COVID -19 in India: Challenges and Successes

Education
Health
Livelihoods and economic shocks
Poverty

COVID -19 in India: Challenges and Successes

India in a state of war against coronavirus” - Narendra Modi, Prime Minister of India

COVID-19 has multi-faceted implications on the health and wellbeing of individuals as well as for the economy in general. India with a population of 1·4 billion and rampant poverty faces high risk of potential infections and deaths arising from Covid.

Lock-down in India

While the first case was reported on January 30, 2020, India went into a nationwide lockdown at the end of March, 2020, which was extended thrice, making it the longest lockdown ever. During the 75 days of lockdown, only essential services were allowed and educational institutions, flights, hospitality services and large gatherings of any kind were prohibited. Various steps were initiated to boost health infrastructure and a campaign on the importance of social distancing and personal hygiene was commenced.Governmnet of India (“GoI”) also launched ‘Aarogya Setu’ App on April 2nd, 2020[1],

Despite the GoI advising employers to not lay off or reduce the wages of the employees (especially casual and daily workers), the workforce shrunk by 122 million in April. With factories and workplaces shut, millions of migrant workers faced a loss of livelihood.

Unlocking of India and Stimulus Packages

Keeping the aforesaid situation in mind, GoI initiated Unlock 1.0 on June 8, 2020 and various restrictions were relaxed.

On May 16, the GoI announced the National Migrant Information System, an online database to streamline the movement of the migrant workers. State Governments also set up camps to quarantine the returning migrants with the aim of curbing the virus spread. During these measures it is reported that 9.7 million migrants returned home, while 2.6 million were stranded at relief camps, worksites, or other clusters.

Subsequently, the ‘Atmanirbhar Bharat (Self-reliant India)’ stimulus package was announced in May 2020 to address the slowdown of the economy[2] and financial assistance was extended to States.

In terms of relief measures targeted at the poor and vulnerable, the $23 billion Pradhan Mantri Garib Kalyan Yojana (PM-GKY) relief package[3] was criticised as it reallocates funding across existing budgets rather than mobilizing additional funding. GoI also launched the ‘Garib Kalyan Rojgar Yojana’ to provide employment opportunities to migrant workers in their home States[4].

Impact of COVID on Education

Children and youth are affected by the shutting down of educational institutions and despite the impetus towards online classes through schemes like e-Vidya (Erpula, 2020), there exists a huge digital divide that excludes vulnerable populations of students with no/limited internet facilities. While State educational institutes are attempting to upgrade infrastructure and teachers’ pedagogical skills to provide effective online education, this remains an uphill task.

Covid-19- Cases and Recovery

Graph

As seen in the figure above, the epidemic has shown exponential growth[5]. As of August 13, 2020, India ranks third across the world in the total number of confirmed cases with over 2.4 million being recorded across the country and over 48,156 associated deaths. However, the number of confirmed cases and deaths per million of the population are significantly low at 1784 and 35, respectively.

India faces a shortage of healthcare personnel.[6] Additionally, existing hospitals are poorly equipped and have inadequate infrastructure[7].

While the Indian government has been trying its best to address challenges related to health and socio-economic well-being of its citizens, it is amply clear that the war against COVID is far from over. It is time to invest in infrastructure and create systems that are accessible to all.

 

[1] This is a contact tracing, syndromic mapping and self-assessment digital service. It is reported to have reached 100 million individuals.

[2] This stimulus package is estimated at $110 billion, roughly 10 percent of India’s GDP.

[3] Provides 5 kg of wheat and rice and 1 kg of pulse for free in addition to the current 5 kg allocation under the Public Distribution System.

[4] Under the rural-centric employment generation scheme, GoI intends to provide 125 days employment to migrant workers in six States.

[5] During the 6-week period beginning on May 2, 2020, the number of districts with confirmed cases increased from 359 (or 56% of all districts) to 627 (98% of all districts).

[6] For example, there is only one government doctor for more than 11,500 people as opposed to one for every 1,000 as recommended by WHO. There is a shortage of 2,188 community health centres, 6,430 primary health centres and 32,900 sub-centres. 

[7] This can be attributed to the low public health expenditure (sum of central and state spending) which has remained between 1.2% to 1.6% of GDP between 2001-09 and 2019-20.

Listening to Young Lives at Work in Telangana and Andhra Pradesh

Marta Favara
Catherine Porter
Poverty and inequality
Poverty and shocks
Country report
COVID-19 Phone Survey Headlines Report

This brief report provides a first look into the data collected during the first of three calls in Young Lives at Work's Phone Survey in Telangana and Andhra Pradesh and highlights some of the key emerging findings.

The Young Lives Phone Survey aims to investigate the short and medium term impact of the COVID-19 pandemic on the health, well-being, transition to the labour market and education trajectories of young people in our study, tracked since 2001 and now aged 18 and 25.

This brief provides a snapshot of the current situation in Telangana and Andhra Pradesh.  The second phone survey will ask in more depth about young people’s labour market experiences and how this is affecting their work life, their home life and their education.

