Farm distress, low literacy, high infant mortality: The cocktail of troubles ailing Madhya Pradesh

Madhya Pradesh has reported the best agricultural growth in India over eight years, and has improved its infrastructure, but there is widespread farm unrest as incomes remain low and health indicators among the country’s worst, according to an IndiaSpend analysis.

India’s second largest state by area and fifth largest by population (72.6 million, the equivalent of Thailand) has improved its performance on health indicators from a decade ago, but it is still among the worst performers in the country for infant mortality, under-five mortality and the status of women.

The state went to polls on November 28. “Roads, power and water are no longer poll issues in Bharatiya Janata Party-ruled Madhya Pradesh this time unlike 2003,” Finance Minister Arun Jaitley said on November 17.

The claims will be tested, as elections for 230 seats in the state assembly may be an indicator for the 2019 Lok Sabha elections. The assembly elections will also decide 11 seats to the Rajya Sabha (upper house of Parliament) and 29 seats to the Lok Sabha (the lower house of Parliament).

For the BJP, the challenge will be to retain control and fight anti-incumbency after being in power for three terms.

Madhya Pradesh replaced Punjab to become the food bowl of the country and has shed its “Bimaru” tag – acronym for Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh and similar to the Hindi word for sickly – to become aspirational, claimed Shivraj Singh Chouhan, three-time chief minister, on October 28.

High tribal, rural population, low literacy

In 2000, the eastern districts of Madhya Pradesh, which are largely tribal and mineral rich, were divided to form Chhattisgarh. Today, Madhya Pradesh is still a largely rural state with 72% of the population living in rural areas and 30% of its area is forested.

About 21% of the population – 15.3 million – are scheduled tribes while 16%, or 11.3 million, belong to scheduled castes, according to 2011 Census data.

The state lags in terms of literacy: in 2015-’16, 82% men and 59% women were literate – among the lowest in the country – even though there is improvement from 73% and 44% in 2005-’06.

There is a preference for boys, with the sex ratio at birth falling from 960 girls per 1,000 boys in 2005-’06 to 927 in 2015-’16; however, it is still higher than the national average of 919.

IndiaSpend compared Madhya Pradesh’s indicators on health, agriculture, income, unemployment with all states using national data sources, such as the National Family Health Survey, National Sample Survey Organisation and Niti Aayog.

We present comparisons with 11 states: Punjab, Karnataka, Tamil Nadu, Mizoram, Maharashtra, Gujarat, Rajasthan, Chhattisgarh, Bihar, Uttar Pradesh and Kerala. Chhattisgarh saw two-phase polling on November 12 and 20, Rajasthan goes to polls on December 7 and Mizoram on November 28. Maharashtra and Gujarat are large states and also ruled by BJP.

Bihar and Uttar Pradesh are also part of the group of states clubbed together as Bimaru, an acronym created in 1980s by demographer Ashish Bose to indicate the states’ backward condition.

We chose Karnataka and Punjab because they are ruled by the Congress and Kerala since it is the only state currently ruled by an alliance led by the Communist Party of India (Marxist).

Roads, electricity improved; toilet status not fully verified

“When I got down at the Washington airport and travelled on roads, I felt the roads in Madhya Pradesh are better than the United States,” Chief Minister Chouhan said after a trip to the US in October 2017.

Some of it is true: 87% of rural roads in Madhya Pradesh are surfaced (road laid with bitumen or tar), which is higher than the national average (64%) but only 72% urban roads are surfaced, lower than the national average of 80%, according to government data.

All 9.7 million households in Madhya Pradesh have been electrified, according to state data.

Madhya Pradesh has improved its electricity access index – a framework that captures the capacity, duration, quality, reliability, affordability, and legal status of electricity – by almost 100% from 16 to 33.9 points and daily supply has improved from eight hours to 15 hours from 2015 to 2018, according to a November 2018 report by the Council for Energy, Environment and Water, an advocacy.

The proportion of households using kerosene as their primary source of lighting has reduced from 27% in 2015 to 13% in 2018, the Council for Energy, Environment and Water report said. However, 8% households in the state remains un-electrified due to the lack of power infrastructure.

Madhya Pradesh declared itself open-defecation free in October 2018, but 28% of its villages declared open-defecation free are not verified, according to Swachh Bharat Mission website.

Growth in agriculture but incomes don’t rise

Madhya Pradesh is primarily an agricultural state with 55% of the population engaged in agriculture, eight percentage points more than the all-India average of 47%.

Agricultural GDP, over eight years to 2015, increased, on average, 10.9% per annum, the highest in India and higher than the national average of 4.3%.

Madhya Pradesh is the largest producer of soya bean – 51% of national cultivation, and the third largest producer of wheat – with 16% of national production.

