OUR culture has long held that children are a source of pride and joy, both for the family and society, a gift from God to be treasured and cared for with affection. The family is expected to provide nurture throughout childhood – a nascent period of development – to transform the child into an adult. Traditionally, within the confines of the extended family, a number of caretakers, besides parents are available to provide a warm, permissive and stimulating environment that promotes all-round/holistic development to facilitate socialization during formative years.

The global changes in socio-economic conditions have not left Indian society untouched – the delicate fabric of childcare patterns have been altered; women are increasingly joining the workforce in the organized sector; members of the extended family are rarely available to assist in childcare; and a large number of families have been pushed into poverty. All these conditions have made young children vulnerable and more at risk.

Extant scientific knowledge suggests that the early years are critical for healthy growth and formation of synaptic connections in the brain as foundation for social and personal habits which last a lifetime. The environmental forces can work powerfully to retard or enhance the course of human development. Collectively, these factors constitute a sufficient basis for setting up extra-familial services and interventions to provide an enabling environment for every child, thereby ensuring his/her optimal development.

Independence ushered in a new era of child development/welfare in India. The initiatives over the last six decades testify to our commitment. Being a welfare state, India took upon itself the role of a guardian; besides maintaining the sovereignty of the nation, ensuring the well-being of people also became its responsibility. Our Constitution made it obligatory for the state and society in general to protect the child’s right to survival, growth and development.

While Article 15(3) empowered the state to make any special provision in favour of children, Article 24 prohibited deployment of children below 14 years of age in any factory or mine or other hazardous occupations. Articles 39(e) and (f) lay down that the state shall direct its policy in such a manner that the tender age of children is not abused and children are given opportunities and facilities to develop in a healthy manner, and childhood is protected against exploitation and moral and material abandonment. Article 45 further directed the state to provide for free and compulsory education for all children upto the age of 14 years. In order to meet these obligations, concerted measures have been taken at the national level in the field of child development. They include adoption of relevant pro-child policies, launching of welfare and development programmes, enacting legislation and a reaffirmation of global commitments.

 

Over the years, our strategic focus for children in the country has evolved from welfare to development to a rights based approach. Considering that the opportunities of early childhood development determine the present and future human resource development of the nation, child development became a focused activity from the very first five year plan. In successive plans, conscious efforts were made to evolve and crystallize new perspectives and paradigms to initiate multi-linear interventions required for fulfilling the needs of the deprived and underprivileged children through interventions in the sectors of health, nutrition and education.

In the second, third and fourth plans, the same approach for the welfare of children continued. The fourth plan focused on accelerating the basic minimum services for the children, culminating finally in the adoption of a National Policy for Children in 1974. The fifth plan saw a shift in focus from child welfare to child development and an emphasis on integration and coordination of services through the Integrated Child Development Services (ICDS) in 1975, a project for delivering a package of basic childcare services – health checkup, immunization, supplementary nutrition, referral services, preschool education and health and nutrition education to children and their mothers from poor and disadvantaged communities. It aimed to enhance the holistic development of the child through the involvement of the community via an interface/linkages with other related services such as safe drinking water, environmental sanitation and programmes of women empowerment.

The sixth five year plan promoted consolidation and expansion of the programmes started earlier. The seventh plan saw the enactment of the Child Labour Prohibition and Regulation Act, 1986. A year later in 1987, the National Policy on Child Labour was formulated which viewed investment in child development services as an investment for the country’s future. In the eighth five year plan, the government reiterated its commitment to the development of ‘every child’.

 

The ninth plan viewed child development not merely as a desirable societal investment for the nation’s future, but also as the right of every child to achieve his/her full developmental potential. The tenth plan emphasized convergence and inter-sectoral coordination while pursuing a holistic approach to child development and also advocated the rights based approach. The plan clearly spelt out strategies to be adopted to meet the commitments made in the context of schooling, reducing gender gaps, reduction in IMR (infant mortality rate) and MMR (maternal mortality rate). It emphasized the streamlining of infrastructure and improved quality, coverage and efficiency of services and made special efforts to reach the un-reached disadvantaged groups for moving towards an inclusive society. The plan encouraged fostering of partnership with parents, communities, civil society, corporate and private sectors to fulfil national obligations to children.

