The acronym was formed by Ashish Bose, an economist from the 1980s.
The term “BIMARU” itself is an amalgamation of the Hindi words “bimar” (sick) and “ru” (a suffix meaning “land of”).
The economist framed the acronym to stress the fact that the poor economic conditions of these four states are affecting the overall GDP growth of India.
During the Investors Summit conducted in UP, PM Modi recalled the term.
These states had exceptionally high levels of mortality, morbidity, illiteracy, fertility, undernutrition, and social inequality and lagged behind in per capita income.
When this term was coined, the States of Jharkhand, Chhattisgarh and Uttarakhand were not separate States and were part of the grouping.
At times Odisha is also included in the grouping, as BIMAROU, although it is not as big a State in terms of population.
NITI Aayog’s 2019-20 Health Index also ranked Rajasthan, Madhya Pradesh, Bihar, and Uttar Pradesh (in highest to lowest order) at the last four positions out of 19 large states.
As per IIM Ahmedabad’s study of total and rural government hospitals per million people, all the BIMARU states were below the national average of 20.74 except Rajasthan.
Ashish Bose
He was an economist and a demographer. Demographers are persons who study the changes happening in the economy due to population increase or decrease.
In these four states, the population increased tremendously.
According to Bose, these four states are economically backward in terms of health care, education, and other developmental activities mainly due to population explosion.
Role of Bimaru states in Population growth
On the key demographic indicator Total Fertility Rate (TFR), there are now two distinct Indias, one on the road to achieving replacement levels, and one still a long distance off.
The national goal of reaching a “stabilising population”, meaning a TFR of 2.1 was achieved recently.
BIMARU states accounted for 41 percent of India’s total population in 2001 and will account for 43.5 percent in 2026 which has political implications.
Population in Indian states also dictates the delimitation process or the number of seats allotted to them in Parliament.
Currently, the seats are proportional to the Indian population as of the 1971 census. It was frozen until 2001 (extended to 2026) to give states time to meet family planning goals.
BIMARU States: NFHS 5 Survey
The National Family Health Survey (NFHS) had revealed comprises detailed information on key domains of population, health and family welfare. Some key findings are:
Access to Sanitation and Water: Access to a toilet facility was lowest in Bihar (only 62% had access) followed by Jharkhand and Odisha respectively.
Kerala and Lakshadweep had the highest percentage of households with access to basic sanitation facilities, at 98.7% and 99.8% respectively while less than 70% of the households had similar services in Uttar Pradesh, Madhya Pradesh, Chhattisgarh, Jharkhand, Odisha, West Bengal, Assam, and Manipur. In Bihar, it was below 50%.
Wealth Inequities: Inter-State disparities showed that less than 50% of the households surveyed lived in pucca houses in Uttar Pradesh, Madhya Pradesh, Chhattisgarh, Jharkhand, Bihar, Sikkim, and Tripura.
In the South, the percentage of people dwelling in pucca houses was over 80%.
Birth and Death Registration Rates: In birth registration rates, the registration rate was below the national average in Uttar Pradesh, Bihar, and Jharkhand.
Uttar Pradesh, Bihar, Jharkhand, Arunachal Pradesh, Manipur, and Nagaland were among those with the lowest death registration rates. The States in the South fared much better in this regard.
Literacy and Education: Bihar and Kerala “provided two contrasting profiles”, according to the survey.
Literacy among men and women in Bihar was 76% and 55% respectively, whereas in Kerala it was near universal or cent per cent.
Infant and Child Mortality: The under-5 mortality rate (U5MR) was high at 42 deaths per 1,000 live births as was the infant mortality rate (IMR) at 35 deaths per 1,000 live births.
Uttar Pradesh had the highest U5MR followed by Bihar, whereas the lowest rates were in Puducherry followed by Kerala.
Perinatal mortality (stillbirths) was highest in Uttar Pradesh, followed by Bihar, while it was the lowest in Goa.
Total Fertility Rate (TFR): It has further declined from 2.2 to 2.0 at the national level between NNFHS 4 and 5.
The total fertility rate is the average number of children that a woman will have during her lifetime.
Bihar, Meghalaya, Uttar Pradesh, Jharkhand and Manipur have above replacement level of fertility of 2.1.
Behind the slang name ‘BIMAR’
Low per capita income: These have traditionally had low per capita income levels compared to other states in India, with Bihar having the lowest per capita income among Indian states.
High poverty rates: They have a high percentage of people living in poverty, with Bihar and Uttar Pradesh having some of the highest poverty rates in the country.
Low literacy rates: They have lower literacy rates than the national average, with Bihar having the lowest literacy rate among Indian states.
Poor healthcare indicators: They have traditionally had poor healthcare indicators, with high infant and maternal mortality rates.
Agriculture-based economy: These states are primarily agricultural states, with a significant percentage of the population engaged in agriculture and related activities.
Significant population: They are among the most populous states in India, with Uttar Pradesh being the most populous state in the country.
Persisting challenges
These states still face significant challenges, including high levels of poverty and unemployment.
Still a national laggard: There is still a significant development gap between these states and the more developed regions of the country. For example, in 2019-20, per capita income in Bihar was only about a third of the national average, and in UP, only about half of the population has access to basic sanitation facilities.
High Population: The share of BIMARU states in the absolute increase in India’s population during 2001-26 will be of the order of 50.4 per cent while the share of the south will be only 12.6 per cent.
How are these states faring now?
In recent years, some of these states, such as Rajasthan and Madhya Pradesh, have shown significant improvement.
In terms of economic growth, several of these states have experienced high growth rates in recent years, with Madhya Pradesh and Bihar recording growth rates of over 10% in 2019-20.
Uttar Pradesh and Rajasthan have also recorded growth rates of over 7% in recent years.
There has also been progress in improving social indicators such as literacy rates and healthcare infrastructure.
For example, Bihar has seen a significant increase in literacy rates, with the state’s literacy rate increasing from 47% in 2001 to 63% in 2011.
Alternatives to ‘BIMARU’ terms
PM has urged to refrain the use of such terms as they only serves to reinforce negative stereotypes and inhibit progress towards more equitable development across the country.
He coined the term such as ‘Aspirational Districts/Blocks’ as alternative to such negative word.
Is BIMARU Still Valid Today?
Madhya Pradesh (MP): Madhya Pradesh ranks first in distributing Ayushman cards and other States are now adapting MP’s Janbhagidari model.
MP was the first to start a Public Service Guarantee Act (Lok Sewa Guarantee) to ensure that citizens get the benefit of better facilities.
Uttar Pradesh (UP): UP has revised its position in view of GSDP (Gross State Domestic Product) estimates that indicate UP is now the 2nd largest economy after Maharashtra.
Rajasthan: The Rajasthan Government recently signed 4192 Memoranda of Understanding involving investment commitment worth Rs 10.44 lakh crore ahead of the Investment Rajasthan Summit 2022.
Bihar: Improvement in road connectivity, better maintenance of law and order and efforts to raise the literacy levels have boosted the Bihar’s economy.
Conclusion
Overall, while the BIMARU states have made progress in recent years, there is still a long way to go in terms of achieving more equitable development across the country.
