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Education, Health and Womens Empowerment Keralas Experience

in Linking the Triad

K.R. Lakshmy Devi*

Empowerment of women by means of income generating activities is a new orthodoxy in
development discourse which signifies a paradigm shift from women in development to
gender and development and subsequently to gender empowerment. Education and
health are the two important determinants of womens economic participation and thus
have a powerful influence on their ability to control their environment and their lives. At
the same time, education and health are also the two important areas in which persistent
gender inequality exist. Taking the cue from Keralas experience, this paper is an attempt
to hypothesize that better achievements in the areas of education and health can lead to
lesser degree of gender inequality and better prospects for womens economic
participation. This in turn paves the way for greater gender development and better
empowerment of women.
Key words: Gender Equality, Gender Development, Gender Empowerment

Professor, Department of Economics, University of Calicut

Womens empowerment and their full participation on the basis of
equality in all spheres of society including participation in the decision
making process and access to power are fundamental for the
achievement of equality, development and peace
(Paragraph 13, Beijing Declaration)

Empowerment of women is a process, a continuum of several interrelated and mutually

reinforcing components. UNDPs Gender In Development Policy (GIDP) has interpreted
empowerment in a comprehensive manner. The policy aims at, among other things,
providing women with access to empowering facilities like education and training. But,
equally important is the provision of good health because good health is an essential
prerequisite not only for womens participation in economic activities but also for their
better control of their own lives .The experience of Kerala in this regard is note worthy
and holds promise for others to follow the example.
Kerala the tiny state in the southwest corner of the Indian sub continent was very little
known outside India even a decade ago. But the state began to draw the attention of
researchers from all over the world when the so-called Kerala Model of development
became a part of the broad global debate about the ideal pattern of development in the
third world. If the process of development is to be assessed ultimately in terms of what
it does to its people, Kerala has every reason to be euphoric. Experience shows that there
is no direct correspondence between the economic growth of a nation and the quality of
life of its people. Countries and regions with high levels of economic growth are not
necessarily those with high levels of social attainment. On the other hand countries and
regions with low economic profile may turn out to be providers of better and equitable
social gains/opportunities to its people. Kerala provides the best example of the latter.
The development experience of the state of Kerala powerfully picturises how even
economically poor states could transform the lives of its people and attain high levels of
social development. This tiny state with a per capita income of one sixtieth of that of the
United States of America has achieved very high levels of social development, mainly in
terms of health and education, which compare favourably with that of the U.S averages.
In attempting to document the reasons behind the success of the Kerala model,
researchers have drawn attention to the states history of progressive redistribution
measures like land reforms, and a wide network of the public distribution system (Franke
and Chassin, 1995). Beyond the redistribution aspects, many researchers find comfort in
attributing Keralas development to historical factors, the welfare oriented policies of the
state government especially with regard to education and a generous minimum wage, and
the role of a socially engaged population (See, Kapur, 1998 for a summary). Critics of the
model on the other hand highlight the paradoxes of social development without economic
growth that the Kerala experience has become synonymous with (Tharamangalam, 2003).
Despite the plethora of literature on the sustainability or the lack thereof in the Kerala
story, very few studies have chosen to highlight the accomplishments of women in the
human/social development of the state. It is the purpose of this paper to bridge this
caveat by explicitly examining the role and agency of women in Keralas successes with
social growth and through that to their empowerment.

