Out of ‘BIMARU’: Why the road is long, hard, and there are miles to go

BIMARU is an acronym for Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh, a grouping of states that have historically lagged in economic and social indicators. The term, which means “sickly” in Hindi, was coined by demographer Ashish Bose in the 1980s to describe the four states’ poor performance in family planning and population control.

Today, though many politicians claim that the states have shed the BIMARU label, or are making rapid progress towards it, these continue to struggle on several key socioeconomic indicators.

Population

The four BIMARU states are not only among India’s most populous, their populations are expected to continue growing at a higher rate than the national average till 2036, according to projections by the Union Ministry of Health and Family Welfare.

In the 2011 Census, these states alone accounted for nearly 37% of India’s population. Though the population growth rate has been slowing down, by 2021, they are estimated to have accounted for 38% of the population, and by 2036, that number is expected to go up to nearly 40%.

In terms of fertility rate (average number of children born to a woman in her lifetime), though India has already reached the replacement level – 2.1, a rate at which the population replaces itself without growing – the BIMARU states are still some years away. Rajasthan is set to hit replacement-level fertility rate in 2024, UP in 2025 and MP in 2028. Bihar, however, won’t reach replacement level until 2039.

In contrast, India reached it in 2019 and Kerala, the first state to get there, hit replacement level as far back as 1988.

A bright spot in these states’ continuing population growth is their median age. As India gets older, these states will have among the country’s largest young populations. In 2021, India’s median age was just over 28 years; for these four states, the median age ranged from 22 to 26. By 2036, while the median age for most large states will cross 35, these states will have median ages ranging from 28 to 32. A younger population should translate into a larger active workforce and a lower ratio of dependents.

But it’s important to note that these states are largely rural, as per Census 2011 data, and see a considerable amount of out-migration to other states for employment opportunities. While India, on average, is 68% rural, the share is as high as 88.5% in Bihar and 72.1% in MP. In 2011, UP, Bihar and Rajasthan had the largest number of migrants leaving the state, with most heading to more urbanised and economically developed regions like Maharashtra, Gujarat and Delhi.

Economy and poverty

Though per capita income has grown considerably over the past decade, only one BIMARU state’s income grew more than the national average. Between 2011 and 2021, India’s per capita income grew by 44.2%, according to data from the Reserve Bank of India (RBI). While MP’s per capita income grew by 64.6% in the same period, Bihar, Rajasthan and UP grew by 41.5%, 42% and 26.3%, respectively.

In absolute figures, Rajasthan’s per capita income in 2021-22 was the closest to the national average. In Bihar and UP, though, per capita income is less than half the national average.

The Multidimensional Poverty Index, developed by the University of Oxford and the United Nations Development Programme, is a broad measure of poverty using indicators like health, education and standard of living, in addition to the traditionally used per capita income. In 2019-21, Bihar had India’s highest proportion of multidimensionally poor people at 33.8% of the state population, considerably higher than the national average of 15%. In contrast, Kerala’s poor account for just 0.6% of its total population.

However, the BIMARU states also saw the biggest declines in the multidimensional poverty rate between 2015-16 and 2019-21.

Across India and these four states, poor access to nutrition, not enough years of schooling, low school attendance, and deficiencies in maternal health were the biggest contributors to multidimensional poverty.

According to the latest Periodic Labour Force Survey released by the Ministry of Statistics and Programme Implementation, between January and March 2023, Bihar had India’s lowest labour force participation rate (LFPR), which measures the proportion of working-age people who are employed or actively looking for work, as compared to its total population, at just 28.8%. In contrast, the national average is 38.1% and the highest LFPR was in Himachal Pradesh at 44.3%. UP ranked fourth from the bottom, Rajasthan sixth and MP ninth. All four BIMARU states had lower LFPRs than the national average.

Barring Rajasthan, all the BIMARU states had lower daily wage rates for rural men than the national average, according to data from the RBI. Construction work and non-farm labour offered higher daily wages than agricultural labour in all these states.

High rates of poverty and unemployment combined with low daily wage rates in some industries are contributing to these states’ poor economies.

RBI data on state budgets show that these states receive among the highest shares of central taxes. In 2022-23, UP got 17.7% of all central taxes given to states, followed by 11% for Bihar and 7.7% for Madhya Pradesh. While UP also generates large amounts of its tax revenue, behind only Maharashtra, the same can’t be said for the other BIMARU states, which rely on central taxes to boost their revenues. Overall, though, the BIMARU states account for more than a third of all resources transferred from the Centre to the states.

Health

In 2011, the average life expectancy was almost 67 years for Indian men and 70 for women, according to the Ministry of Health and Family Welfare. By 2021, it had risen to 69 and 73, respectively. The BIMARU states saw similar increases but only Bihar has a higher life expectancy than the national average for men and Rajasthan for women. By 2035, only MP and UP’s life expectancies for men are projected to be lower than 70 and only UP’s life expectancy for women will be lower than 74.

Over the past decade, the RBI’s data shows expenditure on health as a percentage of the state’s total expenditure has risen considerably, nearly hitting 7% in all BIMARU states apart from MP, which has only seen a 0.6-percentage point increase since 2011-12. In general, the increases have been sharper since Covid-19.

But indicators like infant mortality rate and maternal mortality rate have largely continued to lag behind the national average despite marked improvements. Poor healthcare infrastructure and a lack of trained personnel could offer an explanation.

Among the BIMARU states, only Rajasthan has filled more than 80% of sanctioned posts for doctors at public health centres, as per RBI data compiled from the Health Ministry and NITI Aayog findings. The situation is worse for specialists like surgeons, paediatricians and OB-GYNs – in 2021, no BIMARU state had filled more than 50% of the sanctioned posts. Less than a third of the sanctioned posts for these specialists have been filled across India, but the figure stands at 12.7% for Bihar, 4.6% for MP, 32.5% for Rajasthan and 30.1% for UP.

Education

Aside from Madhya Pradesh, expenditure on education as a share of total expenditure has remained stable or even declined since 2011-12, according to the RBI. In UP, for instance, the share of education spending has declined by nearly five percentage points since 2011.

Though the gross enrolment ratio (GER) – which measures the proportion of eligible students for each level who are enrolled in school – is high across the board for elementary students, the figures fall considerably for secondary students, according to data published by the Ministry of Education.

Besides MP, all the BIMARU states are at or close to 100% enrolment in elementary school (Class 1 to 8). But enrolment numbers suffer in secondary school – apart from Rajasthan, no BIMARU state has secondary school GERs higher than the national average. There’s a similar trend in drop-out rates. Bihar has a secondary school drop-out rate of 20.5%, well above the national average of 12.6%. Rajasthan, MP and UP have drop-out rates ranging from 7.7% to 10.1%

On average, India has just six teachers in every school — Rajasthan, though, has 7 but Bihar has only 5 — as per the Education Ministry’s UDISE+ database. From upper primary school to higher secondary, the student-to-teacher ratio appears to worsen across these states. Primary schools, where enrolment rates are the highest, also have some of the most overcrowded classrooms. Only Rajasthan has better student-to-teacher ratios than the national average.