Skip to main content

'Unlocking' Covid policy gap? Just 10% Indians 'covered' under healthcare schemes

Counterview Desk
Among many “defining challenges” India’s top policy makers need to address midst Covid-type health emergency is overcoming huge gaps that exist between what India’s CityMakers need and what the government offers. A recent survey has revealed only one out of 10 respondents were covered under the Government of India’s flagship public health as well as life insurance schemes -- Ayushman Bharat, PM Jeevan Jyoti Bima and PM Suraksha Bima Yojna.
Conducted by the Delhi-based Impact and Policy Research Institute (IMPRI), the survey also found that about 65% of the surveyed respondents were aware of the Aarogya Setu app, propagated as the “health body guard” of each citizen, though among them only 62% reported to use it. Further, only 38% respondents were aware of state WhatsApp helplines.
Conducted by a group of IMPRI researchers -- Prof Balwant S Mehta, Dr Soumyadip Chattopadhyay, Dr Simi Mehta, Dr Indu Prakash Singh, Anshula Mehta, Ritika Gupta and Dr Arjun Kumar – while addressing livelihood issues, the survey also found that only 20-30% of respondents were aware of state e-coupon for ration, state e-pass or other different state apps.

An IMPRI note:

Symmetric to the global trends, Covid-19 has had multidimensional impacts on the economy and society of Indian cities. In the absence of any vaccine, prevention through containment and social distancing coupled with frequent handwashing appear to be the only viable strategies to fight against the novel coronavirus.
On March 24, 2020 the Prime Minister of India had announced the nation-wide lockdown to slow down the spread of Covid-19 and to reduce pressures on the inept health infrastructure of the country. In the days and months that followed, the policymakers and the administration faced enormous challenges in the trade-off between ensuring health and livelihood of the people.
Amidst rising concerns of lives and livelihood of the poorer sections of the population becoming jeopardised, the government announced seemingly bold economic packages. However, with few exceptions, lack of coordination in the official spheres at the ground level has had appalling consequences, especially the millions of ‘CityMakers’ who represent a significant share of the workforce and contribute in multiple ways to the economy.
Employed mostly in the unorganized sector and living in informal settlements in cities, they have borne most of the brunt of complete lockdown in India. They have no written job contracts, no regular work and are often employed casually and are without any social safety nets to support them and their families during exigencies.
Moreover, their livelihood opportunities are constrained by multiple barriers that include deplorable housing conditions, inadequacies of urban services, inbuilt socio-economic disparities relating to caste and gender and also the policies and practices of governments.
To understand the ground-realities of how the Covid-19 induced lockdown impacted the lives of the CityMakers, IMPRI conducted a ten-day country-wide telephonic-survey during between May 7 and 17, 2020 to evidence the challenges faced by the poorest sections of society including migrants in India, who have lost their daily wages and now are dependent on the government or non-government support for meeting their daily needs.
This study adds to the existing media literature by systematically evidencing through data from 3,121 CityMakers from over 50 cities of India.
The survey revealed that almost three-fourths of the respondents were engaged in informal employment, i.e. daily wage work, petty trades/business and temporary workers without any social security benefits. These respondents were vulnerable to economic and health shocks due to their irregular income, unstable jobs and lack of access to any social safety nets amid lockdown policies.
It was found that six out of 10 workers had lost their job during the lockdown, with unemployment being highest among the casual labourers and self-employed respondents; 74% of the casual labourers lost their jobs while 67% of the self-employed workers could not pursue their economic activities due to lockdown. When asked about their reasons for unemployment, quite a significant proportion of surveyed respondents cited their inability to visit workplaces and closure of places of works as pressing reasons.
Work from home was coined and advertised as the new mantra to ensure adherence to the diktat of social distancing. But this economic privilege was unavailable to the poorer workers, who had no other option but to remain confined within their houses without any work. They could neither realistically practice social distancing, nor could they afford it.
