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Rural Healthcare and Indebtedness in Punjab

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Rural Healthcare and Indebtedness in Punjab COMMENTARY farmers of Punjab, the present study was Rural Healthcare and undertaken in 2008-09, with following objectives: (1) to estimate the level of Indebtedness in Punjab c redit acquisition for healthcare purpos- es by marginal and small farmers in Pun- jab; (2) to assess the present scenario of Narinder Deep Singh public healthcare services in rural areas of Punjab. Despite many policy measures he agriculture sector in India is In the present study primary data was taken by the central and state presently facing a serious ecologi- collected using personal interview method governments, the indebtedness Tcal and economic crisis. Agricul- from 300 farmers (i e, 150 marginal and tural productivity has nearly stagnated 150 small farmers) spread over two dis- of farmers, especially marginal due to resource degradation (soil and water, tricts, namely, Amritsar and Gurdaspur for and small cultivators, keeps especially) leading to a consistent rise in estimating the income and expenditure of increasing. Some recent studies the cost of production or squeezing of marginal and small farmers, and purpose- on agrarian distress show the profit margins/income levels of farmers wise credit acquisition by these farmers. (GoI 2007). The worst-affected are mar- Secondary data was collected from govern- significant role of healthcare ginal farmers (having landholdings below ment reports/publications, journals, inter- expenditure in increasing one hectare) and small farmers (having net, etc, for evaluating the healthcare indebtedness. This article landholdings below two hectares) result- scenario in rural areas of Punjab. presents the result of a study ing in a high incidence of indebtedness and suicides among them. The most dis- Expenditure Exceeds Income conducted in selected villages concerting fact is that the largest number The annual/monthly income of marginal of Amritsar and Gurdaspur of farmer suicides was reported from and small farmers from all sources was districts of Punjab in 2008-09 states like Maharashtra, Andhra Pradesh, e stimated to be less than their total to estimate the level of credit Karnataka, Kerala and Punjab, which are e xpenditure. Table 1 (p 23) shows that considered to be agriculturally prosperous total annual income was estimated to taken for healthcare purposes by states. The government of Punjab in a re- be Rs 56,428 (marginal farmer) and marginal and small farmers. It port to central government has confirmed Rs 1,05,680 (small farmer), whereas their also analyses the present scenario 2,116 farmer suicides since 1988 due to average annual expenditure were esti- of public health services in i ndebtedness, but the actual figure accord- mated to be Rs 79,769 per marginal farm- ing to unofficial sources was more than er and Rs 1,46,378 per small farmer. The rural Punjab. 40,000 between 1988 and 2005 (Jaijee annual income of both categories of farm- 2005). Some of the reasons identified for ers fell short of their annual total expendi- indebtedness among marginal and small ture by 41.4% in the case of marginal farmers are low income level of farmers farmers and 38.5% in the case of small due to low production/productivity levels, farmers (Table 1). increased cost of production due to Consumption expenditure constituted a d egradation and depletion of soil and wa- major part of the total annual expendi- ter, rising cost of living, inadequate institu- ture of marginal and small farmers. It was tional credit, unproductive expenditure on estimated to be Rs 44,760 (56.1%) and social ceremonies and i ntoxicants, etc. Rs 65,892 (45%) of total annual expendi- In recent studies on agrarian distress, it ture per farm for marginal and small was found that health expenditure has farms, respectively. The annual agricul- been significant in causing or increasing tural production expenditure per farm the indebtedness of farmers, which has, in was only 28% and 35.2% of total annual turn, been a proximate cause of farmer’s expenditure of marginal and small farm- suicides (Economic Research Foundation ers. The annual expenditure on payment 2006). Credit taken for healthcare facili- of old debts constituted 15.9% and 19.8% ties was identified as one of the major of total expenditure of marginal and components of total credit acquisition as small farmers, respectively. The marginal nearly 41.6% of total credit acquired by f armers were incurring annual production marginal and small farmers was for expenditure of Rs 22,325 per farm or Narinder Deep Singh (ndsingh241074@yahoo. healthcare purposes (NSSO 2005). There- Rs 11,750 per acre (as the average farm com) is with the Faculty of Agriculture, Khalsa fore, to have a better insight into health- size of sample marginal farmers is 1.9 College, Amritsar. care credit availed by marginal and small acres), whereas the small farmers were 22 march 13, 2010 vol xlv no 11 EPW Economic & Political