One of the great challenges facing India is the provision of public services effectively and efficiently to its 1.2 billion citizens. This is particularly critical for India’s rural population, especially women and children, who are disproportionally affected by poor health in the country. With an extraordinarily dense population, adaptation to climate-related risks also is a key priority for the government.

The Earth Institute’s experts advise on socio-economic and climate risk-related policy issues, collaborating with state governments around the country.

India offers an array of sustainable development opportunities and challenges. Our teams are working at the request of government agencies around the country to support public policy and applied research. We apply scientific expertise and evidence-based knowledge for the development of national and regional strategies that support stronger health systems, education programs, and climate resiliency. Our efforts primarily fall within the scope of the Model Districts project and two projects on enhancing climate resilience in Assam.

Model Districts Program

The Model Districts program is a collaborative, five-year demonstration program led by Dr. Nirupam Bajpai , Senior Development Advisor, Center for Sustainable Development, The Earth Institute, Columbia University, New York. Housed at the Columbia Global Centers | South Asia, the project, which is funded by the IKEA foundation and works with the Government of India and key stakeholders in selected rural districts of India. At the request of the Government of India, between 2006 and 2013, the Earth Institute convened an International Advisory Panel that met biannually to review the progress on the country’s National Rural Health Mission, which committed to increased health spending with the aim of improving quality of care, particularly in rural areas. The Earth Institute has since tracked progress, conducted evaluations, and made relevant policy recommendations.

The Model Districts project was created to implement the recommendations from the Mid-Term Evaluation of the NRHM, conducted by the Earth Institute in 2009. The project was commissioned with the specific aim of helping India achieve Millennium Development Goals 1, 2, 3, 4 and 5: for health, improving the nutrition status of women and children, and reducing maternal and child mortality; and for education, addressing issues of universal access to primary education, gender equality, and the prevalence of poverty by 2015. From 2016 onwards the projects will focus on India achieving the “Sustainable Development Goals” that the Millennium Development Goals will transition onto.

Education Project

The Model Districts Education Project | Access to Achievement (MDEP) focuses on the Morigaon district of Assam and the Medak district of Telangana. The purpose of the project is to improve the quality of primary education by developing and testing an evidence-based model of primary education that is “locally owned and operated” yet readily adaptable for other locales. Our program demonstrates that a relatively modest, targeted set of innovations and resources can significantly improve the quality of education, even in low-resource rural settings.

The MDEP team conducted studies to identify the challenges in the curriculum, teacher training and conducted in-depth needs analysis on a host of education indicators (infrastructure and quality related) and determined the student’s learning levels in the two districts. Based on the findings of these studies, MDEP suggested a comprehensive package of interventions that address the holistic development of children under the vision of “School as a Way of Life”. These recommendations attempt to address a package of interrelated services that are likely to improve enrollment, grade completion, and educational quality. These interventions are in seven areas; early childhood education, nutrition, health, physical education, school as a safe space, multi-grade multi- level pedagogy, and community-school partnership.

MDEP also contributes to educational policy research in India, building the government’s capacity for teacher training, curriculum analysis, and the development of model schools. This approach is meant to address and target educational issues in policy and interventions; governments and communities; and theory and practice. At the core of our program we have advocated for international best practices and strategies to improve primary education in India, and to set examples for effective public-private partnership models in education.

Please refer to the Model Districts Education Project | Access to Achievement (MDEP) website for more information on the project.

Health Project

The Model Districts Health Project team works with state, district and block officials and development partners to improve the delivery of maternal and child health services in the six districts of Rajasthan, Jharkhand and Telangana, reaching out to a total population of about 11 million. The focus is provision of implementation research, technical advice, data-driven planning, monitoring and evaluation, and policy advocacy to help ensure the successful scaling up of quality services, and coordination of efforts in these districts. The overall goal is to support these districts and states in their efforts to achieve lower rates of maternal, peri/neonatal, infant and child mortality.

Despite some impressive gains being made in the country since the launch of the National Rural Health Mission in April 2005, India’s achievements in the field of public health leave much to be desired and the burden of disease among the Indian population remains high. Infant and child mortality and morbidity and maternal mortality and morbidity affect millions of children and women. An extensive primary healthcare infrastructure provided by the government exists in India. Yet, it is inadequate in terms of coverage of the population, especially in rural areas, and is underutilized because of the dismal quality of healthcare being provided. In most public health centers which provide primary health care services, drugs and equipment are in short supply, there is shortage of staff and the system is characterized by endemic absenteeism on the part of medical personnel due to lack of control and oversight among other reasons.

As a result, most people in India, even the poor, choose expensive healthcare services provided by the largely unregulated private sector. Not only do the poor face the double burden of poverty and ill-health, the financial burden of ill health can push even the non-poor into poverty. On the other hand, a healthy population is instrumental both for poverty reduction and for economic growth, two important developmental goals. In India, public spending on health is slightly above one percent of its GDP, which is grossly inadequate. Additionally, the health system needs to be reformed to ensure efficient and effective delivery of good quality health services.

The average figures for India hide a great deal of variation in the performance of different states, which are on different points along the health transition path. Health transition has three components: demographic, which involves lowering of mortality and fertility rates and an aging population; epidemiological wherein the pattern of diseases prevalent in the population changes from communicable diseases to non-communicable diseases such as the chronic diseases of adulthood; and social whereby people develop better ability to self-manage their health and have better knowledge and expectations from the health system. While Kerala, Maharashtra and Tamil Nadu are much further along in the health transition trajectory, the densely populated states of Orissa, West Bengal, Bihar, Rajasthan, Madhya Pradesh, and Uttar Pradesh are still in the early part, with the other states falling in between.

Please refer to the Model Districts Health Project website for further description and details.

 Managing Climate Risks in Assam

Assam is one of the most hazard-prone states of India, being vulnerable to multiple natural hazards including floods, landslides, cyclonic storm and earthquakes. Guwahati, the state capital, is the largest city in northeastern India with a population close to one million. Despite its critical importance to the governance and economic well-being of the state and region, Guwahati does not have a systematic adaptation strategy to help assess climate risks, dynamically map vulnerability, and plan/design infrastructure and land use to enhance climate resilience of the city. Rapid and unprecedented urbanization and the threats posed by climate change are creating new challenges for city authorities and residents.

With the Assam government providing funds, our team is working with the Assam State Disaster Management Authority and Indian partners to develop contextualized solutions to enhance the resiliency of Guwahati to the impacts of climate extremes. The goal is to assist decision-makers at a variety of levels including state, metropolitan, and city levels to better manage climate and disaster risks.

In addition, the Columbia Water Center at the Earth Institute is advising the state government on Brahmaputra River flooding from the impacts of climate variability and change.

Please contact Kye Baroang for more information.