All these led to a massive shock to the livelihoods and wage earnings of these respondents and their families. For example, the inability to earn during the lockdown translated into 54% of people being unable to pay rent for their accommodations.
So, quite expectedly, most people wanted to return to work. When asked if the respondents and their family members would resume work after lockdown, almost three-fourths of respondents said that they would join the same work in which they were engaged prior to lockdown or they would look for new jobs.
Six out of 10 workers lost their jobs during lockdown, with unemployment being highest among casual labourers and self-employed
In other words, this loss of jobs or livelihood options can be considered as a temporary phenomenon. Importantly, the resumption of normal economic activities or absorption of the city makers in newer economic activities would significantly depend on the nature and type of government policies to jumpstart cities’ economy via providing boosts to local businesses and especially small and micro-enterprises that are hard hit amidst the lockdown.
Direct implications of job losses were revealed through inadequate access to public supply of water and had to rely on accessing water from private tankers which increased expenditure of the already cash-strapped households. The World Health Organization’s recommendations of frequent hand washing with soap, thus became a practical challenge.
Almost one third of the respondents reported improper drainage facilities, including absence of any garbage collection facility in their locality. Further, social distancing was not feasible for the CityMakers as they lived in congested spaces, with three to four people living in a single room within non-notified slums and unauthorized colonies. Such conditions provide ripe grounds for the possibilities of the rapid spread of Covid-19 and compromise the lives of the city makers, leaving them practically defenceless against the pandemic.
Loss of jobs had the spillover impacts on the education of their children, where most of the sent their children to government schools. In the prevailing new normal of online teaching methods and reliance on digital modes of learning, education has become a distant dream because they had no laptop or smart phone for accessing such education.
With 88% of the CityMakers depending on their household income or saving and/or borrowing or taking financial help from relatives, friends etc. for meeting their health related expenditure requirement, this temporary job loss has added to the anxieties that any kind of health emergency including Covid-19 would exacerbate their already weak financial position and make them more vulnerable.
A defining challenge for devising appropriate mitigating policies for the city makers is the lack of data about them both prior to, and during, any kind of emergencies. So, preparedness and early action by the communities are essential. 
To benefit from any central and state government relief measures -- both cash and non-cash to support the poor people during lockdown, people must possess government documents (ration card, aadhaar card), bank account, enrolment in different government welfare schemes and so on.
The survey revealed that coverage of and eligibility for the government support programme was a major concern as evident from the possession status of various important documents by the respondents.
About 23% of the respondents did not have ration card, 32% did not have zero-balance Jan Dhan bank accounts and on an average only one out of 10 respondents were covered under the Government of India’s flagship public health as well as life insurance schemes - Ayushman Bharat, PM Jeevan Jyoti Bima and PM Suraksha Bima Yojna. 
Almost one third of CityMakers reported improper drainage facilities, including absence of any garbage collection facility in their locality
About 65% of the surveyed respondents were aware of the Aarogya Setu app and among them only 62% reported to use the app. Only 38% respondents were aware of state WhatsApp helplines. For others app and e-initiatives, the awareness levels of the surveyed respondents are very poor.
Roughly about 20 to 30% of the respondents were aware of state e-coupon for ration, state e-pass or other different state apps and use of these apps among them turned out to be even more pathetic. Lack of access to smart phones and unstable internet connectivity were the major impediments in using the apps and portals.
Regarding their perception on eligibility of the government support programmes, only 37% of the respondents thought that they were eligible for benefits under Pradhan Mantri Gareeb Kalyan Yojana (having an outlay of Rs 20 lakh crore for the Covid19 response). However, only 34% of the respondents could avail benefits like cash transfers and free ration under this scheme.

