CHILD WELFARE
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- Title
- CHILD WELFARE
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IS
C
I L 3
X -3 L F A R E*
By
Dr. (Mrs. ) V. Rahamathu 11 ah
, M.B.E,S.(DeIhi)DTPS( Lend.)
Medical Adviser9 UPASI CLWS.
"Somehow the fact that ultimately
everything depe^ads on the human
iact or gets rather lost in our
thinking of plans and schemes of
ma.terial development' in terms of
factories. machinery and general
schemes .0„
Ultimately3 of
course it is the human being that
counts ond if the human being
counts well, he counts much more
as a child than
—i as a grown up".
Jawaliarlal Nehru
Child care programmes are not
new to plantations,
'Ad—hoc programmes have been in
vogue since creches are
mandatory.
Today, the concept of child care has
undergone
fundamental changes in concept and it is
necessary to
review the growth of child, care
programmes 9 and its future
. role, to have a better
perspective of money spent on these
programmes.
D3VSL0PEI5NT. OF
CA3.E PE.OGE.xI-XES ;
For centuries human attitudes towards
children have
been to treat them as dependants and
family possessions.
* Tae information in the paper has been extracted
from various Joooks, periodicals, magazines and
Government oi India publications.
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The family system was marriage and procreations,
became more important than care of the child.
parental love was taken for granted.
This
Univers al
This is more true
in old societies and developing countries.
The experience of economically advanced countries
show that they could’progress not because they emphasised
material goodss but they placed a premium on human factors
in economic gr o wth;
prof. J.K, Galbraith in his book "Man
and Capital” says "The fact that this is the age nf ascen
man not triumphant machine, has practical consequences.
dant man,
If machines are the decisive thing then the social arrange
ments by which we increase our physical plant and equipment
will be of first importance.
But, if it is men that count,
then our first concern must be with the arrangements for
conserving and developing personal talents, for it will be
these on which progress will depend.
Should it happen
moreover, that our societies succeeded in supplying itself
with machines and failed in providing itself with adequately
trained manpower there would be cause for concern.
There
z or that is precisely our situation n o
is such cause for
India!s economic plans began to build up the infrastructure for a scientific state with little emphasis on
or such a stjte.
manpower needs Tor
from
It is worthwhile quoting
Souvyfs book from ’’Malthus to Mao Tse Tung".
’’The
apparent over population of an economically under developed
country ? leads to the thinking that there is a surplus of
men but , it is the qualifled work that matters.
If the
men are unemployed it is because they do not know how to
work usefully, xxow to tame nature and transform its products".
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Making a man is a long process, i ts success rests
on txie inputs in tne early formative years of the child,
Maria Montessori revolutionised thim-ing about child
c ar e
with proof that the first 6 years of human life are
the
ones of most rapid growth and capacity to absorb,
Habits
value systems and discipline are implanted into
the human
child at this age.
Kew people realise how
critical this
®
th© development of character,
What is once learnt
is not readily unlearnt
(e.g. j Indians are grossly careless
of their own envircnmento
These habits are engendered in
the young child
If cleaner habits are to be inculcated
in the future generation^ it has to
start in childwood.),
The greatest mistake we make is linking
care of the child
to charity and welfare and not to
economic growth of the
country.
CHILD CAR2 CV
THE
;
The earliest known services to needy children began
with orphanages
Britain in the middle ages looked upon
the poor as bad human material,
of legislations
that govern
their genesis in this
And hence?
the growth
Child Care Programmes had
concept.
0
It’ is only in 1968,
that
Britain sanctioned money for pre-school education in Urban
centres♦
France assumed responsibility for children as early
as 1874 and progressed towards
compr ehen sive chi 1d car e
over th© ye ars
U SA t he lat e entrant
s t ar ted pr o gr anti; e s ,
with an objective of giving coloured
children a head start
through their primary education programme known as
’’Head
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s tart programmes tr from 1964.
It is in the communist
countries tnat chi ld welfare eLooumea
assumed a
a new
new perspective.
Marxists thought embodied the
the realisation
realisation that capital'
formation in economic terms meant
me an i the
t he preparation Of human
capital as a.major component.
Is are is the other
noncommunist country which adopted this policy in
a bid to set
: up a modern state within one geieration.
Cnina has placed
great emphasis on Child Care by reviving
activities familiar
t o the chi Id and inculcating tie concept that even a child
even
is and should be a productive nember of*
society.
CHILD CAxj; IN
iudta;
India is faced with 17h century problems of Europe
and lingland without time as in
advantage.
The idea of a
whole child-is of very recent origin,
Our concepts and
thoughts have been influenced by western thinking.
However 9
as early as 1874, the first centre for prc-school children
was established in Lucknow,
In the field of education WQ
had Tagore in Bengal and Annia Bas ant
i-i South India,
The
first children1 S organisation
was established in 1920 in
Bombay.
