Multi-dimensional deprivation in India: Comparisons with China and Vietnam

While several studies have compared India with China on economic measures such as GDP per capita, this column looks at a measure of people’s deprivation across a wide range of indicators. It finds India lagging behind in several dimensions, particularly on children’s health.

There is now much interest in comparing the two 'awakening giants' of India and China. With nearly two-fifths of the world's population residing in these two countries, India and China parallel each other in size and diversity. Given the huge markets that they offer to the rest of the world, and having registered some of the highest economic growth rates in recent years, it is natural for these two countries to be the focus of attention. Within the academic community, however, many of the existing studies comparing China and India have looked at economic measures such as GDP per capita and growth rates (see for example Bosworth and Collins 2008) . In recent work with colleagues, I depart from this tradition and instead compare the two countries on the basis of their living standards using a measure of deprivation (see Ray and Sinha 2011 and Mishra and Ray 2012).

How to measure deprivation?

Our recent work looks at a measure of deprivation that takes into account whether people have access to things considered essential for a basic standard of living. These include: clean drinking water, electricity, clean fuel for cooking, education, toilet facilities, basic transport with a bicycle, basic communication with a radio and basic income and wealth (measured by whether a household belongs to the poorest 20% in the country). We also look at the health of the household, focusing on the health of the children (measured by whether they are underweight and stunted for their age) and the health of the mother (measured by whether she is underweight for her height). Each household is scored in these different areas giving us an overall measure of what we call ‘multi-dimensional deprivation’.

We pay particular attention to child health. As pointed out by Partha Dasgupta (1993), signs of stunting and malnutrition in a child's early years affects the likelihood of illness and early death, which has obvious knock-on effects for future prosperity.

To carry out the study we have calculated multi-dimensional deprivation for fifteen states in India and nine provinces in China for the years 1993, 2000, and 2006. This allows us to compare deprivation across regions, across countries and across time. Moreover, because we look at deprivation over multiple dimensions, we can identify where the deprivation is particularly acute and where it contributes significantly to the overall multi-dimensional deprivation.

Comparisons with China

The study finds that while both India and China record a decline in multi-dimensional deprivation over the period as a whole, they still have a way to go. In spite of their high economic growth rates over the last 20 years, both countries record significant amounts of deprivation by 2006, particularly in rural areas. In fact there are some areas where deprivation is actually increasing.

In India, for example, despite improvements in access to electricity and in the level of education, access to drinking water has taken a step backwards in both rural and urban areas. In China, meanwhile, access to clean drinking water has greatly improved and access to electricity is much more widespread than in India.

Health of women and their children

Taking the main focus of the study, the health of women and their children, we find that India and China still have alarmingly high numbers of malnourished children. By 2006, as many one in three children had stunted growth in both countries. There are also high rates of anaemic children, in India as many as half of all children suffer from anaemia, which appears to be strongly linked with stunting in very young children.

Overall, China outperforms India in both women's health and children's health. While the problem of malnutrition and underweight children has virtually disappeared in China, it remains a significant issue in India. Moreover, in India there is evidence of a significant link between a mother's health and that of her children, but not in China. This reflects a policy failure in India to stop a mother's ill health from passing on to her children. India has failed to introduce the sort of nutritional programme for mothers and their children both before and after birth that has been in place in China since the National Plan of Action for Nutrition was introduced in 1997.

Comparisons with Vietnam

In work with Kompal Sinha, I extend the comparison of child health between India and China to include Vietnam (Ray and Sinha 2011). Over the period 1993-2005 China does much better than both India and Vietnam in reducing the incidence of both stunted and underweight children aged under three years. Vietnam recorded an impressive reduction in the rates of stunted children over the period 1992-1998 leaving India's record as the worst. While there was an increase in the rates of underweight children in both China and Vietnam during this period, in 2006 they are still below the high rates in India.

The way forward

Both India and China have seen significant improvements in their living standards and a decline in deprivation across a wide range of dimensions. But they still have a long way to go. This study underlines the need to look beyond statistics such as per capita income or economic growth rates and explore issues such as deprivation, where the picture looks much less rosy. For India in particular, there has been a failure to break the link between a mother's ill health and that of her children, while in China there has been nutritional programme aimed at breaking this link in place since 1997. The study has also identified access to drinking water and to electricity as areas where India needs to do much more to match the performance of China.