SOUTH ASIAN CONFERENCE ON CHILDREN
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SOUTH ASIAN CONFERENCE
ON CHILDREN
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SOUTH ASIAN CONFERENCE
ON CHILDREN
INDIA SITUATION ANALYSIS
(JULY 1986)
THE
BASE
1.
Any appraisal of the economy, in relation to its support for the
developnent of all children, necessarily involves value judgements,
social priorities and policy objectives. For present purposes, the
performance of the economy and its implications for children may be seen
with reference to the aims and criteria set by the government Itself.
in strategy
2.1
Over the first half of the period of the six five year plcins
completed, the main emphasis was on the aggregate growth of the economy.
Like in many other developing countries it was thought that growth would
in turn advance the cause of the poor and the objective of equity cind
regional balance. The actual experience in this era was that growth
itself was slcwer than targeted and its percolation effect was also
doubtful. An alternative strategy of development, linking growth with
equity, became politically necessary. In time for the fifth plan,
1975-79, a direct attack on poverty and unemployment was begun and has
continued since. Complementing the creation of employment opportunities
for the poor have been increased plan outlays on sectoral programmes of
health, nutrition, education, sanitation and environmental protection,
focused attention on specific groups like backward, classes and tribes,
landless labourers, marginal farmers and, among these and similar groups,
the more vulnerable, namely, children. The accent on children in the
context of national development strengthens the nexus between growth and
equity. They are a source of growth and growth is mean for them.
3.
Rates of growth
3.1
A conuion indicator of material wellbeing, the gross domestic
product grew at an annual compound rate of 3.6 percent during 1950-51 to
1984-85. However during the decade 1974-75 to 1984-85, the growth rate
was distinctly higher at 4.6 percent. Both the fifth and sixth plans
exceeded the target rates — 5.2 percent, against 4.4 percent, in the
fifth plan and an estimated 5.4, percent against 5.2 percent, in the
sixth plan. Thus the ecorony lias moved on to a higher growth path, a
process that seems to have accelerated in the 1980s.
3.2
In per capita terms, a substantial portion of the growth was
neutralized by the increase in population. During the 35 years 1950-85
it rose only by 1.6 percent per year, which is substantially less than
the rate of population growth of around 2.2 percent during tills period.
However, the per capita growth rate improved to 2.8 percent per year in
the fifth plan and to 3.2 percent in the sixth plan. This encouraging
rate does not in itself imply a reduction of inequalities.
2
3.3
The nonentum to the economy lias been provided over the past decade
and more by a surge in domestic savings. A high point of India's growth
record is that the country has been saving and investing close to a
quarter of its gross dcsnestic product, a level usually associated with
middle or high income countries.
3.4
The high level of domestic savings coupled with a diversified
industrial and technological base explains the degree of self-reliance
achieved in financing most of the investment needs through domestic
resources. The country is self-reliant in foodgrains production which
has tripled since 1950-51 to a peak harvest of 152.4 million tonnes in
1983-84. In spite of widespread drought in 1985-86 the output is
estimated at 147.5 million tonnes with government stocks reaching a
record 30 million tonnes in 1986.
Rate of Saving and Capital Formation
(at current prices)
Percentage
1970-71
1978-79
1981-82
1982-83
1983-84
1984-85
Gross rate of
saving
16.8
24.7
23.0
22.6
22.1
22.1
Gross rate of
capi tai
formation
17.8
24.6
24.8
24.2
23.4
23.4
Net external
capital inflow
as a %age of
GDP (at current
prices)
1.0
0.1
1.8
1.6
1.6
1.3
4.
Agriculture
Agriculture contributes 35 percent of the gross domestic product
4.1
(1984-85) and provides livelihood to about 70 percent of the population.
Industry depends on agriculture for much of its raw materials.
Agriculture-related exports contributed to more than 30 percent of export
earnings in 1983-84.
3
c
4.2
A basic weakness of Indian agriculture is that the output is
subject to large fluctuations, mainly because 70 percent of the effort
continues to depend on rainfall. The breakthrough in agriculture is
confined to only certain crops, like wheat. This lias aggravated the
regional Imbalance. Low productivity affects the income level of about
66 million rice farming families in the six eastern states. The
production of coarse grains, pulses and oilseeds is stagnant, with
serious effects on small and marginal farmers engaged in their
cultivation mostly on dry land. This is the perspective in which the
seventh plan focuses on development in the eastern region and dry land
farming. The success of the strategy will depend on the management of
its diverse operational aspects. The weakest link in the country’s
agricultural development is the subdued production of oilseeds and pulses
which provide the main source for people’s requirements of fats and
proteins.
5.
Industry
5.1
The share of mining, manufacturing, construction and infrastrueture
in the sectoral composition1 (°f" the economy has increased from about 19
percent in 1950--51
at present the change being more rapid
- _ to
—one
--- third
---------------during the first three plans than thereafter. The share of the
traditional manufacturing sectors like food and textiles in industrial
production has declined in favour of new industries like chemicals and
engineering. There has been a spectacular progress in oil exploration
and production, from about 11.8 million tonnes of crude oil in 1979-80 to
29 million tonnes in 1984-85. It may not t>e possible to maintain this
pace, though demand continues to grow rapidly, pointing to the need for a
drastic reorientation of energy policy.
5.2
Most of the requirements in heavy machinery and equipment as well
as engineering and technical skills are being met from indigenous
sources. However the economy is partially dependent on external sources
in critical areas such as energy needs, fertilizers and their raw
materials, and edible oils as well as of technology and equipment in
frontier areas. Two positive features of the overall situation are that
the dependence on foreignl :resources is declining and even in critical
areas self-reliance is growing, The economy has had enough resilience to
absorb the shocks of the world energy crisis in the late 1970s and the
global recession of the 1980s, as well as the recurring droughts within
the country.
6.
Managing the economy
6.1
The^tempo of growth and investment in the sixth plan could be
maintained without effecting serious cutbacks
------ > in 1...^
imports. Current
account deficits steadily decline and remain manageable at about 1.2
percent of the gross domestic product in 1984-85.
4
The management of balance of payments in the seventh plan may be
6.2
difficult on account of the declining imports, discouraging prospects for
concessional aid and for workers remittances from abroad and increase in
the cost of external borrowings, Of late the savings rate lias shown a
tendency to flatten out, at 22.1 percent in 1984-85 ccanpared to the peak
of 24.6 percent achieved in 1978-79, which is about the level projected
in the seventh plan.
7.
Public enterprises
The success of ttie seventh plan hinges heavily on the performance
7.1
of the public sector. Not counting the electricity boards and transport
undertakings which are not seen as sources of surplus, the Central
government enterprises are expected to contribute nearly a third of the
seventh plan outlay of Rs.1800 billion. These enterprises have a total
investment of Rs.428,000 million as of 1984-85, with a net profit of
Rs.9290 million. The financial constraint on the current plan is evident.
8.
Productivity
That brings into focus the imperative to increase the rate of
8.1
return on investment by reducing time and cost over-runs and increasing
capacity utilization. The capital output ratio has shown a trend value
of 5.5 and is expected to be around 5 during the seventh plan. Capital
intensive new technology, rising cost of modernization, high cost of
irrigation and power projects, all tend to push up the ratio. The
efficiency in managing public enterprises thus becomes critical to the
success of the development plan. Though transport facilities including
tte railways have expaiuled significantly, the inadequacy of the transport
infrastructure, particularly the railways, still remains a major
constraint on production and distribution.
The efficiency of management of national resources like land,
8.2
water, forests and energy is even more critical to the development
process. As explained in the Chapter on Environment the general trends
are more disturbing than promising, which suggests the need for policy
review from the point of view of equitable as well as efficient use of
the national assets, particularly the non-renewable sources of support to
life. Operational efficiency has in fact to be increased across the
production sectors. For example 80 percent of the pumpsets in the farm
sector are reported to work on an efficiency of not more than 30 percent.
The transmission and distribution losses in the pcwer system of the
country exceeds 20 percent. In the coal sector, some 8 million tonnes
are wasted each year through wrong practices in storage, handling,
preparation and combustion.
3
5
9.
Science and technology
9.1
Thie progress made by India in science and technology holds the
promise for modernising the economy, The fields of achievement range
from agriculture on the one hand to industry, nuclear energy, space and
ocean technology on the other.
10.
Resources
10.1 Foreign trade is not a large proportion of the gross domestic
product (Imports around 7 percent and exports 5 percent of GDP), The
trade deficit is offset by remittances by non-resident Indians, currently
averaging US $3 billion a year and a combination of aid and commercial
borrowings. The share of total external aid in plan finance has reduced
from 33 percent in the third plan to around 10 percent in the sixth
plan. Aid is also becoming less in external financing terms, net aid
financing about 9 percent of imports in 1984-85 as against 40 percent in
the late 1960s.
10.2 Of the total seventh plan investment (public and private sectors)
of 3224 billion, 94 percent is financed from domestic resources; and,
incidentally, 52 percent from the private sector — private investment
exceeding public Investment for the first time in any plan. All the
foreign loans and grants of around 1.5 billion.utilized in 1984-85, less
than 5 percent would have gone in support of social factors of
development, including health, family planning, urban development, water
supply and sewerage.
11.
Inflation and unaccounted money
11.1 Two aspects of the Indian economy, extremely relevant to the
standard of living of the majoring are the increasing prices of essential
commodities aid the social economic consequences of the parallel "black
economy".
11.2 Tlie wholesale price index has registered a decline in inflationary
rate which has been limited to a single digit in the past three years.
This has been possible by effective supply and demand management through
import of mass consumption items like sugar and edible oil and their
controlled distribution. On the demand side, tlie money supply was
regulated and non-plan expenditure kept under some control. Even so the
fact remains that ttie wholesale price index rose by 56 percent between
1979-80 and 1984-85, the prices of food articles rose by 49 percent.
11.3 The consumer price index provides a better measure of the
purchasing power of the average family. According to it, the prices of
food articles rose by 56 percent, while the cost of living index rose by
62 percent in the past 5 years. These rates, do not reflect the full
impact of changes for price level on the living conditions of low-income
€
6
groups. Also, prices used for the computation may not actually be those
paid by the people (such as prices fixed for the public distribution
system), thereby underestimating the cost of living. Also the present
consumer price index has a distant base year, 1960-61. Unless a
disaggregated analysis for commodity prices is made with reference to
different income groups, a true picture of the relationship between
prices and cost of living cannot be had.
11.4 The extent of the parallel economy in India has been variously
estimated between 10 percent and 48 percent of the gross national
product. A 1985 estimate by the National Institute of Public Finance and
Policy places the magnitude of black income generation in 1983-84, rather
conservatively between 18 and 21 percent of the gross domestic product,
that is some Rs.370 billion out of a total GDP at a cost of Rs.17,342
billion.
11.5 The sizeable presence of black income distorts and destabilizes the
economy as well as corrupts the social-political system. A reasonably
correct estimate of the level of economic activity and growth- in national
income consequently becomes difficult. The percentage rate of savings is
likely to be over- estimated. On account of the leakages, the level of
public investment and its impact are likely to be exaggeraged, including
anti-poverty programmes and social support measures. The distribution of
incomes and consumption is also likely to be distorted. Apart from the
loss of revenue through tax evasion, effectiveness of fiscal, monetary
and credit policies is weakened by unaccounted incomes.
12.
Duality
12.1 In a social perspective perhaps the most striking aspect of the
Indian economy is its entrenched duality reflected not only in the
parallel economy: the overall national self-sufficiency in foodgrains is
yet to make a serious difference to tlie lives of nearly two-fifths v#io
live below the poverty line. High-yield agriculture coexists with
rain-dependent subsistence farming. A high savings and investment ratio
and sophisticated indigenous technology exist side by side with a high
capital output ratio. A growing public sector on which nearly 30 percent
of the gross domestic product is spent (current plus investment
expenditure), is virtually stagnant in the value added. And an
impressive aggregate rate of economic growth, coexists with an estimated
20-25 percent unemployment in a labour force of around 300 million. The
fairly successful macro-economic management does not alter the fact of
structural imbalances due to the persistent presence of poverty-related
factors of development.
7
t
Socio-Economic Indicators
1984-85
1989-90
1999-2000
Life Expectancy (Years)
Male
Female
56.1
57.0
58.6
59.7
63.3
64.7
Infant Mortality Rate
(per thousand births)
106
90
60
3.
Death rate (per ’000)
11 .9
10.4
8.2
4.
Birth rate (per '000)
32.6
29.1
23.1
5.
Fertility rate (per ’000)
152
132
99
6.
Urbanisation (per cent)
24.70
26.85
32.20
7.
Per capita GDP (1984-85 prices)
(Rs)
2616
3027
4163
8.
Per capita consumption exp.(Rs)
1979
2271
3124
9.
Pei’ capita consumption of
foodgrains (Kg)
178
193
215
10. Per capita consumption of cloth
(metres)
16.16
17.78
22.36
11. Per capita generation of
electricity (KWH)
226
362
578-621
12. Savings - GDP Ratio (%)
23.3
24.5
25.8
13. Investments GDP Ratio (%)
24.5
25.9
26.4
14. Foreign savings - investment
ratio (%)
4.9
5.5
2.4
15. Percentage of people belc*v
poverty line
37
26
5
16. labour force (million in the
age group 15 t)
288
327
408
17. Employment (million standard
person year's)
187
227
318
1.
2.
8
13.
Demographic transition
13.1 As of March 1985 the? total population was estimated at 761
million, On this basis the number by the end of the century would be 972
million. The country is undergoing a slow demographic transition, with
the proportion of people below 15 years of age likely to come down from
about 40 percent in 1980 to 36 percent in 1990. However this transition
seems to be presently confined to some states such as those of the south.
13.2 Population increase at the rate of 2.25 percent a year during
1971-81, compared to 2.22 percent the previous decade. The labour force
is projected to grew at an annual rate of 2.56 percent during 1985-90,
resulting in addition of 39 million. The urban population, new 23
percent of the total is likely to be 32 percent by the end of this
century. Urban labour is likely to grow by 3 to 4 million per year in
the coming years.
14.
Employment
14.1 it is estimated that the sixth plan created some 37 million jobs
against an addition of 34 million to the labour force in that period.
The seventh plan lias an employment potential of some 40 million
additional jobs, the added labour force during the period being nearly
that many. The backlog remains. Several million children below 15 years
are also employed, mostly in the unorganized sector at exploitative wages
and working conditions that hamper their development.
9
Expenditure cm Social Services
(Rs. in million at current prices)
Sixth Plan
1980-85
Allocation
Actual
(estimated)
Seventh Plan
1985-90
Allocation
Total Public
Sector plan outlay
975,000
(WO)
1,099,501
(100)
1,800,000
(100)
Total Social Services
140,350
(14.4)
156,961
(14.3)
293,504
(16.3)
Education
25,240
(2.6)
28,310
(2.9)
28,354
(2.6)
34,539
(3.1)
63,826
(3.5)
66,491
(3.7)
Housing and Urban Development
24,884
(2.6)
28,308
(2.6)
42,595
(2.4)
Water and Sanitation
39,220
(2.8)
39,775
(2.5)
65,224
(3.6)
Other Social Services
22,701
(1-6)
25,985
(1.6)
55,368
(3.1)
Health and Family Welfare
Figures in brackets are percentage to total plan outlay.
Source: Government of India, Seventh Five Year Plan (Planning Commission) and
Economic Survey 1984-85 (Ministry of Finance)
10
15.
Tackling pcrverty
15.1 Lately, the concept of human resources development has been
figuring, more explicitly than before, in economic planning not only in
terms of demographic terms arid manpower requirements but also in
qualitative? terms through programmes in education, nutrition, health and
sanitation. In this context social equity, and therefore anti-poverty
programmes, have acquired an added import. The? government as well as
private research organizations like the National Council of Applied
Economic Research (NCAER) have been assessing the extent of poverty from
year to year. The poverty line is defined by the Planning Commission as
representing a per capita monthly expenditure of Rs. 107 in rural areas
and Rs. 122 in urban areas at 1984-85 prices — for providing 2100
calories in urban areas and 2400 in rural areas respectively. According
to NCAER poverty in rural areas decreased from 56.90 percent in 1970-71
to 48.54 percent in 1981-82. While the extent of reduction depends on
the manner of computation and reliability of data, there seems to be a
trend of reduction in poverty. It must be the result of the compound
impact of employment programmes and social support measures.
15.2 Various deficiencies have been noticed in the poverty alleviation
programmes, including leakages in schemes like Integrated Rural
Development (IRDP), National Rural Employment (NREP) and Rural Landless
Employment Guarantee (RLEG). There are socio-economic programmes for
specific population groups like women, children, and backward castes and
tribes as well as for backward areas like hill and desert tracks. The
minimum needs programme seeks to meet the basic needs of the people such
as elementary education, adult education, health, water supply, roads,
electrification, housing, environmental improvement and nutrition.
Started in the fifth plan it has continued and reinforced during the
seventh plan. Of similar relevance is the price subsidies provided by
the public exchequer. Food, imported edible oils and controlled cloth
Involve substantial subsidies. Fertilizers supplied to farmers are
subsidized though these do not represent a transfer of incomes to the
weaker sections but it lie Ips to keep food prices down.
r
11
Impact on Poverty
SI
No.
Year
1.
1977-78*
51.2
2.
1984-85**
3.
1989-90
Poverty Ratio (Per cent)
Rural
Urban
Total
Rural
P001" (million)
Urban
Total
38.2
48.3
253.1
53.7
306.8
39.9
27.7
36.9
222.2
50.5
272.1
28.2
19.3
25.8
168.6
42.2
210.8
Estimated on the basis of NSS 32nd Round Consumer Expenditure
Distribution (1977-78)
On the basis of NSS Consumer Expenditure Distribution 38th Round
(Provisional), 1983.
15.3 land reforms is a vital element of the anti-poverty strategy but
its implementation lias shown chronic ineffectiveness. The core of
poverty in India consists of the scheduled castes and tribes, nearly a
fourth of the total population. In their case, as in that of others,
there is a problem of preventing those raised above the poverty line from
sliding back to below it. A number of special programmes have been
launched in support of women in rural areas and among the weaker
sections. These concentrate on literacy and income generation, health
and child care. According to the 1981 census, only 14 percent of the
total female population were workers. The unpaid economic activity of
women and their contribution through work in the domestic sector remained
unreckoned. According to an ILO study, the value of unpaid household
work constitutes 25-30 percent of GNP in developing countries.
