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World Children’s Day 2019 – has India progressed?

India celebrates Children’s Day every year on November 14th — a week earlier than the global celebration of World Children’s Day on November 20th. The earlier date marks the birthday of India’s first Prime Minister Jawaharlal Nehru, informally known as Chacha Nehru (“Uncle Nehru”) among children.

School children having mid-day meal in school, Radhu Khandu Village, Sikkim, India

The day is celebrated by giving children treats, presents, and extra attention. However, the day is also an opportunity to reflect on the state of child health in India, a situation that is dire, yet slowly improving.

A recent study published in the healthcare journal, The Lancet Global Health, discovered that India had more child deaths in 2015 than any other nation. Given the population of India being second in the world, this figure in itself comes as little surprise. However, there are a number of metrics and socioeconomic factors that go unaddressed that have resulted in this considerable death toll among country’s youth.

Among these factors, malnutrition stands as the most prominent by a clear margin. In 2017, more than 1.04 million children under the age of five lost their lives in India. Of these deaths, malnutrition accounted for seven lakh. 

Poverty is one of the major drivers behind malnutrition. Those in impoverished positions are often unable to provide healthy meals for their children. This can result in conditions such as stunting and wasting which can have a lifetime of impacts on the child affected. Such conditions are relatively widespread in India. In 2017, wasting had a 15.7 percent prevalence in India and stunting had a 32.7 percent prevalence.

The issue of malnourishment often becomes cyclical. When a child is malnourished, both their physical and mental development are hindered. This often has an outcome on school performance, with those suffering from malnourishment underachieving. This, in turn, leads to worse economic prospects upon entering the workforce, perpetuating the impoverished situation and making it more likely for the individual — and indeed their own children — to be suffering from malnourishment.

The rate of poverty — and, by extension, malnourishment incidence — coincides with child mortality rates. In many instances, the figures differ so much between states that it is as though the figures originate from entirely different countries. Goa, for instance, recorded 9.7 under-five deaths per 1,000 births in 2015, while comparatively poorer Assam recorded a significantly higher 73.1 per 1,000 births.

These figures may paint a bleak situation for children in India. However, it is worth noting that compared to just a few decades ago, the situation has markedly improved.

A Save the Children report released earlier this year asserted that, globally, “a generation ago, a child was twice as likely to die before reaching age five, seventy percent more likely to be involved in child labour and twenty percent more likely to be murdered.” The reduced exposure to these adverse life events “translates (in part) to 4.4 million fewer child deaths every year; 94 million fewer children forced into child labour; and 115 million fewer children deprived of education.” 

The report highlighted India’s eradication of smallpox and polio through extensive and well orchestrated vaccination campaigns as a major boon to the health of the nation’s children. Progress in bringing down the number of cases of other infectious diseases such as malaria has also provided a considerable boost to child healthcare.

For India to further reduce instances of childhood mortality, it must seek to alleviate the considerable disparities between states. Wealthier states such as Goa have shown that mortality rates can be reduced to very low levels. However, in resource-stretched states where much of the population resides in difficult to access regions with limited access to healthcare, more must be done at the central level to accommodate for these difficulties. Failure to do so will continue to see India’s average child mortality rates remain stagnant, resulting in thousands of deaths every year.


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