The second phone survey call has been piloted and the fieldwork will take place during August-October 2020.

"Food prices were high, and the dal became watery". Mixed-method evidence on household food insecurity and children's diets in India

Virginia Morrow
Poverty and shocks
Nutrition, health and well-being
Journal Article

Food insecurity and malnutrition are key policy priorities in India. Evidence on children’s experiences of household food insecurity and how food insecurity influences their dietary quality is limited for India and other low- and middle-income countries. Evidence on mid-childhood and adolescence is even scarcer. The authors present longitudinal evidence on household food insecurity and child diets by drawing on the India sample of Young Lives, a mixed methods study with two cohorts of children from Andhra Pradesh and Telangana (India).

Analysis of survey data shows that children living in food insecure households had lower dietary diversity and probability of consumption of micronutrient- and protein-rich foods, which are critical for their healthy development. Inequalities in child dietary quality by household food security status were most pronounced at preschool age.

Children identified dietary quality as a critical dimension of their well-being. From an early age, children were able to describe and explain the food security challenges of their families and recognize the negative consequences of household food insecurity on their diets, health and education. Children were found to not only be cognizant of household responses to food insecurity, but they were also actively involved in such strategies through limiting the quantity and quality of food purchased and consumed, reducing dietary diversity, and/or engaging in work or social protection. The latter were often mentioned as critical safety nets in face of economic, demographic or climate shocks, although children expressed criticism about implementation.

Longitudinal mixed methods can enhance our understanding of children’s experiences of household food insecurity and its repercussion on their health and broader well-being. Child-focused evidence is key to shaping social protection implementation to context-specific needs at critical human development stages.

Read the journal article published in World Development, Volume 111, November 2018 here. This builds on a Young Lives Working Paper published in 2015 and related blog, available here. 

 

Do in utero shocks have adverse effects on child health outcomes and can welfare schemes ameliorate such effects? Evidence from Andhra Pradesh

Poverty and shocks
Journal Article

This study uses Young Lives evidence to assess whether shocks experienced by children in the mother’s womb can have an adverse effect on their future health, and whether these effects can be ameliorated by government welfare schemes. Data were taken from three phases of the Young Lives Survey carried out in the Indian state of Andhra Pradesh in 2002, 2007 and 2009–2010. Different types of in utero shock were distinguished from the data. Using ordinary least squares (OLS) estimation, it was observed that multiple in utero shocks reduced children’s weight-for-age and height-for-age z-scores by 0.07–0.08 and 0.08–0.15 units respectively. The roles of two Indian government welfare schemes – the Midday Meal Scheme (MDMS) and the National Rural Employment Guarantee Scheme (NREGS) – in mitigating the adverse effects of in utero shocks were examined. While the effect of the MDMS was statistically insignificant, that of the NREGS was significant. Although not designed to protect child health, the NREGS has been playing a more effective role than the MDMS in acting as a buffer against the damaging effects of in utero shocks on child health. The study points to the need for greater co-ordination between the two welfare schemes.

Read the article here

Citation: Ahmed, S., & Ray, R. (2017). DO IN UTERO SHOCKS HAVE ADVERSE EFFECTS ON CHILD HEALTH OUTCOMES AND CAN WELFARE SCHEMES AMELIORATE SUCH EFFECTS? EVIDENCE FROM ANDHRA PRADESH, INDIA. Journal of Biosocial Science, 1-30. doi:10.1017/S0021932017000591

Can the Major Public Works Policy Buffer Negative Shocks in Early Childhood?

Poverty and shocks
Social protection
Working paper

The study examines the role of the largest public works program in the world-the National Rural Employment Guarantee Scheme (NREGS) - in buffering the negative effects of early childhood exposure to rainfall shocks on long-term health outcomes. Exploiting the spatial and temporal variation in NREGS coverage, the study estimates the extent to which nutritional shocks in early childhood can be offset by access to the policy. The study employs a unique identification strategy by integrating detailed administrative records of drought shock and phase-wise roll-out information of NREGS with a household level panel data-the Young Lives survey- conducted over three waves (2002, 2007 and 2009-10) in the state of Andhra Pradesh, India. Using individual fixed effects estimation the study finds that while the policy does not help correct for long term past health deficiencies it is useful in buffering recent drought shocks, which varies by policy relevant sub-groups. We find that an increase in 22 working days per household increases height-for-age by around 0.26 standard deviations which is bridging about half the rural-urban gap in average height for age score.We find the program is most effective for the case of lower educated households and scheduled castes, who are presumably more vulnerable in the face of climatic variability.  Hence there is much room to reap in the indirect benefits of the program by ensuring food security issues of these households.

This paper was presented at a conference on Inequalities in Children's Outcomes in Developing Countries hosted by Young Lives at St Anne's College, Oxford on 8-9 July 2013.

In 2017, this paper was published in a special edition of Economic Development and Change journal, available at: http://www.journals.uchicago.edu/doi/full/10.1086/691992