The Role of Women in Keralas Development: A preliminary analysis
Kerala has often been referred to as the land of women. Historically the state has been
quite different from the rest of the country in terms of the indicators of womens
development. Starting with the turn of the last century, the state had a favorable sex ratio
(1004) which gradually picked up and reached 1058 in 2001. This should be compared to
the all India figures, which in 2001 stood at 933. The 2001 census reflects that Kerala is
the only Indian state where the sex ratio is above the equality ratio and is at a hundred
year high. Similarly in terms of literacy, life expectancy, and mean age at marriage,
women in Kerala score higher than their counterparts elsewhere in the country. In 1950
when India became a democratic republic, the female literacy rate at the national level
was merely 7.9 percent. Keralas female literacy at the same time was four times higher
(32 percent). Similarly in 1950, while the female life expectancy at the national level
was only 31.7 years, the same was 42.3 years in Kerala. Thus historically a favorable
ground was set for Kerala women while most of the Indian states were deplorably poor in
this regard. Perhaps this paved the way for the outstanding achievement of Kerala in
terms of women's development, and as a result, the increase in the overall human
development. Today Keralas female literacy is 88 percent (54 percent at the national
level) and life expectancy is 72.4 years (60.4 years at the national level).
The Kerala model of development owes its attributed success to the achievements in the
areas of health and education where the contribution of women is particularly significant.
Several factors have contributed to the success. The matriarchal system that prevailed
among some of the dominant communities in the past, the progressive social movements,
government policies, and a historically conducive climate are a few of the other factors
that have been identified as contributors to the success of women in Kerala. The
traditional matriarchal system gave women the freedom to access several services that
have not traditionally been offered to women. Education is among the opportunities
offered to females in Kerala. The first girls school in the private sector of the state was
established in 1819. In the following years, a Government Girls School (1859) and a
training school for women teachers (1887) were opened. These early achievements in
literacy and education have positively influenced the status of women in the state. Hence
in addition to not being outperformed by men in their achievements in education and
health areas, women have also played a substantial role in the development of these two
sectors in the state. In fact statistics (from different human development reports) indicate
that women have contributed more than men in the development of education programs
and health sectors of the state. This fact is overlooked by those who analyze and praise
the so-called Kerala model. Without the contributions of women in the development of
Kerala, the Kerala Model would be nonexistent.
Keralas high levels of human development and gender development and the consequent
gender empowerment is the result of its achievements in the field of health and education
for women. Data given in tables 1 and 2 clearly indicate the better status of women in
Kerala in terms of education and health compared to their counterparts in other states. In
Table 1, data on four indicators on education namely female literacy, the gender gap in
literacy, enrolment and dropout rates in primary schooling level for major Indian states
are given. As could be seen from the data, Kerala has the highest female literacy, lowest
gender gap in literacy and lowest primary school drop out rates for girls. While literacy

rate is affected by a variety of factors like availability of school teachers, availability of
equipment and infrastructure, the gender gap in literacy is the result of general attitude of
society towards girls education. Keralas low gender gap in literacy thus points out to its
progressive attitude towards girls education. Even though Keralas enrolment rate for
girls in primary schools is not the highest, its drop out rate is the lowest, thereby implying
a very high retention rate for girls at the primary school level. Many of the states like
Rajastan, U.P., Bihar and West Bengal, have a low enrolment and high dropout rate
implying a very low retention rate. This is the dangerous sign because, in such states,
very few girls reach higher levels of education. This has a cumulative effect in pushing
women to low paid informal sector jobs which do not require any special education or
skills. Low education further impacts upon their health through lack of awareness about
various health programmes for women. Kerala womens better educational status
perhaps may be a forerunner of their better health status.
The indicators selected to reflect the health status of women are mean age at marriage,
total fertility rate, percentage of women with anemia, maternal mortality rate and female
infant mortality rate. The data on these are given in Table 2 .The better health status of
Kerala women are easily demonstrated by the data presented in Table 2. Kerala has the
highest mean age at marriage for women. Early marriage is often interpreted as a
negation of womens autonomy and independence. In many states the mean age at
marriage is less than the stipulated minimum of 18 years. Similarly Kerala has the lowest
total fertility rate and lowest percentage of women with anemia. Keralas maternal
mortality rate is also much lower than the all India average even though a few states have
still lower rates. Several researchers have pointed out that high maternal mortality is the
outcome of general poor conditions of health rather than risks involved with child birth.
Keralas female infant mortality is significantly lower than all other states. All these
clearly indicate the better health status of Kerala women.
Keralas achievement in human development is in fact the outcome of the better status of
women in terms of education and health .Today, Kerala ranks first among the Indian
states in terms of performance on the Human Development Index (HDI), Gender Equality
Index (GEI) and Gender Empowerment Measure (GEM). States such as Haryana and
Punjab, which have very high levels of economic development and per capita income
have greater gender disparity and lower overall levels of human development compared
to Kerala. Also the degree of gender empowerment is much lower in these states
compared to Kerala. By contrast states such as Kerala, Maharashtra, Karnataka and
Tamilnadu rank high in terms of gender development, as well as overall human
development (see Table 3). The National Human Development Report 2001 defines
gender development in terms of a newly developed index called the Gender Equality
Index (GEI). It gives the attainments of women as a proportion of the attainments of
men for the same set of variables used in the construction of HDI. Thus, the average
attainments of women were the highest in Kerala ,83% of the attainments of men,while
at the national level it was only 68%. It is a clear indication of the fact that Kerala had
the highest gender equality in the entire country. These findings prompt the following
hypothesis. Economic development per se does not guarantee gender equality and that
gender development is a pre-requisite for overall human development. And also gender
development in terms of better educational and health attainments leads to greater gender

