Health and human development at sub-state level in India

A prominent outcome of the Indian development strategy has been disparity in well being. It is reflected in differential per capita incomes, access to basic facilities and human development indicators across Indian States. In order to analyze the factors that have led to disparities across states and to reflect upon the phenomenon of convergence and divergence and two-way causation between human development and income, in this study we focus on district level (sub-state level) for three Indian States, namely, Orissa, Karnataka and Maharashtra representing respectively a poor, middle-income and high-income state. The analysis is carried out to provide specific answers to certain pertinent questions and to suggest relevant policy implications. A comparison of state level averages and human development parameters for top and bottom districts indicates a tendency to neglect the development of poorer districts in richer states. Skewed development priorities also have favored better off districts in poorer states. Regression analysis highlights the inadequacy of social sector interventions and indicates differences in sensitivity of human development across the selected states. Our results point to the need for incorporating these differences in a more substantive way in human development planning in the states. Our two-way regressions indicate that a more suitable development strategy incorporating appropriate state intervention may lead to enhanced income, through improved skills or better quality of labor force, much faster in poorer states. With some exceptions, our results also support the hypothesis of convergence for both the rich and the poor states which varies with duration and parameter. The results support the contention that over a longer period of time an ongoing process of convergence at district level might minimize inequality provided state intervention is made to counteract divergence in identified parameters of the social and economic infrastructure policies. This could be taken care of in recommending and making use of central transfers and grants to the respective states.