Children’s health: India
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Government spending on child development
No. of malnourished kids up but food funds down
In spite of the National Family Health Survey (NFHS-5) done in 2019-20 showing an increase in proportion of children under five years suffering from chronic malnutrition in many states, the government has cut its Budget for its main nutrition programme, the Integrated Child Development Services (ICDS) scheme, by over Rs 5,000 crore.
The huge slash has come as a shock to public health experts working on health, nutrition and right to food.
After the increase in the proportion of underweight and stunted children revealed by the national survey, most had expected a substantial increase in allocation for nutrition. However, though the FM talked about merging the supplementary nutrition programme and Poshan Abhiyan and about an intensified strategy to improve nutritional outcomes across 112 aspirational districts, the annexure to the speech indicated a Rs 1,000-crore cut for nutrition.
A closer look at the Budget documents shows that the budget for the umbrella Integrated Child Development Scheme (ICDS), the largest early childhood programme for children under 6 years, has been slashed by over Rs 5,000 crore from Rs 26,057 crore to just Rs 21,005 crore. The programme provides food, pre-school education, immunisation, and health check-up through anganwadis at the village level.
“One expected that given that one phase of Poshan Abhiyan is over and it hasn’t achieved its target, as shown by the NFHS-5, there would be an increase in funds. It is disappointing that in the present situation of hunger and malnutrition facing the people in this country, the Union Budget has actually reduced the allocations for crucial food and nutrition schemes such as the ICDS, midday meals and maternity entitlements,” said Dipa Sinha of the Right to Food Campaign.
Some components of the erstwhile umbrella ICDS scheme have been split up and clubbed differently with other schemes making comparison difficult. However, it’s clear most components have faced budget cuts (see graph). The flagship nutrition scheme has been rechristened as Saksham Anganwadi and Poshan 2.0.
Allocation for the midday meal programme has increased marginally from Rs 11,000 crore in the Budget estimates for the current year to Rs 11,500 crore, but has fallen by Rs 1,400 crore when compared to the revised estimates for 2020-21 of Rs 12,900 crore.
Due to lack of immunisation
See graphic: Number of children up to 5 years old, conditions-stunted, under weight, anemic, not immunised in cities-Gorakhpur, Maharajganj, Kushinagar, Deoria, 2015-16
Health, nutrition and cognitive growth
Kerala emerged on top while Bihar fared the worst in outcomes linked to health, nutrition and cognitive growth of children in 0-6 years age group, based on a comparative analysis of public data for 2005-06 and 2015-16. The overall India score on a scale of 0-1 adds up to 0.585, far from impressive, though it reflects an improvement of 0.142 over the 2005-06 score of 0.443.
The findings — Young Child Outcomes Index (YCOI) — are part of the “State of the Young Child in India” report, brought out by civil society organisation Mobile Creches and supported by Bernard Van Leer Foundation.
The report, released by Vice President Venkaiah Naidu, also presents a Young Child Environment Index (YCEI) for 2015-16, concluding that the indices make one thing clear that states with better circumstances tend to have better young child outcomes.
YCOI takes into account three major components — health, nutrition and cognitive growth — and the respective indicators selected include infant mortality rate, stunting and net attendance at the primary school level. The YCEI is based on indices using data related to various indicators on gender, poverty, health, safe water supply and education.
The India score for 2015-16 for the child environment Index is 0.672. Kerala and Goa are the top two states in both indices while Jharkhand, UP, Bihar and Madhya Pradesh are among the bottom five.
In YCOI, Kerala leads with an impressive score of 0.858 in 2015-16. Goa comes second with a score of 0.817 in 2015-16.
Pointing that while all states have registered different levels of improvement between 2005-06 and 2015-16, there are eight states with scores below the national average of 2015-16. These are: Assam (0.583), Meghalaya (0.562), Rajasthan (0.556), Chhattisgarh (0.555), Madhya Pradesh (0.526), Jharkhand (0.500), UP (0.460) and Bihar (0.452). All these eight states also fare poorly on the YCEI.
In YCOI, Tripura has made significant improvement moving from a score of 0.582 for 2005-06 to 0.761 in 2015-16. Bihar has the lowest score of 0.452 in 2015-16. On the YCEI, Kerala yet again tops the child environment index (0.855), followed by Goa (0.846) and Sikkim (0.819). Arunachal Pradesh has the lowest score with 0.533 followed by Manipur at (0.537) and Jharkhand (0.578).
Child mortality is down, but malnutrition worsens
Stunting, Wasting Up In Many States, Finds Govt Survey
Mortality indicators for infants and children under five years have improved, with some exceptions, over the four years since the last National Family Health Survey (NFHS) in 2015-16, reports Rema Nagarajan. However, malnutrition indicators have worsened: the proportion of children with stunting increased in 11 out of 18 states for which data was available, of those with wasting went up in 14 states, and of those with anaemia in 17.
Maharashtra has seen a marginal worsening in figures, with 35% of its children found stunted.
80% Guj kids anaemic, Maha’s neonatal mortality rate worsens
The government put out data for 22 states and Union territories from the NFHS of 2019-20. The states referred to include Jammu & Kashmir, now a UT. What is disturbing is that instead of indicators related to malnutrition improving, it has become much worse in most states.
Stunting, caused by chronic deprivation of food and defined as less height for age when compared to the child growth standards median, has gone up by as much as eight percentage points in Tripura, almost six percentage points in Telangana and about four percentage points in Kerala and Himachal. Among larger states, besides Maharashtra, Gujarat has recorded a marginal worsening, with 39% children stunted.
Wasting, caused by acute food shortage and defined as inadequate weight for height, has increased in most states, with almost one out of five children being wasted in many of the states that have seen the situation worsening. Even the proportion of severely wasted children has gone up in 14 out of the 18 states. While the proportion has marginally increased in most states that have registered a worsening, in states/UTs like J&K and Telangana, it has increased by about four percentage points to almost 10%. There has also been a huge increase in the proportion of children with anaemia in most states, with Assam showing a jump of almost 33 percentage points, which means more than twothirds of children (68%) below 5 years in the state are anaemic. Gujarat is the state with the highest proportion of anaemic children, 80%, a big jump from about 63% in the last survey.
Child mortality indicators—infant mortality rate, which pertains to deaths before the completion of one year, neonatal mortality rate (NMR), which is deaths in the first four weeks of life, and under-five mortality—have improved in most states with some like J&K and Assam showing significant improvement. Among the few states which have shown a worsening of these indicators, the worst off are Meghalaya, Manipur and Tripura. Among bigger states, Maharashtra has shown a marginal worsening on NMR and hardly any improvement in the other two mortality indicators for young children.
Among bigger states, Maharashtra has shown a marginal worsening on NMR and hardly any improvement in the other two mortality indicators for young children
Children’s health: India