Karnataka: Will Mid-tier Performance on ‘Access Equality’ Affect the Election?

We have looked at access to education, healthcare, basic amenities, socio-economic security, and justice.

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As Karnataka votes for a new state government this week, it might be timely to review the state’s performance across different socio-economic development performance indicators.

A year ago, our Centre for New Economics Studies (CNES) research team developed a multi-dimensional index, to measure a state’s performance on various ‘access’ equality measures. More details on the index findings and broader observations have been earlier discussed here and here.

For Karnataka’s upcoming assembly election, beyond the social identity-based markers that may be pertinent for communities to vote for their candidates, much of the broader state-electoral politics (unlike national polls) and the party campaigns may ultimately pivot around local, developmental issues, including those of civic-municipal importance and access to social, economic opportunities: evident from enabling access to better jobs, better wages, decent working conditions, healthcare, education, power, drinking water, social security, finance, and digital access, to name a few.

But first, given it has become modish in popular discourse (often echoed by government-supported echo chambers) to critique indices, before seeing what results they reflect (and testing the validation of those), some conceptual and methodological clarity on the Index itself may be warranted here.

Methodology and Context of the Index

 In creating AEI (Access Equality Index) we have conceptualised “access” in our index’s framework in derivation from a set of theoretical inferences developed by scholars like Penchansky and Thomas (1981) amongst others (Levesque et al 2013, Haddad & Mohindra, 2002, Peters et al 2008) from established discourse present in the healthcare policy literature.

Source: AEI Report 2021

Though “access” in general means a way of approaching, reaching, or entering a place, as the right or opportunity to reach, use or visit, it is here broadly conceptualised to encompass the “4As”: affordability, approachability, appropriateness, and availability (provided in the figure above).

These four dimensions are not only critical in addressing inequalities in accessing healthcare services but can be expanded to cover various other sectors including basic amenities, education, justice, and for addressing socio-economic inequalities.

The index in its analytical framework includes five fundamental pillars of assessment (illustrated in the figure below) for states and Union Territories across India:

1. Access to education,

2. Access to healthcare,

3. Access to basic amenities,

4. Access to socio-economic security,

5. Access to justice.

Source: AEI Report 2021

Karnataka’s Performance in Overall State-wise Rankings

Based on the composite ranking score range of 0.67-0.23, states in our index are grouped into three categories – “aspirants” (below 0.33), “achievers” (0.42-0.33), and “front runners” (above 0.42).

Source: AEI Report 2021

As you see from the above figure, Karnataka, in terms of composite (overall) performance, ranks as a ‘Front Runner’ (with a score of 0.46), though compared to other front runners, it performs below states like Goa, Sikkim, Tamil Nadu, Kerala, Telangana, Himachal Pradesh, and Punjab.

Access to Basic Amenties and Healthcare

Basic Amenities: In terms of access to basic amenities, which we measured in context to looking at spatial access for communities across each state to piped drinking water, sanitation, housing, clean energy, and nutrition, Karnataka's overall performance is as a ‘front runner’ but below states like Goa, Punjab, Kerala, Haryana, Gujarat, Maharashtra, Tamil Nadu, and Telangana.

Healthcare: This pillar captures various indicators that play an important role in accessing healthcare services in Indian states and UTs. The frontrunners (index value ≥0.57) are Goa, Tamil Nadu, Sikkim, Kerala, Himachal Pradesh, Mizoram, Andhra Pradesh, Punjab, and Karnataka.

There exists huge inequality in terms of affordability of healthcare services and availability of beds, which are crucial indicators of assessing access to health infrastructure among states.

India also has one of the least as well as most unequal access to health insurance which along with high medical out-of-pocket expenditure, makes healthcare inaccessible. With the government’s focus on maternal and child healthcare since Independence through multiple programs under National Health Mission, accessibility to maternal and child healthcare is relatively reached a high proportion of the targeted population.

In Karnataka, some of the social welfare programmes in health have received mixed success depending on the rural-urban context and the social community-based identity markers (say from SCs, STs to other backward castes). The report details this for each state.

Access to Education

In studying access to education, Karnataka, compared to other Indian states, doesn’t do as well as other better performers. The top five front-runner states based on the overall performance in terms of ensuring access to basic education are Punjab (0.47), Goa (0.45), Himachal Pradesh (0.43), Sikkim (.41), and Kerala (0.37). Meanwhile the list of ‘aspirants’ are Arunachal Pradesh (0.22), Jharkhand (0.21), Bihar (.20), Uttar Pradesh (.19), and Meghalaya (0.13).

In determining performance for this pillar, we looked at sub-indicators like net enrolment ratios, net attendance ratios, pupil-teacher ratios, average expenditure by students on secondary education that a household pays (to assess ‘affordability’ of education in determining ‘access’), and per capita spending on education by the government.

