Archive for July, 2015

The Importance of Data – Why Numbers Matter

The much delayed release (that too only partially, with data at the state level not being officially published) of the Rapid Survey on Children (RSOC) carried out by the Government of India (GoI) and UNICEF has caused considerable disquiet in those working in the area of child health and nutrition. As with any report whose publication is delayed by the government, reasons have been ascribed. The Economist, in its editions of 27 June 2014 and 4 July 2014, has carried articles on this apparent reluctance of the Indian government to disclose data. One of the possible reasons adduced is the less than flattering performance of the Prime Minister’s home state of Gujarat, which he ruled for nearly 13 years before his move to New Delhi. In fact, as the Economist points out, data on child immunisation released by the Ministry of Health and Family Welfare (MoHFW), GoI, in October 2014 did not include figures for Gujarat. Even the July 2015 release of data by the Ministry of Women & Child Development (MWCD), GoI, gives figures only at an aggregated national level. The Economist, which has gained access to the RSOC report, has published state-wise data on various indicators of child nutrition, which show encouraging improvements over the numbers in the last published National Family Health Survey-3 (NFHS-3) conducted in 2005-06. Unfortunately, this good news has been buried under the controversy over the delay in releasing the Report. Sources in the GoI claim that the delay has been occasioned by the conflicting data from two different surveys launched at the same time by two Ministries, the MWCD and the MOHFW. One finds this reasoning very difficult to digest. The MOHFW had no cause to commission a study on child nutrition indicators, a subject that falls squarely within the ambit of the MWCD. It (the MOHFW) has already lost three precious years in bringing out NFHS-4, which means that there has been no authentic data to guide policy making on child nutrition since 2005-06. In apparently getting in each other’s way, the two Ministries seem to be not only confused about the Rules of Business in government specifying which Ministry should carry out what functions, but also seem to be uncoordinated in the area of child nutrition, where they should be operating in close harmony from Dilli to galli.

This lack of critical data in the public domain in India is a malaise that has long affected the development of meaningful public policy initiatives in the social sector, especially in the health and nutrition sectors. Even where data exists, it is generally aggregated numbers, either at the state level or, at best, at the district level. Only one or two states provide disaggregated online monthly data on child nutrition outcomes. As any public policy practitioner will tell you, data at the sub-district (tehsil or block) and village or urban ward levels is crucial for programme implementation, monitoring sectoral outcomes and enforcing accountability of the “street-level bureaucracy” and their immediate supervisors. I have personally encountered frustration in trying to gain access to Integrated Child Development Services (ICDS) data, supposed to be sent online monthly by all states to the MWCD. I suspect that most states do not even bother to send monthly reports or, where they do send it after months of delay, it is no better than garbage. Since there is no analysis of this data at the national or state level, its authenticity is highly suspect. My requests for state-wise data (at the block level) have met with stony silence from successive bureaucrats in the MWCD in New Delhi. Even my reasoning that this is not data vital to the nation’s security or commercial interests and is, therefore, to be disseminated online as per Section 4 of the Right to Information Act has met with no response. An earlier blog (The Gadfly Column: India, The Flailing State: 15 September 2014) has brought out the depressing experience of my colleagues in promoting the use of online tracking systems to monitor mother and child health and nutrition and provide timely public services. While frontline health and nutrition workers enthusiastically adopted the system, the obstructive attitudes of their supervisors and the lack of support at the higher levels of the health and nutrition bureaucracy prevented the widespread use of the tracking system. In any case, the emphasis is always on reporting based on inputs like personnel, financing and supplies rather than on the outcomes generated by the use of these inputs. In my experience in the nutrition sector in Maharashtra, I found that the only time when outcomes were monitored systematically were when the state set up a Nutrition Mission in 2005 to reduce child malnutrition.

