15.6.4 The earlier plans perceived child development mainly in the frame of child welfare. The First Plan laid the major responsibility of developing child care services on voluntary organisations. The Central Social Welfare Board established in 1953 was assigned a leading role in promoting and assisting the voluntary effort. In the Second, Third and Fourth Plans, child welfare services were added in different sectors of the Plan. The Fifth Plan ushered in a new era with a shift in focus from child welfare to child development and emphasis on integration and
395
coordination of services. The National Policy on Children adopted in 1974 provided a framework for the development of services to children. The programme of Integrated Child Development Services (ICDS) with a package of services comprising immunisation, health check-up, re- ferral, supplementary nutrition, pre-school education, and nutrition and health education, was launched in 1975 in 33 blocks in the country on an experimental basis. A school health programme was also started. Maternal and child health services in rural areas were strengthened. The national programme of minimum needs included some services which directly benefited children.
15.6.5 The Sixth Plan saw consolidation and expansion of the programmes started earlier. It also witnessed expansion of the programme of ICDS, with the sanction of 1037 projects. Implementation of the programme of universalisation of elementary education was accelerated. Non-formal education programmes were promoted. Vocationalisation of education was given priority. Pre-school education centres were supported in the educationally backward States through grants to voluntary organisations. The national policy statement on health adopted in 1983 set the goals and the targets for health by the year 2000 AD.
Review of Seventh Plan and Annual Plans 1990-92 15.7.1 The Seventh Plan continued the strategy of promoting early childhood survival and development through programmes in different sectors, important among these being ICDS, universal immunisation, maternal and child care services, nutrition, pre-school education, protected drinking water, environmental sanitation and hygiene, and family planning.
15.7.2 The ICDS continued to be the main integrated national programme for early childhood survival and development. In 1991, the number of sanctioned ICDS projects was 2,594, of which 1,656 were in rural areas, 711 in tribal areas and 227 in urban slums. By the end of December, 1991, about 129 lakh children below 6 years of age and more than 27 lakh pregnant and nursing mothers were getting supplementary nutrition under ICDS. About 67 lakh children of 3-5 age group were getting pre-school education services. The feedback on the impact of ICDS reported a faster decline in the incidence of infant and early childhood mortality in ICDS project areas. There was also better utilisation of vitamin `A', iron-folic acid, and immunisation services in the ICDS projects compared to non-ICDS areas. Programme implementation in several States, however, suffered from a number of deficiencies including inadequacy in the cold chain for vaccines, irregular supply of nutrition supplements, inappropriate food, low coverage of "under-three-year olds", and weak coordination between the health and welfare departments at the field level. Nutrition and health education of mothers and community participation were also weak.
15.7.3 Under the maternal and child health services of the Ministry of Health and Family Welfare, the universal immunisation programme to protect children from six major diseases which affect early childhood mortality and morbidity, viz., diptheria, whooping cough, tetanus, polio, measles and childhood tuberculosis was strengthened and expanded to provide universal coverage. In 1989-90, more than 82 per cent coverage was reported for DPT, OPV, BCG, and about 70 per cent for measles and TT (PW). Surveillance systems to monitor the inci- dence of these diseases were set up which reported a decline in the incidence of reported cases of these diseases. Prophylaxis programme against nutritional anaemia of mothers and children through a daily dose of iron and folic acid for a period of 100 days was expanded. A prophylaxis programme against blindness due to vitamin A deficiency was also implemented. Pre-school and school feeding programmes were continued in the States, with priority accorded to children below 6 years. To prevent and control diarrhoea and diarrhoea- related diseases which account for about 1.5 million deaths every year, the oral rehydration therapy was launched, which now covers all the districts. During 1990, an acute respiratory infection control pro- gramme was started in 15 districts. The primary health care set-up of rural areas was strengthened. In urban slums, the urban basic services programme included services for children and mothers. The programme of health posts for meeting maternal and child health needs in urban slums was strengthened. A massive programme for providing safe drinking water facilities in the rural areas launched in the Sixth Plan was accelerated in the Seventh Plan.
396
15.7.4 Since the age of the mother at the time of birth of her child, her health acid nutrition status and birth order are important factors which affect child survival and development, the strategy for raising the age at marriage of girls, adoption of the two-child norm and spacing of births was vigorously promoted in the Seventh Plan to project family planning basically as a programme for the well being of the mother and her child. In March 1990, an overall couple protection rate of 43.3 per cent was reached. There was also a modest decline in the age of acceptors of various birth control devices.
15.7.5 For pre-school educational development, in addition to lCDS, 4,365 early childhood education centres were assisted through grants- in-aid to voluntary organisations. The National Policy on Education (1986) emphasised universal enrolment and universal retention of the child at the elementary school stage and a substantial improvement in the quality of education. In 1988-89, about 127 million children were enrolled in classes I to VIII. Of these, 96 million were in classes I to V and 31 million in classes VI to VIII. The enrolment ratio in 1988-89 was 99.6 per cent in classes I to V (age group 6-11 years) and 56.9 per cent in classes VI to VIII (age group 11-14 years). The scheme of non-formal education, introduced in the Sixth Plan as an alternative stream to impart education to children who for various reasons could not attend formal schools, was continued.
