Projecting the Next Five Years of Growth in Uttar Pradesh | Excerpt

With a population that would make it the fifth most populated in the world if it were a country, Uttar Pradesh has undoubtedly been India’s most politically important state since Independence. It sends the highest number of Lok Sabha members to Parliament and has the biggest legislature in the country. It also has to its credit the highest number of prime ministers and powerful political dynasties.

From Lucknow to Lutyens by Abhigyan Prakash tells the fascinating story of UP in post-Independence India and the intertwined fortunes of the two. Read an excerpt.

Having examined all the facets of Uttar Pradesh that have a bearing on its politics—its deep-rooted social reality of caste and its role in the state’s politics, the collapse of the Congress in the state, the political bastions in the state, the extraordinary criminality and communalization that beset its politics, and its agrarian crisis—it is imperative to ask where does UP go from here. What are the possible challenges that it needs to overcome in the near future to live up to the expectations of its huge population?

In this concluding chapter of the book, I try to paint a broad picture of the state, describing where it has improved and what it needs to work upon for a better future.

Any discussion on Uttar Pradesh has to start with its complex demography, a distinction that always made it stand out in India. It is home to almost one-sixth of India’s population and has remarkably diverse regional cultures. It has been rightly called a ‘country’ and not a state. In terms of its population, it has been from time to time compared with the UK, France, Germany, and of course with our neighbour, Pakistan, as it surpassed these countries in population over the years. Geographically, it is a huge state nestled in the northern part of India. It is land-locked, with no direct access to the sea—considered a natural disadvantage for the state and also one of the reasons for its weak growth pattern over the years. In many ways, the compulsion to keep looking at UP along these lines has not changed with successive governments and policymakers.

Without any doubt, its large population and the high population growth rate are the biggest challenges for the state. To put it in perspective, a patch of land slightly over 7 per cent of the total area of the country houses almost 15 per cent of its total population. Handling such a large number of people—and a dense population at that—of many different and distinct communities, castes and groups has always been a daunting task for governments. The decadal population growth in UP is higher than the national average, a trend that is worrisome, but in recent years, with a significant decline in the total fertility rate, the population growth in the state is slowing slightly. It has been demonstrated consistently in the past few years’ economic surveys of the country that UP has reached the next phase of demographic transition, from where its population growth will slow down in the next two decades.

The key solution for UP would be to take advantage of this demographic transition, and this would naturally depend on the future governments and their policymakers’ ability to give momentum to this demographic decline. UP has not been able to achieve a decline in population since the 1970s. It was from this decade that the state appeared an anomaly compared with the rest of the country. From the 1970s to the 2000s, the national-level population growth declined, but not in the case of UP, making it difficult for the state to compete with other states. (Of course, now a population control law is being proposed by the state government and is a hotly debated development).

In order to make the most of its demographic shift southward, the future governments of UP should identify the key areas of concern and put in place policies that address them positively and in a time-bound manner. It’s very important to understand that the benefits of demographic shifts do not come naturally; you need to have proper policies and programmes in place.

From this perspective, the biggest challenge is public health. Health should always be a key area of concern; investment in public health is investment in human resources. But with the Covid-19 pandemic, public health has suddenly emerged as one of the top priorities for any government anywhere in the world. The belief now is that handling of public health would be a key determinant of any country’s overall performance and development in the near future. This seems absolutely true, given the threat the coronavirus pandemic has posed to every country’s health system, irrespective of the country’s social and economic standing. And the pandemic has not been an ordinary threat. It has been an existential crisis for humanity, demonstrating that investment in health cannot be compromised. The task ahead for the most populous state of the country is going to be far more difficult and challenging than for any other in this regard.

The pandemic has clearly demonstrated that the state has to pump a lot of capital into its basic medical infrastructure, especially in rural areas, where the majority of its population lives. Without drastically improving primary healthcare services in the interiors of the state, the pathetic state of UP’s health system is unlikely to change. This involves a number of tasks, from building adequate physical infrastructure to creating a huge medical workforce that can cover the entire rural region of the state. On both fronts, the state currently presents a very dark picture. There are only 18,000 sanctioned posts for doctors in government hospitals in UP. This figure in itself is indicative of the huge crisis the state faces, as, given its population of almost 20 crore, this works out to one doctor for 10,000 people. Since the majority of the people living in the rural parts of the state can’t afford the expensive services of private hospitals, they mostly rely on government hospitals. So, the acute shortage of staff in public hospitals is very alarming.

