According to the pre-Budget Economic Survey 2016-2017, tabled in Parliament yesterday, Indian states are “doing well” and are on par with their international counterparts in terms of life expectancy at various levels of income and a declining fertility rate, both of which bode well for India’s population problems. However, the report also states that Indian states are doing “not-so-well” when it comes to the infant mortality rate (IMR), and says that this indicates that “mother-and-child” pay the price for weak delivery of health services.
According to Poonam Mutreja, Executive Director of the Population Fund of India, India currently spends just 1.3 percent of its GDP on healthcare (Brazil spends around 8.3 percent, and Afghanistan spends 8.2 percent). Health organisations across the country have consistently lobbied for an increase in government spending in health, particularly in sanitation and family planning.
The Survey recognised that a lack of access to proper sanitation facilities also disproportionately affects women and girls, and once again recommended ensuring toilets in every household. It said the lack of proper toilets in every household constitutes a “threat to life and safety while going out for open defecation, reduction in food and water intake practices to minimise the need to exit the home to use toilets, polluted water leading to women and children dying from childbirth- related infections”. According to this report in the Hindu Business Line, 32 million lack access to family planning, which also contributes to a high infant mortality rate, making Donald Trump’s global-gag rule even scarier in context. It’s clear that an increase in health and sanitation investment by the Indian government is needed now more than ever, and would have a targeted impact on women’s health in particular.
The Survey also polled men and women on their exclusive usage of toilets. In the cases of both rural households with toilets and urban households with toilets, a higher percentage of women reported using toilets “always” than men. This pattern of higher exclusive toilet usage by women led the Survey to suggest that women could play a leading role in creating open-defecation free communities by “nudging men and boys of the household to change their own defecation behaviours”.