Policy suggestions to tide over the crisis

In light of the above evidence, it is becomes extremely important to think of precise policy improvements to tide over the crisis. To start with, the stringent aadhaar-requirements for accessing different schemes must be relaxed for at least next six months. Another option could be a job assurance programme would give needy households livelihood security during the health crises.
Essentially, the Covid-19 crisis requires extremely localized and coordinated responses. So, city governments and their elected representatives should have decided on vigorous delivery of basic urban services that might be the most effective in their contexts. Financially empowered city governments with clear functional domain and adequate institutional capacity can respond rapidly and contain the outbreak of Covid-19.
It is equally important to improve and expand the coverage through the Public Distribution System (PDS). Bridging the awareness gap regarding available government support programs, especially the PDS, through timely and reliable information and expanding the coverage of such programs to needy but non-registered segments via certain temporary forms of authentication as alternatives can be very useful.
While the latest Economic Survey (2019-20) spoke of 'Thalinomics', which says that a good vegetarian and non-vegetarian platter costs a minimum of Rs 25 minimum and Rs 40, respectively, therefore, in order to ensure that the poorest sections of the population are able to fulfill their dietary requirements, each identified needy person must be provided with ‘a $ a day’ (around Rs 2000 per month).
Further, for everyone to be vigilant of the spread of Covid-19, digital literacy for children belonging to poor families, and smooth transfer of digital payment of welfare scheme, poor households should be provided an Android phone either for free or at a subsidised rates through PDS shops. 
In addition, the private sector (under the CSR component) should come forward and encourage for providing free sim and data coupon to the poor households by identifying through Below Poverty Line (BPL)/Antyodaya Anna Yojana (AAY) cards It is the most opportune time to ensure digital literacy among the people.
To ascertain the per person benefits from the PMGKY package, each person of the country would get Rs. 15,000. But in reality, we do not give poor people more than Rs 500 per month. Contrasted with developed countries, this meagre sum is spent only on a one-time meal.
In the United States, $300 to $400 are being given weekly to the unemployed as allowance. Therefore, to ensure dignified assistance to the poor, the Government of India can afford to give $1 (about Rs. 75) a day to each poor person of India.
If we give Rs 2,000 assistance to 12 crore people (the bottom quartile population in the urban economic ladder), it will translate to Rs 24,000 crore a month, and 72,000 crore for three months. Moreover, if we can give an Android phone in a graded manner to around five crore people (prioritizing elderly, women and children going to government schools) in the cities, it would amount to around Rs 30,000 crore (cost per handset around Rs 6,000).
Overall, this would amount to Rs 100,000 crore and would be crucial as India moves to the ‘Unlock’ phase. Such provisioning is certainly doable and would just need a reorientation of the Budget 2020-21 and to this the Rs 35 lakh crore worth of forex reserves could be rightly utilised to pay for the war against Covid-19, as it would help distribute the pain similar to the Keynesian tenets during the World War II and create a better society.
---
For YouTube links, click here for release of the survey, here for webinar on the survey, and here for web policy talk on the survey

Comments

TRENDING

Tracing roots of Hindutva Zionism: cannon fodder for 'warped' nationalist pretensions

By Shamsul Islam*  Those who believe in a world free of hegemonic ethno-nationalism, racism, religious bigotry and hatred have rightly taken note of Zionism and its ally Christian Zionism, major perpetrators of ethnic cleansing of ‘Others’. However, the civilized world with its core belief in multi-culturalism and peaceful co-existence is oblivious to a no less dangerous threat to the present human civilization: the Hindutva Zionism. As the term reads it is part of the Hindutva world-view which stands for an exclusive Hindu India minus Muslims and Christians. The other religions like Sikhism, Buddhism, and Jainism will have no independent status but treated as part of Hinduism. The Rashtriya Swayamsevak Sangh (RSS; National Volunteer Organization) is the most prominent flag-bearer of the Hindutva politics whose cadres presently rule India, the largest democracy in the world. RSS was founded by Keshav Baliram Hedgewar (1889-1940) in 1925 who was disillusioned with the Indian freedom st

Regional parties, anti-Congress progressives, civil society groups 'joining' Bharat Jodo