12
Measure of Inequality
1977-78 (revised)
Urban
Rural
Per capita consumption
69.10
Expenditure (Rs. per month) at
current prices
1983-84
Rural
i
Urban
100.00
112.68
170.46
Share of top 30%
53.84
54.86
50.84
53.27
Share of bottom 30%
14.31
13.53
15.24
13.90
15.4 There appears to be a ('
'‘ ‘
declininq
trend in the wage employment of
vomen. Some of the new technologies have displaced them
frail traditional
activities. A new phenomenon in the
ruralareas
<_
—---is that women have to
run the household with the large scale migrationa of men to urban areas.
The priority for women 5in planning is increasing as part of a social
movement to enhance their status and role.
15.5 A critical criterion for the success of anti-poverty programmes is
the invovement of people to assure local initiative and control over
development programmes for the community. However, local self-government
institutions, like the panchayati raj, cooperatives and similar forms of
democratic decentralization either do not exist in many parts of the
country or have not been properly involved in the development process,
mile decentralized planning and development seems to be accepted policy
the basis for such a design of development seems to be lacking. In fact'
a plethora of administrative mechanisms and development programmes have
centrally evolved leading to a multiplicity of functionaries and. an
overlapping of programmes — which is not the most effective way to
respond to local needs by making the best use of local resources.
II. NUTRITION
1.
The nutritional status of the population can be measured in terms of
one or more of the fallowing: intake of calories, proteins and other
nutrients; growth and development of children; and manifestations of
nutritional deficiencies.
In analysing the recognized situation of
massive malnutrition in India, several factors are relevant, like
purchasing power, availability and price, quality, composition and amount
of food consumed, capacity to digest and absorb and a basic knowledge of
the nutritive values of l"
”llv available items of food as well as of the
locally
bearing of health and hygiene on nutrition.
2.
Food intake
2.1
According to an estimate by the Food and Agricultural Organization
(FAO), the number of malnourished people in India would be around 200
million-, almost half the world's total.
Available indications point to a
conjunction of various factors usually associated with malnutrition.
I.
the intake of calories, proteins and other nutrients is taken as the
measure, the situation is mixed.
Though foodgrain production increased
from 50 tonnes in 1950 to 154 tonnes in 1983-1984, the per capita food
grain availability, currently at 460 gm per day, has not significantly
increased beyond what it was in the early 1960s.
The availability of
pulses, which is the main source of protein for most people, has been
declining and is around 40 gms per person.
However, averages such as
these conceal wide disparities in a situation where around nearly half the
rural population live in poverty assessed in terms of calorie
consumption. The picture becomes more dismal in areas of draught which
are not uncommon.
For example during 1986 acute water scarcity and
distress to life affected 106 districts, a fifth of the total number,
affected some 75 million people, mostly the poor, and a comparable number
of cattle.
2.2
Some changes in the pattern of calorie consumption might be
occurring, as suggested by results of annual surveys conducted by the
National Nutrition Monitoring Bureau (NNMB) in the rural areas of 10 of
■ India's 22 states over the period 1975-1981.
Consumption of rice, which
forms a staple food, has been increasing, with a consequent improvement in
calorie consumption from 2296 kcal in 1975, almost steadily, to <.408 kcal
in 1981. However, in 1982 the figure fell to 2243 kcal, presumably
because of drought.
There has been a decline, or no perceptible change,
in the consumption of wheat, millets like bajra, jowar, ragi and maize and
pulses.
Consumption of vegetables increased over the five years only to
drop substantially the next year.
Milk, the only source of animal protein
in vegetarian households, and edible oils showed no consistent trend.
The
protein intake appeared above the recommended level of 55 gms per person
per day but there was no clear trend of improvement. The same was the
case with iron and vitamin A intake levels.
2
O
T
C. o ■->
Separate investigations conducted by the Department of Food show
that of all the 18 states covered by one time surveys between 1973 and
1982, only five in the north had an average calorie intake above the
recommended level of 2400 kcal.
The lowest, at 1892 kcal was reported in
Orissa.
However, the protein intake was satisfactory in 11 of the states.
Changes, in_outQut_gf_select'ed_cr ops
1949-50 to 1983-84
Crop
Average Annual Output
(Million tonnes)
1949-50 to
1931-82 to
1951-52
1983-84
Increase
in output
Percentage
increase
Rice
21.81
53.58
31.57
145.
Wheat
5.35
41.80
35.45
558
i
Other cereals
16. 10
30.94
14.84
92
I
Total cereals
44.25
126. 1 1
81.86
185
Pul ses
8.33
12.01
3.68
44
Total f oodgrains
52.58
138. 12
85.54
163
Edible oil seeds
4.65
10.85
6.20
133
Sugarcane
56.30
184.30
123.00
227
Pot at oe
1.64
10.71
9.07
553
Sweet potatoe
0.93
1.59
0.66
71
Tapioca
1.28
5.48
4.20
323
)
Source: Department of Agriculture
2.4
The NNMB data (for 10 states) also suggest that the gap in
consumption between the highest and the lowest income categories
from 1173 kcal in 1975 to 526 kcal in 1982.
Apparently this has
result of increased consumption by the lowest income group.
The
which might explain this welcome trend are still to be studied.
calorie
reduced
been the
factors
!
3
Statewise_pietary_Intake_gf.Nutrients
(Calories and Proteins)
State/Union Territory
Year of
Survey
Ca 1 or ies
(kcal)
Protein
(grams)
Haryana
1974-76
2750
88.0
Himachal Pradesh
1974-75
2811
88.0
Jammu and Kashmir
1978-79
2259
64.3
Rajasthan
1978
2115
71.0
Uttar Pradesh
1974-77
2584
80.0
Punjab
1973-74
2760
85.0
Delhi
1982
2158
69.0
Madhya Pradesh
1973-78
2239
67.0
Dadra and Nagar Haveli
1981
2060
51.5
Goa, Daman and Diu
1980
2129
63.2
Orissa
1979-80
1892
43. 1
Sikkim
1978
2051
54.0
Tripura
1979
1967
45. 1
Bihar
1981-83
2055
55.5
Andaman and Nicobar
1982
2133
64.5
West Bengal
1979-80
2242
54.5
Kerala
1977-80
1944
45.4
* Pond icher ry
1982
2000
46.9
Source: Food and Nutrition Survey by the Department of Food
2.5
An analysis of NNMB data for 1975-1979 shows that the intake of
calories as well as proteins by pregnant and lactating women was much
The gap was over 1000
below the recommended level in all the 10 states,
calories and 15-25 gms in protein.
In the case a f children, the
The percentage of
inadequacy was mostly in the younger age group,
children below five years suffering from severe malnutrition (assessed by
weight-for-age) was 8.1 in 1975-79, 4.7 in 1981 and 6.1 the following
year.
The proportion of moderately malnourished children did not come
down significantly.
As of 1982, Kerala had, among the 10 states, the
Also
highest percentage of children of normal nutritional status (31.8).
over 83 per cent of children below five years in these states suffered
from various grades of malnutrition.
4
CALORIE.INIAKE.jkcal /Qerson/day )._BY_INCOME
Per Cap 11 a
Income
Rs^/day__
12Z5
12Z6
___ Year_o£_Suryey___
19721978
1979
122g
1280
1281
< 1
1770
2047
2063
2123
2130
2217
2328
1-2
2370
2324
2251
2284
2415
2368
2353
2-3
2644
2646
245 1
2649
2480
2583
2458
3-5
2847
2727
2598
2630
2749
2689
2515
> 5
2943
2714
2463
2775
2752
2792
2854
Source: National Nutrition Monitoring Bureau
2.6
Interesting inferences flow from the NNMB data. Though Kerala has
shown a low protein calorie intake among children below five years, their
nutritional status showed a high percentage of "normal" and "mildly"
malnourished categories. While the number of "moderate" to "severe"
mainourishment among this age group has drastically come down in the
state, protein calorie intake has not shown much improvement between 1975
and 1980. The enhanced nutritional status is probably because of better
health facilities and higher female literacy than in the other states.
The linkage between nutrition and health is again highlighted by a reverse
phenomenon noticed in Gujarat. Here, the protein calorie intake for
children below five years increased impressively between 1975 and 1980
while the extent of "severe" and "moderate" malnutrition among them went
far above the national average. This suggests that higher intakes of food
may not improve nutritional status without supportive health services.
Nytritignal-Statuso£_chiIdren.JIzS.year5^_by_weight^for^age
Year
Number of
states
Number of
population
Normal
MALNOURISHMENT
Mild
Moderate
Sever e
1975-79
10
15169
13.0
41.9
36.9
8. 1
1979
10
3713
14.2
43.2
34.7
7.9
1980
8
4008
14.8
47.9
32.6
4.7
1981
7
1340
15.3
45.5
34.5
4.7
1982
8
c. Jc. J
16.7
42.4
34.8
6. 1
Source: National Nutrition Monitoring Bureau
V
5
Nytrtional_status_gf_children_1125_Year5)
State
Normal
1982
1975-79
___ MAINOUR ISHMENT
Moderate
Mild
1975-79
1982
1975-79
1982
Severe
1975-79
1982
Kerala
16.4
31.8
45.3
49.3
33.5
17.4
4.8
1,5
Tamil Nadu
14.6
16. 1
43.6
44. 1
35.3
34.6
6.5
5.2
Karnataka
9.9
13.8
43.0
43.4
39.4
37.2
7.7
5.6
Andhra Pradesh
13.3
12.6
42.2
43.0
36.7
38.5
7.8
5.9
Maharashtra
9.3
13.6
37.4
33.8
42.0
40.7
11.3
6.9
Gujarat
9.8
11.7
37.8
28.7
43.0
44.4
9.4
15.2
Madhya Pradesh
12.0
Orissa
15.3
13.0
42. 1
35.8
33.3
42.3
9.3
8.9
West Bengal
10.6
21.3
43.0
55. 7
39.3
23.0
6.6
0.0
Uttar Pradesh
18.8
11.5
40.2
36.3
6. 1
26.8
48.3
Source: National Nutrition Monitoring Bureau
P§£_[!aBilf*..Q£l_aYailabilitY_gf_fgodgrains_and_edible_ oils
1967 to"1984
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
Cer ea 1 s
grams/day
Pulses
kg/year
Edible Oils
k g /year
361.7
404. 1
397.9
403. 1
417.6
419.1
380.5
410.4
365.8
373.8
386.4
422.5
431.8
379.5
416.2
414.5
395.9
442. 1
39.7
56.0
47.3
51.9
51.2
47.0
41.1
40.8
39.7
50.5
43.3
45.5
44. 7
30.9
37.2
39.2
39.5
41.0
3.4
4.2
3.5
3.9
4.5
4. 1
3.4
4.2
3.9
4.3
4. 1
4.7
4.3
4.7
5.0
5.9
5.3
Source: Department of Agriculture
6.4
6
3.
Vitaain A
3.1
The manifestat.ion of serious deficiencies in various micro-nutrients
like vitamin A, iron and iodine, and possibly others, are being recognized
as so widespread as to limit efficacy of health and nutrition interventions
in other directions.
The studies by NNMB as well as the Department of Food
confirm the gross inadequacy of vitamin A in an average Indian diet.
Over
the years 1975-82, the intake has improved by about 100 mg of retinol, but
the level attained was still about half the norm. 'Many of the northern and
eastern states are relatively better off in this respect. Only West Bengal
had an intake higher than the recommended level.
_10_states_Jger/gerson/dayX
Year of
sur vey
Vitamin A
(ug)
I r on
(mg)
1975
263
31.3
1976
292
31.4
1977
262
29.3
1978
307
31.1
1979
270
30.3
1980
313
29.6
1981
373
31.7
1982
366
30.4
700
30.00
ICMR Recommended level:
Source: National Nutrition Monitoring Bureau
3«2
It is seen that the dietary intake of vitamin A has been low among
pregnant women, leaving poor stores of vitamin in infants born to them.
Also the poor vitamin A status in the diet of lactating women leads to its
low concent rat ion in the breast milk. As a result the incidence of vitamin
A deficiency among children continues to be high, with an estimated 40,000
children going blind each year for. this reason.
Recent research suggests
that vitamin A deficiency has a bearing on the general health and survival
of children.
Fortification of milk with vitamin A was started in 1980 in
Delhi.
By 1935 over one million litres per day were being fortified in
Delhi and Calcutta.
The target for 1990 is 4.5 million litres a day.
7
I n_ApeHciencY_afflong_ children
(Percentage)
States
1980
l_Z_5_years
1981
1982
Kerala
Tamil Nadu
1.6
1.9
7.0
Karnataka
7.2
1.7
3.2
Andhra Pradesh
8.6
6.6
3.5
13. 1
3.4
2. 1
7.5
1.8
Orissa
7.2
20.0
10.6
West Bengal
2.9
4.3
9.8
Uttar Pradesh
2.7
1.3
Maharashtra
Gujarat
Madhya Pradesh
Source: National Nutrition Monitoring Bureau
4.
Iron
Iron deficiency anaemia is a major public health problem in India,
4. 1
mainly because of poor absorption of iron from a predominantly cereal based
diet.
That is to say, even though the average intake of iron approximates
• the recommended levels in several states, as seen from NNMB surveys during
1975-81, only a minor fraction of the iron derived from the cereal intake
is actually absorbed into by the body.
Most o( the wheat-eating states like Punjab, Uttar Pradesh, Haryana
4.2
and Himachal Pradesh have a higher intake of iron compared to the rice
But even in states where
eating populations in Kerala, Orissa and Tripura,
the average iron intake is not low, the intake by pregnant women, young
This is so
children and lactating women is severely inadequate.
In the
particularly in Maharashtra, Madhya Pradesh and Uttar Pradesh.
other states too, these vulnerable segments of the population are exposed
to this deficiency. Children born to mothers with a low iron status have a
This
low haemoglobin level at birth and low iron stores in the body,
burden at the beginning of life is made worse by low intake of iron in the
first few years, until anaemia sets i n.
F
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4.3
Studies conducted by the National Institute of Nutrition show that 65
per cent of India's children below 3 years and 45 per cent between 3-5
years suffer from anaemia.
A survey in the district of Bidar in Karnataka
estimated that 90 per cent of children of pre-school age had anaemia,
nearly 14 per cent to a severe degree.
Besides law intake and poor absorption, a third reason for high
This suggests that iron
incidence of anaemia is infestation by worms,
suppl emen t at ion, if not combined with deworming, tannot lead to higher
haemoglobin levels.
In the absence of definite data, it is difficult to
infer whether the problem of iron deficiency in India, evidently
widespread, is increasing or not. The need for a massive intervention
countrywide is in no doubt, particularly when the high economic and social
benefits of doing so at moderate costs have been established.
Intervention
is feasible, on a social scale, against iron deficiency anaemia.
The case
for it is straight-for ward because anaemia restricts the capacity of the
blood to carry oxygen to the cells, limits the body's ability to produce
energy and meet other functional needs, increase susceptibility to
infection and impairs performance at school or work place.
4. 4
h'
4.5
While better sources of iron in the daily food is the long-term
answer, fortifying edible items, like common salt, with iron is within
technical and financial reach. A beginning is being made with the proposal
to set up capacity for annual production of 45,000 tonnes of iron fortified
salt by 1990.
5.
Iodine
5.1
Prevention and control of iodine deficiency disorders is yet another
public health priority, the seriousness of which has been unfolded only
recently.
About 170 million people are estimated as at risk, a third of
them, including at least 16 million children, already suffering.
5.2
The endemic belt for iodine deficiency disorder stretches over the
entire sub-Hima 1ayan region.
The disease has also been identified in
several states elsewhere.
Iodine deficiency during pregnancy decreases the
synthesis of thyroxine, an essential hormone produced by the thyroid
gland.
This prevents the normal development of the baby's brain and body,
a condition which at birth is known as neonatal hypo-thyroidism.
The
foetal brain damage is irreversible and limits intellectual growth in later
years.
Iodine deficiency has therefore to be considered, and countered, in
terms broader than the common symptom of goitre.
The social consequences
are more than even the relatively rare manifestation of cretinism, for
iodine deficiency interferes in the educability of large numbers through
successive generations.
It perpetuates social-economic deprivation and
lays waste the already scarce national resources invested in childhood
educat ion.
I
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9
5.3
Of all public health problems iodine deficiency is perhaps the
One needs only to supplement the daily diet with
easiest to prevent,
minute quantities of iodine, just three grams during an individual’s
lifetime.
In India, it can be controlled by a two pronged strategy universal iodination of salt, by 1990, and in the interim, by
administering iodized oil to the population severely at risk,
The policy
aim is to ensure the availability of a minimum of 150 mg of iron per
person per day to all the people with priority to women and children.
6.
Respond 1!19
9-00 Yf-tiY
6.1
The root cause of malnutrition,
aa1 nutr11ion, nutritional disorders and allied
diseases in India is lack of purchasing power of the malnourished masses.
While this was recognized by the first three five year plans, nutrition as
such was identified as a focus for specific action only during the fourth
plan, 1969-74.
More food specifically for the under-nourished was
recognized as the first necessary step. The applied nutrition programme
was introduced in 1959 to spread the concept of a balanced diet,
production and consumption of protective foods and propagation of ,proper
techniques of preparing foods. A special nutrition programme, including
supplementary feeding, production processing and supply, health based
nutrition activity and nutrition education and extension was started in
1970.
The mid-day meal programme in schools, centrally sponsored since
1962, continued till the sixth plan.
In the fifth plan, the feeding
programmes were brought under a minimum needs programme. Finally, the
integrated child development services (ICDS), conceptually the most
ambitious programme as yet for children upto five years and mothers, was
launched in 1975 and is slated for steady, if careful, expansion.
6.2
ICDS is however much more than a nutrition programme as it provides
for children from poor families, access to basic health care and
pre-school learning opportunities.
It also caters to the nutritional and
health needs of pregnant and nursing mothers.
Presently about 1.5 million
of them are covered by the nutrition component of ICDS, besides some 6.5
million children below 6 years. Studies show that indicators like infant
mortality rate, child mortality rate and malnutrition (assessed by
• weight-for-age) have significantly been reduced in the ICDS project
populations, compared to the national averages.
Mutually reinforcing the feeding and learning processes, the school
6.3
meals programme continues on a large scale in several states, particularly
in the south, and has reached a coverage of 16 million school children,
against a target of 87 million.
The applied nutrition programme has,
however, tapered off mainly because of unsatisfactory results traceable to
weaknesses in management.