15.7.6 Creche services to children of poor working women in the unorganised sector were substantially expanded. By the end of 1990- 91, there were about 121,500 creches. Training of creche workers was also organised. however, the creche facilities fell far short of the requirements.
15.7.7 The Government of India enacted the Child Labour Prohibition and Regulation Act, 1986. In 1987, the National Policy on Child Labour was formulated. Projects were sanctioned to voluntary organisations for the welfare of working children to provide non- formal education, supplementary nutrition, health care and skill training.
15.7.8 For children in need of care and protection, grants were given to voluntary organisations through the State Governments. By the end of the Seventh plan, 47,600 children wore benefited. The programme, however, was heavily weighed in favour of institutional services. Adoption services were promoted and a concerted effort made to promote in-country adoption.
15.7.9 The Juvenile Justice Act (JJA) was enacted in 1986, repealing the then existing Children Act, to deal effectively with the problem of neglected or juvenile delinquents and provide for a standardised framework for the handling of such children. To provide financial support to State Governments for establishing the institutional infrastructure and to standardise the minimum services as envisaged under the Act, a scheme of prevention and control of social maladjustment was started in 1986-87. However, many States and Union Territories are yet to set up suitable administrative machinery with appropriate professional expertise to implement the provisions of the Act.
Status of Children 15.7.10 The mesures undertaken in the earlier Plans have undoubtedly improved the situation of children. The infant mortality rate (IMR) declined from 129 per 1000 live births in 1971 to 91 in 1989. There are, however, considerable inter-State variations in IMR, the highest being 123 in Orissa and the lowest 17 in Kerala. IMR is also high in Madhya Pradesh (111) and Uttar Pradesh (98). The rural-urban differential in IMR continues to be very high. It was 58 in urban areas as compared to 98 in rural areas in 1989. Although the age specific death rate of children 0-4 years declined form 53.0 in 1970 to 33.3 in 1988, the inter State variation continued to be large, the lowest being 7.7 in Kerala and the highest 51.0 in Madhya Pradesh. The rural-urban differential is also high 35.7 in rural areas and 18.7 in urban areas. Deaths among children 0-4 years accounted for two- fifths of the total number of death rate among pre-school children are diarrhoeal diseases, respiratory infection, communicable diseases, and causes peculiar to infancy.
15.7.11 Malnutrition among children is an important cause of high mortality and morbidity. Its incidence is quite high among the disadvantaged segments of the population. It is, by and large, the result of insufficient calorie in-
397
take; unbalanced diets lacking in adequate quantities of vitamins, minerals and other nutrients; susceptibility to diseases due to poor environmental sanitation and hygiene and consumption of polluted water. The poor nutrition status during pregnancy and ignorance of health ad nutrition needs are also contributory factors.
15.7.12 While there have been gains in the education of children, particularly of girls, the age specific literacy rate available for 1981 indicates that only 34.7 per cent boys and 25.6 per cent girls in the age group of 5-9 years were literate. In the age group 10- 14 years, the literacy rates were 66.7 per cent for boys and 44.8 per cent for girls. There were also considerable inter-State and rural urban variations. The age specific literacy rates for 1991 are not yet available but given the difference of only 9.7 per cent in the female literacy rate for the age group of 7+ between 1981 and 1991, the slow pace educational development is a cause for concern, specially if one sees the large inter-State variation in the age specific literacy rates and the situation in the educationally backward States. The drop-out rates, particularly for girls, con- tinues to be high. For instance, in 1986-87, the drop out rate in the case of girls was 51.2 at classes I-V stage and 70.2 in classes I to VIII.
15.7.13 The problem of child labour still persists particularly in the unorganised sectors of industry. The 1981 census
reported about 13.6 million child workers, who constituted 1.96 per cent of the total population, 5.57 per cent of the total work force and 5.17 per cent of total child population. The main factors for the prevalence of child workers are poverty, dropping out from school and the interest of employers in getting docile workers at a cheap rate. Putting children to work deprives them of the opportunities of education and training. In certain industries, children are subjected to long hours, poor working conditions, low wages, insecurity of employment and occupational hazards which affect them rather ad- versely.
15.7.14 The decline in social obligations by extended family members towards children who become orphaned, the breakdown of familes and the absence of support to single-parent womanheaded households has increased the problem of child neglect and child abuse. Although there is no reliable data about the magnitude of the problem, its increasing visibility, specially in urban areas in the form of street children, beggary and vagrancy, is a pointer. Problems of delinquency are also on the rise. In 1989, the number of juvenile crimes under IPC was 18,457, representing 1.2 per cent of all crimes. The number of cases under local and specific laws was 18,537. Drug abuse is a new problem which is becoming a growing menace affecting children from all segments of society.
Strategy for Eighth Plan 15.8.1 Since human development will be the main focus of the Eighth Plan, policies and programmes relating to child survival and devel- opment will receive high priority. While it is true that successful implementation of programmes of poverty alleviation, reforms in existing social and economic structures, institutional changes and female education will help in raising the standard of living of the under-privileged segments of society and have a favourable impact on child survival and development, specific programmes and services directed at children will also be necessary.
