Lesson 54 of 76 7 min Premium

Health, Education, Poverty and Human Development

Measuring development

Index	By	Measures
Human Development Index (HDI)	UNDP	Long and healthy life (life expectancy), knowledge (years of schooling) and standard of living (GNI per capita)
Multidimensional Poverty Index (MPI)	UNDP and Oxford (OPHI); NITI Aayog makes a national MPI	Health, education and living standards – 10 indicators globally
Global Hunger Index	Private European NGOs	Undernourishment, child stunting, child wasting, child mortality

Why multidimensional? Income alone misses things like lack of a toilet, clean fuel, schooling or nutrition.

Health

India has a three-tier public system: Sub-centres/Health and Wellness Centres → Primary Health Centres → Community Health Centres, then district hospitals.
Ayushman Bharat (2018) has two parts: Health and Wellness Centres (comprehensive primary care) and PM-JAY (health cover of ₹5 lakh per family per year for hospitalisation).
Challenges: low public spending, shortages of doctors and nurses in rural areas, high out-of-pocket expenditure, and the rise of non-communicable diseases.

Education

National Education Policy 2020: a 5+3+3+4 school structure, mother tongue/regional language as the medium of instruction where possible up to at least Class 5, foundational literacy and numeracy, multidisciplinary higher education, multiple entry and exit options.
Challenges: learning outcomes (many children cannot read at grade level), dropouts, teacher vacancies and the digital divide.

Poverty and hunger

Causes: low productivity in agriculture, informal jobs, poor health and education, and social exclusion.
Approaches: growth plus safety nets – food security (NFSA), employment (MGNREGA), livelihoods (NRLM self-help groups), housing (PM Awas Yojana), financial inclusion (Jan Dhan) and nutrition (POSHAN Abhiyaan, Anganwadis under ICDS).

💡 Shortcut / exam tip

For any welfare question, show the triangle Access – Quality – Affordability and end with community participation and accountability.

Background: human development in one idea

Amartya Sen's capability approach says development is about expanding people's freedoms – to be healthy, educated, and able to earn and participate. The UNDP's Human Development Index (HDI) combines:

life expectancy at birth (health);
mean and expected years of schooling (education);
GNI per capita (PPP) (standard of living).

India is in the "medium human development" category, ranked around 130 out of about 190 countries in recent reports.

Health – the picture

Indicator	Recent value (source)
Infant mortality rate	About 28 per 1,000 live births (SRS 2020)
Maternal mortality ratio	About 97 per lakh live births (SRS 2018–20)
Stunting (under 5)	35.5% (NFHS-5)
Anaemia among women (15–49)	57% (NFHS-5)
Public health spending	About 1.3–1.8% of GDP (the National Health Policy 2017 target is 2.5% by 2025)
Out-of-pocket expenditure	Falling, but still high (about 39% of total health expenditure in recent National Health Accounts)

Key programmes:

Ayushman Bharat – PM-JAY (₹5 lakh per family per year for secondary and tertiary care; extended to all senior citizens aged 70+ in 2024) and Ayushman Arogya Mandirs (formerly Health and Wellness Centres) for primary care;
the National Health Mission;
Mission Indradhanush (immunisation);
POSHAN Abhiyaan (nutrition, 2018);
the Ayushman Bharat Digital Mission (health IDs – ABHA);
Jan Aushadhi (cheap generic medicines).

Education – the picture

NEP 2020 – the main reforms:

5+3+3+4 structure replacing 10+2;
foundational literacy and numeracy (NIPUN Bharat);
mother tongue as the medium up to at least Grade 5 "wherever possible";
multidisciplinary higher education with multiple entry and exit;
a single higher-education regulator (proposed);
6% of GDP public spending target.

Learning outcomes: ASER surveys show many Class 5 children cannot read a Class 2-level text, though they recovered after Covid. Other challenges include teacher vacancies, dropouts at the secondary level and the digital divide.

Poverty – how India measures it

Committee / measure	Key point
Tendulkar (2009)	Poverty line based on consumption basket; 21.9% poor in 2011–12
Rangarajan (2014)	Higher line; 29.5% for 2011–12
NITI Aayog Multidimensional Poverty Index (based on the Oxford–UNDP method; 12 indicators across health, education and living standards)	Showed a fall from about 25% (2015–16) to about 15% (2019–21); NITI's 2024 discussion paper estimated about 11% by 2022–23
HCES 2022–23	New household consumption data; several estimates suggest a sharp fall in extreme poverty

Causes of poverty: low productivity in farming, informal jobs, poor health and education, social exclusion (caste and gender), regional imbalance, and shocks (disease, disaster, price rises).

Effects: malnutrition, child labour, debt traps, and an intergenerational cycle.

Linking it together – the life-cycle approach

Nutrition in the first 1,000 days → school readiness → learning → skills → jobs → health insurance → pensions. Policy works best when it covers the whole life cycle and converges across departments (e.g. anganwadis, schools and health centres in the same village).