Various voluntary organisations established
centres for children in various parts cf the
country.
in
1956j the Government recognised the work done
by voluntary
organisations.
Tn 1958, the lanning Oommission recognised
the need for child welfare
prigrammes. However, it is only
in 1974, tne Parliament
approzed India's first child
welfare policy,
The Parliamcit stated,, children are
a
nati on fs Supremely importantasset and -hat their
programmes
must find a prominent place ,n our national plans
for t he
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development of human resources.
The premise was that the
investment in a child represented investment in human capital.
CHIL3ARN ^HAT THEY LIVE.
If
achild lives with criticism he. learn_s
to condemn.
If
achild lives with hostility he Learns
to fight,
If a child lives with redicule he learns to be shy.
If
achild lives with shame he learns to feel .gu-i Ity.
If
achild lives with toler ance he learns
to b-e patient.
If a child , lives with encouragement he learns confidence.
If a child lives with praise he learns to appreciate.
If a child lives with fairness he learns jnsticje*
If a child lives with security he learns to..Lave fai.th.
If - a chi Id lives with approval, he learns to like himself.
If a child lives with acceptance and friendship he
learns to find love in the world.
Dorothy Law Holtz
REQUIREMENTS OF a CHILD;
Health and nutrition has to be an important component
in child care programmes.
However, education and play must
However,
s-ejure equal importance in the formative years if our aim
is to prepare them for future, responsible citizenship.
It
is only by transforming the human being in these formative
years that social transformation can be brought about.
The education in this period should be deliberately designed
to give children new habits of both behaviour and thought.
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ChiId Care programmes shouId have the following inputs;-
Child Health
Nutri tion,
Education
Welfare•
DEMOGRAPHIC PROFILE OF
and
CHILD IN INDIES
According to the 1971 census, children 0-14 years
form 42 per cent of the population.
The registered infant
mortality rate in 1970 is given as 113/lOOC live births(1)o
However,
the estimated infant mortality rate given by Doctor
Shanthi Ghosh for 197& is 122/1000 live births.
4o per cent
of the children born do not reach age 5 (Shanthi Ghosh).
It is estimated that 75 per cent of the child population can
be classified as not’healthy (2) due to major and minor
illness.
High morbidity is largely attributed to unfavour
able sanitary conditionsj yeaning is another critical period
in the life of the Indian child.
56 per cent of illness
seen in the health centres are related to intestinal
inf ections, respiratory complaints and nutritional disorders(3).
Where death does not result,3 it is obvious that enormous
human suffering is entitled besides loss of growth , health,
efficiency and wastages of human‘resources.
Though a child
(1)
Infant mortality, Population growth and
Family Planning in India. - S. Chan dr as eke r.
(2)
Perspectives on the child in India, Central
Institute of Research and Training in public
co-operation.
(3)
-do-
—do-
— do-
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born in India today has a better chance
of survival,
the fact cannot be glossed over that infant
mortality
rates are high. Mortality rate in India does not
; even
compare, very well with countries like Sri Lanka, :
Malaysia
or Taiwan (^).
CEILD E3ALTH£
The Indian Council of Medical Research. (iCMR) Survey
points out that the one year old Indian child starts with
tae deficit of 1.6 cms. in height (2.3^) and by five
ye arc
Of age
ag'e 9a the deficit increases to 3 cms. (5.5%) (5).
The
deficit in body weight is much more marked.
This, in spite
of tae fact the uncorn Ind_i_an baby weighs trie same
as the
unborn western child up to 33 weeks of gestation (Doctor
Shanthi Ghosh).
At the heart of the problem
problem of
of the
the young
cnild is the problem of the mother.
WTRITI ON:
In ta,j. field of study covering 1400 pre-school
children it Was ^ound that 32 per cent of the children
belonging to the birth order 4 and above exhibited various
(4)
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(5)
•Perspectives on the child in India Central Institute of Research and Training
m public co-operation,
N.’Z. Patkhe & H.D, Kulkarni, Grovzth and
Development of pre-school children in
Report of the Seminar on the Pre-school
unilu, Madras, IGCW, 1973.
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signs of malnutrition while only 1? per cent of children
of earlier birth orders showed such symptops.
.The heights
and weights of pre-school children , showed negative cone■
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lati oh'With-family size.'
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6? per ce: t! of all nutritional
deficiencies were encountered in children of birth orders
4 and above (6).
this implies that even under the current
economic and living condition mere limitation of the family
can bring down incidents of malnutrition in pre-school
children by 60 per cent (7).
^0 per cent of physical growth
and 80 per cent of mental growth takes place in the first
6 years of life.
A countrywide survey of children 1-5 years
done by ICMR reveals that 92 per cent suffer from malnutri
tion (8).
The 1972 survey by ICMR reports th^t 60>per cent
of the children suffer from nutritional anaemia.