Meanwhile the special nutrition programme
continues with a coverage of 8 million children of pre-school age, with
another 3 million to be covered by 1990.
10-
6.4
There are numerous other nutrition programmes across the country for
small groups of vulnerable children and mothers, organised mostly by
voluntary agencies with or without assistance from outside the community
or country.
Many of them have a strong education-communication component,
as also simple interventions for health care and linkages with safe water
and sanitation.
6.5
The problem of malnutrition, arising mainly from poverty, cannot, of
course be countered solely or even mainly by government sponsored
nutrition programmes, in a context such as of the country's economic
pattern.
The fifth plan, for example, recognized that employment was the
best and easiest way of enhancing the nutritional status of families.
The
1985-90 plan pursues this path by coordinating nutrition concerns with
employment, public distribution of essential commodities, safe drinking
water, immunization against childhood diseases, expansion of health care,
awareness about personal hygiene and control of diarrhoeal diseases and
intestinal infestations.
6.6
Accordingly several schemes are being currently promoted at varying
levels of efficiency and mutuality.
The Food for Work programme was
introduced in 1977 to create additional employment as well- as community
assets.
Wages are paid partially in food.
The Intensive Rural
Development Programme (IRDP) was launched in the sixth plan, mainly to
promote se1f-emp1oyment in a variety of fields.
The Rural Landless
Employment Guarantee Programme (RLEGP) was started in 1983 with focus on
the rural landless.
These poverty alleviation programmes are being
strengthened by removing the weaknesses that have been brought out, mostly
managerial, and by increased financial allocations in the current plan.
Together with programmes of concurrent thrust like the minimum needs
programme, the tribal sub-plan, drought prone area projects and the public
distribution system, a steady reduction in the levels of poverty and
malnutrition is expected, more so with support from social services, basic
education, sanitation and health on the one hand and on the other by
improving agriculture through expanded irrigation and better inputs.
7.
Public Distribution
7.1
In this context, the public distribution system for essential
commodities, particularly foodgrains, becomes relevant for reaching the
economically and nutritionally vulnerable sections of the people.
The
number of fair price shops has steadily increased to 320,000 in 1985.
Some 250,000 of them are in the rural areas.
The off-take of food
commodities through the system has also steadily increased to nearly 25
million tonnes in 1984. However, a closer look at their functioning
suggests that except in a few states like Kerala, Tamil Nadu, Andhra
Pradesh and West Bengal, the bulk of the distribution is actually confined
to the urban areas, raising serious issues in policy planning and
management.
11-
8.
?! y 111B1 § _ I * 19 £ 5
8. 1
As discussed, improvement in nutritional status, is not a matter of
Revels of education and practices in health and sanitation
f ood alone.
count equally.
This is illustrated by states like Kerala which have a low
average intake of many nutrients, also have a comparatively low incidence
of deficiency symptoms - apparently because of better access to health and
education.
In a similar paradox, Gujarat has a relatively high level of
vitamin A intake but also a relatively high'level of vitamin A deficiency
among children - presumably because of the poor absorption of the
nutrients due to unsafe water, diarrhoeal diseases, worms and inadequate
This squares with the phenomenon, noted earlier, of
health services.
Gujarat showing a protein calorie adequacy for the younger children
alongside a high incidence of protein energy malnutrition among them.
X’
8.2
The inter-rel ationship between nutrition and a variety of other
factors becomes crucial.
A mention must be made here of distribution of
food within the family, personal hygiene, environmental sanitation and
safe drinking water, control of gastro-intestinal disorders caused,by
germs, viruses and parasites, disposal of human, animal, industrial and
agricultural wastes, superstitions and taboos related to eating habits
including infant feeding practices, response of the health system to
people's needs and planned limitation of family size.
8.3
Improvement in nutritional states calls for a multi-sectoral
inter-disciplinary approach, embracing conventional and innovative methods
as well as short-term interventions and long-term programmes.
These
include higher productivity of crops and animals, research in evolving new
o f food crops yielding not only higher yields but also higher
varieties of
nutritive value in balanced proportion,
A coordinated approach and
corresponding managerial, executive and evaluative mechanisms, from the
policy 1 eve 1 all the way to the village are called for.
8.4
Prevent ion of food adu1 ter at i on, which appears to be common and
increasing, is a priority.
Absorption of food to derive its full value
for the body i s another important consideration in support of which
' traditional and modern methods have to be used,
Insofar as the focus is
on those with insufficient purchasing power, the price factor is not less
important than any other.
A cushion against price inflation, discussed in
the chapter on the Economic Base, has to be built into the nutr it ion
policy and programme.
Under-pinning a credible trans-sector a 1 approach is
the process of communication and education relevant to the lives of those
presently in illiteracy, isolation and under-nutrition.
9.
lQ£3nt_feeding_practices
9.1 Two examples of improving the nutritional status, practically at no
cost, through an educational process are the promotion of breastfeeding
and the practice of timely and proper weaning,
While breastfeeding is
prolonged in rural areas, food supplementation is generally delayed and
12-
the child's needs to meet the body's demand are met only partially leading
to a state of under-nutrition. Where the child is weaned too early from
the breast and the supplement started, the immune system fails to develop
fully, because the main source of immune factors is breast milk.
Enteric
infections are rare in breast fed infants, unlike in those artificially
f ed.
,r
9.2
It has been found that the quantity of breast milk is apparently
inadequate to sustain adequate nutrition in a number of cases. At the
same time infants on supplements, especially of commercial baby foods,
fare no better-indicating that in the prevailing socia 1-economicenvironmental situation, early supplementation of breast milk (with the
increased risk of infection that it involves) is not the answer.
9.3
There is thus a situation in which a number of infants in poor
families are undernourished even in early infancy when they are solely
breastfed.
They are even more undernourished with supplements to
breastmilk during early infancy.
A straight inference would be that
attempts must first be directed to improve the lactation of the mother ,
through nutritional supplementation and counselling.
If the promotion of
breastfeeding is to be (as it must be) the most important plank in the
policy for promoting infant and child nutrition, especially in poor
communities, then we have to understand and overcome the factors
responsible for relatively poor lactation in a number of mothers.
This
perhaps is the greatest challenge in the field of child nutrition today.
9. 4
Unethical promotional effort by commercial baby food manufacturers
is prohibited by a code of conduct prescribed by government, but it does
not have the force of law.
While regulatory measures are essential, the
best protection comes from the educated judgement of the people,
particularly mothers.
10.
Maternal malnutrition
10.1 How disease and death impinge harshly on the lives of mothers and
children is described in the chapter on 'Health'.
A basic factor beneath
this-situation is maternal malnutrition and consequent ill-health.
The
nutritional status of a child at birth is influenced considerably by the
nutritional and health status of the mother.
The high incidence of
pre-maturity, neo-natal mortality (within first 29 days of life) and low
birth weight can be attributed mainly to the deprivation of the mother.
It is known that around 30 per cent of child births in India have low
birth weight, that is, less than 2500 gms.
This means that seven to eight
million infants born in the country each year are low in birth weight.
This situation does not seem to have changed over the past two to three
decades.
J
I
13-
10.2 A recent study by the Indian Council of Medical Research (ICMR),
points to the correlation between low birth weight and a fairly high rate
of still births (over 29 per 1000 deliveries).
This gives a figure of
nearly 700,000 still births a year.
The policy implications of the
findings of this study relate not only to medical technologies but also to
nutritional policy, education and human behaviour.
If the trend is to be
reversed, the first pregnancy should not be below 20 years of age, the
inter-pregancy interval should be more than two years, and even more
important, every mother should be helped to -go to term with not less than
8 gm per cent of haemoglobin and 40 kgs of body weight,
The key to child
survival and health is clearly nutrition of the mother.
11.
!l^Q^9iQ9_Nyt r i t i on
11.1
It is a widely held view that the support of the system of public
administration in the country, cast in a mould suited to times past, to
the field of nutrition, (as indeed to the other social service sectors) is
weak in many aspects.
These relate, among other things, to social
development management capability including the planning, formulat ip n,
coordination, implementation and evaluation of projects and programmes,
from the national level to the local community.
5888A/ka
III.
HEALTH
1. Mother and child
1.1 rCentral to the health and development of the people is the
health and nutrition of the mother and
her child.
—----- - As an organic unit,
the mother and child constitute the core of the family and the biological
continuity which exists between them during pregnancy is followed by/ a
social continuity thereafter. rThis
“’ ‘ is the logic behind the plea that
maternal and child health must be seen as a holistic
------ aim
--- and
-- 1 as the
vanguard of the primary health movement.
1.2 It is on this understanding that India began to establish,, a s
long ago as in 1952, primary
] ’
’health
’ ' centres and' subcentres, mainly to
provide health support to mothers and
--- children.
------- - In actual fact, the
health infrastructure has expanded impressively but thei status of
maternal and child health, including family planning has not Improved
commensurately as seen from health related indicators. Understanding
this reality becomes the main concern of analysing the health situation.
1.3 As a policy, the country is wedded to the primary health care
approach, which implies intersectoral action for health, Integrating
curative, preventive, promotive and rehabilitative services and
increasingly involving the people in policy formulation, planning,
programming, and Implementing health services,
- ----- A serious impediment to
the progress of primary health care seems
t
to be the very poverty of the
mass of the people for whom the concept is most relevant,
-- --- . The situation,
as analysed below, supports the view that health can be promoted only in
conjunction with nutritional, environmental and educational improvement.
2. Progress made
2.1 Since 1947 when India achieved independence, health related
progress has been made in several directions for the population as a
whole. For example, mortality rate per thousand population has reduced
from over 27 to about 12 during this period, life expectancy at birth has
increased from over 32 to more than 54. Smallpox has been eliminated.
Mortality from cholera and related diseases has decreased, Control over
malaria has considerably improved.
2.2 At another level, the health system has expanded rapidly, the
main contribution coming from the government and in the rural areas.
Maternal and child health is a distinct element in the total health care
services. There are some 89,000 subcentres, 11,500 primary health
centres, over 350,000 (voluntary) health guides, 240,000 (government)
multi-purpose health workers, and 375,000 (private) trained birth
attendants. The total number of medical practitioners is around 600,000,
over half of them following the allopathic system. In addition, there
are some 150,000 nurses and as many midwives, mo?t of them in the public
health system.
U’
I
2
2.3 Maternal and child health services are Integrated with family
welfare services and are also provided through rural-urban family welfare
centres, post-partum and maternal and child health centres — in
addition to the primary and subcentres. Progress is being made towards
community health centres for every 100,000 population with a 30-bed rural
hospital which will have, among its four clinical specialists, a
gynecologist and a paediatrician. Some 650 community health centres have
been established by 1985 and another 1500 are planned by 1990.
2.4 Apart from the governmental Institutions, municipalities and
private groups run a large number of dispensaries, health centres and
hospitals. It is estimated that about half the total number of patients
attending all hospitals and clinics, public or private, are children
below the age of 15 years.
3. Concerns
3.1 In spite of such progress as has been made in the health sector,
the demographic picture as well as the health status of the country
remains a matter for concern. The high rate of population growth
continues to be a drag on health and human development. The mortality
rates for mothers and children are still dlstressly high over two-fifths
of the total deaths in the country occur among children below the age of
five years. Infant mortality rate at an estimated 105 for every thousand
live births is high even by standards of developing countries. The
nutritional status of the people, and among them that of the vulnerable
sections like women and children, is unsatisfactory, as outlined in the
chapter Nutrition. Some 44 per cent of the rural population do not have
access to safe drinking water, Over 99 per cent of them are without
basic sanitary facilities.
3.2 Communicable and other diseases are extensively prevalent though
it is not easy to arrive at an overall and reasonably uptodate assessment
of the nature and extent of the disease burden on the country as a
whole. Hospital statistics are incomplete in themselves and they relate
mostly to serious cases and in any case only to those who have access to
medical facilities. The pattern of drug consumption, irrational as it
is, is again not the best guide. Most assessments seem to suggest a
heavy incidence of communicable diseases like malaria, tuberculosis,
gastroenteritis and tetanus, which together account for a large share of
all deaths in India. Apart from these and increasing load of
degenerative diseases like rheumatic heart disease, coronary artery
disease, hypertension, diabetes and cancer (on which there are no recent
reliable estimates), there are a number of widespread deficient diseases
related to lack of nutrients like iron, iodine and vitamin A. (See
chapter on Nutrition)
3.3 The damage inflicted by vaccine-preventable childhood diseases
as well as by other diseases that affect children, among others, is
heavy. For example, in 1981 nearly a quarter million infants died of
I
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- 3
tetanus in the first month of life. The estimated mortality rate from
this infection is over 13 per thousand live births in rural areas and
over three in the urban areas. The reported Incidence of dlptherla is
around an average 25,000 cases a year during 1975-81. This figure could
be an underestimate. Around 300,000 cases of pertussis are reported
annually; the actual might be higher. Estimates of incidence of
poliomyelitis is around 1.5 to 1.8 per thousand children, 0-4 years, The
estimated number of cases of measles is around a million a year, the
fatality rate is upto three per cent. There are about 10 million
tuberculosis patients in India, a quarter of them infectious. Some
500,000 deaths occur annually from it, most of them of children below 15
years. Sone 300,000 typhoid cases are reported annually, the majority
among school children. The number of unreported cases would be large.
The number of malaria cases reported is 75 million in 1952. The figure
came down to 100,000 in 1965 but rose to six million in 1976 and 1.6
million in 1983. About 40 million persons are estimated to have
fllarlasis, a larger number are micro-filaria carriers. Some 12 million
people in over 18 districts in eight states are affected by guineaworm
infestation. Some 200 million people in India could be suffering from
hookworm. Over 17 per cent of infant deaths are on account of acute
respiratory infections, the proportion being next only to mortality
related to low birth weight and prematurity. About 10 per cent of infant
deaths are on account of diarrhoea, which is estimated to take the lives
of 1.5 million children under five years of age.
4. Priorities
4.1 There are atleast four immediate reasons why child and maternal
health should have primacy in health priority. First, health for all by
the turn of the century would be Impossible unless children today, all of
them, are on the road to health. Second, some 40 per cent of the total
population consists of children and the sheer proportion underlines their
decisive importance. Third, childhood is the most sensitive and
vulnerable period in the life span and it needs to be specially protected
against an adverse environment, familiar in India as in most developing
countries. Fourth, the early years of life account for the maximum
growth and development of a human being and any deceleration of this
process can have long term, often irreversible effects on health. This
is the rationale for the accepted policy of priority for child health and
development. In spite of it, the health status of child remains
unsatisfactory.
5. Infant mortality
5.1 The Infant mortality rate is a faithful indicator of the
effectiveness, among other conditions, of health care services available
in the community, particularly ante-natal, natal and post natal care.
Even though the infant mortality rate has declined from around 150 at the
time of independence to an estimated 105 today, it is unacceptably high.
- 4 -
5.2 There are wide variations in the infant mortality rate between
states, Kerala (30) to Bihar (112), Orissa (132), Madhya Pradesh (134)
and Uttar Pradesh (147). It will be seen, from the chapter on Education
that there is a close correspondence between the infant mortality rate
and female adult literacy.
5.3 There is a similar significant variation in infant mortality
between the rural and urban areas. The national average of the rural
rate of 114 is almost double the urban rate of 65. Studies have shown
that variations in infant mortality in India depends significantly on the
sex of the child, the educational level of the mother, the mother’s age
at marriage and her occupation, the nutritional status of the mother and
that of the child and the birth interval over and above the geographical
and rural-urban differentials.
5.4 It is also observed that the most critical period for the
infant s life is the neo—natal period (the first 29 days). For examp]et
of the infant mortality rate of 110 in 1981, it can be said that of 1000
babies born, 20 die on the first day, 35 in the first week, 60 in the
first month and another 50 between 1-12 months. This pattern broadly
holds in the rural as well as urban areas. Most of the causes of
neo-natal deaths can be attributed to maternal factors while those of the
post neo-natal Infant deaths are mostly related to the ill-effects of the
envi ronment.
Percentages of
infant deaths
to total deaths
States
10-15
Kerala
15-20
Karnataka
20-25
Andhra Pradesh, Himachal Pradesh
Jammu & Kashmir, Maharashtra and
Tamil Nadu
25-30
Assam, Bihar, Punjab and West
Bengal
30-35
Gujarat, Madhya Pradesh, Orissa
and Rajasthan
35-40
Haryana and Uttar Pradesh
Source: Sample Registration System, 1982
u
5
Estimated infant death rates by rural/
urban, India and major states, 1982
INDIA
Andhra Pradesh
Assam
Bihar
Gujarat
Haryana
Himachal Pradesh
Jammu & Kashmir
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Orissa
Punjab
Rajasthan
Tamil Nadu
Uttar Pradesh
West Bengal
114
65
105
86
103
116
120
100
70
74
71
32
145
77
139
82
105
97
156
93
50
72
60
89
62
42
43
47
24
79
55
64
53
60
51
99
52
79
102
112
111
93
68
68
65
30
134
70
132
75
97
83
147
86
Source: Sample Registration System, 1982
6. Child mortality
6.1 A critical study by the Registrar General, of the death rates
for the age group 0-4 years for the different states in 1G77, brought out
certain facts which could not have changed drastically since then.
For
example, 47 per cent of deaths were among children below five years of
age, the percentage in the rural areas being 48.6 and tiiat fo/ female
children in rural areas over 50. The variation by state was wider than
that for infant mortality. The 0-4 year child death rate was 12.6 in
Kerala as against 64.9 per thousand population in Uttar Pradesh. Uttar
Pradesh, Rajasthan, Madhya Pradesh, Orissa and Assam had the highest
child death rates. Excessive mortality in infancy was, of course, partly
responsible for the high rates for this age. Child mortality responds to
better health care much more than Infant mortality does. As such, it is
a useful measure of the impact of programmes like Immunization, oral
rehydration therapy and nutrition. The foremost common causes of
childhood mortality in India are respiratory infections, diarrhoeal
diseases, tetanus, low birth weight and prematurity. The estimated rates
ner 100,000 population of deaths from these causes are: respiratory
infections (2707), tetanus (1980), diarrhoeal diseases (1289) and low
birth weight and/or prematurity (1248). Underlying the respiratory tract
infections are pneumonia, whooping cough, tuberculosis, measles. Some
studies indicate that tetanus and measles together account for 26 per
cent of infant deaths.