Expanded irrigation, backed by reliable power supplies for groundwater irrigation, strong procurement system for wheat along with bonus on minimum support price, and expanded network of all-weather roads to connect farmers to the markets are the interventions credited for Madhya Pradesh’s improvement in agriculture, according to this 2017 paper by Ashok Gulati, Pallavi Rajkhowa and Pravesh Sharma.

Despite the growth, the state has been plagued by farmers’ protests: the 2017 farmers’ protest demanding loan waivers and better prices in Mandsaur district spread to six other districts and led to deaths of six farmers in police firing.

The trigger for the unrest was bumper crops in 2017, which led to a 30%-50% drop in prices of cash crops like onion, green peas, potato and garlic that farmers were encouraged to cultivate under crop diversification.

Inequality in incomes – agricultural income in Madhya Pradesh (Rs 6,210) lagged national income (Rs 6,426) from 2002 to 2012 despite increase in farm earnings, suggesting other earnings from farm labour and non-farm earnings did not rise fast enough, Mint reported on June 16, 2017.

Three farmers committed suicide every day in Madhya Pradesh in 2016, the third highest number of farmer suicides (1,321) after Maharashtra (3,661) and Karnataka (2,079), according to this reply to the Lok Sabha on March 20.

Even as income from agriculture did not rise, Madhya Pradesh had the highest share of income from agricultural activities (76.5%) and the lowest share of households involved in non-form business (5%), according to 2016 NSSO data.

Per capita income

The per capita income of the state increased from Rs 16,631 in 2005-06 to Rs 56,182 in 2014-15, the fifth lowest in the country.

About 23.4 million, or 31% of Madhya Pradesh’s population, lives below the poverty line, earning less than Rs 717 per month in rural areas and Rs 897 per month in urban areas. There are more people living below the poverty line in Madhya Pradesh than the national average (21.9%), according to this 2013 report by the Planning Commission.

More than one in three households in Madhya Pradesh – (37%) – have average monthly earnings not exceeding Rs 5,000 – the highest in the country, followed by West Bengal (35%), Uttar Pradesh (30%) and Odisha (30%), according to the employment-unemployment survey 2015.

The state’s female labour participation rate (17.4%) is lower than the national average (23.7%) and much lower than Chhattisgarh (54.3%), which has the highest female labour participation in the country.

There was a 53% rise in people registering in the employment exchanges in the state between 2015 and 2017 – from 156,000 to 237,000 – the Times of India reported on February 9, 2018.

Poor performance on health and women empowerment

With 47 infants dying per 1,000 live births in 2016, Madhya Pradesh has India’s worst infant mortality rate, according to the 2016 sample registration survey.

On under-five mortality rate – children under-five dying per 1,000 births – Madhya Prades (65) is at par with the east African country Djibouti and is the second worst in the country after Uttar Pradesh (78), according to the National Family Health Survey 2015-’16.

Only 54% of children in Madhya Pradesh have received all basic vaccinations – eight percentage points lower than the national average (62%). This may explain high under-five and infant mortality rates.

As many as 42% children are stunted – short for their age – (fourth from the bottom) and 26% children are wasted – thin for their height – (fourth from the bottom).

Mother’s education, body mass index and age at birth are crucial determinants for malnutrition of children, according to studies (here and here).

Only 59% women in Madhya Pradesh are literate – (Chhattisgarh is 66% and India average is 68%), the fourth lowest in the country.

Only 23% women have completed 10 or more years of education (Chhattisgarh is 27% and India 36%) and 32% women were married before 18 years (Chhattisgarh 21% and India is 27%).

More women in Madhya Pradesh face violence (35%) compared to the national average ( 31%). There are lesser women who are involved in decision making at home and using their bank accounts themselves in Madhya Pradesh compared to the national average.

Only 69% women received antenatal care from a skilled provider, the fourth worst in the country and ten percentage points lower than the national average (79%). As many as 91% women received antenatal care in Chhattisgarh.

Maternal mortality rate, deaths per 100,000 women giving birth, which was 335 in 2005-06 declined to 173 in 2014-16, according to National Family Health Survey 2015-’16. Institutional deliveries also improved from 26% to 81%.

Madhya Pradesh isn’t investing enough in health despite the poor state of health. It spends Rs 716 per person per year on health (average spent in its group of under developed states was Rs. 871), which is the lowest in the country. It spends only 4.17% of state expenditure on health (average was 5.05%) as per National Health Profile 2018.

This may explain why 28% sub-centres – most peripheral outposts of India public healthcare system – are without water supply and 20% are without electricity and there are 51% vacancies for specialists in government hospitals.

This article first appeared on IndiaSpend, a data-driven and public-interest journalism non-profit.