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Is India experiencing health convergence? An empirical analysis

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Abstract

A comprehensive study on health convergence based on beta (β), sigma (σ) and club convergence is attempted here across 26 Indian states over time using NFHS (1–4) data. We formulate an overall health index (OHI) from three sub-health dimensions like child, reproductive and general health based on selected health indicators. The results show that the states are improving in respect of OHI; there exist absolute β convergence in respect of OHI and its sub-dimensions; however, we find σ divergent in respect of OHI and its sub-health dimension indices except child heath index. The club convergence based on kernel density provides a clear picture about stratification, polarization and uni-modal distributions of states in respect of OHI; over time states are converging to a steady state at higher value of OHI, but in the long-run there exists ‘low level health trap’ among five major states like UP, MP, Rajasthan, Bihar and Assam. Except Rajasthan, all the four major states remain at the lower level in respect of sub-health dimensions too. These five major states roughly account for 50% of India’s population, and more than 50% of India’s future demographic dividend will emerge from these major states. Therefore, in order to reap the benefits of demographic return, a major investment in human capital is urgently needed. Such ‘low level health trap’ justifies the ‘big push’ theory to health. This analysis can be applied at the sub-state level for policy intervention.

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Acknowledgements

The authors are grateful to the Centre for Advanced Studies (CAS), Economics Department, Jadavpur University for providing access to data. The authors acknowledge the suggestions provided by an anonymous referee of this journal. The usual disclaimer applies.

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Authors and Affiliations

  1. Department of Economics, Muralidhar Girls’ College, Kolkata, 700029, India

    Sulekha Hembram

  2. Centre for Advanced Studies, Department of Economics, Jadavpur University, Kolkata, 700032, India

    Sushil Kr. Haldar

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Appendices

Appendix 1

See Table 9.

Table 9 Rank correlation coefficient between LEB and other health indicators, NFHS-1 to 4.
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Appendix 2

See Table 10.

Table 10 Factor loadings of CHI, RHI and GHI.
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Appendix 3

See Table 11.

Table 11 Result of absolute β convergence of CHI, RHI and GHI.
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Appendix 4

See Table 12.

Table 12 Gini coefficient and standard deviation of health parameters over time: NFHS-1 to 4.
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Appendix 5

5.1 Transitional probability matrices of each health sub-dimension

See Table 13.

Table 13 (A) TPM of child health index (CHI), (B) TPM of reproductive health index (RHI), (C) TPM of general health index (GHI).
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Appendix 6

See Table 14.

Table 14 Transitional patterns of states in respect of CHI, RHI and GHI from NFHS-1 to 4.
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Hembram, S., Haldar, S.K. Is India experiencing health convergence? An empirical analysis. Econ Change Restruct 53, 591–618 (2020). https://doi.org/10.1007/s10644-020-09269-6

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