Addressing Regional Imbalances in South Asia’s Human Development

South Asia is home to nearly a quarter of humanity and has posted some of the fastest economic growth rates in the world. Yet beneath these impressive headline numbers lies an uncomfortable truth: the benefits of growth have been distributed very unevenly. A child born in Colombo and a child born in Kandahar face dramatically different odds of surviving infancy, attending school, or drinking clean water. These gaps between and within countries are what we call regional imbalances in human development, and understanding them is essential to making sense of the region’s future.

What human development really measures 🔗

Before examining the imbalances, it helps to be clear about what “human development” means. It is not the same as economic growth. The Human Development Index (HDI), developed by economists Mahbub ul Haq and Amartya Sen, measures a country’s achievements across three dimensions: a long and healthy life (life expectancy), access to knowledge (years of schooling), and a decent standard of living (gross national income per capita). A country can have a growing economy while still failing its people on health and education. This is precisely the paradox South Asia faces.

The UNDP classifies countries into four tiers based on fixed cut-off points: low human development below 0.550, medium between 0.550 and 0.699, high between 0.700 and 0.799, and very high at 0.800 or above. No South Asian country has yet reached the very high category, which already tells us something about the region’s collective standing.

The wide gap between the leaders and the laggards 🔗

The clearest way to see regional imbalance is to line up the countries side by side. According to the 2025 Human Development Report, Sri Lanka leads the region with an HDI of 0.776, followed closely by the Maldives at 0.766. Both fall into the high human development category. At the other end, Pakistan sits at 0.544 and Afghanistan at 0.496, both in the low human development tier.

That is a gap of nearly 0.28 points between the best and worst performers in the same neighbourhood. India and Bangladesh share a value of 0.685, placing them in the medium category, with Nepal at 0.622 and Bhutan at 0.698. The pattern is striking: smaller island and coastal nations have outperformed larger, resource-rich neighbours.

Why Sri Lanka and the Maldives pull ahead 🔗

Sri Lanka’s success is not an accident. For decades it invested heavily in free public healthcare and education, building a system that reached rural populations and women. Researchers studying maternal healthcare access point to Sri Lanka as a model that other countries in the region could learn from, precisely because it managed to reduce inequality in access to services despite sharing similar socio-demographic challenges with its neighbours. The lesson is that targeted social spending, sustained over time, produces better human development outcomes than economic growth alone.

Why Afghanistan and Pakistan fall behind 🔗

The countries at the bottom share a common thread: political instability and weak governance. A panel data study of SAARC nations found that Afghanistan consistently lags behind its regional counterparts even after accounting for income, schooling, and life expectancy, suggesting that deeper structural barriers, including conflict and the absence of stable institutions, hold the country back. Political stability, governance quality, and economic capability emerge again and again as the decisive factors separating the leaders from the laggards.

Health disparities: the survival gap 🔗

Nowhere are the imbalances more visible, or more tragic, than in maternal and child health. South Asia carries a heavy share of the world’s burden. A review of child deaths found that around 34 percent of all child deaths globally occur in South Asia, and that maternal mortality ratios within the region range enormously, from about 23 deaths per 100,000 live births in Sri Lanka to far higher figures in countries with weaker health systems.

The disparities exist not just between countries but within them. In Pakistan, the overall maternal mortality rate of 276 per 100,000 climbs to as high as 785 in the province of Balochistan, where fewer than ten percent of pregnant women receive adequate immunisation. South Asia as a whole still accounts for roughly one in three maternal deaths worldwide, a sobering statistic for a region experiencing rapid economic expansion.

The role of women’s education and autonomy 🔗

Health outcomes are tightly linked to how societies treat women. Studies on infant mortality in SAARC countries show that female education, women’s autonomy, and sanitation facilities are powerful predictors of child survival. The same research notes that Afghanistan and Pakistan report very low female enrolment at the primary level, while Sri Lanka and Bangladesh have achieved impressive rates of female schooling. When mothers are educated, they make better health decisions, seek timely care, and break the cycle of poverty that drives mortality.

Education and the literacy divide 🔗

Education is the second pillar of human development, and here too the region is split. While countries like Sri Lanka and the Maldives have achieved near-universal literacy, others continue to struggle with large populations of out-of-school children, particularly girls. The link is not just about building schools. It is about whether families can afford to send children, whether girls are allowed to attend, and whether the quality of teaching is good enough to keep them there.

