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International audience ; This paper presents a novel approach to measure the human development, progress and growth of any country. The authors have developed an alternative index to the conventional 'HDI', named as 'Composite Development Index (CDI)' and have also presented an original approach to evaluate it quantitatively. The CDI integrates all the three (social, economic and environmental) aspects of sustainable development, along with peace and happiness. As proposed, the CDI is based on four parameters, i.e. Inequality adjusted HDI (IHDI), Scaled Green Index, Scaled Peace Index and Scaled Happiness Index, evaluated from globally accepted standard databases. Hence, the CDI is much more comprehensive and rational than the conventional HDI or GDP. The CDI values have been evaluated quantitatively for 126 countries of the world. Further, comparative assessment of the CDI has been done with the HDI for all the 126 nations. The results obtained have been startling as no country was even able to have a CDI score of 0.8 on a scale of 0.1 to 1. Switzerland had the highest CDI of 0.767. A country like Norway with the highest HDI of 0.953 had a CDI of only 0.742. On the other hand, countries like Costa Rica, Romania and Uruguay are in the top 20 nations in the CDI Ranking, much ahead of the countries like United Kingdom, France, and USA. The CDI can act as a single point of reference for policy-makers, governments and other development agencies, as it presents a consolidated picture of a country's development. Future course of action on the basis of the concept of CDI are also proposed. It can be concluded that efforts to have a high CDI (in comparison to a high GDP or HDI only) will pave the way forward for sustainable development and holistic progress for all the countries of the world. JEL Classifications: 011, 015 Additional disciplines (besides field of economics reflected in JEL classifications): sociology; ecology and environment.

International audience This paper presents a novel approach to measure the human development, progress and growth of any country. The authors have developed an alternative index to the conventional 'HDI', named as 'Composite Development Index (CDI)' and have also presented an original approach to evaluate it quantitatively. The CDI integrates all the three (social, economic and environmental) aspects of sustainable development, along with peace and happiness. As proposed, the CDI is based on four parameters, i.e. Inequality adjusted HDI (IHDI), Scaled Green Index, Scaled Peace Index and Scaled Happiness Index, evaluated from globally accepted standard databases. Hence, the CDI is much more comprehensive and rational than the conventional HDI or GDP. The CDI values have been evaluated quantitatively for 126 countries of the world. Further, comparative assessment of the CDI has been done with the HDI for all the 126 nations. The results obtained have been startling as no country was even able to have a CDI score of 0.8 on a scale of 0.1 to 1. Switzerland had the highest CDI of 0.767. A country like Norway with the highest HDI of 0.953 had a CDI of only 0.742. On the other hand, countries like Costa Rica, Romania and Uruguay are in the top 20 nations in the CDI Ranking, much ahead of the countries like United Kingdom, France, and USA. The CDI can act as a single point of reference for policy-makers, governments and other development agencies, as it presents a consolidated picture of a country's development. Future course of action on the basis of the concept of CDI are also proposed. It can be concluded that efforts to have a high CDI (in comparison to a high GDP or HDI only) will pave the way forward for sustainable development and holistic progress for all the countries of the world. JEL Classifications: 011, 015 Additional disciplines (besides field of economics reflected in JEL classifications): sociology; ecology and environment.

SummaryDrawing upon data from the third round of the National Family Health Survey (NFHS-3) conducted in India during 2005–06, this study compares the utilization of selected maternal and child health care services between the urban poor and non-poor in India and across selected Indian states. A wealth index was created, separately for urban areas, using Principal Component Analysis to identify the urban poor. The findings suggest that the indicators of maternal and child health care are worse among the urban poor than in their non-poor counterparts. For instance, the levels of antenatal care, safe delivery and childhood vaccinations are much lower among the urban poor than non-poor, especially in socioeconomically disadvantageous states. Among all the maternal and child health care indicators, the non-poor/poor difference is most pronounced for delivery care in the country and across the states. Other than poverty status, utilization of antenatal services by mothers increases the chances of safe delivery and child immunization at both national and sub-national levels. The poverty status of the household emerged as a significant barrier to utilization of health care services in urban India.