Weekly COMMENTARY Table 1: Annual Expenditure and Income of Marginal and Small Farmers in Punjab (in Rs /farm) (80,000 for hilly areas). But in rural areas A Annual Expenditure Marginal Farmers Small Farmers 1 Consumption expenditure (monthly/farm) of Punjab, there are only 2,858 SCs against (a) On food items 2,755 3,878 the requirement of 3,219 (according to (b) On non-food items 183 298 population estimates of 2001 Census, i e, (c) On education of children 376 535 (d) Miscellaneous 416 780 1,60,96,488 persons), 484 PHCs against Sub total (monthly) 3,730 5,491 the requirement of 537 and 126 CHCs, Sub total (annual) 44,760(56.1) 65,892(45) whereas 134 are required. More over, the 2 Agricultural production expenditure (annual/farm) including labour charges 22,325 (28) 51,526(35.2) number of health institutions in rural are- Agriculture production expenditure/acre 11,750 12,268 as of the state has not increased and has 3 Payments of old debts (annual/farm) (a) Short-term credit 5,088 13,170 remained more or less stagnant over the (b) Medium/long-term 7,596 15,790 years, which highlights the poor commit- Sub total 12,684 (15.9) 28,960 (19.8) ment of state governments, whereas the Average annual total expenditure (1+2+3) (100) 79,769 (100) 1,46,378 (100) B Total average annual income/farm 56,428 1,05,680 population in rural Punjab which consti- Difference of expenditure and income 23,341 (41.4) 40,698 (38.5) tutes 63.3% of the total population, has C Agricultural production expenditure/acre increased significantly over the years. The (as per recommendation of PAU, Ludhiana) 15,500 actual requirement of medical institu- D Present annual agricultural production expenditure/acre 11,750 12,268 tions, on the basis of projected population E Difference 3,750 (24.2) 3,232 (19.6) * Figures in parenthesis are in percentage. PAU: Punjab Agriculture University. estimates of r ural Punjab for the year Source: Field Survey. 2008, i e, 1,84,62,672 persons (calculated incurring an annual production expendi- credit acquired. Moreover, credit which on the basis of state’s average annual ture of Rs 51,526 or Rs 12,268 per acre (as was sought for agricultural production population growth rate of previous average farm size of sample small farmers purpose was diverted to other purposes decade, i e, 2.1% per annum) is much in 4.2 acres). which were mostly unproductive like higher – nearly 3,693 SCs, 615 PHCs, and c onsumption of liquor, social/religious 154 CHCs are required which outstrips the Credit Acquisition ceremonies, etc, resulting in accumulation actual availability of these institutions Credit was acquired by marginal and of the debt burden on the farmers. The (Table 3, p 24). small farmers for various purposes/uses miscellaneous category includes credit Due to the existence of a smaller number from various sources. The maximum credit taken for purchase of two-wheelers, tele- of public health institutions than their was acquired for production by both mar- visions, mobile phones, etc. Under this a ctual requirement, these institutions in ginal and small farmers, i e, nearly 46.4% category nearly 4.9% and 3.5% of total rural areas are overburdened in terms of and 40.9%, respectively of the total credit credit was acquired by marginal and small both area and the number of persons de- taken (Table 2). farmers (Table 2). pendent on them. On an average, one PHC Short-term production credit which is covers nearly 100 sq km, whereas one CHC 68.4% and 62.7% for marginal and small Healthcare Credit caters to 383 sq km of area. One doctor is, farmers was acquired for purchase of agri- Healthcare credit had a major share in the therefore, available for 26 villages (on an cultural inputs such as seeds, fertilisers total borrowing by marginal and small average basis), as one PHC is available for and agrochemicals, whereas medium- farmers as cheap medical facilities 26 villages. And one CHC is available for long-term credit was acquired for pur- through government health services were every 101 villages, which sounds unbeliev- chase of farm machinery, implements, inadequate, and not available at times. able. Some of the basic facilities in these farm buildings, livestocks, irrigation There are fewer subcentres (SCs), primary government health institutions are not structures, etc, and it was estimated to be health centres 38.9% and 31.3% for marginal and small (PHCs) and commu- Table 2: Credit Acquisition by Marginal and Small Farmers for Different Purposes (in Rs /farm) farmers, respectively. The second impor- nity health centres Short-Term Credit Medium/Long-Term Credit Total Credit Use of credit Marginal Small Marginal Small Marginal Small tant purpose for which credit was acquired (CHCs) than their Production purpose 7,794 13,547 12,930 1,75,304 20,724 28,851 by marginal and small farmers was for actual requirement (68.4) (62.7) (38.9) (31.3) (46.4) (40.9) health reasons, i e, nearly 20% and 23.2%, in the rural areas of Consumption purpose 536 691 2,859 3569 3,395 4,260 respectively.
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