By Harshavardhan Purandare, Sandeep Pandey*  The Congress party declared Bharat Chhodo (Quit India) movement against the British regime in 1942. The Congress party has now launched a movement Bharat Jodo (Connecting and Uniting India) against the Modi regime in 2022. Indian people have had a journey of 80 years since Mahatma Gandhi gave that Quit India call to the British and we have to agree that we stand most divided in our modern history when Rahul Gandhi is giving this Bharat Jodo call to the nation. And back then, Congress was a thriving idealistic political movement against the British rulers and now it is an ever weakening political organization electorally defeated several times. However, it is India at stake, not just the Congress party. That is why so many regional political parties, civil society organizations, traditional anti-Congress progressive forces like socialists and communists, intellectuals and civil servants have declared their support and are proactively partici

Shocking? No Covid vaccine trials conducted on pregnant, lactating women: RTI reply

By Rosamma Thomas*  A Right to Information applicant who sought details of safety trials conducted in India on pregnant and lactating women for three Covid vaccines in use in India – Covishield, Covaxin and ZyCov-D -- was shocked to learn from the Central Drugs Standard Control Organization (CDSCO) that Serum Institute, manufacturer of Covishield, and Cadila Healthcare, manufacturer of the ZyCov-D vaccine, had not sought permission for such trials.  Bharat Biotech, manufacturer of Covaxin, had sought permission for trial on pregnant women and later withdrawn its application. This response , provided after the applicant was initially unsatisfied with the response and went in appeal, is from the joint drugs controller, CDSCO. It was dated September 13, 2022. One researcher closely following the vaccine rollout, however, is of the opinion that the lack of a trial on pregnant and lactating women is a blessing; potential trial participants and their unborn babies thus escaped harm. Aruna Ro

'Blatant violation' of law by Central government in making NREGA payments

By Our Representative  In September third week, NREGA workers across the country were mobilised for two day so raise their issues and submit a memorandum to the Prime Minister. Organised the NREGA Sangharsh Morcha (NSM), a collective of groups that work with NREGA labourers across the country, workers from 13 states -- Andhra Pradesh, Bihar, Chhattisgarh, Gujarat, Haryana, Jharkhand, Karnataka, Madhya Pradesh, Odisha, Rajasthan, Telangana, Uttar Pradesh and West Bengal -- carried out Kaam Do Abhiyaan, staging demonstrations and rallies against what they called blatant violation of law by the Central government in making NREGA payments. While NREGA has had very positive impacts, it has lately become fruitless, exploiting labour, even though workers who have put in honest hard work have to wait for their wages endlessly, it was suggested.  In such a situation, there is a need to firm up NREGA implementation and end systematic corruption to ensure that workers get their basic NREGA entit

Grave error? Scholar blames ex-Gujarat babu for anti-Christian riots 'citing fake report'

By Rajiv Shah  A few days back, I received a message from one of the finest former Gujarat government bureaucrats, PG Ramrakhiani, a 1964 batch IAS official, who retired in November 2000. I would often interact with him in 1997-99, even later, after I was sent to Gandhinagar as a Times of India man to cover Sachivalaya. Those were turbulent times. Shankarsinh Vaghela was the Gujarat chief minister, under attack from two sides – from the BJP, which he had left to form a separate breakaway party, Rashtriya Janata Party (RJP), one one hand, and the Congress, which was supporting him from outside, on the other. Ramrakhiani, in his message, referred to the book authored by Ghanshyam Shah and Jan Breman, both top-notch scholars who have known Gujarat in and out. Called “Gujarat, Cradle and Harbinger of Identity Politics: India’s Injurious Frame of Communalism”, I reviewed the book in January 2022.  It claims that Muslims in Gujarat have been turned into “new untouchables”, thanks to the Hin

Rajasthan cops 'halt' Gujarat Dalit women's rally: homage to untouchability victim boy

