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According to Human Development Report (HDR) 2010, the Human Development Index (HDI) for India was 0.519 in 2010 with an overall global ranking of 119 (out of the 169 countries).

We are still in the medium human development category and countries such as China, Sri Lanka, Thailand, Philippines, Egypt, Indonesia, and South Africa have better overall HDI ranking than us. There is a need for much faster and wider spread of basic health and education.

Despite overall allocation increasing by 17 per cent over last year, budget seems to lack the punch for accelerating inclusive development agenda. PwC analyses the implication of Budget allocations for select schemes in the social sector.

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Health (Public health care)

Even with 20 per cent increased allocation, total plan allocation of Rs 26,760 crore is way below 1 per cent of GDP. Out-of-pocket (OOP) private expenditure on health care by an average Indian is one of the highest in the world.

Around 71 per cent of the health care expenditure is borne through own resources as compared to average 15 per cent spend by individuals in developed world.

The proposal for widening of service tax net to cover diagnostics and hospitalisation in AC hospitals, will create a larger hole in the pockets of patients. This is likely to be rolled back after its huge criticism.

No major initiative has been announced in the Budget for improving the quantity and quality of human resources in health sector, being one of major bottlenecks faced by the sector.

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NATIONAL RURAL HEALTH MISSION

NRHM, the flagship programme to improve health status, seeks to provide accessible, affordable and effective primary care, especially to poor and vulnerable rural population.

	2009-10	2010-11	2011-12
Allocation (Rs crore)	13,306	13,464	16,056
Increase over previous year		1%	19%

Since the launch of the NRHM, institutional deliveries have jumped from around 10 lakh to 90 lakh; largely riding on the incentives provided under Janani Suraksha Scheme (JSY). The increased plan outlay will augur well for this scheme. Convergence of this scheme with other related schemes is essential to reap greater benefits.

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INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS)

The key objective of the scheme is to ensure adequate nutritional and health care for pregnant and nursing women; as well as children under six years.

There has been significant progress in the implementation in terms of increase in number of operational projects, anganwadi centres (AWCs) and coverage of beneficiaries.

However, based on the National Health Family Survey 2005-06, the all India average for malnourished children is 47 per cent and 58 per cent of pregnant women are anaemic. These figures suggest how far we are lagging behind.

	2009-10	2010-11	2011-12
Allocation (Rs crore)	13,306	13,464	16,056
Increase over previous year		1%	19%

The proposal in the Budget to raise the remuneration levels of anganwadi workers and anganwadi helpers is a welcome move. The increased allocation is a good sign for the scheme.

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RASHTRIYA SWASTHYA BIMA YOJANA (RSBY)

The RSBY has the prime objective of providing smart card-based cashless health insurance cover of Rs 30,000 per family per annum to BPL families in the unorganised sector where beneficiaries pay only Rs 30, while the government pays the balance premium to the insurer. The plan allocation for RSBY is 37 per cent lower than last year.

	2009-10	2010-11	2011-12
Allocation (Rs crore)	265	446	280
Increase over previous year		68%	-37%

The scheme is being proposed to cover other unorganised sector workers in hazardous mining and associated industries like slate and slate pencil, dolomite, mica and asbestos. The plan outlay for the scheme is far below the expectation.

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Education

In the Union Budget 2011-12, total allocation for education sector has been increased by 24 per cent to Rs 52,057 crore. The elementary education in India has made strides in recent years.

However, the challenge of reducing dropout, increasing retention and maintaining quality of education persists. The dropout rate continues to be high (primary level Boys 28.7 per cent, Girls 21.8 per cent), and elementary level (Boys 48.7 per cent, Girls 49 per cent).

SARVA SHIKSHA ABHIYAN (SSA):
The objective of SSA is to achieve universalisation of elementary education. In addition to strengthening school infrastructure, scheme aims at providing quality education and promotes inclusiveness through regional interventions.