Nutritional
dwarfism is a common feature of the child population in
this country.
>
(6)
(7)
(8)
-
C. Gopalan, Nutritional Status, Needs & Services
Reports of the seminar on the pre-school child,
New Delhi, ICCW 1973.
-do-
—do-
-do-i
Malnutrition among pre-school children, Indian
Express, November 2nd, 197^»
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The Balwadi teacher is to prepare the child through
liaSe with thQ co;riaunity
constructive play
the
child as the central figure.
Tho .inganwadi concept started wit’? the "Meadow
school concept".
This was to provide constructive
ooc^ation for children during the mot..erS< working hours,
envisaged
^sa
setting up of open spaces under the- tree.
The **n anwadi tea ch er has
a condensed training programme
in comparison to
the Salasevika training prograde.
The
idea is to texke
a woman from tho village and give her just
sufficient training to look after the children.
The
Balasovika has 9 months training after S.S.L.C. while an
-mganwadi teacz;er is less
qualified and undergoes training
for 3 months,
Another important development is the mobile
creche
or construction
_
workers1 children.
.
SH3ST:
A.
Infant Mortality Rate
The average world-wide
infant mortality rate is 83/1000
live births.
in developing
countries it ranges between 42/1000 live births to 200/1000
live births,
rn India it is stated to be 122/1000 live
births in 1978.
Karala has the lowest infa.it mortality
rate at 52/1000 live births,
30 per cent of inf riots die
within a week of birth, 20 per cent betwe
an one week to on©
month , 27 per cent one
week to 6 months ? 40 pex- cent do not
reach age 5*
The .^oal set for 2000 41). is- less than
50/l000 live births by all
countries.
Nutritional deficiancles with low birth wei^hts accounts for 57 per cent
of all infant deaths.
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The ‘terms used in mortality amonsr childrens
“
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Perinatal mortality
- The period from 28th week
of pregnancy to the 7th day of life.
Noo-natal mortalit
life
ear 132
Neo-nat,?.! period 1 ate
The first 7 days of
Upto 28 days of life.
Post noo^rie/ta 1 period From the 28th day of
life to the end of the year.
s.1 i t y
months of life.
Deaths during the first
ChiIdhoodrnort ali ty
age 1 to
”
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Deaths occurring from
The last two are commonly used as an. indication of
the health of the children and as a guage of social
deveLopment 5 60 to 80 per cent childhood deaths occur
between the ages of 1 month and 1 year.
These are mainly due to diarrhoeas9 respiratory
infection etc.
Nutritional deficiencies are a major
contributoring cause.
The more malnutrition and anaemia
in the mother, the more uncertain the future of the child,
The greater the numboz* o'' the children the more serious
is the risk to the mother and the child.
Post neo-natal
mortality increases steadily with birth order.
ChiIdhood
mortality (age 1 to 4) account for 33 per cent of all
deaths while in developed countries it accounts for less
than 1 per cent B
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a-t Births
indicator of health.
Birth weight is the
-
70 per cent of all deaths in the
neo-natal period were among babies with weight of less
them 2500 gms,
Factors influencing birth weight are the
hea.lt h, si ze 5 nutritional status of the mother, obstetrical
s
hi s t o ry, birth order of the child, and in terval bet we on
births .
In developing countries 25 to
per cent of all
b abi e s born are underweight and they are born full term
to undernourished mothers.
in India,
s tiid. ie s h s.ve sh own
that the weight of the foetus is the same as that of the
.American ^oetus upto 33 weeks of gestation. However, the
.American baby weighs 3300 gms.
gms . at birth while the Indian
baby has the following weights:
Rural
...
Urban
•. •
Well to do Indian.
2500 gms.
2800 gms.
3 100 gins o
Low birth weight is a ve r y i mp o r t ant c au s e o f , in Tan t
deaths.
It affects development of a child , growth and
possibly even brain development,
Studies in South India
have shown that treatment of anaemic mothers with iron
Folic Acid tablets in the last 6 weeks of pregnancy
increased birth weights of children.
Co
Height as an indicator
weight is a reliable incii cat or*.
p.
7 3-i-inn Xrs
in
io Sy
Hei c;ht as well as
ShnrtnA^H in any c.hi Id
likely related to genetic factors than
to in a Inu t r i t i on and infection.
With the exception of a.
few ethnic groups , there
uMwi e- is evidence showing that all
children have a similar growth potential.
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Fac t sheet about pla,nt at ions;
?
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The information given h’ere is for the Comprehensive
Labour Welfare Scheme estates only as information from
other estates are not available.
The population covered
is 2,02,616 in 1979v
Crude birth rate in 1970 when the
programme was started was 4la7/lOOO population and has
come down to 27*7/1000 population in 1979*
The infant
mortality rate was 118/1000 live births in 1970 and has
come down to 63.7/1000 live births in 1979.
