- 56 percentage of children aged 12-23 months do not receive all recommended vaccines
- 46 percentage of children under age 3 are underweight
- 57 number of infant deaths per 1,000 live births in the last 5 years
- Only 26.2 percent of children with diarrhoea receive ORS
- 79.2 percent Children age 6-35 months are anaemic
National Family Health Survey 3
Clearly, child health indicators of India are anything but encouraging. While the country talks about reaping demographic dividend with a high proportion of young population, the truth is that, it is doing little to ensure that the young have access to basics of nutrition and healthcare. The current share of programs on children in the budget is around 4.86 per cent. Out of this, nearly 70 per cent is marked for education while health gets a modest 11.43 per cent. In these circumstances, it is not surprising that problems like Infant mortality and malnourishment persist.
What is most unfortunate is that a lot of this is preventable- it needs penetration of the programs. However, despite a fleet of programs, achievements remain far from satisfactory. While budgetary ‘constraints’ – or should we say ‘priorities’- remain a challenge, the questions of accountability cannot be evaded. The anganwadi worker (AWW), for example, has it in her job description to provide care to expectant and lactating mothers and their infants. However, this is rarely done. One of the reasons for low motivation levels is the poor remuneration. Improved pay, with training in identifying and solving some newborn health problems, could go a long way in promoting neo natal health. Unfortunately, we fall short on doing the additional bit.
Talking about accountability, a WHO study reports about the Child Survival and Safe Motherhood (CSSM) intervention undertaken by the National Neonatology Forum (NNF) with support from the government. Under the program, operationalization of newborn care was initiated at district level. This included training of medical officers and nurses in newborn care at the Primary Health Centre (PHC), first referral unit (FRU) and District Hospitals in 30 districts along with the supply of essential neonatal care equipment.. The project monitoring report revealed that at PHCs and FRUs the utilization of neonatal care equipment such as weighing machines, thermometers and warmers was a mere 50%. In some facilities the NNF review staff found the equipment still in their packing cases even after a year. Most of the trained medical staff had been transferred and the new incumbents were unaware of the use of the equipment or the principles of essential newborn care. (Source: http://www.whoindia.org/LinkFiles/Commision_on_Macroeconomic_and_Health_Bg_P2__Newborn_and_child_health_in_India.pdf).
Why do we put up with this? Where do we fix accountability?
It is important to empower communities, families and mothers, so that they not only seek but demand health care for the children. Let this demand be articulated through political forums. Sensitize the media to report about these chronic issues so that it hits the collective conscience of the society. Fight elections on these issues. Make it a national priority. Else, we will lose another generation before we can hand over the mantel of development to them.