Development Economics

Social sector/ Infrastructure Developement

Instructor: Mamona Sadaf

 Social Infrastructure and Development

Human capital is the term economists often use for education, health
and other human capacities that can raise productivity

Health Education

Their dual role as both inputs and outputs gives health and education
their central importance in economic development.
Improvement in productive efficiency
from investment in education raises the
return on a lifesaving investment in
health.

Greater education capital may improve the return to investments in health

Greater health capital may improve the return to investment in education

Education is also needed for the formation and training of health personnel
Health programs rely on basic skill often learned at school, including personal hygiene and sanitation
Health Sector
1. Improvement in income of households does not necessarily
lead to improvement in nutrition and education of their
children.

2. An increase in income frequently allows families to switch

consumption

3. Morbidity did not necessarily decrease significantly with

income.

4. A mother’s basic health knowledge had a positive effect on

her children’s health

5. Health status, once achieved, also affects school performance.

 Education

Health

Capabilities
6. With higher income people and governments can afford to
spend more on education and health;

7. with greater health and education, higher productivity and

incomes are possible.

8. Because of these relationships, development policy needs

to focus on income, health, and education simultaneously.

9. New Growth Theory suggests that continuous capital

formation is the key to growth and human
 Health Sector in Pakistan Year Life Life Infant
Expectan Expectan Mortality
cy cy
(Women) (Overall)

1965 44.5 45.8 149

• Life expectancy of both male and 2008 62 63.5 82
female has continued to increase over
the years.
• Similarly, infant mortality rate has also
fallen.

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Common Diseases
• Most of the diseases in Pakistan are caused by
inadequate and contaminated sources of water.
• In the year 2002 about 40% and 60% population in
Pakistan had no access to clean drinking water and
sanitation, respectively.

40%

60%

No Access to clean drinking water No Access to sanitation

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Cont.,
• The most widespread disease:
• typhoid,
• cholera and
• intestinal infections,

• All are mostly result of poor water and sanitation availability!

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Issues In Health Sector
• Health care in Subcontinent before colonization
was primarily based on preventive measures.

• Curative medicine was used on natural and

herbal substances and

• surgery was used in extreme cases only.

Todaro, M. P., & Smith, S. C. (2010). Economic development.

 Bias in health provision
Source

Types of treatment Regional Income Level Quality by Sector

Preventive/Her
Curative bal Urban Rural Rich Poor Govt. Private

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Cont.,
• During colonial era medical and public health
services was subordinated to commercial, political
and administrative interest of imperial government.
• After independence rich classes were integrated to
consume modern medical care.
• Rulers of independent Pakistan largely continued
this practice.
• Health care system in Pakistan is inequitable.
• The system is based on curative care that does not
fulfil the requirements of a great majority of people
in Pakistan.
Todaro, M. P., & Smith, S. C. (2010). Economic development.
 Cont.,
• Health system in Pakistan is
urban biased.
• most of the medical personnel
and health facilities are found
in the cities.
• 85% of all practicing doctors
work in the cities.
• doctor-population ratio in
urban areas is 1:1801.
• In rural areas it is 1:25829 .
Todaro, M. P., & Smith, S. C. (2010). Economic development.
Reasons for biasedness
• Since the dominant classes live in the cities, the best facilities are also
located there.
• Due to lack of facilities in rural areas.
• Lack of incentives.
• Health system is not only urban-biased, but it primarily favours rich classes.
• Landlords can easily access to these facilities although they basically belong
to rural areas.
• not all urban inhabitants have equal access to health facilities

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Cont.,
• Health education is primarily based on Western experience.
• there exist differences in common diseases and their diagnostics
between West and East.
• in the West cardiovascular diseases are common.
• whereas in the East diseases of poverty, such as typhoid, cholera,
malaria, and most infections, are common.
• Western educational content is a cause of medical brain drain from
Pakistan to the West.

