Save our children

While India has made remarkable progress on the economic front in recent years, the same cannot be said about its track record on the social front. Even today, the country ranks 129^th in terms of the Child Development Index.
"When we are growing rapidly economically, we should be ashamed of having such indicators," remarks Puja Marwaha, CEO, Child Rights and You (CRY), a leading NGO working for the cause of children.

Marwaha points out that 44 per cent of children under the age of two remain unvaccinated. This adds up to 13 million unimmunised children, susceptible to deadly diseases. About 40 per cent of these children are underweight.
"There is misinformation and many parents are not well-informed about vaccines," explains the CEO. "Typically, a child gets ill after getting vaccinated, which panics the parents. There is a lot of superstition around vaccines, and we should address all these issues."
Moreover, storage and transportation of vaccines is a major concern. Due to lack of proper cold chain storage systems in far-flung areas, sometimes vaccines become ineffective before they are administered to children.
Marwaha also refers to another practical problem confronting poor people. Many of the parents in poverty-stricken communities are daily wage earners and cannot afford to take leave to bring their children to the primary health centres for vaccination. "We need to incentivise them so that they bring their infants for vaccination."
A combination of these factors has resulted in 13 million children not being immunised. Of course, there are wide variations within India with some states, namely Tamil Nadu and Kerala, performing very well. "Maharashtra and Bihar have also improved a lot of late," says Marwaha. 
However, immunisation is just the first step. There are other issues related to children, including malnutrition. One of the most crucial periods in a child's life is from birth to the age of five; every child needs a healthy start in life, says Marwaha. Access to proper services in terms of healthcare, nutrition and early childhood care are very important.
Proper care for the mother plays a very important role before birth as well as during the months of breastfeeding. Therefore, along with the child, it is also important to ensure that pregnant and lactating mothers also get proper care.
Lack of adequate care for the child at this stage could result in permanent damage to its development, which affects her for the rest of the life. CRY has been working with the government's Integrated Child Development Services (ICDS) scheme to ensure that the services - including immunisation, food, care and early education - are delivered to children.
"If we don't focus on children at this age, a lot of later developmental milestones get fundamentally affected," points out Marwaha. "We cannot tackle malnutrition or lack of mental development in children at age 14."
Sadly, the statistics are frightening. In India, 48.4 per cent of children are stunted - an indicator of chronic malnourishment - and 20 per cent of children are wasted. Part of the reason for this is early marriage of girls. Marwaha says that because of gender discrimination, young mothers are usually underweight, which also affects their children.
Of course, a lot of work is being done both by the central and state governments, she admits. In Andhra Pradesh, the government incentivises families to ensure that young girls are not married off. Similarly, incentives are given, by way of additional subsidised rice, if girls are kept in school. Many governments are also building toilets in secondary schools to ensure that girls do not drop out after the age of 12.
"This is a very complex issue," remarks Marwaha. "There is lack of awareness and education even among parents, but a lot of efforts are being put in."
Unfortunately, many in India are over-focused on economic growth, ignoring the fact that the purpose of such growth is to ensure a better and healthier population. If children remain unhealthy and uneducated, all that talk about India reaping from a demographic dividend will go awry, she warns.

• India