Case study: Tamil Nadu's Mid-day Meal and Breakfast Schemes

Tamil Nadu pioneered school meals (from the 1920s in Madras city; scaled up statewide under M.G. Ramachandran in 1982). It became a national programme (now PM POSHAN) after the Supreme Court's 2001 order in the PUCL case. Studies show it raised enrolment and attendance, especially of girls, reduced classroom hunger, and helped break caste barriers through shared meals. In 2022, Tamil Nadu added a Chief Minister's Breakfast Scheme. Lesson: simple, universal interventions can transform human development.

Common misconceptions

"Higher GDP automatically means better health and education." – Kerala and Sri Lanka show social investment matters more than income alone.
"Insurance alone can fix health." – Insurance needs strong primary care and public hospitals; otherwise costs rise and outpatient care (the biggest out-of-pocket item) is missed.
"Enrolment equals learning." – Near-universal enrolment has not meant equivalent learning outcomes.

How UPSC asks it

Mains themes include the effectiveness of health insurance schemes, the challenges of NEP implementation, the multidimensional approach to poverty, malnutrition, and the role of NGOs/SHGs. Prelims picks HDI components, the MPI's dimensions and schemes.

Mains answer framework

Q-type: "Despite progress, malnutrition remains a challenge in India. Discuss the causes and suggest measures."

Intro: NFHS-5 data on stunting, wasting and anaemia.
Causes: maternal health, poor diet diversity, sanitation, early marriage, poverty, low awareness.
Measures: POSHAN 2.0, fortified rice, the first 1,000 days focus, millets in meals, WASH, women's education, convergence.
Conclusion: nutrition as the foundation of the demographic dividend.

Measuring poverty and development

Measure	What it captures
Income/consumption poverty line	Households below a minimum consumption level (Tendulkar and Rangarajan committees proposed methods)
Multidimensional Poverty Index (MPI)	Deprivations in health, education and living standards (NITI Aayog publishes a national MPI)
Human Development Index (HDI)	Life expectancy, education and income (UNDP)

Education: policy landmarks

Right of Children to Free and Compulsory Education Act, 2009 – ages 6 to 14; 25% reservation in private unaided schools for disadvantaged children at entry level.
National Education Policy 2020 – 5+3+3+4 structure, foundational literacy and numeracy, mother tongue as medium where possible up to at least Grade 5, multidisciplinary higher education.
PM POSHAN (mid-day meal) – improves attendance and nutrition.

Health: policy landmarks

National Health Policy 2017 – target of public health spending at 2.5% of GDP.
Ayushman Bharat (2018) – health and wellness centres for primary care and PM-JAY insurance for secondary and tertiary hospital care.
National Health Mission – rural and urban components, ASHA workers.

Mains practice question

Q. Why does high out-of-pocket health expenditure matter for poverty? Outline: hospitalisation and chronic illness push households into debt; the poor delay treatment; public spending on primary care and insurance reduces the burden; quality of public facilities and regulation of private care are equally important.

⚡ Quick revision

HDI: health, education, income (UNDP)
MPI: health, education, living standards
PM-JAY: ₹5 lakh per family per year
NEP 2020: 5+3+3+4

UNDP index combining life expectancy, education and per-capita income (GNI). Full coverage: Growth versus Development: HDI, Inequality and Sustainable Development.A measure of poverty that counts how many people are deprived in several basic aspects of life at once, such as health, education and living standards, and how severe those deprivations are, instead of relying only on income or consumption.The Government of India's apex policy think tank, set up on 1 January 2015 by a Union Cabinet resolution to replace the Planning Commission, with a focus on cooperative and competitive federalism, strategic policy advice and monitoring rather than allocating funds.India's umbrella health programme launched in 2018, with two pillars: a network of upgraded primary care centres (now Ayushman Arogya Mandirs) and the Pradhan Mantri Jan Arogya Yojana, which gives eligible families cashless hospital cover of up to ₹5 lakh a year.A 2013 law that gives a legal right to subsidised food grains to up to 75% of the rural and 50% of the urban population, and provides nutritional support to pregnant women, lactating mothers and children.A 2005 law that gives every rural household a legal right to at least 100 days of unskilled manual wage work a year on public works, with an unemployment allowance if work is not provided within 15 days of demand.The National Rural Livelihood Mission (now Deendayal Antyodaya Yojana–NRLM), launched in 2011 by the Ministry of Rural Development, organises poor rural women into self-help groups (SHGs) and their federations to give them access to savings, credit, skills and markets, with the aim of lifting households out of poverty.Small groups, mostly of women, that pool savings and access credit together. Full coverage: Self-Help Groups, Development Processes and the Role of Civil Services.The market value of all final goods and services produced within a country's borders in a given period. This hub page shows where GDP turns up across the syllabus as a yardstick; the measurement methods are covered in the linked lesson.Immunity is the body's ability to resist infection; vaccines are biological preparations that safely train the immune system to recognise a pathogen, so that it can respond quickly if exposed later.POSHAN Abhiyaan (Prime Minister's Overarching Scheme for Holistic Nourishment), launched in March 2018, is India's flagship mission to reduce stunting, undernutrition, anaemia and low birth weight among children, adolescent girls and pregnant and lactating women through convergence, technology and community mobilisation.

Register free to keep reading