Amarjeet Sinha, IAS, is the Principal Secretary (Health and Family Welfare), Government of Bihar. In his latest book, An India for Everyone: A Path to Inclusive Development, the education expert who has played a major role in designing the Sarva Shiksha Abhiyan and the National Rural Health Mission, offers a companion dream to the economic one. I had the opportunity to meet him and listen to him while he addressed a gathering at TERI, Bangalore on 15 April 2013. When I read his thoughts in a couple of articles, I was able to relate them to similar thoughts that I have been having in my mind from quite some time. We all speak about the huge economic divide that the nation is seeing, we all know that education is so important, we all know that child labor has to stop, we all know that the growth should be inclusive but then, we all are clueless about how to bring all that we know into our lives. Administrators like Mr Sinha are taking some interesting initiatives that can go a long way in helping India find some solutions to the problems that she faces. Here are some of his thoughts from the address.
- India has seen high rates of growth seen since 1991 due to economic growth. However, what holds good for economic growth may not be the right path for human development.
- What makes a difference between accident of births and living life is qualitative factors like education, healthcare, nutrition, etc.
- Human development is the supported cause by any advanced nation. Across the world, it has played a major role in determine the trajectory of the nation and its people's growth.
- We cannot grow away from the public system. Partnerships with private sectors are definitely required, but then, still, the ultimate strength lies in developing our public system.
- We do not have systems to correct our mistakes in India. A lot of good academic work happens but as far as public systems are concerned, we do not have any strong evidence based research to take appropriate decisions, unlike in the developed nations.
- When I took the book to Harper Collins, they were glad to take it but they wanted in a perfect shape. My wife was doubtful on who would read it.
- Completed the draft during the 5 week training programme that was held for IAS officers at a university in Mussorie.
- Private sector is not the ultimate answer. Developing a good public system is no rocket science. The book argues for crafting a better public system.
- Brazil 8% of GDP education expenditure, 4.5% healthcare.
- Critic - How do you guarantee service? The book deals with these questions. While dealing with failures of system, there are exemplary systems in India that others want to adopt. For eg, India's electoral process. We make every effort for such systems. However, for greater issues like say NREGA, we do not make so much effort and pass the buck to the lower offices.
- The intent is always good but the outcomes are not in line with expectations because our decisions are ideological but not based on evidence based facts.
- Instead of policy making, our leaders are involving themselves into the executive. That is the main reason why we have lost focus. Community organisations must be seen as a complement to the PRI.
- The habitations must be seen as units and not the gram panchayats.
- It is easier to get into the government than to be thrown out. We need to revisit the skills that public servants need. The public service commission has played an important role in this process. Now, we need people with different and better skilled people to manage programs in this world. In the health mission, most states hired health managers at district level and the results are better. In case we had hired people purely based on competitive exams testing one's math and English, we would not have achieved such result.
- In Rajasthan, Shiksha Karmi project selected local teachers to teach students in some 15% schools where no teachers taught. The gram panchayat selected some people who had education beyond class 7. These people were taught rigorously for a long time. They hired them at Rs 2000. A group of leaders, including some NGOs, said that in case they clear all the 8 levels, all these people will be paid regular salaries. Today, most of them earn regular salaries.
- Irrespective of the type of Organization, they have to be assessed and accredited.
- Tamilnadu medical services corporation system is a great example from which all states can adopt from.
- Number of schools, colleges, students, educators, everything has gone up but the way education is being delivered has remained the same.
- We can't have mediocrity in training institutions.
- It is national shame to have such a high nutrition deficit in India.
- But then you will not find a single professional who understands nutrition completely. Unless we have a proper nutrition level in the nation, we can not progress in education and healthcare.
- Clean water, food security, basic public health facilities, basic health practices, barefoot doctor in every village to do the 4 above. 18 months mandatory course for all doctors. This was done by China.
- We are far ahead in advanced medicine in India but we don't have basic expertise on basic medicine.
- Janani Suraksha Yojana.
- Public health and hygiene is the most important factor for any city or nation, we have to fight for water and sanitation instead of fighting for antibiotics.
- We should not only have an economic advisory council but also human development advisory council that advises the PM on bettering our human development index.
- Departments have to come with clear outcomes and analyse their performance at the end of the year.
- The development as the best contraceptive - article in business standard.
- We can be far ahead in the BRIC category in case we implement some basic changes in our system. A little increase in healthcare expenditure can make a huge difference in the quality of life.
- Public systems ought to be strengthened.
- RSBY Rashtriya Swastha Bhima Yojana - insurance company model. Claims ratio varies from 30% to 600% in some districts. Thus, the premiums shoot up next year and people can not pay the premiums.
- Yashasvini - group of hospitals give services at fixed costs and a major portion of it is contributed by the government.
- Between 1949 and 1979, China worked with a single belief to grow. Austerity was the most important thing, nobody could buy a car, wear a steel buckle belt, etc. The single mindedness helped them take a strong growth path.
- Thailand has achieved a phenomenal improvement in healthcare by appointing community level healthcare experts.
Often, 2-3 questions on education, economy have been going around in my head.
Several NGOs claim that at Rs 2000 per head, they can make a person literate over a period of one year. We are not speaking about education, we are speaking about literacy. After all, when the Government speaks about education levels in the nation, they speak about literacy and not education. So, when 25% of our population is illiterate, the cost of reaching 100% literacy would be Rs 50,000 Crores (Rs 2000 x 25 Crore people) against the center's Education Budget of Rs 65,000 Crores and aggregate State Budget expenditure of Rs 5 Lac Crores. Why don't we make this one time expenditure and get rid of the drama behind education and literacy? Why should we increase literacy at 1% every year and wait till 2050 for 100% literacy? In fact, if our aim is to be 100% literate by 2050, we don't need to make any effort. After all, children are going to school, at least up to such standard that we can stamp them as literate and the illiterate adults will die of old age by 2050. If somebody is really serious, they should aim at reaching 100% literacy by 2015, not 2050. Its not a rocket science.
We all speak about changes in the education delivery system. I'm a strong believer in chalk and board system of teaching. I have been thinking on this from a longtime. If we try to copy the systems that advanced nations have implemented, they have clearly failed. Europe has an unemployment rate of 25%. US grows at 1%, though they spend a billion dollars on election campaigns. In the name of bringing technology to education, we have only helped companies like Apple, Google to hoard billions of dollars while websites like Wikipedia do not have funds. Education has been almost equaled to google. I read an article recently that said, I hate schools but I love education. We ought to understand that exposing children to computers even before their brains grow can only make them brainless. Gosh, whoever invented computers and mobile phones saying they will save our time, he would kill himself seeing what happened to his inventions, if he were alive today.
We all speak about human development. One of the biggest gauges of it is happiness. Should we rather go the Bhutan way, which tops the happiness index? They do not do anything, they just live life. What kind of race are we into? The world tell us that we have to buy an apartment and a car and we start running behind them. The economy makes it even more difficult with each passing day to buy these and thus, the unending struggle to grab those papers printed by the Government goes on. Sometime we sound philosophical while we look at this hysterical life.
I put up a couple of questions to Mr Sinha and he did his best to answer them. An important point that he made, which I completely believe in, is, "Good nurses and teachers are irreplaceable." Of course, they are not.