title: The national employment guarantee scheme and inequities in household spending on food and non-food determinants of health in rural India.
abstract: BACKGROUND
  Inequities in a population in spending on food and non-food items can contribute to disparities in health status. The Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) was launched in rural India in 2006, aimed at providing at least 100 days of manual work to a member in needy households.
  
  
  METHODS
  We used nationally representative data from the consumer expenditure surveys of 2004-05 and 2009-10 and the employment survey of 2009-10 conducted by National Sample Survey Organisation to assess the effect of MGNREGS in reducing inequities in consumption of food and non-food items between poor and non-poor households in the states of India. Variations among the states in implementation of MGNREGS were examined using the employment and unemployment survey data, and compared with official programme data up to 2012-13. Inequity in spending on food and non-food items was assessed using the ratio of monthly per capita consumer expenditure (MPCE) between the most vulnerable (labourer) and least vulnerable categories of households.
  
  
  RESULTS
  The survey data suggested 1.42 billion person-days of MGNRGES employment in the 2009-10 financial year, whereas the official programme data reported 2.84 billion person-days. According to the official data, the person-days of MGNRGES employment decreased by 43.3% from 2009-10 to 2012-13 for the 9 large less developed states of India. Survey data revealed that the average number of MGNREGS work days in a year per household varied from 42 days in Rajasthan to less than 10 days in 14 of the 20 major states in India in 2009-10. Rajasthan with the highest implementation of MGNRGES among the 9 less developed states of India had the highest relative decline of 10.4% in the food spending inequity from 2004-05 to 2009-10 between the most vulnerable and less vulnerable households. The changes in inequity for non-food spending did not have any particular pattern across the less developed states. In the most vulnerable category, the households in Rajasthan that got 100 or more days of work in a year under MGNREGS had a 25.9% increase in MPCE.
  
  
  CONCLUSIONS
  MGNREGS seems to have contributed to the reduction in food consumption inequity in rural Rajasthan in 2009-10, and has the potential of making a similar contribution with higher level of implementation of this programme in other states. Non-food consumption inequities benefited less from MGNRGES until 2009-10. The reported decrease in the MGNRGES employment person-days in the less developed states of India from 2009-10 to 2012-13 is of concern.
authors.forename: T R
authors.initials: TR
authors.lastname: Dilip
authors.forename: Rakhi
authors.initials: R
authors.lastname: Dandona
authors.affiliation: Public Health Foundation of India, ISID Campus, 4 Institutional Area, Vasant Kunj, New Delhi 110070, India. lalit.dandona@phfi.org.
authors.forename: Lalit
authors.initials: L
authors.lastname: Dandona
mesh_terms: D002201:Capital Expenditures / Q000706:statistics & numerical data*; D004651:Employment; D005502:Food / Q000191:economics*; D054624:Health Status Disparities; D006801:Humans; D007194:India; D011203:Poverty; D011640:Public Policy; D012424:Rural Population