Apart from affordability, social factors like pre-defined patriarchal roles of men and women prevent about 30 percent of girls, especially adolescent girls, from attending school by engaging them in domestic activities instead. For example, the availability of girls' toilets in schools is a crucial indicator representing the appropriateness of the infrastructure. “Education for girls can be supported and fostered by something as basic as a girls-only toilet,” (UNICEF, 2005). This is a very important means of ensuring access to education to girls and especially at the secondary level to ensure menstrual hygiene.

Karnataka, unfortunately, performs sub-par on most of these sub-indicators. It doesn’t mean its performance is very low (compared to Bihar or UP) but is significantly lower than the better performers (Telangana, Kerala and even Punjab outscore it by a decent margin).

Access to Socio-Economic Security

Access to social security or protection is necessary to reduce the vulnerability of citizens when at risk and enhance their capacity to manage those. These risks include unemployment, exclusion, sickness, disability, and old age.

However, the government-controlled social security structure in India applies to only a small portion of the population with the overall public expenditure on social protection (excluding public healthcare) being approximately 1.5 percent of the GDP, which is lower than many middle-income countries across the world.

Access to socio-economic security Sub-Index Score ranges between .77 and .24 for states. Goa and Lakshadweep are the top performers among the States and the UTs. Sikkim, Telangana, Himachal Pradesh, and Tamil Nadu are other front runners for the provision of access to social, financial, and economic security. Additionally, among the states, Jharkhand, Assam, and UP have the least access to socio-economic security while among UTs, Jammu and Kashmir and Daman and Diu rank the last.

Karnataka ranks sixth on this pillar (only below: Goa, Sikkim, Telangana, Himachal Pradesh, and Tamil Nadu). The measurement of this is based on the study of ‘access to financial security’ (plus access to decent work, and other social security-enabled assistance, including to those with disability)  through the implementation of different state-based welfare programs or the (better) implementation of Union Government funded/supported programs.

Access to Legal Recourse (‘Justice’)

Much like the other indicators discussed above, the role of infrastructure (physical and digital) and human resources in accessing justice (or legal recourse) is not only imperative for peace, stability, and effective governance but is also detrimental to timely justice for the communities. Karnataka performs the worst on this pillar.

Karnataka falls in the category of ‘aspirants’ (with a score of less than 0.32) in this pillar along with states like Mizoram, Rajasthan, Uttar Pradesh, Assam, Jharkhand, Uttarakhand, and Meghalaya. It has an insufficient number of police personnel and judges (on a demographic basis) and is juridically understaffed.

Our data indicates state level that the number of police per lakh population at all India levels averages 221.4, slightly below the United Nation’s recommended ratio of 222. However, state-level disparities indicate that states such as Bihar, Karnataka, Uttarakhand, and West Bengal have less than 100 police personnel per lakh population. What is astonishing is that the share of women police personnel across states and UTs is 10 percent which is way below the recommended level of 33 percent.

Except for seven states including Tamil Nadu, Goa, Himachal Pradesh, Gujarat, Maharashtra, Bihar, and Uttarakhand; the share of women in police are below 10 percent. Bihar has the highest share at 25.03 percent.

There are 49 judges per 1000 population. The population per high court judge is as low as 2,41,818 in Sikkim to as high as 47,55,909 in Andhra Pradesh. The lower the population load on a high court the better the state's ranking is. The shortage of women judges is also a concern. On average, Indian states have 10 percent women judges while UTs have 16 percent women judges available in the high court.

Even the high court judge vacancy rate is high in Indian states. Only Sikkim and Puducherry have less than 20 percent vacancy rate, with the highest vacancy being observed in Andhra Pradesh at 70.3. The continuous vacancy of more than one-third of sanctioned posts is a worrying trend when it comes to the administration of justice in India. More details are explained in the report here.

Despite the complexities evident in electoral dynamics of Karnataka’s voting patterns (National vs. Lok Sabha Polls), what cannot be denied though is how enabling ‘access’ to key social and economic services (and public goods) at the local level, as measured by different performance indicators, will play a vital role in shaping who ultimately wins (or moves closer to winning) this Vidhan Sabha- and, perhaps in the broader context of a run-up to 2024 Lok Sabha Polls, Karnataka’s own electoral outcome, may offer to have some vital signalling effect. 

(Deepanshu Mohan is Professor of Economics and Director, Centre for New Economics Studies (CNES), Jindal School of Liberal Arts and Humanities, O.P. Jindal Global University. This is an opinion article and the views expressed are the author’s own. The Quint neither endorses nor is responsible for them.)