Bachhe Children in india UP 5 Opportunities
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Bachhe Children in india
UP 5 Opportunities - extracted text
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children in india
UP 5 opportunities
The state of Uttar Pradesh (UP) is usually intro
duced as the most populous state in India with a
population of 170 million. UP is known for present
ing many challenges, such as one of the highest
maternal mortality rates in India at 707/100,000
live births, some 1.5 million children engaged in
child labour and pervasive gender discrimination.
Against these odds, UNICEF considers UP a
unique opportunity to develop reforms involving
local elected bodies (called panchayats in rural
areas, na'gar palikas in urban settings). The 73rd
and 74th constitutional amendments increased
decentralisation and reserved one third of the seats
in local bodies for women. Villages now have a
greater say in the planning, delivery and monitor
ing of social services, including health and educa
tion.
Community participation fits into UNICEF’s holis
tic approach to development with a human face,
promoting the convergence j?f services, a nd. com
munity ^wnershjj). Children and women are the
first beneficiaries of this approach. In Uttar
Pradesh, UNICEF supports the training of female
panchayat members and the creation of bal pan
chayats - local bodies of elected children who are
involved in the development of their communities
and their own lives. The creation of the new state
of Uttaranchal (out of UP) will not have a signifi
cant impact on social indicators as only 5% of UP's
population will live in the future state.
Six of the most disadvantaged districts have been
selected for intensified efforts based on close col
laboration between all sectors: education, health,
nutrition, child protection, communication, water
and sanitation. Our starting point is the survival
and development of the new born child, as some
150,000 babies die every year of preventable dis
eases. By mobilising and empowering communities, UNICErcan'c^htnButrtdlheT^ucfion df the
number of infant deaths.
Johan Fagerskiold
State Representative
UNICEF Uttar Pradesh
unicef
Ch- i ,h-
SDA-RF-CH-1A.4
saving children’s lives
early childhood care for survival growth & development
There are many obstacles to the survival and full development of chil
dren under the age of 3 years in UP: malnutrition, lack of health care,
poor parental knowledge of infant care and proper feeding practices.
According to WHO, 55% of annual child deaths due to diseases could
be prevented if children were well nourished in UP.
The causes of malnutrition are multiple. 46% of women are married
before the age of 18 (although legislation fixes the minimum age of
marriage at 18) giving rise to many early pregnancies. 40% of first con
ceptions are in the age group 15-19 years. And many of these women A
are anaemic or malnourished, and so they give birth to under-weight j/
children. In fact, the incidence of low birth weight babies is four times*
higher among mothers below the age of 19.
Studies conducted by UNICEF in Uttar Pradesh reveal that the major
at-risk factors leading to higher child mortality and malnutrition rates
are: poor infant feeding practices, mother’s low nutritional status, poor
knowledge of hygiene and illiteracy of the mother.
Based on this analysis of the situation, UNICEF’s approach to early
childhood care for survival, growth and development is necessarily
multi-sectoral. The water and sanitation sector needs to be involved to
ensure that families have access to safe water and know about hygiene;
the education sector should give priority to girls’ education - so that
future mothers can make informed choices; the health sector has the
primary responsibility for informing families about correct child feeding
practices and immunisation.
UNICEF in UP has been working with academics and medical colleges
to develop a better understanding of early childhood care, particularly
with regard to psychosocial stimulation and breast-feeding of young
children. The focus on changing behaviour means that communities
must be involved. Hence UNICEF supports a pilot project in 12 blocks
of 6 districts - covering a population 2.4 million people, including
about 150,000 children under 2 years of age - with the objective of
improving family childcare behaviour and to create demand for servic
es. Community health, nutrition and sanitation mobilisers called Bal
Mitra Parivar have been identified. Each mobiliser is responsible for
spreading awareness about early childhood care through 50 house
holds. The UP Government has expressed interest in expanding the
experience to other districts.
early childhood care for survival,
growth & development
Early C^ildli00^ Care f°r Jurvival,
Breastfeeding
Gr°wth and Development
Breastfeeding is widely practised in India, but not always in the
right way. For instance, many communities discard Colostrum
(first milk after birth) - this means that many lactating mothers
start breastfeeding a few days after birth, preferring to give their
children mixtures of water and honey for the first three days, until
the mother’s milk is no longer yellow. Mothers also tend to intro
duce water mixtures too early and do not complete six full
months of exclusive breast-feeding - as a result, many children
are malnourished and/or suffer from diarrhoea or other dis
eases. UNICEF and other partners have been working with the
Government of India, local authorities, NGOs and medical pro
fessional groups to ensure: 1) pregnant and lactating women are
provided with accurate information on breastfeeding; 2) the
International Code on Breastfeeding and Breast-Milk Substitute
is enforced in India, especially in hospital and maternity wards;
3) Hospitals and health centres become baby-friendly and pro
mote early and exclusive breastfeeding.