A further analysis of the role and significance of womens agency on Keralas
development pattern utilizes the Euclidian Squared Deviations Method. It measures
the development distance between the different states with the help of different
development indicators. In this analysis, 11 indicators for womens development for 16
major Indian states are identified and are taken from the National Human Development
Reports. The data in Table 4 clearly indicates that women in Kerala experience
significantly better living conditions than their counterparts elsewhere in the country. In
particular, Table 4 depicts that significantly higher values exist for the state of Kerala on
almost all the development indicators, relative to the rest of India. For example, female
infant mortality rate (X3) in Kerala is lower at 41 per thousand, than all the other Indian
states and also the all India rate of 79 per thousand. The female literacy rate (X7), depicts
that Kerala is far above all the other Indian states, at 87.86 percent and also much higher
than the all India rate of 54.03 percent.
A Squared Euclidian Coefficient Matrix( Table 5) has also been constructed to better
explain the distance between states with regard to womens development, by using the 11
above defined variables. Thus, the (i,j)th element in the Squared Euclidian Matrix
measures the distance with respect to the 11 indicators between the ith and jth States.
Dij2 = ( X1i X1j)2 + (X2i X2j)2 + ..+(X11i X11j )2
The cell entries in Table 5 provide a summary measure of the development
distance between any two given states, taking all the eleven indicators together. For
example, the elements in the 8th column and the 8th row are the summary measures of
Keralas female development distances from 15 other major states. Clearly, the entries in
this column and row are the highest in value, in comparison to the development distances
of all other states with only a few exceptions. Womens achievements in Kerala widely
differ from those of their counterparts in other states. Moreover, a comparison of the
absolute values of the 11 selected development indicators given in Table 4 for various
states, taken individually, also clearly indicates that the values for Kerala are much higher
than those of other states. Thus, women in Kerala are far better than their counter parts
elsewhere in the country in terms of indicators of health and education. Not only that,
they are almost on a par with their male counterparts in this regard.
Feminist researchers and development planners believe that lesser the inequality between
the sexes greater is the gender empowerment. Keralas experience really endorse this
belief. To demonstrate this, the present paper employs a simple regression where GEM is
regressed upon GEI (as an independent variable) using state wise data for major Indian
states. The results of the regression( Table 6) substantiates that higher levels of GEI are
associated with higher levels of GEM. As Table 6 indicates, the coefficient for GEI (the
X variable) is not only positive (0.9671) but statistically significant as well. This is
indicative of a strong direct relationship between the GEM and GEI. Already there is
evidence that countries with worst GEM ranks, Mauritania (94), Togo (93) and
Pakistan(92) also have high incidence of poverty (UNDP 1997). The present study takes
this cue further and tries to correlate gender equality with gender empowerment. Table 6
provides support for the assertion that empowerment depends significantly on the
equality of sexes. In sum Tables 4, 5, and 6 demonstrate that gender plays an important
role in the human/social development of Kerala and that empowerment of women is
positively related to equality between the sexes.

The foregoing analysis demonstrates that gender equity and the agency of women appears
to have played a significant role in Keralas human development. These achievements in
development by women have contributed significantly to the overall development pattern
of the state that is often referred to as the Kerala Model of Development. Indeed there
have been detractors that question the sustainability of the pattern of development Kerala
has come to typify. Many observers have pointed to the worsening fiscal situation, the
prolonged economic stagnation, and the high unemployment rate in Kerala as indicators
of the non-viability of the model. More over the increasing violence and crimes against
women give us little reason to be euphoric. How ever, in light of our empirical analysis
we must acknowledge the role of women in Keralas achievements in health and
education and through that on womens empowerment.

