Fase de ejecución

India was chosen as the case study for this project for three broad reasons: its consequentiality, its puzzling nature, and its “cruciality.” The consequentiality of the Indian case stems from the fact that India is a developing country home to one-sixth of the world’s women. Thus, the evolution of women’s social policy in India affects a large proportion of women in the (developing) world. To the extent that India is among the more powerful or influential of the developing countries active on the international stage,132 _{social policy in India is also likely to enjoy greater visibility across the world,}

multiplying the potential impact of its social policy model. For reasons of practical significance alone, then, India is a suitable case study for examination of maternalism in social policy in the global south.

Maternalism in India is also puzzling for three reasons: (1) decline in conservative attitudes on gender in recent years, (2) low public health expenditures, and (3) concerns about the low rate of women’s employment. Let us examine each in turn. Social attitudes toward gender in India today are less conservative than in decades past. For

132

See “India Ranks 7th among Countries with Positive Influence on Global Affairs: Survey”; Thakur, “India’s Growing International Clout.”

instance, compared to their parents and grandparents, young adults in India today express greater support for a range of ideas associated with gender equality (egalitarian marriages, sharing of childcare responsibilities, women’s equal access to education, women’s equal capacity for paid work, uniform treatment of sons and daughters,

women’s equal claim to inheritance) and greater condemnation of sexism and misogyny (as evidenced by falling approval of dowry-giving and violence against women).133

Although reliable panel surveys are rare, the limited time-series data that are available show similar patterns.134 _{A decline in conservative attitudes and a greater acceptance of}

non-traditional, non-familial roles of women sits uncomfortably with social policy that increasingly sees women through a familial lens.

Another reason India’s rising maternalism, most of which manifests as rising policy effort on maternal health, is puzzling is the country’s otherwise low public health expenditure, widely known to be “one of the world’s lowest.”135 _{In 2014, for instance,}

public health expenditure in India equaled 1.4% of GDP.136 _{At around the same time}

public health expenditure in the United States was 8.5% of GDP, and that in India’s

former colonizer, the United Kingdom, was 7.7%.137 _{The corresponding share for the set}

of countries considered India’s international peers ranged from 3.1% in China, 3.7% in

133

Shukla, “Attitudes towards Role and Status of Women in India: A Comparison of Three Generations of Men and Women,” 124; UN Women, “Making Women Count: An Annual Publication on Gender and Evaluation by UN Women Multi Country Office for India, Bhutan, Sri Lanka and Maldives,” 90.

134 _{See Jensen and Oster, “The Power of TV: Cable Television and Women’s Status in India.”} 135 _{“In Budget Speech, Few Specifics on Health Care;” Kumar, “Swine Flu Outbreak: Blame Govt’s}

Shamefully Low Pubic Health Expenditure;” Mohan, “Why India’s Healthcare Trends in 2016 Do Not Bode Well for the Future;” Kurian, “Financing Healthcare for All in India: Towards a Common Goal,” 3; Chaudhary, “Why Price Control for Medical Devices Is Flawed and Counter Productive.”

136 _{The World Bank, “Health Expenditure, Public (% of GDP).”}

Russia, and 3.8% in Brazil to 4.2% in South Africa.138 _{India’s public health expenditure}

thus lags behind not only the rich democracies but also the other members of the BRICS group. Yet, despite the overall shortfall in public health expenditure relative to its peers, in 2013-14, India spent nearly 66% of the funding earmarked for women-specific

programs on maternal health, as Figure 2.2 shows (and the following chapter describes in further detail). In other words, India, which otherwise has among the lowest public health expenditures in the world, spends most of the funds earmarked for women’s programs on women’s health – and especially on maternal health.139 _{This paradox, too,}

makes India’s maternalism puzzling.

Figure 2.2: Public expenditure on maternal health programs and other women’s programs in India140

138 _{The World Bank, “Health Expenditure, Public (% of GDP).”} 139 _{This is}

not to say that public spending on women’s health in India is sufficient. In fact, public health experts tend to agree that neither India’s total health spending nor total spending on women’s health is sufficient to meet the health needs of the country’s population. Yet, the overall inadequacy of health expenditure does not detract from the fact that a large proportion of women-specific funds is allocated to women’s (maternal) health. Thus, without taking a position on the overall adequacy of health expenditure for women, this project seeks to probe its composition of women-specific expenditure.

A final reason India’s maternalism presents a puzzle is that much concern has been expressed both domestically and internationally about the falling female labor force participation in the country. In rural areas, women’s labor force participation rate declined from 33% in 1993-94 to 25% in 2011-12. The corresponding trend in urban areas was less pronounced but occurred in the same direction: women’s workforce participation declined from 16.5% to 15.5% over the same period.141 _{Worries about this}

trend abound in scholarly and policy literature. Scores, if not hundreds, of articles and reports have been written to problematize the decline, and books devoted entirely to analyzing it are being published as well.142 _{Yet, despite the belief, expressed almost}

unanimously by those studying the decline of women’s labor market participation in India, that women’s labor market activation would do wonders not only for Indian women but also for the Indian economy, Indian social policy focuses increasingly on women’s maternal role and programs designed especially to encourage women’s higher education or enabling their labor market participation are conspicuous only by their absence, negligible funding, or limited coverage. The widespread concern over declining labor participation by women, too, makes the relative dearth of effort to increase

women’s economic participation – that is, the lack of a more individualistic social policy for women – puzzling.

141 _{Verick, “Women’s Labour Force Participation in India: Why Is It so Low?,” 1.} 142 _{Dasgupta and Verick,}

Transformation of Women at Work in Asia: An Unfinished Development Agenda; Bhalla and Kaur, “Labour Force Participation of Women in India: Some Facts, Some Queries”; Klasen, “Low, Stagnating Female Labour-Force Participation in India”; Klasen and Pieters, “What Explains the

Stagnation of Female Labor Force Participation in Urban India?”; Afridi, Dinkelman, and Mahajan, “Why Are Fewer Married Women Joining the Work Force in India? A Decomposition Analysis over Two Decades”; Lahoti and Swaminathan, “Economic Growth and Female Labour Force Participation in India.”

Beyond being a consequential and puzzling case, India is also a “crucial” case for existing explanations for maternalist social policy. In his work on the different types of case studies, Gerring (2009) argues that there are two types of crucial cases: the most- likely case and the least-likely case. The least-likely case is “one that, on all dimensions except the dimension of theoretical interest, is predicted not to achieve a certain outcome, and yet does so.”143 _{For our purposes, the “dimension of theoretical interest” – or, our}

key hypothesis – is the international spotlight on maternal mortality (see introduction and theory section below); the “outcome” in question is maternalist social policy; and “all [other] dimensions” are the three key predictors of maternalism derived from the historical welfare literature, which, as documented earlier in this chapter, are missing from the Indian setting.144 _{The absence of all (three literature-derived hypotheses) but}

one (hypothesis of this project) theorized explanations of maternalism means that, from the perspective of existing literature, India is least likely to exhibit maternalism in social policy. For this reason, if social policy maternalism in India is found to predominate, it would strengthen the case for the one theorized predictor present in the Indian setting. India thus meets the conditions for a least-likely case, making it, once again, a suitable case study for examining maternalist social policy.