If governments (and the personnel manning them) are loath to set up data networks that monitor programme outcomes, they are equally reluctant to use information gathered by reputed private or non-profit organisations. A case in point is the Annual Status of Education Report (ASER) brought out annually by PRATHAM, a non-profit working in the area of primary education. The response of the education bureaucracy to the efforts of PRATHAM (through the ASER Reports) to improve learning outcomes in schools has been, to put it frankly, dismissive (this has been clearly brought out in the Note “Looking Back and Looking Ahead” by Madhav Chavan in the 2014 ASER Report). I have personal experience of this in the education sector. Between 1998 and 2004, my colleague Sumit Mullick and I attempted to improve learning outcomes in 13 backward districts in the Vidarbha and Marathwada areas of Maharashtra through a rigorous monthly testing of basic language and arithmetic competencies in class I-VII students in government schools and school-wise monitoring of these monthly results. Its adoption throughout the state in 2005 spelt its death knell: faced with opposition from the education bureaucracy and the teachers’ unions, the programme was swiftly wound up, including in the areas where it was originally started.

The inability (or unwillingness) of governments to use even data that is generated by the decennial Census of India is illustrated by the Total Sanitation Campaign, promoted by the GoI and implemented in all states of India since 1999. This has obviously had its adverse impact on effective programme implementation and realisation of the outcome of reducing open defecation. Comparative data on the percentage of household toilets in tehsils in India as of 2001 and 2011 show that apart from coastal areas, parts of north and most of north-eastern India and some urban pockets, there has been very little progress in provision of toilets under a programme that enjoyed high visibility. I am willing to hazard a guess that the reason probably lies in the lack of use of available data. Disaggregating data on available toilets down to village and urban ward level would have enabled focus on specific areas lacking in amenities and the reasons for non-adoption of toilets — these might be on account of behavioural reasons related to location or use of toilets or due to lack of awareness or of funds. In the absence of a clear understanding of the reasons for continued open defecation (which poses one of India’s greatest public health challenges), the government machinery probably focused just on inputs without any monitoring of the outcome, which should have been the percentage reduction in open defecation.

What all these examples highlight is the failure to measure outcomes right down to the sub-district and village/urban ward levels and to monitor and demand accountability at the implementation level. The present government at the centre has laid stress on outcomes — given the “business as usual” approach of government structures at all levels, it would not be surprising if this strategy is given short shrift in the course of time. The critical requirement is the availability and use of disaggregated data by policy makers and supervisors of programmes at the central, state and local levels. In the last one year of this government, I do not see any such urgency on data use informing the actions of government departments even in New Delhi. The less said about the states and districts, the better (or should I say, worse?). Till India’s administrators learn to be comfortable with numbers and use them as tools for devising solutions to problems, we will continue to muddle through, maintaining our three digit position in the country-wise Human Development Index, way behind all our BRICS partners.

 

The Evil That Men Do Lives In Them

Forty years ago, India lost her innocence. After bumbling through more than twenty seven years of existence as an independent nation, the dire prognostications of Western doomsayers, who were pessimistic about the survival of the tender plant of democracy on Indian soil, appeared to have been proved right. In the late hours of 25 June 1975, a process was set in motion which led to constitutional rights being severely abridged, the press being muzzled and thousands of political activists and others being thrown into prison. A dark night of twenty one months followed, till the ruling government was unceremoniously ejected from power by the Indian voter. I am not here going into the events of the 1975 Emergency and its manifestations, which have been covered in great detail by various writers, but am more intrigued (and grieved) by the presence of that quality in man which impels him towards evil action.

This reflection on man’s innate capacity for the greatest good and the vilest crime was brought home to me starkly by the recent shooting incident in Charleston, South Carolina, USA, where a young white barely into his twenties sprayed bullets into a crowd of African-Americans gathered in a church for evening prayers, killing nine worshippers in the process. When I saw photographs of the cherubic visage of the assailant after he was apprehended, I found it impossible to correlate his angelic demeanour with the ghastly crime against humanity he had committed. An explanation of this seeming paradox came from an article in the New York Times by author Brit Bennett, titled “White Terrorism is as old as America“. The Declaration of Independence in 1776 did not bring freedom to blacks in the USA. It took another ninety years and a Civil War to take the first hesitant steps towards giving blacks an equal position in American society. Another century was to pass before the blacks formally secured their due rights as citizens with the passage of the Civil Rights Act in 1965. But even today, fifty years after that epochal event, blacks labour under disabilities, whether in terms of access to education and employment opportunities or even in terms of being accepted as equals by their white brethren. There still remains a strong undercurrent of animosity, bigotry and prejudice that informs white attitudes towards blacks, manifesting itself in the unfortunate recent incidents of police excesses and random shootings, with blacks at the receiving end. However, this is a tendency prevalent among dominant communities in all countries. Sometimes it is activated by historical grievances, as in the case of sections of the Hindu community who mourn their lost ascendant position and the eight centuries of political domination by another community. It can also arise from basic insecurity, as when historically oppressed communities (blacks and Dalits) improve their economic and social standing by availing of education and employment opportunities through affirmative action policies. There can also be a more immediate impetus to teach the other ethnic group a lesson — the anti-Sikh pogrom of 1984, the Bosnian massacre of Muslims in the 1990s and the wholesale murders in Gujarat in 2002 are cases in point.

