India Inequality Report 2021: Oxfam

  • IASbaba
  • July 22, 2021
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  • GS-2: Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

India Inequality Report 2021: Oxfam

The report was released by Oxfam India 

Who is Oxfam?

  • Oxfam International is a group of independent NGOs formed in 1995.
  • The name “Oxfam” comes from the Oxford Committee for Famine Relief, founded in Britain in 1942.
    • The group campaigned for food supplies to starving women and children in enemy-occupied Greece during the Second World War.
  • Oxfam aims to maximize efficiency and achieve greater impact to reduce global poverty and injustice.
  • The Oxfam International Secretariat is based in Nairobi, Kenya.

Key Findings of the 2021 report

  • It provides a comprehensive analysis of the health outcomes across different socioeconomic groups to gauge the level of health inequality that persists in the country.
  • The findings are primarily based on secondary analysis from rounds 3 and 4 of the National Family Health Survey and various rounds of the National Sample Survey.
Female Literacy
  • Literacy rate for women in the general category is 18.6 percent higher than SC women and 27.9 percent higher than ST women.
  • Inequality is evident in the attainment of female literacy with a gap of 55.1% between the top and bottom 20 percent of population in 2015-16 


  • Two out of three households have access to improved, non-shared sanitation facilities in the general category. While SC households are 28.5 percent behind them, and ST are 39.8 percent behind them. 
  • Only 30.2 % of Total Households have piped water into residence 
Health Expenditure
  • 81 percent of the total hospitalisation expenditure is covered through the savings of the household while one in every six rupees spent is through borrowing
  • More than 50 percent of out of pocket expenditure is utilized in purchasing medicines and another 10 percent in medical and diagnostic labs. 
  • The share of institutional deliveries in india has increased from 38.7 percent in 2005-06 to 78.9 percent in 2015-16, indicating a rise of 40.2 percent in a decade. 
  • Institutional births in ST households was 15% below the general category in 2015- 16. 
  • 810 women lose their lives daily from preventable pregnancy and/or childbirth-related causes.
  • Teenage childbearing has gone down significantly from 16 percent in 2005-06 to 8 percent in 2015-16: a 50 percent decline. 
  • The percentage of mothers who have received full antenatal care has declined from 37 percent in 2005- 06 to 21 percent in 2015-16.  Full antenatal care for urban areas is close to two times that of rural areas. 
Infant Mortality Rate
  • IMR is the number of deaths per 1,000 live births of children under one year of age
  • IMR has dropped to 32 in 2018, which is closer to the world average of 28.9. 
  • SCs still have IMR 13.1 higher than the general category, while infant deaths in STs are 12.3 more. 
  • Under-five mortality rate (U5MR) has dropped to 36 in 2018, close to the world average of 38.6. 
Child Wasting
  • Percentage of wasted children (deficient in weight- for-height) has increased from 19.8 to 21 percent between 2005-06 and 2015-16. 
  • One in every two children are anaemic in India (50 percent), with three out of every five children anaemic in SC and ST households (60 percent) 
Child Stunting
  • The percentage of stunted children (deficient in height-for-age) has decreased from 48% to 38.4% between 2005-06 and 2015-16 in India. 
  • The difference between stunted children in SC and ST households and those in households belonging to the general category is 12.6 and 13.6 percent, respectively. 
Government Interventions
  • The National Health Profile in 2017 recorded one government allopathic doctor for every 10,189 people and one state-run hospital for every 90,343 people.
  • In the 2021-22 budget, the health ministry has been allocated a total of INR 76,901 crore, a decline of 9.8 percent from INR 85,250 crore from the revised estimates of 2020-21. 
  • The public expenditure on health by the central government as a percentage of GDP was a mere 0.32 percent in 2019-20. 
  • The combined expenditure by state and central government was about 1.16 percent of the GDP in 2019 rising marginally by 0.02 percent from 2018 
  • 1.58 lakh sub centres, 26 thousand PHCs and 5.6 thousand CHC. There is a shortfall of 43,736 sub-centres (23 percent), 8764 PHC (28 percent) and 2865 CHC (37 percent) across the country
  • The private health sector accounts for 66% of hospitalization and non-hospitalization cases and 33% of institutional births. This growth has been boosted by government concessions 
  • Only 14 percent of both SC and ST households are registered with the PM-JAY. 


  1. The right to health should be enacted as a fundamental right that makes it obligatory for the government to ensure equal access to timely, acceptable, and affordable healthcare of appropriate quality 
  2. Increase health spending to 2.5 percent of Gross Domestic Product (GDP) to ensure a more equitable health system in the country; 
    • Ensure that union budgetary allocation in health for SCs and STs is proportionate to their population; 
    • Prioritize primary health by ensuring that two-thirds of the health budget is allocated for strengthening primary healthcare; 
    • Centre should extend financial support to the states with low per capita health expenditure to reduce inter-state inequality in health 
  3. Widen the ambit of insurance schemes to include out-patient care 
  4. Institutionalize a centrally-sponsored scheme that earmarks funds for the provision of free essential drugs and diagnostics at all public health facilities. 
  5. Direct all states to notify the Patients’ Rights Charter forwarded to them by the Ministry of Health and Family Welfare, and set up operational mechanisms to make these rights functional and enforceable by law 
  6. Regulate the private health sector by ensuring that all state governments adopt and effectively implement Clinical Establishments Act or equivalent state legislation; 
  7. Extend the price capping policy introduced during the COVID-19 pandemic to include diagnostics and non-COVID treatment in order to prevent exorbitant charging by private hospitals and reduce catastrophic out-of-pocket health expenditure. 
  8. Augment and strengthen human resources and infrastructure in the healthcare system by regularising services of women frontline health workers especially ASHA
  9. Inter-sectoral coordination for public health should be boosted to address issues of water and sanitation, literacy, etc. that contribute to health conditions. 

Connecting the dots:

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