	2009-10	2010-11	2011-12
Allocation (Rs Crore)	13,100	15,000	21,000
Increase over previous year		14%	40%

In the Budget, Rs 21,000 crore has been allocated for SSA as whole, which is 40 per cent higher than Budget for 2010-11 and expected to provide boost to elementary education initiatives.

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MID-DAY MEAL SCHEME

MDM is the flagship programme closely linked to SSA, implemented to improve nutritional status and increase attendance of students at primary level.

The marginal increase in allocation for scheme over previous year Budget will not be even offsetting the inflation. This indicates that funds will not be available for extending the scheme to include the students of secondary level, as envisaged.

	2009-10	2010-11	2011-12
Allocation (Rs Crore)	8,000	9,440	10,380
Increase over previous year		18%	9.6%

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RASHTRIYA MADHYAMIK SHIKSHA ABHIYAN (RMSA)

The RMSA launched in with the objective of providing universal access to secondary education and universal retention by 2020. On the lines of SSA, a national mission is also proposed to implement this scheme. RMSA has 60 per cent increased allocation in the current Budget.

The focus under this scheme would be on large scale infrastructure development. Objective of the scheme is to increase the enrolment rate at secondary stage from 52.26 per cent in 2005- 06 to 75 per cent within five years by providing a secondary school within reasonable distance of any habitation.

	2009-10	2010-11	2011-12
Allocation (Rs  Crore)	549	1,357	2,179
Increase over previous year		147%	61%

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Livelihood & Sanitation

MAHATMA GANDHI NATIONAL RURAL EMPLOYMENT GUARANTEE SCHEME (MGNREGS):

MGNREGS is one of the most discussed central flagship programme to facilitate rural development through guaranteed rural wage employment of 100 days annually to all adults with special focus on women.

Despite, all the criticism and issues, the scheme has been able to provide benefits to over 4 crore households covering nearly one-sixth of the population and helped in building permanent infrastructure and assets in rural areas and also brought down migration from rural areas.

	2009-10	2010-11	2011-12
Allocation (Rs Crore)	39,100	40,100	40,000
Increase over previous year		3%	-0.3%

The budgetary provisions have been maintained at stagnant level. Recent announcement of the Ministry of Rural Development to enhance the wage rate in parity with the CPI for Agricultural Labour is expected to enhance utilisation in less responsive states. However, allocation in the Budget with revised wage rates looks inadequate.

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TOTAL SANITATION CAMPAIGN (TSC)

A target of achieving 62 per cent by 2015 in terms of the number of families having sanitation facilities has been set. The country is still in a challenging situation with more than 57.7per cent (DLHS-3 2007-08) families not yet having access to improved sanitation facility with 74per cent of them in rural areas.

	2009-10	2010-11	2011-12
Allocation (Rs Crore)	1,200	1,580	1,650
Increase over previous year		32%	4%

The planned allocation has been marginally increased in the Budget. This could be sufficient considering the lower fund utilisation in past. There is a need to strengthen the core approach of the campaign to make it demand driven and people centric.

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NATIONAL RURAL DRINKING WATER PROGRAMME

The Bharat Nirman Programme plans to cover approximately 55 thousand uncovered habitations and provide safe drinking water to approximately 2.16 Lakh villages affected by poor water quality by 2012.

In addition to coverage, sustainability of water resources and appropriate quality for drinking water supply continues to be difficult.

	2009-10	2010-11	2011-12
Allocation (Rs Crore)	39,100	40,100	40,000
Increase over previous year		3%	-0.3%

The Budget outlay for National Rural Drinking Water Programme (NRDWP) for the 2011-12 has been raised marginally similar to the sanitation programme. It seems the focuses here also is on quality enhancement and complete the coverage rather than on extension.

Ashok Varma
Executive Director, Government Reforms and Infrastructure Development

Team members: Aditi Bhutoria, Aditi Das, Alka Chadha, Gautam Anand, Sonal Shivagunde, Sujata Mullick and Sundeep Paulose