Key Insights | Drivers of Primary Healthcare and Elementary Education Initiatives in Karnataka (2014–2024)

This study examines the drivers of state-level initiatives in primary healthcare and elementary education in Karnataka, focusing on urban areas over the decade from 2014 to 2024.

Karnataka is often praised in nationally prominent indices as a progressive state with strong fiscal, health, and education indicators. However, our analysis questions this categorisation, suggesting that Karnataka’s good performance is limited to certain indicators, where it is only marginally better than the national average. In many other health and education indicators, such as out-of-pocket expenditure and learning levels, Karnataka’s performance is sluggish. The state exhibits stark intra-state disparities, and the uptake of public health and education facilities compared to private ones is poor. Despite historically undertaking prominent initiatives, Karnataka is not a national leader in health and education. It possesses a strong financial resource base, with one of the highest Per Capita Income (PCIs) in India, and an active, skilled civil society. We analyse the drivers of state-level initiatives to understand why Karnataka has not become a national leader with high uptake and quality of primary health and elementary education in urban areas. Our focus is on initiatives funded or ideated by the state during 2014–2024, specifically those addressing elementary education and primary care as a whole.