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Overview
• Health care is a reflection of the social, economic and political structure of a
country.
• In aggregative terms health care in Pakistan improved over time
• The ratio of population per (hospital) bed is improved.
• However, this ratio is far less in Pakistan than in other developing countries.
• Government in Pakistan spent meagre resources, i.e. only 0.7% of GDP on
health.
• Private sector provides health care for rich classes is more than 50% of total
health services.
• Rural health centres reflect unmanned and unsupervised health services.

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Policies
• Need to decentralize health care system in Pakistan.
• Local governments can be given responsibility in terms of finances
and skill to supervise smallest health facilities in rural areas.

• Government can encourage indigenous system of health care.

• This may include development of Tibbi and Homeopathic medical
colleges and alternative medicine.

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Education Sector

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Literacy Situation

• Literacy is one of the three basic

components in HDI.
• Although literacy rates in Pakistan
have been improving over time.

• Literacy rate in Pakistan is one of the

lowest in the world, and is worse than
countries which have per capita
income close to Pakistan’s level.

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Cont.,
Disparities
• Trends in literacy rates are not satisfactory.

Regional Provincial Gender

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Cont.,

• The level of female literacy rate, specifically in the rural areas of

Pakistan, is lower than male literacy rate.
• Comparing Punjab literacy rates in other provinces (excluding Karachi)
are under average literacy rate.
• Rural female literacy rates are lowest in Sindh and Balochistan
provinces.

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Trends in Enrollment Gross Enrollment Rate
80%
70%
60%

• gross enrolment rate at the primary 50%

40%

level for Pakistan has increased. 30%

20%
10%
0%

1992-03 2001-02

Dropout Rate
• The dropout in public sector primary 70%

schools for girls is more significant 60%

50%

than boys. 40%

30%

• rise in poverty levels and low 20%

expenditures on education are main 10%

0%

reasons. 1996-07

Dropout Rate Male

1999-2000

Dropout Rate Female

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Todaro, M. P., & Smith, S. C. (2010). Economic development.
• During 1960-2000 primary schools have in creased by nine times .
• primary school enrolment has gone up tenfold.
• number of professional colleges increased by two-and-half times
• number of students in professional colleges increased by six times.
• The biggest increase is in universities.
• number of students increased by twenty nine times.
• sevenfold increase in the number of universities.
• At all levels growth in enrolment was greater than growth in the number
of educational institution.
• However, classrooms and institutions are becoming congested by
increasing number of students
• It has a negative effect on educational standards.
Todaro, M. P., & Smith, S. C. (2010). Economic development.
Issues in Education Sector
• The educational system in Pakistan is at a low level of development.
• Dualistic structure,
• divide along class.
• Divide along medium of instruction.

Todaro, M. P., & Smith, S. C. (2010). Economic development.

• attempts were made in 1970s to reduce inequalities through
nationalization.
• the process was reversed in the 1980s.
• At present, at least half of the schools, especially in urban areas, are
in the private sector.
• bulk of private schools provide a quality which is only marginally
better than average public school.
•

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Reasons
• lack of any regulation and control of entry into the private sector is
main reason for poor quality.
• inappropriate curricula.
• poor quality of teachers’ training.
• poor quality of textbooks.
• improper teaching methods and techniques.
• Absence of link between market demand and output from the
educational sector.

Todaro, M. P., & Smith, S. C. (2010). Economic development.

Cont.,
• Poor governance, limited accountability , limited responsiveness to
clients and over-urbanization are also argued as major factors.
• Politicians and bureaucrats appoint teachers, who are often absent
from classes.
• Curriculum decisions are very centralized.
• Monitoring and evaluation activities have not been carried out.

Todaro, M. P., & Smith, S. C. (2010). Economic development.

 Policy Options

• High dropout can be addressed by reducing absolute poverty and

providing facilities to very poor household for sending their children
to schools.
• Educational disparity on gender and regional basis can be addressed
by creating awareness about the importance of education.
• Providing local educational facilities can also reduce disparities.

Todaro, M. P., & Smith, S. C. (2010). Economic development.