Table 1
Indicators of Womens Education
Female Primary School Primary School
Gender Gap in
State Literacy Enrolment 1999- Dropout 1999-
Literacy 2001
2001 2000 2000
Bihar 33.57 61.46 58.64
U.P 42.98 50.18 62.16
Rajastan 44.34 83.81 62.68
M.P 50.28 102.4 22.97
Orrissa 50.97 91.48 44.38
A.P 51.17 101.39 41.23
Assam 56.03 105.36 42.20
Haryana 56.31 82.98 12.78
Karnataka 57.45 105.87 27.19
Gujarat 58.60 101.43 28.10
West 17.36
60.22 94.86 58.48
Bengal (19)
Punjab 63.55 81.71 20.15
Tamil Nadu 64.55 98.62 39.19
Maharashtra 67.51 112.32 21.72
Kerala 87.86 84.74 -5.00
All India 54.16 21.69 85.18 42.28
Note: Figures in brackets are rank on the basis of the intensity of gender gap
Source: Column 2&3, Census of India 2001; Column 4 &5- government of India, Selected
Educational Level Statistics, 2001, Ministry of Human Resource Development

Table 2
Indicators of Womens Health
Percentage of Infant
Mean age At Total Maternal
State women with Mortality for
Marriage Fertility Mortality
anemia girls
Bihar 16.95 3.31 63.4 452 62.3
U.P 17.27 3.99 48.7 707 83.5
Rajastan 16.67 3.78 48.5 670 83.9
M.P 16.62 3.31 54.3 498 89.5
Orrissa 17.96 2.46 63.0 367 96.0
A.P 16.81 2.25 49.8 159 63.5
Assam 18.23 2.31 69.7 409 76.4
Haryana 17.88 2.88 47.0 103 78.4
Karnataka 18.00 2.13 42.4 195 56.7
Gujarat 19.01 2.72 46.3 28 64.8
West Bengal 17.21 2.29 62.7 266 43.0
Punjab 19.70 2.21 41.4 199 56.4
Tamil Nadu 19.12 2.19 56.5 79 54.5
Maharashtra 17.91 2.52 48.5 135 48.5
Kerala 19.85 1.96 22.7 198 15.3
All India 17.68 2.85 51.8 407 70.8
Source: Column 2- Census of India 2001; Coolum 3 & 4 National Family Health
Survey 2000; Column 5 & 6 Sample Registration Bulletin 2000

Table 3
HDI ,GEI and GEM for 16 Major Indian States
HDI 1991 GEI 1991 GEM*
Value Rank Value Rank Value Rank
Andhra Pradesh 0.38 9 0.80 3 0.51 8
Assam 0.35 10 0.58 11 0.46 11
Bihar 0.31 12 0.47 13 0.45 12
Gujarat 0.43 6 0.71 6 0.56 3
Haryana 0.44 5 0.71 6 0.53 6
Karnataka 0.41 7 0.75 5 0.55 4
Kerala 0.59 1 0.83 1 0.63 1
Madhya Pradesh 0.33 11 0.66 10 0.48 9
Maharashtra 0.45 4 0.79 4 0.60 2
Orissa 0.35 10 0.64 9 0.47 10
Punjab 0.48 2 0.71 6 0.54 5
Rajasthan 0.35 10 0.69 7 0.48 9
Tamil Nadu 0.47 3 0.81 2 0.52 7
Uttar Pradesh 0.31 12 0.52 12 0.47 10
West Bengal 0.40 8 0.63 10 0.53 6
India 0.38 0.68 0.51
Note:* - Figures for GEM are taken from Asha Kapoor Mehta : Recasting Indices for
Developing Countries: A Gender Empowerment Measure, EPW, October 26,1996
Source: Planning Commission National Human Development Report, 2001

