`Child development has been neglected'

Jean Dreze  

ACCORDING to the latest Human Development Report, India shares the highest rate of child undernutrition along with Bangladesh and Nepal. How did we achieve this unenviable record?

Mass poverty is obviously a major part of the answer. But that's not the end of the story, otherwise we would find similar rates of child undernutrition in, say, Tamil Nadu and Uttar Pradesh, where poverty levels are quite similar. In fact, child undernutrition rates are about twice as high in Uttar Pradesh, for reasons that are not exactly mysterious: education levels there are abysmal, public health services are virtually non-existent, women have no voice in the family and society, and so on. If child undernutrition is to be abolished, far-reaching intervention is required on all these fronts, as has happened to some extent in Tamil Nadu, and of course in Kerala.

What role do you see for the government in protecting children from undernutrition?

In India as elsewhere, the well-being of children depends crucially on public intervention. Of course, in many respects the parents are best placed to look after their children. But the rights of children, including their right to nutrition and health, cannot be entrusted to the family alone. Indeed, it is an interesting paradox of Indian society that children are deeply loved, yet they are also terribly neglected. If we are serious about children's rights, then every child has to be under the supervision and care of public institutions such as anganwadis and primary schools. Going beyond this, public intervention is also required to address the deeper roots of child undernutrition, from mass poverty to gender inequality.

How have different governments over the years viewed child development and what have been their responses on the ground?

Child development has been grossly neglected in public policy. One reason for this is that children have no voice in the political system. In fact, children from disadvantaged families are twice removed from the democratic process: not only are their interests represented by others, such as their parents, but the parents themselves are often unable to participate in democratic institutions. It is because of this lack of voice that, say, anganwadis can remain non-functional for months at a time in particular states without anyone taking much notice of the problem. The absence of any serious political commitment to children's rights is another reflection of this lack of voice.

The ICDS is supposed to address children's needs in a holistic manner. How is the programme doing on the ground?

I have been associated with a recent a survey of ICDS in six States. The contrasts are really startling. In Uttar Pradesh, for instance, anganwadis are closed most of the time, when they exist at all. Even when they are open, children rarely get any food, not to speak of other essential services such as vaccination or pre-school education. In Tamil Nadu, by contrast, most children are enrolled in the local anganwadi centre, nutritious food is available there every day of the year, and more than 90 per cent of children are fully vaccinated. These contrasts are all the more interesting as ICDS is a centrally sponsored scheme, based on similar guidelines throughout the country. There is an important message here about the overwhelming influence of the social and political context in shaping the outcome of particular policies.

The Supreme Court has issued strong orders calling for the universalisation of ICDS. What are the fiscal implications of doing this, and as an economist, do you think it is feasible?

There are about 14 crore children below the age of six in India. Suppose the government were to spend Rs. 5 per child per day on ICDS throughout the year. This is not a magic figure, but five rupees per day could make a dramatic difference to the health and well-being of the average Indian child. The total cost would be Rs. 25,000 crores, approximately one per cent of GDP. This may sound like a large amount, but it's a trivial price to pay to liberate Indian children from the present morass of hunger and ill health. One does not need a PhD in economics to see that this is not only feasible but also imperative.

Do you really expect the government to commit one per cent of GDP to child development, in the present climate of fiscal conservatism?

I do not expect this to happen on its own, but I believe that it can happen with adequate public pressure. Aside from its importance for children, the universalisation of ICDS has tremendous political significance. It is a crucial test of the ability of Indian democracy to resist the dismantling of social services and initiate a visionary programme of public support for children. If this happens, India could become an inspiring example for the world, instead of being known as a land of starving babies.