The recently launched Rashtriya Kishor Swasthya Karyakram (RKSK) health program seeks to enable all adolescents and youth to realize their full potential by making informed and responsible decisions concerning their health and well-being and by accessing the services and support needed to implement their decisions. To realize this vision, the RKSK framework acknowledges that the strengthening of Adolescent Friendly Health Clinics (AFHCs) and the provision of correct knowledge and information through counseling services are two of its seven critical components. As the government makes efforts to roll out the RKSK program at scale across the country, reviewing the experiences of the AFHCs established under the National Adolescent Reproductive and Sexual Health Strategy (the predecessor of RKSK) can provide useful lessons. With this in view, at the request of the Ministry of Health and Family Welfare, the Population Council conducted an assessment of AFHCs from the perspectives of adolescents and youth, and health care providers in three states in India. This report presents the findings of the assessment conducted among adolescents and youth.

Background Child marriage (<18 years) and school drop-out disproportionately affect girls living in impoverished households in rural areas, with long-term economic and health consequences. Improving retention in education, and delaying age at marriage and first pregnancy have received substantial attention at the national and global level, in line with the Millennium Development Goals and the Sustainable Development Goals (SDGs) (2015-2030). Methods We examined changes over time in economic, education and child marriage indicators among adolescents from rural households in (i) Northern Karnataka (the most deprived region of Karnataka), (ii) Karnataka state, and (iii) all India, using individualized data from four pre-existing, nationally-representative datasets (District Level Household and Facility Surveys (DLHS 2-4) (2002/4–2012/3) and the National Family Health Survey (NFHS-4) (2015-16)). Results At the national and state level, we found large improvements in secondary educational attainment among girls and boys living in rural settings (proportion of adolescents completing age-appropriate secondary school education (all India): girls 12.4% 2002/3 vs. 31.6% 2015/6; boys 18.9% 2002/4 vs. 36.8% 2015/6). We also observed large reductions in child marriage and early child-bearing rates (proportion of married women aged 18-24 years married <18 years: 62.4% 2002/4 vs. 23.8% 2015/6; proportion of married girls aged <19 years who are pregnant or have children: 62.4% 2002/4 vs. 21.9% 2015/6). In addition, we found evidence of "clustered deprivations", whereby girls in rural areas from the poorest families and lowest castes continue to experience multiple forms of disadvantage, with child marriage significantly associated with scheduled caste / scheduled tribe (SC/ST) caste (odds ratio (OR)=1.25, 95% confidence interval (CI)=1.18-1.32), poorest quintile (OR=2.38, 95% CI=2.21-2.55) and illiteracy (OR=2.09, 95% CI=1.95-2.23); and not completing secondary education significantly associated with SC/ST caste (OR=1.52, 95% CI=1.45-1.59), poorest quintile (OR=4.17, 95% CI=3.90-4.46), and child marriage (OR=2.05, 95% CI=1.85-2.26). Conclusions The results show substantial improvements in economic, educational and child marriage indicators at the state and national level over the past 14 years. The government has implemented multiple programmes and policies to address child marriage and school drop-out, and these trends suggest such efforts may be having a positive impact. If India is to achieve the SDGs, designing targeted interventions to reach those who continue to be left furthest behind is going to be key.

BACKGROUND: Child marriage (<18 years) and school drop-out disproportionately affect girls living in impoverished households in rural areas, with long-term economic and health consequences. Improving retention in education, and delaying age at marriage and first pregnancy have received substantial attention at the national and global level, in line with the Millennium Development Goals and the Sustainable Development Goals (SDGs) (2015-2030). METHODS: We examined changes over time in economic, education and child marriage indicators among adolescents from rural households in (i) Northern Karnataka (the most deprived region of Karnataka), (ii) Karnataka state, and (iii) all India, using individualized data from four pre-existing, nationally-representative datasets (District Level Household and Facility Surveys (DLHS 2-4) (2002/4–2012/3) and the National Family Health Survey (NFHS-4) (2015-16)). RESULTS: At the national and state level, we found large improvements in secondary educational attainment among girls and boys living in rural settings (proportion of adolescents completing age-appropriate secondary school education (all India): girls 12.4% 2002/3 vs. 31.6% 2015/6; boys 18.9% 2002/4 vs. 36.8% 2015/6). We also observed large reductions in child marriage and early child-bearing rates (proportion of married women aged 18-24 years married <18 years: 62.4% 2002/4 vs. 23.8% 2015/6; proportion of married girls aged <19 years who are pregnant or have children: 62.4% 2002/4 vs. 21.9% 2015/6). In addition, we found evidence of "clustered deprivations", whereby girls in rural areas from the poorest families and lowest castes continue to experience multiple forms of disadvantage, with child marriage significantly associated with scheduled caste / scheduled tribe (SC/ST) caste (odds ratio (OR)=1.25, 95% confidence interval (CI)=1.18-1.32), poorest quintile (OR=2.38, 95% CI=2.21-2.55) and illiteracy (OR=2.09, 95% CI=1.95-2.23); and not completing secondary education significantly associated with SC/ST caste (OR=1.52, 95% CI=1.45-1.59), poorest quintile (OR=4.17, 95% CI=3.90-4.46), and child marriage (OR=2.05, 95% CI=1.85-2.26). CONCLUSIONS: The results show substantial improvements in economic, educational and child marriage indicators at the state and national level over the past 14 years. The government has implemented multiple programmes and policies to address child marriage and school drop-out, and these trends suggest such efforts may be having a positive impact. If India is to achieve the SDGs, designing targeted interventions to reach those who continue to be left furthest behind is going to be key.

