Asia | India’s health data

Sparing Mr Modi’s blushes

Missing data should embarrass the prime minister

|DELHI

WEALTH and child welfare are sensitive topics in India. As the country has grown richer in the past couple of decades, Indians’ health has improved only slowly. The story has varied widely from state to state. Governments of southern ones like Kerala and Tamil Nadu do a lot to help women and children; health indicators there show steady gains. In the north and west, even in better-off states, nutrition, prenatal care, school attendance and other measures of childhood well-being are worse than in the south.

A much-debated case study is the western state of Gujarat, where Narendra Modi was chief minister for a dozen years before becoming prime minister. Calling his state a model, he boasted that incomes there were among India’s highest. He dismissed critics who said he was neglecting health and social policy—once explaining how Gujarati women suffer high levels of malnourishment because they are “beauty-conscious” and refuse to eat.

India has not published comprehensive figures on nutrition or health since a national assessment in 2007. However, a countrywide survey involving 200,000 interviews was conducted in 2013 and 2014 by Unicef, the UN agency for children, and the Indian government. The results should have been published in October 2014. A limited set of data, on immunisation, was released that month by the ministry of health. It covered most large states, but figures on Gujarat, oddly, were excluded.

Unicef and India’s government have still not published the full report. Unicef did release a 72-page study on global child welfare on June 23rd, warning that millions of children would suffer because of some countries’ failure to meet development goals. In it Unicef spells out the benefits of publishing survey data. One is that it helps “citizens to hold their governments to account”. Ironically, Unicef itself did not use its best data from India in the report, relying instead on figures a decade old. Unicef officials blamed the government for the delay, suggesting the accuracy of the data was under review; various Indian officials declined to comment. It seems possible that data were held back for political reasons, to avoid embarrassing Mr Modi.

India's malnourished children: Explore India in our interactive map

The full set of figures on immunisation rates, obtained by The Economist, suggests a striking lack of progress in Gujarat under Mr Modi. Just after he took office in 2001, 54% of children were being fully immunised against preventable diseases—well above the national average of 46%. Gujarat was then 16th-best of 31 Indian states and territories assessed. By 2014 when he left there was only a tiny improvement, to 56.2%, far below the national average of 65%. Gujarat’s rank had fallen to 21st of 29 states surveyed. Most remarkable, it was behind even notably poor and backward states such as Bihar (see chart). One indicator of the strength of a health system is how many of those who get a first dose of a vaccine fail to get subsequent ones. The new survey suggests that wealthy Gujarat’s dropout rate for the polio vaccination is almost 21%. The national average is 12%.

As prime minister, just as previously, Mr Modi has paid scant attention to health. Overall spending by the central government on health and education, already low, has been cut. Mr Modi prefers to let individual states take charge. His record in Gujarat suggests that approach is flawed.

This article appeared in the Asia section of the print edition under the headline "Sparing Mr Modi’s blushes"

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