The connection between female education and broader development is direct. Where girls finish secondary school, fertility rates fall, child health improves, and household incomes rise. This is why educational inequality is not merely a social concern but an economic one. A country that educates only half its talent pool cannot compete with one that educates all of it.

Water and sanitation: a basic right still denied to millions 🔗

Access to clean water and decent sanitation is a foundation of human dignity, yet it remains out of reach for vast numbers of people. The disparities follow the now-familiar pattern of rich versus poor and urban versus rural. A study of water, sanitation, and hygiene (WASH) coverage across four countries found a wide range: Nepal achieved overall WASH coverage of about 75 percent, while Afghanistan managed only around 34 percent.

The rural-urban divide is especially stark. Across South Asian nations, about 5.6 percent of the urban population practises open defecation compared to as much as 45 percent in rural areas. The same WASH research confirms that wealthier households, those with educated heads, and those living in cities consistently enjoy far better access, meaning the burden of poor sanitation falls hardest on the already disadvantaged.

Why these gaps persist 🔗

Underdeveloped infrastructure is the immediate cause, but the deeper problem is governance. Research on the region’s pursuit of Sustainable Development Goal 6 on clean water identifies poor governance and a lack of regional cooperation as key obstacles slowing progress. Water does not respect borders, and rivers shared between nations cannot be managed by any single government acting alone.

What it would take to close the gap 🔗

Addressing these imbalances requires action on two fronts: within countries and across the region. Within countries, the evidence consistently points to one priority. The SAARC panel study concluded that policymakers should prioritise investments in health, education, and equitable income growth to bridge the development gaps and accelerate progress toward the Sustainable Development Goals. Targeted spending aimed at rural areas, lower-income groups, and women yields the highest returns.

Across the region, cooperation matters because many problems are shared. Frameworks like the South Asian Association for Regional Cooperation and treaties governing shared rivers are essential for managing common resources and building climate resilience, though inconsistent implementation has limited their impact so far. The sobering reality, according to the 2024 Asia-Pacific Human Development Report, is that the wider region is not on track to achieve any of the Sustainable Development Goals by 2030, and on current trends will not reach them until 2065.

Growth is necessary but not sufficient 🔗

Perhaps the most important takeaway is that economic growth, on its own, does not guarantee human development. The Asia-Pacific region will account for a large share of global economic growth, yet income and wealth disparities are worsening, particularly in South Asia, where the wealthiest ten percent control over half of total income. Without deliberate redistribution and investment in public services, growth simply concentrates wealth at the top while leaving health, education, and sanitation gaps unaddressed.

What do you think? If two neighbouring countries with similar histories and resources can end up so far apart on human development, what does that tell us about the relative importance of governance versus economic growth? And should wealthier nations in the region bear greater responsibility for helping their poorer neighbours close these gaps, or is human development ultimately each country’s own responsibility?

References

1. https://hdr.undp.org/
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3. https://en.wikipedia.org/wiki/List_of_SAARC_countries_by_HDI
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5. https://pmc.ncbi.nlm.nih.gov/articles/PMC12173378/
6. https://www.researchgate.net/publication/397444064_HUMAN_DEVELOPMENT_DISPARITIES_IN_SOUTH_ASIA_A_PANEL_DATA_INVESTIGATION_OF_AFGHANISTAN_AND_SAARC_COUNTRIES
7. https://pmc.ncbi.nlm.nih.gov/articles/PMC383381/
8. https://hsph.harvard.edu/maternal-health-task-force/news/accounting-for-1-in-3-maternal-deaths-health-disparities-persist-in-south-asia
9. https://link.springer.com/article/10.1007/s12187-020-09734-8
10. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0319754
11. https://reliefweb.int/report/world/despite-progress-south-asia-faces-daunting-challenges-water-sanitation
12. https://www.sciencedirect.com/science/article/pii/S1342937X25002515
13. https://www.undp.org/asia-pacific/rhdr2024
14. https://reliefweb.int/report/world/2024-regional-human-development-report-making-our-future-new-directions-human-development-asia-and-pacific