AbstractUttar Pradesh (UP), with more than 220 million people, is the most populous state in India. Despite a high unmet need for modern family planning methods, the state has experienced a substantial decline in fertility. India has also seen a decline during this period which can be attributed to the increased prevalence of modern methods of family planning, particularly female sterilisation, but in UP, the corresponding increase was marginal. At the same time, Traditional Family Planning Methods (TMs) increased significantly in UP in contrast to India, where it was marginal. The trends in UP raise questions about the drivers in fertility decline and question the conventional wisdom that fertility declines are driven by modern methods, and the paper aims to understand this paradox. Fertility trends and family planning practices in UP were analysed using data from different rounds of National Family Health Surveys (NFHS) and the two UP Family Planning Surveys conducted by the UP Technical Support Unit to understand whether the use of TMs played a role in the fertility decline. As per NFHS-4, the prevalence of TM in India (6%) was less than half that of UP (13%). The UP Family Planning Survey in 25 High Priority Districts estimated that 22% of women used TMs. The analysis also suggested that availability and accessibiility of modern contraceptives might have played a role in the increased use of TMs in UP. If there are still couples who make a choice in favour of TMs, they should be well informed about the risks associated with the use of traditional methods as higher failure rate is observed among TMs users.

Abstract Background Uttar Pradesh (UP) is the most populous state in India with historically high levels of fertility rates than the national average. Though fertility levels in UP declined considerably in recent decades, the current level is well above the government's target of 2.1. Data and methods Fertility and family planning data obtained from the different rounds of Sample Registration System (SRS) and the National Family Health Survey (NFHS). We analyzed fertility and family planning trends in India and UP, including differences in methods mix, using SRS (1971–2016) and NFHS (1992–2016). Bivariate and multivariate regression analyses were used. Results From 2000, while the total fertility rate (TFR) declined in UP, it is still well above the national level in 2015–16 (2.7 vs 2.18, respectively). The demand for family planning satisfied increased from 52 to 72% during 1998–99 to 2015–16 in UP, compared to an increase from 75 to 81% in India. Traditional methods play a much greater role in UP than in India (22 and 9% of the demand satisfied respectively), while use of sterilization was relatively low in UP when compared to the national averages (18.0 and 36.3% of current married women 15–49 years in UP and India, respectively in 2015–16). Within UP, district fertility ranged from 1.6 to 4.4, with higher fertility concentrated in districts with low female schooling, predominantly located in north-central UP. Fertility declines were largest in districts with high fertility in the late nineties (B = 7.33, p < .001). Among currently married women, use of traditional methods increased and accounted for almost one-third of users in 2015–16. Use of sterilization declined but remained the primary method (ranging from 33 to 41% of users in high and low fertility districts respectively) while condom use increased from 17 and 16% in 1998–99 to 23 and 25% in 2015–16 in low and high fertility districts respectively. Conclusions and implications Greater reliance on traditional methods and condoms coupled with relatively low demand for modern contraception suggest inadequate access to modern contraceptives, especially in district with high fertility rates. Family planning activities need to be appropriately scaled according to need and geography to ensure the achievement of state-level improvements in family planning programs and fertility outcomes.