6
Neo-natal and post-natal mortality rates 1982
Post-natal mortality
Neo-natal mortality
40.8
26.4
38.1
72.9
38.8
66.7
Rural
Urban
Total
Source; Sample Registration System, 1982
Percent distribution of births, by type of attention at birth, 1982
Institutional
med la
Trained
attendants
Untrained
attendants
15.7
27.2
17.7
73.2
31.3
65.7
11.1
41.5
16.6
R ur al
Urban
Total
Source: Health Statistics of India, 1985
Perinatal mortality rate and stillbirth rate, 1982
Rural
Urban
Total
Peri-natal
mortality rate
Still birth
rate
57.7
33.1
53.2
9.8
5.2
8.9
Source: Sample Registration System, 1982
Death rates for children aged 0-4 years, India, 1982
Rural
Urban
Total
Male
Female
Pe rson
42.2
21.2
37.9
45.7
20.5
40.5
43.9
20.9
39.1
Source: Sample Registration System, 1982.
7. Birth weight
7.1 Prematurity and low birth weight as major causes of infant and
child mortality is related directly to health of the mother.
It is
estimated that about 25-30 per cent of all babies bom are premature.
The proportion of low birth weight among all babies born is similar, if
not more.
7
7.2 Low birth weight Is in all population group the single most
important determinant of the chances of the new born to survive and to
grow. Low birth weight babies are three times more likely to die in
Infancy than the others. Many states in India show that perinatal deaths
(within the first seven days of life) are five times common among low
birth weight babies than in those with normal birth weight. Also, nearly
three-fourths of the neonatal deaths are babies with low birth weight.
Of the 24 million children born in India each year, some 6-7 million
children have low birth weight, the major causes being malnutrition of
the mother and short birth Interval between children.
8. Maternal mortality
8.1 Maternal mortality rate is a sensitive index of the health of
It is estimated that in India the maternal mortality rate is
the mother.
3-5 per thousand live births. It would take a strenuous effort in and
outside the health sector if this is to be brought below two per thousand
live births by the end of the century.
9. Family size
9.1 There are no shortcuts either to maternal and child health or to
birth regulation, Contemporary history shows that the two belong
together, that if there are fewer deaths in the womb, at birth and during
early childhood, there will be fewer births. This demonstrated
relationship has been reinforced by recent research. For example, birth
spacing has a positive impact on the duration of breastfeeding and degree
of maternal attention. The rates of Infection are likely to be lower
among children more widely spaced. In a short birth interval, both the
older child and the one bom after, face serious health problems. The
former is taken off the breast earlier, mostly due to the new pregnancy.
Mortality is found to be much higher among those weaned ahead of normal
time. A child bom before an Interval of less than two years is more
likely to be malnourished than the child who was two or more more years
old before the next child was born, more so in poor families. The child
bom after an Inadequate Interval is also not spared.
Maternal depletion
on account of short spacing probably explains the diminishing birth
weight generally associated with higher order births beyond four or
five. Intelligence scores, too, seem significantly lower in short birth
interval groups.
9.2 All this is in keeping with the experience that in communities
where child health has improved and infant deaths have reduced, it has
been easier to have birth spacing accepted. Birth spacing provides the
breathing space for a couple to move voluntarily towards the small family
norm.
This is the time when public service and community support can
demonstrate the meaning of the familiar message that the health of both
child and mother will be better with fewer and well spaced births,
A
change in the parental perception is the key to birth regulation.
- 8
9.3 These considerations are increasingly being reflected In the
family welfare programmes in the Seventh Plan built around the following
five elements:
increasing contraceptive practices
enhancing child survival
raising the status of women
respecting the dignity of the individual, and
active community Involvement
10. The health system
10.J A number of studies reveal that the massive growth of
infrastructure, personnel and expenditure has had less than optimal
impact on the health status of the people. Sane of the reasons for the
gap between effort and effect are obvious, like the weaknesses in areas
like nutrition, education, safe water supply and sanitation. Certain
other reasons relate to the functional weaknesses within the health
sector. Sane of these are briefly discussed below:
A sizeable proportion of the sanctioned number of staff
positions under various categories in the public health system
remain unfilled at any given time.
The system of primary health centres, though well conceived and
endowed with resources, lacks leadership and managerial skills.
The present training of doctors is examination-oriented:
didactic, clinical and curative in emphasis. While social
aspects of diseases are recognized, students are not given
experience in community interaction nor a role of responsible
leadership of a health team, nor managerial competency.
Medical colleges have often interpreted community health
services as their own outreach operation, rather than as
supportive of the responsibility for the health of a defined
population group.
9 10.2 The scheme of community health workers (now called village
health guides) has been conceived as an essential element of the primary
health care approach.
It has expanded impressively to a total strength
of about 350,000. Critical appraisals of the working of tlte scheme have
shed some light on the following problem areas:
The community has an apathetic attitude towards environmental
sanitation, in contrast with quick allopathic cure preferably
through injections.
The role of the community tended to be that of a passive
recipient of curative services from the community health worker.
The community health worker appeared to confine himself to
treatment of minor ailments and first aid — without being able
to enlist people’s cooperation for deeper health-related issues
like environmental sanitation or personal hygiene.
The training of community health workers was Inadequate for
imparting health education or preventive care.
A majority in the medical profession, particularly private
practitioners, was against or unenthuslastic about the community
health workers scheme.
A provider approach rather than a participatory spirit
characterised the community health workers scheme.
There was some role conflict between the multipurpose worker and
the community health worker.
The one aspect that people appreciated was the availability of
an Immediate resource for health care, particularly drugs free
of cost.
10.3 Another study reveals other sets of problems, from the viewpoint
of both the health personnel and the people.
The health personnel found the following typical hurdles in
their way: Illiteracy of the people and their traditional
beliefs; too large an area to be covered; lack of
transportation; and lack of medicines or their irregular supply.
In the perception of the people, the factors inhibiting
utilization of health services were; non-availability of
medicines; too long a distance to the primary health centre;
lack of transportation; illiteracy and pre-existing beliefs.
- 10 -
10.4 Some other reasons for low utilization of the established
facilities at the primary health centres have been mentioned: better
attention by private doctors and better medicines outside, and easier
access to them; the tendency of some primary health centre doctors to ask
for payment for better treatment; long wait and non-avallability of
doctors; and improper behaviour of health staff. The point favourable to
government health centres and hospitals was that the treatment was free.
11. Community health projects
11.1 Apart from the government health system, there Is a large number
of privately organized hospitals, health centres and dispensaries. Some
of them extend concessional medical care to the economically weaker
sections. Even more significant are a number of community health
projects — organized by committed health workers in various parts of
India. They cater to population groups ranging in strength from 1,000 to
40,000 or more.
Some of them are hospital centred while the others are
community based. Some are run on the cooperative principle using
people’s contributions while others are organized as health Insurance
schemes. These projects vary in range and scope. So too the emphasis,
which may fall on nutrition, mother and child care, family planning and
control of communicable diseases. The source and magnitude of funding
may also differ. But all these projects have a basic orientation towards
the primary health care approach.
1].p Among the initiatives taken by some of these community health
projects are:
Training and equipping traditional health attendants.
Training of community health wrkers to identify
mothers and Infants for intensive care.
"high risk,
Greater attention by communities to environmental sanitation.
Training of health workers in home management of diarrhoea.
Training of health workers in ante-natal and infant care,
especially in immunization, and
Education in health and nutrition.
- 11
12. Alms for 1990
12.1 The important targets set for child health in the seventh plan,
1985-90 are the following:
Effective couple protection rate (per cent)
Crude birth rate/1000 population
Crude death rate/1000 population
Infant mortality rate/1000 live births
Maternal mortality rate/1000 live births
Birth weight below 2500 gms (per cent)
Immunization (per cent)
Ante-natal care (per cent)
1985
1990
32
32.6
11.9
106
3-4
30-25
below 50
below 50
42
29.1
10.4
90
2-3
18
Universal
75
13. Strategy
13.1 To achieve these aims a synergistic combination of five major
types of services are being oirganized during this plan period:
medical
care, immunization and oral rehydration,, nutrition, family welfare and
health education.
[edical Care
Family Welfare
Nutrition
Xmmunizatlo:
Health - Education
13.2 Medical care: Medical care facilities for children are being
made available in all the urban and rural institutions. The health
professional in his under graduate training is being trained in
paediatrics. (Child health is being emphasized in the medical curricula
and examinations, including the post graduate level, A proportion of
hospital beds are earmarked for childhood illness care (40,000
, . beds
__ > out
of over 500,000) as at present the number of medical specialists in child
care in the country fall far short of the number required (barely 5000
l^OOO)tOtal 300,000 alloPaths’ as against the current requirement of
O/Z/3S
COMMUNITY HEALTH CELL
47/1, (First Floor)St. Marks Road
BANGALORE • 560 C01
- 12 -
13.3 Immunization: The Expanded Programme on Immunization (EPI) was
started in India in 1978. Till 1985 the diseases being covered under the
programme were dlptheria, pertussis, tetanus, poliomyelitis, tuberculosis
and typhoid. Measles was Introduced from that year. The effective
coverage achieved by then would be 30 per cent of the eligible
population, on a rough estimate. Beginning with the first year of the
Seventh Plan, 1985-86, 30 districts and the practice areas of 50 medical
colleges have been covered to achieve near-universal immunization for
children upto the age of one year and pregnant women. During 1986-87, 60
more districts and the practice areas of the remaining 60 medical
colleges is being taken up for similar coverage. All the vaccines except
measles and polio are produced indigenously and self-sufficiency in them
is expected by 1990.
13.4 Dehydration from diarrhoeal diseases is among the most common
causes of infant and child deaths. There are about 100 million children
below five years and each child has 2-3 bouts of diarrhoeal infections
each year; that is, a total of over 200 million diarrhoeal episodes, 90
per cent of these episodes can be managed in home by the mother with
home-made solutions. Another nine per cent would be mild to moderate
cases requiring the pre-packed solution and about one per cent would be
severe requiring medical attention. A major effort has been launched in
the Seventh Plan to promote Oral Rehydration Therapy, tie main thrust of
which is to transfer the knowledge, skills and confidence for the simple
technology from the medical scientist and health professional to the
family and in particular to the mother.
13.5 Nutrition, which is a basic pre-requisite to health, is
discussed in another chapter but mention may be made here of the
demonstrated result of concurrent multi-sectoral basic services for
children, as provided by the Integrated Child Development Services (ICDS).
Impact of ICDS
1976
non-ICDS
Malnutrition
grade III & IV (percentage
of children below 6 years)
19.1
1983
non-ICDS
ICDS
11.4
1981
national
average
1982-83
ICDS
Infant mortality
(0-1 year)
110
88.2
Child mortality
(0-4 years)
48.4
20.5
7.8
- 13 -
14. Education for Health
14.1 Health related education of the people, including the
illiterate-two-thirds of the population, is basic to health promotion
particularly for mothers and children.
Currently the accent is put on
the following aspects:
The role of parents in enhancing the health of children
The role of teachers in improving the health of children
Immunization
Oral Re hydration Therapy
Breastfeeding
‘Nutrition and growth surveillance
Early diagnosis and treatment of diseases
14.2 This effort implies a massive and complementary use of the
family educational channels, all available communication media.and
interpersonal exchange of information and ideas. The inter-connected
aspects of this alm are briefly discussed in the chapters on Education
and Communication.
14.3 The educational and training effort has to focus mainly on the
family, the parents, especially the mother, But it has to go beyond to
train up birth attendants, considering that almost 70 per cent of the
births are being attended today by untrained persons. Their initial
training needs to be followed up by continuous educational reinforcement
for involving them more and more in maternal and child health programmes
at the community level. The school health programme, presently active in
a few states like Karnataka, Kerala, Tamil Nadu and Maharashtra, has to
be built around the school teacher and expanded countrywide. This is of
specific relevance to the control of environmental and behavioural
factors directly or indirectly undermining child health, as outlined in
the chapter on Environment.
14.4 The educational process, aiming at a change in the culture
prevailing the health system, has to permeate health workers at all
levels, including the professionals, who are involved in supporting
primary health care for all of the people. The present grossly
inadequate system of reporting, recording and retrieving information on
aspects of human health need to be revamped.
15. Drugs
15.1 It would be sometime before the burden of disease on the country
is demonstrably reduced a rational policy for providing essential drugs
at a cost the community can afford and through channels that reach them,
is overdue. While the number of pharmaceutical production units has
grown by 300 per cent between 1952 and 1983, the question remains whether
the production pattern conforms to the health needs of the people.
Developing countries like Bangladesh have shown, as recently in 1982,
- 14
that a large number of irrational drugs can usefully make way to a few
essential drugs.
In addition to regulating drug production by law, it
would be worthwhile to market essential drugs at control prices through
the public distribution system.
It is estimated that among lower income
groups, more than a tenth of the total family income is spent on
purchasing medicines, mostly unwanted and expensive.
16. Resources
Five fold increase in the financial outlay on mother and child health
in the Seventh Plan is welcomed against a background of relatively low
priority In the preceding vears, yet It would not be adequate to achieve
the targeted tasks ahead. Including family planning, the plan outlay for
health at Rs 64,492 mn is 3.7 per cent of the total. This is an
improvement on the Sixth Plan expenditure of Rs 34,477 mn (3.1 per cent
of the total), yet Inadequate to support the aim of access to health for
all by the year 2000.
It is therefore all the more important that a
professional management system is quickly Introduced in health
administration. The apparent paucity of resources can also be overcome
by systematic encouragement to voluntary organizations, including Mahila
Mandals, Youth Clubs and Village Health Committees, dedicated to the
principles of primary health care. Another hopeful feature is the lively
presence of several health care projects across the country which
illustrate that so much can be done with so little, provided the
contributory potential of the people is liberated.
SAARC006/ppr
- 15 INFANT AND CHILD MORTALITY TRENDS
Three-year moving average 1971-34, India
Peri od
BI rth
Death
Infant
Age specific
% Population
Rate
Rate
Mortality
Death rate
(0-4) to total
Rate
(0-4)
population
1971-73
36.3
15.9
134
53.8
14.66
1972-74
35.3
15.7
133
53.2
14.55
1973-75
34.8
15.3
133
52.4
14.21
1974-76
34.4
15.0
132
52.0
13.84
1975-77
34.2
15.2
133
52.3
13.65
1976-78
33.3
14.5
129
50.1
13.36
1977-79
33.1
13.9
126
48.3
13.28
1978-80
33.3
13.1
120
45.3
13.19
1979-81
1980-82
1981^83
J 982-84
SOURCF: Sample Registration System
16
Decades, 1901 - 1984
Yearly rates 1971 - 1984
Infant
Death
Death rate
Infant mortality
mortality
rate
ove rail
rate
rate
(0-4 years)
190J-10
42.6
1911-15
204
1971
129
51.9
1911-20
47.2
1921-25
174
1973
134
52.3
1921-30
36.3-
1931-35
174
1976
129
51.0
1931-40
31.2
1941-45
161
1978
126
50.1
1941-50
27.4
1951-61
146
1979
120
45.7
1952-60
22.8
1961-71
129
1980
114
41.8
1971
14.9
1980
114
1981
110
1980
12.4
1981
1982
1981
1982
1983
1982
1983
1984
1983
1984
1984
Source: Census actua-
Source: Census actua-
rial report till
rial report till
1960 SRS
1961
after
there -
SRS thereafter
Source: Sample Registraition
System
u
t
!
IV. EDUCATION
I•
The nature and size of the tasks of development on democratic lines,
facing India, are closely reflected in the field of education.
Since
people can develop only by their own effort, the educational process is a
precondition for development to take root in their consciousness before it
proceeds on the ground in a durable or endogenous manner.
2s
position
2.1
It is in this perspective that free and compulsory elementary
education for all children upto the age of 14 years became a goal included
in the Indian Constitution for achievement by 1961.
The er ad i cat ion of
adult illiteracy has been a comp 1 ementary national aim for much the same
reason.
The situation today is that 60 per cent or more of the people
cannot read or write. And, even more d i sturbing, a similar proportion of
children are out of school at any given time, notwithstanding a fairly high
proportion of children getting enrolled in the first year of the primary
grade.
As a result, India has nearly half the illiterate adults in the
world.
2.2
A reviewed effort in the coming years is imperative if this situation
is to change.
Irrespective of political pursuasion or soc i a 1 system, the
industrialized countries of today had accorded, despite initial resistance,
priority to universal primary education as a matter o f state policy,
largely for social reasons including the need to foster national unity and
a spirit of community.
Many developing countries are currently investing a
sizeable proportion of the national income in education, including
literacy.
An integral view o f human development which pays balanced
attention to primary education, primary health and basic nutrition - as
sources of social support to life
seems to be gaining acceptance in India
•as well.
3.
on education
3.1
A number of studies have shown a close relationship between
educational status and a propensity to adopt improved nutritional and
hygienic practices, better production methods, the small family norm and a
positive attitude towards the purpose of life,
Economists have computed
the higher returns of primary education than of investments in steel or
electricity or other industries. Literate farmers are seen to be doing
better than their illiterate counterparts.
The inverse relationship
between maternal literacy and infant mortality is established.
The success
of water supply and sanitation projects seems to be related to the level of
literacy in the community.
Equal access to educational opportunities,
starting with a chance to break the illiteracy barrier appears central to
the country's effort to promote human development and social change.
In
the current context of reshaping the national policy on education, there
has been a revival of discussion which has thrown helpful light on the many
issues a ffecting the system, process and content of education.
n
4.
lit eracy
4. 1
Universal education will require changed attitudes among parents,
even if policies and practices make education available for all.
There 1 5
evidence that parents who attended schools are more likely to send their
own children to school and help them complete their formal education.
If,
however, drop out rates are high, it will be decades before this kind of
parental sup’port can be effective.
There are other equally important
reasons in support of mass literacy through non-formal methods on a
sustained basis.
The Indian experience reveals the need for investment, O f
an unprecedented order, in financial and organizational terms for
maintaining extensive and adult education programmes complemented by a wide
availability of written materals and messages through various media.
4.2 Literacy-Rates
(percentage, 1981)
Rural
Urban
Total
Ma 1 e
40.79
65.83
46.89
Female
17.96
47.82
24.82
Total
29.65
57.40
36.25
4.3
Wide variations in literacy levels are seen between states, from 70
per cent in Kerala to 20 per cent in Arunachal Pradesh.
The variation
between males and females, rural and urban areas, scheduled castes/tribes
and others are also pronounced.
