Child Survival - Health and Nutrition
Item
- Title
- Child Survival - Health and Nutrition
- Creator
- Kamala JayRao
- Date
- 1988
- extracted text
-
COMNWNITV
CHILD SURVIVAL
HEALTH
AND
NUTRITION.
1.
Kamala JayRao.
On of the arguments against the present policy of
population control is that it will not be successful as long
as there is no substantial reduction in infant and child
mortality. The present day emphasis on oral rehydration
therapy and universal immunisation which are part of the GOBI
project of the WHO, is a response to this realisation. Although
these may reduce the mortality rates, they cannot or may not
bring about any significant change in the nutritional status
of the children. As is well known, poverty is one of the main
reasons for the extensive magnitude of undernutrition in the
country. While supplementary feeding programmes may help
tide over a crisis, in the ultimate analysis,? an overall
economic upliftment is needed.
Rural development programmes are meant primarily to
improve the ecnomy of the villages. They are planned to
improve the economic status of the poor and the landless in
the villages. It is generally assumed that an improved
economic status of the family will result in better food
intakes and therefore the nutritional status of the family
members. To what extent is this true, and to what extent
are the children benefited, needs to be examined.
Punjab and Haryana are held out as outstanding
examples of the success of the green revolution. A look at
the countryside reveals the Statues' prosperity and these
states are considered to be among the well-developed regions
of the country. However, the infant and toddler mortality
in this region is still very high (117 and 12 respectively;
the IMR is almost similar to the national average). Going
1
into the reasons for this,1 Betty Gowan has the following
observations to makei
1)
The benefits of development were being enjoyed by
approximately two-thirds of the village. These are landowners 1
do not belong to the Scheduled Castes and have a high rate
of literacy.
2)
Development, nonetheless, improved the work
opportunities, income and amount of food consumed by the
pior, landless failles. But it also brought about certain
undesirable consequences.
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3)
y
Wi.th_introduction of high-milk yielding (HMY) buffaloes
the work of the women of the poor household increased.
Previously, whatever milk was available was used for family
consumption. With better transport facilities and increased
opportunity for selling milk, there was not enough left at
home. Whatever remained was just enough for family tea.
4)
'Women got more job m opportunities. As a result the
time they could devote for child care and also for breast
feeding, decreased. An additional observation was that
more female children ,_5Cf/o of those below 2^+ months)
suffered from severe degrees of malnutrition than male
children, 20$ „ However this sex difference is not unique
because as mentioned in another paper, generally more
female children suffer from malnutrition.
Another significant aspect is that a mother could
easily carry a young infant to work with her, whereas a
bhreo-year old would wander and enter any house in the
neighbourhood. It is theseven to twenty four month old child
who had to be left with an older sibling, or even left alone
outside the house in some cases. This could account for the
higher Uffi ? and high malnutrition and mortality among toddlers.
5)
The Ml buffaloes need more fooder. The women of the
poor households walked long distances to bring fodder and
sell it to the richer households. VIomen continued this work
even in late pregnancy. Consequently there was a greater
incidence of premature births,? which contributed to the
high IMP-,
6)
The hope that an increased income will naturally lead
to better food intakes does not always hold good. Other studies
show that increased income of the male members leads to
increased alcohol intake and purchase of consumer goods
(e.g. transistors, wrist watches etc.) With the Government
itself encouraging alcohol sale and consumerism, this is, one
supposes, inevitable.
*
p
Despite all this, according to Gopalan the incidence
of malnutrition among l-< year olds is less in Punjab compared
to some other orates. That is, those who survived the vulner
able perioct ofinfancy, appeared to be nutritionally better off.
...3...
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In contrast to Pubjab is Kerala - a comparatively poor
state (whether and towhat extent the recent inflow of Gulf
money has improved the State's economy, I do not know).
However, Kerala has a very low IMR, the lowest in India^.
-t also has a low death rate, a low child mortality rate and
a low birth rate. However the incidence of under-five
malnutrition is not lower than in Punjab^, This is because
in Kerala food intakes are very low, one of the lowest in
the country. The body weights and heights of the children
are lower than in Punjab,? and similar to that seen in U.P. -a
very backward state.
Kerala has a fairly good and well -spread out health
services. It also has a good road transport system. In
addition, it has a very high female literacy rate (the
difference between male and female literacy rates is
extremely small here). It is believed that the mothers may
therefore seek medical treatment early and utilise the health
services better here (This is a conjecture and needs to be
scientifically validated). This may explain the lew IMR and
child mortality in Kerala. However due to poverty, (percent
below poverty line in Kerala, Punjab and U.P. are about h-7, 1?
and
respectively), food intakes continue to be low.
Gopalan suggests that while the improved economic
status in Punjab resulted in a better child nutrition, the
low female literacy rate may have prevented a reduction in
IMR and child mortality. The exactlyopposite factors might
be the cause for the opposite findings in Kerala. He warns
that during the transitional development stage, child survival
should not be equated with good child nutrition. A situation
like that a in Kerala would mean survival of a larger number
of undernourished individuals, of people with small body size.
Therefore any programme, such as GOBI, aimed at proved child
survival should not be carried out in isolation, but along
with programmes aimed at improving the nutrition of the child.
Programmes for 'child survival' are being planned with a view
1
- b- -
to bring about a reduction in birth rate and therefore the
inherent dangers in such schemes need to be taken cognizance
of by all concerned people.
References
*
* ?;c #
❖ S$C ❖ * ❖
1.
Cowan, B. NFI Bulletin, October 1982.
2.
Gopalan 0. NFI Bulletin, January 198U.
3.
Jaya Rao, K.S. In Under the Lens, pp. 183-192
Anthology III, MFC,s 1986.
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