Nobel laureate economist Amartya Sen advocates reforms that stress on universal health coverage and immunization, as well as increasing public spending on health and education to enable proper human development.
Health is a state subject, and education is in the concurrent list, which restricts the central government’s scope to frame policies. Moreover, the onus of implementation is on the state governments.
Reforms, taken and suggested, in primary education:
- District Information for School Education – DISE: Records all information such as dropout rates, toilets constructed etc for all schools in India and places the information in public domain. Enables transparency and prevents siphoning off of funds.
- Leveraging technology and promoting distance learning via SWAYAM, which provides Massive Open Online Courses (MOOCs) for school to college level.
- National Mission on Teachers and Teaching – to train teachers in appropriate pedagogy as well as improve learning outcomes. There needs to be a national level entrance test for recruiting teachers in order to prevent nepotism and corruption in recruitment as was seen recently in Bihar.
- 4. INSPIRE scholarships have been instituted to encourage students to take up basic sciences. Their quantum needs to be increased and other measures need to be put in place to ensure success.
- Scrapping the no-detention policy, or else restricting it to fifth grade, as suggested by the TSR Subramaniam report.
- Curbing discrimination against children from backward classes by inculcating a sense of brotherhood and through increasing interaction by playful and recreational activities.
- Providing vouchers to parents, so that they can shift their children to schools that are better, incentivizing better outcomes from schools.
- Improving education in local languages, vernaculars. Imparting knowledge to the tribals in their own language. Odisha has made progress in this regard.
- 9. Preventing teacher absenteeism by enabling biometric attendance, and by providing them with adequate salaries in order to increase compliance.
- New Education Policy, which stresses on improving school outcomes, as well as innovative measures such as HEFA to create infrastructure for higher education.
- Sharing best practices through Shagun portal and establishing an Indian Education Service for better, dedicated administration.
Reforms taken, and suggested, in primary healthcare:
- Mission Indradhanush for universal immunization. Pneumococcal conjugate as well as measles-rubella vaccines will be included in the vaccination programme and provide wider coverage.
- ASHAs should be paid on time. PFMS-backed payments are leading to reduced delays.
ASHAs have recently been allowed to administer antibiotics in emergency cases, and they spread awareness regarding common ailments with the help of pre-loaded memory cards and smartphones provided to them. - Provision of adequate medicines under the Jan Aushadhi scheme. Pharmacists also need to be employed in order to dispense proper medication.
- Improving infrastructure in PHCs by monitoring doctor attendance, improving linkages with tertiary care centres for specialists (by video conferencing for consultation etc.), restricting private practice by the doctors.
- Strict action on quacks. Nearly half the doctors in rural areas lack a medical degree.
- Focusing on AYUSH for chronic diseases and complementing primary healthcare with AYUSH. Separate AYUSH departments staffed with practitioners should be opened in every PHC.
- Providing incentives for institutional delivery (Matritiva Sahyog Yojana). Matritva Suraksha Yojana also exhorts doctors to devote one day in the first week every month to institutional deliveries and maternity problems in rural areas.
Himachal Pradesh launched “Suraksha Tablet”, a single dose misoprostol tablet to be administered after delivery, in order to prevent post-partum bleeding and consequent death. Tablet wrapper contains instructions in local language, to enable easy compliance. - Increasing awareness about common diseases, healthy lifestyle etc through nukkad naataks, medical camps etc. Swachh Bharat campaign has achieved progress in improving cleanliness and curbing open defecation.
- Increasing the penetration of health insurance in order to minimize out of pocket expenditure on healthcare which is the biggest cause of families falling back into poverty.
- Implementing the draft National Health Policy, increasing public spending on health to at least 3% of the GDP (from 1.4% currently) and making “Health for All” a reality.
Provision of equitable education as well as healthcare are two separate but interlinked Sustainable Development Goals. In a country like India, in which nearly a third of children are stunted and wasted, and where half the females of reproductive age are anaemic, it is imperative to provide proper healthcare. A healthy body can harbour a healthy mind, which is receptive of the education it gets. Thus, dealing with primary education and primary healthcare in a holistic manner can lead to better social indicators, which can lead to a productive workforce for the future.
Moreover, health and education are labour-intensive sectors. Proper investment here can also create jobs for the millions of people that join the labour force every year.