Scientific research has proved that the first three
years of a child's life determine his or her future
physical, cognitive, social and emotional devel
opment. Investment in early childhood care is
not only crucial for the child but also for the
country, as experience has shown that invest
ment in early childhood care is an essential strat
egy for national development. Health and nutri
tion education should be enhanced by incorpo
rating care in general and psychosocial support.
Early childhood care can only be improved by
strengthening families' and communities’ ability
to provide better care for young children.
------ :
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- Infant mortality rate: 72/1,000 live births
* Timely
complementary
feeding
of
infants
aged 6-9 months: 33.5%
Women aged 20-24 married before age 18 years
old: 50%
Low birth weight babies: 30%
* Malnutrition rate (children under 4): 47%
Polio immunisation: 1999-2000: 2 doses, 98.6%
* Children aged 12-23 months fully immunised:
* Women aged 15-49 years with anaemia: 51.8%
42%
Children aged under 3 years with anaemia: 74.3 %
Immunisation
Immunisation has saved millions of children's lives since the
first universal immunisation movement was launched in the
1980s. Children under 1 year of age need to be immunised
against whooping cough, tetanus, diphtheria, polio, measles
and childhood tuberculosis. Not only does immunisation
save lives, it is also cost-effective as it prevents diseases and
disabilities due to these diseases. In India, the immunisation
rate has increased from 2.3% in 1985-86 to 78% in 1997,
declining to 52% in 1998-99. National Immunisation Days for
polio (NIDs) were launched in December 1995. Since then
two rounds of NIDs were conducted every year covering
around 87-95% of children under five years. In the 1999-2000
campaign, the country conducted four nationwide NIDs and
two sub national immunisation days in 11 high-risk states ■
during which 96-6% of children under 5 received at least 2
doses. Despite this progress, immunising all children less
than 5 years old in India against polio and all infants against
the six main childhood diseases remains a challenge.
Anaemia
Anaemia is the result of iron deficiency. Although iron is pres
ent in certain categories of food, it is common for women
and adolescent girls to suffer from anaemia. Anaemic
women are tired, more vulnerable to infection, and when
pregnant, anaemic women will have low birth weight babies.
Severe anaemia mainly due to iron and folic acid deficiencies,
is directly or indirectly responsible for about 20% of maternal
deaths. To address the problem effectively, a life-cycle
approach is required: anaemia needs to be tackled during
adolescence and throughout reproductive age. Pre-school
children have also been found to show a high prevalence of
anaemia. Distribution of iron and folic acid tablets, particu
larly to pregnant and lactating women, is important for pre
venting anaemia.
news
Aeena (n a ,OWn
S’" ofids SoS XdSeytUTEFt°
A National Commitment to
Early Childhood Care
bcipation of NGOs all ov
! A clear consensus on the priority of addressing the crit
ical prenatal to under three years period of early child
hood care in a rights perspective emerged at the first ever
International Conference on Early Childhood Care for
Survival, Growth and Development in India, which took
place in New Delhi from 3-5 October 2000.
The Conference was organised by the Department of
Women and Child Development, Government of India, and
UNICEF, in collaboration with the World Sank and the
National Institute of Public Co-operation and Child
Development (NIPCCD). Over 300 participants from India
and nine other countries gathered in order to renew strate
gies and propose recommendations for an action plan for
India.
This event marked a major shift from exclusively government
based interventions to family and community delivery of early
childhood care, highlighting the importance of nutrition,
health, cognitive development and the psycho-social well-being
of the young child.
The Conference was inaugurated by the Minister of State for
-Women and Child Development, Mrs. Sumitra Mahajan. She
Stressed that the recommendations made by the Conference
would be incorporated into policy planning to enhance the qual
ity of coverage given to young children by the State. The
UNICEF Country Representative in India, Mr. Alan Court,
emphasised the need for shared responsibility of both parents
in the first three years in the life of a child. “With today’s sci
entific knowledge and with political commitment, we can
make a difference in the lives of children within one genera
tion.”
The Conference’s major recommendation was that pro
grammes intended to improve the well being of disadvantaged
children should prioritise the youngest age group. Expanding
on this decision, further recommendations were * Constitution of national and state level task forces to bring
together all sectors and partners to address the health, nutri
tional, cognitive, emotional and social needs of the young
child.
* Creation of a national ‘early childhood care code’ which pro
motes care for the very young child.
* Inclusion of early childhood care as an integral part of all
training programmes for Panchayati Raj institutions (vil
lage self government), urban local bodies and
women's development programmes.