50 per cent of
all deaths among infants took place in the first week of
life with prematurity accounting for 80 per cent.
Details
are not a.vailable on whether prematurity was by term or by
weight.
However f it would be fair to presume that 70 per
cent of prematurity reported must be by weight.
On the
CLWS estates children 0-l4 were 42 per cent of the population,
However , in 1979,
the child population 0-14 accounted for
37 per cent of the population.
Nutritional status of children by weight for a£ej_
1974
Normal..
1st degree,
'2nd degree0
3rd degree.
27%
46%
16%
10%
1211
.35%
4o%
23%
2%
Information given in the fact sheets is
extracted from 11A Healthy Child a sure
future” - ‘tlorld Health Day, 1979” ;/ho9
Delhi.
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-An. analysis of the nutritional standards of
10,000 children showed that children 1-5 had a higner
weight and height compared to South Indian children’s
height an d we i ght as reported by Dr-G-opalan in his survey
of 1976. However, height ahd weights of children below
The average birth
one year' was fo nd to be much less,
This was based on an
weight was found to be 2500 gms.
analysis of 3500 births.
Birth orders;
In 1975-76 only 51.1 per cent of the births were
among women with 3 or less than 3 children.
In 1979, 75
per cent of the births were among women with 3 or less
than 3 children.
In 1973, 53.1 per cent of births were
among wom®n below 29 years of age while in 1979, women
below 29 accounted for 81.1 per cent of deliveries.
Materna 1 cie at 11 s ;
The data in this has been disappointing.
in 1979, 3.4/1000 deliveries took place.
However ,
nowevwx
90 per cent of
the deaths took place.in the lines and the balance 10 per
cent reached the hospitals late.
Institutional deliveries£
In 1973, less than 42 per cent of the deliveries took
place in hospitals, In 1979, this has increased to 70 per
cent •
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/mt e -n atai _ Car e£
In ibn, only 27 per c-e
cent
n t of pregnant;, motners
examined.
In 1979, 98 per cent have alteast 2
examinations before deliveries.
.
Eo.ever^he proo eu
ol ante-natal care in the last 6 weeks of pregnancy
after the woman goes on.maternity leave is stall poor
T is is t.e most vulnerable period in tho. pregnant
■
Omen’s life-
covering the woman with, iron
folic'acid tablets in the last 6 weeks of pregnancy
•
+g
rhildren considerably,
can increase the birth weights ox children
thereby, reducing infant mortality, rate to a large
e xt en t •
Creche in the plantations ?
- ------ “17 o.tate. have a oreohe
•
ar Olri.nn pravraod,
there are 50 xomin workers empleysS.
W11 W’?"
w U«l. thinking on th. role of
‘"3T‘
-
plantation..
Writer oli.r llliwrato
..Ployed a. ereeh. attendant.
,,lth a view that th.
attendants with.
el.
would h. a .oth.r
mother .nhatnuta.
subs11tut<•
; ""
iaste conflict .ocicty *>» creches were
.
to
brins
female
relatives
worker, prrferr.d
briny i.Wl. r.latiC
■>
.______
changes
nave
talcen
Today, changes
tlie Homes,
t He children m ---- attendants are beins replaced by
p lace and old creche
The replacement par-force has to
young trained women,
Significantly ? the health of the
be a gradual process
for the child has received
child and nutritional inputs
from the analysis'JC2'-the
great attention which;is obvious
and immunis at i on status of the
n.u titional status
The concent of the
children in the p lantations.
fical point for changes in
whole child and the child as a
This is mainly because
society has yet to be developed.
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firm links has yet to be established between the community
and the creche.
This requires thinking and reorganisation
in the functioning of the creche.
It also requires addi
tional inputs in terms of psychological and social inputs
required for the total development of the child.
RECOMMSND^TIONS:
It is suggested the creche should be envisaged as a
place where development of the human resources starts.
The activities should be designed to form the core of* the
human development,
This requires development of activities
that will inculcate good habits,
s.
creative thinking,
team
work discipline and cooperation,
This can be achieved by
making sure that children can play freely , participate in
organised games, indulge in creative art like painting,
drawing etc and actively participate in gardening to main
tain the agricultural background of the children.
It has
been shown that children who have played at gardening have
maintained their interest in agriculture even after the
formal education in the system.
There is need to make the
creche/and the home.
The role envisaged is that of educating
the family on nutrition, personal hygiene, environmental
hygiene and making the mother a participant in the growth
of the child, ^/attendant the link between the child in the
creche
For these, there is need to ensure that all children
attend the creche.
for the role.
The creche attendants need to be trained
However, the health department has to energise
its activities to make the creche the centre of maternal
child health programmes.
They also need to develop the
logistics of constructive supportive services.
sspd.
23.1.1981.
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