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India's Growing Pains: Views of Healthcare, Education Vary by Region

by Steve Crabtree

Satisfaction far lower in Eastern states than elsewhere


PRINCETON, NJ -- India's unprecedented growth has been one of the most remarkable economic achievements of the last two decades. On the whole, the benefits to Indians have been enormous: Poverty levels have been cut by more than half, health indicators have improved dramatically, and the country's overall literacy rate has soared. These results are reflected in Gallup World Poll results from India; overall, majorities of Indians say they are satisfied with access to high-quality education in the country (64%), and with access to affordable healthcare (56%).

But the growth has not come without challenges, among the most serious of which are regional inequalities. The densely populated states in the East -- including Bihar, Jharkhand, West Bengal, and Orissa -- remain poverty-stricken. Their growing disparities with the rapidly modernizing Western states threaten to undermine the national unity important to sustaining India's long-term growth.

Examining World Poll data by region highlights the degree to which these disparities extend to basic infrastructure elements critical for development. Perceptions regarding access to education and healthcare in particular are far less positive among Indians living in the East than those in any other region.

Just 28% of Indians in the Eastern region say they are satisfied with access to high-quality education in the country, compared with 73% in the other four regions. These results are consistent with the sizeable variation in India's literacy rate, which is highest at 90% in the Southern state of Kerala, but drops to just 38% in Bihar.

Indians' perspectives about healthcare services follow a similar regional pattern. Fewer than one in four residents of the Eastern region (22%) say they are satisfied with access to affordable healthcare, versus almost two-thirds (64%) overall elsewhere in the country. Again, resources vary widely among India's states, and although those variances are not systematic by region, several Eastern states are among the worst off. In Bihar and Jharkhand, for example, there is approximately one healthcare practitioner for every 2,000 people -- compared with one for every 450 people across all of India.

Infrastructure disparities are also reflected in Indians' confidence in the country's extensive Civil Services system, which bears a great deal of responsibility for administering the policies intended to advance India's socioeconomic development. About two-thirds (67%) of those living in the Central and Western regions say they have confidence in the Civil Services, compared with about one-third (34%) of those in the North and South. Those living in the East are least likely to express such confidence, at 27%. 

Survey Methods

Results are based on face-to-face interviews with a representative sample of 2,100 residents of India, aged 15 and older, conducted Jan.3-Feb. 15, 2006. Interviews were conducted in English, Hindi, Marathi, Gujarati, Kannada, Tamil, Telugu, and Bengali. For results based on these samples, one can say with 95% confidence that the maximum error attributable to sampling, weighting, and other random effects is ±3 percentage points. In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.


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