It has indeed been heartening to find that the National Common Minimum Programme accords due priority to the children, especially the girl child. It recognizes the criticality of improving the survival of children and promises to strive for elimination of child labour. Adoption of the Charter for Children (2003) and setting up of the National Commission for Children (2005) are two bold moves by the current government which reaffirms its commitment to protect and safeguard the rights of the child.

 

This is indeed an impressive account of attempts in the area of child development in the country during the last sixty years. However, while we have made considerable progress in ensuring child survival, growth and development and basic education, much remains to be done with respect to the major indicators for the child’s development. Though India is now a fast growing global economy, with a vibrant growth rate of around 8%, nearly 30% of the global burden of child deaths is still borne by the country. The prevalence of malnutrition in the country today is higher than that in sub-Saharan Africa. While income poverty in India has been reduced to 26%, underweight prevalence in children under three years remains at 47%.

The unacceptably high infant mortality rate in India exceeds that of countries like Bangladesh which have not experienced such economic growth rates. In India, approximately 2.6 million children under-five die every year from common preventable childhood illnesses. Around 1.7 million infants die before their first birthday. Of these, 1.2 million die within the first four weeks of life. Neonatal mortality presently constitutes nearly two-thirds of infant mortality and around half of under-five child mortality. The wide prevalence and persistence of mass under-nutrition in India reflects the fact that this is largely an ‘invisible’ public health issue. By the time severe malnutrition becomes somewhat more visible, cumulative growth and development deficits have already set in. Micronutrient deficiencies – deficiencies of key vitamins and minerals such as vitamin A, iron, iodine and zinc – constitute a ‘hidden hunger’ that is often not addressed.

Every second newborn is unprotected against brain damage due to iodine deficiency. No state in India is free from iodine deficiency. Young women enter pregnancy with chronic energy deficiency and poor iron status. (36% have BMI less than 18.5; anaemia during pregnancy leads to 20% of all maternal deaths, three times greater risk of premature delivery and low birth weight babies, increased morbidity and deleterious effects on productivity and caring capacity.)

Reductions in infant mortality in India can only be achieved through concerted efforts at controlling neonatal mortality by eliminating neonatal tetanus, improving access to obstetric services, providing skilled birth attendants in the community, controlling neonatal and childhood illnesses and, above all, preventing malnutrition by promoting appropriate feeding practices.

 

Despite significant investments and appropriate policy framework, why is the status of the Indian child still far from satisfactory? The reasons for this limited impact of existing provisions for children include (a) a fragmented, sectoral approach in implementing the schemes which fails to capture the synergies across sectors, (b) over-centralized and standardized programme designs which do not address contextual diversities, (c) inadequate monitoring capacity and, (d) low accountability and issues of inefficient service delivery.

Let us dwell on the sectoral/compartmentalized approach as an issue. Historically, the experience may have been that this specialized approach facilitated more focused attention. In the area of child development, however, a sectoral approach becomes problematic since it disregards the significant inter-dependence of health, nutrition and educational outcomes across the sub-stages of a child’s development. A holistic approach is based on an understanding of the interdependence of outcomes at two levels – vertical and lateral. Vertically, it is seen in terms of the continuous and cumulative nature of the process of a child’s development, so that every preceding sub-stage tends to set the readiness level for the next sub-stage and laterally, it is in terms of the synergistic relationship evident across the human development aspects or sub-sectors, i.e. health, nutrition and education.

 

The vertical linkages are essentially linear and require the entire childhood continuum to be addressed in totality. Their importance rests on the empirical evidence that the first six years of childhood are critical for brain development and evolution of several important social, cognitive and linguistic skills that are important for success in later life. Research in neuro-sciences indicates that by age three, 85% of the child’s core brain structure is already formed and any deficits resulting from a deficient environment in these early years may be difficult to reverse later. Given the crucial importance of the early years and the fact that child development is a cumulative process, it becomes imperative to ensure that every child crosses each sub-stage of the development continuum successfully, before progressing to the next stage. If a child falters in meeting one or more milestones, he/she carries, in either latent or cumulative terms, the burden of failure to the next stage.

There is a strong case for re-engineering a whole range of social sector programmes to incorporate the new sights into the benefits of early intervention. Unfortunately, the planning process has failed to acknowledge this aspect as is obvious from the relative spending on children below six years and that for 6+ years. Actual spending per child below six years is almost one-eighth of that in the 6 to 14 age group, across all states. This indicates a gross neglect of the foundation years of childhood. The key to human resource development is the focus on early childhood years in development planning.