For example in 1981, the female literacy
percentage in rural areas was less than 20 in 13 states.
4.4 LiteracY_Rates_among_Scheduled_Castes_and
Schedules Tribes
1981
India
Scheduled
Castes
Scheduled
Tr i bes
Male
46.89
31.12
24.52
Female
24.82
10.93
8.04
Total
36.20
21.38
16.35
Ma 1 e
40.79
27.91
22.94
Female
17.96
8.45
6.81
Total
29.63
18.48
14.92
65.83
47.54
47.60
All Areas
Rural Areas
Ur ban Ar eas
Male
3
4.5
The magnitude of illiteracy in absolute numbers has grown, despite
the spread of the school system and the steady improvement in the
percentage of literacy.
In 1971, the number of illiterates, excluding
Assam and Jammu and Kashmir was 372 million; in 1981 the number grew to 446
million.
This underlines the need to ensure that children once enrolled
remain at school till they attain "permanent literacy". While enrolment
rates have increased, the drop out rates have remained unchanged. With the
majority of the children dropping out of the primary school between grades
I and III, the contribution of primary education to reduce illiteracy has
not been commensurate with the investments made.
4.6
The sixth plan (1980-85) gave high priority to adult education,
including it as an essential component of the minimum needs programme,
The
scheme had three dimensions: literacy, functionality and awareness,
The
strategy focussed on districts with low literacy rates, rural women,
scheduled castes and tribes and migrant labour and other economically
weaker sections.
It encouraged participation of students, assistance to
voluntary organizations and literacy follow up using both folk and modern
media.
During this period the number of adult education centres and
learners increased from 92,000 to 186,510 and from 2.59 million to 5.53
million respectively. These learners included 2.85 million families, 1.5
million scheduled castes and 88,000 scheduled tribes.
4.7
The seventh five year plan, reinforced by the new national policy on
education, seeks to build on these foundations towards achieving literacy
for all adults in the age group 15-35 years, by 1990.
The challenge of
this task will be clear from the fact that some 90 million will be the size
of this group by that year.
5.
iducatign of children
5.1
The constitutional obligation to provide universal education to
children upto the age of 14 yearsdoes not specify a lower age for
, commencing childhood education.
It was generally assumed that the process
started with the first grade of the primary school. At any rate, not much
attention has been paid to early childhood learning opportunities.
A1 though some government effort has been made in organising the training of
teacher s, development of materials and research in methods, pre-school
learning has remained confined largely
and towns, mostly as the
- , to cities -J
preserve of the private sector for the benefit of the non-poor segments of
soc i ety.
Almost all these institutions immitate Western models. Even in
respect of balwadis, a study showed that they were used more by the
privileged children of the community, and that
activities
— the
-- -------- j were too
structured for flexibility or imaginative play.
4
u.c.
The appreciation of the value of early childhood learning has been
growing, although slowly.
The new national policy on education includes
this emphasis.
It has been shown that pre-school learners are at an
advantage in both language and intellectual development. A welcome
development in recent years has been the spread of the integrated child
development services (ICDS), which is expected to cover half the country's
children in need by 1990.
The ICDS anganwadis. provide an opportunity to
children below six years to play and learn together.
Conceptually the
local community is expected to be fully involved and normal methods and
introduction of reading, writing and arithmetic are to be discouraged
during this phase.
The recognition of the holistic nature of child
development (nutrition, health and social, mental,
menta 1, physical,
phys i ca1, moral and
emotional development) is a welcome feature of this trend.
5.3
The effort to make elementary education universal through expanded
facilities, increased enrolment and retention has met with mixed success,
With steady expansion, facilities for primary education are now available
for some 93 per cent of the population within aa distance
distance of one kilometre.
The number of primary and middle schools increased from 224,000 in 1951 to
more than 620,000 in 1983.
The location of schools is however not always
based on rational criteria so that many habitations, where the population
justified a school, had none.
This sparseners of population was another
reason why some habitations did not have the facility.
5.4
In the provision of educational facilities, there are wide
disparities within states.
Thus primary schooling facility within the
habitation was available for over 98 per cent in Nagaland but only for 28
per cent in Himachal Pradesh, as of 1978.
Seven states had a coverage of
90 per cent or more, nine between 80-90 per cent, eight between 70-80 per
cent, four between 50 and 60 per cent and three below 50 per cent.
Similar
variations existed as between disadvantaged segments of the population and
others.
5.5 Primary schooling
facility
i )
i i)
within the habitation
within a distance of
?§L^§QL^9§_Q£_QQP.yl§tiGn_coyered
All habitations
Habitations predominantly
pogu1 ated by
Scheduled
Scheduled
castes
tribes
(with population of 300
or more)
77.31 55.94
77.78
1 km
93.05
90.65
Middle §^!]291i09 (with population of 500 or more)
i)
within the habitation
i i ) within 3 kms.
33.47
13.47
21.41
78.42
75.27
64. 11
90.48
5
5.6
The progress in enrolment in grade I-VIII during the past 34 years
has been impressive:
^Q£ol®§Qt_§i:_EleraentarY_Stage
Enrolment in grades
(in million)
1?51
Proportion to the
popu1 at i on i n the
y9e_.9rguQ
Boys
Girls
Total
I-V
13.77
5.39
19. 16
VI-VI I I
2.59
0.53
3. 12
60.8
24.9
42.6
1 1-14
20.8
4.3
12.9
1285 __(la r ge t)_
Boys
Girls
Total
48.46
34. 18
32.64
16.63
9.21
25.54
108. 1
81.5
95.2
68. 1
36.3
50.3
5.7
All the same the proportion of children out of school cont i nues to be
1 ar ge because of several reasons: the rapid increase in population with
which the expansion of primary education, even without provision for
quality, could not keep pace; and the drop out rate continued to be high.
5.3
Including those enrolled in non-formal education centres, the total
enrol ment of children in the age group 6-14 is estimated to be 116 million
i n 1935.
With a papulation in this age group of 140 million, the number of
children not yet enrolled would be 24 million.
If the target of universal
enrolment is to be achieved by 1990, nearly 64 million children would need
to be enrolled in the five years from 1985.
1935.
As in the case of establishing
schools, disparities prevail in the enrolment of children as between states
and within states.
In 1980, for instance, the enrolment
enrol ment ratios in the age
r anged from over 100 per cent in Nagaland (the percentage is
group 6-11 ranged
higher than 100 since grades I-V may have children below the age of 6 or
above the age of 11) to about 60 per cent in Rajasthan.
For girls the
variation between these two states was over 100 per cent and 30 per cent.
Even states with a high enrolment ratio have districts at a serious
d i sadvantage.
Andh r a Pr adesh
5.9 Enrolment_in_Grades_l2y_a5_prgportign_g£
poeylatign_in_the_6211_age_grgup (1978)
Aighest-Oistrict____
Lowest Dist rlet
State
Girls
Total
Girls
Total
Average
T5 o o
79.97
92.89
102.68
C_ xJ • tL. /
45.82
Assam
80.71
87.31
106.32
54.02
65.31
Bihar
70.53
61. 18
91.18
20.02
43.92
Kashmir
61.61
76.01
83.98
28.38
45.86
Madhya Pradesh
56.99
58.37
73.52
20.37
39.22
Or issa
85.04
101.78
121.34
41.78
69.55
Rajasthan
59.74
45.42
80.63
22.84
47.57
Uttar Pradesh
72.87
106.65
1 16.50
20.39
44.26
Jammu and
P. p n a p 1
-Q4
QQ
1 A4
z. /I
6
5.10 There is another dlmenSIOn to dxsparitres prevailing among different
popu1 at i on groups in terms of occupation and income, often
expressed as
caste and class distributions.
Reliable
Rellable data
data on
on this is not aval 1ab1e.
6.
D£oeeing_out
6. 1
The problem of children dropping out of school is as serious as
complex.
Over the
..a years, the drop out rates have remained basically
unchanged at the primary stage.
For instance, of over 100 children who
entered class I in 1965, only 33 reached class IV
in 1969.
The
c o r r esponding percentage over the
years 1976-30 was 40.
The
drop out rates
are par ticu1 ar 1y a 1 ar m i ng for
scheduled castes and tribes,.
For
the 1974
entrants to class I, the retention rate was
only 36 for scheduled castes
and j for scheduled tribes.
6.2
While the high drop out rates reflected the low
e f f i cienc y of p r i mar y
schooli n g, they tend to obscure the more serious
problem of repetition of
grades or stagnation, which
’
in fact contributes to the dropp ing out.
Those
who drop out relapse into illiteracy with
no foundations laid for
sei{'learning.
self-learning.
This situation
situation raises
raises a number of cr i t i ca 1 quest i ons
related to the holding ppower of the conventional
by which children becomeJ literate and the content school system, the process
of learning.
The current constraint of financial resources for
a proper learning environment is real,
itself cannot explain
explain all
all of
failure in
in primary
The
of the
the failure
primary education.
education,
pepeated0"t Lmnt
f' the process
P"0"55 whereby children
chlIdren become literate ls that
viewW of
masteiv “f
P,k •
recQ
9n1^ and
and copy
copy the
recognize
the alphabet
alphabet lead
lead to
to ultimate
mastery.
From this viewpoint,
the
only
asset
a
primary
school
class
iewpoint, the only asset a
equires is a teacher who can make the children memorise the alphabet,
them.
n relit"
T’ sound them and Ccopy
°Py lhem
MuCh the sane PrQCSS5 ^curs
in relation to lessons from
fixed text
text book
book,, memorized and copied.
-- the
-..a fixed
Such a system can only work at a low rate of success.
It succeed^ in
success.
making some children capable of reading and writing but it also succeeds in
alienating many more children
---- - ffrom reading and writing.
In fact the
conventional system was
was never
never meant to achieve universal literacy.
It
worked well for a society where only a few were supposed to become literate
for cu1tur a 1 or occupational reasons. A properly trained and reasonably
contented
teacher Wlth a supportive meaningful learning environment isthe
minr
equ
i r ement ffor
or a primary school to serve its purpose.
minimum requirement
Studies
have Shown that stagnation and drop out are related to ill-equipped
due°to3inrtVer crowded classrooms, heterogeneous age composition of children
due to mdiscriminate admissions, teachers ill-equipped to help the
i ion o
e child from the informal home atmosphere to the formal
school environment.
lormai
6.4
It is easier to reduce the incidence
of stagnation than to tackle
wastage due to socio-economic reasons,
The latter is usually sought to be
manipulated through compensation for p
parental loss of income, facilities
for learning while earning and part-time educati
-- ---- ^ion through non-formal
channels.
7
7.
ives
7. 1
The role and relevance of non-formal channels and methods of
education arise from the basic reality that a majority of children r ema i n
out of school.
As a strategy, part-time short duration learning
opportunities for children was first emphasised in the fifth five year plan
(1974-79).
Two types of part-time courses were thought of: continuing
classes for those who have completed the five years of primary schooling;
and second, literacy classes for those who have never been to school or
dropped out too early to attain literacy.
This programme was sought to be
sustained by central assistance to the states for setting up non-formal
centres.
As of 1993-84, there were over 100,000 of them with an enrolment
of over 2 million.
The number of centres established specifically for
girls would be around 20,000.
7.2
Many voluntary agencies are active in reaching learning opportunities
to deprived children, as well as adults, in non-formal ways.
They are
spread out across the country from the tribal interior of Madhya Pradesh to
the street pavements of Calcutta.
7^3
Whatever the merits of the formal system of conventional education i n
relation to certain socio-economic goals, as of now, it cannot obviously
answer the needs of large segments of the population in terms either of
adult education or pre-school learning or, for that matter, elementary
education.
An important means of creating a genuine social demand for
learning opportunities (which is a precondition for universal education) i s
to tune education to the lives and needs of the deprived.
The inab i1i ty to
"sen" education to them is only partially due to their ignorance.
It is
even more due to the fact that the available education is not really
"saleable'’. Based essentially on Western, middle class and urban concepts,
it is removed from the values of a traditional, poor and rural 5ociety from
which the "educated” community itself tends to be alienated.
a.
^ucatign_for_the_pogr
9. 1
Poverty has been a handicap for the spread of education in India as
e 1 sewher e.
But the problem of poverty is more intractable than that o f
ignorance,
So, ways have to be found and techniques evolved whereby
primary education can become universal in spite of poverty.
Fortunately
practical ideas and demonstrated successes are available in the country for
others to follow, adapt and improve upon,
Some of these ideas and
experiences are recounted below:
In the present system, work and education appear mutually
incompat idle, indeed come in each other’s way.
Children, and even
adu Its, from poor families must be enabled to learn even as they work.
One way to bring together the world of learning and the world of work
is to provide for part-time education at convenient hours.
Work experience in socially useful productive activities through the
learning stage can only enhance the quality and value of education,
Even children from well-to-do families would benefit from "learning
by doing" rather than fulltime formal education.
When proper teaching methods are employed, it has been found passible
to bring up the attainments of part-time students almost to the same
level as that of full-time students.
The obstacle of poverty in the iway of' 'learning can be reduced by
providing the needy with free books
and equipment, free clothes and
--- -..J
school meals.
In addition to the socio-economic issues mentioned above there are a
number of academic problems to be resolved to make non-formal
programmes successful.
For example, an elastic educational structure
has to be created to reduce insistence of the formal system on a
single point entry (in class I at about the age of five or six),
sequential annual promotions, almost exclusive use of full-time
professional teachers and absolute conformity with full-time
attendance.
3.2
The non-formal sector has a special relevance to the education o f
out-of-schoo1 youth, adults, particularly women, and the potential
leadership of community groups for work in social and economic
development.
An opportunity i s provided for example, by the training
programmes for health workers, agriculture and animal husbandry workers,
and other village level cadres,
Both the formal and non-formal channels
for learning are
are expected to
to be
be vastly strengthened by a recent
deve1 opment: satellite communication using the radio and television
networks.
The immense potential provided by the electronic media to reach
remote tribal and rural communities with educational programmes is
discussed in the chapter on Commun i cat i on.
8.3
The number of considerations are important in organising part-time
non-formal alternatives in education:
Wastage and stagnation need to be considered as separate phenomena,
While drop out takes place due to social and economic reasons over
which the educational system has but limited control, the incidence
of stagnation can be substantially reduced through educational
manipulation, as is being done presently by several states.
The question of equating education received in non-formal centres
with that of the formal system has to be fully settled.
Otherwise
what had happened to the case of basic education (Nai Talim) decades
ago would overtake the current effort as well,
well, with two parallel
systems trying to co-exist on an unequal footing, one patronised by
the better off and the other for the under-privileged.
Part-time education will by necessity be limited to essentials.
The
curricula of non-formal centres is being condensed so that the first
five years of education in the formal system can be imparted in two
years.
This may lead to serious gaps in the education of those at
the non-formal centres which no amount of "educational enrichment" at
a later stage can remove.
The effective organization of non-formal centres-- where the
situation is unstructured, clientele heterogenous, attainments,
motivation.and basic tasks are ill-defined - will depend largely on
teachers whose competence should be of a different order from that of
teachers of the formal school,
Entrusting education at these centres
to existing teachers whose record of work in full time schools
school
is
uneven, would hardly help, particularly if they are expected to work
on a paltry remuneration.
The organization of non-formal systems constantly runs the risk of
being subjected to considerations of economising expenditure.
This
could imperil the major strategy to promote education and bring about
radical changes in the total education system.
9.
Qy^litY-Qf-educatign
9.1
The quality of education is conditioned by the character of the
learning environment - physical and social.
These, in turn, are related to
the purpose and content of education.
A 1978 All India Survey brought out
the following facts which are unlikely to have changed substantially since.
40 per cent of the primary schools and 14 per cent of middle schools
were running in open spaces, tents, thatched huts and mudplastered
bu i 1 d i ngs; these percentages were 43 and 14 respectively for primary
and middle schools i n rural areas;
Nearly 83 per cent o f primary schools and 77 per cent of middle
schoo1s were short o f one to four rooms;
40 per cent of primary schools and 20 per cent of middle schools
reported shortage of black boards, the percentages f or rural schools
being 42 and 22 respectively;
34 per cent of primary schools and 23 per cent middle schools had no
floor mats or furniture;
In rural areas only 11 per cent primary schools and 30 per cent
middle schools had urinals and lavatories;
About 63 per cent primary schools and 34 per cent middle schools had
no facility for drinking water on school premises; and
Only 29.5 per cent of primary schools had a library and out of these
64 per cent f]ad 100 or less books.
109.2
'he Education Commission, 1964 66, had recommended an optimal size of
a primary school at 4-5 teachers
and an enrolment of 160 to 200 students.
The 1978 survey revealed that less than
I'’’ PGr cent of the primary schools
satisfied these c r i t er i a.
More than half of them had an average enrolment
of 80 or less,
Some 34 per cent of the primary schools were single teacher
schools, 27 per cent had only two teachers and only 14 per cent had four or
more.
The disparities i n the availability of educational facilities are
concealed by national or even state-level averages.
Many disadvantaged
aver ages.
groups are deprived of essential facilities and the disadvantage tends to
get magni fled with t ime, because the better off c—
groups and areas, already
ahead in the race manage to increase their educational capability
constantly.
10.
leaching
10. 1 The general situation in
i n respect of the academic and professional
status of teachers, taken by itself,
In 1951
only 58 per cent of the teachers in appears to have improved.
elementary schools were trained.
This
has improved to 88 per cent in 1933.
A large number of qualified teachers
are available because there are more graduates, |
’
particularly women, looking
for a J0b
'
This does not necessarily imply that the quality of teacher
a ining has improved.
This
aspect
depend
on
a
number
of
variables
and
1S
This
teachers1'5 °r ^U“tlonal
■'esults, as iany other contributory factor.
The
• ■ -1 results,
^chers emoluments have increased,, though
barely in
keeping with the price
though barely
in keeping
index.
10.2 Slementary_Schgol_Teachers
Qy§li£icat ion
Percentage
1951
1978
Graduates and above
1.0
17.2
Completed secondary school and
undergraduate education
14.4
60. 1
Not completed secondary
school education
84.6
100.0
m
7
c. c. . /
100.0
10.3 The increased resources ffor elementary education have not
significantly led to the appointment_ of an adequate number
of teachers.
There are large variations among the states in the
number of pupils per
10 1991 11 varied for Pomary schools from
17 in Manipur to 50 i n
Andhra Pradesh; for middle schools from 13 in
Nagaland to 40 in Gujarat.