Table 4
Selected Development Indicators for Women in 16 Major Indian States
Indicators X1 X2 X3 X4 X5 X6 X7 X8 X9 X10 X11
AP 978 63 51 7.4 54.2 49.8 51.7 46.7 4.17 20.92 0.801
AS 932 56.6 87 9.9 24 69.1 56.03 42.9 4.3 42.99 0.575
BI 921 58.2 89 10.2 26.3 63.4 33.57 26.1 3.66 7.07 0.469
GJ 921 62.5 82 7.5 44.6 46.3 55.61 57.1 4.69 45.54 0.714
HA 861 64.3 54 8 27.4 47 56.31 56.2 4.78 24.15 0.714
HP 970 61.4 81 7 63.4 40.5 57.08 70.7 5.12 41.02 0.858
KN 964 64.5 72 7 45.4 42.4 57.45 57.2 4.34 25.95 0.573
KR 1058 75.8 41 4.9 35.3 22.7 87.86 91.1 5.48 74.31 0.825
MP 920 54.7 136 10.9 50.7 54.3 50.55 40.9 4.42 18.11 0.662
MH 922 66.2 76 6.7 46.3 48.5 67.51 65.1 4.64 41.59 0.793
OR 972 56.6 111 10.7 40.6 63 50.97 48 4.09 20.74 0.639
PU 874 68.6 53 6.8 33.9 41.4 63.55 63.2 4.96 31.03 0.71
RJ 922 59.6 79 8.7 50.2 48.5 44.34 26.3 3.83 8.31 0.692
TN 986 64.8 51 7.2 47.6 56.5 64.55 74.8 5.2 34.89 0.813
UP 898 56.4 104 10.6 29.1 48.7 42.97 28.8 4.33 10.69 0.52
WB 934 63.1 51 7.3 22.2 62.7 60.22 42.4 4.03 28.87 0.631
INDIA 933 61.4 79 8.6 38.5 51.8 54.03 45.4 4.46 23.76 0.676
Note: X1 - Sex Ratio 2001
X2 - Female Life Expectancy 1992-96
X3 - Female Infant Mortality 1991
X4 - Female Death Rate 1997
X5 - Female Labor Force Participation Rate 1999-00
X6 - Percentage of Women with anemia 1998-99
X7 - Female Literacy Rate 2001
X8 - Female enrolment in schools 6-11 age 1991
X9 - Intensity of Female education* 1993
X10 - Literacy Rates for Schedule Caste Women 2001
X11 - Gender Equality Index 1991
* Is the weighted average of the enrolled students from class I to class XII to the total enrolment in Classes I to XII, the weights being 1
for class I, 2 for class II and so on
Source: Human Development Report , 2001

Table 5
Squared Euclidian Distance Matrix

AP 0.00 5268.95 6613.56 5048.97 14553.61 2153.69 946.63 13931.43 10744.64 4868.86 4048.85 11862.73 4572.89 1320.59 10386.43 3290.07
AS 0.00 2242.79 1339.26 7225.03 4660.35 2987.57 24985.08 4134.61 1871.80 3036.13 6151.05 2900.39 6158.93 3300.37 1610.47
BI 0.00 3629.90 6853.38 8083.07 4888.20 34845.40 3530.77 4733.88 4261.91 7017.52 1016.08 10330.75 1090.54 3114.04
GJ 0.00 5142.66 2998.30 2356.39 24301.51 4131.13 280.28 4501.69 3537.07 2518.52 5811.33 3481.18 2416.79
HA 0.00 14453.24 11284.93 44502.70 11205.63 5078.59 16174.69 412.32 6179.77 16662.57 5054.08 5842.04
HP 0.00 864.33 13134.14 7392.91 2849.24 2931.83 11120.90 5757.67 1783.44 9870.04 5348.87
KN 0.00 14833.17 6687.73 2229.32 2262.35 8710.50 3338.27 1569.62 7013.10 2528.73
KR 0.00 36857.60 22764.47 20440.65 37649.93 31556.30 9067.08 40637.61 22617.25
MP 0.00 5231.55 3567.96 10497.18 3663.85 13338.56 2267.85 8599.02
MH 0.00 5076.93 3173.85 3222.28 4936.96 4642.01 2292.05
OR 0.00 14134.60 4508.83 5070.88 6395.50 5619.48
PU 0.00 5628.82 13128.83 5437.66 4674.35
RJ 0.00 8449.13 1674.17 2861.99
TN 0.00 14206.39 4496.65
UP 0.00 5217.53
WB 0.00

Note: AP-Andhra Pradesh, AS-Assam, BI-Bihar, GJ-Gujarat, HA-Haryana, HP-Himachal Pradesh, KN-Karnataka, KR-Kerala, ,MP-Madhya Pradesh, MH-Maharashtra, OR-Orissa, PU-Punjab,
RJ-Rajasthan, TN-Tamil Nadu, UP-Uttar Pradesh, WB-West Bengal
Source: Computed by the author

Table 6
Regression Results
(The regression equation is of the form: GEM= a + bGEI +u)
No. of Standard Adjusted
Co-efficient t-Value
Observations Error R-Square
15 Intercept 0.06211 0.038826 1.599698 0.870651
X-Variable 0.967148 0.099105 9.758814

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