 

The vision for the future is to provide all children of the country the opportunities and chances for their optimal development to attain their full potential. Some critical factors in the context of the Indian child’s development that need to be kept in mind while planning interventions to realize the vision are: a multi-sectoral approach to issues so as to capture the synergy of the different aspects of health, nutrition and education; adequate cognizance of the continuous and cumulative nature of child development through different sub-stages, within and across sectors; and pro-actively addressing not only the child but also the child’s immediate context, particularly the family and the community to effectively reach the child.

While the country is in the process of finalizing the thrust for the 11th plan for child development, it needs to consider the recommendations made by the chairperson of the National Advisory Council to give India’s children a new deal. The five key actions outlined are:

(i) Increase investment in children, across sectors and partners.

(ii) Improve accountability and governance.

(iii) Strengthen public advocacy and partnership for children.

(iv) Address increasing regional disparities in child welfare, across community groups, districts and states.

(v) Bring about radical changes in child development programmes, with greater attention to the more crucial and vulnerable years of early childhood and the girl child.

 

There is adequate empirical evidence to suggest that the early years of life are crucial and critical for life long development. There is a worldwide consensus that interventions made in early childhood provide a head start to an individual for lifelong learning. They enhance the child’s life chances and loosen the intergenerational grip of poverty and inequality. The very core of this endeavour is survival, growth and holistic development of young children. Interventions improve and enhance young children’s survival, growth, development and capacity to learn.

Synergy between interventions for nutrition and psychosocial development is also well researched – evidence shows that combined interventions are more effective than any single one. Further, the same care behaviour that supports good nutrition also promotes optimal cognitive development. Positive childcare practices are likely to result in a better-nourished child, who can both actively interact with the stimulating learning environment and benefit from it. Thus, for investments in education to be profitable, investment must also be made in improving quality of psychosocial care in the first few years of life.

The above analysis calls for priority attention to Integrated Early Childhood Development as the most effective way of breaking an inter-generational cycle of malnutrition, poverty and gender discrimination. Integrated interventions for young children emerge as the natural entry point for a comprehensive human development strategy and as a powerful instrument for ensuring equality of opportunity to present and future generations of the disadvantaged. Early childhood development interventions are also a prerequisite for ensuring enhanced cognitive and social skills in the young, resulting in improved retention and learning outcomes in primary education.

 

Research in India and elsewhere affirms a significant impact of Early Childhood Development (ECD) interventions on the goal of primary enrolment, attendance, completion and learning achievement of children and also on facilitating participation of girls in primary schooling. ECD thus also helps reduce investment costs of subsequent interventions at the primary stage by reducing dropouts and repetition, improving efficiency and contributing significantly to the goals of education for all. The lateral inter-dependence of health, nutrition and education outcomes has also been established. There is evidence to indicate the significant influence of malnutrition in children on their ability to attend to and comprehend instruction, activity level, concentration and overall ability to learn.

The 11th plan for child development needs to focus on the very young child (under three) on a priority basis. There is a need to accelerate actions to ensure survival growth and development of children for meeting unachieved targets of the 10th plan. The most marginalized and excluded groups in far-flung rural, tribal and unrecognized urban groups need special attention. Equity in the acquisition of human capacities through early childhood development is a proven strategy; it can unhinge the inequality trap by expanding people’s capability to lead fuller lives and arrest inter-generation transmission of inequalities. In line with the provisions in our Constitution, achieving equity and social justice for one and all is a national goal and we need to work towards it by focusing on ECD.

 

The National Plan of Action (NPA) for Children (2005) has identified 12 key areas to improving the lives of Indian children. These may serve as reference points to prepare a road map for future actions. For meeting multiple needs of children, it is imperative to have strong political direction for enhanced investment. Efficient utilization of resources, making use of low cost technologies and effective implementation of interventions are critical to reach the desired goal of ensuring optimal development of the Indian child. A favourable climate needs to be created by appropriate advocacy and raising awareness relating to survival, development and protection of children meaningfully. Community resources and organizations, including PRIs, need to be used effectively in endeavours related to child development.

Granting children the right to live with dignity and having access to opportunities for their optimal development may seem a dream at present, but our collective voice, unflinching conviction, and appropriate action backed by the supportive ‘political will’ can make this a reality in the foreseeable future.