Year
1951
1961
1981
Py2ils_per_teacher
Primary-Schools
Midd1e_schoo1s
34
24
36
32
38
33
Il
li.
Managing_education
11.1 The administration of elementary education has still not outgrown its
colonial bureaucratic mould, of which archaic policies of making financial
allocations and obsolete procedures of
accounting and auditing are but two
aspects.
For example a good children’
s ’library cannot be developed or run
on the basis of centraUzed procedures of ordering and
ordering and auditing.
Similarly
oppressive use of inspectorial powers, arbitrary transf
rrational procedures of recruitment and promotion are er of teachers and
inconsistent with a
forward-looking learning system.
11.2 There i s a need to c r iitically appraise the content of
1 ear n i ng.
Although most of the children
-.1 at school do not Lunlinue
years,
centi nue oeyond
beyond five
f
pr imary schools fol 1 ow an instruct ional
programme
derived
from
a
"universal
perspective of what schooling should
consist of". Such a de
terminati
on of
determinat
ion
learning content is useful to the better
off
and
to
the
socially
mobile
for
mobi1
whom each stage of education
is a preparation for the next stage.
It
is
not equally relevant to those who settle down i
in the area to which they
belong; for them education should
assistjn developing a capacity to cope
with the local environment,
Instead of " prescribing" what children should
know on the basis of irrelevant
c r i ter i a,, curricula should be built on the
basis of what children are expected to perfor
-m in the social context to
which they belong.
12.
§£hQol_and_Sgcial_concerns
12.1 al
At a conceptual level, it i
10 1”^lne thal th* primary school
can become a meaningful place in ‘L.f'L
isolation.
It has to become a nucleus of
social action.
-•••
Its curriculum must reflect the
ma.jor concerns and goals of
oOcia action such as equality, conservation
of
nature,
control over
diseases and a human
I
identity outgrowing sectarian loyalties.
Education i n
relation to nutrition, health, san i tat ion and
allied
developmental
priorities, discussed in the other chapters,
should be founded in the
learning content at the elementary stage.
lc.2 A perceptible change that had occurred
in primary education over the
last five decades is its isolation from the
general
social and
developmental concerns of the state and
society.
True, at no time was the
primary school actually recognized as the nucleus of social action,
Yet,
its relationship with the rest of the
society was a matter of great
interest in the first decade of Indian
independence when the philosophy of
basic education had not been totally discouraged'.'
in
ovhihix
x
J ’’ rThe curricula reflected
is relationship, not in exhibitionist
exhibHionist terms,
terms, but
but rather by giving room to
local symbols, crafts and languages,
Local resources can flourish only
when the teacher's role in curriculum is
restored. Allied to it is the
task of assuring essential basic materi
als such as text books, children's
literature and play materials.
12-
13.
Investment in education
13.1 Much of the ineffectiveness of elementary education can be traced to
inadequate financial allocation.
Although the amounts provided for
substantial increases over the years, the share of elementary education in
the total expenditure on education (plan and noo-plan) declined from 33.7
per cent in 1951 to 36.4 per cent in 1973.
Since then it increased to
about 46 per cent in 1973-79.
The variation among states in this
The plan allocation
proportion ranged between 23 per cent to 63 per cent,
for elementary education has shown a downward trend.
13.2 Plan_outlays/Expenditures_gn_Elementary_Educatign
Han
Total
Education
Elementary
Education
1Q _ 511119 D 51
Percentage on
Elementary
Education
First
( 1951-56)
1530
850
55.6
Second
(1956-61)
2730
950
34.8
Third
(1961-66)
5890
1780
30.2
Annual Plans
(1966-69)
3220
650
20.2
Fourth Plan
( 1969-74)
8230
2350
28.2
Fifth Plan
( 1974-79)
Draft
17260
7430
43.6
Final
12850
4 100
31.9
25240
9050
35.8
Sixth Plan
(1980-85)
Outlay
Seventh Plan
( 1985-90)
63826
The law priority given to elementary education is illustrated by the
drastic cut in the draft fifth plan outlay while finalising it.
13.3 An analysis of public expenditure on primary education could be seen
After paying teacher's salaries, nothing much
from ahe data for 1978-79.
was left to provide for basic facilities crucial for effective teaching and
learning.
6218. 14
E®!lh?Qtage_to_Total
95.3
Administration/super vision
121.31
1.9
Other expend!ture
73.42
1. 1
Cap i ta 1 expenditure
113.93
_liZ
6526.80
100
Current expenditure
Teachers' salaries
13-
14.
lQl§9£.il_develogment
14.1 The unfinished task of universal elementary education appear s to be
larger than what has been achieved over the past 35 years,
The task is
difficult because it concerns the quality of the effort and because the
future effort would have to focus on areas and groups which have few
material resources to fall back upon.
This situation implies a change in
planning processes and management structures.
The present centralised
global planning process will have to give way to the decentralized planning.
The physical and qualitative targets should emerge from the needs of local
areas and specific groups rather than be disaggregated downwards from
central or state capitals.
The perspective of local communities must
prevail instead of community requirements as assessed by central planners.
The community needs can be identified by adopting the administrative
"block" as the planning unit and by developing it with suitable
infrastructure for planning and monitoring educational activities. Without
responsibility to formulate programmes and access to adequate resources to
implement them, micro level planning would be no more than a slogan.
14.2 Community involvement in primary education has all along been
emphasized primarily as a source of additional resources like labour,
Some control over
construction materials and maintenance of buildings.
educational activity by the local community is not looked upon with similar
To the extent this
enthus i asm, though commended by developmental wisdom.
has been tried, the teachers exerted a reverse pressure, putting a further
Teacher absenteeism
distance between the community and the administration.
and contract employment are common and a matter for serious concern.
Decentralized planning and community control go together and are essential
for meeting the learning needs of d i f f er r i ng env i ronmen t s.
14.3 Corresponding to changes of this nature at the local level, there has
to be greater interaction between government departments in relation to the
For example, without
various aspects of development of children.
nutritional supplement it is almost impossible to ensure regular attendance
at school and performance by the child in accordance with his potential.
Similarly adult education has to improve to ensure the child's
participation in the educational system.
The care of infants and mothers
is important to ensure that every child attends the school.
The school
health programme is yet to take roots.
A holistic approach to a child's
needs for development presupposes bringing down the walls that divide the
The integrated child development services
bur eauc r acy i nto compartments.
(I CDS) is a good example of a relevant model bringing together the three
b r oad st r earns o f services related to basic nutrition, primary health and
early learning,
However the effectiveness and sustainability of this
scheme would depend on its acquiring progressively the attributes of
decentralized planning and community involvement,
Such a climate at the
pre-school stage could foster the similar aim for primary education.
V.
1.
ENVIRONMENT
Life Support systerns:
1.1
A major determinent of child development is the quality of the
physical, as well as social, environment in which children are born and
are expected to grow up. The current situation marks a revival of public
awareness of the steady deterioration of the natural life support systems
such as land, forests, air, water and sources of energy. Recognizing
that the main causes of the degradation are man-made, there have been
recent attempts, which are yet to attain dimensions of a social movement,
to arrest and, if possible, reverse the disturbing trends. On the
success of this effort would depend the quality of life particularly of
new generations.
1-^
I.and: The land to population ratio is steadily decreasing. Given
a total land area of 328 million hectares, the per capita availability of
land Is coming down from 0.94 hectare in 1951 to a likely 0.33 h at the
end of the century. The actual availability is even less if account is
taken of inaccessible land (24 mh) and barren land (21 mh). The
corresponding figures for the per capita availability of agricultural
land are 0.33 h in 1951 and 0.18 h in 2000 Al). Of the total agricultural
land of about 143 mh, some 40 mh were irrigated as of 1982.
1.3
Almost half the total land area suffers from degradation mainly due
to water and wind erosion (150 mh) and partly from water logging (6 mh),
soil salinity (7 mh) and other causes (9 mh). In effect, 760 mn Indians
have between them around 100 mh. Soil fertility is being depleted by
intensive agriculture without adequate supplementation of organic
manures. The 1980-81 foodgrain output meant wltlrirawal of 18 million
tonnes of plant nutrients from the soil, with farmers adding back only 11
million tonnes of them.
1.4
An estimated 13 mh of permanent grazing land is insufficient to
meet the needs of over 237 million cattle (as of 1972). Grazing land is
being increasingly converted into farmland, apart from the pressure of
over-grazing.
1.5
The total desert area is about 35 mh, excluding an area about half
this extent which is vulnerable to being turned into desert.
1.6
Forests: According to the 1952 National Forest Policy, a third of
the total land area, or about 109 mh, were to be brought under forest
cover, however, the annual rate of deforestation has been about 1.4 mh,
bringing the total area under actual forest cover to about 36 mh.
Allowing for an annual plantation rate of 0.4 mh the rate during 1980-85)
as a result of tree planting drives on state initiative, ’social
forestry’ programmes and innovative community level schemes including
- 2 -
involvement of school children, there is still a loss of a million
hectares of forest each year. At this rate, tte forests of the Himalaya,
for example, which form 25 per cent of the country’s forest reserves,
would be destroyed during the first half of the next century.
1.7
There have been enquiries into the factors responsible for
deforestation. Among them are ’’development projects” which destroyed
some 3.41 mh of forest during 1951-72, demand of raw materials for paper,
packing, and timber industries, tobacco curing, use of forests for
non-forestry purposes and, last but not least, the demand for firewood
which provides 70 per cent of the cooking energy in rural areas and 50
per cent of it in the urban areas.
1.8
Deforestation brings In its trail a number of disturbing
consequences: interference with agricultural production due to change in
pattern of rainfall; floods from reduced soil and water retention
capacity particularly in hill areas; monoculture forestry encouraged by
Industrial demand and resulting in tribal and other village people being
deprived of minor forest products vital for their livelihood; scarcity
and rising cost of firewood and, latterly, tie spread of viral diseases,
such as in the Western Ghats of Karnataka, after the large scale cutting
down of trees.
1.9
It has been estimated that over 80 per cent of forest dwellers in
states like Orissa, Bihar, Madhya Pradesh and Himachal Pradesh depend on
forests for upto half their requirements of food. Tie minor forest
produce of which they depend include flowers like the mahua, seeds like
tie sal, leaves such as the sal and tendu, fruits like the mango and
mahua, honey, resins, bamboo and lac, apart from wild animals and birds.
1.30 The preservation of forests and their access to tiie people have a
direct bearing on the lives and future of over 20 million children of the
tribal people and a good part of the remaining about 80 million children
of families with incomes below the poverty line.
Forest area lost between 1951 and 1972
Lost to:
River valley projects
Agricultural purposes
Roads and communications
Establishment of industries
Others
Total loss
hectares:* 000s
401
2,433
55
125
388
3,402
Source: Forest resources of tropical Asia, FAO, 1981.
3
1.11 Air: The daily pollution of the atmosphere comes from modern
industrial as well as traditional sources. As of 1980, some 75 major
thermal power stations, some 3.5 million motor vehicles, 67 large
fertilizer plants, a number of textile mills, among a large and growing
number of air polluting industries and, 90 per cent of households burning
wood, cattle dung and crop residues add daily to tlie pollution of the
air. The level of sulphur dioxide and suspended particles in some Indian
cities has already exceeded permissible limits for health. In the large
cities air pollution has become a major health hazard. 60 per cent of
Calcutta’s 10 million residents were reckoned to be suffering from
respiratory diseases on account of it. In the rural areas, a study of
women in Gujarat showed that they Inhaled each day 40 times tlie volume of
suspended particles considered to be unsafe by the World Health
Organlzation. They inhaled in three hours, an amount of carcinogenic
benzopyrene equalling 20 packets of cigarettes. And, this amount is more
than what an industrial worker is exposed to in any industry in an eight
hour shift. Exposure to wood smoke is particularly harmful to
malnourished, anemic women as carbon monoxide, an important component of
wood smoke, Increases the effect of anemia by reducing the haemoglobin
level in tie blood.
1.12 The negative consequences of these unabated trends would be
irreversible for the health and development of children.
1.13 Water: The rivers of India have traditionally sustained life in
India. They still do. However, inefficient use of water, neglect of
maintenance of irrigation works and short-sighted practices have resulted
in huge waste, frequent flooding and recurrent scarcity.
1.14 Only a tenth of the total annual rainfall of some 393 million
hectare metres is being actually used. Present policies and plans
envisage a steady increase of this proportion.
1.15 Ground water resources amount to some 10 times the volume of the
total annual rainfall. However, excessive exploitation of ground water
for irrigation, without ensuring recharging, has resulted in a lowering
of the water table in many areas. The average annual number of
irrigation tube wells Installed during 1970s is 170,000. If the present
approach to the management of water resources remains unchanged, It is
estimated that the country would face a major water famine after a couple
of decades.
1.16 About 70 per cent of all available water is unsafe for drinking.
This has a tremendous bearing on the health of children in the country,
of whom nearly 1.5 million die annually due to water-borne diseases like
diarrhoea, dysentery, cholera, typhoid and jaundice. Some 73 million
work days are lost due to these diseases, an economic loss far higher
than work time taken up by Industrial disputes. In terms of medical
treatment and loss of production, these diseases cause tlie nation an
estimated Rs 4500 million each year.
- 4 -
1.17 Some 12.6 million people in seven states were found suffering from
guinea worm in 1982. Fluorosis and schistosomiasis have remained major
health problems in particular areas. A new manifestation of fluorosis,
knock-knees, affecting mostly people below 25 years of age has appeared
around major dams in Andhra Pradesh, Tamil Nadu and Karnataka. It is
believed that elevation of subsoil water, due to large reservoirs, has
caused changes in the fluoride, calcium
(
and trace metal composition of
the soil, in plant life and consequently in tie human body.
1.18 /A rapid rate of urban and industrial spread results in increasing
pollution of tlie waters,, of the major rivers across the country. Factory
effluents, untreated isewage and other wastes regularly dumped into rivers
with uncalculated damage to health. Recently
Recently an ambitious project was
launched to clean the Gangs. In the seven kilometre curve of this river
around Varanasi it receives 60 million litres of untreated sewage every
day and 10,000 half burnt bodies and 60,000 carcasses each year.
lower
down, near Mokamah bridge in Bihar some 2,500,000 litres of unprocessed
industrial wastes are added to it every day. Further downstream, the
Hooghly is choked by a similar discharge from tie 150 or so major
factories around Calcutta, The story is not very different for the other
major rivers.
1.19 Energy: According
Accorxiing to the Food and Agricultural Organization there
would be a fall in fuelwood production by 40 per cent by the end of the
century with serious consequences to tiie health and nutrition of the poor
who will find it difficult to adequately cook such food as they might
have. This prospect, whatever the marginal variation, could come true
for India as well.
1.20 Non-commerclal sources of energy provide nearly 90 per cent of the
country’s cooking requirements, And, cooking energy constitutes half the
country’s total energy consumption, Coal and kerosene together
contribute to around 15 per cent of cooking energy, This underlines the
heavy reliance on fuelwood. /As against an estimated total requirement of
133 million tonnes of fuelwood for cooking, the supply is around 103
million tonnes, leaving a substantial unmet deficit.
1.21 The cattle in the country, some 237 million, yield around 575
million tonnes of dung a year. Properly used, this could produce 22,424
million cubic metres of biogas which would be
- - sufficient
---------------- j to meet a third
of the fuel needs for cooking. F
’' this
’ *
Until
happens, the poor have no
option but to dry and bum dung to partly meet their fuel needs.
1.22 A sense of proportion has to inform the priorities for developing
energy sources. For instance, the country’s vast electricity network
just about matches its 80 million work animals in energy generation: the
animal labour force adds up to 40,000 hp, equivalent to 30,000 mw.
However, the investment on work animals is a till rd of the Rs 300,000
million which have been invested in electrical power generation
capacity.
In nuclear energy, from an installed capacity of 1100 mw, the
country now plans to reach 10,000 mw by the end of the century, Instead
by tlie end of 1970s as earlier intended.
u
5
2.
Sanitation
2.1
As a development priority, the aims of sanitation do not seem to
have socially advanced since Mahatma Gandhi wrote in 1941:
"Divorce
between Intelligence and labour has resulted In criminal negligence of
the villages. And so, instead of having graceful hamlets dotting the
land, we have dung heaps. The approach to many villages is not a
refreshing experience. Often one would like to shut one's eyes and stuff
one's nose; such is the surrounding dirt and offending smell. A sense of
national or social sanitation is not a virtue among us. We may take a
kind of a bath, but we do not mind dirtying tie well or the tank or the
river by whose side or in which we perform ablutions. 1 regard this
defect as a great vice which is responsible for tie disgraceful state of
our village and the sacred banks of the sacred rivers and for the
diseases that spring from insanitation."
2.2
The situation has probably worsened these past decades, partly due
to the rapid rate of population growth,> but mainly due to widespread,
continuing ignorance of, and apathy towards observing the simple laws of
health and hygiene.
Sanitation and safe water together are a major
determinant of people's health. For example, if everyone had access to
both, It is estimated that half the nearly five million deaths of
children below five years of age in the country would not be dying.
2.3
Progress: The progress towards better sanitation, rural or urban
during the 1970s has been negligible or nil. Only 5.6 per cent of the’
country’s population was served by reajsonably adequate facilities at the
beginning of that decade. The proportion improved to 6.4
- » per cent in
1981, and tliat too because of the very slight progress in tie rural
coverage (0.1 per cent to 0.5 per cent; and despite a slippage from 27.5
per cent to 26.9 per cent in the urban population sen/ed)’. In 1980 only
198 towns, out of 3119, had sewerage facilities. Among cities with
a
population of 100,000 or more, only 46 per cent had sewerage system and
some arrangement for sewage
— treatment. Except for some pilot projects in
a few states, sanitary facilities have been absent in the rural areas.