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/ joo° was the large-scale
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calender of events
a life cycle approach
to child rights
November
14th
November
Children’s Day
20th
November
Child Rights Day
The Convention on the Rights of the Child (CRC) was unanimously adopted by
the United Nations General Assembly on 20 November 1989. This was the first
international human rights instrument focusing exclusively on children and it has
been ratified by virtually all countries in the world. India acceded the CRC in
December 1992. Child Rights Day is celebrated by children all over India. It is
used as an opportunity to sensitise children and adults about child rights.
December
1st
December
HIV/AIDS Day
HIV/AIDS is a growing threat in India, with some 3.7 million people reported to have been
already infected. It is estimated that 570,000 young men and 340,000 young women are
HIV positive. The number of HIV cases has increased by 400% over the past few years.
UNICEF, as part of UNAIDS, works with the Government of India and other national and
international agencies to increase awareness of the population, with a special focus on
pregnant women and young people.
10th
December
International Children’s Day of Broadcasti NG
A few years ago, UNICEF started working together with the radio and television to encourage
child participation in their programmes. The 10th of December was selected as the day on which
the electronic media would open their programmes and their studios to children. This year
UNICEF in India has supported 4 regional orientation and planning workshops for the media. As
a result, 31 state TV centres and 60 radio stations have agreed to consult with children on their
interests and broadcast special programmes on this particular day.
Uth
December
UNICEF Day
12th
December
Launch of the State of the World’s Children 2001
The State of the World’s Children Report is a flagship publication released annually by
UNICEF. A new theme related to children’s well-being is presented and analysed in each issue.
This year, the report focuses on early childhood care for survival, growth and development. It
also contains worldwide statistical tables on children's education, health, nutrition, survival
and development. The launch will take place on the 12th of December both internationally and
within India.
pulse polio
campaign 2000
India has the largest number of polio cases in the world. Polio can
ONLY BE ERADICATED FROM THE WORLD WHEN INDIA BECOMES POLIO FREE.
’*•934 polio cases were reported in India in 1998. This year as of September
21st, only 142 cases have been reported. As cases of polio are decreasing, pulse
polio campaign 2000 is focusing on those communities who have traditionally
remained out of reach.
Eastern State of Bihar, September 24th 2000. An auto-rickshaw stands on the
corner playing popular film songs on a loud speaker. A woman's voice asks,
“Why now? Why again? How many times?” The subject is polio. And the voice
answers: every child under 5 years old should have four doses of two polio
drops in the upcoming months.
Research shows that some minority communities refused to accept the polio
drops because of a prevalent myth that the vaccine will cause sterility. In
response, UNICEF in Uttar Pradesh asked religious leaders to issue a state
ment dispelling misconceptions and to explain the need for every child to have
two drops.
Caste is also considered to be a challenge - although there have been signifi
cant changes in perceptions, caste still dictates behaviour in India. UNICEF
research maintains that if the volunteer or government worker is of a different
caste, communities will not accept the vaccine from him or her, for reasons of
superiority or inferiority. Even when a volunteer of a different caste visits the
house, there is no success in vaccinating children. This year, a strategy was
implemented to co-opt a volunteer from the local neighbourhood and predomi
nant caste to accompany the government care worker.
Some of the urban elite are also cited as a hard-to-reach community - especially
those who depend entirely on the family physician’s advice. To mobilise private
doctors and to convince them of the need to vaccinate every child, a national
consultation of the Indian Academy of Paediatrics (IAP) was organised in May
2000. This was followed by state level workshops in seven States. IAP has
committed to keeping private clinics open on national immunisation days,
advising clients to immunise their children and promoting a high level of advo
cacy with national and state politicians, functionaries and technical experts,
along with their members.
India’s largest challenge to becoming polio free is the ever-growing population.
For example, between the last immunisation round in March 2000 and the first
immunisation campaign in August, approximately 4.5 million babies were born
in Uttar Pradesh and Bihar alone. Communicating the need for children to
receive their two drops is essential. UNICEF and partners continue to evaluate
the results of every polio campaign and communicate the urgency to make
India polio free.
Polio Dates
24th September 2000 - Uttar Pradesh, Bihar, Delhi and West Bengal.
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The 1999-2000 evaluation of the polio campaign reveals that several communi
ties remain unreached - especially several minority communities, populations
of varying castes and the urban elite. So the September 24th campaign
mobilised various means of communication, based on extensive qualitative
research organised by UNICEF between April and September, in an attempt to
‘reach the unreached.'
School children are running this polio booth. A yellow
flag marks the spot. How many drops do children need?
“Only two” a student says very seriously. Seven children
are helping at the booth and the others are out in the vil
lage making sure everyone comes. The students organ
ised a polio rally this morning to make sure everyone
knew today was pulse polio day and they are planning
another for tomorrow.