15.8.2 The World Declaration on the Survival, Protection and Development of Children in 1990 indicated the challenges and the tasks and stressed the need for political action at the highest level for the well-being of children. A Plan of Action intended as a guide to Governments has also been prepared for implementing the Declaration in the 1990s. Major goals and targets for child survival, their protection and development in the 1990s have been set out. It would be necessary to undertake national and disaggregated State level exercises both for rural and urban areas in the light of these goals and targets, the national policy statements on health (1983), education (1986) and child labour (1987), and the Directive Principles of State Policy. A multi-tier system for monitoring progress will also need to be developed.
15.8.3 Child development programmes in the Eighth Plan will give high priority to preventive services, which are family and community based to be able to combat effectively high infant and early childhood mortality and morbidity. Special attention will be paid to those States where childhood morbidity and mortality are
398
high. Children belonging to the poor and the under-privileged sections of population will be covered by basic minimum child development services. Emphasis will be placed on integration and convergence of services. Better coordination among health, family planning, education, social welfare, nutrition, water supply and sani- tation programmes will be effected at all levels. The basic strategy for organising services for children will be to design area and beneficiary-specific schemes, utilising local resources and institutions. The efficiency and cost effectiveness of different services will be closely monitored. The capabilities of the families, specially of mothers, to look after the basic health, nutritional and emotional needs of children in the age-group 0-6, will be enhanced through nonformal modes of learning. Social discrimination against the girl child will be effectively countered, through a massive campaign, to ensure equal treatment and equal opportunities for their growth and development.
Programmes 15.8.4 The national programme of ICDS will continue to be the basic strategy for child survival and early childhood development with special focus on areas predominantly inhabited by the tribal people, scheduled castes, droughtprone regions and urban slums. In the location of new projects, preference will be given to areas having high levels of infant mortality and morbidity. The quality of services will be improved by removing the existing constraints in immunisation, delivery of supplementary nutrition and pre-school education inputs. Nutrition and health education of mothers and community participation in running the anganwadi, which were hitherto neglected, will receive special attention. The quality of pre-school education services will be improved. The lCDS infrastructure at the village and supervisory level would be used for early detection and identification of physical handicaps in children under 6 years of age and for support to the family welfare programme. The programme will be backed by convergence of environmental sanitation and hygiene and safe drinking water supply. The training of lCDS functionaries will be augmented. A system for decentralised monitoring and qualitative feedback will be developed for ICDS. Paper work by anganwadi worker (AWW) will be reduced to the minimum. The AWW and the Child Development Project Officer (CDPO) will be trained to use the data generated from the records kept by the anganwadi worker to monitor both inputs and outputs.
15.8.5 The universal programme of immunisation will be expanded and strengthened further to increase the effective levels of Bottlenecks in the supply line of vaccines and also the time-gap in the posting of personnel will be reduced. Greater awareness will he created about the need and importance of immunisation through mass media and non- formal channels. A child survival and safe motherhood project will be implemented to provide an integrated package of services in six States with high birth and mortality rates. The Maternity and Child Health Programme (MCH) will be considerably strengthened with special attention on immunisation of pregnant women and of infants and the control of communicable diseases. Other measures to be promoted are: greater access for mothers to pre-natal care; training of midwives so that a larger percentage of births are assisted by trained attendants; and creation of awareness in families of the special health and nutrition needs of pregnant women. Programmes for the control of diarrhoea and acute respiratory infections will be strengthened. The merits of breast feeding and low cost weaning foods will be communicated in a big way through mass, folk and non-formal media.
15.8.6 The accelerated implementation of the family planning programme by affording choice to woman in the planning of births will be an effective and inexpensive way of ensuring better chances of survival of the child, by reducing the incidence of high risk babies. The coverage of problem villages and urban slums with protected water supply will ensure accessibility and use of safe drinking water, thereby reducing the incidence of water borne diseases. The en- vironmental sanitation and hygiene programme and the urban basic services programme will help bring down the incidence of early childhood morbidity and mortality.
15.8.7 Early childhood education programmes will be strengthened. Emphasis will be laid on improving retention of children in schools at the elementary stage so that the goal of universalisation of elementary education by 1995 can be achieved. The elementary school system will be improved both in terms of physi-
399
cal facilities and quality of learning. The programme of non-formal education for children will be strengthened.
15.8.8 Creche and day-care facilities will be expanded with the help of voluntary organisations to cover more children of the poor working women. In the organised sector, where creche/day care facilities are to be provided statutorily, it will be ensured that the employers implement the provisions pertaining to setting up of creches with the required basic minimum services. Training of creche workers will be organised.
15.8.9 Programmes will be developed with the assistance of voluntary organisations to suit the specific needs of children in need of care and protection with focus on family and community based services. In many cases, convergence of services and programmes- which help the families to improve their incomes and the quality of their lives will be necessary. The standards of services of children's homes will be improved and a constructive intake and discharge policy formulated. Half-way homes to cover the transitional period of rehabilitation will be set up with the assistance of voluntary organisations. Programmes will also be developed for street children.