By Our Representative  In a surprise move, the Rajasthan police stopped a Dalit women's rally from Gujarat on the borders after it crossed Gujarat alleging that it would "disturb peace" in village Surana, Jalore district, where the gruesome incident of death of a Dalit boy took place on August 13 after he was brutally beaten up by his teacher on touching the drinking water pot. Sources said, while the Gujarat government had "no objection" in allowing the rally, which originated from the Dalit Shakti Kendra (DSK), an empowerment-cut-technical institute for teens founded by human rights leader Martin Macwan, on September 24 morning, the Rajasthan police stopped it for two and a half hours before allowing it to proceed to Surana. The decision to take out a women's rally was taken at a DSK meeting on September 5 following a condolence meeting of the NGO Navsarjan Trust, also founded by Macwan, activists committed to work against caste-based discrimination, orga

Excess to cheetah in Kuno to increase 'woes' of local people, 'disturb' wildlife balance

Bharat Dogra*  The release of eight cheetahs into the Kuno National Park ( Madhya Pradesh) by Prime Minister Narendra Modi on September 17, although accompanied by a media blitz, has raised several questions. The animals were flown from Namibia to Gwalior and from there they were taken to the release site in a helicopter. Official sources have stated that this is the first time a large carnivorous species has been moved across continents for establishing a new population. This first release will be followed by others under this project. However, precisely for this reason, it is important to be cautious because if such translocations have been generally avoided in the past, there may have been reasons for this and at the same time we do not have much learning experiences from the past. The Cheetah became extinct in India in 1952, although this very fast moving animal is still remembered in the folklore of many areas. Hence the first impulse is to say that trying to introduce and revive

Introducing non-native cheetahs is 'not equivalent' to restoring pride in the nation

By Bappaditya Mukhopadhyay*  The Cheetahs from the African continent has finally been introduced to India by the Indian Prime Minister on his 72nd birthday. The process had started with the previous Government in 2009. However, the Supreme Court clearance was pending owing to the objection by the National Tiger Conservation Authority (NTCA) plea to reintroduce cheetahs. Finally the clearance was obtained in January 2020 and thereafter Kuno National Park (KNP) was chosen for the reintroduction of first set of Southeast African Cheetahs. In the near future, depending upon the success story of the current reintroduction, more cheetahs from South Africa may also be introduced. This exercise has generated a lot of interest among various stakeholders with opinions on both sides galore. It is important to pose some questions that surround the whole exercise. Let us evaluate some of these arguments. The first set of arguments are quite detached from the issues of conservation as they most

'Military diplomacy': US praises Bangladesh Army for leadership role in UN operations

By Kamal Uddin Mazumder* As the Indo-Pacific region represents the world’s economic and strategic center of gravity, the Indian Ocean today is becoming the centerpiece of all geo-strategic play. Cooperation in the region is crucial to implementing the international community’s global agenda, including achieving the UN’s Sustainable Development Goals. Major powers like the US have enhanced and deepened their strategic engagement and leadership roles with countries in the region. The Indo-Pacific Army Management Seminar, or IPAMS, is a U.S. Army Pacific (USARPAC) initiated conference that is aimed at facilitating and enhancing interactions among the armies of the Indo-Pacific region. This year's 46th Indo-Pacific Armies Management Seminar (IPAMS)-2022, co-hosted by the Bangladesh Army and US Army Pacific (USARPAC), concluded in Dhaka. The objective of IPAMS is to promote peace and stability in the region through mutual understanding, dialogue, and friendship. It is the largest confer

Buddhist shrines were 'massively destroyed' by Brahmanical rulers: Historian DN Jha

Nalanda mahavihara By Our Representative Prominent historian DN Jha, an expert in India's ancient and medieval past, in his new book , "Against the Grain: Notes on Identity, Intolerance and History", in a sharp critique of "Hindutva ideologues", who look at the ancient period of Indian history as "a golden age marked by social harmony, devoid of any religious violence", has said, "Demolition and desecration of rival religious establishments, and the appropriation of their idols, was not uncommon in India before the advent of Islam".