The problem of quality physical infrastructure, in the form of hospitals, is also something that has come under severe criticism in UP, but in my view that is the secondary issue. The focus should be on staffing hospitals with doctors, nurses and technicians, and in ensuring the availability and maintenance of equipment and supply of drugs. If this alone is achieved, it would mean a huge health turnaround for the state. It is crucial to note that most of the efforts aimed at improvement of the state’s poor health services fail because there is hardly any change at the grassroots level. It has been widely reported over the years that most of UP’s community healthcare centres located in the remote villages do have some physical infrastructure but no workforce to make them operational.

It was this gap more than anything else that the coronavirus pandemic, with all its consequences, brought to the fore. The handling of the pandemic became challenging for the state government precisely because of the limited human resources at its disposal. One should also not forget that the public’s perception of the coronavirus disease, especially in the rural areas of the state, also contributed significantly to the worsening of the situation. This is also a typically UP phenomenon, arising from the low levels of education and awareness in the state, particularly in the highly populated region of eastern UP. This made it difficult for the authorities to execute their disease-control strategies. The unimaginable scale of reverse migration of workers from different parts of the country to their villages also put a huge burden on state resources during the pandemic.

Thus, enduring reforms in the health sector are something that successive governments in the state should target. In this effort, they should coordinate with the Centre and make sure the budget allocated for health is utilized to the maximum and brings improvement at the ground level in the state. It goes without saying that the Centre should also reprioritize its healthcare spend, and the signs in this direction are already positive. In 2020-21, India allocated only 1.8 per cent of its GDP to healthcare. But with health and well-being becoming one of the six pillars of the Union Budget 2021-22, the government committed 2.5–3 per cent of GDP for healthcare.

UP could also learn from the healthcare models of other states that have done well in delivering healthcare services to their people. Many of the southern states have utilized private investments in the health sector to their advantage by opening medical colleges. This has not yet happened in UP very effectively. A public–private approach can perhaps do wonders for public healthcare in UP if implemented in the right spirit.

UP also needs to be socio-economically inclusive. Currently, its average per capita income is around half of India’s, but at the time of Independence the state’s per capita income wasn’t so dismal and stood somewhat on a par with the rest of India’s. To maintain this, it required to accelerate growth, but its measures did not keep pace with the population growth in the decades between the 1970s and 2000s. There were some patchy periods of good performance, for example, in the decade of 1980–1990, when its growth rate really picked up, but the state completely failed to capitalize on it.

The key reason for this was, of course, the politics of the 1990s, characterized by casteism and communalism, which dealt a decisive blow to UP’s growth. While the economic reforms of 1990 brought in a new era in India where every state planned its developmental strategy from a fresh perspective, keeping in mind the new set of economic and social challenges that were emerging, the states of the Hindi heartland were notoriously trapped in the age-old issues of caste and religion. No government during this period was able to come up with plans or schemes that could put UP at the top, or at least in the race in the competitive world of post-reforms India.

While the rest of India grew at an average rate of 6.8 per cent per annum between 1990 and 2004, UP completely veered off the growth path. In fact, in the pre-liberalization period, the gap between the country’s per capita income growth rate and that of UP had been less than 1 percentage point, but this widened to over 3 percentage points in the post-reforms period. UP managed to compensate for this loss to some extent after 2005, but could not fully bridge the growth-rate gap with the rest of the country, which remained fluctuating between 1 and 2 percentage points. It is this glaring gap that successive governments should plan to address, and that’s where the potential of demographic transition that I have talked about earlier is significant.

Another social indicator that requires attention when we talk about UP and overhaul of its growth pattern is employment. The problem of unemployment has always plagued the state, and of course it is connected to the state’s high population. The question of how to employ the young and productive component of the state’s population has always remained a challenge for policymakers. Not long ago, there were discussions on how its predominantly young population gives UP an edge over other states. It’s true that a third of UP’s population consists of youth and this holds enormous potential for the future growth of the state. But that is where the challenge lies too. The mere availability of a young workforce will not automatically translate into growth for the state. The workforce needs to be made employable and labour-intensive industries must come up to absorb them. The creation of such industries will be vital for the realization of the potential of this workforce.