2.4
/As of March• 1981, 93.7 per cent of the total population was without
sanitary facilities. This situation improved marginally to 92.7 by March
1985:
19 8 1
Urban
Rura 1
Total
Population
(million)
Pe rcentage
40.03
2.80
42.83
25.1
0.5
6.3
___________ 1 9 8 5
Population
Pe rcentage
(mllli on)
49.56
4.03
53.59
28.4
0.72
7.3
6
2.5
Against this background the plan for 1985-90 is somewhat subdued in
its ambition:
_______________ 1985 - 90
Population to be served
(million)
U rban
Rural
Total
87.91
12.06
99.96
Percentage
44.7
1.8
12.5
2.6
The goals for India for the International Drinking Water Supply and
Sanitation Decade may therefore have to be redefined as below:
Percentage of population
with basic sanitary facility
Original plan
Urban
Rural
81
25
Revised goal
50
5
7 -
RURAL SANITATION
2.7
(Population & Coverage in OOP’s)
1985
Progrcss/Set1981-85
(Percentage)
+1.7
State/
Union Territory
Rural
population
Andhra Pradesh
4 3112
Population
coverage
(pe rcentage)
I .7
Assam
20290
0.9
-0.1
Bihar
64836
3.7
-0.2
Gujarat
24914
0.24
-0.06
Ha ryana
10865
Himaci'al Pradesh
4355
Jammu and Kashmir
52 27
0.1
+0.1
Karnataka
27776
0.17
+0.07
Kerala
21872
1.6
+1.1
Madhya Pradesh
44782
Maharashtra
42371
Manipur
1106
0.09
+0.09
Meghalaya
1175
Nagaland
71
0.3
+0.3
Orissa
24700
Punjab
12671
Rajasthan
29671
Sikkim
275
0.2
Tamil Nadu
33116
Tripura
2007
Uttar Pradesh
96433
West Bengal
42754
0.06
+0.06
Andaman and Nicobar
169
7.7
+7.7
Aruna chai Pradesh
650
0.2
+0.2
Chandigarh
19
52.6
+52.6
Delhi
472
Dadra and Nagar Have11
107
Daman and Dlu
765
Goa,
Lakshadweep
24
Mizoram
412
43.7
-^3.7
Pondicherry
318
1.0
+1.0
8
2.8
URBAN SANITATION
(Fopulation & Governpe in 000's)
J 985
S tate/
Union Territory
Ur ba n
populat ion
Andhra Pradesh
13638
Popula11 on
coverage
(percentage)
10.9
Assam
2347
15.7
41.0
Bi ha r
9669
22.9
+2.9
Gujarat
11602
38.0
-3.2
Haryana
3097
28.4
+16.0
Pradesh
366
13.7
-1.7
Jammu and Kashmir
1420
7.7
-0.3
Kama taka
11740
38.4
+4.6
Kerala
5271
28.2
+21.9
Madhya Pradesh
11896
7.8
+2.7
Mahara sht ra
24164
39.8
+1.5
Manipur
505
0.8
+0.8
Meghalaya
271
Nagaland
150
Orissa
3480
9.5
+ 0.2
Pun jab
5078
48.5
+13.2
Ra ja st han
7250
9.6
+5.4
82
32.9
+3 2.9
1730 2
47.5
+1.10
266
13.2
+8.8
Uttar Pradesh
21329
14.1
+1.2
West Bengal
15167
19.5
+4.0
Andaman and Nicobar
60
55.0
+15.0
Arunachal Pradesh
52
38.5
-9.1
Cliand igarh
563
100.0
+5.9
Delhi
6818
73.4
+1.2
13.3
-3.8
Hi madia 1
SIkk i m
Tamil Nadu
Tri pura
Prog ress/Set back - 1981-85
(Percent age)
+0.3
Dadra and Nagar Havell
17
Goa, P’aman and Dlu
452
Laks hadweep
21
Mizoram
132
1.5
+1.5
Pond 1c l»e rry
346
39.9
+1.9
174551
28.4
+3.3
INDIA
9 -
2.9
Sanitary latrines are an important part, though not of course the
only component, of a sanitation programme.
however, it is neither
feasible nor necessary for public funds to be invested for household
facilities. The 1985-90 (seventh) plan has allocated some Rs.2750
million for promoting sanitation, compared to a negligible amount in the
preceeding plan. Clearly, the aim is more than a matter of construction;
it is a question of building awareness to a level of self-discipllne when
health and hygiene practices change.
Tl»e water seal latrine, along with
Increased rural water supply and public education through health related
communication at the community level Is a key element of tlie projected
social change.
latrines will be built by people (and not for them) when
tl>ey convince tl'emselves that there can be no health without sanitation
and no sanitation without safe disposal of wastes, particularly human
ex c re t a.
2.10 Promise: There are some Indications that a breakthrough in
knowledge, attitude and behaviour would be possible.
For example, In the
rural areas, public investment during 1985-90 focuses on construction of
some 500,000 sanitary latrines for the scheduled castes and tribes and
freed bonded labourers. Such latrines will be t Im? Integral part of the
housing programme for these population groups. They will also be
provided in all village level institutions like health sub-centres,
schools, panchayat offices and anganwadls. There will also be an effort
to link community latrines with bio-gas and soil nutrient schemes. And,
health education and hygiene work will be systematically imparted to the
rural population particularly the children.
2.11 Outside the government sector a few promising agencies have come up
with successful construction designs as well as tie capacity to build and
maintain public conveniences on a ’’pay and use” Evisis. Several ways for
a low Income family to meet the cost are being tried out; loans repayable
In easy Instalments, revolving funds administered by voluntary
organizations, cost sharing including contributions in unskilled labour.
All of these are, however, on a modest scale in relation to the task
ahead. A hopeful factor is the spreading recognition that more important
than the Investing of money is the training of the mind. Another is that
women, the worst-affected for want of household sanitary facilities, are
increasingly making their demand heard.
3.
Drinking Water
A mention was made in the preceeding section about current trends
3.1
of decline in the natural life support systems including water sources.
In particular, the scarcity of drinking water and its uneven quality and
availability was reviewed against a cluster of contributory factors:
geographical, geological, physical, demographic and seasonal.
For
example, the system of monsoon winds, the lie of the mountain ranges,
erratic rainfall and unpredictable cyclones lead to periodic flooding of
helpless villages and recurrent droughts leading to conditions bordering
- 10 -
of family in vast areas. Neither flood control nor irrigation has
readied a stage of development in which tic end of these conditions
familiar in many parts of the country, can be foreseen. However,
substantial progress has been achieved in recent years in making drinking
water available to water scarce villages by drilling borewells and
fitting them with handpumps and in hilly areas through gravity-fed
schemes.
3.2
Experience: That thirst could be as disastrous, or even more so,
than hunger was recognized in India at least from the end of the 1960s.
However, the ’’International Drinking Water Supply and Sanitation Decade
1981 gave the national effort an impetus and a perspective on the health
and developmental dimension of drinking water supply, particularly for
children from low income groups including the scheduled castes and
tribes. Tic decisive link between water supply, sanitation, health,
education and socio-economic development appear to be better recognized
today tlian before.
3.3
The number of ’’problem villages” identified as of 1980 was about
231,000 (out of the total number of nearly 600,000 villages). During
1980-85 over 190,000 villages have been provided with at least one
source, presumably perennial of drinking water. However, the "problem
village" — defined in terms of non-avallability of water within a depth
of 50 ft. or a distance of 1.6 km or in terms of endemic diseases like
cholera or guineaworm or contamination by toxic elements — is a variable
phenomenon, with more and more villages being identified for special
attention from year to year.
3.4
Also, while tlie percentage of villages with at least one perennial
source of drinking water is, of course, an index of progress, that by
itself does not tell what proportion of a community actually consumes
safe water. Again, experience shows that the norms set for priority in
reaching health to communities may have to be made more liberal to derive
the intended benefit - for example, enhancement of the provision of 40
1
i t re
s j person per day ’ to 70 litres
“ ~ - • and providing a source of drinking
per
-----water within half a kilometre Instead of 1.6 kms, or an elevation of 15
in hilly areas.
3.5
P
~ ‘
Participation
: Even more, questions have to be asked and answered
about cost and quality, use and maintenance, utility and effect,. In
short, the challenge of bringing safe water to village or urban slum, is
much more than the physical task, formidable as it is in itself. To
illustrate, water supply without knowledge related to health and hygiene
would be as unproductive as a good borewell without a proper handpump.
And, to sustain a cluster of allied services over time, and to derive an
optimal field from them for the intended population, the local community
must have a roie and a voice in the location, planning, installation,
maintenance, use and evaluation of the services. Experience shows that
any alternative to this strategy is bound to be costlier and to increase
the dependence of the people on agencies in the public or private sector.
n
3.6
Some 60 per cent of the total population, or over 400 million
people were without safe drinking water as of March 1981. According to
government data, the number and percentage of the population served with
at least one source of drinking water (which includes communities covered
only partially) is as follows:
____________ 1981
Populati on
Percenta ge
cove red
of total
(million)
population
____________ 1 985
Populat ion
cove red
(mi I lion)
Pe rcentage
of total
population
Urban
115.48
72.3
127.23
72.9
Rural
162.07
30.8
313.56
56.2
Total
277.55
40.5
440.79
60.2
3.7
Among the population provided with a source of drinking water, the
scheduled castes and tribes figured to a substantial extent, namely 18
per cent and 10 per cent respectively during 1980-85, about 13 and 7 per
cent respectively during 1985-86.
3.8
The investment for drinking, water supply has been increased
signlficantly from the 1980-85 (sixth) plan to the seventh plan, from
Rs.24 ,576 million to Rs.34 ,544 million. The strategy is to cover
villages in tl>e following order of priori tv:
the remaining villages based on the 1980 assessment;
’’problem villages’’ identified after 1980; and
full coverage of partially covered villages and habitations.
3.9
Constraints: Among the constraints that have been recognized as
limiting progress are financial stringency, lack of skilled manpower and
training facilities, shortage of materials and equipment among other
lesser factors. The seventh plan seeks, for the first time, to involve
voluntary agencies for enlisting community involvement in tl?e execution
and maintenance of drinking water supply schemes.
3.10 ’
The expected* size
of the population who will have safe drinking
water by 1990 is as follows:
Rural
Urban
Total
Populat 1 on
(million)
Pen: ent age
452.38
169.96
622.34
75.2
86.2
77.9
COMMUNITY HEALTH CELL
47/1 (First Floor)St. Marks Hoad
BANGAL03E - 560 001
12
3.11 The drinking water supply programme is executed as part of the
Accelerated Rural Water Supply Programme in tie Central Government sector
and the Minimum Meeds Programme in the States sector. A recent realistic
re-assessment indicates that the original aim of th' goal for the decade
for drinking water supply may have to be scaled downward:
Percentage of Population
with safe drinking water
C rig Inal plan
Revlsed goal
Urban
100
90
R u ra 1
1 00
85
3.12 Survey: An index of the dimensions of promoting water used in
village India is provided by a recent survey in 18 districts in 6 states,
of a total sample of 4840 handpumps in 1864 villages. Some 80 per cent
of tie pumps we re in working order at tie time of tie survey. Nearly 40
per cent of the pumps were located at one end of the village, some 25 per
cent in public places and 35 per cent in tie middle of the village.
Some
60 households use a pump on an average. Over 90 per cent of the pumps
are used for drinking and cooking purposes. Nearly 69 per cent of the
pumps have surroundings that are waterlogged, some 57 per cent are
unclean. A pump is used on an average for over eight hours in summer and
nearly six hours in winter. The average flow is 12.5 litres in 40
strokes in about as many minutes. Tlie proportion of pumps remaining out
of order, as noticed during the survey, is substantial:
Downtime
Upto 15 days
Percentage of pumps
out of order
12.62
16 - 30
15.90
90
27.26
91 - 180
24.84
More than 180
19.38
31
3.13 The expected life of an India-Mark II pump is 10 years, A la rg e
number of pumps go out of order much earlier due to poor installation,
maintenance and repair. A pump is seldom used by households 150 or more
metros away from it. Women who form 80 per cent of those who fetch
water, do not like to go to pumps located at public places. They are
seldom consulted about location of the pump.
Tltere Is very little
involvement of the villagers in matters relating to location,
installation, maintenance, breakdown and repair of pumps. These and
allied factors have a direct bearing on the national aim of safe drinking
water to all tlie people.
13 -
3.14
RURAK WATER SUPPLY
(population and Coveragp in OOP’s)
1985
4 3112
Lopula t ion
coverage
(je rcent age )
71 .4
Prog ress
1981-85
( pc? rc ent ago)
30.6
Assam
20290
71.4
17.9
B j 1 ia r
64836
77.8
9.3
Gujarat
24914
79.7
10.5
Haryana
10865
57.8
30.5
Himachal Pradesh
4 355
59.5
13.7
Jammu and Kashmir
5127
62.7
25.9
Kama taka
27776
82.9
52.0
Kara la
21872
40.8
11.5
Madhya Pradesh
44782
62.7
31.3
Maha ra sht ra
42371
51.0
32.3
Manipur
1106
67.6
41 .8
Meghalaya
1175
35.1
15.0
Nagaland
715
65.9
15.5
Orlssa
24700
82.0
48.2
Punjab
126 71
23.8
4.2
Rajast han
29671
58.7
22.1
275
43.3
24.4
Tamil Nadu
33116
46.8
26.9
Tripura
2007
65.6
25.1
Uttar Pradesh
96433
28.3
21. 2
West Bengal
42754
52.5
36.1
Andaman and Nicobar
169
94.7
37.1
Arunaclial Pradesh
650
90.2
24.1
Glia nd igarh
19
52.6
52.6
Delhi
472
100.0
35.8
Dadra and Nagar Havell
107
84.1
42.9
Goa, Daman and Diu
765
44.2
21.1
Lakshadweep
24
45 .8
10.3
Mizoram
412
64.3
34.7
Pond ic lie rry
3.18
100.0
16.7
557859
56.2
25.4
S ta te/
Union Territory
R u ra 1
population
And lira Pradesh
Sikkim
INDIA
14 -
3.15
URBAN WATER SUPPLY
(Population and Coverage in 000’s)
1985
State/
Union Territory
Urban
population
____________
Population
Progress/Set
back - 1981-85
(Pe rc entage)
-3.3
Andhra Pradesh
13638
cove rage
(pe rc ent age)
52.1
Assam
2347
37.5
+ 11.6
Bihar
9669
59.5
-3.9
GuJarat
11 602
83.2
-5.8
Ha ryana
30Q7
69.1
+29.1
Himacl«l Pradesh
366
89.1
-10.9
Jammu and Kashmir
1420
86 .6
-11.0
Karnataka
11 740
81.2
-7.6
Kerala
5271
64.5
+4.7
Madbva Pradesh
11 896
79.7
+ 12.6
Maharashtra
24164
87.1
-7.8
Manipur
505
51.5
-17.8
Meghalaya
271
22.1
-2.8
Nagaland
150
46.7
-11.6
Orissa
3480
38.1
+3.7
Punjab
5078
71.2
+5.6
Ra jasthan
7250
56.0
-0.3
82
89.0
+42.8
17302
83.8
+ 2.9
266
51.5
+2.8
Uttar Pradesh
21329
70.1
-0.2
West Bengal
15167
63.7
+3.7
Andaman and Nicobar
60
100.0
Arunachal Pradesh
52
88.5
+ 40.9
Chandigarh
563
100.0
+5.9
Delhi
6818
98.1
+16.6
Dadra and Nagar Haveli
17
76.5
+76.5
Goa, Daman and Diu
452
81.9
-11.9
Sikkim
Tamil Nadu
Tri pura
Lakshadweep
21
Mizoram
132
7.6
-0.6
Pondicherry
346
76.3
419.3
174551
72.9
0.6
INDIA
c
J5
4.
Urban Slums
4.1
Tn a typical discussion of urban development, tliere would likely be
no more than a peripheral mention of slums however defined. And, within
slums the needs of children and women may receive but token priority.
Tike polluted air in deteriorating cities, slums represent a part of the
social and environment costs of tlx? growth of modem industry’ and
concomitant values. While the main cause of migration from village to
city or tovm is economic, its major consequence is degradation of the
social as well as plrysical environment and quality of life, particularly
of cbiId ren .
4.2
Dimensions: By the
t he turn of tlie
Cite century, a third of India’s
population is likely to be living in nearly 4,000 towns and cities as
against a fourth today. Around 40 million people including some 6
million children are living in urban slums, possibly a majority of them
below the poverty line defined in terms of calories consumed. An
alarming trend Is that for the first time in India, during 1971-81, the
urban population began to grow faster (4.6 per cent) than tlie overall
national growth rate (2.5 per cent) and the rural rate (1.9 per cent).
To all indications the population of tl'e urban slums is growing faster
than the overall urban rate. And, it is argued that restrictions on
urban migration might adversely affect the growth of the (urban)
economy. Thus the basic ecology of slums is accepted and attention to
tlefr needs focuses mainly on environmental improvements without
interfering with the social and economic functions of the slums.
Relocation is not easy as it wipes out investment in the huts to be
demolished, increases transportation time and cost, reduces employment
opportunities to tlx? slum resident.
4.3
Municipal corporations and local bodies find it difficult to meet
the demand made on them by the unabated migration from village to town.
During tlie 1980-85 national plan, some Rs.1510 million were allocated for
environmental Improvement of urban slums. In the following plan 1985-90, Rs.2695 million have been earmarked for tlx? purpose
. (representing 0.15% of the total public sector outlay in the plan).
4.4
The norms for environmental improvement relate to water supply,
sewers, storm water drains, community bathrooms, street-lights, roads and
lanes, ratlier tl>an housing as such which tlie slum residents constantly
try to improve on their own. Progress in implementing the scheme has
been slow during 1980-B4, while it has picked up pace tliereafter. The
major constraints have been the absence of any long term strategy for
slum improvement in different states, lack of adequate administrative and
technical expertise at local levels, inadequate budgetary resources of
local bodies, absence of information on slum projects, and finally the
problem of coordination among agencies concerned with water supply,
electricity, sewerage and the like. All the same, it is estimated that
over 9 million slum dwellers benefitted from the Improvement scheme.
16
An example: Among the states, Maharashtra has the highest slum
population of about 7 million (or 30 per cent of its total urban
population).
Dharavi in Bombay has the dubious rank of being the largest
slum in Asia, with a population of 800,000 over a area of 4.5 kms.
It
has grown from a group of fishermen, potters and tanners originally
settled there but now includes migrants from all over India. They come
to Bombay because it is India’s most affluent city.
It is estimated that
44 per cent of Bonbay’s 8.2 million population Jive in slums such as
Dharavi or on street pavements. The situation in Calcutta and other
large cities is not very different.
Health and nutrition: While shim dwellers comprise around a third
of the urban population of the four major cities - Bombay, Calcutta,
Delhi and Madras - they occupy only six to 10 per cent of tl<e urban land
area in these cities. The pliysical, social and psychological
consequences of the lid ph density are loudly evident. While reliable data
are not available in tlie absence of any organised countrywide serveys,
such studies as have been made point to certain inferences. The health
status is poor with respiratory diseases, gastro-intestinal disorders,
skin diseases, fever, worms, ear-nose-tbroat diseases and tuberculosis
all of which are common.