It is another category of evil that has manifested itself in human actions in more recent times that causes even greater unease. This is what the political theorist Hannah Arendt has termed “the banality of evil”. She used this term in her book “Eichmann in Jerusalem“, in which she analysed the motives which influenced Adolf Eichmann to organise the deportation and mass murder of six million Jews by the Nazi regime. She reached the startling (and to many, upsetting) conclusion that Eichmann was no more than a mediocre bureaucrat executing as efficiently as possible the orders he received from above. It is chilling to contemplate that the Holocaust was the product of the thoughtless actions of numerous individuals: there was never any reflection by them on the consequences of their actions, no stirring of what we term as “the voice of conscience”. A similar absence of thinking that discriminates between good and evil actions can be seen in the actions of mobs that indulge in murders of their neighbours solely on the grounds of their different religion, caste or ethnicity or of the thousands of misguided individuals who today murder fellow humans in the name of religion.

It is in this context that there are sobering lessons for today’s Indians from India’s tryst with absolutism four decades ago. Every institution of democracy crumbled when challenged by dictatorial might. With honourable exceptions, the press acted like the pet parrot of those in power. The judiciary went by the letter of the law: “procedure established by law” rather than “due process of law” was the touchstone for the evaluation of draconian legislation which damaged the basic structure of the Indian Constitution. The greatest tragedy was the Eichmann-like behaviour of the bureaucracy and the police. The Shah Commission set up after the Emergency to inquire into its excesses, trained its guns on the shenanigans of the then Prime Minister’s second son and the coterie around him. Not nearly as much attention as was required was focused on the bureaucracy/police, which not only implemented orders directly affecting the life and liberty of many Indians, but displayed a frightening zeal over and above the call of duty in forcibly resettling poor people in insanitary surroundings and carrying out forced sterilisations of thousands of Indians, not only in Delhi but elsewhere in the country as well.

Evil manifests itself in humans in three dimensions. There is the class of psychopathic megalomaniacs (Stalin, Hitler, Pol Pot) for whom human life is only an instrument for their overweening ambitions — they use the weapon of terror to beat people into submission. Then there are the soulless, thoughtless beings who are either hatchet men in the Eichmann mould, pursuing their amoral role of executing orders with efficiency and with not the slightest moral stirrings, or persons venting their frustrations and insecurities on “the other” — of a different religion, race or language, often with the tacit support of the state or powerful groups. Finally, there is the large amorphous mass of people who are indifferent to and who condone the crimes committed by the first two groups. They rationalise their position by saying that they can make no difference — their reluctance to take a principled stand is occasioned by their insecurity. Most of us fall in this category. I often wonder why, as college students, we did not protest against the throttling of our democratic rights. Probably, it was because we were concerned with our future careers and because we considered it futile to resist. In that respect, we behaved rather like the Holocaust victims who meekly walked to their certain death rather than heroically face death confronting their oppressors.

Let us face the stark truth: there is no predicting when the authoritarian streak in an individual politician or a political group will act up. Given current trends in the bureaucracy, there will also be enough helpers willing to push the authoritarian agenda. True, 2015 is not 1975 — citizens are more vociferous regarding their rights, aided by active social and other media networks. And yet, a nagging doubt remains — will there be enough strength in civil society and its institutions to withstand a concerted assault on democratic rights? The answer can be a qualified yes, provided each of us recognises that condonation of and complicity in evil amount to one and the same thing. Purging ourselves of the evil of indifference when injustice is committed is the only way to realise the yearning of Rabindranath Tagore expressed so vividly in the Gitanjali:

Where the mind is without fear and the head is held high;

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Into that heaven of freedom, my Father, let my country awake.