India is home to 472 million children. Forty percent of India’s population consists of minors. The country is home to one-third of the world’s population of women who become mothers even before they have reached adulthood. Yet the budget allocated for their health is only 4% of India’s already meagre health spending.
In the remote hamlet of Mai in Bihar’s Munger district the tragic consequences of this low spending is immediately apparent. Situated on the banks of the Ganga, Mai is home to around 100 families. Most of them do not have ration cards or any other official documents.
For the past 11 years, the village has played host to a facility of the Integrated Child Development Scheme, which aims to provide provide food, preschool education, and basic healthcare to children under six years of age and their mothers. In fact, the facility in Mai has been named a “model ICDS centre”. But the condition of the building appearance belies this accolade. The area surrounding the centre is occupied by children, buffaloes and other domestic animals. The building also serves as the village community centre, which means that ICDS services are not available any time there is a community programme or meeting. The roof of the centre is rickety and the floor is blistered. A solitary weighing machine that arrived after two years of asking for it stands in a corner and there is no other equipment to monitor children’s growth.
Whether the ICDS centre is a model one or nor, it is unlikely that children of this village, with little access to enough nutritious food, will grow up healthy. Mai is evidence of the conclusions drawn from the fourth round of the National Family Health Survey – that nine out of 11 states surveyed have not been able to reduce the rate of infant mortality by even two points annually. In India, 40 out of 1,000 infants do not reach their first birthdays.
In Damodarpur Mohuli, a small village on the outskirts of Samastipur district also in Bihar, the ICDS centre has not been functioning for the past six months due to a lack of funds. “If I cannot give the children proper medicines or nutritious food, what is the point of keeping the ICDS centre open?” asked Savita Devi, the government-appointed helper or sevika at the centre who has not got her salary for half a year.
Intent versus investment
The ICDS has the right intent – to provide a sound foundation for children given that 90% of human brain development occurs within 5-6 years of age. Implemented from 1974, this scheme is implemented through the wide network of anganwadi centres, giving it the potential to provide comprehensive coverage. Over the years, the coverage and services of this scheme have increased multi-fold. The latest policy speaks of restructuring the ICDS to enhance anganwadis with crèches that will provide universal healthcare and also preschool education.
Such a transition will require special training of ICDS staff. The plan can only be realised with adequate investment – but funding for the scheme has only been falling.
The budget allocation for the ICDS in 2016-’17 has declined 9.6% from 2015-’16. Some states have seen deeper cuts than others. Maharshtra’s ICDS spending fell from Rs 3,463 crores in 2015-’16 to Rs 1,307 crores in 2016-’17.
Moreover, the scheme is presently able to cover only about 50% of the population of children under the age of six. Large number of children still only have access to anganwadis that are devoid of education services.
The ICDS also lags in terms of reach, leaving more than 18 lakh of the 35 children who should be covered by the scheme without ICDS services – a poor strike rate of just 50%.
It also suffers from many vacant positions in anganwadis.
The case of Meera, a child in Pokhadia village near the Jharkhand-Bihar border, illustrates what might be happening in places with no anganwadis. Meera was born prematurely three years ago to a malnourished mother and was so fragile that her family thought she was dead and was ready to bury her. However, anganwadi worker Lila Bai rushed to the house and saved the baby. She taught Meera’s mother how to look after the premature child and encouraged her to make sure she was vaccinated. It may like likely that other children have not been saved because there was no anganwadi worker at hand.
Getting priorities straight
Investing in children has a cascading effect on individual growth and development and on economic growth. It also reduces social inequity and breaks cycles of poverty.
Over the past few years, the Indian government has initiated policy recommendations to provision early childhood care under the Right to Free and Compulsory Education, 2009, and has introduced the National Early Childhood Care and Education Policy. The government also acknowledges the critical links between early learning and improvement in learning outcomes in formal primary schooling.
The need of the hour is to translate this intent to action. While policies can be created and legal frameworks can be built, as long as there is minuscule investment, these grand visions will come to naught.
Komal Ganotra is the director of policy, research and advocacy at CRY – Child Rights and You.