4.7
Malaria has re-emerged. While safe water supply, improved drainage
and latrines have reduced the level of gastro-intestinal disorders to a
par with nearly non-slum areas, viral infections, skin diseases and
respiratory Illnesses remain signlfleantly higher, presumably due to
over-crowding. The major illnesses tend to be chronic, with patients
rarely completing the full course of treatment. Malnutrition among
children and women is extensive, maternity and ante-natal services are
poor, the rates of Infant and child mortality a re high, family planning
acceptance is Inadequate in relation to national aims.
4.8
Education and income: 11 teracy rates, pa rt icu1 ar1y among womcn
are low, tlough tie younger age groups show relatively higlier levels of
attainment. Access to non-fonnal channels of education is rare and
uneven. Under-employment is common. Vocational skills are low and
income levels are generally below the poverty line. Over 90 per cent of
the income is spent on food, yet the majority remains under-nourished.
The exploitive vzages of indispensable categories of maintenance jobs in
the urban unorganised sector such as sweepers, barbers, porters, domestic
helpers and semi-skilled mechanics represent the hidden subsidies to the
urban economy. The urban slums are also a source of cl'eap child labour.
These categories, substantially concentrated in the urban slums, also
provide support to the continuing stream of migrants attracted through
the social network based on kinship, caste, language and place of origin.
4.9
Aberrations: Tn this setting tie slum population lags behind the
non—slum urban communities in many respects. They seem to have a larger
proportion of their population in the lower age groups. Their lower
u
.17
ratio of females to males tends to even out, specially among the younger
groups. Slum families would seem to have an even greater need than
others for child care services, maternity centres, educational
facilities, training programmes and other facilities geared to the young,
family. Parents are unable to meet the physical and emotional needs of
tl>ei r children. Problems related to persona] relationship, mental and
emotional stability, marital disharmony, retardation of growth, speech
and intellect, prostitution, crime, vagrem-y, and so prevail extensively.
4.10 Another approach: lately there have beeni attempts by the
government, in association with voluntary groups and development
agencies, to improve basic services like child and mother care, women’s
income skills, health, education and prc-scf’ool learning facilities,
linking water supply’, sanitation facilities and shelter -Wroyernent. A
L? this
J.13 current
effort, intended to reach the urban
significant feature of
(
300
towns
by
the
end
of
the decade, is the role of the local
poor in some
—
- -y -tlieir needs, and
a
slum community Itself in understanding and1 analysing tleir
organising and maintaining services In ai decentralized design based on
people's involvement and responsibility and adequately supported by
government.
By this approach, which is in its initial but hopeful stage,
it may be possible to reverse, if not the migration to the urban areas,
at least the alienation of the migrants from their new surroundings,
surroundings. An
allied aim is to view the district with its towns and viJ Japes as a
single planning unit, with the town or city complementing the rural
"■ it.
This approach can however succeed
hinter land rather than Jiving off
only on the strength of a new lsocial ethic which does not accept the
inhumanity of life In the slum, tl’e worst victim of which happens to be
the chi Id.
5772A
VI .
1.
COMMUNICATION
Overview:
a s a means to break out of t h e po vert y ignorance trap, the
1.1
Viewed as
o I communication t o the process o ! e d uc a tion and human
relevance of
development becomes obvious,
Thus, extending communication in all its
varied trends from a minority to a 1 1 of the population iiss a priority in
any scheme of socia 1 change,
However the content and mutuality o f
communication determine its usefulness. a p a r t from t h e question o I access
to it.
1.2
The right to expression as we 1 1 a s t o information i s a basic need o f
children as well as of adults,
This need is al I the more urgent when a
change in the way
wa y ooff life and living is t h e aim, involving breaking away
I r om o 1 d systems of tradition and belief even on simple daily concerns
like eating habits, hygienic practices, farming metfiods and the equation
with the natural e n v i r o n m e n t.
1.3
The communication system in India has steadily expanded during the
past four decades to become one o f the largest in the world.
At the same
time, there ha E been a dec line in the "old information
informal ion order", based on a
rich and ancient heritage including song , drama and dance which still
lingers in the village in its minstrels, ba 1 ladders. story-tel lers,
puppeteers and theatre groups.
1. 4
Common i c at i on f 1 ows cor r espond to community structures.
To the
extent the latter are strengthened; communication becomes more
democratic.
This precisely represents t li e present challenge in the face
of a fairly rapid, but still inadequate expansion of the modern media.
Given the prevailing high rate of illiteracy and the poor means o f
transportation in much of the countryside where most people live, 11 was
perhaps to be expected that the electronic as well as the print media
wouId cater mainly to the not-so-poor among the urban people.
In terms of
ownership and control, the press and the ccommercial
o m iii e r c i a 1 films are almost
wholly in non-government hands while the radio and the television are
owned and managed directly by the government,
1 h e printing industry is
again largely in private hands while public utilities like the postal and
• telecommunication systems are in the public sector.
n
Television:
2.1
In recent years there has been a pronounced shift in policy towards
sophisticated technology in communication, o f which satellite
communication, the computer, television aand
n d video are the major
mani f estations.
India had its first experimental television centre i n
Delhi in 1959, with a limited range and programmes meant for
f or schools and
rural audiences.
Regular transmission tfor
or the general public began i n
1965.
In 1?75, an ambitious project. using an American satellite
I he
Sa t e 1 1 i te Instructional Television Experiment (SITE) was launched to beam
programmes on agriculture, health, hygiene, family welfare, science,
2
education and the like in four Indian languages, four hours daily for one
year.
About 2400 villages spread over the six states were provided with
community viewing facilities.
The viewers, some three million were mostly
first generation mass media participants in that they were never before
exposed to television, radio, film or newspaper,
To provide additional
information and new inputs demanded by the audience, SITE could not be
followed up, though it paved the way for later satellite systems like the
Indian satellite, INSAT, to convey programmes of educational value to
children as well as adults.
o o
The pace of expansion of television picked up during the 1980s.
There are today 181 transmitters - 47 high power (10 kw) and 114 low power
(1 kw) - with a coverage of about 7700 per cent of the country's
population.
Some 14 centres have their own production facilities,
10
more centres are scheduled to have them soon,
soon. Until recently when a
second channel was opened in Delhi and Bombay, the Indian television has
had only a single channel.
Through several thousand community viewing
sets have been provided in villages
villaaes and tribal areas
arpac their number remain
small in relation to requirements.
Meanwhile
M e a n w h i 1 e the number of television
receivers, presently estimated at nearly 6 million sets with about 60
million viewers, is set to increase at an
an annual
annual rate of 3 million.
2.3
Two aspects of this quantitative explosion deserve
a mention.
On
the one hand, television programmes providing glib
entertainment or
pander i ng to consumer gullibility are becoming an addiction
with urban
aud iences, and se
r
seriously
encroach on time available to the young f or
regular study,
On the other, the television infrastructure offers
unprecedented scope for educational programmes not only related t o
institutional learning but well beyond it to reach children out of school
as well as unlettered adults, both of whom are in
greatest need of
information relevant to knowledge, skills, heal th and wellbeing.
1his
potential remains, by and large, untapped.
3.
Radio:
3. 1
I n 1947 when the country attained political freedom, there were only
s i x radio stations.
Today the radio network is one of the largest
anywhere, with 87 stations with 128 med i urn wave, 35 short wave and four
frequency modulation transmitters, broadcast ing for around 1600 hours a
day in 21 major languages and 246 dialects,
The broadcasts cover 80 per
cent of the area and 95 per cent of the popu 1 at i on.
3*2
All the same, the number of broadcast receivers, about an estimated
30 million, is rather limited at 4.4 sets for every 100 persons.
There is
also an imbalance between the rural and urban areas in terms of possession
of radio sets.
Some 80 per cent of the sets are reckoned to be in urban
areas.
Another disparity is the skewed distribution of receivers among
the states, with 5.26 for every 100 persons on an average in Tamil Nadu to
less than one set for every 100 persons in Bihar and Orissa.
3
3.3
A response by the government to the limited reach of the radio in
rural areas and among low income groups, has been the policy of financial
subsidy for community radio receivers.
Dy 196? there were about 210,000
community radio sets installed for organised discussion groups in
villages.
With the spread of low priced transistor sets (which still
remain beyond the financial reach of the majority), the relevance of state
subsidized community listening sets was perceived as declining.
Today
their number is much less than a decade ago and the spread is highly
uneven, with two states accounting for nearly half the total number of
community sets in the country.
3.4
Group listening of specially prepared series of radio programmes has
revived in the 1980s particularly in the field of mother and childcare.
At present some 21 radio stations are broadcasting child survival and
development messages in 11 different language dialects.
Each week,
programmes for over 21 hours cater to more than 10,000 listening groups
organised in 81 districts in 19 states.
These radio forums are linked to
expanding network of the government sponsored Integrated Child Development
Services (ICDS) presently involving some 100,000 anganwadis (child care
centres).
4.
Filas:
4. 1
i ndust r y in India is the world's leading
The mu 11i-mi 11ion film industry
producer of feature films, over 700 a year in 20 languages.
The
commercial interest heavily colours the content which typically provides a
mix of song, dance, crime, violence, sex and melodrama.
A minority of
powerful films on themes like untouchability, bonded labour, caste
discrimination and other topics of social relevance appear now and again,
gaining recognition in India and abroad mainly (or their sensitivity, but
seldom make a commercial success.
While the run of commercial cinema
provides escapist fare and promotes questionable social values, attitudes
and habits, it can also be said that they have contributed to the spread
of the national language, Hindi, and thereby to a common element in the
cultural mosaic of the country.
4.2
For the country as a whole, the facilities for film exhibition are
limited.
Most of the 12,000 cinema halls are in the larger towns. On a
national average, there are 7.5 seats for every 1000 population.
The
number of cinema houses is unevenly distributed, with the four southern
states, alongwith Maharashtra and West Bengal, showing the highest, density.
4
EEATyRE_FILM51._BY_LANGyAGE
Language
1951
1961
197 1
1901
Hindi
100
109
120
153
Iam i 1
26
49
73
137
Telugu
20
55
95
132
Malayalam
7
11
52
111
Kann ad a
2
12
33
65
Benga 1 i
38
36
30
42
Guj a r a t i
6
7
3
34
Others
20
24
37
63
Total
219
303
433
737
4.3
The screening of the official weekly news reviews and documentaries
is compulsory and is a source of revenue for the government.
Some 70
million people are estimated to be the a'verage weekly audience.
Mobile
units carry government documentaries farther afield.
The rural audience,
unlike many of their urban counterparts, do see the documentary, yet
pref er the f eature film.
4.4
Ihe mass entertainment provided by the film industry tend to
compromise artistic standards, exerting an unwholesome influence on
programme pattern and content of the other media, from television and
radio to newspapers and magazines.
5.
Videos
5. 1
A recent arrival, the video has spread quickly to an estimated half
3 million,
It has acquired a place in small town restaurants, long route
buses and even remote villages as a source of ready entertainment,
somet i mes as a status symbol.
Its enormous potential as a medium (or
educat ion has hardly been touched.
6.
Presss
6.1
The Indian press exerts a major influence in politics and public
affairs, despite the rather subdued circulation due to factors like
widespread illiteracy and low purchasing power.
5
The number ol nc’wspapers at the end of 1982 was 19,937.
Of these
6.2
1334 were dailies, 5898 weeklies and the rest publications of other
frequencies.
Newspapers are brought out in 16 major and 69 other Indian
languages.
The number of newspapers in Hindi was the highest (5655)
followed by English (3689); the respective aggregate circulation was 13.7
million and 9.7 million.
CIRCULATION OF.NEWSPAPERS
Number
Daily
Others
Circulation ( ’000)
Others
Daily
Hindi
442
5213
3797
9966
Engli sh
11
3578
3072
6650
Assamese
3
73
48
230
Bengal i
43
149 4
1044
C 1C J
Guj ar at i
39
686
1050
1502
Kannada
80
545
489
1092
Language
1
Kashmir i
Malayalam
103
699
1439
3096
Marathi
124
1002
1266
1533
Or i ya
11
261
205
256
Punjabi
24
408
283
792
Sanskrit
2
29
n
5
S i ndh i
4
58
12
54
Tamil
102
7 18
825
3432
T e 1 ugu
31
522
477
1519
Urdu
134
1196
736
1533
Bilingual
32
1532
39
1078
Multilingual
9
34 1
5
24 4
Others
40
247
58
142
Total
1334
18603
14847
35247
I
6
6.3
the largeness of
o I the number of
newspapers is, in a sense,
misleading.
Only 176 Of them have a
circulation
of more than 50,000.
Another 373 have a circulation between
15,000
and
50,000.
o f dai1ies i s <on ’1 y about 21 copies (or
Ihe circulation
every 1000 persons on
on an
an average
but the readership
per copy seems to be high, by internat ional
comparison.
The main centres
Delhi, Bombay, C a 1 c u 11 a — 3 of newspaper public at ion are the four cities
and Madras.
Nearly 93 per cent of the total
sales of dailies is confined to 1
large towns and cities with a population
of over 100,000.
Newspapers published
- —..vJ in the bigger cities do reach smal1
towns and some vi11 ages but
on a limited scale and
only to a wel1-to do
cl i en t a 1 e. Not more than a
fifth of the total circulation of the major
da i 1 i es seems to enter rural
areas.
6.4
(\
r
—-
«■
survey of district level r
newspapers in Uttar Pradesh and t a r n a t a k a
showed that they are
usually irregular in
i
publication, unethical in
practice and have littl
o
reading
material
—
1
of interest to the rural people
All the same, the
concept of district level r
years, appears sound,
newspapers, discussed for
though 1argely untried.
•
A judicious mix of news and
views on ar ea-spec i fic
development issues, public
concerns, political,
social and cultural a f fairs
-- 3 - dealt within the local
and backed by
good management and
some advertisement, should make the
grade, as
illustrated by some successes
a 1 ready.
6.u
In Kerala, Tamil
lamil Nadu
Nadu and Andhra Pradesh,
relatively higher circulation in the rural areas newspapers have a
Kerala with a
s population) has
in the country, with
million copies
a c ;n «u
. .
*3, political events,
press coverage, along with crime
and entertainment in urban areas
Reporting on rural areas is rare, with
Jss^cJar5 like P°litical eve"ts or calamiti
.vies,
Rur al people hardly
ssociate a newspaper W1th developmental
i n f or ma t ion.
Though the press
it pl
plays
erratic ?
^s ‘ significant role in political
lif e and its
re?aM
,uncll°">ng.•
There
There appears to be a
recent trend toward 5
on and
related to human
acnodnl;Trtsies and p—ut^s dox ;he other mBdl
The Government has its own print media
for publ icity on behalf o I
the different departments and
autonomous bodies.
The printed publicity
materials are distributed by post
- upto about 1.2 million addresses.
There
is also the government information network i
in the rural areas,
^hn " !rly f°r promotin9 f^ily planning; th
ie field units organize films
shows and cultural events.
Studies reveal a estrong association between
b ack war dness and lack of uummunication resources, socio-economic
I common i cat i on
A study of the rural
poor showed that the majority was not exposed to
any
mass med i a.
On 1 y
five per cent o f them r egu 1 ar1y listened
to
the
radio.
As
of
now,
to the media can hardly be expected
access
among the rural poor.
7
urban_6roups_by_income
7. 1
NOT EXPOSED TO MASS MEDIA
Media
Per cent
Rs.501 to
Rs. 1000
and above
Upto
Rs.250
Rs.251 to
Rs.500
Any daily
82.5
69.2
51.1
37.7
Any publication
62. 1
52.6
33.2
21.2
Cinema
41.2
31.3
25.6
20.2
Vi v i dh Bhar at i
68.4
49.5
34.2
30.0
Television
96.9
92.7
83.5
68.8
Source:
Rs. _iooo__
Reports of National Readership Survey II, 1978 (ORG).
7.2
EXPOSURE TO MASS MEDIA IN RURAL INDIA
Study area
District (State)
Newspaper
Radio
Film
Bal 1 ia
(Uttar Pradesh)
15.6
26.2
9. 1
Almora
(Uttar Pradesh)
4.5
16.8
4.2
A1 w a r^
(Raj asthan)
18.3
26.5
5.0
Moh indergarh
(Haryana)
23.7
53. 1
7.2
Mandya
(Karnataka)
39.4
62.6
25.4
Sources Reports of 11MC Research studies.
8
7.3
The radio and television systems devote about two-fifths their time
to development related programmes in agriculture, health and child care,
However, the impact of the mass media in terms of ac t ua1 adoption of
development messages seem to be small, partly due to limited access and
partly due to the larger association and expectation of entertainment
rather than education.
Analyses show that the mass media are effective
usually in proportion to the social relevance or political significance of
content and credibility of source.
8.
Fol k I or ®s:
8. 1
In t er per sona 1 and folk forms of communication are fairly active and
make up for the limited reach of the mass media.
Experience suggests that
the interplay □( the mass media and the traditional modes of communication
are eeffective.
f f ec t i ve.
Radio listening groups engaging themselves in related
discussion is an example of effective use of a combination of media.
lhe
o I Grandhash ala (library) Movement in Maharashtra and
V 1£ a§
support of
the communication effort
e ffort to popularise science in ferala are good examples
of inter-personal communication combined with other media.
8.2
The social structure and cultural norms influence the pattern of
interpersonal communication,
lhe factors of caste and kinship affect
communication flows.
So do hierarchial institutional arrangements.
The
principles traditionally emphasized in social organization and
communication pattern in India seem to be asymmetry and hierarchy.
Making
communication democratic implies the opposite.
This is particularly
important if the potential of folk forms of communication to convey
developmental messages iiss to be fully liberated from the cultural
domination from which they suffered until not long ago.
8.3
Perhaps an effective strategy of communication for development would
be to strengthen the interface between various modes of communication -the mass media, folk forms and interpersonal exchange -- each performing
its specific function and supplementing and reinforcing one another.
For
example, the mass media can help in spreading awareness and creating a
climate necessary for change.
Folk forms can reflect the area's specific
needs and provide local colour and flavour.
1 nterperson a 1 communication,
as for example, between community workers and the people, can underline
priorities, clarify doubts, provide details and enhance acceptability of
changes in attitude and practice.
5869A
HO
9
- Media
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