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Rains welcomed the volunteers as they walked into the
village. It has rained so much in the past months that
many districts in West Bengal have been flooded. In the
village of Kemia Razkola, it is still raining as government
workers begin visiting houses to administer the polio
drops. School children come rushing to help with
umbrellas. By the end of the morning round, five black
umbrellas are moving through the village, trying to keep
the government workers dry so they can continue to give
two essential drops.
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The cadets are manning transit points today and for the
next three days all over India. With their cold coolers on
their shoulders they get onto the buses that arrive and
are about to leave, identify a child under 5 years old. ask
if he or she has been vaccinated and if not, give the child
two polio drops. Why do the cadets think it is important
to administer polio drops? "For a polio free India" they
answer.
2:32 p,rn. Lunch time, Hospital, Lajpat Nagar, New Delhi
Some cite the urban elite as being a hard-to-reach com
munity. But at a hospital in South Deihi, members of this
hard to reach community are arriving in cars with drivers
to give their children the drops they need. “They are used
to getting treatment here." a volunteer explains. A back
room of the hospital is filled with cold carriers for the
vaccines and maps of the areas the volunteers will begin
to cover on their house to house trips tomorrow.
5th November 2000 - Uttar Pradesh, Bihar, Delhi, West Bengal, Orissa,
Assam, Madhya Pradesh, Haryana, Punjab, Gujarat and Rajasthan.
10th December 2000 - National Campaign
21st January 2001 - National Campaign
Last year, between 135 -150 million children were immu
nised on pulse polio day.
fingerprint *
postcards
Jn Nautala village, Uttar Pradesh (UP),
India, children have sent postcards t° the
District /Magistrate requesting water-testing kits
to determine the quality of their water.
To the District 7\agstrate,
V/hy don't you come visit cur village?
Abram Lincoln, age 8. Kamal Bal Jabha
If you had a problem in your village that you wanted to
solve, what would you do? too children in a remote vil
lage of Uttar Pradesh wanted to know if the water they
were drinking was safe, so they wrote postcards to the
district magistrate (DM) asking for water testing kits.
One postcard after another arrived at the District
Magistrate’s office, on different days and from different
post offices, but all asking for the same thing: water
testing kits. The children signed their names, added a
finger print for good measure and reminded the DM of
the name of their village: Nautala.
Dear Jir.
Qur water is dirty and makes us sick, please send us
the kits so we can see what is wrong with the water.
Guldi Jevi, age 12.-. Nautala Village
The District Magistrate bound the postcards together
with an elastic band and sent them to the department of
water. In search of the postcards, we visited the office of
the District Engineer. A fan spins overhead as the Junior
Engineer explains, “Responding to the postcards’
request, I went to the village and met children who
wanted bottle kits to test for bacterial impurities.” The
Junior Engineer suggested that he take a water sample
to be tested in the district lab - but the children were
adamant, they had 50 wells, and all the water sources
needed to be tested. One child added, “we have to see
for ourselves if our water is safe to drink.”
The children of Nautala decided at a meeting of all of
the Bal Sabhas or children’s groups in the village to test
the quality of their water. Children's groups were creat
ed in the end of 1998 as a part of Project Masoom, sup
ported by UNICEF Lucknow. Young people in the village
are trained as motivators who will in turn encourage
children to form groups in their own community - the
goal is to initiate children’s participation in their own
development. The children elect a chair person for the
group and a postman who will let everyone know when
and where the meetings are. Then the children meet
twice a month to discuss their rights and what they can
do to fulfil them. The children understand their rights to
be what they need in their lives. They play games based
on their ‘needs’ such as ‘darpan’ (mirror), a game
where every child has to imitate the facial expressions of
another: darpan celebrates every child's right to expres
sion. At one of their meetings, the children were trained
in testing water quality and decided to write postcards
to ask for the water testing kits. Ambika Prasad, the
retired schoolteacher from Nautala village, gave too
rupees (US$2.50) to buy stamped postcards.
Only 20% of the rural population in Uttar Pradesh has
access to sanitary facilities. Although 88% of the popu
lation has access to water, contaminated water, lack of
latrines and poor hygiene practices cause diseases that
account for nearly 400,000 child deaths in India every
year. Children are at risk from the water they drink. The'
District Engineer agreed to train children to be water
testing engineers, to be able to use the kits he can sup
ply, so the children can ensure their water quality.
To date the children are still waiting for a response, but
they are not disillusioned, “We will just send more post
cards until someone comes,” giggles Ancha, "and when
they do, we’ll send you a postcard.”
Hell°, we need water testing kits
Ancha
For more information please contact:
Sandie Blanchet
UNICEF, Communication Section
73 Lodi Estate . New Delhi 110003 India . Tel. 91 11 469 0401 (extn. 1228)
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