Pitre is assistant adviser, department of economic analysis and policy, RBI, Pune. The views expressed here are their own.