India, May 12 -- 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 ...