Children younger than six years of age account for one- sixth of India’s population, and yet just 1% of the government’s budget is spent on them.
In a country where a quarter of the population is estimated to live on $1 a day or less, lack of state funding is a serious deficiency in ensuring that children get a decent start.
Four out of five toddlers in India are anaemic. Less than half have received all recommended vaccines. The chances of a child’s survival—at least for the poorest 20% of the population—are worse than in Bangladesh or Vietnam.
Neither the lawmakers nor the media has done much to highlight the plight of the very young.
This long-standing neglect has now become a major problem. Correcting the sad state of affairs will require a “massive increase in financial allocations,” a group of doctors, social workers and economists said in a recent report.
The working group on children under six, set up at the behest of the government’s economic planning agency, estimates the cost of reaching out to 80 million children and 10 million pregnant and breast-feeding women with day-care centres, medicines, counselling and nutrition—including eggs for a protein-rich diet—at Rs30,000 crore a year.
That’s one-and-a-half mon- ths of taxes that the government collects from levies on personal incomes and corporate profits. Can India afford to devote such a large share of fiscal resources to young children, putting their needs ahead of other claimants in society?
The wisdom of public investment in early-life human capital is now fairly well established.
Research by Mark Huggett at Georgetown University in Washington and two other economists suggests that differences in initial human capital—acquired before 20 years of age—matter more for how people fare later in life than either being born rich or possessing higher learning abilities.
The question, therefore, isn’t so much about whether the state should invest more in very young children, but how and where it should spend the money to ensure maximum gains.
It isn’t a trivial issue.
Shantayanan Devarajan, the chief economist for South Asia at the World Bank, says the determinants of child mortality in poor countries lie mostly outside the realm of conventional health care.
For instance, improving access to safe drinking water can probably do more to save young lives in India than boosting state spending on nutrition.
“Health inputs have only a weak relationship with child mortality,” Devarajan says on his website.
This isn’t to say Indian taxpayers should resent paying for an egg in each young child’s meal every other day, which is what the committee recommends. But surely provision of clean water, for which the panel has very little advice to offer, should take precedence?
Likewise, if the Indian government heeds the committee’s suggestion on cash grants for pregnant women, it should give an even bigger monetary award to women who delay childbirth.
The fewer the number of children born in extreme poverty, the smaller will be the problem of their neglect.
Population control efforts in India have lost their urgency.
The fertility rate, which stands at 2.7 children per woman, is likely to miss the government’s target of 2.1 by 2010. And after India hits that rate, the population will still take another 35 years to stabilize.
In parts of the country, overpopulation, ignorance and poverty have reinforced one another to produce a hostile environment for young children.
Take the state of Bihar, which is more populous than Germany and poorer than Ethiopia.
It’s also feudal, lawless and largely untouched by the rapid economic growth that’s pulling millions of Indians out of poverty every year.
Only 17% of the women in Bihar had access to three rounds of antenatal care before their last child was born, the National Family Survey of 2006 said.
And yet, the fertility rate in Bihar is as high as four children per woman; and the figure has been rising in the past few years, partly because of a strong preference for sons.
Contraceptive usage is less than half of the national average; only 35% of women have heard of HIV/AIDS, compared with 57% nationally.
There’s no way the plight of children can be reversed in Bihar with nutrition alone; controlling the birth rate, something that the Indian government seems to have overlooked lately, is crucial.
If eggs are important for India’s future, condoms may not be any less so.
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